JP2016198277A - Control device for tomosynthesis imaging, radiographic system, control system, control method, and program - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a control device which facilitates follow-ups performed using oblique images acquired by tomosynthesis imaging.SOLUTION: When an oblique cross-section is displayed, the control device prompts for an oblique cross-section of a past examination and reconstructs and displays a new oblique cross-section at the oblique angle of the oblique cross-section of the past examination. The control device also indicates a region where the oblique angle of the oblique cross-section is changeable and a region where the display position is changeable, guide-displays the oblique cross-section of the past examination, and when an operator instructs a changeable region, displays an oblique cross-section in response to the input instruction. The control device further indicates that the newly created oblique cross-section is correctable such that it fits the effective region of the oblique cross-section of the past examination, and when the operator instructs a correction, corrects and displays the oblique cross-section according to the oblique cross-section of the past examination.SELECTED DRAWING: Figure 1

Description

  The disclosure of the present specification relates to a tomosynthesis imaging control device, an X-ray imaging system, a control system, a control method, and a program.

  In tomosynthesis imaging, multiple frames with different imaging angles are obtained by irradiating the subject with X-rays at different angles while moving the X-ray generator and detecting the X-rays transmitted through the subject with the X-ray detector. The projected images are taken continuously. Then, by applying a three-dimensional reconstruction process such as FBP (filtered back projection) method to the captured images of a plurality of frames, a predetermined coronal section of the subject (detection surface of the X-ray detector) And a tomographic image at an oblique section (oblique section) intersecting the detection surface of the X-ray detector (Patent Document 1).

JP 2000-46760 A

The tomographic image obtained by tomosynthesis needs to designate a half-plane cross section that can be observed with a plurality of cross sections. In particular, when performing the follow-up observation, an operation for aligning the cross section of the observation target between the two tomographic images is performed. However, the manual operation is laborious.

Therefore, a control device according to an embodiment of the present invention is a control device for tomosynthesis imaging using a radiation detector, an acquisition unit that acquires a plurality of projection images obtained by first tomosynthesis imaging, and the projection image Determination means for specifying an oblique image, which is a tomographic image of the subject obtained based on the determination, and whether or not the second tomosynthesis imaging is an imaging for follow-up from the first tomosynthesis imaging And the specified oblique image and the projection obtained by the second tomosynthesis imaging according to at least one of the means and the determination that the imaging is for the follow-up observation or the execution of the second tomosynthesis imaging Display control for displaying a tomographic image based on an image and a cross-sectional tomographic image corresponding to the oblique image side by side on the display unit And having a stage, a.

  This facilitates follow-up observation with oblique images.

It is a figure which shows the structure of the tomosynthesis imaging | photography system which concerns on embodiment of this invention. It is a figure which shows the imaging | photography system of tomosynthesis imaging | photography concerning embodiment. It is a figure which shows the information regarding the position and distance relevant to tomosynthesis imaging | photography. It is a figure which shows the structure of the control part which concerns on embodiment. It is a figure which shows the hardware constitutions of the imaging | photography control apparatus which concerns on embodiment. It is a flowchart which shows the flow of a process from the test | inspection start which concerns on embodiment to completion | finish. It is a flowchart which shows the flow of the process for the follow-up display which concerns on embodiment. It is the figure which showed the patient information input screen which concerns on embodiment. It is the figure which showed the imaging technique selection screen which concerns on embodiment. It is the figure which showed the imaging | photography screen which concerns on embodiment. It is the figure which showed the coronal section display screen in the reconstruction screen which concerns on embodiment. It is the figure which showed the oblique section display screen in the reconstruction screen which concerns on embodiment. It is the figure which showed the oblique section display screen in the reconstruction screen which concerns on embodiment. It is the figure which showed the past test | inspection information selection screen which concerns on embodiment. It is the figure which showed the past test | inspection information selection screen which concerns on embodiment. It is the figure which showed the past test | inspection information selection screen which concerns on embodiment of this invention. It is the figure which showed the past inspection oblique image comparison display screen which concerns on embodiment of this invention. It is the figure which showed the result of having performed the effective area | region correction | amendment of the oblique cross section on the past test | inspection oblique image comparison display screen which displayed the past test | inspection image and the present test | inspection image from which the oblique angle concerning this embodiment differs. It is the figure which showed the 3D slider for oblique cross-section editing in the past inspection oblique image comparison display screen which concerns on embodiment of this invention. It is the figure which showed the 3D slider for oblique cross-section editing in the past inspection oblique image comparison display screen which concerns on embodiment of this invention. It is the flowchart which showed the flow of the process from the test | inspection start to completion | finish which concerns on other embodiment.

  An X-ray imaging system capable of tomosynthesis imaging according to an embodiment of the present invention will be described below with reference to the drawings as appropriate. Tomosynthesis imaging is an imaging method for obtaining a plurality of projection images for obtaining a tomographic image of a subject by radiographing the subject from a plurality of different directions.

  The configuration and operation of an X-ray imaging system, which is an example of a radiation imaging system according to an embodiment of the present invention, will be described based on FIG. The X-ray imaging system may be referred to as an X-ray imaging apparatus.

  The X-ray imaging system 101 includes an X-ray generation device 102, an X-ray detector 106, and an imaging control device 107, and is an imaging system that can perform tomosynthesis imaging. The imaging control device 107 is a control device that controls tomosynthesis imaging, and includes a communication circuit 112 that communicates with the radiation detector 106, an image processing unit 110 that includes a GPU (GRAPHIC PROCESSING UNIT), and a control that includes at least one central processing unit. Part 111. The control unit 111 is a control circuit (control unit) that performs control of the X-ray detector 106, control of image processing by the GPU, and control of display contents displayed on the display unit 109. The communication circuit 112 functions as an acquisition unit that acquires a plurality of projection images of a subject obtained by tomosynthesis imaging from the radiation detector 106.

  The X-ray generator 102 has a target that generates X-rays when electrons collide, and a diaphragm that shapes the generated X-ray bundle, and is formed into a cone beam or a quadrangular pyramid shape with respect to the subject. Irradiate. The X-ray generator 102 is fixed to the imaging table 105 and emits X-rays while moving by a moving mechanism controlled by the moving mechanism control unit 1051. The movement mechanism control unit 1051 transmits to the X-ray control unit 104 position information such as imaging conditions such as tube voltage and tube current, an imaging angle, and an X-ray source moving distance with X-ray irradiation. The X-ray control unit 104 is connected to the X-ray generation device 102, the X-ray irradiation switch 103, and the imaging control device 107, and controls the start and end of X-ray irradiation and transmits imaging conditions and position information.

  The X-ray generator 102 may receive default imaging conditions and default position information from the X-ray control unit 104 and perform imaging preparation processing. The X-ray irradiation switch 103 may be connected to the X-ray generation apparatus 102 and transmits an irradiation start notification and an irradiation end notification to the X-ray control unit 104. When the operator presses the switch, the X-ray irradiation switch 103 transmits an irradiation start notification. Further, when the operator releases the switch, the X-ray irradiation switch 103 transmits an irradiation end notification. The X-ray control unit 104 may receive default imaging conditions and default position information from the imaging control apparatus 107 and notify the X-ray generation apparatus 102 of them.

  The X-ray detector 106 is an imaging unit that detects X-rays that have passed through the subject and converts them into X-ray image data, and includes a scintillator that converts X-rays into visible light, and a plurality of devices that convert visible light into electrical signals. And a sensor array in which two pixels are arranged two-dimensionally. The X-ray detector 106 is connected to the imaging control device 107 via a wired cable or wirelessly, and changes the power supply state to the sensor array, for example, according to control from the imaging control unit 107. The X-ray detector 106 transmits X-ray image data to the imaging control device 107. For example, the communication circuit 112 transmits an X-ray irradiation preparation request and an X-ray irradiation preparation cancellation request to the X-ray control unit 104 and the X-ray detector 106 via the communication I / F. The communication circuit 112 receives X-ray image data, imaging information, and position information from the X-ray control unit 104 and the X-ray detector 106.

  Here, the X-ray detector 106 may transmit the X-ray image data obtained by the conversion to the imaging control device 107 as imaging execution information such as a reading area and a binning size. Further, positional information such as the X-ray detector moving distance may be transmitted to the imaging control apparatus 107 together with the X-ray image data. Furthermore, the X-ray detector 106 may perform imaging preparation processing in response to receiving default position information from the imaging control apparatus 107.

The operation unit 108 sets image processing conditions such as user-desired shooting conditions and reconstruction conditions, confirms the projection image and the reconstructed image, or accepts an operation input for transmitting the image to an external device. . The operation unit 108 includes a keyboard, a mouse, a touch panel formed integrally with the display unit 109, or a combination thereof.
The display unit 109 may display a user interface of X-ray imaging control software. The display unit 109 may be a single monitor or a monitor incorporated in an X-ray imaging apparatus. A plurality of monitors that display captured images may be connected to one imaging control device 107, and the captured images and past images may be previewed on different monitors. In that case, the display unit 109 determines which image is to be displayed on which monitor based on the notification from the imaging control device 107 and displays the image on the determined monitor.

  In addition, the X-ray imaging system 101 may be connected to the HIS / RIS 114, the PACS 115, the VIEWER 116, and the printer 117 via the network 113 from the imaging control apparatus 107. The HIS / RIS 113 is an in-hospital / radiology information management system that manages information such as subject information and examination request information in the radiology department. The PACS 115 is a server whose main purpose is image storage, and includes a memory that stores images and a controller that manages the data. The VIEWER 116 is connected to the PACS 115, and performs image inspection work, detailed post-processing, and diagnosis work of an image photographed by the X-ray imaging system 101 mainly by a high-definition monitor. The printer 111 prints out X-ray image data and tomosynthesis image data. In this case, the communication circuit 112 of the imaging control apparatus 107 receives inspection request information, transmits inspection execution information, and outputs X-ray image data and tomosynthesis image data via the network 113.

The control unit 111 according to the embodiment is a control device for tomosynthesis imaging using the X-ray detector (imaging unit) 106, and is an imaging device that performs both tomosynthesis imaging control and output control of the obtained oblique image. is there.
The control unit 111 includes an imaging control unit 123 that generates a signal for controlling the sensor array with respect to the X-ray detector (imaging unit) 106 based on imaging conditions of tomosynthesis imaging. Under the control of the imaging control unit 123, the X-ray detector 106 captures a plurality of projection images by the first tomosynthesis imaging. The communication circuit 112 acquires a plurality of projection images obtained by the first tomosynthesis imaging by receiving from the X-ray detector 106. The designation unit 122 designates an oblique image that is a tomographic image of the subject obtained based on the projection image. The tomographic image or oblique image is reconstructed based on the projection image by the image processing unit 110, for example. The determination unit 125 determines whether or not the second tomosynthesis imaging different from the first tomosynthesis imaging is an imaging for follow-up observation from the first tomosynthesis imaging. Shooting for follow-up observation refers to shooting for continuously observing changes in the state of, for example, surgery, medication, or injury, and usually a plurality of shootings are performed. Here, it is assumed that a lot of tomosynthesis imaging is performed in the X-ray imaging system 101, and a certain tomosynthesis imaging (second tomosynthesis imaging) is performed for the same purpose as the previous tomosynthesis imaging (first tomosynthesis imaging). It is determined whether or not the shooting is for follow-up observation. Such a determination is performed before or after execution of the second tomosynthesis imaging. The display control unit 124 is a tomographic image based on the designated oblique image and the projection image obtained by the second tomosynthesis photographing according to the determination that the photographing is for follow-up observation, and corresponds to the oblique image. The tomographic images of the cross section to be displayed are displayed side by side on the display unit. Such display control may be performed according to the execution of the second tomosynthesis imaging, or both the determination that the imaging is for follow-up observation and the execution of the second tomosynthesis imaging are performed. The display control may be performed accordingly.

  By doing in this way, since it is possible to perform a display suitable for follow-up observation, it becomes easy to confirm whether or not photography by an engineer is appropriate.

  The determination unit 125 according to the embodiment determines whether or not the photographing for follow-up observation is based on the photographing information of the second tomosynthesis photographing. In one embodiment, the shooting information of the second tomosynthesis shooting is a Boolean type parameter that takes a value of 1 if shooting related to follow-up observation and 0 if not shooting related to follow-up observation. Include flag information. And it shall include also the follow-up observation ID provided about each follow-up observation. If the flag information is 1 and the follow-up ID is assigned, it is determined that the shooting is related to follow-up observation. If the flag information is 0, it is determined that the shooting is not related to follow-up observation. As described above, by determining whether or not the follow-up observation is based on the photographing information, it is possible to reduce the trouble of an operation input for determining whether or not the follow-up observation is performed.

After the corresponding two cross-sectional images are displayed by the display control unit 124, the other cross-sectional image is also switched in response to an operation input for switching one of the two cross-sectional images. In such interlocking control, the display control unit 124 sets the cross-sectional correspondence between the first tomographic image obtained from the first tomosynthesis image and the second tomographic image obtained from the second tomosynthesis image. While maintaining, it is displayed on the display unit in conjunction with each other. In this way, it is possible to facilitate follow-up observation with a plurality of different cross-sectional images.
The imaging control unit 123 controls the X-ray detector 106 and X-ray generation in an integrated manner. In response to the instruction signal generated by the imaging control unit 123, the communication circuit 112 outputs a signal for capturing a projection image to the X-ray detector 106. The signal output here includes an instruction to apply a bias to the sensor array of the X-ray detector 106 and an instruction to switch an imaging mode such as fluoroscopic imaging and still image imaging. For example, the imaging control unit 123 obtains information for specifying a pixel that reads a signal as an X-ray image corresponding to information on the set image size. Also, the resolution information is converted into information (2 × 2, 3 × 3, etc.) indicating the presence or absence of binning driving for adding a plurality of pixels to the output of one pixel and the range of pixels to be binned. The imaging control unit 123 transmits these pieces of information to the X-ray detector (imaging unit) 106 via the communication circuit 112. Based on the transmitted information, the X-ray detector 106 sets the switch element of each pixel to the drive circuit that drives the sensor array according to the information for specifying the pixel that reads the signal as an X-ray image. Controls the on / off timing. The X-ray detector 106 controls to operate the summing switch element for binning pixel output in the sensor array and the column summing circuit included in the readout circuit for amplifying the output from the sensor array.
In addition, the imaging control unit 123 includes an X-ray generation rate (frame rate) generated by the X-ray control unit 104, irradiation condition information such as tube current, tube voltage, and irradiation time, and an X-ray generation device configured by the moving mechanism control unit 1051. 102 includes the range of the irradiation angle size (± Θ) of 102 and the movement range of the X-ray detector 105. The X-ray detector 106, the X-ray control unit 104, and the movement mechanism control unit 1051 that have received the signal are set according to information included in the signal and start X-ray imaging triggered by the irradiation switch 103. I will wait.
From a plurality of projection images obtained by X-ray imaging, a tomographic image is generated by, for example, filter back projection processing or successive approximation reconstruction processing by the image processing unit 111. The tomographic image generated here may be a plurality of coronal images having different cross sections (or may be an axial image or a sagittal image) or volume data including a plurality of voxels in a predetermined three-dimensional region. .

  In addition, the X-ray imaging system may include an imaging table 105 that is a gantry on which the subject is placed. For example, in the case of tomosynthesis imaging in a standing position, a table is not necessary. The imaging table 105 may be provided with a storage unit for storing the X-ray detector 106 and a moving mechanism for moving the X-ray detector 106 by moving the position of the storage unit. In the case of tomosynthesis imaging in which the X-ray detector is not moved, a moving mechanism is unnecessary.

  Here, a configuration example of an imaging stand used for tomosynthesis imaging will be described with reference to FIG. The imaging table 105 includes a top plate 200 that holds the subject, a column 201 that holds the X-ray generator 102, a base 202 of the column 201, a first moving mechanism that moves the X-ray generator 102, and movement. A moving mechanism control unit 1051 for controlling the mechanism. The column 201 can be tilted with respect to the base 202, and the X-ray generator 102 is fixed to the column 201. When collecting projection image data in tomosynthesis imaging, the X-ray generator 102 moves in the longitudinal direction of the top plate 200 around the position where the top plate 200 and the column 201 are vertical before the start of irradiation.

  Furthermore, the imaging stand 105 may include a holding unit 204 that holds the X-ray detector 106, a guide unit 203 of the holding unit 204, and a second moving mechanism that moves the X-ray detector. In this case, the holding unit 204 moves along the guide unit 203 in the same direction in the longitudinal direction of the top plate and in the opposite direction to the X-ray generator 102 by a preset distance. In this manner, the X-ray generator 102 and the X-ray detector 106 move in the opposite directions with the start of irradiation, and collect projection image data and acquire position information that are the basis of reconstruction processing.

  The X-ray detector 106 has a linear trajectory and the X-ray generator 102 has an arcuate trajectory. However, the X-ray generator 102 may be moved so as to draw a linear trajectory. In this case, the X-ray generator 102 may be moved in a direction perpendicular to the long axis direction of the column 201 while appropriately changing the position of the X-ray generator 102 with respect to the long axis direction of the column 201.

  The first and second moving mechanisms that move the column 201 and the holding unit 204 of the X-ray detector 106 are controlled by the moving mechanism control unit 1051. The moving mechanism control unit 1051 moves the X-ray generator 102 and the X-ray detector 106 so as to be arranged at a predetermined position at a predetermined speed at a predetermined speed according to the input control parameter.

  In addition, the angle of the top plate 200 of the imaging stand 105 with respect to the direction of gravity may be changeable. When standing-up imaging is performed, the top 200 is tilted in the direction along the direction of gravity and functions as a holding unit that holds the subject.

  In addition, the imaging stand used for tomosynthesis imaging can take other embodiments in which the X-ray generator 102 can be moved.

  FIG. 3 illustrates information indicating the geometric arrangement (geometry) of tomosynthesis imaging. Such information is acquired, for example, when collecting projection image data, and is transmitted from the above-described movement control unit to the imaging control device 107.

  The isocenter is a center position for tomosynthesis imaging. Although it depends on the reconstruction method, the image quality of the coronal image that passes through the isocenter is usually the highest, so that it is preferably determined before imaging so as to pass through the region of interest of the subject. The X-ray generator 102 and the X-ray detector 106 move so that the X-ray focal point of the X-ray generator 102 and the center of the detection surface of the X-ray detector 106 (detector center position) always pass through the isocenter. The isocenter position is set, for example, by a distance (a distance between the full crumb or the isocenter table top) from the top surface of the top of the imaging table.

  The imaging angle or projection angle is an angle formed by a straight line connecting the X-ray generator 102 and the isocenter and a direction line of the detection surface of the X-ray detector 106, and is a parameter related to image quality. It is done.

  In addition, there are an imaging area and a reconstruction area as parameters affecting the geometric arrangement of tomosynthesis imaging. The direction parallel to the detection surface is determined by the irradiation area of the collimator light when the X-ray generator 102 is at the column center position. Further, the direction perpendicular to the detection surface may be determined by the height from the isocenter or the height from the table top. Alternatively, the reconstruction area may be determined by displaying a schematic diagram of the subject placed on the table on the display unit 109 and designating the three-dimensional region of the subject. In FIG. 3, it is assumed that X-rays are irradiated on the front surface of the X-ray detector 106, but the present invention is not limited to this, and the imaging region can be limited according to the imaging target region.

  The range of the X-ray source movement distance and the detector movement distance are determined in accordance with the isocenter, the imaging angle (projection angle), and the reconstruction area thus determined. The distance between the table top X-ray detectors is determined in advance, but may be variable. These pieces of information are determined by, for example, the imaging control device 107 or are input to the imaging control device 107 via the operation unit 108 and held.

  The number of projection images to be captured is determined in advance before imaging, and thereby the amount of movement of the X-ray generator 102 and X-ray detector 106 per imaging is determined. Thereby, the irradiation interval of the X-ray generator 102 is determined.

  The photographing angle, the X-ray source moving distance, and the X-ray detector moving distance are changed by shooting each projection image. When the X-ray generator 102 draws a curved trajectory, the X-ray source subject distance and the X-ray source detector distance also change. The moving mechanism control unit 1051 records these parameters for each projection image capturing timing, that is, for each X-ray irradiation, and transmits the parameters to the imaging control device 107 as geometric information corresponding to each projection image.

  Although FIG. 3 shows an example in which the column 201 is tilted at the contact portion with the base 202 as a method of moving the X-ray generator 102, a method of horizontally moving the column 201 may be used.

  Next, FIG. 4 shows a detailed configuration example of the control unit 111 according to the embodiment of the present invention. The control unit 111 includes a storage unit 403 that stores examination information and a specifying unit 404, in addition to the above-described specification unit 122, imaging control unit 123, display control unit 124, and determination unit 125.

  The imaging control unit 123 performs data transmission / reception with the X-ray generator 102 and the X-ray detector 106 via the communication circuit 112 regarding whether imaging is possible, imaging conditions, and position information. In addition, control related to execution of reconstruction processing, control of one X-ray imaging flow such as storage of X-ray image data, and overall flow of reconstruction processing execution are performed. The imaging control unit 123 also controls the overall flow of the examination execution, such as patient information, scheduled examination information, imaging technique information update / registration control, screen transition control, tomosynthesis image data storage, and tomosynthesis image addition processing. Do. The imaging control unit 123 performs display control on the display unit 109 such as reception control of input information from the operation unit 108 and screen transition. Further, the imaging control unit 123 determines whether or not an image included in the received examination information can be output, and causes the communication circuit 112 to output the image.

The storage unit 403 stores, updates, deletes, and searches for shooting technique information. The shooting technique information shown here includes various types of information. For example, shooting from post-processing to post-processing and image output settings such as information for specifying the shooting technique such as the shooting part and shooting direction, default shooting conditions, default image processing parameters, default reconstruction parameters, storage transfer settings, print output settings, etc. All items that can be set for each procedure. The storage unit 403 is configured with a database. The storage unit 403 performs registration, update, deletion, and search of the inspection information of the inspection information. The storage unit 403 includes a database.
The identifying unit 404 identifies the first tomosynthesis imaging information related to the second tomosynthesis imaging based on the second tomosynthesis imaging information. This is performed, for example, by specifying shooting information including the same follow-up ID as the follow-up ID included in the shooting information of the first tomosynthesis shooting. Then, from the imaging information of the first tomosynthesis imaging, a tomographic image obtained by the first tomosynthesis imaging and an oblique image specified by the specifying unit 1222 is specified. The specifying process includes information indicating the position and orientation of the designated tomographic image when the tomographic image is designated by the designation unit 122 for the tomographic image obtained by the first tomosynthesis imaging. Then, the specifying unit 404 specifies the position and orientation by acquiring information indicating the position and orientation included in the imaging information of the first tomosynthesis imaging. When the imaging information includes information indicating a plurality of positions and orientations, a plurality of positions and orientations are specified, and each of the tomographic images corresponding to the plurality of positions and orientations is subjected to second tomosynthesis imaging by the specifying unit 404, for example. Is obtained based on the projection image obtained in (1). Of course, it may be acquired from a tomographic image group reconstructed in advance from the projection image obtained by the second tomosynthesis imaging and stored in the storage unit 403. The display control unit 124 displays the tomographic image related to the acquired second tomosynthesis imaging and the tomographic image related to the first tomosynthesis imaging stored in the storage unit 403 and specified by the specifying unit 122 side by side. .
In another embodiment, the specifying unit 404 specifies the position and orientation of the tomographic image related to the second tomosynthesis imaging based on the position of the corresponding point. In this case, for example, the specifying unit 404 performs display or output based on points corresponding to each of the first tomographic image obtained by the first tomosynthesis imaging and the second tomographic image obtained by the second tomosynthesis image. The target tomographic image is specified. In this case, if there is a designated point in the tomographic image obtained by the first tomosynthesis imaging, the oblique cross section passing through the designated point is identified by the tomographic image obtained in the second tomosynthesis imaging. The Then, the position and orientation of the oblique image are specified so as to include the designated point.
Here, there may be some deviation between the imaging ranges of the first tomosynthesis imaging and the second tomosynthesis imaging, and there may be a deviation in the position and orientation of the subject. Therefore, a point having the same coordinate as the designated point related to the first tomosynthesis imaging is not necessarily a corresponding point related to the second tomosynthesis imaging. Therefore, a process for matching the position and orientation in this order is required. Such processing may be automatically performed by the image processing unit 110 by image processing, but also corresponds to manual alignment. In this case, the display control unit 124 displays the tomographic image including the designated point related to the first tomosynthesis imaging in the first region, and is the tomographic image related to the second tomosynthesis imaging, and the designated tomographic imaging. A tomographic image including a point having the same coordinate as the point is displayed in the second region. Here, the display control unit 124 switches the tomographic image to be displayed in the second area in accordance with the operation input from the user, and designates one point in the tomographic image displayed in accordance with the operation input from the user. In this case, the tomographic image displayed in the first area may be switched. The specifying unit 404 specifies the specified one point and the specified point related to the first tomosynthesis imaging as positions corresponding to each other.
Then, the specifying unit 404 performs processing for matching the position and orientation of the tomographic image displayed in the second area. Such processing may be performed even when one point of the coronal image is designated in the first tomosynthesis imaging. In this way, it is possible to cope with the case where the direction of the coronal section is different between the first and second tomosynthesis imaging. The display control unit 124 changes the posture of the tomographic image displayed in the second area while not changing the tomographic image displayed in the first area. Here, for example, if the display control unit 124 sets the initial posture of the tomographic image displayed in the second area to be the same as that of the tomographic image displayed in the first region, the alignment operation becomes easy. .

As described above, by supporting the alignment of the corresponding position and posture, it is easy to confirm whether an image for performing the follow-up observation is appropriately captured.
Next, FIG. 5 shows a hardware configuration of the control unit 111 related to the X-ray imaging system 101 in the present invention. The control unit 111 includes a CPU 501, ROM 502, RAM 503, HDD 504, input detection unit 505, communication I / F 506, and graphic board 507. These are connected to each other via a bus such as a data bus. The hardware of the control unit 111 may be a commercially available electronic computer. A program including instructions for realizing the processes of FIGS. 6, 7, and 22 and data for realizing the GUIs of FIGS. 8 to 20 and FIG. 23 is installed in the electronic computer. Thus, each function of the control unit 111 is realized. A CPU (CENTRAL PROCESSING UNIT) 501 is an arithmetic processing circuit that integrally executes control by the control unit 111, and executes a command program stored in the ROM 502 or a program stored in the HDD 504 and expanded in the RAM 503. Control is carried out in Further, the CPU 501 performs processing for designating an oblique image that is a tomographic image of the subject obtained based on the projection image. Further, a process for determining whether or not the second tomosynthesis imaging is an imaging for follow-up observation from the first tomosynthesis imaging. Then, in accordance with the determination that the imaging is for follow-up observation, a tomographic image based on the designated oblique image and a projection image obtained by the second tomosynthesis imaging, and a tomogram of a cross section corresponding to the oblique image The image is displayed side by side on the display unit. Such display processing may be performed according to execution of the second tomosynthesis imaging. The RAM 503 is also used to secure a working storage area when the CPU performs control by the instruction program. The HDD 504 is an auxiliary storage device that stores various data such as X-ray image data. A communication I / F 506 is a communication interface constituting the communication circuit 112, and transmits and receives data between the control unit 111, the X-ray control unit 104, the X-ray detector 106, and the network 114. Here, the communication I / F 506 functions as a communication circuit that is acquired by receiving a plurality of projection images from a radiation detector used for tomosynthesis imaging. In addition, the communication I / F 506 includes the specified oblique image as an image obtained by the tomosynthesis imaging, and includes information on the imaging conditions and information specifying the position and orientation of the oblique image as incidental information. Output as a secondary capture image. Note that the communication I / F that communicates with the X-ray detector (imaging unit) 106 and the communication I / F that outputs DICOM images may be the same hardware, or separate network interface cards may be provided for each. It may be used.
The graphic board 507 serves as at least a part of the image processing unit 110 and a display driver that executes the function of the display control unit 124. The graphic board 507 has a GPU (GRAPHIC PROCESSING UNIT) inside, and performs image processing by the GPU, reconstruction processing, and generation and display processing of an oblique section according to an operation input. For example, the graphic board 507 functions as a graphic processor that displays an oblique image of a cross section including the specified position and the isocenter of tomosynthesis imaging on a display. Some image processing may be performed by the CPU 501, in which case the CPU 501 and the graphic board 507 correspond to the image processing unit 110.

  Next, an example of the flow from the start to the end of the tomosynthesis imaging examination according to the embodiment of the present invention will be described with reference to FIG.

In step S601, the imaging control unit 123 generates patient (subject) examination information. Patient information is created prior to the start of the examination. The patient information shown here includes all information for specifying the patient, such as patient name, patient ID, age, date of birth, gender, carefulness, weight, and pregnancy status. The display control unit 124 displays a patient information input screen 801 (FIG. 8) on the display unit 109. The imaging control unit 123 specifies patient information to be examined according to an operation input from the operation unit 108. In response to this, the imaging control unit 123 newly generates scheduled examination information. The scheduled examination information shown here includes the above-mentioned patient information, examination information including all for specifying the examination such as examination ID and examination date, and imaging technique information including all information for specifying the imaging technique such as an imaging region. Including. Then, the imaging control unit 123 inputs the patient information included in the patient information confirmation notification into the scheduled examination information. Thereafter, the imaging control unit 408 requests the registered all imaging technique information to the storage unit 403, and acquires all registered imaging technique information. Upon receiving the shooting technique information, the shooting control unit 408 causes the display control unit 124 to display a shooting technique selection screen 901 (FIG. 9). The display control unit 124 displays all the received shooting technique information on the shooting technique selection screen 901.
In step S602, the imaging control unit 123 creates inspection information. The examination information creation shown here includes a scheduled imaging procedure. In response to an instruction to start an examination from the operation unit 108, the imaging control unit 123 inputs the examination information and the scheduled imaging technique to the scheduled examination information generated when the patient information is determined.

  In this embodiment, patient information, examination information, and scheduled imaging procedure are created manually. In another embodiment, selecting worklist information acquired from HIS / RIS115 enables patient information, examination information, and implementation at once. Create a scheduled shooting technique. In this case, step S601 is omitted. In response to an operation input for instructing the start of an examination from the operation unit 108, the imaging control unit 123 performs the scheduled examination information generated when the patient information, the examination information, and the scheduled imaging technique included in the selected work list information are determined. To enter.

  Subsequently, in step S603, the imaging control unit 123 executes an inspection start process. When the creation of the inspection execution information is completed in step S602, the imaging control unit 123 newly registers the scheduled inspection information as inspection information. Then, the storage unit 403 updates the inspection status of the newly registered inspection information to “in progress”. The inspection status includes “not started”, “pending”, “pending”, and “finished”. The display control unit 124 displays an imaging screen 1001 (FIG. 10) for the scheduled examination information on the display unit 109. The imaging screen 1001 displays patient information, examination information, and imaging technique information included in the received examination information.

  In step S <b> 604, the imaging control unit 123 selects an imaging technique for performing imaging next from the scheduled imaging techniques included in the started examination information. In response to this, the imaging control unit 123 sets imaging conditions for tomosynthesis imaging. The shooting technique is selected by pressing a shooting technique display area 1009 displayed on the shooting screen 1001. Upon receiving an irradiation permission request notification in response to an operation input for pressing an imaging technique button from the operation unit 108, the imaging control unit 123 uses a signal for controlling the sensor to the X-ray detector 106 based on the imaging conditions. A certain irradiation permission request notification is output to the communication circuit 112. When receiving the irradiation permission request notification, the communication circuit 112 transmits the irradiation permission request notification to the X-ray control unit 104 and the X-ray detector 106. Further, the display control unit 124 switches the display of the sensor status display area 903 of the shooting screen 1001 displayed on the display unit 109. Note that the irradiation permission request notification includes the selected photographing technique information.

  When receiving the irradiation permission request notification, the X-ray control unit 104 notifies the X-ray generation apparatus 102 of default imaging conditions and default position information included in the imaging technique information included in the irradiation permission request notification. Thereafter, when the condition setting of the X-ray generation apparatus 102 and the movement to the default position are completed, the X-ray control unit 104 transmits an irradiation permission notification to the communication circuit 112. Note that the irradiation permission notification includes photographing technique information for which irradiation is permitted.

  Upon receiving the irradiation permission request notification, the X-ray detector 106 moves to the default position based on the default position information included in the imaging technique information included in the irradiation permission request notification. The X-ray detector 106 transmits an irradiation permission notification to the communication circuit 112 when the X-ray detection preparation is completed. When receiving the irradiation permission notification from both the X-ray control unit 104 and the X-ray detector 106, the communication circuit 112 transmits the irradiation permission notification to the imaging control unit 123.

  When receiving the irradiation permission notification, the imaging control unit 123 transmits the irradiation permission notification to the imaging control unit 123. When receiving the irradiation permission notification, the imaging control unit 123 transmits the irradiation permission notification to the display control unit 124. When the display control unit 124 receives the irradiation permission notification, the display control unit 124 switches the display of the sensor status display area 903 of the imaging screen 1001 displayed on the display unit 109. In addition, on the display unit 109, a scheduled shooting thumbnail 912 is displayed in a shooting technique display area 1009 on the shooting screen 1001. In this way, by switching the display of the sensor status display area 903 and the shooting technique display area 1009, it is possible to easily determine that the irradiation is possible and the shooting technique in which an image is added in the next irradiation. Although the flow of selecting a manual shooting technique has been described so far, in the embodiment of the present invention, the shooting technique is automatically selected at the timing when the next shooting preparation is ready, such as at the start of examination or at the end of irradiation. It is also possible to do. In this case, when the preparation for the next photographing is ready, the photographing control unit 123 acquires photographing technique information whose status is “unphotographed” from the scheduled photographing technique information included in the scheduled examination information. . The status of the shooting technique information includes “not shooting”, “shooting”, and “shooting completed”. The imaging control unit 123 selects the imaging technique whose registration order is the first in the imaging technique information “Unphotographed”, and transmits an irradiation permission request. However, the method of selecting one shooting technique is not limited to this. This eliminates the need for the operator to manually select the next shooting technique each time shooting is performed, thereby reducing the workflow.

  In addition, before and after Steps S601 to S604, the subject or the person in charge of performing the examination arranges the subject. Subsequently, the center position of reconstruction is set in step S606. Mainly, an operator or a person in charge of performing an examination measures the center position (hereinafter referred to as isocenter position) based on the region of interest of the subject, and the isocenter position is input from the operation unit 108. When the isocenter position is input from the operation unit 108, the imaging control unit 123 inputs the isocenter position information to the position information included in the selected shooting technique information.

  In step S607, the subject is aligned using fluoroscopic imaging. The imaging control unit 123 controls reception and display of an image obtained by fluoroscopic imaging. In particular, in tomosynthesis imaging, the influence of artifacts is greatly related to the irradiation direction of X-rays to the subject. Therefore, fluoroscopy is performed to confirm the placement of the patient, and whether the placement position of the subject is correct is confirmed.

  When the X-ray irradiation switch 103 is pressed, the X-ray irradiation switch 103 transmits an irradiation start request to the X-ray control unit 104. When receiving the irradiation start request, the X-ray control unit 104 transmits an irradiation start instruction to the X-ray generation apparatus 102. When receiving the irradiation start instruction, the X-ray generation apparatus 102 starts X-ray irradiation. Thereafter, the X-ray generation apparatus 102 transmits an irradiation start notification to the X-ray control unit 104. When receiving the irradiation start notification, the X-ray control unit 104 transmits the irradiation start notification to the imaging control unit 123 via the communication circuit 112. Upon receiving the irradiation start notification, the imaging control unit 123 updates the status of the imaging technique for which irradiation has been started among the imaging technique information included in the scheduled examination information to “during imaging”. Further, the imaging control unit 123 transmits an irradiation start notification to the display control unit 124. When receiving the irradiation start notification, the display control unit 124 switches the display of the sensor status display area 903 of the imaging screen 1001.

  The X-ray detector 106 detects the irradiated X-rays and converts them to X-ray image data. Further, the X-ray detector 106 acquires position information in synchronization with the X-ray detection. The X-ray detector 106 transmits X-ray image data and position information to the imaging control unit 123 via the communication circuit 112. When receiving the X-ray image data and the position information, the imaging control unit 123 inputs the position information to the selected imaging technique. Further, the imaging control unit 123 controls the display control unit 124 to display the X-ray image data live on the image display area 902 of the imaging screen 1001 of the display unit 109.

  Thereafter, when the X-ray irradiation switch 103 is released, the X-ray irradiation switch 103 transmits an irradiation stop request to the X-ray control unit 104. When receiving the irradiation stop request, the X-ray control unit 104 transmits an irradiation stop instruction to the X-ray generation apparatus 102. When receiving the irradiation stop instruction, the X-ray generator 102 stops the X-ray irradiation. Thereafter, the X-ray generation apparatus 102 transmits an irradiation end notification and an imaging execution condition notification to the X-ray control unit 104. Note that the shooting execution condition notification includes the shooting execution condition and position information. When receiving the irradiation end notification and the imaging execution condition notification, the X-ray control unit 104 transmits the irradiation end notification and the imaging execution condition notification to the imaging control unit 123 via the communication circuit 112. Upon receiving the irradiation end notification and the imaging execution condition notification, the imaging control unit 123 updates the status of the imaging technique for which irradiation has ended in the imaging technique information included in the scheduled examination information to “imaging complete”. In addition, the imaging control unit 123 inputs the irradiation execution condition to the imaging technique information for which irradiation has ended among the imaging technique information included in the scheduled examination information. The imaging control unit 123 switches the display of the sensor status display area 903 of the imaging screen 1001 displayed on the display unit 109 by the display control unit 124 and updates the corresponding display annotation on the image display area 902.

  Note that, here, the X-ray generation apparatus 102 shows a case where the irradiation end notification and the imaging execution condition notification are transmitted at the same time, but the present invention is not limited to this. The imaging execution conditions may be transmitted in real time during irradiation, or may be transmitted at a timing different from the irradiation end notification after the irradiation ends. Further, the shooting execution condition and the position information may be transmitted at different timings.

  Subsequently, in step S608, the projection image is captured. The flow of processing at the time of shooting a projected image is substantially the same as that in the case of fluoroscopy in step S607. However, in capturing a projection image, when receiving the X-ray image data and the position information, the imaging control unit 123 inputs the position information to the selected imaging technique and saves the X-ray image data. In addition, when receiving a projection image irradiation end notification, the imaging control unit 123 determines an imaging interruption status from the position information. The imaging control unit 123 determines whether or not reconstruction processing is possible or whether or not an oblique section display is possible according to the determination result of the imaging interruption status. As a result, it is possible to prevent an invalid tomosynthesis image from being displayed by performing the reconstruction in vain when the projection image capturing is interrupted. Similarly, it is possible to avoid the risk of misdiagnosis by referring to the oblique section where information is missing.

  Subsequently, reconfiguration processing is performed in step S609. When receiving the X-ray image data and position information of the projection image, the imaging control unit 123 transmits a reconstruction start notification to the display control unit 124. At the same time, a reconstruction request notification is transmitted to the image processing unit 110. The reconstruction request notification includes imaging technique information, X-ray image data, and position information.

  In step S610, the display control unit executes display processing of the reconstructed image. Upon receiving the reconstruction start notification, the display control unit 124 displays the reconstruction screen 1101 (FIG. 11) on the display unit 109 and displays a progress bar on the image display area 1002 of the reconstruction screen 1101. On the other hand, when receiving the reconstruction request notification, the image processing unit 110 performs a reconstruction process using the default reconstruction parameter, position information, and X-ray image data of the imaging technique information. When the reconstruction process is completed, the image processing unit 110 transmits a reconstruction completion notification to the imaging control unit 123. The reconstruction completion notification includes the generated tomosynthesis image, reconstruction parameter, and image processing parameter. When receiving the reconstruction completion notification, the imaging control unit 123 newly generates tomosynthesis image information, and inputs the tomosynthesis image, the reconstruction parameter, and the image processing parameter included in the reconstruction completion notification. Then, newly generated tomosynthesis image information is added to the imaging technique for which reconstruction has been completed among the imaging technique information included in the scheduled examination information. The display control unit 124 hides the progress bar being displayed in the image display area 1002 displayed on the display unit 109. Then, the display control unit 109 displays a preview of the tomosynthesis image in the image display area 1002, and updates the display annotation. The reconstruction screen 1002 enables an operation input for editing a WINDOW process, a reproduction process, or a reconstruction parameter for a tomosynthesis image.

  Thereafter, in response to an operation input for confirming the reconstruction from the operation unit 108, the imaging control unit 123 stores the reconstructed tomosynthesis image. The imaging control unit 123 causes the display control unit 124 to transition the screen displayed on the display unit 109 to the imaging screen 1001. In addition, a captured image thumbnail 911 of the tomosynthesis image is added and displayed as a preview.

  While the tomographic image reconstructed as described above is displayed, post-processing on the tomosynthesis image is performed. The post-processing on the tomosynthesis image includes editing of the cut-out area, parallel display of the tomosynthesis image (multiview), re-shooting instruction, and failure instruction.

  In step S611, the determination unit 125 determines whether to perform re-shooting according to whether re-shooting is instructed during the display process of step S610. If it is determined that re-shooting is to be performed, the process proceeds to step S606, and a shooting technique similar to the shooting information corresponding to the re-shooting is selected, and shooting is performed as described above. In addition, since the case where irradiation conditions and an isocenter position are incorrect is considered, it is performed from the setting of the center position of step S606.

  In step S612, the shooting control unit 123 determines whether or not the next shooting based on the shooting information that has not been shot is performed. If there is unphotographed shooting information, it is determined that the next shooting is to be performed, the process proceeds to step S604, and one of the unphotographed shooting information is selected, and shooting is performed as described above. The shooting control unit 123 determines whether or not the next shooting based on the shooting information that has not been shot is performed. If there is unphotographed shooting information, it is determined that the next shooting is to be performed, the process proceeds to step S604, and one of the unphotographed shooting information is selected, and shooting is performed as described above.

  In step S613, the imaging control unit 123 determines whether the end of the inspection is instructed. The end of the inspection is instructed by an operation input for pressing the inspection end button 1017 by the operation unit 108, for example. When the input is received, it is determined that the imaging control unit 123 has instructed the end of the inspection. If there is an instruction to end the inspection, the process proceeds to step S614. If there is no instruction to end, the process proceeds to step S603, and the display control unit 124 displays an imaging screen for the started inspection on the display unit 109.

  In step S614, an inspection end process is performed. The imaging control unit 123 transmits an inspection end notification to the storage unit 403 and the display control unit 124. Note that the inspection end notification includes scheduled inspection information. The image output notification includes scheduled examination information. When the storage unit 403 receives the inspection end notification, the storage unit 403 searches and acquires the scheduled inspection information from the registered inspection information. Then, the storage unit 403 updates the inspection status of the acquired inspection information to “end”. Upon receiving the examination end notification, the display control unit 124 changes the screen displayed on the display unit 109 to the patient information input screen 801. In addition, when the operation unit 108 accepts the inspection suspension, the flow is the same as the end of the inspection. However, the storage unit 403 updates the inspection status of the acquired inspection information to “pending”.

  In step S615, image output is performed. The imaging control unit 123 performs image output processing via the communication circuit 112 in accordance with the end of the inspection. The communication circuit (output unit) 112 outputs the DICOM image file created by the imaging control unit 123 for the image designated as the output image in S610.

The flow of processing relating to the display of the tomographic image according to step S610 will be described with reference to the flowchart of FIG. In step S701, an instruction to start displaying a tomographic image related to the second tomosynthesis imaging is input to the imaging control unit 123. Such an instruction may be performed in response to, for example, pressing the reconstruction button 1010 in FIG. 10, or in parallel with the acquisition of a plurality of projection images photographed by the X-ray detector 106 or at the completion of the acquisition. An instruction may be given in accordance with the reconstruction process performed by the image processing unit 110 in response. In the middle of the reconstruction process, the imaging control unit 123 may be instructed to sequentially display the tomographic images that can be displayed, or the display start instruction may be performed after the reconstruction process is completed.
By executing step S701, the user can switch and display the tomographic images displayed in the image display area 1102. For example, here, the designation unit 122 designates a tomographic image (coronal image or oblique image) to be displayed. Note that the processing in step S701 by the imaging control unit 123 may be performed in accordance with the designation by the designation unit 122.

  At this time, the first tomosynthesis imaging is completed, and a plurality of projection images obtained by the imaging are acquired by the communication circuit (acquisition unit) 112. Further, it is assumed that an oblique image, which is a tomographic image of the subject obtained based on the projection image related to the first tomosynthesis imaging, is designated by the designation unit 122. At this time, the first tomosynthesis imaging need not be specified.

  In step S702, the determination unit 122 determines whether to perform follow-up display. For example, the determination unit 122 determines whether or not the second tomosynthesis imaging is imaging for follow-up observation from the first tomosynthesis imaging. In this determination process, for example, each piece of shooting information stored in the storage unit 403 is used as shooting information related to the first tomosynthesis shooting. The determination unit 122 determines whether the second tomosynthesis imaging corresponds to imaging for follow-up observation from the first tomosynthesis imaging with reference to information included in the imaging information. If it is determined that the shooting is related to the follow-up observation, the process proceeds to step S703. If the shooting is not related to the follow-up observation, the process proceeds to step S706.

  Such processing includes, for example, determination of whether or not to perform follow-up observation, determination of whether or not the second tomosynthesis photographing is photographing for follow-up observation, and follow-up observation included in the photographing information of the second tomosynthesis photographing And a process of specifying imaging information including a common follow-up ID.

  For example, in a state where the imaging information of the first tomosynthesis imaging includes 001 as the follow-up observation ID, the imaging information of the second tomosynthesis imaging is acquired by the imaging control unit 123, and the imaging information includes the follow-up ID as the observation ID. Consider a case where 001 is assigned. In such a case, the determination unit 122 determines that the second tomosynthesis photographing is photographing for follow-up observation from the first tomosynthesis photographing. If 002 is given as the follow-up observation ID and no follow-up observation ID 002 is given other than the shooting information of the second tomosynthesis shooting, the shooting information stored in the storage unit 403 is used as the first tomosynthesis. Sequential determination processing is performed as shooting information related to shooting. In each determination process, it is determined that the second tomosynthesis imaging is not imaging for follow-up observation from the first tomosynthesis imaging.

  Such determination processing only needs to include imaging information, and can be performed before or after the first and second tomosynthesis imaging.

  In another embodiment, the first tomosynthesis imaging may be identified afterwards. For example, the tomosynthesis imaging is performed in the first and second order, the imaging information of the second tomosynthesis imaging includes 002 as the follow-up observation ID, and includes the follow-up observation ID 002. Consider the case where there is no shooting information. In this case, the determination unit 125 sequentially performs determination processing using the shooting information stored in the storage unit 403 as shooting information related to the first tomosynthesis shooting. In each determination process, it is determined that the second tomosynthesis imaging is not imaging for follow-up observation from the first tomosynthesis imaging.

  Here, when 002 is added as follow-up ID to the imaging information of the first tomosynthesis imaging, the determination unit 125 determines that the second tomosynthesis imaging has progressed since the first tomosynthesis imaging. It is determined that the image is taken for observation.

  In step S703, the specifying unit 404 specifies a tomographic image to be compared. For this purpose, the specifying unit 404 specifies the position and orientation of the oblique image that is the tomographic image of the first tomosynthesis imaging and is specified by the specifying unit 122 based on the imaging information of the second tomosynthesis imaging.

  In step S704, the display control unit 124 switches the display of the display unit 109 to a display screen suitable for follow-up observation. For example, the display control unit 124 switches the reconfiguration screen 1101 displayed on the display unit 109 to the comparison display screen 1511 for follow-up observation and displays it. On such a display screen, the user switches the tomographic image to be displayed according to the operation input from the operation unit 108. The processing in step S704 is performed according to at least one of the determination that the imaging is for follow-up observation in step S702 and the execution of the second tomosynthesis imaging that is one of the triggers of the processing in step S701. In this way, the display control unit 124 includes the oblique image specified by the specifying unit 122, the tomographic image based on the projection image obtained by the second tomosynthesis imaging, and the tomographic image of the cross section corresponding to the oblique image. Are displayed side by side on the display unit.

  In step S705, the imaging control unit 123 determines whether or not an instruction to end the display for follow-up observation has been instructed, and the process proceeds according to the operation input from the operation unit 108 as described above until an instruction to end the display is given. Display for observation can be executed. An instruction to end the display for follow-up observation is performed by the imaging control unit 123 in response to pressing of the comparison end instruction button 1505 on the comparison display screen 1511, for example. When the end of the follow-up observation display is instructed in step S705, the display control unit 123 displays the reconfiguration screen 1101 from the comparison display screen 1511, for example, the display of the display unit 109.

  When the end of the follow-up display is instructed in step S705, or when it is determined that the follow-up observation is not in step S702, the imaging control unit 123 determines in step S706 whether or not there is an instruction to end the display of the tomographic image. . The instruction to end the display of the tomographic image is determined by, for example, whether or not the reconstruction confirmation button (confirmation button) 1122 on the reconstruction screen 1101 is pressed. If the follow-up observation is not determined (NO in step S702) and there is no instruction to end the display of the tomographic image (NO in step S706), the reconfiguration screen 1101 or the comparison is displayed on the display unit 109. A display screen 1511 is displayed. As a result, it is possible to display a tomographic image in accordance with an operation input from the operation unit 108.

  If there is an instruction to end the display of the tomographic image in step S706, the display process according to step S710 is ended.

  An example of a screen displayed on the display unit 109 by the display control unit 124 according to the embodiment of the present invention will be described with reference to FIGS.

  First, an example of the patient information input screen 801 displayed in step S601 in FIG. 6 is shown using FIG. The patient information input screen 801 is a screen for inputting information on a patient to be examined. The patient information input screen 801 includes a patient information input area 802, a patient information list 803, a patient information confirmation button 804, a patient information display area 805, an examination information display area 806, and an examination start button 807. The patient information input area 802 is an area for inputting and selecting values of items included in the patient information. The patient information list 803 displays a list of patient information of tests performed in the past. In the column of the patient information list 803, one item included in the patient information is displayed for one column. In the list portion, patient information for one person is displayed per line. When arbitrary patient information on the list is selected, the selected patient information is input to each input area of the patient information input area 802. The patient information confirmation button 804 is a button for confirming the value input in the patient information input area 802 as patient information. When the button is pressed, it is confirmed whether or not a value is input to the required input item and whether or not a correct value that does not violate the standard is input to the input item. The patient information display area 805 is an area for displaying confirmed patient information. Until the patient information is confirmed, no value is displayed for each item, and is displayed when the patient information is confirmed. The examination information display area 806 is an area where the inputted examination information is displayed. The examination information shown here includes information for specifying the examination such as examination ID, inquiry doctor name, interpretation doctor name, examination description, and facility name. Also included is a shooting technique selected as a shooting schedule. Note that at least one imaging technique can be selected for one examination. The examination information display area 806 includes an area for displaying each item of the examination information and an area for displaying the selected photographing technique. A value is not displayed for each item until inspection information is input. Similarly, the shooting technique is not displayed until it is selected. Each is displayed when the examination information is input and the imaging technique is selected. Moreover, it is possible to carry out a plurality of inspections at a time in one imaging. In that case, the inspection information display area 806 is displayed side by side by the number of inspections. The inspection start button 807 is a button for instructing the start of inspection. When the button is pressed, it is confirmed whether patient information and examination information have been input and at least one imaging technique has been selected for each examination. If there is no problem, examination start processing is performed. If there is even one examination for which no imaging technique is selected, an imaging technique selection screen 901 is displayed.

  Next, an example of the shooting technique selection screen 901 displayed in step S602 in FIG. 6 will be described with reference to FIG. The shooting technique selection screen 901 is a screen for selecting a shooting scheduled shooting technique in the scheduled inspection. The imaging technique selection screen 901 includes an imaging technique display area 902, an imaging technique button 903, a patient information display area 904, an examination information display area 905, a selected imaging technique button 906, and an examination start button 907. The shooting technique display area 902 is an area in which shooting techniques stored in the storage unit 403 are displayed one by one with the shooting technique button 903. The display location of the button can be arbitrarily changed. When one page cannot be displayed, it can be displayed over a plurality of pages, and the display page is switched by a page switching instruction. The shooting technique button 903 is a button displayed for each shooting technique stored in the storage unit 403. On the shooting technique button, the name of the shooting technique and the name of the sensor used are displayed. When the button is pressed, the selection is confirmed as a shooting schedule in the selected examination. The patient information display area 904 is an area for displaying confirmed patient information. The examination information display area 905 is an area where the inputted examination information is displayed. The selected shooting technique button 906 displays the shooting technique button 903 selected in the shooting technique display area 902. Since one or more photographing techniques can be selected for the examination, the selected photographing technique button 906 is added to the end of the examination information display area 905 every time the photographing technique button is selected. The inspection start button 807 is a button for instructing the start of inspection. When the button is pressed, it is confirmed whether patient information and examination information have been input and at least one imaging technique has been selected for each examination. If there is no problem, examination start processing is performed. When the inspection start process is performed, the screen transitions to the imaging screen 1001. If there is even one examination for which the imaging technique is not selected, the operator is notified to select the imaging technique, and the screen transition is not performed. A shooting technique selection screen 901 having the above configuration is displayed.

  Next, an example of the shooting screen 1001 displayed in step S603 in FIG. 6 will be shown using FIG. An imaging screen 1001 includes an image display area 1002, a status display area 1003, a single view button 1004, a multi-view button 1005, a frame view button 1006, a patient information display area 1007, an examination information display area 1008, an imaging technique display area 1009, and a reconstruction. Button 1010, captured image thumbnail 1011, scheduled shooting thumbnail 1012, WINDOW LEVEL editing unit 1013, WINDOW WIDTH editing unit 1014, examination hold button 1015, image output button 1016, examination end button 1017, annotation display button 1018, clockwise rotation button 1019, Left rotation button 1020, left / right inversion button 1021, up / down inversion button 1022, monochrome inversion button 1023, L mark arrangement button 1024, R mark arrangement button 102 5, a cutout setting button 1026, a mask processing button 1027, a re-shooting button 1028, a failure button 1029, an UNDO button 1030, and a reset button 1031. The image display area 1002 displays a preview of a captured image after still image capturing or a tomosynthesis image after reconstruction processing. During movie shooting, the shot image is displayed in real time. When the preview selection is switched after shooting, the shot image selected for preview is displayed as a preview. In addition, patient information, examination information, irradiation conditions, and the like are displayed as annotations according to the settings. In the initial state immediately after the start of inspection, no image is displayed. The status display area 1003 is an area for distinguishing and displaying colors and characters so that the operator can easily determine the status notified from the X-ray control unit 105 or the X-ray detector 104. The imaging control unit 123 that has received the status notification from the X-ray control unit 105 or the X-ray detector 104 via the communication circuit 112 determines the display content according to the combination of the statuses of the X-ray control unit 105 or the X-ray detector 104. . Then, the imaging control unit 123 transmits a status display switching instruction to the display control unit 124. For example, “NOT READY” is displayed on the sensor status when the X-ray control unit 105 cannot perform X-ray irradiation or the X-ray detector 104 cannot detect X-rays. In addition, when the X-ray control unit 105 is capable of X-ray irradiation and the X-ray detector 104 is capable of X-ray detection, “READY” is displayed on the sensor status and the background color is easily displayed as “NOT READY”. Change to a distinguishable color. A single view button 1004 is a button for switching to a single view that displays one frame of an image selected for preview in the image display area 1002. In the case of an image having a plurality of frames, another frame can be displayed and a movie can be played by operating the keyboard or mouse during preview display. A multi-view button 1005 is a button for dividing the image display area 1002 into a plurality of grid-shaped display areas and switching to a multi-view that displays in parallel an image group captured in the examination being performed. The button is disabled until two or more images are captured in the current examination, and multi-view is impossible. A frame view button 1006 is a button for dividing the image display area 1002 into a plurality of grid-like display areas and switching to a frame view in which a frame image group of moving images selected for preview is displayed in parallel. If the preview selected image is not a moving image, the button is disabled and frame view is not possible. The patient information display area 1007 is an area where patient information such as a patient name and a patient ID is displayed. In the examination information display area 1008, examination information such as examination ID and examination description is displayed, and the imaging technique selected in the examination is displayed side by side in the imaging technique display area 1009. The shooting technique display area 1009 includes a reconstruction button 1010, a shot image thumbnail 1011, and a shooting scheduled thumbnail 1012. In the shooting technique display area 1009, shooting technique information such as a shooting technique name and all the shot image thumbnails 1011 performed are displayed. In the initial state immediately after the start of the inspection, since no shooting has been performed, the shot image thumbnail 1011 is not displayed. A reconstruction button 1010 is a button for instructing execution of reconstruction processing for a tomosynthesis photographing technique including an image being selected for preview. The display area is filled without being displayed by photographing techniques other than tomosynthesis. In addition, when a plurality of tomosynthesis imaging techniques are displayed, all buttons except for the tomosynthesis imaging technique including the image being selected for preview are invalid. By giving an instruction from the reconstruction button 1010, it is possible to perform reconstruction again for the tomosynthesis imaging technique that has been subjected to reconstruction processing once. On the photographed image thumbnail 1011, a thumbnail image corresponding to each photographed image, a photograph type mark, a similar mark, a failure mark, and the like are displayed. The shooting type mark is a mark that can distinguish the shooting types of still images, fluoroscopy, cine, and tomosynthesis images. For example, cine is “C” and tomosynthesis image is “T”. However, the mark is not limited to this as long as it is a mark that can distinguish the shooting type. By selecting the photographed image thumbnail 1011, the preview display is switched. Further, in the shooting technique display area 1009 during the next irradiation schedule selection, a shooting schedule thumbnail 1012 displayed in a blank at a position where a thumbnail is scheduled to be added at the next irradiation is displayed. When the irradiation schedule selection state is canceled, the shooting schedule thumbnail 1012 is hidden. The WINDOW LEVEL editing unit 1013 and the WINDOW WIDTH editing unit 1014 are portions for editing the WINDOW LEVEL and WINDOW WIDTH for the image being selected for preview. Editing is applied to the image being preview-displayed by changing the display value of the edit box or by dragging the mouse on the image display area 1002. The examination suspension button 1015 is a button for instructing suspension of an ongoing examination. In response to the pressing of the button, the imaging control unit 123 performs an examination suspension process. The image output button 1016 is a button for instructing image output of a captured image included in the examination being performed. When the image output is instructed, the image is output as in S616 described above. The inspection end button 1017 is a button for instructing the end of the inspection in progress. In response to the pressing of the button, the imaging control unit 123 performs an examination end process. The annotation display button 1018 is a button for switching between displaying and hiding the annotation displayed on the image display area 1002. The right rotation button 1019 is a button for rotating the photographed image being previewed to the right. The left rotation button 1020 is a button for rotating the captured image being previewed to the left. The left / right reversal button 1021 is a button for reversing the captured image being previewed horizontally. The upside down button 1022 is a button for upside down the photographed image being previewed. The black / white reversal button 1023 is a button for reversing the WINDOW value of the captured image that is being previewed. The L mark placement button 1024 is a button for placing the side marker “L” on the captured image being previewed. The button can be switched ON / OFF, “L” is arranged when ON, and “L” is deleted when OFF. The R mark placement button 1025 is a button for placing the side marker “R” on the captured image being previewed. The button can be switched ON / OFF, “R” is arranged when ON, and “R” is deleted when OFF. A cutout setting button 1026 is a button for instructing a cutout setting of a region of interest for a captured image that is being previewed. The mask processing button 1027 is a button for instructing mask processing for a captured image that is being previewed. The re-photograph button 1028 is a button for instructing re-photographing for a photographing technique including an image for which preview is being selected. The re-photographing shown here refers to a process of performing a photographic loss process on an image instructed to re-photograph and newly adding the same photographing technique. The image loss button 1029 is a button for instructing image loss for the image currently selected for preview. When the image loss process is performed, the image loss setting included in the image information is switched to ON. The UNDO button 1030 is a button for instructing UNDO processing for returning the history of processing for an image being selected for previewing in the newest order. The reset button 1031 is a button for instructing a reset process for discarding all the processes for the image currently selected for preview and returning to the state immediately after shooting. A shooting screen 1001 having the above configuration is displayed.

  Next, an example of the reconstruction screen 1101 displayed in step S609 or step S610 will be shown using FIG. The reconstruction screen 1101 includes an image display area 1102, a frame designation slider 1103, an image manipulation toolbar 1104, a coronal section display button 1105, an oblique section display button 1106, a frame view button 1107, a reconstruction method selection unit 1108, and a reconstruction filter type selection. Unit 1109, reconstruction filter DC editing unit 1110, cut-off frequency editing unit 1111, tomographic pitch editing unit 1112, slice number editing unit 1113, noise reduction processing editing unit 1114, reconstruction processing button 1115, default setting button 1116, frame reproduction Range setting section 1117, WINDOW adjustment display button 1118, playback process display button 1119, reconstruction cancel button 1120, reconstruction confirmation button 1121, 3D slider 1122, comparison display button 1123 Constructed. The image display area 1102 displays a preview of the tomosynthesis image after the reconstruction process. During the reconstruction process, a progress bar for notifying the operator that the reconstruction process is being performed is displayed, and a tomosynthesis image is displayed simultaneously with the completion of the reconstruction process. The frame designation slider 1103 confirms or switches the frame image being displayed in the tomosynthesis image being previewed. At the same time as the preview display of the tomosynthesis image, the memory for all valid frames of the tomosynthesis image being displayed in the preview is displayed uniformly from the upper end to the lower end of the slider. Here, by controlling so that only valid frames can be specified, the risk of erroneously displaying invalid frames is reduced. A frame having a number corresponding to the memory selected by selecting or dragging on the frame designation slider 1103 is displayed in the image display area 1102. In the image operation toolbar 1104, controls for instructing processing on the tomosynthesis image being previewed are arranged. The arranged controls are the same as 918 to 931 on the shooting screen 1001. The coronal section display button 1105 is a button for instructing to display a tomosynthesis image displayed in the image display area 1102 in a coronal section. The oblique section display button 1106 is a button for instructing to display the tomosynthesis image displayed in the image display area 1102 in the oblique section. The frame view button 1107 is a button for dividing the image display area 1102 into a plurality of grid-like display areas and switching to a frame view in which the frame images of the tomosynthesis image being previewed are displayed in parallel. During oblique section display, it becomes invalid and frame view display becomes impossible. The reconstruction method selection unit 1108 is a control that selects a reconstruction method such as an FBP (FILTER BACK PROJECTION) method or a shift addition method. The reconstruction filter type selection unit 1109 is a control that selects a filter type to be used when performing reconstruction processing. The reconstruction filter DC editing unit 1110 is a control for editing the DC parameter of the filter used when performing the reconstruction process. The cut-off frequency editing unit 1111 is a control for editing the cut-off frequency of the filter used when performing the reconstruction process. The tomographic pitch editing unit 1112 is a control for editing the thickness between frames when performing the reconstruction process. The slice number editing unit 1113 is a control for editing the total number of frames when the reconstruction process is performed. The noise reduction process editing unit 1114 is a control for switching whether to apply the noise reduction process when performing the reconstruction process, and a control for editing the degree of influence when applying the noise reduction process. The reconfiguration processing button 1115 is a button for instructing execution of the reconfiguration processing. Reconfiguration is performed again using the reconfiguration parameters that were entered when the button was pressed. At this time, the same projection image as the tomosynthesis image being previewed is used. The default setting button 1116 is a button for instructing to change the default reconstruction parameter of the tomosynthesis photographing technique during preview display. When the button is pressed, a reconstruction parameter change notification is transmitted from the imaging control unit 406 to the examination execution 407 together with the reconstruction parameter being displayed. The imaging control unit 123 updates the reconstruction parameter of the reconstruction parameter target tomosynthesis imaging technique, and transmits a “registration / update” processing request to the storage unit 403. The frame reproduction range setting unit 1117 is a control for designating a reproduction range at the time of range designation reciprocal reproduction. Consists of knobs for specifying the minimum frame number, center frame number, and maximum frame number. By moving each knob, the range from the specified minimum frame number to the maximum frame number is set as the playback range. An attention point button 1118 specifies an attention point passing through the oblique image. The WINDOW adjustment display button 1118 is a button for switching display / non-display of the WINDOW adjustment control. When the WINDOW adjustment display button 1118 is switched to ON, a WINDOW adjustment control is displayed in the display area of the 3D slider 1122. When the WINDOW adjustment display button 1118 is switched to OFF, the WINDOW adjustment control is hidden and the 3D slider 1122 is displayed. The reproduction process display button 1119 is a button for switching display / non-display of the reproduction process control. When the reproduction process display button 1119 is switched to ON, a reproduction process control is displayed in the 3D slider 1122 display area. When the playback processing display button 1119 is switched to OFF, the playback processing control is hidden and the 3D slider 1122 is displayed. The reconstruction cancel button 1120 is a button for instructing to discard the tomosynthesis image being previewed. When the reconfiguration cancellation is instructed, step S609 is completed without saving the tomosynthesis image and the image information, and the screen transitions to the shooting screen 1001. In the shooting screen 1001, the previewed image is continuously selected before the reconstruction screen is displayed. The reconstruction confirmation button 1121 is a button for instructing confirmation of saving the tomosynthesis image being previewed. When saving is instructed, the tomosynthesis image being previewed is saved in the HDD 505. Thereafter, step S608 is completed, and the screen transitions to the shooting screen 1001. The 3D slider 1122 is a control that performs pseudo 3D display of a frame of the generated tomosynthesis image and designates a display frame. On the 3D slider 1122, a ruled line that relatively indicates the positional relationship of the frames of each tomosynthesis image is displayed, and a reduced image is displayed at the position of the same frame number as the display frame image. The display frame can be easily switched by selecting a ruled line on the 3D slider 1122 or dragging with the mouse. Here, the ruled lines displayed on the 3D slider 1122 are displayed only for the valid frames of the tomosynthesis image. Also, in conjunction with the editing of the tomographic pitch and the number of slices, the frame of each tomosynthesis image frame after reconstruction processing is displayed. A preview is displayed with the positional relationship superimposed on the current state. Thereby, it becomes possible to easily grasp the change in thickness when the operator changes the tomographic pitch or the number of slices. A reconfiguration screen 1101 having the above configuration is displayed.

  The comparative observation button 1123 is a button for instructing a display for follow-up observation. In the description of the flowchart illustrated in FIG. 7, the determination as to whether or not the follow-up observation is performed is performed based on the imaging information or the like. However, in one embodiment, the follow-up observation is performed in response to pressing of the comparison observation button 1123. A comparison display screen 1511, which is a display screen for displaying, is displayed.

  Next, a reconstruction screen 1101 at the time of oblique section display displayed in step S609 or step S610 will be shown using FIG. When the oblique section display button 1106 is pressed, the section of the tomosynthesis image displayed in the image display area 1102 is switched from the coronal section to the oblique section. When the coronal section display button 1105 is pressed, the section of the tomosynthesis image displayed in the image display area 1102 is switched from the oblique section to the coronal section. During the oblique section display, the frame designation by the frame designation slider 1103 and the reproduction instruction from the reproduction processing unit 1901 are ignored. Also, the frame view button 1107 is disabled, and the frame view becomes impossible. During the oblique cross-section display, it changes to the normal 3D slider 1122, and includes an oblique slider 1201, a cross-section rotation button 1202, a vertical adjustment button 1203, and a horizontal adjustment button 1204 as a 3D slider for the oblique image. Also good.

  An oblique slider 1201 is displayed. The oblique angle is changed corresponding to the editing of the display angle of the frame image displayed on the oblique slider 1201. In conjunction with the oblique angle edited by the oblique slider 1201, the oblique angle of the tomosynthesis image previewed in the image display area 1102 is also changed. A reconstruction screen 1101 at the time of displaying an oblique section having the above configuration is displayed.

  When the section rotation button 1202 is pressed, the oblique slider 1201 is displayed, for example, in a state of being rotated 90 degrees around the vertical direction. FIG. 13 shows a display example of the oblique slider 1201 when the section rotation button 1202 is pressed. In the oblique slider 1201 of FIG. 12, an X mark indicating the isocenter position is displayed on the side surface. In the oblique slider 1201 in FIG. 13, the isocenter position is the front. The section rotation button 1202 is an icon for changing the display form of an area for receiving an operation input for designating an oblique section, for example, indicating the relative positional relationship between an isocenter position or a reconstruction area and an oblique section to be displayed. It is an example. For example, in the example shown in FIG. 13, since the positional relationship between the oblique section and the isocenter is easy to see, it is suitable for an operation of adjusting the position of the oblique section while referring to the position of the isocenter. In this way, by changing the display form of the oblique slider 1201 in accordance with the purpose of adjustment, the operation of designating the oblique section becomes easy.

  On the reconstruction screen 1101, the oblique angle is changed in response to a change input of the display angle of the frame image by operating the vertical adjustment button 1203. In conjunction with the change of the oblique angle, the oblique angle of the tomosynthesis image previewed in the image display area 1102 is also changed. In addition, on the reconstruction screen 1101, the horizontal position of the oblique section is changed in response to a change input of the horizontal position of the frame image by operating the horizontal adjustment button 1204. In conjunction with the change in the horizontal position, the horizontal position of the oblique section of the tomosynthesis image displayed in the preview in the image display area 1102 is also changed. Here, the oblique angle of the tomosynthesis image is changed by the vertical adjustment button 1203, and the horizontal position of the tomosynthesis image is changed by the horizontal adjustment button 1204. The embodiment is not limited to this. In another embodiment, the oblique angle is changed by the horizontal adjustment button 1204, and the horizontal position of the oblique section is changed by the vertical adjustment button 1203.

  When the section rotation button 1202 is pressed, each time the oblique slider 1201 is pressed, the display angle is rotated by 90 degrees or less, for example, 15 degrees, 30 degrees, 45 degrees, 60 degrees, and 75 degrees. it can. When the section rotation button 1202 is pressed, the oblique slider 1201 is rotated and displayed. However, the present invention is not limited to this, and the change input by the vertical adjustment button 1203 and the change input by the horizontal adjustment button 1204 may be interchanged with the oblique angle and the horizontal position of the cross section. Alternatively, when the section rotation button 1202 is pressed, the oblique slider 1201 may rotate and display the display angle by 90 degrees. Furthermore, when the rotation center point is displayed in front of the oblique slider 1201, the vertical adjustment button 1203 may be used to input an oblique angle change input, and the horizontal adjustment button 1204 may be used to input a horizontal position change of the cross section. . On the other hand, when the rotation center point is displayed on the side surface of the oblique slider 1201, the vertical adjustment button 1203 can input the change of the horizontal position of the cross section, and the horizontal adjustment button 1204 can input the change of the oblique angle. It may be a method.

  FIG. 14 shows a comparison target selection screen 1401 for selecting past imaging information to be subjected to comparative observation and tomographic images related to the imaging information. The comparison target selection screen 1401 displays at least one piece of shooting information 1402. In the example of FIG. 14, two shooting information displays 1402 are displayed. In either case, the original imaging information and the subject are the same, and the imaging site is the same imaging information. In one embodiment, when the comparative observation button 1123 is pressed on the reconstruction screen 1101, selection of tomographic images (oblique cross-sections) of the same subject and the same part from the imaging information stored in the storage unit 403. A shooting information display 1402 for prompting is displayed. The shooting information display 1402 displays a selected state and a non-selected state. In the example shown in FIG. 14, a check mark is displayed in the check box at the left end of the shooting information display 1402 in the selected shooting information. The Note that in response to pressing of the comparative observation button 1123, the reconstruction display screen 1101 may transit to the comparison target selection screen 1506 shown in FIG. 15 or the comparison target selection screen 1510 shown in FIG.

  On the comparison target selection screen 1401 shown in FIG. 14, a confirmation button 1403 and a cancel button 1404 are displayed. When a cancel button 1403 is pressed in the shooting information display 1402, the screen changes to a reconstruction display screen 1101. When the confirmation button 1403 is pressed in the shooting information display 1402, the screen shifts to a comparison display screen 1511 shown in FIG.

  FIG. 15 shows an example of a comparison target selection screen 1506, which is another example of a selection screen for selecting photographing information to be a follow-up display. Here, a tomographic image relating to, for example, past imaging (first tomosynthesis imaging) to be compared is displayed in the first area 1501, and imaging immediately after imaging (second tomosynthesis imaging, for example) is displayed in the second area 1502. ) Is displayed. The tomographic image displayed in the first area 1501 is a tomographic image selected from candidates for comparison tomographic images displayed below the first area 1501 and the second area 1502. For example, a tomographic image corresponding to imaging information selected in response to a user operation input is displayed with a frame in the area 1503. When a button 1504 is pressed, a tomographic image that cannot be displayed on the comparison display screen 1506 can be displayed.

  When a cancel button 1505 is pressed on the comparison target selection screen 1506 or 1510, if a comparison target tomographic image is not displayed in the first area 1501, the screen changes to the reconstruction screen 1101. On the other hand, when a past examination image is displayed on the past examination image display unit 1501, the display transitions to the comparison display screen 1511. The comparison target selection screens 1506 and 1510 are replaced with an area for selecting a comparison target in the image display area 1102 of the reconstruction screen 1101, and both a comparative observation button 1123 and a cancel button 1505 are displayed. When the comparison observation button 1123 is pressed, an area for selecting a comparison target is displayed, and when a cancel button 1505 is pressed, an area for selecting the comparison target is not displayed.

  FIG. 16 shows an example of a comparison target selection screen 1510, which is another example of a selection screen for selecting shooting information to be a follow-up display target. In this screen, the first area 1501 is displayed below the second area 1502, and the tomographic image candidates to be compared are displayed in the left area of the first area 1501 and the second area 1502 in a selectable manner. The

  In the above example, the operator can select the oblique section of the past examination by pressing the comparative observation button 1123. However, for example, the oblique section taken in the previous examination may be automatically selected and displayed. . Alternatively, the oblique cross section taken in the initial inspection may be selected and displayed.

  FIG. 17 is an example of a comparison display screen 1511 that is a display screen for follow-up observation according to the embodiment. In the comparison display screen, the first area 1501 and the second area 1502 in the comparison target selection screen 1506 shown in FIG. 15 are displayed instead of the image display area 1102 in FIG. In such a display screen, the display control unit 124 obtains a first tomographic image group obtained in the first tomosynthesis image and displayed in the first area 1501, and a second tomosynthesis image obtained in the second area 1502. The second tomographic image group to be displayed is displayed on the display unit in an interlocked manner while maintaining the cross-sectional correspondence. For example, when coronal sections are displayed in the first region 1501 and the second region 1502, depending on the relationship between the slice pitch of the first tomographic image group and the slice pitch of the second tomographic image group, The corresponding cross section is displayed. When the slice pitch is 2: 1, the other display object is the Mth slice in response to changing one display object from the Nth slice to the adjacent slice (N + 1th slice). To the next adjacent slice (M + 2nd slice). Note that it is also possible to switch the display of only one area by releasing the display switching interlock. For example, a toggle button is displayed next to the comparative observation button 1123 on the comparison display screen 1511 and the toggle button is pressed or not. Can be non-interlocked. In non-interlocking display control, for example, when the first region 1501 is selected, the display of the first tomographic image group is switched according to the operation of the mouse wheel or the touch panel flick. Then, in a state where the second region 1502 is selected, display control is performed to switch the display of the second tomographic image group in accordance with the operation input. Alternatively, in the case of an operation input starting from the first area 1501, for example, a wheel operation with a flick or a mouse pointer placed, the display of the first tomographic image group is switched and the first area 1501 is set as the starting point. In the operation input, the display of the first tomographic image group is switched.

  In the example of FIG. 17, an example of comparison between oblique images is shown. Also in this case, the display control can be switched between interlocking and non-interlocking, as in the case of coronal sections. When the first area 1501 is selected and an oblique image is displayed in the first area, the 3D slider is displayed as an oblique slider 1507. On the other hand, when the second area 1502 is selected and the coronal image is displayed in the second area, the display of the 3D slider is the normal 3D slider 1122.

  The oblique slider 1507 displays a cross-sectional display corresponding to the first region 1501 and a cross-sectional display corresponding to the second region 1502. By making the cross-sectional display of the oblique slider 1507 correspond to the display forms of the frames of the first and second regions, the correspondence between each oblique image and the cross-sectional display can be easily understood.

  Note that comparative display in which an oblique image is displayed in one area 1501 and 1502 and a coronal image is displayed in the other area is also possible. In this case, an oblique image is manipulated when the first region 1501 is selected, and a coronal image is manipulated when the second region 1502 is selected. Since the display of the coronal image and the oblique image can be switched for each region, it is useful when the photographing system is shifted between the two photographings.

  Note that the display control in the case of non-interlocking is also used to specify the corresponding cross section.

  The fit button 1701 is an icon for instructing processing in which the shapes of the oblique images displayed in the first and second regions 1501 and 1502 match each other, and is a so-called toggle button, for example. When the fit button 1701 is pressed, the shape of at least one of the oblique images is corrected by the image processing unit 110. The three-dimensional reconstruction image in tomosynthesis imaging is a rectangular parallelepiped, but the three-dimensional region projected from the X-ray generator 102 to the X-ray detector 106 is a square pyramid. Therefore, the effective area of the oblique section reconstructed by the filtered back projection method becomes trapezoidal because it narrows as it goes upward from the bottom surface. Furthermore, the trapezoidal shape of the effective area of the oblique section varies depending on the oblique angle.

  In response to pressing of the fit button 1701 provided on the comparison display screen 1511, the effective area of the oblique section displayed in the second area 1502 by the image processing unit 110 is the oblique displayed in the first area 1501. The shape is changed to the shape of the effective area of the cross section.

  FIG. 18 shows a display screen when the fit button 1701 is pressed. In this example, the oblique image displayed in the second area 1502 is deformed and displayed in accordance with the oblique image displayed in the first area 1501.

  Next, the oblique slider 1507 according to the embodiment will be described based on the display content shown in FIG. By pressing the comparison observation button 1123 on the reconstruction screen 1101, the operator selects the oblique section of the past examination, and the display of the oblique slider 1201 on the comparison display screen 1511 transitions to the oblique slider 1507. The oblique slider 1507 displays a frame image 2001 related to the current shooting (second tomosynthesis shooting) and at least one frame image 2002 related to the first tomosynthesis shooting. Furthermore, the vertical adjustment button 1203 or the horizontal adjustment button 1204 described above with reference to FIG. 15 and the cross-section rotation button 1202 may be displayed. When the section rotation button 1202 is pressed, the oblique slider 1507 is rotated and displayed at an angle of 90 degrees or less, for example, 15 degrees, 30 degrees, 45 degrees, 60 degrees, and 75 degrees each time the section slider is pressed. .

  The oblique slider 2003 in FIG. 19 is obtained by rotating the oblique slider 1507, for example, by 90 degrees. When the section rotation button 1202 is pressed, the oblique slider 1507 is displayed as the oblique slider 1507. Further, when the rotation center point is displayed in front of the oblique slider 1201, the vertical adjustment button 1203 can be used to input an oblique angle change input, and the horizontal adjustment button 1204 can be used to input a horizontal position change of the cross section. On the other hand, when the rotation center point is displayed on the side surface of the oblique slider 1201, the vertical adjustment button 1203 can input the change of the horizontal position of the cross section, and the horizontal adjustment button 1204 can input the change of the oblique angle. It may be a method. For example, when the oblique angle is changed by a change input using the vertical adjustment button 1203, the angle at which the current inspection frame image 2001 forms the bottom surface around the rotation center in the oblique slider 1507 changes. When the section rotation button 1202 is pressed, it is displayed as an oblique slider 2003.

  On the other hand, when the horizontal position of the cross section is changed by, for example, a change input using the horizontal adjustment button 1204, the horizontal position of the cross section is changed in the oblique slider 1507 so that the current inspection frame image 2001 exceeds the rotation center as shown in FIG. Is done. When the section rotation button 1202 is pressed, it is displayed as an oblique slider 2003.

  The flow of processing according to another embodiment will be described with reference to the flowchart of FIG. In the present embodiment, it is determined whether or not the follow-up observation is performed before the second tomosynthesis imaging. The description common to the flowchart of FIG. 6 is omitted.

  In step S2101, the determination unit 125 determines whether the selected shooting technique is a shooting technique for follow-up observation according to the selection of the shooting technique (S604). The imaging technique here includes, for example, information on the imaging region, imaging direction, and imaging method (simple imaging, fluoroscopy, DSA, etc.) of the imaging information described in the above-described embodiment, without including information about the subject. including. The information on the follow-up observation ID can be included in the information on the photographing technique. In the determination processing in step S2101, it is determined whether or not the photographing technique is related to the follow-up observation, for example, based on whether or not the follow-up observation ID is included in the photographing technique information. If it is determined that it is follow-up observation, the process proceeds to step S2102.

  In step S2102, the specifying unit 404 specifies a tomographic image to be compared. Here, the tomographic image is specified by the same processing as in step S703 described above.

  In the above-described embodiment, an imaging apparatus that performs tomosynthesis imaging using X-rays has been described. However, the imaging apparatus may be used for an apparatus that performs tomography using radiation other than X-rays or tomography using a medium other than radiation.

  The imaging control device 107 in the above-described embodiment is a single device, but in another embodiment, this is a control system including a plurality of information processing devices. In this case, each of the plurality of information processing apparatuses has a communication circuit, and can communicate with each other by the communication circuit. One of the plurality of information processing apparatuses can function as the image processing unit 110, and another apparatus can function as the imaging control unit 123. The plurality of information processing apparatuses need only be able to communicate at a predetermined communication rate, and do not need to exist in the same hospital facility or in the same country. In such a control system, for example, the image processing unit 110 can be a server device or a server group common to a plurality of control systems.

  Alternatively, in the X-ray imaging system 101 shown in FIG. 1, some or all of the functions of the imaging control apparatus 107 may be performed by an X-ray imaging system 101 such as an X-ray detector 106 having an X-ray sensor and an X-ray control unit 104. It may be performed by other units. In this case, the above-described function of the imaging control device 107 is realized in the entire imaging system that performs tomosynthesis.

  The above-described processing may be applied to a radiographic image using radiation other than X-rays.

  In the embodiment of the present invention, a software program for realizing the functions of the above-described embodiments is supplied to a system or apparatus, and the computer of the system or apparatus reads and executes the supplied program code. Including the form. Further, based on instructions included in the read program, the OS or the like running on the computer performs part or all of the actual processing, and the functions of the above-described embodiments are also realized by the processing. obtain.

  Embodiments appropriately combining the above-described embodiments are also included in the embodiments of the present invention.

Claims (11)

A control device for tomosynthesis imaging using a radiation detector,
Acquisition means for acquiring a plurality of projection images obtained by first tomosynthesis imaging;
A designation means for designating an oblique image, which is a tomographic image of the subject obtained based on the projection image;
Determining means for determining whether the second tomosynthesis imaging is an imaging for follow-up from the first tomosynthesis imaging,
Based on the specified oblique image and the projection image obtained by the second tomosynthesis imaging according to at least one of the determination that the imaging is for the follow-up observation and the execution of the second tomosynthesis imaging Display control means for displaying a cross-sectional tomographic image corresponding to the oblique image on the display unit,
A control device comprising:   The control device according to claim 1, wherein the determination unit determines whether the shooting is for follow-up observation based on shooting information of the second tomosynthesis shooting.   2. The apparatus according to claim 1, further comprising a specifying unit that specifies a position and orientation of the designated oblique image that is a tomographic image of the first tomosynthesis imaging based on imaging information of the second tomosynthesis imaging. 2. The control device according to 2.   2. The apparatus according to claim 1, further comprising a specifying unit that specifies a cross section corresponding to the designated oblique image based on the imaging condition of the first tomosynthesis imaging and the imaging condition of the second tomosynthesis imaging. 4. The control device according to any one of items 1 to 3.   A projection image obtained by the second tomosynthesis imaging based on points corresponding to each of the first tomographic image obtained by the first tomosynthesis imaging and the second tomographic image obtained by the second tomosynthesis image. 4. The control device according to claim 1, further comprising a specifying unit that specifies a tomographic image based on the cross-section corresponding to the oblique image. 5.   The display control means links the first tomographic image obtained by the first tomosynthesis image and the second tomographic image obtained by the second tomosynthesis image while maintaining the cross-sectional correspondence. The control device according to claim 1, wherein the control device is displayed on a display unit. A control device for tomosynthesis imaging using a radiation detector,
A communication circuit for acquiring a plurality of projection images obtained by first tomosynthesis imaging;
A process for designating an oblique image that is a tomographic image of the subject obtained based on the projection image;
A process of determining whether the second tomosynthesis imaging is an imaging for follow-up from the first tomosynthesis imaging;
Based on the specified oblique image and the projection image obtained by the second tomosynthesis imaging according to at least one of the determination that the imaging is for the follow-up observation and the execution of the second tomosynthesis imaging A tomographic image and a cross-sectional tomographic image corresponding to the oblique image;
An arithmetic processing circuit for executing
A control device comprising: A radiation detector for obtaining a radiation image by a sensor for detecting radiation;
Designation means for designating an oblique image, which is a tomographic image of a subject obtained based on a plurality of projection images obtained from the radiation detector by first tomosynthesis imaging;
Determining means for determining whether the second tomosynthesis imaging is an imaging for follow-up from the first tomosynthesis imaging,
Based on the specified oblique image and the projection image obtained by the second tomosynthesis imaging according to at least one of the determination that the imaging is for the follow-up observation and the execution of the second tomosynthesis imaging Display control means for displaying a cross-sectional tomographic image corresponding to the oblique image on the display unit,
A radiation imaging system comprising: A control system for tomosynthesis imaging using a radiation detector,
Acquisition means for acquiring a plurality of projection images obtained by first tomosynthesis imaging;
A designation means for designating an oblique image, which is a tomographic image of the subject obtained based on the projection image;
Determining means for determining whether the second tomosynthesis imaging is an imaging for follow-up from the first tomosynthesis imaging,
Based on the specified oblique image and the projection image obtained by the second tomosynthesis imaging according to at least one of the determination that the imaging is for the follow-up observation and the execution of the second tomosynthesis imaging Display control means for displaying a cross-sectional tomographic image corresponding to the oblique image on the display unit,
A control system comprising: A method for controlling tomosynthesis imaging using a radiation detector,
Obtaining a plurality of projection images obtained by first tomosynthesis imaging;
Designating an oblique image, which is a tomographic image of the subject obtained based on the projection image;
Determining whether the second tomosynthesis imaging is an imaging for follow-up from the first tomosynthesis imaging;
Based on the specified oblique image and the projection image obtained by the second tomosynthesis imaging according to at least one of the determination that the imaging is for the follow-up observation and the execution of the second tomosynthesis imaging A tomographic image that is a tomographic image of a cross section corresponding to the oblique image, and displayed on the display unit;
A control method characterized by comprising:   A program for causing a computer to execute the control method according to claim 10.

Images