JP2018175379A - Medical image processing apparatus, medical image processing method, and medical image processing program - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a medical image processing apparatus which enables a direction where a medical appliance should be advanced in a tubular tissue in a subject, to be easily visually recognized.SOLUTION: The medical image processing apparatus comprises: an acquisition part acquiring volume data including a tissue having a tree structure; an extraction part extracting at least a section of the tree structure out of the volume data as tree structure data; a setting part setting a first point in the tree structure data; a generation part connecting the first point to a second point which is positioned closer to a proximal end side than the first point in the tree structure data, and generating a path extended along the tree structure data; and a display part which discriminates the path from a sub path branched from the path in the tree structure data, and displays the path, the branch of the sub path from the path, and a travel direction of the sub path from branch, the display part displaying travel directions of the path and the sub path in different display modes.SELECTED DRAWING: Figure 2

Description

  The present disclosure relates to a medical image processing apparatus, a medical image processing method, and a medical image processing program.

  Conventionally, an IVR (Interventional Radiology) is known which treats a subject by inserting a catheter into the subject while using an imaging diagnostic apparatus such as X-ray fluoroscopy, ultrasound imaging, and CT (Computed Tomography). It is done. In order to perform IVR, a physician refers to medical images before and during surgery for the blood vessel into which the catheter is inserted. At this time, it is known to explore tubular tissue.

  For example, a medical image processing method is known which displays all the blood vessels searched for in a subject by a blood vessel search algorithm (see Non-Patent Document 1). In this medical image processing method, arteries and veins branching toward the periphery are searched. In this medical image processing method, all blood vessel search results are displayed. The arteries and veins branching toward the periphery can be represented by a tree structure.

  There is also known a medical image processing method of extracting a path of a blood vessel connecting between two points (for example, point A and point B) in a subject using a blood vessel search algorithm (see Patent Document 1). ). This medical image processing method uses the point B as a start point according to a blood vessel search algorithm, and terminates the blood vessel search when the point A is reached.

U.S. Pat. No. 7,639,855

C. Boldak, Y. Rolland, C. Toumoulin, "An Improved Model-based Vessel Tracking Algorithm with Application to Computed Tomography Angiography", Biocybernetics And Biomedical Engineering, vol. 23 nr 1, p. 41-63, 2003

  In the technique of Non-Patent Document 1, since all of the blood vessels searched for in the subject are displayed, the number of elements to be displayed increases, and the display tends to be complicated. Therefore, it may be difficult for a doctor who performs IVR while confirming this display to determine which blood vessel the catheter should be advanced. Moreover, the possibility that blood vessels overlap and are displayed in the depth direction in the three-dimensional image is high. A physician performing IVR while confirming this indication may have difficulty distinguishing and observing overlapping blood vessels, and may cause the catheter to progress to the wrong blood vessel.

  In the technique of Patent Document 1, since only a path connecting two points is displayed, it is difficult to grasp how other blood vessels are branched from the blood vessel represented by this path. Therefore, a doctor who performs IVR while confirming this display views the branch ports of a plurality of blood vessels when it is necessary to change the blood vessels that progress from the first blood vessel to the second blood vessel toward the observation target Because it is difficult to do, there is a possibility that the direction of advancement of the catheter may be incorrect. Further, when the branched blood vessel extends in the depth direction on the display screen, it is difficult to grasp the branched blood vessel, which easily leads to an erroneous operation of the catheter.

  The present disclosure has been made in view of the above circumstances, and a medical image processing apparatus, a medical image processing method, and a medical image processing program capable of easily visually recognizing a direction in which a medical instrument should be advanced in a tubular tissue inside a subject. I will provide a.

  A medical image processing apparatus according to the present disclosure includes an acquisition unit for acquiring volume data including a tissue having a tree structure, an extraction unit for extracting at least a portion of the tree structure of the volume data as tree structure data, and tree structure data Connecting the first point to a setting unit for setting a first point in the tree structure, a second point located on the proximal side of the first point in the tree structure data, and the first point; To distinguish the route, the route and the sub-path, and the generation unit for generating a path traveling along the road, the path, and the sub-path branching off from the path in the tree structure data; And a display unit that displays a traveling direction from the branch of the auxiliary road, and displays the traveling direction of the route and the auxiliary road on one image in different display modes.

  A medical image processing method according to the present disclosure is a medical image processing method in a medical image processing apparatus, which acquires volume data including a tissue having a tree structure, and at least a part of the tree structure in the volume data is tree structure data Extracting a first point in the tree structure data, and connecting a second point located on the proximal side of the first point in the tree structure data and the first point; A route traveling along the tree structure data is generated, and the route and the secondary route branched from the route in the tree structured data are distinguished, and the traveling direction of the route and the secondary route branched from the route As a different display mode, the traveling direction from the path, the branch between the path and the auxiliary path, and the branch of the auxiliary path is displayed on one image.

  The medical image processing program of the present disclosure is a program for causing a computer to execute the steps of the medical image processing method.

  According to the present disclosure, the direction in which the medical device should be advanced can be easily viewed in the tubular tissue inside the subject.

Block diagram showing an example of the hardware configuration of the medical image processing apparatus according to the first embodiment Block diagram showing an example of functional configuration of a medical image processing apparatus A diagram for explaining an example of a display target of a path included in tree structure data Diagram for explaining another example of the display object of the path included in the tree structure data A diagram showing an example of an image including a path, a sub path and a branch A diagram showing an example of an image including a pathway, an alternative pathway, a branch, and an affected area Diagram for explaining variations of display modes of routes and sub routes Diagram for explaining variations of display modes of routes and sub routes Diagram for explaining variations of display modes of the route and the sub route 2 Flow chart showing an operation example of the medical image processing apparatus Diagram for explaining that the point in front of the affected area is set as the target point A schematic view showing a display example showing the traveling direction of the auxiliary road at a position separated by a predetermined distance from the branch A schematic diagram showing an example of tree structure data

  Hereinafter, embodiments of the present disclosure will be described using the drawings.

First Embodiment
FIG. 1 is a block diagram showing a configuration example of a medical image processing apparatus 100 according to the first embodiment. The medical image processing apparatus 100 includes a port 110, a user interface (UI: User Interface) 120, a display 130, a processor 140, and a memory 150.

  A CT apparatus 200 is connected to the medical image processing apparatus 100. The medical image processing apparatus 100 acquires volume data from the CT apparatus 200 and performs processing on the acquired volume data. The medical image processing apparatus 100 may be configured by a PC (Personal Computer) and software installed in the PC.

  The CT apparatus 200 irradiates a living body with X-rays, and uses the difference in absorption of X-rays by tissues in the body to capture an image (CT image). Examples of the living body include the human body. A living body is an example of a subject.

  A plurality of CT images may be captured in time series. The CT apparatus 200 generates volume data including information on any part inside the living body. Any place inside the living body may include various organs (eg, heart, kidney, large intestine, small intestine, lung). By capturing a CT image, a pixel value (CT value) of each pixel (voxel) in the CT image is obtained. The CT apparatus 200 transmits volume data as a CT image to the medical image processing apparatus 100 via a wired line or a wireless line.

  Specifically, the CT apparatus 200 includes a gantry (not shown) and a console (not shown). The gantry includes an X-ray generator (not shown) and an X-ray detector (not shown) and detects X-rays transmitted through the human body by imaging at a predetermined timing instructed by the console. Obtain line detection data. The x-ray generator comprises an x-ray tube (not shown). The console is connected to the medical image processing apparatus 100. The console acquires a plurality of X-ray detection data from the gantry, and generates volume data based on the X-ray detection data. The console transmits the generated volume data to the medical image processing apparatus 100. The console may include an operation unit (not shown) for inputting patient information, imaging conditions for CT imaging, contrast conditions for administration of a contrast agent, and other information. The operation unit may include an input device such as a keyboard or a mouse.

  The CT apparatus 200 can also acquire a plurality of three-dimensional volume data by continuously imaging and generate a moving image. The data of moving images by a plurality of three-dimensional volume data is also referred to as 4D (four-dimensional) data.

  The CT apparatus 200 may capture a CT image at each of a plurality of timings. The CT apparatus 200 may capture a CT image in a state in which the subject is imaged. The CT apparatus 200 may capture a CT image in a state in which the subject is not imaged.

  The port 110 in the medical image processing apparatus 100 includes a communication port and an external device connection port, and acquires volume data obtained from a CT image. The acquired volume data may be immediately sent to the processor 140 for various processing, or may be sent to the processor 140 for various processing after being stored in the memory 150 when necessary. Also, volume data may be acquired via a recording medium or a recording medium.

  The volume data imaged by the CT apparatus 200 may be sent from the CT apparatus 200 to an image data server (PACS: Picture Archiving and Communication Systems (not shown)) and stored. The port 110 may acquire volume data from the image data server instead of acquiring from the CT apparatus 200. Thus, the port 110 functions as an acquisition unit that acquires various data such as volume data.

  The UI 120 may include a touch panel, a pointing device, a keyboard, or a microphone. The UI 120 receives an arbitrary input operation from the user of the medical image processing apparatus 100. Users may include physicians, radiologists, or other paramedic staff.

  The UI 120 receives an operation such as designation of a region of interest (ROI) in volume data or setting of a luminance condition. The region of interest may include regions of various tissues (eg, blood vessels, bronchi, organs, bones, brain, heart, feet, neck, blood flow). The tissue may widely include tissue of a living body such as diseased tissue, normal tissue, organ, organ and the like.

  The display 130 may include an LCD (Liquid Crystal Display) and displays various information. The various information includes a three-dimensional image obtained from volume data. The three-dimensional image may include a volume rendering image, a surface rendering image, a virtual endoscopic image (VE image), an MPR image, a CPR image, and the like. The volume rendering image may include a RaySum image, a Maximum Intensity Projection (MIP) image, a Minimum Intensity Projection (MinIP) image, an Average image, or a Raycast image.

  The memory 150 includes various types of read only memory (ROM) and primary storage devices such as random access memory (RAM). The memory 150 may include a secondary storage device such as a hard disk drive (HDD) or a solid state drive (SSD). The memory 150 may include a USB memory or an SD card tertiary storage device. The memory 150 stores various information and programs. The various information may include volume data acquired by the port 110, an image generated by the processor 140, setting information set by the processor 140, and various programs. The memory 150 is an example of a non-transitory recording medium in which a program is recorded.

  The processor 140 may include a central processing unit (CPU), a digital signal processor (DSP), or a graphics processing unit (GPU). The processor 140 functions as a processing unit 160 that performs various types of processing and control by executing the medical image processing program stored in the memory 150.

  FIG. 2 is a block diagram showing an example of the functional configuration of the processing unit 160. As shown in FIG.

  The processing unit 160 includes an area extraction unit 161, an image generation unit 162, a tree structure extraction unit 163, a point setting unit 164, a path generation unit 165, and a display control unit 166.

  The processing unit 160 supervises each part of the medical image processing apparatus 100. Note that each unit included in the processing unit 160 may be realized as a different function by one hardware, or may be realized as a different function by a plurality of hardware. Also, each unit included in the processing unit 160 may be realized by a dedicated hardware component.

  The region extraction unit 161 may perform segmentation processing on volume data. In this case, the UI 120 receives an instruction from the user, and the information of the instruction is sent to the area extraction unit 161. The region extraction unit 161 may perform segmentation processing from volume data by a known method based on the information of the instruction to extract a region of interest (segment). Also, the region of interest may be set manually according to a detailed instruction from the user. In addition, when the observation target is determined in advance, the region extraction unit 161 may perform segmentation processing from volume data without a user instruction to extract a region of interest including the observation target. Areas to be extracted may include areas of various tissues (eg, blood vessels, bronchi, organs, bones, brain, heart, feet, neck, blood flow). Various tissues may include arteries, veins, portal veins, bile ducts, and the like.

  The image generation unit 162 may generate a three-dimensional image based on the volume data acquired by the port 110. The image generation unit 162 may generate a three-dimensional image based on the designated area or the area extracted by the area extraction unit 161 from the volume data acquired by the port 110. The image generation unit 162 generates display information as guide information which is displayed together with the three-dimensional image and which assists the progress of the medical instrument into the tubular tissue included in the volume data.

  Based on the acquired volume data, the tree structure extraction unit 163 extracts a portion of the tree shape (tree structure) included in the volume data as tree structure data TR (see FIG. 11). Volume data to be acquired includes a tissue having a tree shape (tree structure). The tree structure shows, for example, vascular travel and has parts of one or more blood vessels with one or more branches. The tree structure extraction unit 163 may extract tissue as volume of interest including tissue having a tree structure as a region of interest and extract it as a tree structure by thinning the region of interest. . The tree structure extraction unit 163 may perform the thinning process after the region of interest of the tissue is formed by so-called Morpology processing. The tree structure extraction unit 163 may extract the tree structure by applying known search processing (for example, search processing described in Non-Patent Document 1) to volume data including a tissue having a tree structure. The tree structure extraction unit 163 extracts the tree structure data TR from the volume data by thinning processing and search processing.

  The point setting unit 164 sets an arbitrary point in the tree structure data TR as a target point (Target) T1. The target point T1 may be a point included in the area of the affected part (observed part) T3 that the user desires to observe. The target point T1 may be a point located outside the area of the affected area T3 and may be independent of the affected area T3. The target point T1 may be set via the UI 120. That is, the target point T1 may be set manually by the user. Further, as the target point T1, an arbitrary point in the area (for example, the liver) extracted by the area extraction unit 161 may be set. That is, the target point T1 may be automatically set. The point setting unit 164 may set a point on the tree structure data TR closest to the affected area T3 as the target point T1. The point on the tree structure data TR which is originally close to the affected area T3 may be a point before the affected area in the insertion direction of the catheter (the base side of the tree structure data TR). When a cancer is extracted inside the subject by the cancer extraction algorithm, the point on the tree structure data TR that is the most extracted cancer may be taken as the target point T1. The target point T1 may be the point at which the physician intends to reach the catheter. From the catheter that has reached the target point T1, a hemostatic agent, an anticancer agent, or another drug can be administered, or a coil or a stent can be placed. The target point T1 may be the point at which the physician intends to reach the bronchoscope. From the bronchoscope that has reached the target point T1, it is possible to administer an anticancer agent and other drugs, to deploy a stent, and to perform a biopsy.

  The point setting unit 164 may set the area (affected area) or the point (affected area) of the affected area independently of the target point T1. The affected area or the affected area point is also simply referred to as "affected area". The affected area T3 may be set via the UI 120. That is, the affected area T3 may be set manually by the user. In addition, the affected area T3 may be automatically set according to the operation method or the like. For example, the point setting unit 164 may automatically set the affected area T3 in accordance with the operation method or identification information of the affected area input through the UI 120.

  The point setting unit 164 may set an arbitrary point different from the target point T1 in the tree structure data TR as the start point T2. The start point T2 is located on the proximal side (the root side of the tree) of the target point T1 in the tree structure data TR. When IVR is performed, the start point T2 may be a catheter insertion position in the subject. In this case, the start point T2 is a position of a standard for starting the catheter insertion. On the other hand, the start point T2 may not be the catheter insertion position.

  The point setting unit 164 may set an arbitrary point in a specific tissue (for example, the aorta) as the start point T2 according to the operation method. The start point T2 may be set as an intermediate point, a center point, a center of gravity, or the like in a specific tissue area. The technique information may be input via the UI 120, for example. The specific tissue may be the tissue of the area extracted by the area extraction unit 161 according to the information on the procedure.

  The point setting unit 164 may set the start point T2 in accordance with the target point T1. For example, when the target point T1 is a point included in one of the celiac artery and the hepatic artery, the start point T2 may be a point included in the aorta. The celiac artery and the hepatic artery are branched from the aorta. The region of the aorta may be extracted by the region extraction unit 161. For example, when the target point T1 is a point included in a cerebral aneurysm, the start point T2 may be a point included in a carotid artery. Because a carotid artery fistula occurs in the carotid artery. The region of the carotid artery may be extracted by the region extraction unit 161. In this case, the catheter insertion point may be different from the carotid artery as the starting point T2. This is because it is easy to recognize the advancing direction of the catheter on the side of the catheter insertion point with respect to the start point T2, and the possibility of the catheter entering the wrong branch is low even if there is no guide by display.

  Also, the start point T2 may be set via the UI 120. That is, the start point T2 may be set manually by the user.

  The path generation unit 165 generates, as a path (main path), a path connecting the start point T2 and the target point T1 along the tree structure data TR. The path generation unit 165 may set all paths indicating traveling of blood vessels and the like other than the main path in the tree structure data TR as the sub path. That is, the path generation unit 165 may generate a path obtained by subtracting the main path from the tree structure data TR as a sub path. The path generation unit 165 may use a path indicating traveling of a blood vessel or the like connected to the main path in the tree structure data TR, that is, branched from the main path, as the sub path. Therefore, the path generation unit 165 generates the main path and the sub path separately in the tree structure data TR. The path generation unit 165 detects the connection position of the main path and the sub path as a branch (branch position). The bifurcation may be, for example, a bifurcation point, an area near the bifurcation point, or a part of an auxiliary path located within a predetermined distance from the bifurcation point.

  The display control unit 166 causes the display 130 to display the route P1, the traveling direction PD2 of the auxiliary route P2, and the branch BR between the route P1 and the auxiliary route P2. The traveling direction PD2 of the sub road P2 may coincide with the position of the branch BR of the sub road P2 or the tangential direction of the sub road P2 as a path at a position separated by a predetermined distance from the branch BR. The traveling direction PD2 of the sub road P2 mainly aims at which direction the sub road P2 extends, and is not mainly intended to indicate the sub road P2 itself. That is, instead of displaying the entire sub road P2, the display is such that the traveling state of the sub road P2 can be grasped. The traveling direction PD2 of the sub road P2 may be represented by an arrow attached to the sub road P2, or represented by a line indicating the sub road P2 drawn within a predetermined distance (for example, several mm) in the vicinity of the branch BR. It may be expressed by other marks. As described above, the medical image processing apparatus 100 can suppress the decrease in the visibility of the display related to the traveling of the path P1 by suppressing the excessive display of the sub path P2.

  The display control unit 166 distinguishes the path P1 from the traveling direction PD2 of the auxiliary path P2, and the display direction of the path P1 and the traveling path PD2 of the auxiliary path P2 is different. And to display. For example, the display control unit 166 changes the line type of the line indicating the path P1 and the line indicating the traveling direction PD2 of the sub path P2 (for example, changing the type of solid line, dotted line, broken line, dashed line, hatching) to display You may control. The display control unit 166 may change the display color of the path P1 and the traveling direction PD2 of the sub path P2 (for example, change the color to black, red, blue, yellow, or green) to perform display. . The display control unit 166 may perform control so as to change the thickness of the line indicating the route P1 and the thickness of the line indicating the traveling direction PD2 of the sub route P2 for display.

  The display control unit 166 may perform control to add information (for example, an arrow or another mark) indicating the traveling direction of the route P1 to the tip or the like of the route P1 and display it. The display control unit 166 may perform control such that information (for example, an arrow or another mark) indicating the traveling direction PD2 of the sub road P2 is attached to the tip or the like of the sub road P2 and displayed. Note that the extension direction of the path displayed as the route P1 may be treated as information indicating the traveling direction of the route P1. Similarly, the extending direction itself of the path displayed as the sub path P2 may be treated as information indicating the traveling direction PD2 of the sub path P2.

  Information that assists (guides) the medical instrument to advance tissue, such as the path P1, the traveling direction PD2 of the sub path P2, and the branch BR, is also referred to as guide information in this embodiment.

  The display 130 performs various displays in accordance with control by the display control unit 166. The display 130 displays the path P1, the traveling direction PD2 of the auxiliary path P2, and the branch BR. The display 130 distinguishes the route P1 from the traveling direction PD2 of the auxiliary route P2, and displays the route P1 and the traveling direction PD2 of the auxiliary route P2 so that the display modes of the route P1 and the traveling direction PD2 of the auxiliary route P are different. indicate. For example, the display 130 changes the line type of the line indicating the path P1 and the line indicating the traveling direction PD2 of the sub path P2 (for example, changing the type of solid line, dotted line, broken line, dashed line, hatching) and displaying Good. The display 130 may change the display color of the path P1 and the traveling direction PD2 of the sub path P2 (for example, change the color to black, red, blue, yellow, green), and display. The display 130 may change and display the line of the path indicating the path P1 and the thickness of the line indicating the traveling direction PD2 of the sub path P2.

  The display 130 may display information (for example, an arrow or another mark) indicating the traveling direction of the path P1 on the tip of the path P1 or the like. The display 130 may display information (for example, an arrow, another mark) indicating the traveling direction PD2 of the auxiliary passage P2 on the tip end of the auxiliary passage P2 or the like.

  FIG. 3A is a view for explaining an example of a display target of a path included in the tree structure data TR.

  In FIG. 3A, the affected area T3 is set via the UI 120 or the like, and the target point T1 is set at a position closest to the affected area T3. The affected area T3 is, for example, an area of the liver. A start point T2 is set at the midpoint of the aorta A1. In this case, the route P1 passes from the start point T2 through the aorta A1, from the aorta A1 through the celiac artery and the hepatic artery A2 branched at the branch BR1, and several branches BR2 existing in the celiac artery and the hepatic artery A2, Pass BR3 and reach the target point T1. If it branches from branch BR1, BR2, BR3 of the path | route P1, it will become subpath P21, P22, P23. Further, in the vicinity of the branch point of the branches BR2 and BR3 (within a predetermined distance from each branch point), the traveling direction PD2 of the route P1 and the sub path P2 is distinguished and visualized. In FIG. 3, the route P1 is shown by a solid line, and the traveling direction PD2 of the sub route P2 is shown by a dotted line.

  The display 130 displays the path P1, the traveling directions PD21, PD22, and PD23 of the auxiliary paths P21, P22, and P23, the branches BR1, BR2, and BR3, and the affected area T3. The display 130 indicates the direction in which the sub path P21 branched from the path P1 in the branch BR1 extends as a traveling direction PD21 of the sub path P21. The display 130 indicates the direction in which the sub path P22 branched from the path P1 in the branch BR2 extends as the traveling direction PD22 of the sub path P22. The display 130 indicates the direction in which the sub path P23 branched from the path P1 in the branch BR3 extends as a traveling direction PD23 of the sub path P23.

  Thus, the medical image processing apparatus 100 can visualize information (branch information) of the branches BR1, BR2, and BR3 present on the path P1 where the catheter should travel. In this case, the medical image processing apparatus 100 can suppress the display of a large number of unrelated paths which are neither the path P1 nor the sub path P2 branched from the path P1. In addition, by indicating the traveling direction PD2 of the sub road P2, excessive display of the sub road P2 can be suppressed. That is, the medical image processing apparatus 100 can prevent the paths 130 from being overlapped due to excessive paths other than the path P1 actually to be passed by the catheter, making the paths indistinguishable. Can be suppressed. In addition, for the secondary path P2, the traveling direction PD2 is indicated by connecting to the path P1 in the branch BR, so whether the secondary path P2 is branched from the path P1 or the path P1 and the secondary path P2 (irrelevant path) Makes it easy to distinguish and see if they cross. Further, as compared with the case where only the path P1 connecting the start point T2 and the target point T1 is displayed, the medical image processing apparatus 100 can visualize the branches BR1, BR2 and BR3 as branch portions. Therefore, the user can suppress the insertion of the catheter from the branch BR into the sub passage P2. In particular, even when there is a branch overlapping in the depth direction when compared with the angio image, the user can distinguish and visually recognize the path P1 and the sub path P2 according to the display target. Thus, the three-dimensional image with the guide information obtained by the medical image processing apparatus 100 can be used as an image for preoperative planning of a catheter procedure and intraoperative reference.

  In addition, the image generation unit 162 is configured to output from the CT apparatus 200 based on an angle of a cross-sectional image (also referred to as an angio image) based on data captured by a three-dimensional angiographic apparatus (3D angiography apparatus: also referred to as an angio apparatus). An angle of a cross-sectional image (also referred to as a three-dimensional image of a CT image) based on volume data may be determined. That is, when the user performs a procedure while confirming the display of an angio image during IVR surgery, the image generation unit 162 displays a CT as a guide as a guide according to the angle of an angio image and the orientation of an angio image. The angle and orientation of the three-dimensional image of the image may be determined. In this case, the port 110 acquires, from the angio device, angle information set for displaying an angio image, and the image generation unit 162 displays a three-dimensional image of a CT image based on the acquired angle information. You may In addition, the UI 120 may receive an input of angle information for displaying an angio image, and the image generation unit 162 may display a three-dimensional image of a CT image based on the input angle information. As a result, the user can easily visually recognize the correspondence between the angio image and the three-dimensional image to which the guide is attached, and it is possible to suppress the erroneous insertion of the catheter into the wrong side passage P2 or the like.

  In addition, the angle of the angio image is, in principle, an angle rotated around the body axis. Also, the angle of the angiographic image may be determined by a technique. For example, when percutaneous coronary intervention (PCI) is performed, angles of angiography include RAO (Right Anterior Oblique) and LAO (Left Anterior Oblique).

  FIG. 3B is another diagram for describing another example of the display target of the path included in the tree structure data TR. In FIG. 3B, illustration of the celiac artery and the hepatic artery A2 is omitted. Moreover, in FIG. 3B, the advancing route C1 of the catheter inserted by the user is shown. In FIG. 3B, descriptions similar to those in FIG. 3A will be omitted or simplified.

  As compared with FIG. 3A, in FIG. 3B, the start point T2 exists near the connection point between the aorta A1 and the celiac artery and the hepatic artery A2. Thus, no visualization of the path within the aorta is performed. Since the aorta is an organ with a clear display, the medical image processing apparatus 100 can keep the possibility of catheter misstep low, even without showing how to advance the catheter inside the aorta. Further, even if an arbitrary point in the aorta A1 is selected as the start point T2 via the UI 120 or the like, the point setting unit 164 sets the vicinity of the connection point on the target point T1 as shown in FIG. 3B as the start point T2. May be

  FIG. 4A is a view showing an example of an image including the traveling direction PD2 of the route P1 and the auxiliary route P2 and the branch BR. FIG. 4B is a view showing an example of an image including the traveling direction PD2 of the path P1 and the sub path P2, the branch BR, and the affected area T3. The images shown in FIGS. 4A and 4B are cross-sectional images based on the same volume data, but show cross-sectional images of cross sections at different positions.

  In the cross-sectional image of FIG. 4A, the affected area T3 is not displayed. That is, the affected part T3 does not exist in this cross section. On the other hand, in the cross-sectional image of FIG. 4B, the affected area T3 is displayed. That is, the affected area T3 is included in each cross section. In FIGS. 4A and 4B, the path P1 along which the catheter should travel during IVR is indicated by a solid line, and the traveling direction PD2 of the subpath P2 where the catheter should not travel is indicated by a dotted line. That is, the display mode is different between the route P1 and the traveling direction PD2 of the sub route P2, and it is possible to visually recognize at a glance whether it is the route P1 or the sub route P2. The traveling direction of the path P1 is represented by the direction of the arrow. The traveling direction PD2 of the sub road P2 is represented by the directions of the dotted line and the arrow along the sub road P2. Note that at least one mark such as a dotted line or an arrow may be attached as the information indicating the traveling direction PD2 of the sub road P2.

  Next, variations of the display mode of the traveling direction PD2 of the route P1 and the auxiliary route P2 will be described.

  FIGS. 5-7 is a figure for demonstrating the variation of the display mode of traveling direction PD2 of the path | route P1 and the subpath P2. 5 to 7 show guide information when a catheter is branched from a relatively thick blood vessel (e.g., aorta A1) and inserted into a relatively thin blood vessel (e.g., celiac artery and hepatic artery A2). The line indicated by the path P1 is displayed separately from the actual blood vessel.

  In FIG. 5, the path P1 is shown by a solid line, and the traveling direction PD2 of the sub path P2 is shown by hatching (in this case, hatched). As described above, the display modes of the path P1 as a positive path and the traveling direction PD2 of the auxiliary path P2 as an incorrect path are different. By changing the display mode of the path P1 and the traveling direction PD2 of the auxiliary path P2, the user can visually distinguish the path P1 from the traveling direction PD2 of the auxiliary path P2 and the progress of the catheter It is easy to understand the direction to be done.

  In FIG. 5, the traveling direction PD2 of the auxiliary road P2 immediately after the branch from the path P1 is indicated by an arrow. The traveling direction PD2 of the sub road P2 indicates the direction to the wrong path. The traveling direction PD2 of the sub road P2 may include one bent at a position slightly ahead of the branch (a position separated by a predetermined distance) (see the sub road P24). The traveling direction PD24 after bending of the sub road P24 is indicated by an arrow. Thus, the traveling direction PD2 of the sub road P2 at a position separated from the branch of the path P1 by a predetermined distance or more may be indicated by a mark such as an arrow.

  In FIG. 6, the path P1 is displayed thicker than the traveling direction PD2 of the sub path P2. As described above, the display modes of the path P1 as a positive path and the traveling direction PD2 of the auxiliary path P2 as an incorrect path are different. As the medical image processing apparatus 100 displays the path P1 thicker than the traveling direction PD2 of the sub path P2, the user is more likely to pay attention to the path P1, and the sub path P2 is less likely to be paid attention to. Thus, the user can easily understand the direction in which the catheter should be advanced.

  In FIG. 7, the path P1 is shown by a straight line, and the traveling direction PD2 of the sub path P2 is shown by hatching (in this case, hatched). Further, no arrow is attached in the traveling direction PD2 of the sub road P2. In FIG. 7, instead of the arrow, the direction in which the sub path P2 extends indicates the traveling direction PD2 of the sub path P2. As described above, the medical image processing apparatus 100 can indicate the traveling direction PD2 of the auxiliary path P2 even if the arrow of the auxiliary path P2 is omitted, and the user can enter the auxiliary path P2 in the traveling direction PD2. We can call attention to control.

Next, the operation of the medical image processing apparatus 100 will be described.
FIG. 8 is a flowchart showing an operation example of the medical image processing apparatus 100. In FIG. 8, it may be assumed that a catheter is inserted into a blood vessel in the abdomen.

  First, the port 110 acquires volume data of the abdomen of the subject from the CT apparatus 200 or the like (S11).

  The region extraction unit 161 extracts various arteries (for example, aorta A1, celiac artery branching from aorta A1, superior mesenteric artery, inferior mesenteric artery, other arteries, arteries further branching from the above-mentioned arteries) (S12).

  The tree structure extraction unit 163 extracts (generates) the tree structure data TR based on the artery extracted by the region extraction unit 161 (S13).

  The point setting unit 164 sets an arbitrary point in any of the left and right common iliac arteries included in the tree structure data TR (for example, the midpoint between any of the left and right common iliac arteries) as the start point T2 (S14) . The start point T2 may indicate a catheter insertion point in the subject.

  The point setting unit 164 sets the affected area T3 via, for example, the UI 120 (S15).

  The point setting unit 164 sets a target point T1 (S16). In this case, the point setting unit 164 may set a point on the tree structure data TR closest to the set affected part T3 as the target point T1.

  The path generation unit 165 generates a path P1 connecting the start point T2 and the target point T1 included in the tree structure data TR (S17). The path generation unit 165 generates a traveling direction PD2 of the sub road P2 indicating the direction in which the sub road P2 which is at least a part of the path other than the path P1 included in the tree structure data TR travels. The sub path P2 itself may also be generated.

  The path generation unit 165 acquires all the branches BR which are branched from the path P1 existing on the path P1 to the sub path P2 (S18).

  The image generation unit 162 generates a volume rendering image based on the volume data acquired via the port 110 or the like (S19).

  The display control unit 166 generates guide information including the traveling direction PD2 of the path P1 and the auxiliary path P2 and the branch BR with the path P1 as a solid line and the traveling direction PD2 of the auxiliary path P2 as a dotted line. Under the control of the display control unit 166, the display 130 superimposes the route P1 included in the guide information, the traveling direction PD2 of the sub route P2, and the branch BR on the volume rendering image and displays the superimposed information (S20). At this time, the guide information is displayed in a display mode such as a predetermined solid line or dotted line.

  Next, variations of guide information displayed by the medical image processing apparatus 100 will be described.

  There may be a plurality of target points T1. That is, a plurality of positions may be registered in the memory 150 as the target point T1 in the tree structure data TR. The registration of the position of each target point T1 may be performed manually via the UI 120, as in the setting of the target point T1 described above, or may be performed automatically based on other information.

  The UI 120 may receive an input for selecting a target point desired by the user among the plurality of registered target points T1. The point setting unit 164 may set the selected target point T1. That is, the target point T1 selected reflecting the user's intention may be set as the position where the catheter should pass. In this case, a path P1 connecting the target point T1 selected and set among the plurality of target points T1 and the start point T2 is generated. With the selection and setting of the target point T1, the sub path P2 and the branch BR are also generated. The display 130 displays the traveling direction PD2 of the path P1 and the auxiliary path P2 and the branch BR based on the selected target point T1.

  The UI 120 may receive an input for changing the currently set target point T1 among the plurality of registered target points T1 to another point. The point setting unit 164 may set the target point T1 input as the changed target point. That is, the target point T1 changed to reflect the user's intention is set as the position where the catheter should pass. In this case, among the plurality of target points T1, a path P1 connecting the target point T1 changed and set and the start point T2 is regenerated. Along with the change and setting of the target point T1, the sub path P2 and the branch BR are also regenerated. The display 130 redisplays the traveling direction PD2 and the branch BR of the path P1 and the sub path P2 based on the changed target point T1. Therefore, the path that was the path P1 before the change becomes the sub path P2 after the change, and the display mode can be changed and displayed. Similarly, the path which has been the sub path P2 before the change becomes the path P1 after the change, and the display mode may be changed and displayed.

  As described above, the medical image processing apparatus 100 can generate the path P1 and the auxiliary path P2 according to the selected target point T1, even when there are a plurality of target points T1. Therefore, when there are a plurality of candidates for the target point T1 in advance, it is possible to generate a desired path P1 or a sub path P2 according to the intention of the user. Further, even when there are a plurality of target points T1, the medical image processing apparatus 100 can switch between the path P1 and the sub path P2 by changing the setting of the target point T1. Therefore, for example, when the affected area T3 to be treated is changed during IVR, or when it is desired to change the path P1 for advancing the catheter, it can be changed to the desired path P1 according to the user's intention. Along with the change of the path P1, the sub path P2 and the branch BR are changed.

  FIG. 9 is a diagram for describing setting of a point before the affected part T3 (the base side of the tree structure data TR) as the target point T1.

  In FIG. 9, the input of the position of the target point T1 is accepted by, for example, user specification via the UI 120, and the point setting unit 164 sets the target point T1. The path generation unit 165 generates a path P1 connecting the target point T1 and the start point T2 along the tree structure data TR. The sub path P2 is branched from the branch BR of the path P1. Further, between the target point T1 and the affected area T3, one or more end side paths P3 can be present as paths extending to the end side in the tree structure data TR. In FIG. 9, the two distal pathways P3 reach the affected area T3.

  Therefore, the path generation unit 165 generates one path as the path P1 between the target point T1 and the start point T2. By confirming the guide information including the path P1 displayed on the display 130, the user can reach the catheter with high accuracy to the front of the affected area T3. If the catheter reaches the target point T1 before the affected part T3 via the path P1, it may be sufficiently effective as a treatment. For example, it is conceivable to administer the drug from the tip of the catheter. When administering a drug, the tip of the catheter may not necessarily reach the affected area T3.

  In addition, the path generation unit 165 can generate a plurality of end-side paths P3 starting from the target point T1. That is, the display 130 may display one path P1 and may display one or more distal paths P3. The user can grasp a plurality of routes (for example, all routes) from the target point T1 to the affected part T3 by confirming the guide information including the route P1 displayed on the display 130, and the catheter is advanced with high accuracy it can. In addition, when the medical image processing apparatus 100 can reach the affected area T3 from the plurality of distal side paths P3 by displaying the plurality of distal side paths P3 located distal to the target point T1, the user has a plurality of options for the user. Can provide

  In FIG. 9, the distal side path P3 includes a distal side path P31 extending toward the affected area T3 and a distal side path P32 extending away from the affected area T3 with the target point T1 as a base point. The display control unit 166 may display the distal path P31 and the distal path P32 in different display modes. For example, the guide information may be generated such that the distal path P31 is indicated by a solid line and the distal path P32 is indicated by a dashed line. The display 130 may display the distal path P31 and the distal path P32 in different display modes according to the control of the display control unit 166. As a result, the user who has confirmed the guide display on the display 130 can identify the distal path P3 for advancing the catheter toward the affected area T3 by confirming the display mode.

  FIG. 10 is a schematic view showing another display example showing the traveling direction PD2 of the sub road P2 at a position separated by a predetermined distance from the branch BR.

  Depending on the tissue to be observed, the traveling direction PD2 of the sub road P2 changes at a predetermined distance after branching from the path P1, or the sub road P2 twists and the traveling direction PD2 of the sub road P2 changes frequently. It is possible. Therefore, the display 130 displays the traveling direction PD2 of the sub road P2 at a position separated by a predetermined distance (for example, several mm) from the branching point, not the traveling direction PD2 of the sub road P2 near the branching point related to the branch BR. You may do so. Further, the display 130 may display a plurality of traveling directions PD2 of the sub road P2 at predetermined distances from the branch point.

  Thus, the medical image processing apparatus 100 can display guide information including information on the traveling direction PD2 of the sub path P2 in accordance with the shape of the sub path P2 in the tissue to be observed. Therefore, the user can, for example, confirm the traveling direction PD2 of the sub road P2 displayed on the display 130 and understand the representative traveling direction PD2 of the sub road P2 and the traveling direction PD2 at each position in the sub road P2. The catheter can be advanced smoothly inside the blood vessel.

  As described above, in the medical image processing apparatus 100 according to the present embodiment, the port 110 may acquire volume data including a tissue having a tree structure. The tree structure extraction unit 163 may extract at least a portion of the tree structure in the volume data as tree structure data. The point setting unit 164 may set the target point T1 in the tree structure data. The path generation unit 165 may connect a target point T1 and a start point T2 located on the proximal side of the target point T1 in the tree structure data, and generate a route P1 traveling along the tree structure data. The display 130 distinguishes the path P1 and the sub path P2 branched from the path P1 in the tree structure data, and divides the path P1, the branch BR of the path P1 and the sub path P2, and the sub path P2 branched from the path P1. The traveling direction PD2 may be displayed, and the traveling direction PD2 of the path P1 and the auxiliary path P2 may be displayed on one image in different display modes. The port 110 is an example of an acquisition unit. The tree structure extraction unit 163 is an example of an extraction unit. The point setting unit 164 is an example of a setting unit. The path generation unit 165 is an example of a generation unit. The display 130 is an example of a display unit. The target point T1 is an example of a first point. The start point T2 is an example of a second point.

  Thereby, the medical image processing apparatus 100 can visualize the path to which the catheter should be advanced by the path P1. The medical image processing apparatus 100 can visualize a portion which is likely to cause the catheter to misstep by the branch BR. The medical image processing apparatus 100 can visualize the direction in which the catheter is likely to mistravel by the traveling direction PD2 of the sub path P2. The medical image processing apparatus 100 can easily identify the traveling direction PD2 of the path P1 and the auxiliary path P2 visually by setting the traveling direction PD2 of the path P1 and the auxiliary path P2 in different display modes. Thus, the user can easily view the direction in which the medical device should be advanced in the tubular tissue inside the subject.

  Further, since the medical image processing apparatus 100 displays a part of the blood vessels searched for in the subject, compared with the case where all the blood vessels are displayed, the number of displayed elements can be reduced, and the complexity can be reduced. Therefore, the user who performs IVR while confirming this display can easily determine which blood vessel the catheter should be advanced to. In addition, the possibility of overlapping and displaying blood vessels in the depth direction on the display 130 is reduced. In addition, by making the display mode of the main route and the auxiliary route different, it becomes easy for the user to distinguish and observe a plurality of blood vessels even if the plurality of blood vessels overlap in the depth direction. It is easy to progress in the direction of

  Further, as compared with the case where only a path connecting two points is displayed, the medical image processing apparatus 100 shows the traveling direction PD2 of the branch BR or the sub path P2 together with the path P1 between the two points. In other words, it can be said that it indicates a certain point of the branch BR and the direction of the branch BR. Therefore, the user can easily grasp how other paths are branched from the path to be observed (path P1). Therefore, the user who performs IVR while confirming this display needs to change the blood vessel progressing from the first blood vessel to the second blood vessel toward the observation target, even if it is necessary to branch or branch multiple blood vessels. (The traveling direction PD2 of the sub passage P2) can be easily recognized, and the possibility of mistaking the catheter's traveling direction can be reduced. Further, even when the bifurcated blood vessel extends in the depth direction on the display 130, the medical image processing apparatus 100 can easily grasp the bifurcated blood vessel by displaying the path P1 and the sub-passage P2 with different display modes. , Can support the progress of the catheter.

  In order to get the catheter to the target position in IVR, it is often via several branch ports. Therefore, the user advances the catheter to the target position via the branch BR to which a plurality of blood vessels are connected. In this case, according to the medical image processing apparatus 100, it is possible to prevent the catheter from erroneously advancing from the branch BR to the auxiliary passage P2 and advancing the catheter to the erroneous blood vessel. The user advances the catheter while confirming the tip position of the catheter displayed by the angio device or the like. In the angio apparatus, there are blood vessels that do not appear to be seemingly branched due to the display positions of the plurality of blood vessels overlapping in the depth direction of the display screen due to the captured angle. Even if the structure of a blood vessel is difficult to confirm with an angio apparatus, the medical image processing apparatus 100 can be introduced to support IVR, allowing the user to perform IVR treatment with high accuracy, and the patient's invasion or The burden can be reduced.

  The start point T2 may be included in a predetermined range (for example, trachea or aorta) located proximal to the target point T1 in the tree structure data.

  Thus, the medical image processing apparatus 100 can support the progress of the catheter from a location where the progress of the catheter is relatively error free. Thus, the user can smoothly perform IVR treatment. In addition, for example, at a location where it is difficult to misstep the catheter, the guide information can be omitted. For example, a catheter is often inserted from the foot and advanced to another blood vessel through the aorta, but it is difficult for the catheter to misstep within the aorta, so the catheter insertion position and the position of the start point T2 should be matched. It is not necessary. For example, even with any position of the aorta as the starting point T2, the accuracy of IVR treatment can be maintained.

  The UI 120 may accept the designation of the affected area T3 in the volume data. The point setting unit 164 may determine the position of the target point T1 in the tree structure data based on the position of the affected area T3. The UI 120 is an example of a first operation unit.

  Thereby, the medical image processing apparatus 100 can set, for example, a point on the tree structure data closest to the designated affected part T3 as the target point T1. That is, by specifying the affected area T3 to be observed in the volume data of the subject, it is possible to extract a blood vessel heading for the affected area T3 as the path P1. Therefore, even if the user does not know the position of the blood vessel as the tree structure data, the medical image processing apparatus 100 can generate the path P1 for advancing the catheter by designating the affected part T3, and can present it to the user .

  The UI 120 may accept the designation of the target point T1 in the tree structure data as the designation of the affected area T3. For example, an affected area T3 may be present at the target point T1 in the tree structure data, as in the case of a blood vessel stenosis.

  As a result, the medical image processing apparatus 100 can acquire the path P1 to be traveled by the catheter reaching the affected area T3 and can easily advance the catheter to the affected area T3.

  The path generation unit 165 sets a plurality of end-side paths P3 related to the affected part T3 from a plurality of end-side paths P3 traveling on the end side of the target point T1 in the tree structure data TR based on the position of the affected part T3. You may The display 130 may display the set distal path P3. The path generation unit 165 is an example of a path setting unit. The distal route P3 associated with the affected area T3 is a distal route intended for treatment with the treatment for the affected area T3 (target to be treated) or an end route for treatment with the treatment for the affected area T3 (target to be treated) You may For example, the distal pathway P3 associated with the affected area T3 may be the distal pathway P3 feeding the tumor if the affected area T3 is a tumor. The distal pathway P3 associated with the affected area T3 may be the distal pathway leading to hemorrhage when the affected area T3 is a hemorrhage.

  The medical image processing apparatus 100 can identify the affected area T3 according to the position of the affected area T3 and recognize the state of the affected area T3. Depending on the state of the affected area T3, it is changed which of the distal side routes P3 between the target point T1 and the affected area T3 needs treatment or treatment. The medical image processing apparatus 100 can visualize a treatment or treatment distal side path in relation to the affected area T3 according to the state of the affected area T3. Therefore, the user can easily grasp the distal side route requiring treatment and treatment together with the affected part T3 and can smoothly implement the treatment and treatment on the distal side route.

  The display 130 may display a plurality of distal paths P3 traveling distal to the target point T1 in the tree structure data.

  Thereby, for example, when there are a plurality of paths from the target point T1 to the affected part T3, the medical image processing apparatus 100 can present the plurality of paths to the user. For example, when the affected area T3 is located distal to the target point T1, the user may check the display of the guide information and go to the distal path P3 when the blood vessel is blocked at the target point T1 before the affected area T3. The effect of the anti-cancer agent can be predicted, or the progress of the anti-cancer agent in the distal pathway P3 when the anti-cancer agent is injected at the target point T1 can be predicted.

  The plurality of distal side routes P3 are a distal side route P31 traveling in a direction approaching the affected area T3 with the target point T1 as a base point, and a distal side route P32 traveling in a direction away from the affected area T3 with the target point T1 as a base point And may be included. The display 130 may display the distal path P31 and the distal path P32 in different display modes. The distal route P31 is an example of a first distal route. The distal pathway P32 is an example of a second distal pathway.

  Thereby, the user can determine whether the distal path P3 approaches or goes away from the affected area T3 at first glance according to the display mode. That is, the medical image processing apparatus 100 can easily understand to which way the catheter advanced to the target point T1 should be advanced.

  There may be a plurality of target points T1. The UI 120 may receive an input for selecting any one target point T1 among the plurality of target points T1. The display 130 may display the path P1 based on the target point T1 selected via the UI 120 and the traveling direction PD2 of the sub path P2 branched from the path P1 in different display modes. The UI 120 is an example of a second operation unit.

  Thereby, for example, the medical image processing apparatus 100 registers in advance the target point T1 predicted to be frequently set, and based on the position of the target point T1 actually set, the path P1 and the auxiliary path P2 The traveling direction PD2 of the vehicle may be determined. Since the display mode is different between the path P1 and the traveling direction PD2 of the sub path P2, the medical image processing apparatus 100 can guide the progress of the catheter in consideration of the position of the selected target point T1.

  The UI 120 may receive an input for switching from the target point T1 selected among the plurality of target points T1 to another target point T1. Display mode of the route P1 based on the target point T1 before switching and the traveling direction PD2 of the auxiliary route P2 branched from the route P1, and the auxiliary route branched from the route P1 and the route P1 based on the first point after switching The display mode of the traveling direction PD2 of P2 may be different.

  Thereby, the medical image processing apparatus 100 changes the target point T1 to change the path P1. Therefore, the traveling direction PD2 of the branch BR or the sub road P2 is also changed. Therefore, depending on the position of the target point T1, whether the path is the path P1 or the sub path P2 changes even in the same position path. The user can grasp whether it is the route P1 or the sub route P2 by confirming the display mode. Therefore, the medical image processing apparatus 100 can change the target point T1 in order when performing treatment on a plurality of affected parts in order, can prevent the catheter from advancing in the wrong path direction, and can support rapid treatment. . Therefore, when the medical image processing apparatus 100 sequentially operates a plurality of affected areas, the user changes the target point T1 in order, thereby moving the catheter to be newly treated from the affected area after the treatment, a new path P1. It is easy to pull back the catheter.

  The tissue may include at least one of an artery, a vein, a portal vein, a bronchus and a bile duct.

  As a result, the medical image processing apparatus 100 can apply the above-described display of the guide information to a tissue in which a large number of tubular tissues are formed in an intricate manner or in which a large number of tubular tissues intersect each other. Therefore, the medical image processing apparatus 100 can display, for example, a portal vein formed by intermingling fine blood vessels or a bronchus that becomes thinner as it goes to the tip, a path P1 where a catheter or bronchoscope should advance. Therefore, the user can perform IVR and treatment with various endoscopes, treatment, examination, etc. with high accuracy by confirming the display of the guide information.

  The image generation unit 162 may generate a volume rendering image based on the volume data. The display 130 may superimpose the path P1, the branch BR, and the traveling direction PD2 of the auxiliary path P2 on the volume rendering image. In the volume rendering image, the volume rendering image may include a ray sum image, an MIP image, a MinIP image, an average value image, or a ray cast image. In addition, since the Latham image becomes an image close to an angio image, an image obtained by superimposing and displaying the path P1, the branch BR, and the traveling direction PD2 of the auxiliary channel P2 on the Latham image is used for preoperative planning and intraoperative reference of the catheter procedure. It can be used as an image of

  As a result, the medical image processing apparatus 100 expresses the actual state of the path P1, the branch BR, and the sub path P2 in a volume rendering image, and simultaneously determines the traveling direction PD2 of the path P1, the branch BR, and the sub path P2. It can display the guide information including. Therefore, the medical image processing apparatus 100 can more easily and intuitively understand the position to be advanced of the catheter.

(Other embodiments)
The present disclosure is not limited to the configuration of the above-described embodiment, but may be any configuration that can achieve the function described in the claims or the function of the configuration of the present embodiment. Is also applicable.

  In the first embodiment, the medical imaging apparatus 100 may be applied to IVR performing TAE hepatic artery embolization or TACE hepatic artery chemoembolization.

  In the first embodiment, the treatment using a catheter is mainly exemplified as the IVR. However, the medical image processing apparatus 100 may be applied to an IVR in which a catheter is intubated into a portal vein or a bile duct via laparotomy or laparoscope. .

  In the first embodiment, the medical image processing apparatus 100 may be applied to an IVR for hemostasis or nutrition cut on a tumor. Thereby, for example, the medical image processing apparatus 100 sets the target point for hemostasis or nutrition cut to the main part as the target point T1, and easily advances the catheter via the path P1 as a path to the target point T1. it can. For example, in order to stop bleeding, the catheter needs to be moved to the target point T1 in a short time, but the medical image processing apparatus 100 uses the target point T1 and the traveling direction PD2 of the branch BR and the secondary path P2 easily mistaken as guide information. By including and displaying, it is possible to guide the catheter to the target point T1 quickly and accurately.

  In the first embodiment, the medical image processing apparatus 100 may be applied to an IVR for performing occlusion blood vessel embolization using a PTA (Percutaneous Transluminal Angioplasty) balloon or an IVR having a coronary artery as an affected area. Thereby, the medical image processing apparatus 100 can easily advance the catheter via the path P1 as an appropriate path inside the subject.

  In the first embodiment, the medical image processing apparatus 100 may be used for stent placement. Thereby, the medical image processing apparatus 100 can easily carry the stent via the path P1 as an appropriate path inside the subject in order to deploy the stent.

  In the first embodiment, the medical image processing apparatus 100 may be applied to drug injection into the inside of a subject using a catheter. Drug infusion may include infusion of thrombolytics and anti-cancer agents. The medical image processing apparatus 100 may be used during live research. As a result, the medical image processing apparatus 100 can easily set the target point for drug injection to the target point T1 and easily advance the catheter via the path P1 as a path leading to the target point T1.

  In the first embodiment, the medical image processing apparatus 100 may be used for catheter treatment for the bile duct besides catheter treatment for blood vessels. As a result, the medical image processing apparatus 100 can suppress the progress of the catheter in the wrong path, even when performing catheter treatment for complicated and intricate proficiency.

  In the first embodiment, the medical imaging apparatus 100 may be applied to a bronchoscope to the bronchus. The bronchus is formed of a tissue having a substantially tree structure with branches. The bronchoscope images the inside of the bronchus having the tree structure data TR. Therefore, when the user advances the bronchoscope to the bronchus of the subject, the user can check the three-dimensional image to which the guide information displayed by the medical image processing apparatus 100 is attached, thereby causing an error in the bronchoscope. Progress can be suppressed. Also in the case where the medical device advances the inside of a branched tubular tissue (for example, an artery, a vein, a portal vein, and a bile duct) other than the bronchus, the medical imaging apparatus 100 can suppress misprogression of the medical device. In addition, the medical image processing apparatus 100 can suppress misprogression of the medical instrument even when the medical instrument advances inside the region of the subject (for example, the abdomen, the brain containing many blood vessels, etc.) in which the tubular tissues are assembled in an intricate manner. .

  In the first embodiment, the medical image processing apparatus 100 exemplifies setting of the affected area T3 after extracting tree structure data, but may be reversed. That is, the medical image processing apparatus 100 may set tree structure data after setting the affected area T3.

  In the first embodiment, the medical image processing apparatus 100 manages a path including the path P1 and the sub path P2 using tree structure data, but any tree structure data can be realized. The tree structure data may be realized using a general purpose graph structure or a tree structure dedicated data structure. It may be realized by a data structure such as an adjacency list, an adjacency matrix, a binary tree, a multitree, or an equilibrium tree. In addition, tree structure data may be created on volume data. Also, even if the path is represented by a cyclic graph, the tree structure may be substantially obtained by deleting the edge each time. This is because the tree structure is obtained by extracting the path P1 and the sub path P2 from the cyclic graph.

  In the first embodiment, when the angle between the path P1 and the sub path P2 is equal to or less than a predetermined angle (for example, 10 °), the medical image processing apparatus 100 displays warning information indicating that the catheter is likely to mistravel. It may be displayed through 130. When the angle between the path P1 and the sub path P2 is small, it means that the path P1 and the sub path P2 travel in the same direction, and from the user's point of view, which path should travel. It is difficult to determine By displaying warning information on the display 130 to alert the user, the medical image processing apparatus 100 can increase the possibility of guiding the catheter advancing by user operation to the correct path.

  In the first embodiment, it is illustrated that volume data as a captured CT image is transmitted from the CT apparatus 200 to the medical image processing apparatus 100. Instead of this, the volume data may be transmitted to a server or the like on the network and stored in the server or the like so as to be temporarily accumulated. In this case, the port 110 of the medical image processing apparatus 100 may acquire volume data from a server or the like via a wired line or a wireless line when necessary, or may acquire it via an arbitrary storage medium (not shown). May be

  In the first embodiment, it has been illustrated that volume data as a captured CT image is transmitted from the CT apparatus 200 to the medical image processing apparatus 100 via the port 110. This also includes the case where the CT apparatus 200 and the medical image processing apparatus 100 are substantially combined into one product. In addition, the case where the medical image processing apparatus 100 is treated as a console of the CT apparatus 200 is also included.

  In the first embodiment, an example of capturing an image by the CT apparatus 200 and generating volume data including information inside the living body is exemplified, but another apparatus may capture an image and generate volume data . Other devices include MRI (Magnetic Resonance Imaging) devices, PET (Positron Emission Tomography) devices, angiography devices (Angiography devices), or other modality devices. Also, the PET device may be used in combination with other modality devices.

  In the first embodiment, the human body is exemplified as the subject, but it may be an animal body.

  In the first embodiment, a blood vessel is illustrated as a branched tubular tissue, but it may be other than a blood vessel (for example, a lymphatic vessel, a bronchial tube).

  The present disclosure supplies a program for realizing the function of the medical image processing apparatus of the first embodiment to the medical image processing apparatus via a network or various storage media, and a computer in the medical image processing apparatus reads and executes the program. The program is also in scope.

  The present disclosure is useful for a medical image processing apparatus, a medical image processing method, a medical image processing program, and the like that can easily view the direction in which a medical instrument should be advanced in a tubular tissue inside a subject.

100 medical image processing apparatus 110 port 120 user interface (UI)
130 display 140 processor 150 memory 160 processing unit 161 area extraction unit 162 image generation unit 163 tree structure extraction unit 164 point setting unit 165 display control unit 200 CT device BR, BR1, BR2, BR3 branch P1 path PD2, PD21 , PD22, PD23, PD24 Direction of travel P3 on the side road Side path T1 Target point T2 Starting point T3 Affected area

Claims (13)

An acquisition unit for acquiring volume data including an organization having a tree structure;
An extraction unit for extracting at least a part of the tree structure in the volume data as tree structure data;
A setting unit that sets a first point in the tree structure data;
A generation unit configured to connect a second point located on the proximal side of the first point in the tree structure data and the first point, and generate a route traveling along the tree structure data; ,
Differentiating the route and the secondary route branching from the route in the tree structure data, the traveling direction from the route of the route, the route between the route and the secondary route, and the secondary route is displayed. A display unit for displaying the traveling direction of the route and the auxiliary route on one image in different display modes;
A medical image processing apparatus comprising: The medical image processing apparatus according to claim 1, wherein
The medical image processing apparatus according to claim 1, wherein the second point is included in a predetermined range located proximal to the first point in the tree structure data. The medical image processing apparatus according to claim 1, further comprising:
A first operation unit configured to receive designation of an affected area in the volume data;
The medical image processing apparatus, wherein the setting unit determines the position of the first point in the tree structure data based on the position of the affected area. The medical image processing apparatus according to claim 3, wherein
The medical image processing apparatus, wherein the first operation unit receives the designation of the first point in the tree structure data as the designation of the affected area. The medical image processing apparatus according to claim 3, further comprising:
A path setting unit configured to set a plurality of end side routes related to the affected area from a plurality of end side routes traveling on the end side of the first point in the tree structure data based on the position of the affected area;
The medical image processing apparatus, wherein the display unit displays the set distal path. The medical image processing apparatus according to any one of claims 1 to 4, wherein
The medical image processing apparatus, wherein the display unit displays a plurality of distal side paths traveling distal to the first point in the tree structure data. The medical image processing apparatus according to claim 6, wherein
The plurality of distal side routes are a first distal side route that travels in a direction approaching the affected area when the first point is a base point, and a plurality of distal side routes run in a direction away from the affected area when the first point is a base point Two distal pathways, and
The medical image processing apparatus, wherein the display unit displays the first end side route and the second end side route in different display modes. The medical image processing apparatus according to any one of claims 1 to 7, wherein
There are a plurality of the first points,
A second operation unit configured to receive an input for selecting any one of the plurality of first points;
The display unit displays a medical image different in display mode from the route based on the first point selected through the second operation unit and the traveling direction of the auxiliary route branched from the route. Processing unit. The medical image processing apparatus according to claim 8, wherein
The second operation unit receives an input for switching from a selected first point to another first point among the plurality of first points,
The display mode of the route based on the first point before switching and the traveling direction of the auxiliary route branching from the route, and the route based on the first point based on the switching and the route The medical image processing apparatus which differs from the display mode with the traveling direction of the road. The medical image processing apparatus according to any one of claims 1 to 9, wherein
The medical imaging apparatus, wherein the tissue includes at least one of an artery, a vein, a portal vein, a bronchus and a bile duct. The medical image processing apparatus according to any one of claims 1 to 10, further comprising:
An image generation unit configured to generate a volume rendering image based on the volume data;
The medical image processing apparatus, wherein the display unit superimposes and displays the path, the branch, and the traveling direction of the auxiliary path on the volume rendering image. A medical image processing method in a medical image processing apparatus, comprising:
Acquire volume data including an organization having a tree structure,
Extracting at least a part of the tree structure of the volume data as tree structure data;
Set the first point in the tree structure data,
Connecting a second point located on the proximal side of the first point in the tree structure data and the first point to generate a route traveling along the tree structure data;
The route, the route, and the route are distinguished as a display mode that distinguishes the route and a secondary route branching from the route in the tree structure data, and the traveling direction of the secondary route branching from the route and the route is different. Displaying a branch with a road and a traveling direction from the branch of the auxiliary road on one image;
Medical image processing method. A medical image processing program for causing a computer to execute the medical image processing method according to claim 12.