JP2018099505A - X-ray diagnostic apparatus, medical image diagnostic system and control method - Google Patents

Abstract

PROBLEM TO BE SOLVED: To reduce a labor and time for positioning, while avoiding collision with a device projecting from a subject.SOLUTION: According to one embodiment, an X-ray diagnostic apparatus includes a couch, an imaging unit, image generation means, setting means, and control means. The couch includes a couch top on which a subject lies. The imaging unit includes an X-ray generator, an X-ray detector, and holding means. The holding means movably holds the X-ray generator and the X-ray detector. The image generation means generates an X-ray image of the subject, on the basis of an output of the X-ray detector. The setting means sets a first interference determination area including a device projecting from the subject, on the basis of an image of the device included in the X-ray image. The control means controls the holding means such that movement of the imaging unit is restricted in the set first interference determination area.SELECTED DRAWING: Figure 1

Description

  Embodiments described herein relate generally to an X-ray diagnostic apparatus, a medical image diagnostic system, and a control method.

  The X-ray diagnostic apparatus for a circulator has an interference prevention function for preventing contact between a moving body such as a C-arm and the subject and a bed. There is also known a medical image diagnostic system that alternately uses this type of X-ray diagnostic apparatus and other modalities (medical diagnostic apparatuses). As other modalities, for example, a CT (Computed Tomography) apparatus or an MRI (Magnetic Resonance Imaging) apparatus can be used as appropriate. When a CT apparatus is used as another modality, the medical image diagnostic system is also referred to as an “angio CT apparatus” or an “angio CT system”. In addition, this type of X-ray diagnostic apparatus and medical image diagnostic system may be used when a puncture needle is punctured into a subject for the purpose of collecting a tissue piece of a tumor or ablation treatment.

  In this case, in the medical image diagnostic system, auto-positioning is performed after the puncture needle punctured under the fluoroscopy of the X-ray diagnostic apparatus is advanced to the target site. Thereby, each unit such as a holding device and a bed in the X-ray diagnostic apparatus is retracted to the target position, and the CT gantry in the CT apparatus is positioned. Here, the automatic positioning is performed by previously registering the target position of each unit of the X-ray diagnostic apparatus in association with the unit identification information (eg, number), and automatically by inputting the unit identification information and operating the trigger switch. This is a function to move each unit to the target position. In the case of an angio CT system, the CT gantry can be positioned simultaneously with the movement of each unit of the X-ray diagnostic apparatus. After positioning the CT gantry, the CT apparatus performs confirmation imaging.

  The medical image diagnosis system as described above is usually not particularly problematic, but according to the study of the present inventor, when auto-positioning is performed without considering the puncture needle protruding from the body surface of the subject, X-ray The diagnostic device or CT gantry may collide with the puncture needle. In order to avoid this collision, auto-positioning is not performed, and positioning by manual operation is performed while taking care of the position of the puncture needle, which takes time and effort. This is not limited to the puncture needle, and the same applies when any device protrudes from the subject. In addition, this is not limited to the medical image diagnostic system, and the same applies to the case where auto-positioning is performed so that the holding device is temporarily retracted to the target position and then returned to the imaging position in a single X-ray diagnostic apparatus. .

JP 2001-120525 A

  The problem to be solved by the present invention is to reduce the labor and time of positioning while avoiding a collision with a device protruding from a subject.

  According to one embodiment, the X-ray diagnostic apparatus includes a bed apparatus, an imaging apparatus, an image generation unit, a setting unit, and a control unit.

The bed apparatus has a top plate on which a subject is placed.
The imaging apparatus includes an X-ray generator, an X-ray detector, and a holding unit.
The X-ray generation unit generates X-rays that irradiate the subject.
The X-ray detector detects X-rays transmitted through the subject.
The holding means holds the X-ray generation unit and the X-ray detector in a movable manner.
The image generation means generates an X-ray image of the subject based on the output of the X-ray detector.
The setting unit sets a first interference determination region including a device protruding from the subject based on an image of the device included in the X-ray image.
The control unit controls the holding unit so as to limit the movement of the imaging apparatus in the set first interference determination region.

1 is a perspective view showing an appearance of a medical image diagnostic system according to a first embodiment. It is a block diagram which shows typically schematic structure of the medical image diagnostic system in the embodiment. It is a block diagram which shows the structure of the medical image diagnostic system in the embodiment. It is a schematic diagram for demonstrating the table in the same embodiment. It is a schematic diagram for demonstrating the puncture assistance function in the embodiment. It is a schematic diagram for demonstrating the direction parallel to the path | pass in the embodiment. It is a schematic diagram for demonstrating the direction perpendicular | vertical to the path | pass in the embodiment. It is a flowchart for demonstrating the operation | movement in the embodiment. It is a flowchart for demonstrating the operation | movement in the embodiment. It is a flowchart for demonstrating operation | movement of the modification of the embodiment. It is a block diagram which shows the structure of the X-ray diagnostic system which concerns on 2nd Embodiment. It is a flowchart for demonstrating the operation | movement in the embodiment. It is a flowchart for demonstrating the operation | movement in the embodiment. It is a flowchart for demonstrating operation | movement of the modification of the embodiment.

Each embodiment will be described below with reference to the drawings.
<First Embodiment>
FIG. 1 is a perspective view showing an appearance of the medical image diagnostic system according to the first embodiment, and FIG. 2 is a block diagram schematically showing a schematic configuration of the medical image diagnostic system. The medical image diagnostic system 1 is an angio CT system including a CT gantry 2, a CT console 3, an imaging device 5, an angio console 6, and a bed device 7. The CT console 3 and the angio console 6 may be integrated (integrated). An angio CT system is an example of a medical image diagnostic system. The medical image diagnostic system may be provided with other modalities instead of the CT apparatus. Examples of other modalities include an MRI apparatus. The other modalities are not limited to this, and may be any modality that is used alternately with the imaging device 5 and can move toward or away from the subject P. Further, the “imaging device 5” may be referred to as an “angio device 5”.

  Here, the CT gantry 2 has an opening 2a into which the top plate 7a of the bed apparatus 7 is inserted, and can move on a plurality of rails r1 provided on the floor along the long axis direction of the top plate 7a. It has become.

  The imaging device 5 can move under a plurality of rails r2 provided on the ceiling along the long axis direction or the short axis direction of the top plate 7a, and the long axis of the top plate 7a by a moving mechanism (not shown). It is possible to move between the rails r2 along the direction and the minor axis direction.

  The imaging device 5 has an X-ray tube 52 at one end and a C-arm 54 having an X-ray detector 53 at the other end, a holding portion 54a that holds the C-arm 54, and a holding portion 54a that is held at the tip. And a support arm 54b. The support arm 54b has a substantially arc shape, and a base end is attached to a moving mechanism for the rail r2. The C-arm 54 is held by the holding portion 54a so as to be rotatable about an axis in the X direction perpendicular to both the Z direction perpendicular to the top plate 7a and the Y direction along the major axis direction of the top plate 7a. Yes. The C arm 54 has a substantially arc shape centered on the axis in the Y direction, and is held by the holding portion 54a so as to be slidable along the substantially arc shape. Alternatively, the C-arm 54 can rotate around the axis in the X direction around the holding portion 54a, and it is possible to observe X-ray images from various angular directions by combining the slide and this rotation. To do.

  The couch device 7 is used in common with the CT gantry 2 and the imaging device 5, and has a top plate 7a on which the subject is placed. The bed apparatus 7 holds the top plate 7a so as to be movable in the vertical direction. The top plate 7a is held so as to be movable along the long axis direction or the short axis direction of the top plate 7a, and is held so as to be rotatable about an axis in the Y direction. Such a common couch device 7 is controlled by the system control circuits 37 and 66 of the CT console 3 and the angio console 6, respectively.

Next, the configuration of such a medical image diagnostic apparatus will be specifically described.
FIG. 3A is a block diagram showing a configuration of a medical image diagnostic system. In the medical image diagnostic system 1, the CT apparatus includes a CT gantry 2, a CT console 3, and a bed apparatus 7. The CT gantry 2 includes a slip ring 21, a tube voltage generator 22, an X-ray tube 23, an X-ray detector 24, a data acquisition circuit (DAS) 25, a non-contact data transmission circuit 26, a carrier A device 27 and a gantry control circuit 28 are included. The CT gantry 2 includes a rotation ring 29, a ring support mechanism that supports the rotation ring 29 so as to be rotatable about the body axis (Z axis) of the subject, and a rotation drive device (electric motor) 30 that rotationally drives the rotation ring 29. Etc. The rotating ring 29 is accommodated in the CT gantry 2 and holds the X-ray tube 23 and the X-ray detector 24 arranged to face each other via the opening 2a. A top plate 7 a on which the subject P can be placed is inserted into the opening of the rotating ring 29. The top plate 7 a is supported by the bed apparatus 7 so as to be movable along the central axis of the rotating ring 29. Here, the top 7 a is positioned so that the body axis of the subject P placed on the top 7 a coincides with the central axis of the rotating ring 29. The rotating ring 29 is equipped with a tube voltage generator 22, an X-ray tube 23, an X-ray detector 24, a DAS 25, a non-contact data transmission circuit 26, a cooling device (not shown), and the like. The tube voltage generator 22 generates a tube voltage applied to the X-ray tube 23 and a filament current supplied to the X-ray tube 23 under the control of the CT console 3 via the gantry control circuit 28. Occur.

  The X-ray tube 23 receives application of tube voltage and supply of filament current from the tube voltage generator 22 via the slip ring 21. The X-ray tube 23 emits X-rays from the X-ray focal point to the subject P placed on the top 7a. The X-ray tube 23 generates X-rays having an energy spectrum corresponding to the tube voltage applied by the tube voltage generator 22. The radiation range of X-rays is indicated by a two-dot chain line in FIG. 3A.

  The X-ray detector 24 is attached to the rotating ring 29 at a position and an angle facing the X-ray tube 23 across the rotation axis. The X-ray detector 24 has a plurality of light receiving bands for detecting X-rays emitted from the X-ray tube. Here, a description will be given assuming that a single light receiving band constitutes a single channel. The plurality of channels are orthogonal to the rotation axis and centered on the focal point of the emitted X-ray, and the arc direction (channel direction) and the Z direction have a radius from this center to the center of the light receiving band for one channel. They are arranged two-dimensionally in two directions (slice direction). A DAS 25 is connected to the output side of the X-ray detector 24. The X-ray detector 24 arranges a plurality of light receiving bands in one row. At this time, each of the plurality of light receiving bands is arranged one-dimensionally in a substantially arc direction along the channel direction. Further, the plurality of light receiving bands may be arranged two-dimensionally in two directions of the channel direction and the slice direction. That is, the two-dimensional arrangement may be configured by arranging a plurality of channels arranged one-dimensionally along the channel direction in a plurality of rows in the slice direction.

  The DAS 25 includes an IV converter that converts a current signal of each channel of the X-ray detector 24 into a voltage, an integrator that periodically integrates the voltage signal in synchronization with an X-ray exposure period, and the integrator. An amplifier that amplifies the output signal and an analog-digital converter that converts the output signal of the amplifier into a digital signal are attached to each channel. The DAS 25 transmits the output data (pure raw data) to the CT console 3 via the contactless data transmission circuit 26 using magnetic transmission / reception or optical transmission / reception.

  The transport device 27 is a device that can transport the CT gantry 2 to the bed device 7. The transport device 27 can transport the CT gantry 2 using, for example, a rail L1 provided on the floor of the examination room.

  The gantry control circuit 28 has a function of controlling the tube voltage generation device 22, the transport device 27, the rotation drive device 30 and the like in the CT gantry 2 in accordance with a control signal output from the CT console 3. The gantry control circuit 28 includes, as hardware resources, a processor such as a CPU or MPU and a memory such as a ROM or RAM. The gantry control circuit 28 may be realized by an ASIC, FPGA, CPLD, SPLD, or the like. The processor implements the above functions by reading and implementing a program stored in the memory. Instead of storing the program in the memory, the program may be directly incorporated in the circuit of the processor. In this case, the processor realizes the function by reading and executing a program incorporated in the circuit.

  The CT console 3 includes a preprocessing circuit 31, a reconstruction circuit 32, an input interface (I / F) 33, a communication interface (I / F) 34, a display 35, a storage circuit 36, and a system control circuit 37.

  The preprocessing circuit 31 performs preprocessing on the pure raw data output from the non-contact data transmission circuit 26. Preprocessing includes, for example, logarithmic conversion processing for pure raw data, sensitivity non-uniformity correction processing between channels, X-ray strong absorbers, processing to correct extreme signal strength reduction or signal dropout mainly due to metal parts, etc. It is. The preprocessing circuit 31 represents a view angle when data (collected as raw data or projection data, here referred to as projection data) immediately before the reconstruction process that has been preprocessed is collected. The data is transmitted to the reconstruction circuit 32 and the storage circuit 36 in association with the data.

  Here, the projection data is a set of data values corresponding to the intensity of X-rays transmitted through the subject P. Here, for convenience of explanation, a set of projection data over all channels having the same view angle collected almost simultaneously in one shot is referred to as a projection data set. Further, the view angle represents each position of the circular orbit around which the X-ray tube 23 circulates around the rotation axis as an angle in a range of 360 ° with the uppermost portion of the circular orbit vertically upward from the rotation axis as 0 °. It is. The projection data for each channel of the projection data set is identified by the view angle, cone angle, and channel number.

  The reconstruction circuit 32 uses, for example, the Feldkamp method or the successive approximation reconstruction method based on the projection data set transmitted from the preprocessing circuit 31 and having a view angle of 360 ° or 180 ° + fan angle. The volume data having a substantially cylindrical shape is reconstructed. The reconfiguration circuit 32 is realized by, for example, a memory and a predetermined processor. The reconstruction circuit 32 reconstructs a three-dimensional image (volume data, hereinafter simply referred to as a 3D image) from the plurality of projection data sets. The Feldkamp method is a reconstruction method when a projection ray intersects the reconstruction surface like a cone beam. By assuming that the cone angle is small and treating it as fan beam projection, reconstruction can be speeded up. The reconstruction circuit 32 transmits the reconstructed 3D image to the storage circuit 36.

  The input interface 33 is realized by a trackball, a switch button, a foot switch, a mouse, a keyboard, a touch pad for performing an input operation by touching an operation surface, a touch panel display in which a display screen and a touch pad are integrated, or the like. . The input interface 33 is connected to the system control circuit 37. The input interface 33 converts the input operation received from the operator into an electrical signal and outputs it to the system control circuit 37. In the present embodiment, the input interface 33 is not limited to one having physical operation parts such as a trackball, a switch button, a foot switch, a mouse, and a keyboard. For example, an electric signal processing circuit that receives an electric signal corresponding to an input operation from an external input device provided separately from the apparatus and outputs the electric signal to the system control circuit 37 is also an example of the input interface 33. included.

  The communication interface 34 is a circuit for communicating with an external device by wire, wireless, or both. The external device is, for example, a server included in a system such as a modality, a radiation department information management system (RIS), a hospital information system (HIS), and a PACS (Picture Archiving and Communication System). Workstations.

  The display 35 is a display main body that displays medical images and the like according to control by the system control circuit 37, an internal circuit that supplies a display signal to the display main body, and peripheral circuits such as connectors and cables that connect the display main body and the internal circuit. It is composed of

  The memory circuit 36 includes a memory that records electrical information such as a read only memory (ROM), a random access memory (RAM), a hard disk drive (HDD), and an image memory, and a memory controller and a memory interface associated with the memory. It consists of peripheral circuits. The storage circuit 36 stores the projection data transmitted from the preprocessing circuit 31 and the 3D image reconstructed by the reconstruction circuit 32. The storage circuit 36 stores a control program for controlling the timing for applying the tube voltage to the X-ray tube 23.

  The storage area of the storage circuit 36 may be in the medical image diagnostic system 1 or in an external storage device connected by a network.

  The system control circuit 37 includes a processor and a memory (not shown). The system control circuit 37 functions as the center of the CT apparatus. Specifically, the system control circuit 37 reads out the control program stored in the storage circuit 36 and expands it on the memory, and controls each part of the CT apparatus according to the expanded control program. Further, the system control circuit 37 controls the bed apparatus 7 based on an operator instruction sent from the input interface 33.

  Next, the angio system in the medical image diagnostic system 1 will be described. The angio system includes an imaging device 5, an angio console 6, and a couch device 7 in common with a CT device.

  The imaging device 5 includes a tube voltage generation device 51, an X-ray tube 52, an X-ray detector 53, a C arm 54, a holding unit 54 a, a support arm 54 b, a drive device 55, and an imaging control circuit 56.

  The tube voltage generator 51 generates a tube current supplied to the X-ray tube 52 and a tube voltage applied to the X-ray tube 52. The tube voltage generator 51 supplies tube current to the X-ray tube 52 and applies tube voltage to the X-ray tube 52 in accordance with the X-ray imaging conditions under the control of the angio console 6 via the imaging control circuit 56. To do.

  The X-ray tube 52 generates X-rays at the X-ray focal point based on the tube current supplied from the tube voltage generator 51 and the tube voltage applied by the tube voltage generator 51. X-rays generated from the X-ray focal point are irradiated onto the subject P through an X-ray emission window provided in front of the X-ray tube 52. A part of the X-rays generated from the X-ray focal point is shielded by a collimator 52a provided between the X-ray tube 52 and the X-ray emission window.

  The X-ray detector 53 detects X-rays generated from the X-ray tube 52 and transmitted through the subject P. Electrical signals generated by a plurality of semiconductor detection elements with the incidence of X-rays are output to an analog-to-digital converter (ADC) (not shown). The ADC converts an electrical signal into digital data. The ADC outputs digital data to the image generation circuit 61. As the X-ray detector 53, an image intensifier may be used.

  A support mechanism (holding device) including the C arm 54, the holding portion 54a, and the support arm 54b supports the X-ray tube 52 and the X-ray detector 53 so as to be movable. Specifically, the C arm 54 mounts the X-ray tube 52 and the X-ray detector 53 so as to face each other. The holding portion 54a supports the C arm 54 so as to be slidable in a direction along the C shape of the C arm 54 (hereinafter referred to as C direction). The support arm 54b that holds the holding portion 54a is installed to be movable along a rail L2 provided on the ceiling. For example, the rail L2 is provided on the ceiling along the long axis direction or the short axis direction of the top plate 7a. The holding portion 54a holds the C arm 54 so as to be rotatable in a direction orthogonal to the C direction (hereinafter referred to as a C orthogonal direction) with the connection portion connecting the C arm 54 and the support arm 54b as a substantial center. In addition, the C arm 54 connects the X-ray tube 52 and the X-ray detector 53 such that the distance between the X-ray focal point and the X-ray detector 53 (source image distance (SID)) can be changed. To support.

  The C arm 54 is not limited to a support mechanism using the holding portion 54a and the support arm 54b. The C arm 54 may be supported by a support column that is movable along the floor surface. Alternatively, the C arm 54 may be supported so as to be movable in an arbitrary direction, for example, by an articulated arm of an industrial robot. Further, the C-arm 54 may be provided so as to be able to be transported to the floor instead of a structure that is suspended from the ceiling. Further, the C arm 54 may have a biplane structure.

  The drive device 55 drives the bed device 7, the C arm 54, the holding portion 54 a, and the support arm 54 b under the control of the angio console 6. Specifically, the driving device 55 supplies a driving signal corresponding to the control signal from the system control circuit 66 to the holding unit 54a, and slides the C arm 54 in the C direction and rotates it in the C orthogonal direction. At the time of X-ray imaging, the subject P placed on the top 7a is disposed between the X-ray tube 52 and the X-ray detector 53.

  The drive device 55 moves the couchtop 7 a by driving the bed device 7 under the control of the system control circuit 66. Specifically, the driving device 55 slides the top plate 7a in the short axis direction or the long axis direction of the top plate 7a based on the control signal of the system control circuit 66. Moreover, the drive device 55 raises / lowers the top plate 7a in the vertical direction. In addition, the driving device 55 may rotate the top plate 7a to tilt the top plate 7a with at least one of the major axis direction and the minor axis direction as a rotation axis.

  The imaging control circuit 56 drives the tube voltage generator 51, the X-ray detector 53, and the drive according to control from the system control circuit 66 based on the operator's instruction, X-ray imaging direction, X-ray irradiation range, X-ray irradiation conditions, and the like. The device 55 and the like are controlled.

  The angio console 6 includes an image generation circuit 61, an input interface 62, a communication interface 63, a display 64, a storage circuit 65, and a system control circuit 66. Here, the image generation circuit 61 and the system control circuit 66 may be collected in a processing circuit 67 as hardware. In other words, the image generation circuit 61 and the system control circuit 66 may be realized by the processing circuit 67. The processing circuit 67 may be a processor that implements the image generation circuit 61 and the system control circuit 66 corresponding to the program by calling and executing the processing program in the storage circuit 65. The same applies to the following embodiments and modifications.

  The image generation circuit 61 performs preprocessing on the digital data output from the X-ray detector 53. The pre-processing includes, for example, correction of non-uniform sensitivity between channels in the X-ray detector 53 and correction regarding an extreme decrease in signal intensity or data loss due to an X-ray strong absorber such as metal. The image generation circuit 61 has a function of generating an X-ray image based on preprocessed digital data. The image generation circuit 61 outputs the generated X-ray image to the display 64 and the storage circuit 65.

  The input interface 62 is realized by a trackball, a switch button, a foot switch, a mouse, a keyboard, a touch pad for performing an input operation by touching an operation surface, a touch panel display in which a display screen and a touch pad are integrated, or the like. . The input interface 62 is connected to the system control circuit 66. The input interface 62 converts the input operation received from the operator into an electrical signal and outputs it to the system control circuit 66. In the present embodiment, the input interface 62 is not limited to one having physical operation parts such as a trackball, a switch button, a foot switch, a mouse, and a keyboard. For example, an example of the input interface 62 includes an electric signal processing circuit that receives an electric signal corresponding to an input operation from an external input device provided separately from the apparatus and outputs the electric signal to the system control circuit 66. included.

  The communication interface 63 is a circuit for communicating with an external device by wire, wireless, or both. The external device is, for example, a server included in a system such as a modality, a radiation department information management system (RIS), a hospital information system (HIS), or a PACS, or another workstation.

  The display 64 is a display main body that displays a medical image or the like according to control by the system control circuit 66, an internal circuit that supplies a display signal to the display main body, and a peripheral circuit such as a connector or a cable that connects the display main body and the internal circuit. It is composed of

  The storage circuit 65 includes a memory for recording electrical information such as a ROM, a RAM, an HDD, and an image memory, and peripheral circuits such as a memory controller and a memory interface associated with the memory. The storage circuit 65 includes an X-ray image generated by the image generation circuit 61, a control program for the imaging device 5, a puncture support program, an imaging protocol, an operator instruction input from the input interface 62, an imaging condition regarding X-ray imaging, and Various data groups such as fluoroscopic conditions, X-ray dose, etc. are stored. The storage circuit 65 stores size information (semi-cylindrical model) of the subject P used for the interference prevention function, size information of the imaging system and the C arm 54, and size information of the top 7a. These pieces of size information are used for specifying the position and size of the interference object together with the position information of the imaging system and the C-arm 54 and the position information of the top plate 7a. Further, the storage circuit 65 may hold a preset full length of the needle. As the total length of the needle, for example, an arbitrary value such as 25 mm, 100 mm, or 200 mm can be set as appropriate. Further, the total length of the needle may be set in association with, for example, needle identification information (eg, name, product number, product code, or model number). This setting may be performed when the total length of the needle is one or plural. For example, as shown in FIG. 3B, the storage circuit 65 may store a table 65a in which the total length of the needle and the setting flag are associated in advance for each piece of needle identification information. In the setting flag, for example, a value “1” may indicate validity and a value “0” may indicate invalidity. In this case, as the total length of the needle, any one may be set as a default value, or the total length corresponding to the needle identification information designated from the input interface 62 may be set. Alternatively, as the total length of the needle, any one is set as a default value, and when needle identification information is specified, the total length corresponding to the specified identification information is set (updated) instead of the default value. May be. Here, when the storage circuit 65 stores a plurality of full lengths, setting the full length means setting a setting flag associated with the full length. When the storage circuit 65 stores one full length, setting the full length and storing the full length have the same meaning. The table 65a may be updated regularly or irregularly from a medical device approval information database (not shown) based on the medicinal machine method. The table 65a may be updated by, for example, the user operating the input interface 62, or may be updated by executing an update program. Examples of the needle include “puncture needle”, “biopsy needle”, “transplant needle”, “cautery needle”, “electrode needle”, and the like depending on the application. In each of the following embodiments, a puncture needle is used as an example of a needle.

  The system control circuit 66 includes a processor and a memory (not shown). The system control circuit 66 does not illustrate information such as an operator instruction, an X-ray imaging position, an X-ray imaging direction by the X-ray tube 52, an X-ray irradiation range, and an X-ray irradiation condition sent from the input interface 62. Temporarily store in memory. The system control circuit 66 is connected via the imaging control circuit 56 in order to execute X-ray imaging in accordance with the operator's instructions, X-ray imaging direction, X-ray irradiation range, X-ray irradiation conditions, etc. stored in the memory. The voltage generator 51, the X-ray detector 53, the driving device 55, the bed device 7 and the like are controlled. In addition, the system control circuit 66 can implement a puncture support function by executing a puncture support program. The puncture support function accurately punctures the puncture needle 8 as shown in FIG. 4 when performing an operation method in which a puncture needle is inserted from the body surface of the subject P for the purpose of collecting a tumor tissue piece or ablation treatment, This is a function for executing a puncture plan and performing navigation of a puncture operation under fluoroscopy. The puncture plan includes a process of designating a path 9 connecting the puncture site 91 and the target site 92 and a process of determining two observation angles. The “site” in the puncture site 91 and the target site 92 may be read as “position”. In the vicinity of the path 9, the distance between the puncture site 91 and the target site 92 may be displayed. In the case of the path 9 shown in FIG. 4, for example, a distance such as “80.00 mm” may be displayed above the path 9. The distance may be displayed near the path 9 as in FIGS. 5 and 6. The navigation includes a process of superimposing and displaying a part of the 3D image g2 on the X-ray image g1, which is an X-ray fluoroscopic image, and a process of displaying the path 9 on the superimposed 3D image. In FIG. 4, the straight line on the right side from the puncture site 91 represents the puncture needle 8a in the subject P. The straight line on the left side from the puncture site 91 represents a part of the puncture needle 8b protruding from the body surface of the subject P.

  The two observation angles (Working Angle) are angles corresponding to the angle at which the C-arm 54 is inclined with respect to the vertical axis. Each observation angle is a parallel observation angle and a vertical observation angle, and is alternately switched during puncture to confirm the state of the puncture needle 8.

  The parallel observation angle is an observation angle corresponding to a direction D1 parallel to the path direction Dn, as shown on the left side of FIG. When the C arm 54 is arranged at a parallel observation angle, the axial direction of the imaging axis SA is substantially parallel to the path direction Dn. The imaging axis SA is an axis that passes through the X-ray focal point of the X-ray tube 52 and the detection surface center of the X-ray detector 53. In the X-ray image taken at the parallel observation angle, the puncture needle 8 is represented by a dot or a short straight line as shown on the right side of FIG. When the puncture needle 8 is represented by a dot, the puncture needle 8 is punctured along a path 9 (not shown), and when the puncture needle 8 is represented by a short straight line, the puncture needle 8 is out of the path 9 It can be seen that the puncture is in the direction of the puncture.

  The vertical observation angle is an observation angle corresponding to a direction D2 perpendicular to the path direction Dn, as shown on the left side of FIG. When the C arm 54 is disposed at a vertical observation angle, the axial direction of the imaging axis SA is substantially perpendicular to the path direction Dn. In the X-ray image taken at the vertical observation angle, the puncture needle 8 is represented by a long straight line as shown on the right side of FIG. In the X-ray image in FIG. 6, the puncture needle 8 overlaps on a path 9 (not shown).

  Further, the system control circuit 66 has an interference prevention function including an update function. The update function is a function for updating the second interference determination area A2 including the top 7a and the subject P, as shown in FIGS. 5 and 6, based on the geometric imaging conditions of the X-ray image. Specifically, the update function derives the position and size of the top 7a and the subject P based on the geometric imaging conditions of the X-ray image, and based on the derived result, the top 7a and the subject P are determined. The second interference determination area A2 is updated. However, the update function is an arbitrary additional matter and may be omitted. The interference prevention function is a function that updates the second interference determination area A2 by the update function and controls at least the movement of the imaging device 5 based on the updated second interference determination area A2. For example, the interference prevention function controls to sound a warning sound or to decelerate or stop the movement of the CT gantry 2 and the imaging device 5 when the clearance between the moving body and the interfering object falls below a threshold value. Note that the interference prevention function can control at least the movement of the imaging device 5 based on the second interference determination area A2 that is not updated even when the update function is omitted. The system control circuit 66 controls the display 64 and the like.

  Here, in addition to the control described above, the system control circuit 66 sets the first interference determination region including the device protruding from the subject P based on the device image included in the X-ray image, and the set The holding device is controlled so as to limit the movement of the imaging device 5 in the first interference determination region. The holding device is a support mechanism including a C arm 54, a holding portion 54a, and a support arm 54b. When restricting the movement of the imaging device 5 in the first interference determination area, the movement of the imaging apparatus 5 may be restricted so as not to enter the first interference determination area. Or you may restrict | limit the movement of the imaging device 5 so that the moving speed of the imaging device in a 1st interference determination area may become smaller than the moving speed in the area | region outside a 1st interference determination area. That is, the system control circuit 66 may control the holding device so that the movement of the imaging device 5 in the first interference determination area is stopped or decelerated. Further, when the movement of the imaging device 5 is restricted, the approach of the imaging device 5 in the first interference determination area may be notified. In this case, the system control circuit 66 may output a notification signal to a warning sound generator (not shown) or the like. Such a system control circuit 66 may have the following functions (f66-1) to (f66-3). Further, as a function that combines the functions (f66-1) and (f66-2), the amount of protrusion of the device from the subject P is derived, and the first interference determination region is set based on the derived amount of protrusion. You may have the function to do.

  (F66-1): A derivation function for deriving the protrusion amount of the device from the subject P based on the device image included in the X-ray image. In this example, the image of the device included in the X-ray image is an image of the puncture needle 8, and the device protruding from the subject is the puncture needle 8. However, the device is not limited to this, for example, a needle that is inserted into a subject and partially protrudes from the subject, such as a needle that is a medical instrument used for collection of tissue pieces or ablation treatment. Good. Supplementally, as the needle, any medical instrument that pierces the subject can be used. Examples of this type of needle include a needle used for puncture, a needle used for ablation, a needle used for drainage, and a needle used for bone cement injection. The same applies to the device image (needle image). Here, the derivation function derives the length of the device that has entered the subject P based on the image of the device, for example, and subtracts the derived length from the preset total length of the device, thereby The amount of protrusion from the subject P may be derived. In this case, the total length of the device is stored in the storage circuit 65 in advance. That is, the system control circuit 66 may read the preset full length of the device from the storage circuit 65 and use it for the subtraction. The derivation function may derive the length of the device that has entered the subject P based on the device image and the puncture plan. For example, the length of the device that has entered the subject P can be derived by comparing the length of the image of the device that has entered the subject P with the length of the path 9 in the puncture plan. The derivation function may start the derivation of the protrusion amount with a predetermined operation by the operator as a trigger. This predetermined operation may be an operation of pressing a physical button or an operation of clicking an icon on the screen. Further, the derivation function may derive the protrusion amount in real time in a state where the device is entering the subject P. The situation where the device is entering is a situation where the puncture needle 8 is punctured, for example. “Real time” means “every predetermined short period”. That is, “real time” may be called “substantially real time”. Moreover, when calculating | requiring a protrusion amount in real time, it is not necessary to calculate | require a protrusion amount with all the fluoroscopic images, You may obtain | require about one part among the perspective images produced | generated sequentially. For example, when a fluoroscopic image is acquired at 30 fps, a process of deriving a protrusion amount at a rate of one out of 30 sheets is performed, and the setting of the first interference determination area is repeated once / sec. can do. In this case, “every predetermined short period” is “every period between the fluoroscopic image update interval (1/30 second) and the first interference determination region setting interval (1 second)”, that is, “0 0.03 to 1 second of arbitrary period ”, for example,“ every 0.5 seconds ”. In addition, when the amount of protrusion of the device changes, it is preferable that the setting of the first interference determination area is updated with as little delay as possible, but there may be some delay. For example, a delay of about 10 seconds is acceptable. This is because, generally, after the puncture according to the puncture plan is completed, it takes about 10 seconds to confirm the direction and depth of the puncture needle 8 and to start autopositioning. That is, if the first interference determination area is set about every 10 seconds, the latest first interference determination area is already set when auto-positioning is started. Note that “real time” means “every predetermined short period”, and is not limited to the illustrated second value.

  (F66-2): A setting function for setting the first interference determination area A1 including the device (puncture needle 8) protruding from the subject P as shown in FIG. 5 or 6 based on the derived protrusion amount. Note that the setting function may set the first interference determination area A1 in real time when the protrusion amount is derived in real time. "Real time" here means "every predetermined short period" as described above, but may be every period longer than "real time" of the process of deriving the protrusion amount. Similarly, when setting the first interference determination area A1 in real time, it is not necessary to set the first interference determination area A1 for each of all the protrusion amounts, and a part of each protrusion amount derived sequentially. The first interference determination area A1 may be set for the amount of protrusion. In addition, the first interference determination area A1 including this device and the above-described second interference determination area A2 including the top plate 7a and the subject P may be in contact with each other without overlapping or may partially overlap. .

  (F66-3): A control function for controlling the movement of the CT gantry 2, the imaging device 5, and the top board 7a while preventing entry into the set first interference determination area A1. For example, this control function moves the imaging device 5 without entering the first and second interference determination areas A1 and A2 when the imaging device 5 is retracted from the imaging position. Further, for example, this control function controls the movement of the CT gantry 2 and the top plate 7a so as not to enter the first and second interference determination areas A1 and A2 when the CT gantry 2 is arranged at the imaging position. For example, when the height of the top plate 7a and the height of the opening 2a do not match and the CT gantry 2 is moved toward the imaging position, the control function causes the CT gantry 2 to be temporarily moved if it collides with the top plate 7a. The top plate 7a is moved in the vertical direction. Accordingly, the control function moves the CT gantry 2 while inserting the first and second interference determination areas A1 and A2 into the opening 2a of the CT gantry 2. Such a control function controls, for example, the movement of the CT gantry 2, the imaging device 5, and the top plate 7a so as not to enter the first interference determination area A1 and the second interference determination area A2 during execution of auto-positioning. . However, the period during which the control function is controlled is not limited to the time when autopositioning is being executed. Further, the control function prevents at least the first interference determination area A1 from entering the first and second interference determination areas A1 and A2 from the viewpoint of avoiding a collision with a device protruding from the subject. What is necessary is just to control movement.

  The system control circuit 66 may further include an initialization function in addition to the above functions. The initialization function is a function that initializes the first interference determination region A1 so as to return a region that has been reduced by repeated setting, when a predetermined condition is satisfied as a trigger.

  Next, the operation of the medical image diagnostic system configured as described above will be described with reference to the flowcharts of FIGS. In the following description, an image of a puncture needle is used as an example of an image of a device, and a puncture needle is used as an example of a device. This is the same in the following embodiments and modifications.

  In step ST1, the system control circuit 37 of the CT console 3 sets the CT gantry 2 at the imaging position of the subject P placed on the top 7a. Here, the imaging position is a position where the puncture site 91 and the target site 92 can be imaged.

  In step ST2, CT imaging by the CT gantry 2 is performed, and a 3D image of the subject P is generated and displayed in the CT console 3. If there is no problem, the 3D image is transferred from the CT console 3 to the angio console 6 and stored in the storage circuit 65 in the angio console 6. If there is a problem with the 3D image, step ST2 is executed again.

  In step ST3, the system control circuit 66 in the angio console 6 executes a puncture support plan in accordance with the operation of the operator. In the puncture support plan, the 3D image in the storage circuit 65 is displayed on the display 64, and the path 9 connecting the puncture site 91 and the target site 92 is designated on the 3D image by the operation of the operator. Further, based on the designated path 9, a parallel observation angle corresponding to the direction D1 parallel to the path direction Dn and a vertical observation angle corresponding to the direction D2 perpendicular to the path direction Dn are determined.

  In step ST4, after the CT gantry 2 is retracted from the imaging position, the imaging device 5 is set at a position close to the imaging position of the subject P.

  In step ST5, when a geometric imaging condition of the X-ray image is input according to the operation of the operator, the system control circuit 66 determines the positions of the top 7a and the subject P based on the imaging condition. And derive the size.

  In step ST6, the system control circuit 66 updates the second interference determination area A2 including the top 7a and the subject P based on the derivation result.

  In step ST7, the system control circuit 66 controls the movement of the entire C arm 54 including the X-ray tube 52 and the X-ray detector 53 based on the updated second interference determination area A2. For example, when the clearance between the moving body (the entire C arm 54) and the interference (top plate 7a and subject P) is equal to or less than a threshold value, the system control circuit 66 sounds a warning sound from a warning sound generator (not shown). Or control to decelerate or stop the movement of the moving body. As the warning sound generator, for example, a speaker or a buzzer can be used as appropriate. Thereby, the X-ray tube 52 and the X-ray detector 53 are arranged in the vicinity of the top board 7a and the subject P, respectively, while preventing the collision between the moving body and the interference. Note that, as the X-ray tube 52 and the X-ray detector 53 are brought closer to the top plate 7a and the subject P, respectively, a higher-quality X-ray image can be taken. For this reason, it is preferable to perform X-ray imaging by bringing the X-ray tube 52 and the X-ray detector 53 close to the top plate 7a and the subject P as close as possible. However, since the risk of a collision increases when approaching to the last minute, as described above, the movement of the moving body is controlled while sounding a warning sound.

  In step ST8, X-ray fluoroscopy is performed by the imaging device 5, and an X-ray image is generated. That is, the X-ray tube 52 generates X-rays that are irradiated to the subject P, and the X-ray detector 53 detects the X-rays that have passed through the subject P. The image generation circuit 61 generates an X-ray image based on the output of the X-ray detector 53. The X-ray image is displayed on the display 64.

  In step ST9, the system control circuit 66 executes the puncture support program and activates the puncture support function by the operation of the operator. The puncture support function controls the display 64 so that a part of the 3D image including the path 9 specified in step ST3 is superimposed on the X-ray image displayed in step ST8. In addition, the system control circuit 66 performs alignment between the superimposed X-ray image and a part of the 3D image by the operation of the operator. Puncturing can be started after the alignment is completed.

  In step ST10, the system control circuit 66 sets the observation angle to the parallel observation angle as necessary, and arranges the C arm 54 at an angle corresponding to the parallel observation angle. If the C arm 54 is disposed at an angle corresponding to the parallel observation angle at the end of step ST9, step ST10 is omitted. In any case, the puncture is started or continued under X-ray fluoroscopy at a parallel observation angle at which the puncture site 91 on the body surface of the subject P is easily visible.

  In step ST11, the angio console 6 generates an X-ray image at the time of puncture and displays it on the display 64. When puncturing is completed, the process proceeds to step ST12.

  In step ST12, the imaging device 5 is withdrawn from the imaging position for confirmation imaging by CT, and the CT gantry 2 is set at the imaging position of the subject P.

  Here, the processing of step ST11 at the time of puncturing and step ST12 for confirmation imaging will be described in detail with reference to the flowchart of FIG. In the following description, the process included in step ST11 is described as steps ST11-1 to ST11-9, and the process included in step ST12 is described as steps ST12-1 to ST12-3.

  In step ST11-1, the angio console 6 generates an X-ray image at the time of puncture and displays it on the display 64.

  In step ST11-2, the system control circuit 66 determines whether or not a predetermined condition is satisfied. If the predetermined condition is satisfied, the system control circuit 66 proceeds to step ST11-3. If not, the system control circuit 66 proceeds to step ST11-4. Transition. The predetermined condition is a condition indicating the possibility that the puncture needle 8 has come out of the updated first interference determination area A1, and includes, for example, a decrease in the length of the puncture needle 8 in the subject P.

  In step ST11-3, the system control circuit 66 initializes the first interference determination area A1 so as to return the area reduced by the repetition of the setting in step ST11-6, using a case where a predetermined condition is satisfied as a trigger.

  In step ST11-4, the system control circuit 66 determines whether or not the observation angle is a vertical observation angle. If the observation angle is the vertical observation angle, the system control circuit 66 proceeds to step ST11-5. If not, the system control circuit 66 proceeds to step ST11-7. Transition.

  In step ST11-5, the system control circuit 66 derives the amount of protrusion of the puncture needle 8 from the subject P based on the image of the puncture needle 8 included in the X-ray image. The image of the puncture needle 8 is detected as an image of a black line in the vicinity of the puncture site 91 and the path 9 and substantially parallel to the path 9. When there are a plurality of images of the puncture needle 8, the operator may select the image of the puncture needle 8. Further, the system control circuit 66 derives the length of the puncture needle 8 in the subject P based on the image of the puncture needle 8, and subtracts the derived length from the preset total length of the puncture needle 8. The protruding amount of the puncture needle 8 from the subject P may be derived. At this time, the system control circuit 66 may read the preset full length of the puncture needle 8 from the storage circuit 65 and use it for subtraction. Such a modification can be similarly applied to the following embodiments and modifications.

  In step ST11-6, the system control circuit 66 sets the first interference determination area A1 including the puncture needle 8 protruding from the subject P based on the derived protrusion amount. Note that steps ST11-5 to ST11-6 (derivation of protrusion amount, setting of first interference determination area A1) may be started automatically after activation of the puncture support function, for example, and trigger an operation by the operator. You may start as

  In steps ST11-7 to ST11-8, the system control circuit 66 determines whether or not to switch the observation angle according to the presence or absence of the switching operation by the operator. If the determination result is affirmative, the system control circuit 66 determines the observation angle. Switch. When not changing an observation angle, it transfers to step ST11-9. Each observation angle is alternately switched during puncturing in order to confirm the state of the puncture needle 8. At the vertical observation angle, the position of the tip of the puncture needle 8 and the direction of the puncture needle 8 are confirmed. At the parallel observation angle, the direction of the puncture needle 8 is confirmed. Further, when the observation angle is switched alternately, the system control circuit 66 controls the holding device so as to limit the movement of the imaging device 5 in each of the interference determination areas A1 and A2. Further, when restricting the movement of the imaging device 5, the system control circuit 66 may notify the approach of the imaging device 5 in each of the interference determination areas A1 and A2.

  In step ST11-9, the process is divided depending on whether or not the puncture is completed. If the puncture has not ended, the process returns to step ST11-1, and the puncture is continued. When puncturing is completed, the process proceeds to step ST12-1.

  In step ST12-1, the system control circuit 66 starts auto-positioning by the operator's operation.

  In step ST12-2, when retracting the imaging device 5 from the imaging position, the system control circuit 66 performs imaging in the second interference determination area A2 updated in step ST6 or the first interference determination area A1 set in ST11-6. The holding device is controlled so as to limit the movement of the device 5. The system control circuit 66 controls the movement of the CT gantry 2 and the top plate 7a while preventing the entry to the first and second interference determination areas A1 and A2 when the CT gantry 2 is placed at the imaging position. To do. For example, if the CT gantry 2 is moved toward the imaging position, the CT gantry 2 is temporarily stopped and the top plate 7a is moved in the vertical direction when it collides with the top plate 7a or the like. Thereafter, the CT gantry 2 is moved so as to be placed at the imaging position.

In step ST12-3, the imaging device 5 is retracted from the imaging position and the CT gantry 2 is set at the imaging position of the subject P due to the end of auto-positioning.
Thus, step ST12 is completed.

  In step ST13, as shown in FIG. 7, confirmation imaging by the CT apparatus is executed.

  In step ST14, the processing is divided depending on whether or not the puncture end is confirmed based on the result of the confirmation photographing. When the end of puncturing is not confirmed, the process proceeds to step ST15 and the puncturing is continued. If the end of puncturing is confirmed, the process proceeds to step ST16.

  In step ST15, after the CT gantry 2 is retracted from the imaging position, the imaging device 5 is set to a position before execution of step ST12.

  In step ST16, with the end of puncture, the collection of tumor tissue pieces or ablation treatment is performed via the puncture needle 8, and then the first and second interference determination areas A1 and A2 are initialized. Thereafter, the puncture support function is terminated.

  As described above, according to the first embodiment, the first interference determination region including the device protruding from the subject is set based on the image of the device included in the X-ray image. In addition, the holding device is controlled so as to limit the movement of the imaging device in the set first interference determination region.

  Therefore, it is possible to reduce time and labor for positioning while avoiding a collision with a device protruding from the subject. In addition to this, it is possible to improve the procedure efficiency while maintaining safety by setting an optimal interference determination area during the procedure without adding a dedicated sensor or jig.

  Here, controlling the holding device may include controlling the holding device so that the imaging device does not enter the first interference determination region. In this case, the collision with the device protruding from the subject can be avoided more reliably.

  Further, controlling the holding device may include controlling the holding device so that the moving speed of the imaging device in the first interference determination area is lower than the moving speed in an area outside the interference determination area. In this case, the imaging apparatus can be arranged in the vicinity of the device while avoiding a collision with the device protruding from the subject.

  In addition to this, a high-quality X-ray image is obtained by arranging the X generation unit and the X-ray detection unit in the vicinity of the top plate and the subject, respectively, by the second interference determination region for protecting the top plate and the subject. it can. In addition, the first interference determination region for protecting the device protruding from the subject can protect the device from collision with a moving body that moves during auto-positioning. Supplementally, the shorter the distance from the X generation unit to the X-ray detection unit through the subject, the X-ray image is not blurred and the image quality of the X-ray image is improved. Here, with the configuration in which the second interference determination region and the first interference determination region are separately provided, the outer edge of the second interference determination region and the subject to the extent that the device protruding from the subject protrudes from the second interference determination region. Can be thinned between the body surface. For this reason, the image quality of the X-ray image can be improved by arranging the X-ray detection unit near the body surface of the subject. Further, a device protruding from both the subject and the second interference determination area can be protected by the first interference determination area. Therefore, at the time of X-ray imaging, the image quality of the X-ray image can be improved, and as described above, it is possible to improve the technique efficiency while maintaining safety by setting the optimum interference determination area during the procedure. In addition, at the time of auto-positioning, as described above, it is possible to reduce the time and effort of positioning while avoiding the collision with the device protruding from the subject.

  In the first embodiment, a memory (storage circuit 65) that stores the entire length of the device in advance is provided. Based on the total length of the device, the protrusion amount of the device from the subject is derived, and the derived protrusion amount The first interference determination area may be set based on the above. In this case, even if the image of the device in the X-ray image is a part of the device, the amount of protrusion of the device from the subject can be derived. Specifically, the amount of protrusion of the device may be derived by deriving the length of the device that has entered the subject based on the image of the device and subtracting the length from the total length of the device. In this case, confusion between the image of the device in the X-ray image and the image of the black line other than the image of the device can be prevented.

  In the first embodiment, the first interference determination area may be initialized so as to return an area that has been reduced by repeated setting using a case where a predetermined condition is satisfied as a trigger. In this case, for example, when the condition that the length of the device that has entered the subject has decreased is satisfied, the first interference determination area is returned to the initial maximum area, and the device protrudes from the first interference determination area. Safety can be improved. Here, the condition that the length of the device that has entered the subject has decreased means, for example, that the length of the device that has protruded from the subject (the amount of protrusion) has increased due to the operation of the device by the operator. ing.

  Further, in the first embodiment, the derivation of the protrusion amount may be started with a predetermined operation by the operator as a trigger. In this case, the derivation of the protrusion amount may be started at a timing desired by the operator. it can.

  In the first embodiment, in a situation where a device has entered the subject, the amount of protrusion may be derived in real time, and the first interference determination area may be set in real time. In this case, the first interference determination area can be set according to the device entry status.

<Modification>
Next, a modification of the first embodiment will be described.
Unlike the first embodiment in which the first interference determination area A1 is set at the time of puncture, the modified example of the first embodiment sets the first interference determination area A1 in response to the start of arm operation by auto-positioning. .

  Specifically, the system control circuit 66 starts the derivation of the protrusion amount, triggered by the start of the process of moving the entire C arm 54 including the X-ray tube 52 and the X-ray detector 53 to a predetermined retracted position, The first interference determination area A1 is set based on the derived protrusion amount.

  Other configurations are the same as those of the first embodiment.

  Next, the operation of the modified example configured as described above will be described with reference to the flowchart of FIG. This modified example is generally the same as the operation of steps ST1 to ST16 shown in FIG. However, in this modification, as shown in FIG. 9, the details of steps ST11 to ST12 are different from those of the first embodiment. Therefore, in the following description, only details of steps ST11 to ST12 will be described.

  In step ST11, the above-described steps ST11-1 to ST11-3 and ST11-7 to ST11-9 are executed. That is, in the modification, steps ST11-4 to ST11-6 (confirmation of the vertical observation angle, derivation of the protrusion amount of the puncture needle, and setting of the first interference determination area A1) are not performed during puncture.

  Subsequently, in step ST12, steps ST12-2a to ST12-2d are executed between step ST12-1 and step ST12-2 described above. That is, in the modification, at the start of auto-positioning in step ST12-1, confirmation of the vertical observation angle, derivation of the puncture needle protrusion amount, setting of the first interference determination area A1, and the like are executed.

  Specifically, in steps ST12-2a to ST12-b, the system control circuit 66 determines whether or not the observation angle is a vertical observation angle, and if not, switches to the vertical observation angle. In the case of the vertical observation angle, the process proceeds to step ST12-2c. If the observation angle at the start of auto-positioning is determined to be the vertical observation angle by an inspection routine or the like, steps 12-2a and ST12-2b are not necessary.

  In step ST12-2c, the system control circuit 66 uses the start of the process of moving the entire C arm 54 including the X-ray tube 52 and the X-ray detector 53 to a predetermined retracted position as a trigger, and the puncture included in the X-ray image. Based on the image of the needle 8, the amount of protrusion of the puncture needle 8 from the subject P is derived.

  In step ST12-2d, the system control circuit 66 sets the first interference determination area A1 including the puncture needle 8 protruding from the subject P based on the derived protrusion amount.

  Thereafter, steps 12-2 to ST12-3 are executed in the same manner as described above.

  As described above, according to the modification of the first embodiment, the protrusion amount is derived using the start of the process of moving the entire holding unit including the X-ray generation unit and the X-ray detector to a predetermined retreat position as a trigger. Start. For this reason, in addition to the effects of the first embodiment, the process of deriving the protrusion amount and the process of setting the first interference determination region can be collectively executed at the start of autopositioning.

<Second Embodiment>
FIG. 10 is a schematic diagram showing the configuration of the X-ray diagnostic apparatus according to the second embodiment. The same reference numerals are given to substantially the same parts as those in FIG. 3A, and detailed descriptions thereof are omitted. Mainly stated.

  The second embodiment is a modification of the first embodiment, and the CT gantry 2 and the CT console 3 are omitted from the medical image diagnostic system shown in FIG. 3A. As shown in FIG. And it is comprised as an X-ray diagnostic apparatus provided with the console 6 for Angio.

  Here, the imaging device 5 and the angio console 6 have the same configuration as in the first embodiment. However, with the omission of the CT gantry 2 and the like, the system control circuit 66 in the angio console 6 omits a control function for placing a modality (eg, CT gantry 2) at the imaging position among the functions described above. The That is, the system control circuit 66 functions to control the movement of the modality and the top plate 7a while preventing the entry to the first interference determination area A1 and the second interference determination area A2 when the modality is arranged at the photographing position. Is omitted. Moreover, since there is no fear that the top plate 7a collides with the modality due to omission of the modality, the top plate 7a may not necessarily be movable in the vertical direction. The system control circuit 66 has a control function for controlling the movement of the imaging device 5 as described above. Further, as described above, the period during which the control function is controlled is not limited to the time during execution of autopositioning. Similarly, the control function prevents entry into at least the first interference determination area A1 among the first and second interference determination areas A1 and A2 from the viewpoint of avoiding a collision with a device protruding from the subject. The movement may be controlled as described above.

  Next, the operation of the X-ray diagnostic apparatus configured as described above will be described with reference to the flowcharts of FIGS.

  In step ST21, CT imaging is performed in advance by a CT apparatus (not shown), and a 3D image of the subject P is obtained. This 3D image is transferred from the CT apparatus to the angio console 6. Thereby, the 3D image of the subject P is stored in the storage circuit 65 in advance.

  In step ST <b> 22, the system control circuit 66 in the angio console 6 displays the 3D image in the storage circuit 65 on the display 64.

  In step ST23, the system control circuit 66 executes the puncture support plan as in step ST3.

  In step ST24, the system control circuit 66 in the angio console 6 sets the imaging device 5 at a position close to the imaging position of the subject P placed on the top 7a.

  Steps ST25 to ST31 are executed in the same manner as steps ST5 to ST11 described above.

  In step ST32, the imaging device 5 is withdrawn from the imaging position for some procedure or treatment.

  Here, the process of step ST31 at the time of puncture and step ST32 at the time of angio retraction will be described in detail with reference to the flowchart of FIG. In the following description, the process included in step ST31 is described as steps ST31-1 to ST31-9, and the process included in step ST32 is described as steps ST32-1 to ST32-3.

  Steps ST31-1 to ST31-9 and ST32-1 are executed in the same manner as steps ST11-1 to ST11-9 and ST12-1.

  In step ST32-2, the system control circuit 66 prevents entry into the first and second interference determination areas A1 and A2 updated in steps ST26 and ST31-6 when the imaging device 5 is retracted from the imaging position. The movement of the imaging device 5 is controlled.

In step ST <b> 32-3, the image capturing apparatus 5 is withdrawn from the photographing position by the end of auto-positioning.
Thus, step ST32 is completed.

  In step ST <b> 33, as shown in FIG. 11, an arbitrary procedure or treatment is performed on the subject P by the doctor with the imaging device 5 retracted.

  After the procedure or treatment in step ST33, in step ST34, the process is divided depending on whether or not the end of puncturing is confirmed. If the end of puncturing is not confirmed, the process proceeds to step ST35 and the puncturing is continued. If the end of puncturing is confirmed, the process proceeds to step ST36.

  In step ST35, the imaging device 5 is set to a position before execution of step ST32.

  Step ST36 is executed in the same manner as step ST16 described above. Thus, the first and second interference determination areas A1 and A2 are initialized, and the puncture support function is terminated.

  As described above, according to the second embodiment, among the X-ray diagnostic apparatus and the CT apparatus in the first embodiment, the CT apparatus may be omitted, and the first embodiment may be configured by the X-ray diagnostic apparatus. The same effect can be obtained.

  That is, according to the second embodiment, as described above, it is possible to reduce the time and effort of positioning while avoiding the collision with the device protruding from the subject. In addition to this, it is possible to improve the procedure efficiency while maintaining safety by setting the optimum interference determination area during the procedure without adding a dedicated sensor or jig.

  Similarly, when the length of the device that has entered the subject is derived based on the image of the device, and the length is subtracted from the preset total length of the device to derive the projection amount, This can prevent confusion between the image of the device and the image of the black line other than the device image.

  Similarly, when initializing the first interference determination region so as to return the region reduced by repeated setting using a predetermined condition as a trigger, for example, when the length of the device in the subject decreases, Since the device can be prevented from protruding from one interference determination area, safety can be improved.

  Similarly, when the derivation of the protrusion amount is started using a predetermined operation as a trigger, the derivation of the protrusion amount can be started at a timing desired by the operator.

  Similarly, when the device has entered the subject and the amount of protrusion is derived in real time and the first interference determination region is set in real time, the first interference determination region is set according to the device entry state. Can be set.

<Modification>
Next, a modification of the second embodiment will be described.
Unlike the second embodiment in which the first interference determination area A1 is set at the time of puncturing, the modification of the second embodiment sets the first interference determination area A1 after the start of autopositioning. In other words, the modification of the second embodiment is an application of the modification of the first embodiment to the second embodiment.

  Here, the system control circuit 66 starts and derives the protrusion amount by using the start of the process of moving the entire C arm 54 including the X-ray tube 52 and the X-ray detector 53 to a predetermined retreat position as a trigger. The first interference determination area A1 is set based on the protrusion amount.

  Other configurations are the same as those of the second embodiment.

  Next, the operation of the modified example configured as described above will be described with reference to the flowchart of FIG. This modified example is generally the same as the operations of steps ST21 to ST36 shown in FIG. Further, in this modification, as shown in FIG. 13, the details of steps ST31 to ST32 are different from those of the second embodiment. Therefore, in the following description, only details of steps ST31 to ST32 will be described.

  In step ST31, the above-described steps ST31-1 to ST31-3 and ST31-7 to ST31-9 are executed. That is, in the modified example, steps ST31-4 to ST31-6 (confirmation of the vertical observation angle, derivation of the protrusion amount of the puncture needle, setting of the first interference determination area A1) are not performed during puncture.

  Subsequently, in step ST32, steps ST32-2a to ST32-2d are executed between step ST32-1 and step ST32-2 described above. That is, in the modified example, at the start of auto-positioning in step ST32-1, confirmation of the vertical observation angle, derivation of the amount of protrusion of the puncture needle, setting of the first interference determination area A1, and the like are executed.

  Specifically, in steps ST32-2a to ST32-b, the system control circuit 66 determines whether or not the observation angle is a vertical observation angle, and if not, switches to the vertical observation angle. In the case of the vertical observation angle, the process proceeds to step ST32-2c.

  In step ST32-2c, the system control circuit 66 derives the amount of protrusion of the puncture needle 8 from the subject P based on the image of the puncture needle 8 included in the X-ray image.

  In step ST32-2d, the system control circuit 66 sets the first interference determination area A1 including the puncture needle 8 protruding from the subject P based on the derived protrusion amount.

  Thereafter, steps 32-2 to ST32-3 are executed in the same manner as described above.

  As described above, according to the modification of the second embodiment, the protrusion amount is derived using the start of the process of moving the entire holding unit including the X-ray generation unit and the X-ray detector to a predetermined retracted position. Start. For this reason, in addition to the effect of the second embodiment, the process of deriving the protrusion amount and the process of setting the first interference determination area can be collectively executed at the start of autopositioning.

  The term “processor” used in the above description is, for example, a CPU (Central Processing Unit), a GPU (Graphics Processing Unit), or an application specific integrated circuit (ASIC)), a programmable logic device (for example, It means a circuit such as a simple programmable logic device (SPLD), a complex programmable logic device (CPLD), and a field programmable gate array (FPGA). The processor implements a function by reading and executing a program stored in the storage circuit. Instead of storing the program in the storage circuit, the program may be directly incorporated in the processor circuit. In this case, the processor realizes the function by reading and executing the program incorporated in the circuit. Note that each processor of the present embodiment is not limited to being configured as a single circuit for each processor, but may be configured as a single processor by combining a plurality of independent circuits to realize the function. Good. Further, a plurality of components shown in FIGS. 3A and 10 may be integrated into one processor to realize the function.

  The X-ray tube 52 in each embodiment is an example of an X-ray generation unit in the claims. The C arm 54, the holding portion 54a and the support arm 54b, the support mechanism, and the holding device in each embodiment are examples of holding means in the claims. The image generation circuit 61 in each embodiment is an example of an image generation unit in the claims. The derivation function and setting function in the system control circuit 66 of each embodiment are examples of setting means in the claims. The control function, the initialization function, and the update function in the system control circuit 66 of each embodiment are examples of the control unit, the initialization unit, and the update unit in the claims. The storage circuit 65 of each embodiment is an example of a storage unit in the claims. The image of the puncture needle 8 in each embodiment is an example of the image of the device and the image of the needle in the claims. The puncture needle 8 in each embodiment is an example of a device and a needle in the claims.

  Although several embodiments of the present invention have been described, these embodiments are presented by way of example and are not intended to limit the scope of the invention. These embodiments can be implemented in various other forms, and various omissions, replacements, and changes can be made without departing from the spirit of the invention. These embodiments and their modifications are included in the scope and gist of the invention, and are also included in the invention described in the claims and the equivalents thereof.

  DESCRIPTION OF SYMBOLS 1 ... Medical diagnostic imaging system, 2 ... CT gantry, 3 ... CT console, 5 ... Imaging apparatus, 6 ... Angio console, 7 ... Bed apparatus, 7a ... Top plate, 8, 8a, 8b ... Puncture needle, 9 ... Path, 21 ... slip ring, 22 ... tube voltage generator, 23, 52 ... X-ray tube, 24, 53 ... X-ray detector, 25 ... data collection circuit, 26 ... non-contact data transmission circuit, 27 ... transport device, 28 ... gantry control circuit, 29 ... rotating ring, 30 ... rotary drive device, 31 ... preprocessing circuit, 32 ... reconfiguration circuit, 33, 62 ... input interface (I / F), 34, 63 ... communication interface (I / F), 35, 64 ... display, 36, 65 ... storage circuit, 65a ... table, 37, 66 ... system control circuit, 67 ... processing circuit, 51 ... tube voltage generator, 54 ... C-arm, 54a ... holding unit 54b ... support arm, 55 ... drive device, 56 ... imaging control circuit, 61 ... image generation circuit, 91 ... puncture site, 92 ... target site, P ... subject, A1, A2 ... interference determination area, Dn, D1, D2 …direction.

Claims (20)

A bed apparatus having a top plate on which the subject is placed;
An X-ray generator that generates X-rays that irradiate the subject, an X-ray detector that detects X-rays transmitted through the subject, and the X-ray generator and the X-ray detector are movably held. An imaging device comprising holding means for
Image generating means for generating an X-ray image of the subject based on the output of the X-ray detector;
Setting means for setting a first interference determination region including a device protruding from the subject based on an image of the device included in the X-ray image;
Control means for controlling the holding means so as to limit movement of the imaging device in the set first interference determination area;
An X-ray diagnostic apparatus comprising:   The X-ray diagnostic apparatus according to claim 1, wherein the control unit controls the holding unit so that the imaging apparatus does not enter the set first interference determination region.   The control means controls the holding means so that a moving speed of the imaging apparatus in the set first interference determination area is smaller than a moving speed in an area outside the first interference determination area. The X-ray diagnostic apparatus according to 1.   The X-ray diagnostic apparatus according to claim 1, wherein the setting unit derives a protrusion amount of the device from the subject and sets the first interference determination region based on the derived protrusion amount.   The setting means derives the length of the device that has entered the subject based on the image of the device, and subtracts the derived length from the preset total length of the device, thereby the protrusion. The X-ray diagnostic apparatus according to claim 4, wherein the quantity is derived. Comprising storage means for previously storing the total length of the device;
The X-ray diagnostic apparatus according to claim 5, wherein the setting unit reads the preset total length of the device from the storage unit and uses it for the subtraction.   7. The apparatus according to claim 1, further comprising: an initialization unit configured to initialize the first interference determination region so as to return a region reduced by repeating the setting when a predetermined condition is satisfied. The X-ray diagnostic apparatus described.   The X-ray diagnostic apparatus according to any one of claims 4 to 6, wherein the setting unit starts derivation of the protrusion amount with a predetermined operation by an operator as a trigger.   The setting unit starts derivation of the protrusion amount by using a start of a process of moving the entire holding unit including the X-ray generation unit and the X-ray detector to a predetermined retreat position as a trigger. X-ray diagnostic apparatus as described in any one of these.   The said setting means derives | leads-out the said protrusion amount in real time, and the said 1st interference determination area | region is set in real time in the condition where the device has approached the said test object, It is any one of Claim 4 thru | or 6 The X-ray diagnostic apparatus described.   The X-ray diagnostic apparatus according to claim 1, wherein the device is a needle, and an image of the device is an image of a needle. Updating means for updating a second interference determination area including the top and the subject based on a geometric imaging condition of the X-ray image;
The X-ray according to any one of claims 1 to 11, wherein the control unit controls the movement while preventing entry into the updated second interference determination region and the first interference determination region. Diagnostic device.   The X-ray diagnostic apparatus according to claim 1, wherein the control unit controls the movement when the imaging apparatus is retracted from an imaging position. A bed apparatus that holds the top plate on which the subject is placed movably in the vertical direction;
An X-ray generator that generates X-rays that irradiate the subject, an X-ray detector that detects X-rays transmitted through the subject, and the X-ray generator and the X-ray detector are movably held. An imaging device comprising holding means for
A modality that is used alternately with the imaging device and is movable to approach or leave the subject;
Image generating means for generating an X-ray image of the subject based on the output of the X-ray detector;
Setting means for setting a first interference determination region including a device protruding from the subject based on an image of the device included in the X-ray image;
Control means for controlling the holding means so as to limit movement of the imaging device in the set first interference determination area;
A medical image diagnostic system comprising:   The medical image diagnostic system according to claim 14, further comprising notification means for notifying the approach of the imaging device in the set first interference determination area. A bed apparatus having a top plate on which the subject is placed;
An X-ray generator that generates X-rays that irradiate the subject, an X-ray detector that detects X-rays transmitted through the subject, and the X-ray generator and the X-ray detector are movably held. An imaging device comprising holding means for
Image generating means;
Setting means;
Control means;
A method for controlling an X-ray diagnostic apparatus comprising:
An image generating step in which the image generating means generates an X-ray image of the subject based on an output of the X-ray detector;
A setting step in which the setting means sets a first interference determination region including a device protruding from the subject based on an image of the device included in the X-ray image;
A control step for controlling the holding means so that the control means limits the movement of the imaging device in the set first interference determination area;
A control method comprising: The control method according to claim 16, wherein the control step includes a step in which the control unit controls the holding unit so that the imaging apparatus does not enter the set first interference determination region. In the control step, the holding means is configured so that the moving speed of the imaging device in the set first interference determination area is smaller than a moving speed in an area outside the first interference determination area. The control method according to claim 16, comprising a controlling step. The setting step includes a step in which the setting means derives a protrusion amount of the device from the subject and sets the first interference determination region based on the derived protrusion amount. Control method. In the setting step, the setting means derives the length of the device that has entered the subject based on the image of the device, and subtracts the derived length from the preset total length of the device. The control method according to claim 19, further comprising a step of deriving the protrusion amount.