JP2017113050A - Medical image processing device, and control method and program thereof - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a mechanism to determine whether or not there is a blood vessel outside a tubular structure.SOLUTION: A medical image processing device capable of determining whether or not there is a blood vessel outside a tubular structure based on medical image data including at least the tubular structure specifies coordinates inside the tubular structure, acquires a profile curve indicating a signal value of a voxel on a straight line passing through the coordinates, and determines whether or not there is a blood vessel on the straight line based on the profile curve.SELECTED DRAWING: Figure 5

Description

  The present invention relates to a medical image processing apparatus capable of determining whether or not a blood vessel exists outside a tubular structure, a control method thereof, and a program.

  A doctor may acquire a tissue of a lesion (target) of a patient in order to perform a pathological examination or the like of the patient.

  Specifically, a doctor inserts an endoscope into a tubular structure such as a bronchus of a patient, and inserts an injection needle into the inner wall of the tubular structure, so that the outside of the tubular structure (for example, a lung field region). Acquiring the tissue of the lesion existing in

  When the needle is inserted into the target from the inside of the tubular structure, if the blood vessel is accidentally inserted, there is a danger to the patient, so the doctor avoids the blood vessel outside the tubular structure and extends the needle, and then inserts the needle. There is a need.

  The following Patent Document 1 discloses a mechanism capable of performing more efficient surgical navigation by displaying so that the positional relationship between the distal end of a surgical instrument and an organ, a blood vessel, and the like can be accurately recognized. .

JP 2011-135937 A

  Patent Document 1 includes an organ and the like as a virtual three-dimensional surgical instrument image based on a tomographic image acquired by an X-ray CT apparatus or a nuclear magnetic resonance image (MRI image) 3. Combining with a dimensional image is described.

  However, in order to know how the blood vessel travels outside the tubular structure when viewed from the inside of the tubular structure, an image displaying the inner wall of the tubular structure and the outside of the tubular structure are traveled. It was troublesome for the doctor to confirm each of the images for displaying the blood vessels.

  Therefore, there has been a demand for a method for simply judging whether or not there is a blood vessel outside the tubular structure as viewed from the inside of the tubular structure.

  Then, an object of this invention is to provide the mechanism which can determine whether there exists a blood vessel in the outer side of a tubular structure.

  In order to achieve the above object, the medical image processing apparatus of the present invention can determine whether a blood vessel exists outside the tubular structure based on medical image data including at least the tubular structure. The specifying means for specifying the first coordinates inside the tubular structure and the second coordinates of the lesioned part outside the tubular structure, the first coordinates specified by the specifying means, and the first coordinates An acquisition unit that acquires a signal value of a voxel on a straight line that passes through two coordinates, and determines whether or not there is a blood vessel on the straight line based on the signal value of the voxel on the straight line acquired by the acquisition unit And determining means for performing the processing.

  According to the present invention, it is possible to provide a mechanism capable of determining whether or not there is a blood vessel outside the tubular structure.

It is a figure which shows an example of the hardware constitutions of the medical image processing apparatus 100 in this embodiment. It is a figure which shows an example of a function structure of the medical image processing apparatus 100 in this embodiment. It is a flowchart for demonstrating the detailed process in 1st Embodiment. It is an example of the profile curve of CT value corresponding to the voxel on a straight line when the blood vessel close to the wall of a tubular structure does not exist. It is an example of the profile curve of CT value corresponding to the voxel on a straight line when the blood vessel close to the wall of a tubular structure exists. It is an image 600 for explaining the positional relationship between a lesioned part, a bronchus, and a blood vessel when there is no blood vessel on a straight line. It is a figure which shows the example of 700 A of screen examples on which a lesion part marker is displayed on a virtual endoscopic image, and the example of screen 700B where a danger marker is displayed on a virtual endoscopic image. It is a flowchart for demonstrating the detailed process in 2nd Embodiment.

  Preferred embodiments of the present invention will be described below with reference to the accompanying drawings. The embodiment described below shows an example when the present invention is specifically implemented, and is one of the specific examples of the configurations described in the claims.

[First Embodiment]
In this embodiment, a viewpoint is set inside a tubular structure based on volume data generated from an X-ray CT image (medical image) acquired by an X-ray CT (Computed Tomography) apparatus (medical image diagnostic apparatus), An example of an image processing apparatus that generates a two-dimensional image of a model viewed from the viewpoint by projection with the viewpoint as the projection center will be described. When a two-dimensional image is displayed, if there is a blood vessel between the lesioned part existing outside the tubular structure from the viewpoint position, the user is notified that there is a blood vessel. Note that the present invention is not limited to the X-ray CT image, and may be an image captured by another modality such as an MRI (Magnetic Resonance Imaging) apparatus as long as it can display the form of an organ.

  First, a hardware configuration example of the medical image processing apparatus 100 according to the present embodiment will be described with reference to the block diagram of FIG.

  The CPU 201 executes processing using computer programs and data stored in the RAM 202 and the ROM 203, thereby controlling the operation of the entire medical image processing apparatus 100, as well as each of which will be described later as what the medical image processing apparatus 100 performs. Execute or control processing.

  The RAM 202 has an area for storing computer programs and data loaded from the external memory 211, data received from the outside via the communication I / F controller 208, and the like. Further, the RAM 202 has a work area used when the CPU 201 executes various processes. Thus, the RAM 202 can provide various areas as appropriate.

  The ROM 203 stores setting data that does not require rewriting of the medical image processing apparatus 100, computer programs that do not require rewriting of the medical image processing apparatus 100, and the like.

  The input controller 205 notifies the CPU 201 of input from the input device 209. The input device 209 is configured by a user interface such as a keyboard and a mouse, and can input various instructions to the CPU 201 when operated by the user.

  The video controller 206 performs display control of the display 210. The display 210 is an example of a display device, and can display processing results by the CPU 201 using images, characters, and the like. Note that the input device 209 and the display 210 may be integrated to form a touch panel screen.

  The memory controller 207 controls reading and writing of computer programs and data with respect to the external memory 211. The external memory 211 is a mass information storage device such as a hard disk drive (HDD). The external memory 211 stores an OS (Operating System) and computer programs and data for causing the CPU 201 to execute or control each process described below as performed by the medical image processing apparatus 100. This data includes what is described as known information in the following description. Computer programs and data stored in the external memory 211 are appropriately loaded into the RAM 202 under the control of the CPU 201 and are processed by the CPU 201.

  The communication I / F controller 208 controls data communication with an external device.

  The CPU 201, RAM 202, ROM 203, input controller 205, video controller 206, memory controller 207, and communication I / F controller 208 are all connected to the system bus 204.

  Next, the functional configuration of the medical image processing apparatus 100 will be described with reference to FIG. The medical image processing apparatus 100 includes a specifying unit 2001, a storage unit 2002, an acquiring unit 2003, a blood vessel determining unit 2004, a display control unit 2005, a section specifying unit 2006, a distribution information acquiring unit 2007, and a lesion position acquiring unit 2008. The specifying unit 2001 specifies the coordinates inside the tubular structure. The storage unit 2002 stores medical image data including at least a tubular structure. The acquisition unit 2003 acquires a profile curve indicating a signal value of a voxel on a straight line passing through the specified coordinates. The blood vessel determination unit 2004 determines whether there is a blood vessel on a straight line based on the acquired profile curve. A display control unit 2005 displays a two-dimensional image generated based on medical image data. The section specifying unit 2006 specifies a section that exceeds the threshold of the profile curve. The distribution information acquisition unit 2007 acquires distribution information indicating the distribution state of the profile curve. The lesion position acquisition unit 2008 acquires coordinates indicating the position of the lesion part.

  This is the end of the description of the functional configuration of the medical image processing apparatus 100 illustrated in FIG.

  Next, the operation (function) of the medical image processing apparatus 100 will be described. In general, volume data of a subject can be generated from “a plurality of X-ray CT images of the whole body or part of the subject (patient)” captured by an X-ray CT (Computed Tomography) apparatus. As is well known, this volume data is composed of voxel groups, and each voxel is associated with a corresponding CT value (signal value). In the present embodiment, a virtual endoscopic image, which is a two-dimensional image viewed from a specified viewpoint, is generated and displayed on the inner wall model (inner wall model) of the tubular structure (bronchi) based on such volume data. . A process of generating a two-dimensional image of the inner wall model of the tubular structure by the medical image processing apparatus 100 will be described with reference to the flowchart of FIG. Although the flowchart of FIG. 3 describes the case where the tubular structure is a bronchus, even if the tubular structure is something other than the bronchi, for example, the stomach, the flowchart of FIG. 3 can be applied similarly. .

  In step S <b> 301, the CPU 201 of the medical image processing apparatus 100 acquires volume data (medical image data) in the external memory 211 or the RAM 202. The acquisition source of volume data is not limited to a specific acquisition source. For example, volume data is acquired from an external server device or storage device.

  In step S302, the CPU 201 of the medical image processing apparatus 100 sets a start point (corresponding to the viewpoint, first coordinate) inside the bronchus for observing the inner wall model of the bronchus (corresponding to a specifying unit). For example, the CPU 201 displays an image of an inner wall model of the bronchus or a body axis cross-sectional image on the display 210, and the user operates the input controller 205 while observing the displayed image to set a desired position on the screen of the display 210. The designated position may be designated as the viewpoint position. Of course, other setting methods may be adopted as the viewpoint setting method, and the three-dimensional position of the viewpoint may be designated. In any case, the position of the viewpoint is in the coordinate system of the volume data (or another coordinate system that can be converted into the coordinate system), and needs to be a coordinate existing inside the bronchus.

  The CPU 201 stores the start point position set by the user in the RAM 202 or the external memory 211. Note that the start point may be set without user operation, and a preset position may be set as a start point to be used later.

  In step S303, the CPU 201 of the medical image processing apparatus 100 uses the coordinate system of the volume data of the lesion part existing outside the bronchus (for example, the lesion part existing in the lung field region) (or another coordinate system that can be converted into the coordinate system). ) Is received (corresponding to the specifying means). Regarding the reception of the designation of the coordinate system (corresponding to the second coordinate), the designation may be received by the user in advance, or a desired position is selected on the screen of the display 210, and the designated position is determined as the lesion part. You may specify as the position of.

  In step S304, the CPU 201 of the medical image processing apparatus 100 starts with the position of the start point specified in step S302, and the CT corresponding to the voxel on the straight line passing through the end point of the lesion position specified in step S303. A profile curve, which is a graph in which values are arranged in order, is acquired (corresponding to acquisition means). An example of the acquired profile curve is the profile curve shown in FIG.

  In step S305, the CPU 201 of the medical image processing apparatus 100 determines whether there is a blood vessel outside the bronchus based on the profile curve shape acquired in step S304. This will be specifically described.

  As an example of the profile curve acquired in step S304, description will be made using two profile curves shown in FIGS. A section in which the CT value exceeds the threshold θ (for example, −800 HU) in the profile curve acquired in step S304 is specified. 4 and 5, the threshold θ is exceeded in a section from the position P1 (position when the start point position is 0) to the position P2 (position when the start point position is 0). That is, it can be determined that a bronchial wall or blood vessel exists between the start point and the end point of the straight line.

  Here, whether only the inner wall of the bronchus exists or whether the blood vessel exists so as to be close to the wall of the bronchus can be determined according to the distance of the section exceeding the threshold θ (−800 HU), Specifically, it can be determined whether or not the following relationship is satisfied. Let A be the distance from the start point to the position P1, and B be the distance from the start point to the position P2. At this time, if B> k × A (corresponding to a predetermined length) is satisfied, it is determined that a blood vessel close to the bronchial wall exists in the section from the start point to the end point of the target straight line 470, and B ≦ If k × A is satisfied, it is determined that there is no blood vessel close to the bronchial wall in the section from the start point to the end point of the target straight line 470. Here, k is an arbitrary constant, for example, approximately 3. According to this determination method, the profile curve shown in FIG. 4 is an example of a profile curve when there is no blood vessel on a straight line. On the other hand, the profile curve shown in FIG. 5 is an example of a profile curve when a blood vessel exists on a straight line.

  An example showing the positional relationship among a lesion (target), bronchi, and blood vessel is an image 600 (a) shown in FIG. The image 600 is an image diagram of a straight line 601 where a blood vessel (pulmonary artery) does not exist on a straight line from a viewpoint existing inside the bronchus to a lesion, and a straight line 602 where a blood vessel exists. In the case of the straight line 601, a profile curve as shown in FIG. 4 is obtained, and it can be determined that there is no blood vessel on the straight line by the shape of the profile curve. In the case of the straight line 602, a profile curve as shown in FIG. 5 is obtained, and it can be determined that a blood vessel exists. 4 and 5, the profile curve of the lesioned part where the CT value increases rapidly is not displayed. In addition, it is determined whether or not there is a blood vessel on a straight line including a point on a virtual lesion area obtained by expanding the lesion area by a predetermined distance and a start point (viewpoint) as in the image 600 (b). You may do it. In this case, since the straight line 611 of the image 600 (b) includes a blood vessel on the straight line, the user is notified that there is a blood vessel.

  Further, in the present embodiment, it is determined whether or not there is a blood vessel on a straight line connecting the position coordinates of the designated lesion area and the position coordinates of the start point. However, based on the position coordinates of the designated lesion area, three-dimensional A region of a typical lesion is determined, and it is determined whether or not there are blood vessels on a plurality of straight lines connecting the outer periphery of the region and the start point. You may determine that there is. Further, the position coordinates of the start point do not necessarily need to draw a straight line with respect to the lesion from one coordinate, but draw a plurality of straight lines with respect to the coordinates indicating the lesion from the points included in the outer periphery of the region including the start point. Thus, when it is determined that there is a blood vessel on one straight line, it may be determined that there is a blood vessel.

  In the present embodiment, it is determined whether or not there is a blood vessel on the straight line using the profile curve on the straight line. However, the line curve using the profile curve of the line segment between the two points of the start point and the lesioned part is used. It may be determined whether there is a blood vessel above.

  Needless to say, the method is not limited to the above method as long as it can be determined from the shape of the profile curve whether only the bronchial wall or a blood vessel is present close to the bronchial wall.

  If it is determined that there is no blood vessel close to the bronchial wall as a result of the blood vessel presence / absence determination on the selection target straight line, the process proceeds to step S306, and if it is determined that there is a blood vessel close to the bronchial wall. The process proceeds to step S307.

  In step S306, the CPU 201 of the medical image processing apparatus 100 temporarily stores in the RAM 202 that the profile curve acquired in step S304 is a profile curve indicating that there is no blood vessel.

  In step S307, the CPU 201 of the medical image processing apparatus 100 temporarily stores in the RAM 202 that the profile curve acquired in step S304 is a profile curve indicating that there is a blood vessel.

  In step S308, the CPU 201 of the medical image processing apparatus 100 uses a parameter stored in advance, and a virtual endoscope that is a two-dimensional image of the inner wall model of the bronchus viewed from the position of the start point specified in step S302. The image is generated by performing volume rendering, for example. Since a technique for generating an image of a virtual object viewed from a certain viewpoint is well known, a description thereof will be omitted. As the color of the inner wall model, for example, the color defined by the above parameters is assigned to the CT value of the voxel corresponding to the inner wall of the bronchus.

  In step S309, the CPU 201 of the medical image processing apparatus 100 displays the virtual endoscopic image generated in step S308 on the display 210.

  In step S310, the CPU 201 of the medical image processing apparatus 100 starts from the position of the start point specified in step S302 based on the information temporarily stored in step S306 or step S307, and the lesion part specified in step S303. It is determined whether or not there is a blood vessel on a straight line whose end point is. If it is determined that there is no blood vessel, the process proceeds to step S311. If it is determined that there is a blood vessel, the process proceeds to step S312.

  In step S <b> 311, the CPU 201 of the medical image processing apparatus 100 stores the coordinate position of the intersection of the bronchial inner wall model and the straight line in the RAM 202 or the external memory 211. A lesion marker 702 (corresponding to an annotation) indicating that a lesion exists is displayed at the coordinate position of the stored intersection. For example, the lesion marker 702 is displayed in white. For example, a virtual endoscopic image such as a screen example 700B shown in FIG. 7 is displayed. The screen example 700B displays a lesion marker 702 so that the position of the lesion existing outside the bronchus can be identified from the viewpoint existing inside the bronchus.

  In step S <b> 312, the CPU 201 of the medical image processing apparatus 100 stores the coordinate position of the intersection point of the inner wall model of the bronchus and the straight line in the RAM 202 or the external memory 211. A danger marker 701 is displayed at the stored coordinate position of the intersection to make it possible to identify that there is a blood vessel from the viewpoint to the lesion and that it is dangerous. For example, the lesioned part marker 702 is displayed in red, which is a different color from a normal lesioned part marker. For example, a virtual endoscopic image such as a screen example 700A shown in FIG. 7 is displayed. In the screen example 700A, a risk marker 701 is displayed that indicates the position of a lesioned part and that a blood vessel is present and dangerous when the needle is inserted into the lesioned part from the current viewpoint. By displaying in this way, the user can see the position of the lesion existing outside the bronchi at a glance, and there is a blood vessel when the needle is inserted into the lesion from the position of the viewpoint. It has the effect of knowing that it is dangerous. Accordingly, the user can take appropriate measures such as inserting a needle into the lesion from another viewpoint.

<Modification 1>
In the above embodiment, as shown in FIG. 7, when there is a blood vessel between the viewpoint and the lesioned part, the danger marker 701 is displayed on the display 210 at the position of the lesioned part visible from the viewpoint. However, if the user can be notified that there is a blood vessel between the viewpoint and the lesion, and it is dangerous to puncture the lesion from the position of the viewpoint, it is not limited to changing the color of the marker, Other methods, such as changing the blinking speed of the marker or alerting the user even if a pop-up screen is displayed on the virtual endoscopic image, may be used.

[Second Embodiment]
In the first embodiment, a graph in which CT values corresponding to voxels on a straight line starting from the position of the start point specified in step S302 and ending in the position of the lesion part specified in step S303 are arranged in order. The profile curve is acquired, and it is judged from the shape of the profile curve whether a blood vessel exists so as to be close to the bronchial wall.

  The present embodiment is a graph in which CT values corresponding to voxels on a straight line starting from the position of the starting point specified in step S302 and ending in the position of the lesioned part specified in step S303 are arranged in order. A profile curve is acquired, and it is determined from the kurtosis (corresponding to distribution information) of the profile curve whether a blood vessel exists so as to be close to the bronchial wall.

  That is, in the first embodiment, the process according to the flowchart of FIG. 3 is performed, but in the present embodiment, the process according to the flowchart of FIG. 8 is performed. Since the hardware configuration, functional configuration, screen example, and the like of the medical image processing apparatus 100 are the same as those in the first embodiment, description thereof will be omitted.

  The description of the flowchart of FIG.

  Steps S801 to S804 are the same as steps S301 to S304 in FIG. 3 of the first embodiment, and a description thereof will be omitted.

  In step S805, the CPU 201 of the medical image processing apparatus 100 obtains the kurtosis of the profile curve acquired in step S804. In calculating the kurtosis of a profile curve, the respective CT values included in the profile curve are used. Since the process for obtaining the kurtosis of data is well known, the description relating to this is omitted.

  In step S806, the CPU 201 of the medical image processing apparatus 100 determines whether there is a blood vessel on a straight line based on the kurtosis obtained in step S805. If it is determined that there is a blood vessel on the straight line, the process proceeds to step S807; otherwise, the process proceeds to step S808.

  Specifically, determination of the presence or absence of a blood vessel on a straight line based on kurtosis will be described. It is determined whether or not the kurtosis obtained in step S805 is greater than or equal to a threshold value. As a result of this determination, if the kurtosis is equal to or greater than the threshold, it is determined that there is no blood vessel close to the bronchial wall between the start point and the end point of the selection target straight line. It is determined that there is a blood vessel close to the bronchial wall between the start point and the end point of the selection target straight line.

  When the inner wall of the bronchus exists but the blood vessel does not exist between the start point and the end point of the selection target straight line, only the peak corresponding to the inner wall of the bronchus appears in the profile curve, so the kurtosis is equal to or greater than the threshold value. On the other hand, when the inner wall of the bronchus and the blood vessel exist side by side between the start point and the end point of the selection target straight line, the peak corresponding to the inner wall of the bronchus and the peak corresponding to the blood vessel appear side by side in the profile curve. The peak is extended and this causes the kurtosis to be below the threshold. Thus, in the present embodiment, the blood vessel presence / absence determination is performed based on the kurtosis of the profile curve. The threshold value may be an arbitrary value set in advance, or may be a value set by the user operating the input controller 205.

  Steps S807 to S813 are the same as steps S306 to S312 in FIG. 3 of the first embodiment, and thus description thereof is omitted.

  The description of the second embodiment shown in FIG. According to the second embodiment, CT values corresponding to voxels on a straight line starting from the position of the start point specified in step S302 and ending in the position of the lesion part specified in step S303 are sequentially arranged. It is possible to obtain a profile curve as a graph and determine whether a blood vessel is present so as to be close to the bronchial wall based on the kurtosis of the profile curve.

  As described above, according to the present invention, it is possible to provide a mechanism capable of determining whether or not there is a blood vessel outside the tubular structure.

  In the present embodiment, the CT value profile curve has been described as an example. However, as long as it is possible to determine whether or not there is a blood vessel on the straight line, anything can be used as long as the distribution state of the CT value on the straight line is known. For example, it may be determined whether there is a blood vessel close to the bronchial wall using a histogram indicating the frequency distribution of CT values.

  The present invention can be implemented as a system, apparatus, method, program, storage medium, or the like, and can be applied to a system including a plurality of devices. You may apply to the apparatus which consists of one apparatus. Note that the present invention includes a software program that implements the functions of the above-described embodiments directly or remotely from a system or apparatus. The present invention also includes a case where the information processing apparatus of the system or apparatus is achieved by reading and executing the supplied program code.

  Therefore, the program code itself installed in the information processing apparatus in order to realize the functional processing of the present invention with the information processing apparatus also realizes the present invention. That is, the present invention also includes a computer program for realizing the functional processing of the present invention.

  In that case, as long as it has the function of a program, it may be in the form of object code, a program executed by an interpreter, script data supplied to the OS, and the like.

  Examples of the recording medium for supplying the program include a flexible disk, hard disk, optical disk, magneto-optical disk, MO, CD-ROM, CD-R, and CD-RW. In addition, there are magnetic tape, nonvolatile memory card, ROM, DVD (DVD-ROM, DVD-R), and the like.

  As another program supply method, a browser on a client computer is used to connect to an Internet home page. The computer program itself of the present invention or a compressed file including an automatic installation function can be downloaded from the homepage by downloading it to a recording medium such as a hard disk.

  It can also be realized by dividing the program code constituting the program of the present invention into a plurality of files and downloading each file from a different homepage. That is, the present invention also includes a WWW server that allows a plurality of users to download a program file for realizing the functional processing of the present invention with an information processing apparatus.

  In addition, the program of the present invention is encrypted, stored in a storage medium such as a CD-ROM, distributed to users, and key information for decryption is downloaded from a homepage via the Internet to users who have cleared predetermined conditions. Let me. The downloaded key information can be used to execute the encrypted program and install it in the information processing apparatus.

  Further, the functions of the above-described embodiment are realized by the information processing apparatus executing the read program. In addition, based on the instructions of the program, the OS or the like operating on the information processing apparatus performs part or all of the actual processing, and the functions of the above-described embodiments can be realized by the processing.

  Further, the program read from the recording medium is written in a memory provided in a function expansion board inserted into the information processing apparatus or a function expansion unit connected to the information processing apparatus. Thereafter, the CPU of the function expansion board or function expansion unit performs part or all of the actual processing based on the instructions of the program, and the functions of the above-described embodiments are realized by the processing.

  The above-described embodiments are merely examples of implementation in carrying out the present invention, and the technical scope of the present invention should not be construed as being limited thereto. That is, the present invention can be implemented in various forms without departing from the technical idea or the main features thereof.

100 medical image processing apparatus 201 CPU
202 RAM
203 ROM
204 System Bus 205 Input Controller 206 Video Controller 207 Memory Controller 208 Communication I / F Controller 209 Keyboard 210 CRT Display 211 External Memory

Claims (10)

A medical image processing apparatus capable of determining whether a blood vessel is outside a tubular structure based on medical image data including at least the tubular structure,
A specifying means for specifying a first coordinate inside the tubular structure and a second coordinate of a lesion outside the tubular structure;
Obtaining means for obtaining a signal value of a voxel on a straight line passing through the first coordinate and the second coordinate specified by the specifying means;
A medical image processing apparatus comprising: determination means for determining whether or not there is a blood vessel on the straight line based on the signal value of the voxel on the straight line obtained by the obtaining means.   The medical image processing apparatus according to claim 1, wherein the determination unit determines whether there is a blood vessel on the straight line based on a profile curve obtained from a signal value of the voxel on the straight line. . The medical image processing apparatus further includes section specifying means for specifying a section that exceeds a threshold value of the profile curve acquired by the acquiring means,
The medical device according to claim 2, wherein the determination unit determines that there is a blood vessel on the straight line when the length of the section specified by the section specifying unit exceeds a predetermined length. Image processing device. The medical image processing apparatus further includes distribution information acquisition means for acquiring distribution information indicating a distribution state of the profile curve acquired by the acquisition means,
The determination means, based on the distribution information acquired by the distribution information acquisition means, if the distribution information is distribution information indicating a bias of a signal value greater than or equal to a predetermined value, there is no blood vessel on the straight line. The medical image processing apparatus according to claim 2, wherein the determination is performed. The distribution information is a value indicating kurtosis,
The medical image processing apparatus according to claim 4, wherein the determination unit determines that there is a blood vessel on the straight line when the kurtosis does not exceed a threshold value. The display control means for controlling to display a warning that there is a blood vessel on the straight line when the determination means determines that there is a blood vessel on the straight line. The medical image processing apparatus according to 5.   The display control means controls the display mode of the annotation displayed on the virtual endoscopic image of the tubular structure to display whether or not there is a blood vessel on the straight line. The medical image processing apparatus according to claim 6.   The medical image processing apparatus according to claim 7, wherein the first coordinate is a viewpoint position on a virtual endoscopic image of the tubular structure. A control method for a medical image processing apparatus capable of determining whether or not a blood vessel exists outside a tubular structure based on medical image data including at least the tubular structure,
The medical image processing apparatus comprises:
A specifying step of specifying a first coordinate inside the tubular structure and a second coordinate of a lesion outside the tubular structure;
An obtaining step of obtaining a signal value of a voxel on a straight line passing through the first coordinate and the second coordinate identified in the identifying step;
And a determination step of determining whether or not there is a blood vessel on the straight line based on the signal value of the voxel on the straight line acquired in the acquisition step. A program executable by a medical image processing apparatus capable of determining whether or not a blood vessel is outside a tubular structure based on medical image data including at least the tubular structure,
The medical image processing apparatus;
A specifying means for specifying a first coordinate inside the tubular structure and a second coordinate of a lesion outside the tubular structure;
Obtaining means for obtaining a signal value of a voxel on a straight line passing through the first coordinate and the second coordinate specified by the specifying means;
A program that functions as a determination unit that determines whether there is a blood vessel on the straight line based on the signal value of the voxel on the straight line acquired by the acquisition unit.

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