JP2017113540A - Mammography apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a mammography apparatus capable of supporting positioning.SOLUTION: The mammography apparatus includes an X-ray tube, an imaging stage, a pressing plate, a guide information generation unit and an X-ray detection unit. The X-ray tube generates X-rays. The imaging stage supports a breast. The pressing plate presses the breast supported on the imaging stage. The guide information generation unit generates, in the imaging stage, guide information for guiding a placement position of the breast, on the basis of a nipple position, an image start position and an image end position of a previous image relating to the breast. The X-ray detection unit generates X-ray projection data by detecting, by an X-ray detector, X-rays generated by the X-ray tube and transmitted through the breast.SELECTED DRAWING: Figure 5

Description

  Embodiments described herein relate generally to a mammography apparatus.

  The mammography apparatus is a standard image diagnostic apparatus used in breast image inspection. In the mammary gland image inspection, a mammographic image photographed by a mammography apparatus is used.

  Mammary gland image inspection is performed, for example, in breast cancer screening in which asymptomatic women are recommended to visit once a year or once every several years. The radiogram interpreter interprets the captured mammography image to confirm whether there are, for example, microcalcification, structural disorder, mass, and local non-objective shadow (FAD).

  Mammary gland imaging is also performed during follow-up on women with signs of breast cancer. A radiogram interpreter interprets, for example, a lesion and a region of interest (ROI) by interpreting a mammography image taken at the time of medical examination.

  By the way, a mammography image changes by positioning. Positioning affects, for example, how the breast is sandwiched by a compression plate provided in the mammography apparatus, that is, how the mammary gland is stretched. For this reason, the mammography image is changed, and the position of the lesion and the ROI is different from the position of the lesion and the ROI included in the mammography image captured in the past.

  If the position of the lesion and the ROI are changed, it is necessary to consider the difference in positioning when confirming the change with time from the mammography image taken in the past, and the interpretation efficiency is lowered.

Special table 2013-532001 gazette Japanese Patent No. 5551309 JP 2013-200398 A

  An object is to provide a mammography apparatus capable of supporting positioning.

  According to the embodiment, the mammography apparatus includes an X-ray tube, an imaging table, a compression plate, a guidance information generation unit, and an X-ray detection unit. The X-ray tube generates X-rays. The imaging table supports the breast. The compression plate compresses the breast supported by the imaging table. The guidance information generation unit generates guidance information for guiding the breast placement position in the imaging table based on a nipple position, an image start position, and an image end position in a past image related to the breast. The X-ray detection unit generates X-ray projection data by detecting an X-ray generated by the X-ray tube and passing through the breast with an X-ray detector.

FIG. 1 is a diagram illustrating a medical information system including a mammography apparatus according to the present embodiment. FIG. 2 is a diagram showing an appearance of the mammography apparatus shown in FIG. FIG. 3 is a diagram showing an MLO image displayed based on the image data transmitted from the mammography apparatus shown in FIG. FIG. 4 is a view showing a CC image displayed based on image data transmitted from the mammography apparatus shown in FIG. FIG. 5 is a block diagram showing a configuration of the mammography apparatus shown in FIG. FIG. 6 is a diagram showing guide light projected from the mammography apparatus shown in FIG. FIG. 7 is a diagram illustrating positioning when the guide light is projected onto the compression plate and the imaging stand. FIG. 8 is a diagram showing the configuration of the guide light generator shown in FIG. FIG. 9 is a diagram showing an MLO image displayed on the display circuit shown in FIG. FIG. 10 is a diagram showing a CC image displayed on the display circuit shown in FIG. FIG. 11 is a diagram illustrating a flowchart when the system control unit illustrated in FIG. 5 generates guide light in the guide light generation unit. FIG. 12 is a diagram showing another configuration of the guide light generator shown in FIG. FIG. 13 is a diagram showing another configuration of the guide light generating unit shown in FIG. FIG. 14 is a diagram showing another example of the MLO image displayed on the display circuit shown in FIG. FIG. 15 is a diagram showing another example of the MLO image displayed on the display circuit shown in FIG. FIG. 16 is a diagram showing another example of the MLO image displayed on the display circuit shown in FIG. FIG. 17 is a diagram showing another example of the MLO image displayed on the display circuit shown in FIG. FIG. 18 is a diagram showing another example of the mammography apparatus shown in FIG. FIG. 19 is a diagram illustrating an appearance of a mammography apparatus according to a modification. FIG. 20 is a diagram showing a projection image projected from the mammography apparatus shown in FIG. FIG. 21 is a diagram illustrating the positioning when the projected image is projected onto the compression plate and the imaging stand.

  Hereinafter, embodiments will be described with reference to the drawings.

    FIG. 1 is a schematic diagram showing a medical information system including a mammography apparatus 10 according to the present embodiment. The medical information system shown in FIG. 1 includes a mammography apparatus 10, a HIS (Hospital Information System) server 21, an RIS (Radiology Information System) server 31, an RIS terminal 32, an image server 41, a report server 42, a viewer 43, and a PC terminal 50. It comprises. The mammography apparatus 10, the HIS (Hospital Information System) server 21, the RIS (Radiology Information System) server 31, the RIS terminal 32, the image server 41, the report server 42, the viewer 43, and the PC terminal 50 are connected to a local network, Information is transmitted to a device and information transmitted from a predetermined device is received. The medical information system may be connected to an external network in addition to the local network or instead of the local network.

  In FIG. 1, a HIS server 21 is a server that constitutes a hospital information system (HIS). The RIS server 31 and the RIS terminal 32 are a part of elements constituting the radiation department information management system (RIS). The image server 41, the report server 42, and the viewer 43 are a part of elements constituting a picture management system (PACS: Picture Archiving and Communication System).

  The HIS server 21 electronically manages hospital information in the HIS. The information in the hospital includes medical information, patient information, order information, and the like.

  Here, the medical treatment information includes information related to the electronic medical record such as finding information, disease name information, vital information, and examination stage information. The patient information includes patient ID, patient name, sex, age, and the like. The order information is information for requesting a specimen test, a physiological test, a mammary gland image test, a prescription, a medication, and the like by a doctor. In the description of the present embodiment, the order information is described as information for requesting execution of a mammary gland image inspection. At this time, the order information includes, for example, request source information including a medical department name and a doctor name, a patient ID, and information indicating that a mammography image is captured.

  An example of the operation of the HIS server 21 will be specifically described. The HIS server 21 receives a request for providing recorded medical information from the PC terminal 50 used by medical staff such as doctors and nurses. The HIS server 21 provides medical information to the PC terminal 50 in response to a request.

  Further, the HIS server 21 receives order information instructing to perform a mammary gland image examination from the PC terminal 50. When the order information is input, the HIS server 21 outputs the input order information and the patient information of the patient specified by the order information to the RIS server 31.

  Further, the HIS server 21 receives the examination execution information transmitted from the RIS server 31. The examination execution information is transmitted from the RIS server 31 when a mammary gland image examination is carried out using the mammography apparatus 10. The HIS server 21 updates the medical information based on the examination execution information.

  The RIS server 31 manages information related to radiation examination work in the RIS. The information related to the radiation examination work includes patient information, order information, image data, and the like. The image data includes information about mammography images captured in the past by the mammography apparatus 10. The mammography image includes nipple position information indicating the nipple position of the breast on the image, image start position information indicating the start position of the breast outline on the image, image end position information indicating the end position of the breast outline on the image, ROI ( Region of Interest: ROI information indicating the position of a region of interest) and imaging conditions at the time of imaging are associated with each other.

  The positions of the nipple position, the image start position, and the image end position are calculated by, for example, image processing after imaging. The calculated nipple position, image start position, and image end position correspond to the coordinates on the X-ray detector 171.

  The imaging conditions include, for example, the height of the imaging table 13 of the mammography apparatus 10 shown in FIG. 2, the rotation angle of the X-ray output unit 16, the compression pressure by the compression plate 14, and , Shooting direction, and the like. Note that the compression thickness may be used as one of the imaging conditions instead of the compression pressure. The compression thickness means the distance between the compression plate 14 and the support surface 131 of the imaging table 13, in other words, the thickness of the breast. Examples of the imaging direction include a head-to-tail direction (CranioCaudal projection: CC) and an inside / outside oblique direction (MedioLateral Oblique projection: MLO). Note that in the case of shooting by a shooting method using a specific shooting direction, information regarding the shooting method may be used as information regarding the shooting direction. Hereinafter, the mammography image in the MLO direction is referred to as an MLO image, and the mammography image in the CC direction is referred to as a CC image.

  3 and 4 are diagrams showing examples of images displayed based on the image data according to the present embodiment. FIG. 3 is a diagram in which the nipple position P1mlo, the image start position P2mlo, the image end position P3mlo, and an instruction point representing the ROI are superimposed on the MLO image. FIG. 4 is a diagram in which an instruction point representing the nipple position P1cc, the image start position P2cc, the image end position P3cc, and the ROI is superimposed on the CC image.

  The image data is managed by PACS in accordance with, for example, DICOM (Digital Imaging and Communication Medicine) standard. At this time, the mammography image is stored in the value field in the image data, and the nipple position information, the image start position information, the image end position information, the ROI information, the imaging conditions, and the like are stored in the private tag in the image data. Note that the method of associating the mammographic image with the nipple position information, image start position information, image end position information, ROI information, and imaging conditions is not limited to this. For example, nipple position information, image start position information, image end position information, ROI information, imaging conditions, and the like may be managed as individual parameter data and associated with image data in which a mammography image is stored.

  An example of the operation of the RIS server 31 will be specifically described. When receiving the patient information and the order information from the HIS server 21, the RIS server 31 acquires the image data associated with the patient specified by the patient information from the image server 41. The RIS server 31 reads the nipple position information, the image start position information, the image end position information, the ROI information, the imaging conditions, and the like written in the private tag of the acquired image data.

  Further, the RIS server 31 accepts a radiological examination request based on the order information from the RIS terminal 32. The RIS server 31 refers to the radiation examination request, the nipple position information, the image start position information, the image end position information, the ROI information, the imaging conditions, and the like, and creates an imaging order related to imaging of the subject. The imaging order includes, for example, request source information including a medical department name and a doctor name, patient ID, imaging site, radiation intensity, imaging date and time, radiologist name, nipple position, image start position, image end position, ROI, and imaging Conditions are included. The RIS server 31 transmits the patient information and the imaging order to the mammography apparatus 10.

  Further, the RIS server 31 receives the examination execution information transmitted from the mammography apparatus 10. The RIS server 31 transmits the received inspection execution information to the HIS server 21.

  The mammography apparatus 10 performs a mammary gland image examination based on the patient information and the imaging order transmitted from the RIS server 31. The mammography apparatus 10 irradiates a subject's breast with X-rays, detects X-rays transmitted through the breast, and generates a mammography image. The mammography apparatus 10 outputs the generated mammography image to the image server 41.

  The image server 41 stores the mammography image generated by the mammography apparatus 10 and outputs the stored mammography image in response to a request. The viewer 43 displays a mammography image stored in the image server 41 and causes an image interpreter to create an interpretation report for the displayed mammography image. The report server 42 stores the created interpretation report, and outputs the stored interpretation report in response to a request.

  FIG. 2 is a schematic diagram showing an appearance of the mammography apparatus 10 according to the present embodiment. FIG. 5 is a block diagram illustrating a configuration example of the mammography apparatus 10 according to the present embodiment.

  The mammography apparatus 10 has a base 11 and a stand 12 as shown in FIG. The stand 12 is erected on the base 11 and supports the imaging table 13, the compression plate 14, the guide light generation unit 15, the X-ray output unit 16, and the X-ray detection unit 17. At this time, the imaging table 13, the compression plate 14, and the X-ray detection unit 17 are supported so as to be movable in the vertical direction. The imaging table 13, the compression plate 14, the guide light generation unit 15, the X-ray output unit 16, and the X-ray detection unit 17 are supported to be rotatable with respect to the support shaft 121.

  The imaging table 13 is a table that supports the breast B of the subject, and has a support surface 131 on which the breast B is placed.

  The compression plate 14 is formed of a transparent member, for example, an acrylic plate. The compression plate 14 is disposed above the imaging table 13, and is provided so as to be opposed to the imaging table 13 in parallel and to move in a direction in which the imaging plate 13 is in contact with or separated from the imaging table 13. The compression plate 14 compresses the breast B supported on the support surface 131 when it moves in a direction approaching the imaging table 13. The breast B compressed by the compression plate 14 is thinly spread and the overlap of the mammary glands within the breast B is reduced.

  The guide light generator 15 is an example of a guide information generator that generates guide information, and is provided in the vicinity of the X-ray output unit 16. The guide light generator 15 projects guide light corresponding to the outer shape of the breast B onto the compression plate 14 as an example of guidance information. The guide light passes through the transparent compression plate 14 and is also applied to the support surface 131 of the imaging table 13.

  The guide light is, for example, visible light that illuminates positions on the support surface 131 corresponding to the nipple position, the image start position, and the image end position. For example, the guide light is projected onto the compression plate 14 as shown in FIG. When the guide plate 13 is irradiated with guide light through the compression plate 14, it is desirable that the guide light travel straight so that the guide light is not refracted by the compression plate 14. As shown in FIG. 7, the photographer adjusts the positioning so that the nipple of the breast B is aligned with P1 irradiated on the support surface 131, and the beginning portion of the breast B is aligned with P2 and P3.

The X-ray output unit 16 emits X-rays to the breast B compressed by the compression plate 14.
The X-ray detection unit 17 detects X-rays that have passed through the breast B, and generates X-ray projection data based on the detected X-rays.

  As shown in FIG. 5, the mammography apparatus 10 includes an input interface circuit 181, a lift drive unit 182, a rotation drive unit 183, a high voltage generation circuit 184, an image processing circuit 185, an image storage circuit 186, a display circuit 187, A communication interface circuit 188, a storage circuit 189, and a system control circuit 1810 are provided.

  The input interface circuit 181 includes, for example, a mouse, a keyboard, buttons, panel switches, a touch command screen, a trackball, and a joystick. The input interface circuit 181 is connected to the system control circuit 1810, and takes in various instructions / commands / information input from the photographer into the system control circuit 1810. In the present embodiment, the input interface circuit 181 is not limited to one provided with physical operation components such as a mouse and a keyboard. For example, an electric signal processing circuit that receives an electric signal corresponding to an operation instruction input from an external input device provided separately from the mammography apparatus 10 and outputs the electric signal to the system control circuit 1810 is also an input interface. An example of the circuit 181 is included.

  The elevating drive unit 182 is realized by, for example, a gear, a stepping motor, a belt conveyor, a lead screw, and the like, and is connected to the imaging table 13 and the compression plate 14. The elevating drive unit 182 moves the photographic stand 13 according to the position information of the photographic stand 13 output from the system control circuit 1810. The lift drive unit 182 moves the compression plate 14 according to the position information of the compression plate 14 output from the system control circuit 1810.

  The rotation drive unit 183 is realized by, for example, a gear, a stepping motor, a belt conveyor, a lead screw, and the like, and is connected to the support shaft 121. The rotation drive unit 183 rotates the support shaft 121 according to the rotation angle information of the support shaft 121 output from the system control circuit 1810.

  The guide light generator 15 includes a projector 151 and a reflecting mirror 152. FIG. 8 is a schematic diagram illustrating a configuration example of the guide light generation unit 15 according to the present embodiment. The projector 151 is an example of a light source and irradiates the reflecting mirror 152 with visible light according to the irradiation pattern output from the system control circuit 1810. The irradiation pattern is information including coordinate information and pixel information for irradiating visible light onto a region on the support surface 131 corresponding to the nipple position, the image start position, and the image end position. The visible light emitted from the projector 151 may have the same color at the nipple position, the image start position, and the image end position, or may have different colors. The reflecting mirror 152 reflects visible light emitted from the projector 151 in the directivity direction indicated by the system control circuit 1810.

  The X-ray output unit 16 includes an X-ray tube 161 and an X-ray restrictor 162. The high voltage generation circuit 184 is connected to the X-ray tube 161. The high voltage generation circuit 184 supplies the X-ray tube 161 with a voltage having an intensity indicated by the system control circuit 1810. The X-ray tube 161 generates X-rays using the high voltage supplied from the high voltage generation circuit 184. The X-ray restrictor 162 is disposed between the X-ray tube 161 and the compression plate 14. The X-ray diaphragm 162 controls the irradiation range of X-rays generated by the X-ray tube 161 in accordance with an instruction from the system control circuit 1810.

  The X-ray detection unit 17 includes an X-ray detector 171 and a signal processing circuit 172. The X-ray detector 171 detects X-rays transmitted through the breast B and the imaging table 13 and converts them into electrical signals (transmitted X-ray data). The signal processing circuit 172 generates X-ray projection data from the electrical signal converted by the X-ray detector 171.

  The image processing circuit 185 is a processor that implements a predetermined function by reading an operation program from the storage circuit 189 and executing the read program. The image processing circuit 185 generates a mammography image based on the X-ray projection data generated by the signal processing circuit 172. Thereby, an MLO image or a CC image is generated.

  The image processing circuit 185 analyzes the generated MLO image, and acquires a nipple position P1mlo, an image start position P2mlo, and an image end position P3mlo in the MLO image.

Specifically, the image processing circuit 185 extracts the nipple position P1mlo from the MLO image. The image processing circuit 185 sets the _{X_MLO} axis, the _{Y_MLO} axis, and the origin on the X-ray detector 171 in the MLO image. For example, the image processing circuit 185 sets the vertex corresponding to the upper side of the breast among the two vertices arranged on the subject side among the four vertices of the rectangular detection surface of the X-ray detector 171 as the origin. Set as. Further, the image processing circuit 185 detects the skin surface _{S_MLO} depicted in the MLO image. Here, as a method for detecting the skin surface _{S_MLO} , various generally known image detection methods can be used.

Then, the image the image processing circuit 185, and _{S _MLO detected, X _MLO axis, Y _MLO} axis, or of the maximum value and the two points in contact on the _{Y _MLO} axis set in advance, a point closer to the origin A start position P2mlo is set, and a point far from the origin is set as an image end position P3mlo. Note that the image processing circuit 185 may receive an operation for designating each of the image start position P2mlo and the image end position P3mlo on the MLO image from the photographer, and set each point based on the operation.

  In addition, the image processing circuit 185 analyzes the generated CC image, and acquires a nipple position P1cc, an image start position P2cc, and an image end position P3cc in the CC image.

Specifically, the image processing circuit 185 extracts the nipple position P1cc from the CC image. Further, the image processing circuit 185 sets the _{X_CC} axis, the _{Y_CC} axis, and the origin on the X-ray detector 171 in the CC image. For example, the image processing circuit 185 sets the vertex corresponding to the outside of the breast among the two vertices arranged on the subject side among the four vertices of the rectangular detection surface of the X-ray detector 171 as the origin. Set as. Further, the image processing circuit 185 detects the skin surface _{S_CC} depicted in the CC image. Here, as a method for detecting the skin surface S _{_CC} may like the detection of the skin surface S _{_MLO,} using commonly known various image detection method.

Then, the image processing circuit 185 sets, as the image start position P2cc, the point closer to the origin among the two points where the detected _{S_CC} and _{X_CC} axes are in contact with each other and the image end position P3cc as the image end position P3cc. To do. The image processing circuit 185 may receive an operation for designating the positions of the image start position P2cc and the image end position P3cc on the CC image from the photographer, and set each point based on the operation.

  The image processing circuit 185 superimposes the generated MLO image on the display circuit 187 by superimposing an instruction point indicating the nipple position P1mlo, an instruction point indicating the image start position P2mlo, and an instruction point indicating the image end position P3mlo on the MLO image. Display. The image processing circuit 185 also superimposes the generated CC image on the CC image with an instruction point indicating the nipple position P1cc, an instruction point indicating the image start position P2cc, and an instruction point indicating the image end position P3cc. 187 is displayed. 9 shows an example of an MLO image displayed on the display circuit 187, and FIG. 10 shows an example of a CC image displayed on the display circuit 187.

  The image processing circuit 185 sets an ROI for the mammography image. Specifically, the image processing circuit 185 photographs an operation of designating a range of an arbitrary size at an arbitrary position on the MLO image and the CC image displayed on the display circuit 187 via the input interface circuit 181. Accept from the person. The image processing circuit 185 sets the range designated by the photographer as the ROI.

  For example, the image processing circuit 185 automatically detects and detects a candidate region of a lesion part and / or a region having a high mammary gland density from a mammography image by using a computer-aided diagnosis (CAD) function. The region that has been set may be set as the ROI.

  The image processing circuit 185 converts the generated MLO image into image data in a format compliant with the DICOM standard. Specifically, the image processing circuit 185 stores the MLO image in the value field of the image data. Further, the image processing circuit 185 receives imaging conditions for the generated MLO image from the system control circuit 1810, receives the imaging conditions, information that can identify the patient such as a patient ID, nipple position information regarding the nipple position P1mlo, The image start position information regarding the image start position P2mlo, the image end position information regarding the image end position P3mlo, and the ROI information regarding the position of the ROI are written into the private tag of the image data. The image processing circuit 185 stores the image data in the image storage circuit 186.

  Further, the image processing circuit 185 converts the generated CC image into image data in a format conforming to the DICOM standard. Specifically, the image processing circuit 185 stores the CC image in the value field of the image data. In addition, the image processing circuit 185 receives the imaging conditions for the generated CC image from the system control circuit 1810, receives the imaging conditions, information that can identify the patient such as a patient ID, nipple position information regarding the nipple position P1cc, The image start position information regarding the image start position P2cc, the image end position information regarding the image end position P3cc, and the ROI information regarding the position of the ROI are written into the private tag of the image data. The image processing circuit 185 stores the image data in the image storage circuit 186.

  The communication interface circuit 188 transmits a signal to another device via a network and receives a signal transmitted from the other device. For example, the communication interface circuit 188 receives the patient information and the imaging order transmitted from the RIS server 31 via the network. Further, the communication interface circuit 188 transmits the image data stored in the image storage circuit 186 to the image server 41 via the network in accordance with an instruction from the system control circuit 1810. Further, the communication interface circuit 188 transmits inspection execution information to the RIS server 31 via the network in accordance with an instruction from the system control circuit 1810.

  The memory circuit 189 includes a memory that stores electrical information, a memory controller associated with the memory, and peripheral circuits such as an interface. The memory includes, for example, a magnetic or optical recording medium or a recording medium readable by a processor such as a semiconductor memory. The storage circuit 189 stores an operation program executed by the mammography apparatus 10. The storage circuit 189 reads the stored operation program in response to a request from a processor provided in the mammography apparatus 10.

  The storage circuit 189 stores patient information received by the communication interface circuit 188 and information included in the imaging order. The storage circuit 189 reads stored information in response to a request from the system control circuit 1810.

  In addition, the storage circuit 189 stores the height of the imaging table 13, the rotation angle of the X-ray output unit 16, the compression pressure by the compression plate 14, and the like set when imaging a mammography image as new imaging conditions.

  The system control circuit 1810 is a processor that reads the operation program from the storage circuit 189 and controls the operation of the entire mammography apparatus 10 by executing the read program. A specific operation of the system control circuit 1810 will be described with reference to FIG. FIG. 11 is a diagram illustrating an example of a flowchart representing the operation of the system control circuit 1810 according to the present embodiment when a mammography image is taken.

  The system control circuit 1810 receives subject information for specifying the subject to be examined from the input interface circuit 181 (step S111). The input of the subject information in the input interface circuit 181 includes, for example, input of a patient ID or selection of a subject from the examination reservation list. When receiving the subject information, the system control circuit 1810 reads past (previous) examination information about the subject specified by the subject information from the storage circuit 189 (step S112). Thereby, the nipple position information, image start position information, image end position information, ROI information, and imaging conditions in the previous examination are read out.

  The system control circuit 1810 receives an input regarding the imaging direction such as the MLO direction or the CC direction from the input interface circuit 181 (step S113).

  Based on the read nipple position information, image start position information, image end position information, and ROI information, the system control circuit 1810 has a predetermined size to the nipple position, image start position, image end position, and ROI corresponding to the shooting direction. The irradiation pattern for the projector 151 and the directivity direction of the reflecting mirror 152 are calculated so that visible light is irradiated. The system control circuit 1810 transmits the irradiation pattern to the projector 151 and instructs the reflecting mirror 152 in the direction of directivity. Thereby, based on the mammography image imaged in the past about the subject, the guide light corresponding to the external shape of the breast of the subject is projected from the guide light generation unit 15 to the compression plate 14 and the imaging table 13 ( Step S114).

  The system control circuit 1810 displays the read imaging conditions on the display circuit 187, and accepts input of imaging conditions in the current examination (step S115). Here, the imaging conditions to be displayed are, for example, the height of the imaging table 13, the rotation angle of the X-ray output unit 16, and the compression pressure by the compression plate 14. The imaging conditions for receiving the input are, for example, the height of the imaging table 13, the rotation angle of the X-ray output unit 16, and the compression pressure by the compression plate 14.

  Specifically, the photographer refers to the displayed information and the projected guide light, and adjusts the standing position of the subject and the placement position of the breast. Further, the photographer refers to the displayed information and the projected guide light, and adjusts the height of the imaging table 13 and the rotation angle of the X-ray output unit 16 from the input interface circuit 181. The photographer inputs the compression pressure by the compression plate 14 with reference to the displayed information. The system control circuit 1810 outputs position information based on the height of the imaging platform 13 input from the input interface circuit 181 to the elevation drive unit 182, and sets the rotation angle of the X-ray output unit 16 input from the input interface circuit 181. Based on the rotation angle information, the rotation drive unit 183 is output.

  When the adjustment of the breast position is completed, the system control circuit 1810 refers to the input compression pressure and compresses the placed breast (step S116). For example, the system control circuit 1810 lowers the compression plate 14 until the compression pressure applied to the placed breast reaches the input compression pressure. The system control circuit 1810 outputs position information related to the compression plate 14 to the elevation drive unit 182.

  When the compression pressure on the breast reaches the input compression pressure, the system control circuit 1810 receives an instruction to capture a mammography image (step S117). When imaging of the mammography image is instructed from the input interface circuit 181, the system control circuit 1810 instructs the voltage intensity to the high voltage generation circuit 184 based on the radiation intensity included in the examination information read out in step S 111. (Step S118). As a result, X-rays are emitted from the X-ray tube 161 to the breast B, and X-rays transmitted through the breast B and the imaging table 13 are detected by the X-ray detection unit 17.

  The system control circuit 1810 outputs the patient information stored in the storage circuit 189 and the imaging conditions input in the current examination to the image processing circuit 185 (step S119). The image processing circuit 185 generates a mammography image based on the X-ray projection data generated by the X-ray detection unit 17. The image processing circuit 185 analyzes the generated mammography image, and acquires a nipple position, an image start position, and an image end position in the mammography image. In addition, the image processing circuit 185 receives the designation of ROI from the photographer. The image processing circuit 185 stores the generated mammography image in the value field of the image data, and receives patient information and imaging conditions received from the system control circuit 1810, as well as nipple position information, image start position information, image end position information, Then, the image data is acquired by writing the ROI information to the private tag of the image data. The image processing circuit 185 stores the acquired image data in the image storage circuit 186.

  The system control circuit 1810 controls the communication interface circuit 188 to transmit the image data stored in the image storage circuit 186 to the image server 41 (step S1110), and ends the processing.

  The system control circuit 1810 controls the communication interface circuit 188 to transmit examination execution information when the mammary gland image examination is completed.

  As described above, in the mammography apparatus 10 according to the present embodiment, guide light corresponding to the external shape of the breast of the subject is compressed from the guide light generation unit 15 based on the mammography image captured in the past for the subject. The light is projected onto the plate 14 and the imaging stand 13. Thereby, the mammography apparatus 10 can reproduce the positioning when the mammography image is captured in the past.

  Therefore, according to the mammography apparatus 10 according to the present embodiment, positioning can be supported. For this reason, according to the mammography apparatus 10 according to the present embodiment, the reproducibility of the position of the ROI is also improved, and the accuracy when confirming the change with time is increased. Further, since the doctor does not need to consider the difference in positioning, the patient can be diagnosed with certainty based on the mammography image.

  In the present embodiment, the image processing circuit 185 stores the mammography image in the value field of the image data, and includes the nipple position information, the image start position information, the image end position information, and the imaging time in the private tag of the image data. Write the imaging conditions. The image processing circuit 185 stores the image data in the image storage circuit 186. Then, the system control circuit 1810 transmits the image data stored in the image storage circuit 186 to the image server 41. Thereby, the mammography apparatus 10 supports positioning by using the nipple position information, the image start position information, the image end position information, and the imaging information included in the image data stored at this time in the next imaging. It becomes possible.

  In the above embodiment, the image data includes nipple position information, image start position information, and image end position information, and the guide light generation unit 15 projects guide light that indicates the position represented by these information. The case has been described as an example. However, the information indicating the breast position is not limited to the nipple position information, the image start position information, and the image end position information. If the shape of the breast can be grasped, information about positions other than the nipple position, the image start position, and the image end position may be included in the image data. The guide light generation unit 15 projects guide light that indicates positions corresponding to these positions.

  Further, in the present embodiment, as an example, the guide light generation unit 15 includes the projector 151 and the reflecting mirror 152 as illustrated in FIG. However, it is not limited to this. For example, the guide light generator 15 may include a laser pointer 153 and a reflecting mirror 152 as shown in FIG. At this time, the system control circuit 1810 controls the position of the laser pointer 153 so that the guide light is projected through the reflecting mirror 152 to the read nipple position, image start position, and image end position, for example. In addition, it is desirable that the direction of the reflecting mirror 152 is fixed in order to simplify the structure of the guide light generator 15.

  Further, the guide light generator 15 may include a laser pointer 153 as shown in FIG. At this time, the system control circuit 1810 controls the position of the laser pointer 153 so that, for example, guide light is projected to the read nipple position, image start position, and image end position without passing through a mirror. The light output from the laser pointer 153 is directly projected onto the imaging table 13 and the compression plate 14.

  In this embodiment, the guide light generation unit 15 is provided on the X-ray output unit 16 side, and a case where guide light is projected from the X-ray output unit 16 side to the imaging table 13 and the compression plate 14 will be described as an example. did. However, it is not limited to this. The guide light generation unit 15 may be provided on the X-ray detection unit 17 side. At this time, the guide light generation unit 15 includes, for example, a plurality of LEDs embedded in the imaging table 13. For example, the LED emits light so that the shape of the breast can be grasped in accordance with an instruction from the light emission control unit.

  Further, in the present embodiment, the case where the mammography apparatus 10 receives an imaging order including the nipple position, the image start position, the image end position, the ROI, the imaging conditions, and the like from the RIS server 31 has been described as an example. However, it is not limited to this. The mammography apparatus 10 may receive image data in which nipple position information, image start position information, image end position information, ROI information, imaging conditions, and the like are written in a private tag from the RIS server 31. At this time, the imaging order does not include the nipple position, the image start position, the image end position, the ROI, and the imaging conditions. The system control circuit 1810 of the mammography apparatus 10 reads nipple position information, image start position information, image end position information, ROI information, imaging conditions, and the like included in the image data from the received image data. The system control circuit 1810 stores the read nipple position information, image start position information, image end position information, ROI information, imaging conditions, and the like in the storage circuit 189. The system control circuit 1810 projects guide light based on these pieces of information stored in the storage circuit 189.

  In addition, the mammography apparatus 10 receives, from the RIS server 31, for example, request source information including a department name and a doctor name, a patient ID, an imaging region, a radiation intensity, an imaging date and time, a radiographer name, and the like. Image data including imaging conditions at the time of imaging may be received. That is, the mammography apparatus 10 according to the present embodiment can cope with a case where the imaging order and image data do not include nipple position information, image start position information, image end position information, and ROI information. The image processing circuit 185 analyzes a mammography image included in the received image data, and acquires a nipple position, an image start position, an image end position, and an ROI in the mammography image. The system control circuit 1810 stores the acquired nipple position information regarding the nipple position, image start position information regarding the image start position, image end position information regarding the image end position, ROI information regarding the position of the ROI, imaging conditions, and the like in the storage circuit 189. Remember. The system control circuit 1810 projects guide light based on these pieces of information stored in the storage circuit 189.

  In this embodiment, as shown in FIGS. 9 and 10, the image processing circuit 185 displays a mammographic image in which instruction points indicating the nipple position, the image start position, and the image end position are superimposed on the display circuit 187. The case of displaying is described as an example. However, the instruction points to be superimposed on the mammography image are not limited to these.

  For example, the image processing circuit 185 may superimpose an instruction point indicating the ROI included in the imaging order, that is, an instruction point indicating the ROI designated in the past imaging, on the generated mammography image. A display example of the MLO image at this time is shown in FIG. Thereby, the photographer can specify the ROI for the mammography image photographed in the current examination while confirming the past ROI.

  Further, the system control circuit 1810 may project guide light to the position of the ROI designated at the time of past imaging. At this time, based on the nipple position information, the image start position information, the image end position information, and the ROI information, the system control circuit 1810 applies visible light having a predetermined size to the nipple position, the image start position, the image end position, and the ROI. The irradiation pattern for the projector 151 and the directivity direction of the reflecting mirror 152 are calculated so that.

  In addition, the image processing circuit 185 adds to the generated mammography image an instruction point indicating a nipple position, an image start position, and an image end position acquired based on the generated mammography image, a nipple position included in the imaging order, and an image start. The instruction point indicating the position, the image end position, and the ROI, that is, the nipple position, the image start position, the image end position, and the instruction point indicating the ROI relating to the mammography image captured in the past may be superimposed. A display example of the MLO image at this time is shown in FIG. As a result, the photographer can designate the ROI for the mammography image photographed in the current examination while being aware of the past positioning.

  Further, the image processing circuit 185 generates an image in which a mammography image captured in the past is superimposed with a nipple position, an image start position, an image end position, and an instruction point indicating the ROI acquired based on the mammography image. It may be superimposed on the mammography image. A display example of the MLO image at this time is shown in FIG. Thereby, the photographer can specify the ROI for the mammography image captured in the current examination while confirming the nipple position, the image start position, the image end position, and the ROI for the mammography image captured in the past. It becomes possible.

  The past examination information read by the system control circuit 1810 may include specific information about the subject such as age, height, weight, family history, and medical history. When receiving the subject information, the system control circuit 1810 reads out the unique information about the subject specified by the subject information from the storage circuit 189. The system control circuit 1810 displays the read unique information on the display circuit 187 together with the imaging conditions, and accepts input of imaging conditions. Thus, the photographer can operate the mammography apparatus 10 while referring to the specific information. For example, it is assumed that the subject is diagnosed with osteoporosis between the previous breast image examination and the current breast image examination. When osteoporosis is displayed on the display circuit 187, the photographer can recognize the necessity of setting the height of the imaging table 13 to be lower than the height of the imaging table 13 included in the imaging order.

  In this embodiment, image data in which the nipple position information, image start position information, image end position information, ROI information, and imaging conditions at the time of imaging are written in a private tag is stored in the image storage circuit 186, and is stored in the image server. The case of being transmitted to 41 has been described as an example. However, it is not limited to this. The information written in the private tag may be information other than nipple position information, image start position information, image end position information, ROI information, and imaging conditions at the time of imaging.

  For example, the image processing circuit 185 may further write ROI information included in the imaging order, that is, ROI information related to the ROI designated at the time of past imaging, into the private tag. Thereby, an interpreter such as a doctor can interpret a mammography image while comparing the ROI designated in the past with the ROI designated this time.

  Also, the image processing circuit 185 includes the nipple position information, the image start position information, and the image end position information included in the imaging order, that is, the nipple position information, the image start position information, and the image end regarding the mammography image captured in the past. The location information may be further written on a private tag. The image processing circuit 185 includes a nipple position, an image start position, and an image end position related to a mammography image obtained by past imaging, and a nipple position, an image start position, and an image end position related to a mammography image obtained by the current imaging. The deviation may be calculated and the calculated deviation may be written to the private tag. Thereby, an interpreter such as a doctor can interpret a mammography image while confirming a nipple position, an image start position, and an image end position for a mammography image captured in the past.

  Further, the image processing circuit 185 further writes the mammography image captured in the past, and the nipple position information, the image start position information, the image end position information, and the ROI information acquired based on the mammography image to the private tag. You may do it. Thereby, an interpreter such as a doctor can interpret a mammography image while confirming a change in mammary gland density from a mammography image captured in the past.

  Further, the image processing circuit 185 may further write specific information about the subject such as age, height, weight, family history, and medical history to the private tag of the image data. Thereby, an interpreter such as a doctor can interpret a mammography image while referring to the specific information. For example, when performing hormone replacement therapy or performing chemotherapy, the density of the mammary gland may change. FIG. 17 is a diagram illustrating an example of an MLO image displayed on the viewer 43 when the hormone replacement therapy is performed. An interpreter such as a doctor can interpret an MLO image of the MLO image as shown in FIG. 17 while considering a change in mammary gland density due to hormone replacement therapy. Further, the image processing circuit 185 may write to the private tag that it is not appropriate to display the breast density as the ROI when the predetermined therapy is being performed.

  In the above-described embodiment, the case where the irradiation pattern and the directing direction are output as control signals from the system control circuit 1810 to the guide light generation unit 15 has been described as an example. However, it is not limited to this. The guide light generator 15 may include a control circuit 154 as shown in FIG. At this time, the system control circuit 1810 outputs the nipple position information, the image start position information, and the image end position information to the control circuit 154. Based on the received nipple position information, image start position information, and image end position information, the control circuit 154 calculates, for example, the irradiation pattern of the projector 151 and sets the directivity direction of the reflecting mirror 152.

(Modification)
In the above-described embodiment, the mammography apparatus 10 generates guide light corresponding to the external shape of the subject's breast from the guide light generation unit 15 based on the mammography image captured in the past for the subject from the compression plate 14 and the imaging table. The case where light is projected to 13 has been described as an example. However, it is not limited to this. The mammography apparatus 10 </ b> A may project a mammography image captured in the past, instead of the guide light, onto the compression plate 14 and the imaging table 13 as guide information for guiding breast positioning.

  As shown in FIG. 19, the mammography apparatus 10 </ b> A includes an image projection unit 19 instead of the guide light generation unit 15 as a guidance information generation unit that generates guidance information. The image projection unit 19 projects a mammography image captured in the past for the breast B onto the compression plate 14 and the imaging table 13. The image projection unit 19 is provided in the vicinity of the X-ray output unit 16. The image projection unit 19 includes, for example, a projector 191 and a reflecting mirror 192, as with the guide light generation unit 15 shown in FIG.

  When a subject to be examined is identified, the system control circuit 1810 provided in the mammography apparatus 10A identifies the mammography image acquired in the past (previous) examination of the identified subject and the mammography image. The nipple position, the image start position, and the image end position are acquired. The nipple position, image start position, and image end position for the mammography image may be acquired by reading from the storage circuit 189 or may be acquired by performing image analysis on the mammography image.

  The system control circuit 1810 creates projection image data for the projector 191 so that the mammography image is projected onto the support surface 131. The projection image data is data including coordinate information and pixel information for projecting a mammography image onto the support surface 131. The coordinate information is calculated based on the acquired nipple position, image start position, and image end position.

  Further, the system control circuit 1810 calculates the directivity direction of the reflecting mirror 192 so that the mammography image is projected onto the support surface 131 based on the acquired nipple position, image start position, and image end position. The system control circuit 1810 transmits the projection image data to the projector 191 and instructs the reflecting mirror 192 in the direction of directivity.

  The projector 191 projects the projection image onto the reflecting mirror 192 according to the projection image data output from the system control circuit 1810. The reflecting mirror 192 reflects the projection image projected from the projector 191 in the directivity direction indicated by the system control circuit 1810. The projected image is preferably projected from directly above the imaging table 13 so that the projected image is not refracted by the compression plate 14.

  For example, as shown in FIG. 20, the projection image is transmitted through the transparent compression plate 14 and projected onto the support surface 131 of the imaging table 13. As shown in FIG. 21, the photographer adjusts the positioning so that the breast B is aligned with the projection image projected on the support surface 131.

  In this way, by projecting a mammography image captured in the past for the subject onto the compression plate 14 and the imaging table 13, the mammography apparatus 10A can reproduce the positioning when the mammography image was captured in the past. It becomes.

  The image processing circuit 185 of the mammography apparatus 10A generates a mammography image based on X-ray projection data acquired by projecting X-rays onto the breast B. The image processing circuit 185 causes the display circuit 187 to display the generated mammography image.

  In addition, the image processing circuit 185 analyzes the generated mammography image, and acquires a nipple position, an image start position, and an image end position in the mammography image. The image processing circuit 185 matches the position of the mammography image acquired in the past with the position of the newly acquired mammography image. The alignment here is performed based on the nipple position, the image start position, and the image end position for both images. The image processing circuit 185 increases the transparency of the aligned past mammography image, and superimposes the past mammography image with the increased transparency on the mammography image displayed on the display circuit 187. With this superimposed image, the photographer can specify the ROI for the mammography image photographed in the current examination while being aware of the past positioning.

  In this modification, the case where the projection image data and the directivity direction are output as control signals from the system control circuit 1810 to the image projection unit 19 has been described as an example. However, it is not limited to this. The image projection unit 19 may include a control unit. At this time, the system control circuit 1810 outputs the mammography image, the nipple position information, the image start position information, and the image end position information to the control unit of the image projection unit 19. Based on the received mammography image, nipple position information, image start position information, and image end position information, the control unit generates, for example, projection image data of the projector 191 and sets the directivity direction of the reflecting mirror 192.

  The term processor used in the above description is, for example, a central processing unit (CPU), a graphics processing unit (GPU), an application specific integrated circuit (ASIC), or a programmable logic device (for example, a simple programmable logic device (SPLD), CPLD). It means circuits such as (Complex Programmable Logic Device) and FPGA (Field Programmable Gate Array).

  Instead of storing the operation program in the storage circuit 189, the operation program may be directly incorporated in the processor. In this case, the processor implements a predetermined function by reading the operation program incorporated in the circuit and executing the read operation program.

  Further, the functions of the image processing circuit 185 and the system control circuit 1810 described in FIG. 5 according to the present embodiment are not necessarily realized by a processor corresponding to each function. For example, the functions of the image processing circuit 185 and the system control circuit 1810 may be realized by a single processor.

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

  DESCRIPTION OF SYMBOLS 10,10A ... Mammography apparatus, 11 ... Base, 12 ... Stand, 121 ... Supporting shaft, 13 ... Imaging stand, 131 ... Support surface, 14 ... Compression plate, 15 ... Guide light generation part, 151 ... Projector, 152 ... Reflection Mirror ... 153 ... Laser pointer 154 ... Control circuit 16 ... X-ray output unit 161 ... X-ray tube 162 ... X-ray restrictor 17 ... X-ray detector 171 ... X-ray detector 172 ... Signal processing Circuit 181 ... Input interface circuit 182 ... Elevation drive unit, 183 ... Rotation drive unit, 184 ... High voltage generation circuit, 185 ... Image processing circuit, 186 ... Image storage circuit, 187 ... Display circuit, 188 ... Communication interface circuit, 189 ... Memory circuit, 1810 ... System control circuit, 19 ... Image projection unit, 191 ... Projector, 192 ... Reflector, 21 ... HIS server, 31 ... RIS server , 32 ... RIS terminal, 41 ... image server, 42 ... report server, 43 ... viewer, 50 ... PC terminal.

Claims (16)

An X-ray tube that generates X-rays;
An imaging stand that supports the breast,
A compression plate for compressing the breast supported by the imaging table;
A guidance information generating unit for generating guidance information for guiding the placement position of the breast based on a nipple position, an image start position, and an image end position in a past image relating to the breast;
A mammography apparatus comprising: an X-ray detection unit that generates X-ray projection data by detecting an X-ray generated by the X-ray tube and passing through the breast with an X-ray detector.   The mammography apparatus according to claim 1, wherein the guide information generation unit generates guide light corresponding to an outer shape of the breast as the guide information. The guidance information generator is provided on the X-ray tube side,
A light source for generating the guide light;
The mammography apparatus according to claim 2, further comprising: a reflecting mirror that reflects the guide light generated by the light source and projects the light onto the imaging table.   The mammography apparatus according to claim 3, wherein the guide light is light that illuminates three points on the imaging table corresponding to the nipple position, the image start position, and the image end position.   The mammography apparatus according to claim 2, wherein the guide information generation unit generates guide light further indicating the region of interest on the imaging table based on the region of interest in the past image.   The apparatus further includes an image processing circuit that generates a mammography image based on the X-ray projection data generated by the X-ray detection unit, and acquires a nipple position, an image start position, and an image end position from the generated mammography image. The mammography apparatus according to claim 1.   The mammography apparatus according to claim 1, further comprising a display unit configured to display an imaging condition when the past image is acquired.   The imaging conditions include the height of the imaging table when the past image is acquired, the rotation angle of the X-ray tube when the past image is acquired, and the compression pressure when the past image is acquired. The mammography apparatus according to claim 7.   The imaging conditions include the height of the imaging table when the past image is acquired, the rotation angle of the X-ray tube when the past image is acquired, and the compression thickness when the past image is acquired. The mammography apparatus according to claim 7.   The mammography apparatus according to claim 6, further comprising a display unit configured to display the mammography image generated by the image processing circuit together with instruction points indicating the acquired nipple position, the image start position, and the image end position.   The mammography apparatus according to claim 10, wherein the display unit further displays an instruction point representing a region of interest in the past image.   The image data including the past image and the nipple position, the image start position, and the image end position in the past image is acquired, and the nipple position, the image start position, and the image end position are acquired from the image data. The mammography apparatus according to claim 1, further comprising a system control circuit to acquire.   Obtaining image data including the past image, a nipple position in the past image, an image start position in the past image, an image end position in the past image, and an imaging condition at the time of obtaining the past image; The mammography apparatus according to claim 7, further comprising a system control circuit that acquires the nipple position, the image start position, the image end position, and the imaging condition from the image data.   The mammography apparatus according to claim 1, further comprising an image processing circuit that acquires image data including the past image and acquires the nipple position, the image start position, and the image end position from the past image.   The mammography apparatus according to claim 1, wherein the guidance information generation unit generates a projection image based on the past image as the guidance information. The guidance information generator is provided on the X-ray tube side,
A projector for generating the projected image;
The mammography apparatus according to claim 15, further comprising a reflecting mirror that reflects the projection image generated by the projector and projects the projection image onto the imaging table.