JP2016059743A - Medical image system and program - Google Patents

Abstract

PROBLEM TO BE SOLVED: To allow an operator of an ultrasonic inspection to easily and accurately recognize the position corresponding to an attention region on a medical image obtained in an X-ray inspection in a subject portion when performing the X-ray inspection and the ultrasonic inspection on the same subject portion as different inspections.SOLUTION: In a medical image system 100, a control part 31 of a server device 3 estimates the position of an attention region when a breast is seen from the front side on the basis of an inclination angle of an X-ray machine at the time of imaging of a breast image, a position of the attention region in the breast image, and a deformation amount due to compression at the time of imaging of the breast corresponding to the position of the attention region when the attention region is designated from the breast image in an image display device 4, generates estimated clinical position information indicating the estimated position of the attention region, and displays the generated estimated clinical position information on a display part 43 of the image display device 4.SELECTED DRAWING: Figure 9

Description

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

  In recent years, mammography and ultrasonic examinations are mainly performed as breast cancer examinations. The two examinations can play a complementary role, and the diagnosis of lesions can be improved by diagnosing the two examinations in combination.

  In general, in the combined examination, first, a mammography examination is performed by a radiographer or the like, and a region of interest such as an abnormal shadow candidate is detected on a mammogram (hereinafter simply abbreviated as mammogram) obtained by X-ray imaging. Get overhead position information. Thereafter, an ultrasonic examination is focused on the position corresponding to the region of interest on the breast image in the breast by a clinical laboratory technician or the like.

  However, in general, mammography is an examination in the standing position and breast compression, and an ultrasound examination of the mammary gland is an examination in the supine position and no breast compression, and the breast obtained by the mammography examination at the time of the ultrasound examination. It is difficult to find a position corresponding to the attention area on the image.

  Therefore, for example, Patent Document 1 includes an X-ray acquisition unit and an ultrasonic probe, and the position of the ultrasonic probe and the breast corresponding to the region of interest selected in the radiographic image acquired by the X-ray acquisition unit. A medical imaging apparatus that determines a path with a position and guides an ultrasonic probe along the determined path is described.

  Further, in Patent Document 2, the position of the attention area in the breast is specified from the position of the attention area designated for each of the mammographic images captured by CC (vertical direction) and MLO (oblique direction). Have been described.

JP 2011-200655 A JP 2014-14489 A

  However, in the technique described in Patent Document 1, an ultrasound image is generated by placing an ultrasound probe on a breast in a subject state (fixed or compressed state) during X-ray imaging in mammography examination. For this reason, when a lesion is present closer to the X-ray image receiving surface (panel), it is impossible to apply ultrasonic waves from the panel side, and it is not possible to acquire an ultrasonic image with good image quality. In addition, since a series of examinations from mammography examination to ultrasonic examination are performed in a state where the breast at the time of X-ray imaging is compressed, the patient suffers greatly and is not practical.

  In the technique described in Patent Document 2, the position of the attention area in the breast is simply specified based on the position of the attention area designated on the mammography image. However, the breast is uniform due to the compression during imaging. Instead, it deforms complicatedly. Therefore, the technique described in Patent Document 2 may not be able to specify the position of the attention area with high accuracy.

  The subject of the present invention is that when performing X-ray examination and ultrasonic examination of the same subject part as separate examinations, the examiner of the ultrasonic examination pays attention to the medical image obtained in the X-ray examination at the subject part. This is to make it possible to easily and accurately recognize the position corresponding to the region.

In order to solve the above-described problem, a medical image system according to claim 1 is provided.
Display means for displaying one or more medical images obtained by X-ray imaging of a subject region;
Designation means for designating a region of interest from the medical image;
Deriving means for deriving a deformation amount due to compression at the time of photographing the subject portion corresponding to the position of the region of interest in the medical image;
Based on the angle at which the X-ray imaging apparatus is tilted at the time of imaging the medical image, the position of the region of interest in the medical image, and the amount of deformation due to compression during imaging of the subject region corresponding to the position of the region of interest Estimating means for estimating the position of the region of interest when the subject part is viewed from the front;
Generating means for generating estimated clinical position information indicating the position of the region of interest when the subject part estimated by the estimating means is viewed from the front;
Display control means for displaying the generated estimated clinical position information on the display means;
Is provided.

The invention according to claim 2 is the invention according to claim 1,
The estimating means arranges the medical image in an inclined manner based on an angle at which the X-ray imaging apparatus is inclined with respect to an image showing the front of the subject part, and images the subject part corresponding to the position of the region of interest. The position of the region of interest when the subject region is viewed from the front is estimated by projecting the region of interest in the medical image on an image showing the front of the subject region in consideration of the amount of deformation due to pressure at the time And
The generation unit generates the estimated clinical position information based on an image showing a front surface of the subject part onto which the region of interest is projected.

The invention according to claim 3 is the invention according to claim 1 or 2,
The subject region is a breast;
The medical image is a breast image obtained by X-raying the breast.

The invention according to claim 4 is the invention according to claim 3,
The breast image is an MLO image obtained by photographing the breast as the subject part from the oblique direction, and a CC image obtained by photographing the breast from the vertical direction,
The estimating means tilts and arranges the MLO image based on an angle at which the X-ray imaging apparatus is tilted at the time of capturing the MLO image with respect to an image showing the front of the subject region, and also at the X image at the time of capturing the CC image. The CC image is arranged based on the angle of the line imaging apparatus, and the attention area in the MLO image and the CC image are taken into account in consideration of the deformation amount due to compression at the time of photographing the subject portion corresponding to the position of the attention area. Each of the attention areas is projected onto an image showing the front of the subject part, and the area where the projected images overlap is estimated as the position of the attention area when the subject part is viewed from the front.

The invention according to claim 5 is the invention according to claim 3,
The breast image is an MLO image obtained by photographing the breast as the subject part from the oblique direction or a CC image obtained by photographing the breast from the vertical direction.
The estimation means tilts and arranges the breast image based on an angle at which the X-ray imaging apparatus is tilted when the breast image is captured with respect to an image showing the front of the subject region, and corresponds to the position of the attention area The attention area in the breast image is projected on an image showing the front of the subject part in consideration of the amount of deformation due to compression during photographing of the subject part, and the projected image and an image showing the front of the subject part A donut-shaped region having a predetermined width with a radius of a distance between a nipple on the breast image and a region of interest moved on the breast image in consideration of the amount of deformation centered on the upper nipple position, The overlapping area is estimated as the position of the attention area when the subject part is viewed from the front.

The invention according to claim 6 is the invention according to claim 3,
The breast image is an MLO image obtained by photographing the breast as the subject part from the oblique direction or a CC image obtained by photographing the breast from the vertical direction.
The estimation means tilts and arranges the breast image based on an angle at which the X-ray imaging apparatus is tilted when the breast image is captured with respect to an image showing the front of the subject region, and corresponds to the position of the attention area The attention area in the breast image is projected on an image showing the front of the subject part in consideration of the amount of deformation due to compression during photographing of the subject part, and the projected image and an image showing the front of the subject part A region where a circular region whose radius is a distance between a nipple on the breast image and a region of interest moved on the breast image in consideration of the amount of deformation centered on the upper nipple position is the subject part Is estimated as the position of the region of interest when viewed from the front.

The invention according to claim 7 is the invention according to any one of claims 2 to 6,
The generation unit generates, as the estimated clinical position information, an image showing a position of the attention area when the subject estimated by the estimation unit is viewed from the front on an image showing the front of the subject.

The invention according to claim 8 is the invention according to claim 7,
The generation unit generates, as the estimated clinical position information, an image with an annotation indicating the position of the region of interest when the subject estimated by the estimation unit is viewed from the front on an image showing the front of the subject. To do.

The invention according to claim 9 is the invention according to claim 8,
The annotation has a different area and shape depending on the position of the region of interest.

The invention according to claim 10 is the invention according to any one of claims 7 to 9,
The generating unit further projects an image including a process of estimating a position of the region of interest when the region of interest of the medical image is projected onto an image showing the front of the subject and the subject is viewed from the front. Generated as position information.

The invention according to claim 11 is the invention according to any one of claims 1 to 10,
The display control means displays the estimated clinical position information on the same screen as the medical image on which the region of interest is displayed.

The invention according to claim 12 is the invention according to any one of claims 1 to 11,
With operating means,
The designation means designates an area designated by the operation means from the medical image displayed on the display means as an attention area.

The invention according to claim 13 is the invention according to any one of claims 1 to 11,
Detecting means for detecting an abnormal shadow candidate from the medical image;
The designation means designates an abnormal shadow candidate area detected by the detection means as an attention area.

The program of the invention according to claim 14 is:
Computer
Display means for displaying one or more medical images obtained by X-ray imaging of a subject region;
Designation means for designating a region of interest from the medical image displayed by the display means;
Estimating means for estimating the position of the region of interest when the subject part is viewed from the front, based on the position of the region of interest in the medical image and the angle at which the X-ray imaging apparatus is tilted at the time of capturing the medical image;
Generating means for generating estimated clinical position information indicating the position of the region of interest when the subject part estimated by the estimating means is viewed from the front;
Display control means for displaying the generated estimated clinical position information on the display means;
To function as.

  According to the present invention, when performing X-ray inspection and ultrasonic inspection of the same subject region as separate inspections, the person performing the ultrasonic inspection pays attention to the medical image obtained in the X-ray inspection of the subject region. The position corresponding to the region can be easily recognized with high accuracy.

It is a figure which shows the example of whole structure of the medical image system in this embodiment. It is a block diagram which shows the functional structure of the server apparatus of FIG. It is a block diagram which shows the functional structure of the image display apparatus of FIG. (A) is an image in which left and right MLO images are arranged with the chest wall aligned, and (b) is a diagram showing an image in which the left and right CC images are aligned with the chest wall. It is a flowchart which shows the presumed clinical position information generation process performed by the control part of FIG. It is a figure which shows an example of the viewer screen displayed on the image display apparatus of FIG. It is a flowchart which shows the process performed in FIG.5 S6. (A) is a figure for demonstrating the coordinate of a breast image, (b) is a figure for demonstrating the detection of a nipple position. It is a figure for demonstrating the production | generation method of the clinical position information of an attention area. (A) is a front schema image of a right breast, (b) is a figure which shows a front schema image of a left breast. (A) is a figure which shows the example of data storage of CC deformation amount learning table, (b) is a figure for demonstrating the position coordinate (X, Y) of CC deformation amount learning table shown to (a). (A) is a figure which shows the example of data storage of an MLO deformation | transformation amount learning table, (b) is a figure for demonstrating the position coordinate (X, Y) of the MLO deformation | transformation amount learning table shown to (a). It is a figure for demonstrating the 1 direction estimation method. It is a figure which shows the example of clinical position information. It is a figure which shows the example of clinical position information. It is a figure which shows the example of clinical position information. It is a figure which shows the example of clinical position information. It is a figure which shows the example of the viewer screen on which the clinical position information of the attention area was displayed.

(Configuration of Medical Image System 100)
First, the configuration of the embodiment of the present invention will be described.
FIG. 1 shows a system configuration of a medical image system 100 in the present embodiment.
As shown in FIG. 1, the medical image system 100 includes an image generation device 1, an abnormal shadow candidate detection device 2, a server device 3, and an image display device 4. These devices 1 to 4 are connected to each other through a communication network N constructed in a medical facility such as a LAN (Local Area Network) so that data can be transmitted and received between them. The DICOM (Digital Imaging and Communication in Medicine) standard is applied to the communication network N. In the medical facility, an ultrasonic diagnostic apparatus 5 (not shown) is provided. The number of each device is not particularly limited.

  The medical image system 100 X-rays a subject region, stores and manages the obtained medical image, and estimates the clinical position of a region of interest such as an abnormal shadow candidate on the medical image to obtain estimated clinical position information. It is a system that generates and displays to support the examination in the ultrasonic diagnostic apparatus 5 performed in the supine position. The clinical position refers to position information when the subject part is viewed from the front of the human body. The medical image system 100 handles medical images of various object parts. In the present embodiment, the breast is mainly X-rayed, and ultrasound examination of the breast is supported based on the obtained breast image. A case will be described as an example.

Hereinafter, each component apparatus 1-4 is demonstrated.
The image generation apparatus 1 is an X-ray imaging apparatus that X-rays a subject region in a human body and generates digital data of the captured image (medical image). For example, a CR (Computed Radiography) apparatus, an FPD (Flat Panel Detector) Modality such as device can be applied. In the present embodiment, an FPD apparatus that performs X-ray imaging of the left and right breasts is applied as the image generation apparatus 1, and breast image data is generated as a medical image.

  The image generating apparatus 1 is an apparatus that complies with the DICOM standard described above, and can automatically input various information to be attached to each generated medical image, such as patient information and examination information, from the outside. You can also. The patient information includes information such as patient identification information (for example, patient ID) for identifying a patient (subject), patient name, sex, date of birth, and the like. The inspection information includes inspection identification information (for example, inspection ID), inspection date and time, inspection conditions (inspection site, laterality (left, right), direction (for example, vertical direction (CC), oblique direction) (MLO)), imaging angle, modality type, etc. In this embodiment, the examination ID is a series of images (two left and right MLO images, CC images) acquired by mammography examination of the same patient. ) Are managed with the same examination ID assigned.The image generation apparatus 1 includes the above-mentioned patient information, examination information, UID (Unique ID) for identifying the image, etc. as header information in the generated medical image. And is transmitted to the abnormal shadow candidate detection device 2 and the server device 3 via the communication network N. If not conforming to the DICOM standard, a DICOM conversion device (not shown) is used. It is also possible to cause the image generation apparatus 1 to input incidental information.

  An abnormal shadow candidate detection device (CAD) 2 as a detection means is a computer that performs image analysis of a medical image supplied from the image generation device 1 and performs detection processing of an abnormal shadow candidate suspected of a lesion. The abnormal shadow candidate detection device 2 includes a storage unit such as a CPU (Central Processing Unit), a RAM (Random Access Memory), and an HDD (Hard Disk Drive), and a communication unit such as a LAN card. The storage unit of the abnormal shadow candidate detection device 2 stores a detection algorithm detection algorithm corresponding to the type of abnormal shadow, and the CPU of the abnormal shadow candidate detection device 2 stores the detection program stored in the storage unit. An abnormal shadow candidate detection process is executed in cooperation with each other, and an abnormal shadow candidate is detected from each medical image input via the communication unit. For example, the abnormal shadow candidate detection apparatus 2 detects an abnormal shadow candidate of a tumor or a microcalcification cluster in a breast image.

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

  When the detection of the abnormal shadow candidate is completed, the CPU of the abnormal shadow candidate detection apparatus 2 generates abnormal shadow candidate information based on the detection result of the abnormal shadow candidate. The abnormal shadow candidate information includes, for example, position information of each detected abnormal shadow candidate area and information on the type of abnormal shadow candidate (for example, a tumor, a microcalcification cluster, etc.). Then, the abnormal shadow candidate detection device 2 adds the header information (at least UID) of the detection source medical image to the generated abnormal shadow candidate information, and transmits it to the server device 3 by the communication unit.

  The server device 3 constitutes a PACS (Picture Archiving and Communication System) together with the image display device 4 as a client. The server device 3 stores and manages the medical image generated by the image generation device 1 in a database (image DB 351) in association with supplementary information and abnormal shadow candidate information. Further, the server device 3 causes the image display device 4 to display a selection screen for selecting a medical image for the examination to be processed, a viewer screen for displaying the medical image for the selected examination, and the like. Various processes including an estimated clinical position information generation process to be described later are executed in accordance with the operation information transmitted from.

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

The control unit 31 includes a CPU (Central Processing Unit), a RAM (Random Access Memory).
) Etc. The CPU of the control unit 31 reads out various programs such as a system program and a processing program stored in the storage unit 35, expands them in the RAM, and executes various processes according to the expanded programs. The control unit 31 functions as a derivation unit, an estimation unit, a generation unit, and a display control unit by executing an estimated clinical position information generation process described later.

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

  The display unit 33 includes 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 display signals input from the control unit 31.

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

  The storage unit 35 includes, for example, an HDD (Hard Disk Drive), a semiconductor nonvolatile memory, or the like. The storage unit 35 stores various programs as described above. The storage unit 35 is provided with an image DB 351.

  The image DB 351 is a database for storing medical images. For example, the image DB 351 has an image management table that stores management information regarding each medical image stored in the image DB 351. In the image management table, management information for each medical image is stored as one record. The management information includes UID, patient information, examination information, and file information (file name of medical image, file name of corresponding abnormal shadow candidate information, file storage location, update date, file size, etc.).

  When the communication unit 34 receives a medical image from the image generation device 1, the control unit 31 stores the received medical image in the image DB 351 and also receives management information based on the received medical image header information. Created and stored in the image management table of the image DB 351. When the abnormal shadow candidate information is received from the abnormal shadow candidate detection device 2 by the communication unit 34, the received abnormal shadow candidate information is stored in the image DB 351 and included in the abnormal shadow candidate information from the image management table. A record with a matching UID is searched, and the file name, storage location, etc. of the abnormal shadow candidate information are written in the searched record. In this way, in the image DB 351, the medical image and the abnormal shadow candidate information of the abnormal shadow candidate detected from the medical image are stored in association with each other so as to be searchable.

  Further, the storage unit 35 includes a CC deformation amount learning table 352 (see FIG. 11A) and an MLO deformation amount learning table 353 (see FIG. 12A) used in estimated clinical position information generation processing described later. It is remembered. Details of these tables will be described later.

  The image display device 4 displays the selection screen, the viewer screen, and the like transmitted from the server device 3, transmits operation information input from these screens to the server device 3, and operates the operation information transmitted from the server device 3. The processing result corresponding to the is displayed on the viewer screen. The image display device 4 functions as display means and designation means.

FIG. 3 shows a functional configuration example of the image display device 4.
As shown in FIG. 3, the image display device 4 includes a control unit 41, an operation unit 42, a display unit 43, a communication unit 44, and a storage unit 45, and each unit is connected by a bus 46.

  The control unit 41 includes a CPU, a RAM, and the like. The CPU of the control unit 41 reads out various programs such as system programs and processing programs stored in the storage unit 45, expands them in the RAM, and executes various processes according to the expanded programs.

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

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

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

The storage unit 45 includes, for example, an HDD (Hard Disk Drive), a semiconductor nonvolatile memory, or the like. As described above, the storage unit 45 displays system programs and various programs (for example, various screens received from the server device 3) and transmits operation information input from the operation unit 42 to the server device 3 through the communication unit 44. Program) is stored.

(Operation of Medical Image System 100)
Next, the operation of the medical image system 100 will be described.
Here, in the breast cancer test, a combined test using both the mammography test and the ultrasonic test is performed. In the combined examination, generally, a radiologist first performs a mammography examination, and obtains overhead position information of a region of interest such as an abnormal shadow candidate on the obtained breast image. Thereafter, the clinical laboratory technician observes the breast image and conducts an ultrasonic examination focusing on the position of the breast corresponding to the region of interest on the breast image. When both examinations are completed, the doctor interprets the breast image and the ultrasound image of the abnormal shadow candidate and makes a final diagnosis.

  In mammography examinations, in general, the image generation apparatus 1 is used to capture one patient in the oblique (MLO) and vertical (CC) imaging directions for each of the left and right breasts in a standing and breast-compressed state. A total of four times of imaging are performed, and two breast images are generated on each of the left and right sides. On the other hand, in the ultrasonic examination, the examination is performed in a supine position and a breast non-compressed state. Therefore, a clinical technologist who is an inspector performing an ultrasonic examination intuitively converts the position of the region of interest on the breast image into the clinical position that is the position when the breast is viewed from the front of the human body. Inspection must be carried out.

  FIG. 4A shows an image in which left and right MLO images are arranged side by side with the chest wall aligned, and FIG. 4B shows an image in which the left and right CC images are arranged side by side aligned with the chest wall. In general, when observing a breast image, as shown in FIGS. 4A and 4B, observation is performed in a state where the image end is arranged in parallel with the end of the display unit (monitor).

  Since the CC image is an image taken by irradiating radiation from directly above the breast in the image generation apparatus 1 as shown in FIG. 4B, the left and right CC images are arranged with the chest wall aligned. When the image edge is placed parallel to the edge of the monitor and the MLO image and the position where the left and right breasts are displayed correspond to each other (the image of the right breast is left when viewed from the front, the image of the left breast is right ), The upper direction of the CC image is the outer direction of the breast, and the lower direction of the CC image is the inner direction of the breast. That is, from the CC image, the observer can infer whether the region of interest is inside or outside the breast. For example, it can be seen from the CC image shown in FIG. 4B that there is a region P to be noted outside the right breast.

  On the other hand, the MLO image is obtained by photographing the breast from an oblique direction with an optimum photographing angle for each photographing. Here, if the MLO image is an image of the breast taken from the side (when the CC image is taken and the radiation irradiation direction is orthogonal), the image end shown in FIG. 4A is the end of the monitor. The position of the attention area P in the vertical direction (head-foot direction) in the breast can be estimated from the MLO image arranged so as to be parallel to the attention area P, and the attention area P is observed by observing the MLO image and the CC image together. It is possible to roughly grasp the position where the exists. However, as described above, the MLO image is obtained by photographing the subject breast from an oblique direction. Therefore, in practice, it is difficult to estimate the vertical position of the breast by looking at the MLO image arranged as shown in FIG. The incidental information of the breast image includes the information of the imaging angle. However, even if the imaging angle is known, it takes time to estimate the position based on the imaging angle, and the examination efficiency is lowered. In addition, there is a high possibility that the guess is wrong.

  In mammography examination, the breast is photographed in a compressed state, and the breast is deformed by this compression. Therefore, when estimating the clinical position of the attention area P from the CC image or the MLO image, it is necessary to consider the deformation of the breast due to this compression. However, since the deformation of the breast due to the compression is not uniform and complicated, it is difficult for the person performing the ultrasonic examination to estimate the clinical position in consideration of the deformation of the breast.

  Even if the probe is placed in the wrong position and the ultrasonic examination is performed, the shadow corresponding to the attention area is not obtained, the patient is anxious, the examiner is impatient, the examination time is prolonged, and the incompleteness is incomplete. It brings various disadvantages such as a serious inspection.

  Therefore, in the present embodiment, the inspector performs a position corresponding to the attention area in the breast by estimating the clinical position of the attention area based on the breast image obtained by the mammography examination and displaying the estimated clinical position information. Make it easy to recognize.

  FIG. 5 shows a flowchart of the estimated clinical position information generation process executed by the server device 3. The estimated clinical position information generation process is performed when a breast image of an examination to be processed is selected from the image display device 4 and information (examination ID or the like) specifying the breast image of the selected examination is received by the communication unit 34. This is executed in cooperation with the control unit 31 and the program stored in the storage unit 35.

First, the control unit 31 searches and reads out the selected breast image (left and right MLO images, CC images) from the image DB 351, generates screen information of the viewer screen 431 on which the read breast image is displayed, and displays the screen information. Information is transmitted to the requesting image display device 4 by the communication unit 34, and the viewer screen 431 on which the selected breast image is displayed is displayed on the display unit 43 of the image display device 4 (step S1).
The control unit 31 of the server device 3 temporarily stores the examination ID and UID of the breast image being displayed on the image display device 4 in the memory until an end instruction is received from the image display device 4.

  FIG. 6 shows an example of the viewer screen 431 displayed on the image display device 4. On the viewer screen 431, an image display field 431a, an MLO button 431b for instructing to display only the MLO image, a CC button 431c for instructing to display only the CC image, an MLO image and a CC image are displayed. An MLO / CC button 431d for instructing to perform, a CAD button 431e for instructing display of abnormal shadow candidates, and the like are provided. A test practitioner (operator) such as a clinical laboratory technician presses the CAD button 431e or the like by the operation unit 42 and inputs a display instruction of an abnormal shadow candidate, whereby an abnormal shadow candidate is displayed on the displayed breast image. It can be displayed and confirmed.

  When operation information indicating a display instruction for an abnormal shadow candidate is received from the image display device 4 by the communication unit 34 (step S2; YES), the control unit 31 displays an abnormal shadow corresponding to the breast image displayed on the image display device 4. Candidate information is retrieved from the image DB 351 and read out, and screen information in which an annotation indicating the position of the abnormal shadow candidate is displayed on the breast image displayed on the viewer screen 431 is generated. Then, the screen information is transmitted to the request source image display device 4 by the communication unit 34, and the viewer screen 431 on which the annotation indicating the position of the abnormal shadow candidate is displayed on the breast image is displayed on the display unit 43 of the image display device 4. It is displayed (step S3).

  Next, the control unit 31 determines whether or not the position information of the region of interest has been received from the image display device 4 by the communication unit 34 (step S4). In the image display device 4, when a region of interest is designated by the operation unit 42 from the breast image displayed on the viewer screen 431, the server device 3 uses the position information of the designated region of interest as operation information by the communication unit 44. Send to. The attention area is an area that should be noticed by ultrasonic examination, such as the area of an abnormal shadow candidate. For example, if the inspection operator can confirm the same abnormal shadow candidate in the MLO image and the CC image, two areas are selected. For an abnormal shadow candidate that can be confirmed only in one of the images, the operation unit 42 designates that one region as a region of interest.

  When it is determined that the position information of the region of interest from the image display device 4 has been received by the communication unit 34 (step S4; YES), the control unit 31 displays the breast image displayed on the image display device 4 (among the left and right, The imaging angle included in each incidental information of the breast image in which the region of interest is designated) is acquired (step S5), and the imaging angle, the position information of the region of interest, and the compression at the time of imaging of the breast corresponding to the position of the region of interest The clinical position information corresponding to the region of interest on the breast image is estimated based on the deformation amount by (Step S6). The imaging angle is an angle (inclination in the X-ray irradiation direction) at which the image generation apparatus 1 is tilted at the time of breast image capturing. In the initial state, the image generating apparatus 1 includes an X-ray radiation source, a subject table on which a subject is arranged, and an FPD that detects X-rays transmitted through the subject in this order in the vertical direction. These are integrally tilted by an angle corresponding to the subject breast. At the time of CC image shooting, since the image generation apparatus 1 is shot without being tilted in the initial state, the shooting angle is 0 °.

  The clinical position corresponding to the region of interest in step S6 is estimated by executing the processing shown in FIG. FIG. 7 shows a flowchart of clinical position estimation in step S6.

First, the control unit 31 detects the skin line and the nipple from each of the breast images (MLO image and CC image) (step S601).
Here, as shown in FIG. 8 (a), the position of each pixel in each breast image is represented by coordinates (X, Y) where the vertical direction of the breast in the breast image is the X axis and the direction perpendicular thereto is the Y axis. ). Also, the pixel value of coordinates (X, Y) is represented as V (X, Y), the coordinates of the image end in the X-axis direction are represented as Xmax, and the image end in the Y-axis direction is represented as Ymax.

In step S601, the control unit 31 first performs a filtering process using a Sobel filter with each pixel as a target pixel in each breast image. Next, the control unit 31 performs a search in the Y direction for each X coordinate (0 to Xmax) of the breast image subjected to the Sobel filter, and determines the coordinate (S) that maximizes V (X, Y) for each X coordinate. Extract as an edge in coordinates. The extracted edge constitutes a skin line SL that is a boundary between the breast region and the non-breast region.
Next, as shown in FIG. 8B, the control unit 31 connects S (X) and S (X + d (d is, for example, 10)) for each point S (X) on the skin line SL. The distance D between the straight line and each point (S (X + 1), S (X + 2)... S (X + d-1)) between S (X) and S (X + d) is calculated, and the calculated distance D The position of S (X) having the largest value among the maximum values D (X) is detected as the nipple position.

  Next, as shown in FIG. 9, the control unit 31 stores the frontal schema image of the breast (see FIG. 9) on the RAM based on the angle difference θ [°] between the imaging angle at the time of MLO image capturing and the imaging angle at the time of CC image capturing. 9, 500), MLO image (600 in FIG. 9), and CC image (700 in FIG. 9) are arranged (step S602). Note that θ [°] corresponds to the shooting angle at the time of MLO image shooting.

  Here, FIG. 10A shows an example of a frontal schema image of the right breast, and FIG. 10B shows an example of a frontal schema image of the left breast. The frontal schema images of the left and right breasts schematically show the state of each breast viewed from the front, and are images for superimposing and displaying the clinical position of the region of interest. The circle in the front schema image represents the breast, and the center O of the circle represents the nipple position. Region A represents a region on the inside of the breast, region B represents a region on the inside of the breast, region C represents a region on the outside of the breast, and region D represents a region on the outside of the breast. A region C ′ adjacent to the region C represents the bottom of the heel. The frontal schema image of the breast has the same configuration as the body mark for indicating the position where the ultrasonic probe (ultrasonic probe) is placed in the ultrasonic image obtained by ultrasonic diagnosis, that is, the inspection position. This is a display that makes it easy for clinical technologists performing ultrasound examinations to grasp the position of the breast.

  As shown in FIG. 9, in step S602, a front schema image 500 is first placed on the RAM. Next, each of the perpendicular line 602 lowered from the nipple 601 of the MLO image 600 to the chest wall and the perpendicular line 702 lowered from the nipple 701 of the CC image 700 to the chest wall pass through the nipple 501 of the front schema image 500, and the angle of the perpendicular to each other The MLO image 600 and the CC image 700 are arranged so that the difference is the angle difference θ [°] between the shooting angle at the time of MLO image shooting and the shooting angle at the time of CC image shooting. That is, the MLO image 600 and the CC image 700 are arranged so as to be inclined with respect to the front schema image 500 by the shooting angle.

  Next, the control unit 31 normalizes the MLO image 600 and the CC image 700 in accordance with the front schema image 500 (step S603). Specifically, the CC image 700 maintains a state in which a perpendicular 702 lowered from the nipple 701 to the chest wall intersects the nipple 501 of the front schema image 500, and both ends 703 of the breast region match both ends of the circle of the front schema image 500. Are scaled up or down. The MLO image 600 maintains a state in which the perpendicular 602 lowered from the nipple 601 to the chest wall intersects the nipple 501 of the front schema image 500, while the perpendicular 603 lowered from the lower end of the breast region to the chest wall contacts the circle of the front schema image 500. Are scaled up or down. Note that both ends 703 of the breast region in the CC image 700 and the lower end of the breast region in the MLO image 600 can be specified based on the detected skin line.

  Next, the control unit 31 derives deformation amounts due to breast compression at the time of imaging at positions corresponding to the attention area 604 of the normalized MLO image 600 and the attention area 704 of the normalized CC image 700 ( Step S604).

  In step S604, with reference to the CC deformation amount learning table 352 shown in FIG. 11A, a deformation amount corresponding to the position of the attention area 704 of the normalized CC image 700 is derived. Also, the deformation amount corresponding to the position of the attention area 604 of the normalized MLO image 600 is derived with reference to the MLO deformation amount learning table 353 shown in FIG. For the position coordinates for which there is no data in the table, the deformation amount is calculated by interpolation processing using the data of the CC deformation amount learning table 352 and the MLO deformation amount learning table 353. As the interpolation processing, for example, bilinear, bicubic, or the like can be used.

Here, as shown in FIG. 11 (b), the CC deformation amount learning table 352 has a Y-axis on the breast wall of the breast region after the above-mentioned normalization of the CC image obtained in advance by clinical data, and from the nipple to the chest wall. A table in which the position coordinates (X, Y) of the region of interest when the X axis is set on the lowered perpendicular and the deformation amount in the Y axis direction due to breast compression at the position coordinates are stored as learning data in association with each other. is there. As shown in FIG. 12 (b), the MLO deformation amount learning table 353 has a Y-axis on the breast wall of the breast region after the above-mentioned normalization of the MLO image previously obtained from clinical data, and a drooping down from the nipple to the chest wall. This is a table in which the position coordinates (X, Y) of the region of interest when the X axis is set on the line and the deformation amount in the Y axis direction due to breast compression at the position coordinates are stored as learning data in association with each other. In FIGS. 11 and 12, as an example, a case where the distance to both ends of the breast region in the Y-axis direction (the lower end in the case of an MLO image) is normalized is shown as an example.
The learning data in the CC deformation amount learning table 352 and the MLO deformation amount learning table 353 are deformation amounts when breast compression is performed under a certain pressure according to the guideline. The learning data of the CC deformation amount learning table 352 and the MLO deformation amount learning table 353 may be changed as needed by feeding back the examination results of the doctor.

  It should be noted that a function (kernel or the like) derived from the learning data stored in the CC deformation amount learning table 352 or the MLO deformation amount learning table 353 is stored in the storage unit 35, and this function is used in step S604. The deformation amount due to breast compression in the attention area 604 and the attention area 704 may be derived.

  Next, the control unit 31 projects the attention area 604 of the MLO image 600 and the attention area 704 of the CC image 700 on the front schema image 500 in consideration of the derived deformation amount, and pays attention to the position of the overlapped projection area. Estimated as the clinical position of the region (step S605). Specifically, first, the attention area 604 of the MLO image 600 is moved in the Y-axis direction (chest wall direction) by the deformation amount calculated in step S604. Further, the attention area 704 of the CC image 700 is moved in the Y-axis direction (chest wall direction) by the deformation amount calculated in step S604. Next, straight lines 605a and 605b perpendicular to the chest wall are drawn from the head end 604a and tail end 604b of the attention area 604 after the movement of the MLO image 600, and the front schema image 500 is surrounded by the straight lines 605a and 605b. A band-like area is projected. Similarly, straight lines 705a and 705b perpendicular to the chest wall are drawn from the outer end 704a and the inner end 704b of the attention area 704 after the CC image 700 is moved, and are surrounded by the straight lines 705a and 705b on the front schema image 500. A band-like area is projected. Then, the region 502 where the two projection regions overlap is estimated as the clinical position of the region of interest.

  When the attention area is specified only from either the MLO image or the CC image, the processing in steps S601 to S604 and the projection in step S605 are performed on the image in which the attention area is specified, and the above-described band-shaped area Is estimated as the clinical position of the region of interest. Alternatively, the clinical position of the region of interest may be estimated by the following one-direction estimation method.

FIG. 13A schematically shows a first method of the one-direction estimation method based on the CC image. FIG.
FIG. 2 (b) schematically shows a second method of the one-direction estimation method based on the CC image. In the following description, a CC image will be described as an example, but an MLO image can be estimated using a similar method.

In the first method, a distance Rc between the centers of the nipple 701 and the attention area 704 (after movement of the deformation amount) of the CC image 700 is obtained, and a circle 706 having a radius Rc centered on the nipple 501 is displayed on the front schema image. An area (a region indicated by a dot in FIG. 13A) that overlaps a donut-shaped area drawn within a predetermined width from a circle 706 and a band-shaped area obtained by projecting the attention area 704 of the CC image 700 onto the front schema image 500. ) As the clinical position of the region of interest. Note that the width of the donut-shaped region is, for example, a width corresponding to the size of the region of interest 704.
In the first method, since the distance from the nipple is almost the same even when the lesion in the breast region is moved by compression, the estimated position is narrowed down based on the distance between the nipple and the region of interest. It is.

In the second method, the distance Ro between the nipple 701 of the CC image 700 and the attention area 704 (after movement of the deformation amount) (for example, the distance between the end of the attention area 704 farthest from the nipple 701). Ro), and a circle 707 having a radius Ro centered on the nipple 501 is drawn on the front schema image 500, and a region of this circle 707 and a band-like region in which the region of interest 704 of the CC image 700 is projected onto the front schema image 500 (The region indicated by the dark dots in FIG. 13B) is estimated as the clinical position of the region of interest.
The second method is that the lesion in the breast region does not change the distance from the nipple even if it is moved by compression, and the mammary gland is hardly stretched, so the lesion hardly moves away from the nipple. Based on the absence, the estimated position is narrowed down.

  When the estimation of the clinical position corresponding to the region of interest is completed, the control unit 31 proceeds to step S7 in FIG. 5 and generates estimated clinical position information indicating the estimated clinical position (step S7).

14 (a) to 14 (c), 15 (a), 15 (b), 16 (a), and 16 (b) show examples of estimated clinical position information.
For example, as shown in FIG. 14 (a), the estimated clinical position (parallelogram region) in the frontal schema image is surrounded, the color or the like is superimposed on the estimated clinical position, or the estimated clinical position is set. The estimated clinical position information may be obtained by adding an annotation such as a circle mark or the like to the front schema image (drawn in an overlapping manner). Further, as shown in FIG. 14B, an elliptical annotation including the estimated clinical position region and having the same inclination as the long diagonal of the parallelogram indicating the clinical position and the main axis (major axis). The estimated clinical position information may be generated by overlapping and drawing on the front schema image. Further, as shown in FIG. 14C, the area occupied by the clinical position area is calculated (counting the number of pixels) in each of the areas A to D on the front schema image, and the area with the largest calculated area is calculated. Information (or information indicating the rank order of the calculated area) may be generated as estimated clinical position information.

  Further, for example, as shown in FIG. 15 (a), the estimated clinical position is included in the center, and the fan-shaped region annotation with the nipple as the apex of the central angle is overlaid on the front schema image and estimated. Clinical location information may be generated. In addition, since lesions in the breast region have different easiness of movement depending on the location, the angle of the central angle may be changed according to the location where the estimated clinical position is present (the angle is increased as the location becomes easier to move). . Further, as shown in FIG. 15B, a probability distribution in which a region of interest exists is obtained based on the estimated clinical position, and an annotation indicating this probability distribution is overlaid on the front schema image to estimate the estimated clinical position. It may be information. Here, in FIG. 15B, the higher the probability that the region of interest exists, the higher the density.

  Further, for example, as shown in FIGS. 16A and 16B, estimated clinical position information in which the area and shape of the annotation are changed depending on the position of the estimated clinical position may be generated. For example, since the lesion is difficult to move in the breast region corresponding to the oblique circumference of the front schema image, the center portion of the estimated clinical position of the front schema image is relatively small as shown in FIG. As shown in FIG. 16 (b), the estimated clinical position of the frontal schema image is obtained by drawing a circular annotation on the area to obtain estimated clinical position information, and the lesion is likely to move vertically in the vicinity of the lower part of the nipple. A relatively large elliptical annotation with the vertical axis as the long axis centered on and drawn on the front schema image may be used as estimated clinical position information.

  In addition to showing the estimated clinical position on the front schema image, as shown in FIG. 17, the attention area of the standardized CC image and MLO image is also projected onto the front schema image to determine the clinical position. An image including the estimation process may be used as estimated clinical position information. According to this estimated clinical position information, it is possible to indicate to the inspector of the ultrasonic examination how to estimate the clinical position from the attention area of the CC image or the MLO image. It is also effective for use. In this case, the clinical position may be indicated by any of the modes shown in FIGS.

  If the region of interest is specified only from either the MLO image or the CC image, an annotation that surrounds the estimated clinical position in the frontal schema image or overlays the estimated clinical position with a color or the like is estimated. Generate as clinical location information. Alternatively, not only the estimated clinical position in the front schema image but also an image including the process of estimating the clinical position by projecting the attention area of the standardized CC image and MLO image onto the front schema image as the estimated clinical position information. Also good.

  When the generation of the estimated clinical position information is completed, the control unit 31 generates screen information of the viewer screen 431 on which the generated estimated clinical position information is displayed, and transmits the screen information to the image display device 4 through the communication unit 34. The estimated clinical position information is displayed on the viewer screen 431 of 43 (step S8).

  FIGS. 18A and 18B show an example of the viewer screen 431 on which the estimated clinical position information is displayed. FIG. 18A illustrates an example of estimated clinical position information generated based on a region of interest (indicated by a solid line) designated by two breast images of an MLO image and a CC image in an area 431f on the viewer screen 431. Show. FIG. 18B shows an example of estimated clinical position information generated based on a region of interest (shown by a solid line) designated only by the MLO image.

  By displaying the estimated clinical position information indicating the clinical position of the region of interest shown in FIGS. 18A and 18B, the tester can easily recognize where the designated region of interest is located on the breast. This makes it possible to prevent ultrasonic inspection of the wrong position of the breast and improve inspection efficiency. In addition, by displaying the annotation of the specified region of interest on the breast image and the estimated clinical position information side by side on the same screen, the examiner can respond to this while confirming the region of interest on the breast image. It is possible to perform an examination on a clinical position.

  In ultrasound examination, body marks that indicate the right and left breasts and the examination position are recorded on the ultrasound image. If this record is mistaken due to busyness or lack of concentration, this record should be referred to. In addition, there are cases in which a doctor who makes a diagnosis while observing an ultrasound image is confused. However, since the estimated clinical position information displayed in step S8 is displayed on the front schema image in the same manner as the body mark, when the ultrasonic examination is performed at the position corresponding to the estimated clinical position information, the examination is performed. A person only has to transfer the estimated clinical position information as a body mark of an ultrasonic image, and can prevent a record associated with the ultrasonic image from being erroneously recorded.

  After performing an ultrasonic diagnosis based on the estimated clinical position information, when there is another region of interest to be examined next, the examination practitioner changes another breast image displayed on the viewer screen 431 by the operation unit 42. A region of interest can be specified. When another attention area is designated, the control unit 41 of the image display device 4 transmits the position information of the designated attention area to the server device 3 through the communication unit 44. If there is no other region of interest to be inspected next, the inspector performs a transition to another screen or an operation for closing the screen using the operation unit 42. In this case, the control unit 41 transmits an instruction to end the estimated clinical position generation process to the server device 3 through the communication unit 44.

  After displaying the estimated clinical position information, the control unit 31 of the server device 3 determines whether or not the position information of the next attention area has been received from the image display device 4 by the communication unit 34 (step S9). When it is determined that the position information of the next attention area has been received from the image display device 4 by the communication unit 34 (step S9; YES), the control unit 31 returns to the process of step S5 and performs the processes of steps S5 to S9. Run repeatedly. When it is determined that the end instruction has been received without receiving the position information of the next attention area from the image display device 4 by the communication unit 34 (step S9; NO, step S10; YES), the control unit 31 performs the estimation clinical The position information generation process ends.

As described above, according to the medical image system 100, when the attention area is designated from the breast image in the image display device 4, the control unit 31 of the server device 3 activates the X-ray imaging apparatus when capturing the breast image. Based on the tilted angle, the position of the region of interest in the breast image, and the amount of deformation caused by the compression of the breast corresponding to the position of the region of interest, the position of the region of interest when the breast is viewed from the front is determined. Estimation is performed, and estimated clinical position information indicating the position of the estimated region of interest is generated. Then, the control unit 31 causes the display unit 43 of the image display device 4 to display the generated estimated clinical position information.
Specifically, the control unit 31 tilts and arranges the MLO image based on the angle at which the image generation device 1 is inclined at the time of MLO image shooting with respect to the front schema image, and sets the angle of the image generation device 1 at the time of CC image shooting. Based on the arrangement of the CC image, and projecting each of the attention area in the MLO image and the attention area in the CC image on the front schema image in consideration of the deformation amount due to compression at the time of imaging of the breast corresponding to the position of the attention area, The area where the projected images overlap is estimated as the position of the attention area when the subject part is viewed from the front.

  Therefore, when performing mammography inspection and ultrasonic inspection as separate inspections, it becomes possible for the person performing the ultrasonic inspection to easily and accurately recognize the position corresponding to the region of interest on the breast image in the breast.

  In addition, the control unit 41 generates, as estimated clinical position information, an image with an annotation indicating the position of the region of interest when the breast is viewed from the front on the front schema image indicating the front of the breast, and displays it on the display unit 33. Therefore, it is possible to display the position of the region of interest when the breast is viewed from the front so that it can be easily seen at a glance by the person performing the ultrasonic examination.

  The annotation indicating the position of the attention area when the breast is viewed from the front can be displayed in consideration of the range of movement of the lesion in the breast by making the area and shape different depending on the position of the attention area. .

  In addition, a front schema image with an annotation indicating the position of the attention area and an image including a process for estimating the position of the attention area when the attention area of the breast image is projected onto the front schema image and the breast is viewed from the front. Is generated and displayed as clinical position information, so that it is possible to indicate to the practitioner of the ultrasonic examination how to estimate the position of the attention area in the breast from the attention area of the breast image. It is also effective for educational purposes for testers.

  In addition, by displaying the estimated clinical position information on the same screen as the breast image on which the designated attention area is displayed, the examiner of the ultrasonic examination confirms the attention area on the breast X-ray image. Ultrasonic inspection can be performed while doing so.

  In addition, the description content in the said embodiment is a suitable example of this invention, and is not limited to this.

  For example, in the above embodiment, the server apparatus 3 and the image display apparatus 4 are configured as separate apparatuses in the client server system. However, the functions of the two apparatuses may be realized by a single apparatus. That is, programs for causing the computer to function as display means, designation means, estimation means, generation means, and display control means are stored in the storage unit of the apparatus, and these programs are cooperated with a control unit such as a CPU and the program. It is good also as realizing a function. Further, the function of the abnormal shadow candidate detection device 2 may be incorporated in the same device.

  In the above embodiment, the position of the abnormal shadow candidate detected from the abnormal shadow candidate detection apparatus 2 is displayed on the viewer screen 431 for the purpose of assisting the examiner to specify the attention area. It is also possible to display the position of the abnormal shadow candidate manually input by the input means such as an engineer. For example, from the breast image displayed on the viewer screen 431 by the image display device 4 in the radiology department, the abnormal shadow candidate information of the abnormal shadow candidate input (designated) by the radiology engineer using the operation unit 42 is detected in the image DB 351 as the source breast image. The abnormal shadow candidate information is displayed on the breast image according to the operation by the operation unit 42 (for example, displayed according to the operation of the CAD button 431e of the examiner of the ultrasonic examination). ) It's good. In this way, the examination operator of the ultrasonic examination can easily grasp and inspect the area determined that the abnormal shadow candidate exists as a result of observation by the radiation technician or the like.

  In the above embodiment, the case where the region designated by the operation unit 32 on the breast image displayed on the viewer screen 431 on the image display device 4 is designated as the attention region has been described as an example. The region of the abnormal shadow candidate detected from the breast image by the device 2 may be designated as the attention region.

  In the above-described embodiment, the case where the subject part is the breast has been described as an example. However, the present invention may be applied when assisting ultrasonic diagnosis of another part.

  Moreover, in the said embodiment, although demonstrated as displaying clinical position information for ultrasonic diagnoses, it is good also as using as a training tool with respect to the tester who performs an ultrasonic diagnosis.

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

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

DESCRIPTION OF SYMBOLS 100 Medical image system 1 Image generation apparatus 2 Abnormal shadow candidate detection apparatus 3 Server apparatus 31 Control part 32 Operation part 33 Display part 34 Communication part 35 Storage part 351 Image DB
352 CC deformation amount learning table 353 MLO deformation amount learning table 36 Bus 4 Image display device 41 Control unit 42 Operation unit 43 Display unit 44 Communication unit 45 Storage unit 46 Bus

Claims (14)

Display means for displaying one or more medical images obtained by X-ray imaging of a subject region;
Designation means for designating a region of interest from the medical image;
Deriving means for deriving a deformation amount due to compression at the time of photographing the subject portion corresponding to the position of the region of interest in the medical image;
Based on the angle at which the X-ray imaging apparatus is tilted at the time of imaging the medical image, the position of the region of interest in the medical image, and the amount of deformation due to compression during imaging of the subject region corresponding to the position of the region of interest Estimating means for estimating the position of the region of interest when the subject part is viewed from the front;
Generating means for generating estimated clinical position information indicating the position of the region of interest when the subject part estimated by the estimating means is viewed from the front;
Display control means for displaying the generated estimated clinical position information on the display means;
A medical image system comprising: The estimating means arranges the medical image in an inclined manner based on an angle at which the X-ray imaging apparatus is inclined with respect to an image showing the front of the subject part, and images the subject part corresponding to the position of the region of interest. The position of the region of interest when the subject region is viewed from the front is estimated by projecting the region of interest in the medical image on an image showing the front of the subject region in consideration of the amount of deformation due to pressure at the time And
The medical image system according to claim 1, wherein the generation unit generates the estimated clinical position information based on an image showing a front surface of the subject part onto which the region of interest is projected. The subject region is a breast;
The medical image system according to claim 1, wherein the medical image is a breast image obtained by X-raying the breast. The breast image is an MLO image obtained by photographing the breast as the subject part from the oblique direction, and a CC image obtained by photographing the breast from the vertical direction,
The estimating means tilts and arranges the MLO image based on an angle at which the X-ray imaging apparatus is tilted at the time of capturing the MLO image with respect to an image showing the front of the subject region, and also at the X image at the time of capturing the CC image. The CC image is arranged based on the angle of the line imaging apparatus, and the attention area in the MLO image and the CC image are taken into account in consideration of the deformation amount due to compression at the time of photographing the subject portion corresponding to the position of the attention area. 4. The region of interest is projected onto an image showing the front of the subject region, and the region where the projected images overlap is estimated as the position of the region of interest when the subject portion is viewed from the front. Medical imaging system. The breast image is an MLO image obtained by photographing the breast as the subject part from the oblique direction or a CC image obtained by photographing the breast from the vertical direction.
The estimation means tilts and arranges the breast image based on an angle at which the X-ray imaging apparatus is tilted when the breast image is captured with respect to an image showing the front of the subject region, and corresponds to the position of the attention area The attention area in the breast image is projected on an image showing the front of the subject part in consideration of the amount of deformation due to compression during photographing of the subject part, and the projected image and an image showing the front of the subject part A donut-shaped region having a predetermined width with a radius of a distance between a nipple on the breast image and a region of interest moved on the breast image in consideration of the amount of deformation centered on the upper nipple position, The medical image system according to claim 3, wherein the overlapping area is estimated as a position of the attention area when the subject part is viewed from the front. The breast image is an MLO image obtained by photographing the breast as the subject part from the oblique direction or a CC image obtained by photographing the breast from the vertical direction.
The estimation means tilts and arranges the breast image based on an angle at which the X-ray imaging apparatus is tilted when the breast image is captured with respect to an image showing the front of the subject region, and corresponds to the position of the attention area The attention area in the breast image is projected on an image showing the front of the subject part in consideration of the amount of deformation due to compression during photographing of the subject part, and the projected image and an image showing the front of the subject part A region where a circular region whose radius is a distance between a nipple on the breast image and a region of interest moved on the breast image in consideration of the amount of deformation centered on the upper nipple position is the subject part The medical image system according to claim 3, wherein the position is estimated as a position of the attention area when viewed from the front.   The generation unit generates an image showing the position of the region of interest when the subject estimated by the estimation unit is viewed from the front on the image showing the front of the subject as the estimated clinical position information. The medical image system according to any one of 2 to 6.   The generation unit generates, as the estimated clinical position information, an image with an annotation indicating the position of the region of interest when the subject estimated by the estimation unit is viewed from the front on an image showing the front of the subject. The medical image system according to claim 7.   The medical image system according to claim 8, wherein the annotation has a different area and shape depending on a position of the region of interest.   The generating unit further projects an image including a process of estimating a position of the region of interest when the region of interest of the medical image is projected onto an image showing the front of the subject and the subject is viewed from the front. The medical image system according to any one of claims 7 to 9, which is generated as position information.   The medical image system according to any one of claims 1 to 10, wherein the display control unit displays the estimated clinical position information on the same screen as the medical image on which the region of interest is displayed. With operating means,
The medical image system according to any one of claims 1 to 11, wherein the specifying unit specifies an area specified by the operation unit as a region of interest from a medical image displayed on the display unit. Detecting means for detecting an abnormal shadow candidate from the medical image;
The medical image system according to any one of claims 1 to 11, wherein the designation unit designates an abnormal shadow candidate region detected by the detection unit as a region of interest. Computer
Display means for displaying one or more medical images obtained by X-ray imaging of a subject region;
Designation means for designating a region of interest from the medical image displayed by the display means;
Estimating means for estimating the position of the region of interest when the subject part is viewed from the front, based on the position of the region of interest in the medical image and the angle at which the X-ray imaging apparatus is tilted at the time of capturing the medical image;
Generating means for generating estimated clinical position information indicating the position of the region of interest when the subject part estimated by the estimating means is viewed from the front;
Display control means for displaying the generated estimated clinical position information on the display means;
Program to function as.