JP2019063405A - Diagnostic image system - Google Patents

Abstract

To provide a diagnostic image system capable of accurately identifying a collection position and reducing an operation load on a medical doctor or the like to identify the collection position.SOLUTION: This diagnostic image system 100 comprises: an X-ray radiographing device 1 which acquires an X-ray fluoroscopic image 30 in which a collection position P in collecting a blood sample B from a subject T can be discriminated; and a composite image generation unit 18b which generates a composite image 50 by composing the X-ray fluoroscopic image 30 and a DRR image 41 which corresponds to the X-ray fluoroscopic image 30 and displays an angiogram V for identifying the position of the collection position P.SELECTED DRAWING: Figure 4

Description

  The present invention relates to diagnostic imaging systems.

  Conventionally, it is known to diagnose a disease caused by a tumor or the like in the body or organ by collecting a sample sample such as blood or a piece of tissue from the body of a subject (patient). Here, conventionally, while a doctor or the like checks a fluoroscopic image of a subject using a radiographic image diagnostic apparatus, a sampling device for collecting a sample sample is sent to a sampling position in the subject, and the sample sample is collected. It is known (refer nonpatent literature 1).

  In Non-Patent Document 1, various sites of the adrenal gland are inserted by inserting a catheter to the collection position while confirming the X-ray fluoroscopic image of the subject with a radiographic imaging apparatus in real time for the diagnosis of primary aldosteronism. It is disclosed to collect a blood sample (sample sample) from a vein of Here, Non-Patent Document 1 discloses that in order to manage the correspondence between the collected blood sample and the collection position (collection position), the collection position is described along with the sketch of the adrenal vein in the medical chart. It is done.

Makida Kozo, "Adrenal Venous Blood Collection in Primary Aldosteronism-Tips for Successful Adrenal Venous Sampling Techniques," Japan Interventional Radiology Journal, 2013, Vol. 28, No. 2, p. 204-210

  However, in the method of writing the sampling position with sketches of the adrenal veins in the medical chart described in Non-Patent Document 1 above, the identification of the sampling position tends to be inaccurate and the workload of the doctor etc. required to identify the sampling position growing. Therefore, there is a demand for a system that can specify the collection position more accurately and can reduce the workload of a doctor or the like required to specify the collection position.

  The present invention has been made to solve the problems as described above, and one object of the present invention is to be able to specify the sampling position more accurately and to specify the sampling position. An object of the present invention is to provide a diagnostic imaging system capable of reducing the workload of a doctor or the like.

  In order to achieve the above object, the diagnostic imaging system according to one aspect of the present invention has a first image capable of determining the state of tissue at or near the collection position when the sample is collected from the subject. A composite image creation unit that creates a composite image in which an acquisition unit to be acquired and a second image corresponding to the first image and the first image and on which the position reference unit for specifying the collection position is displayed are composited; And.

  In the diagnostic image system according to one aspect of the present invention, by configuring the composite image creation unit as described above, the state of tissue at the sampling position or the vicinity of the sampling position, and the position reference unit for specifying the sampling position Can be included in the composite image, so that the collection position can be accurately identified by using the composite image. Furthermore, since the composite image is automatically created on the diagnostic imaging system, the doctor and the like do not need to sketch on the medical record. As a result, it is possible to reduce the work load of a doctor or the like required to specify the collection position. As a result of these, it is possible to more accurately specify the collection position, and it is possible to reduce the work load of a doctor or the like required to specify the collection position.

  In the diagnostic image system according to the above aspect, preferably, the sampling position is specified in the composite image based on the relative positional relationship between the position reference unit and the sampling position. According to this structure, the sampling position can be more accurately specified based on the relative positional relationship between the position reference portion and the sampling position included in the composite image.

  In the diagnostic imaging system according to the aforementioned aspect, preferably, the position reference unit is a blood vessel image of a subject. According to this structure, since the collection position and the blood vessel image can be included in the composite image, it is possible to accurately specify the collection position of the blood when collecting the blood.

  In this case, preferably, the first image is a non-contrast X-ray image that is acquired by the acquisition unit in a state in which the contrast agent is not used for the subject and the state of tissue around the sampling position or the sampling position can be determined. The second image is a contrast X-ray image obtained by using a contrast agent with respect to the subject and displaying a blood vessel image. According to this configuration, the blood vessel image is not displayed by not using the contrast agent, while the non-contrast X-ray image in which the state of the tissue at the collection position or the periphery of the collection position can be discriminated and the blood vessel image using the contrast agent By combining the X-ray image with the displayed contrast X-ray image, it is possible to create a composite image in which both the collection position and the blood vessel image can be discriminated. This allows more accurate identification of the blood collection position.

  In the diagnostic image system according to the above aspect, preferably, the composite image creation unit is configured to create a composite image by superimposing a second image of a display color different from the first image on the first image. There is. According to this structure, it is possible to easily recognize that the second image is superimposed on the first image, and to allow the doctor or the like to visually recognize the position reference portion for specifying the collection position in the composite image. It can be made easy.

  Preferably, the diagnostic image system according to the above aspect further comprises a display unit capable of displaying an image, wherein the display unit can simultaneously display the first image and the composite image, or the first image and the composite image It is configured to be switched and displayed. According to this configuration, the doctor or the like can confirm the first image displayed simultaneously or switched and displayed while confirming the composite image displayed on the display unit. As a result, it is possible to easily confirm a portion that is difficult to visually recognize on the composite image using the first image.

  Preferably, the diagnostic image system according to the above aspect further includes a generation unit that generates a second image from the three-dimensional image on which the position reference unit is displayed, based on the imaging direction of the first image. Here, the two-dimensional second image corresponding to the predetermined position can be generated by cutting out the three-dimensional image at the predetermined position. Therefore, if the three-dimensional image is cut out based on the imaging direction of the first image, the second image corresponding to the first image can be generated accurately, so that the first image does not correspond sufficiently. It can be suppressed that the two images and the first image are combined.

  In this case, preferably, the generation unit is configured to generate the second three-dimensional images from the plurality of three-dimensional images respectively corresponding to the plurality of time points based on the imaging direction of the first image and the state of the subject at the time of It is configured to generate an image. According to this structure, the second image corresponding to the first image is obtained, for example, even when the subject (collection position and position reference portion) moves due to periodic motion such as respiration and pulsation. Can be generated accurately. Thereby, it is possible to further suppress that the second image and the first image that do not correspond sufficiently to the first image are combined.

  According to the present invention, as described above, it is possible to more accurately specify the collection position, and it is possible to reduce the work load of a doctor or the like required to specify the collection position.

It is a schematic diagram which shows the whole structure of the diagnostic imaging system by 1st Embodiment. It is a block diagram for demonstrating the example of a structure of a X-ray imaging apparatus. It is a figure for demonstrating creating a DRR image from a three-dimensional image. It is a figure for demonstrating preparation of a synthetic | combination image, and specification of a collection position. It is a figure for demonstrating blood-collecting data. FIG. 13 is a diagram for describing creation of a DRR image from a plurality of three-dimensional images in the diagnostic image system according to the second embodiment.

  Hereinafter, an embodiment of the present invention will be described based on the drawings.

First Embodiment
The configuration of a diagnostic imaging system 100 according to a first embodiment of the present invention will be described with reference to FIGS. 1 to 4. In the first embodiment, an example in which the diagnostic imaging system 100 is used for adrenal vein sampling for diagnosis of primary aldosteronism will be described.

(Configuration of diagnostic imaging system)
As shown in FIG. 1, the diagnostic imaging system 100 includes an X-ray imaging apparatus 1 and a sample analyzer 2. The X-ray imaging apparatus 1 receives the X-ray fluoroscopic image 30 (see FIG. 4) of the subject T when collecting the blood sample B from the subject T using the sample collection device 3 such as a catheter inserted in a blood vessel. It is configured to be generated and displayed on the display unit 16. Further, the X-ray imaging apparatus 1 is configured to specify a sampling position P when the blood sample B is sampled from the subject T. The X-ray imaging apparatus 1 is an example of the “acquisition unit” in the claims. In addition, blood sample B is an example of “sample sample” in the claims.

  The sample analyzer 2 is configured to analyze the blood sample B collected from the subject T. Then, the X-ray imaging apparatus 1 is configured to associate the specified sampling position P with the analysis result A of the blood sample B based on the blood collection number N for specifying the blood sample B. The blood collection number N is, for example, a value (eg, 001, see FIG. 5) sequentially assigned to each collection position P, and corresponds to each of the plurality of blood samples B on a one-to-one basis.

  The subject T is a subject to be diagnosed, and a blood sample B for diagnosis is collected from the subject T by a doctor or the like. The subject T is not limited to the human illustrated in FIG. 1 and may be an animal other than human.

  The X-ray imaging apparatus 1 and the sample analyzer 2 are connected to each other via a network 4 based on the DICOM (Digital Imaging and Communications in Medicine) standard. The X-ray imaging apparatus 1 and the sample analyzer 2 are connected to a host computer (server) 5 via a network 4. The host computer 5 can acquire electronic medical record information via the network 4 and information on the subject T (ID, name, age, gender, etc.), a three-dimensional image 40 of the subject T described later, etc. It is possible to hold

(Configuration of X-ray imaging apparatus)
As shown in FIG. 2, the X-ray imaging apparatus 1 includes an imaging unit 11 and a top drive unit 12. The imaging unit 11 includes an irradiation unit 11a, a detection unit 11b, an arm 11c (see FIG. 1), and an arm drive unit 11d. The irradiation unit 11 a includes an X-ray source (not shown) and emits X-rays toward the subject T. The detection unit 11 b detects X-rays (transmission X-rays) irradiated by the irradiation unit 11 a and transmitted through the subject T, and outputs a detection signal corresponding to the intensity to the control unit 13. Further, in the control unit 13 (image processing unit 18), the X-ray fluoroscopic image 30 is acquired based on the received detection signal. The detection unit 11 b is configured of, for example, an FPD (Flat Panel Detector).

  The arm 11c is formed in a C-shape. The irradiation part 11a and the detection part 11b are attached to the C-shaped one end and the other end of the arm 11c, respectively. At this time, the irradiation unit 11a and the detection unit 11b are attached to the arm 11c so as to face each other with the subject T (the top 12a) interposed therebetween. The arm driving unit 11 d moves the arm 11 c in the horizontal direction and the vertical direction to irradiate the subject T with the irradiation position and the irradiation direction of the X-ray from the irradiation unit 11 a (in other words, the imaging position of the X-ray fluoroscopic image 30 and It is configured to change the shooting direction).

  The top driving unit 12 is configured to be able to horizontally move the top 12 a on which the subject T is placed.

  The X-ray imaging apparatus 1 further includes a control unit 13, a storage unit 14, a communication unit 21, a display unit 16, and an operation unit 17. The control unit 13, the storage unit 14, and the communication unit 21 are provided in the X-ray imaging apparatus main body 1 a.

  The control unit 13 controls the entire X-ray imaging apparatus 1. The control unit 13 includes a processor such as a central processing unit (CPU) and a graphics processing unit (GPU), and a memory such as a RAM. The control unit 13 is configured to perform a predetermined control process by executing a predetermined control program stored in the memory. Specifically, the control unit 13 performs image processing that executes a generation unit 18 a that generates a DRR (Digitally Reconstructed Radiography) image 41 from the three-dimensional image 40 and a composite image generation unit 18 b that generates a composite image 50. It is configured to be able to function as the unit 18. The details of control processing of the image processing unit 18 will be described later. Also, the DRR image 41 is an example of the “second image” and the “contrast X-ray image” in the claims.

  The storage unit 14 stores a three-dimensional image 40 (see FIG. 3). The three-dimensional image 40 is an image acquired using an X-ray CT apparatus (not shown), and is configured by combining a plurality of X-ray slice images. Here, the three-dimensional image 40 is acquired in a state in which a contrast agent (blood vessel contrast agent) is used for the subject T, and when displayed as an image on the display unit 16 or the like, The adrenal gland (indicated by a dotted line in the figure) is displayed, and the blood vessel image V is clearly displayed. The blood vessel image V is an example of the “position reference unit” in the claims.

  In addition, the storage unit 14 is configured to be capable of storing the X-ray fluoroscopic image 30 (see FIG. 4) captured by the X-ray imaging apparatus 1 (the imaging unit 11) in a state where no contrast medium is used for the subject T. It is done. When the X-ray fluoroscopic image 30 is displayed as an image on the display unit 16 or the like, bones and adrenals (indicated by hatching in the figure) are displayed, and the sample collection device 3 (catheter) and the collection position (blood collection position ) Is displayed in a distinguishable manner. In the X-ray fluoroscopic image 30, the tip of the sample collection device 3 (catheter) for collecting the blood sample B is displayed as the collection position P so as to be distinguishable. Further, the fluoroscopic image 30 is an example of the “first image” and the “non-contrast X-ray image” in the claims.

  The X-ray fluoroscopic image 30 is stored in the storage unit 14 in association with imaging position information 30 a including the imaging position and the imaging direction when the X-ray fluoroscopic image 30 is acquired. The X-ray fluoroscopic image 30 stored in the storage unit 14 may be stored as a moving image, or may be stored as a still image when a doctor or the like operates the operation unit 17.

  Here, the X-ray fluoroscopic image 30 is taken at a time zone different from that of the three-dimensional image 40. In addition, when the three-dimensional image 40 is captured in advance prior to the X-ray fluoroscopic image 30, it is possible to continuously create the composite image 50 while capturing the X-ray fluoroscopic image 30 continuously. is there. Thereby, the doctor or the like can collect the blood sample B while checking the composite image 50. On the other hand, when the three-dimensional image 40 is captured after the X-ray fluoroscopic image 30, only the DRR image 41 corresponding to the X-ray fluoroscopic image 30 in which the sampling position P can be determined needs to be generated. It is possible to reduce 13 control burdens.

  Further, the storage unit 14 stores a composite image 50 in which the X-ray fluoroscopic image 30 (see FIG. 4) and the three-dimensional image 40 are composited. The details of the composite image 50 will be described later.

  The communication unit 21 is connected to the network 4. The communication unit 21 receives the analysis result A of the blood sample B corresponding to the blood collection number N from the sample analyzer 2 in a state associated with the blood collection number N according to the instruction of the control unit 13. Further, the communication unit 21 receives information on the subject T, a three-dimensional image 40, and the like from the host computer 5 in accordance with an instruction from the control unit 13.

  The display unit 16 is a monitor such as a liquid crystal display, for example, and is configured to be able to display an image such as the X-ray fluoroscopic image 30 or the like. The operation unit 17 includes, for example, a keyboard and a mouse, and is configured to receive an input operation to the X-ray imaging apparatus 1 by a doctor or the like.

  The sample analyzer 2 comprises, for example, a liquid chromatograph mass spectrometer. The sample analyzer 2 analyzes the amounts of predetermined components (eg, the amount of aldosterone and the amount of cortisol etc.) in the blood sample B, and the analysis result A of the blood sample B corresponds to the blood collection number N corresponding to the blood sample B. In the linked state, the signal is output to the X-ray imaging apparatus 1 via the network 4.

  Next, with reference to FIG. 3 and FIG. 4, composite image creation processing and collection position identification in the control unit 13 (image processing unit 18) of the X-ray imaging apparatus 1 according to the first embodiment will be described. In the first embodiment, when the blood sample B is collected by the sample collection device 3, the X-ray fluoroscopic image 30 is taken at any time as a moving image (predetermined frame rate), and the composite image 50 from the X-ray fluoroscopic image 30. An example of creating a file as needed will be described.

(Creating a composite image)
First, the X-ray fluoroscopic image 30 is taken as needed, and stored in the storage unit 14 in association with the imaging position information 30 a. Then, as shown in FIG. 3, the generation unit 18 a of the image processing unit 18 corresponds to the X-ray fluoroscopic image 30 from the three-dimensional image 40 stored in the storage unit 14 based on the imaging direction of the X-ray fluoroscopic image 30 The DRR image 41 is configured to be generated. Specifically, with reference to the imaging position information 30a corresponding to the X-ray fluoroscopic image 30, the generation unit 18a cuts out the three-dimensional image 40 at a position corresponding to the imaging position information 30a. Thereby, a DRR image 41 corresponding to the fluoroscopic image 30 is generated from the three-dimensional image 40. Similar to the three-dimensional image 40, bones and adrenals (indicated by hatching in the figure) are displayed on the DRR image 41, and the blood vessel image V is clearly displayed.

  The generation of the DRR image 41 from the three-dimensional image 40 is not limited to the method of referring to the imaging position information 30a, and, for example, based on bone and adrenal gland included in both the fluoroscopic image 30 and the three-dimensional image 40. The DRR image 41 corresponding to the fluoroscopic image 30 may be generated from the three-dimensional image 40. In this case, the image processing unit 18 performs image processing on the fluoroscopic image 30 to recognize the position of the bone and the position of the adrenal gland in the fluoroscopic image 30, and the recognized position of the bone and the position of the adrenal gland. Based on this, it is possible to generate a DRR image 41 corresponding to the fluoroscopic image 30 by cutting out the three-dimensional image 40 so that the position of the bone and the position of the adrenal gland coincide with each other.

  Thereafter, the composite image creation unit 18 b of the image processing unit 18 creates the composite image 50 by combining the X-ray fluoroscopic image 30 and the created DRR image 41. At this time, the composite image creation unit 18 b changes the DRR image 41 to a color different from that of the X-ray fluoroscopic image 30 (for example, a color such as blue when the X-ray fluoroscopic image 30 is a black and white image) (see FIG. The composite image 50 is created by superimposing the DRR image 41 whose color is changed on the X-ray fluoroscopic image 30 together with medium hatching). Note that, in the composite image 50, in order to suppress a decrease in the visibility of the X-ray fluoroscopic image 30, the superposition is performed in a state where the luminance of the DRR image 41 is smaller than the luminance or the like of the X-ray fluoroscopic image 30. However, the X-ray fluoroscopic image 30 and the DRR image 41 may have the same level of brightness.

  Then, as shown in FIG. 1, the control unit 13 causes the display unit 16 to display the created composite image 50. At this time, the control unit 13 causes the display unit 16 to simultaneously display the radiographed fluoroscopic image 30 together with the composite image 50. Thereby, it is possible to accurately confirm the relationship between the sample collection device 3 and the blood vessel image V when collecting the blood sample B by the sample collection device 3. As a result, it is possible to easily visually recognize the tip portion (collection position P) of the sample collection device 3 based on the blood vessel image V. Further, the created composite image 50 is stored in the storage unit 14 as needed in a state associated with the corresponding X-ray fluoroscopic image 30.

(Identification of collection position)
After that, in the X-ray imaging apparatus 1, during the imaging of the X-ray fluoroscopic image 30 (during the collection of the blood sample B) or after the imaging (after the collection of the blood sample B), specification of the collection position P using the composite image 50 ( The identification shown by the arrow shown in the composite image (after the collection position specification) 50 in FIG. 5 is performed. When specifying the collection position P during imaging of the X-ray fluoroscopic image 30, when collecting the blood sample B, an operation to specify the collection position P for the operation unit 17 is performed by the doctor or the like. Identification of the sampling position P is started on the basis of the above. Here, in the composite image 50 displayed on the display unit 16, the blood vessel image V and the collection position P (the tip of the sample collection device 3) are mutually displayed, so the blood vessel image V and the collection position The sampling position P is identified based on the relative position to P. The image processing unit 18 may perform image processing on the composite image 50 to specify the collection position P. In this case, the distal end portion of the sample collection device 3 may be specified as the collection position P by recognizing the front end portion of the sample collection device 3 in the composite image 50. Also, for example, the position of the sampling position P may be specified as a relative position (coordinates) with respect to the branch point, using the branched branch point in the blood vessel image V as a position reference.

  Further, without performing image processing by the image processing unit 18, the position designated (specified) by the doctor or the like based on the input operation on the composite image 50 by the doctor or the like via the operation unit 17 (for example, a mouse) It may be specified as P.

  When specifying the sampling position P after capturing the X-ray fluoroscopic image 30, the composite image 50 suitable for specifying the sampling position P is selected from among the composite images 50 stored as needed in the storage unit 14 Ru. Then, in a state where the selected composite image 50 and the corresponding X-ray fluoroscopic image 30 are displayed on the display unit 16, an operation to specify the sampling position P for the operation unit 17 is performed by the doctor or the like. Based on the identification of the sampling position P is performed.

  Then, the collection position P, the blood sample B collected at the collection position P, and the blood collection number N are associated one to one. In addition, when blood samples B are obtained at a plurality of collection positions P, different blood collection numbers N are associated.

(Creating blood collection data)
After acquisition of the blood sample B and identification of the collection position P, as shown in FIG. 1, in the state where the analysis result A of the blood sample B analyzed by the sample analyzer 2 is associated with the blood collection number N, radiography It is sent to the device 1. Therefore, for each blood collection number N (blood sample B), the control unit 13 of the X-ray imaging apparatus 1 extracts the blood collection number N, the composite image 50 in which the collection position P is specified, and the blood vessel name corresponding to the collection position P Blood collection data D (D 1, D 2, D 3...) In which the analysis result A is associated with the information on the subject T (not shown) is created. Then, the created blood collection data D is transmitted from the X-ray imaging apparatus 1 to the host computer 5 or the like. As a result, a doctor or the like can easily associate and check the collection position P of the blood sample B and the analysis result A by referring to the blood collection data D.

  Further, in the blood collection data D, for example, an image such as an MRI image or a PET image including the collection position P may be associated or may be associated with other data (such as data of blood components).

(Effect of the first embodiment)
In the first embodiment, the following effects can be obtained.

  In the first embodiment, as described above, the composite image creation unit 18 b displays the blood vessel image V for specifying the position of the collection position P while corresponding to the X-ray fluoroscopic image 30 and the X-ray fluoroscopic image 30. It is configured to create a composite image 50 in which the DRR image 41 is composited. As a result, since the collection position P and the blood vessel image V for specifying the position of the collection position P can be included in the composite image 50, the collection position P can be accurately specified by using the composite image 50. Can. Furthermore, since the composite image 50 is automatically created on the diagnostic imaging system 100, the doctor and the like do not need to sketch on the medical record. Thereby, the work burden of the doctor etc. which are required for specification of extraction position P can be eased. As a result of these, it is possible to more accurately specify the collection position P, and it is possible to reduce the work load of a doctor or the like required to specify the collection position P.

  In the first embodiment, as described above, the sampling position P is specified in the composite image 50 based on the relative positional relationship between the blood vessel image V and the sampling position P. As a result, based on the relative positional relationship between the blood vessel image V and the sampling position P included in the composite image 50, the sampling position P can be specified more accurately.

  In the first embodiment, as described above, the composite image 50 is created using the DRR image 41 in which the blood vessel image V of the subject T for specifying the position of the collection position P is displayed. Thus, since the collection position P and the blood vessel image V can be included in the composite image 50, the collection position P of the blood sample B can be accurately identified when the blood sample B is collected.

  In the first embodiment, as described above, the X-ray fluoroscopic image 30 is acquired by the X-ray imaging apparatus 1 in a state where the contrast agent is not used for the subject T, and the collection position P can be determined. It is a contrast X-ray image, and the DRR image 41 is a contrast X-ray image obtained by using a contrast agent with respect to the subject T and displaying the blood vessel image V. Thus, the blood vessel image V is not substantially displayed by not using the contrast agent, and the non-contrast X-ray image in which the collection position P can be determined, and the contrast X-ray image in which the blood vessel image V is displayed using the contrast agent By combining these, it is possible to create a composite image 50 in which both the collection position P and the blood vessel image V can be discriminated. As a result, the blood collection position P can be specified more accurately.

  In the first embodiment, as described above, the composite image generation unit 18 b generates the composite image 50 by superimposing the DRR image 41 having a display color different from that of the X-ray fluoroscopic image 30 on the X-ray fluoroscopic image 30. Configure to Thereby, it can be easily recognized that the DRR image 41 is superimposed on the X-ray fluoroscopic image 30, and a doctor or the like can use the blood vessel image V for specifying the position of the sampling position P in the composite image 50. It can be made easy to visually recognize.

  In the first embodiment, as described above, the display unit 16 is configured to be able to simultaneously display the X-ray fluoroscopic image 30 and the composite image 50. Thereby, the doctor or the like can confirm the X-ray fluoroscopic image 30 simultaneously displayed while confirming the composite image 50 displayed on the display unit 16. As a result, it is possible to easily confirm, using the X-ray fluoroscopic image 30, a portion which has become difficult to visually recognize on the composite image 50.

  In the first embodiment, as described above, the generation unit 18a generates the DRR image 41 from the three-dimensional image 40 on which the blood vessel image V is displayed based on the imaging direction of the X-ray fluoroscopic image 30. Configure. As a result, the DRR image 41 corresponding to the X-ray fluoroscopic image 30 can be accurately generated, so that the DRR image 41 not sufficiently corresponding to the X-ray fluoroscopic image 30 and the X-ray fluoroscopic image 30 are synthesized. It can be suppressed.

Second Embodiment
A second embodiment of the present invention will be described with reference to FIGS. 1, 2 and 4 to 6. In the second embodiment, unlike the first embodiment, an example in which the DRR image 41 is generated from a plurality of three-dimensional images 40 respectively corresponding to a plurality of time points will be described. The configuration of the diagnostic image system 100 in the second embodiment is substantially the same as the configuration of the diagnostic image system 100 in the first embodiment except that a plurality of three-dimensional images 40 are stored in the storage unit 14. Description is omitted because it exists.

  In the subject T (see FIG. 1), the imaging unit 11 (see FIG. 1) refers to the same position (region of interest) of the subject T due to periodic movement such as breathing and / or pulsation of the subject T itself. Even if imaging is performed according to the above, the internal blood vessel image V and an organ (adrenal gland) may move periodically. For this reason, the position of the sample collection device 3 such as a catheter inserted into a blood vessel and the adrenal gland may periodically change for each fluoroscopic image 30 to be captured.

  Therefore, in the second embodiment, the storage unit 14 stores a plurality of three-dimensional images 40 (see FIG. 3) acquired in a state where a contrast agent (blood vessel contrast agent) is used for the subject T. There is. The plurality of three-dimensional images 40 (also referred to as four-dimensional images) are images previously acquired at a plurality of time points using an X-ray CT apparatus (not shown). Specifically, a plurality of three-dimensional images 40 are acquired in advance at each of a plurality of time points corresponding to at least one cycle of the changing cycle. As a result, one of the plurality of three-dimensional images 40 corresponds to the state of the subject T substantially the same as the state of the subject T when the X-ray fluoroscopic image 30 is captured.

  Then, the generation unit 18a of the image processing unit 18 stores the plurality of images stored in the storage unit 14 based on the imaging direction of the X-ray fluoroscopic image 30 and the state of the subject T when the X-ray fluoroscopic image 30 is captured. The DRR image 41 corresponding to the X-ray fluoroscopic image 30 is generated from the three-dimensional image 40 of FIG. Specifically, first, the generation unit 18a selects a corresponding three-dimensional image 40 from the plurality of three-dimensional images 40 based on the state of the subject T at the time of imaging. In this case, for example, image processing is performed to select a three-dimensional image 40 having the most similar positional relationship and positional relationship between bone and adrenal in the fluoroscopic image 30.

  The selection of the three-dimensional image 40 is not limited to the above method. For example, when taking a plurality of three-dimensional images 40, in parallel with taking a three-dimensional image 40, respiration and / or pulsation are separately measured using a measuring machine. Similarly, in parallel with the taking of the fluoroscopic image 30, respiration and / or pulsation are separately measured using a measuring machine. Then, the three-dimensional image 40 most similar to the respiration and / or pulsation of the fluoroscopic image 30 is selected as the three-dimensional image 40 corresponding to the state of the subject T at the time when the fluoroscopic image 30 is taken. It is possible.

  Then, the generation unit 18a refers to the imaging position information 30a corresponding to the X-ray fluoroscopic image 30, and cuts out the selected three-dimensional image 40 at a position corresponding to the imaging position information 30a, as in the first embodiment. . Thereby, the DRR image 41 corresponding to the X-ray fluoroscopic image 30 is generated from the plurality of three-dimensional images 40 respectively corresponding to the plurality of time points. The subsequent control processing (generation of the composite image 50, identification of the collection position P, and generation of the blood collection data D) is the same as that of the first embodiment, and thus the description thereof is omitted.

(Effect of the second embodiment)
In the second embodiment, the following effects can be obtained.

  In the second embodiment, the DRR image 41 corresponding to the X-ray fluoroscopic image 30 and the X-ray fluoroscopic image 30 and displaying the blood vessel image V for specifying the position of the sampling position P The composite image 50 is configured to be created. As a result, as in the first embodiment, the sampling position P can be specified more accurately, and the workload on a doctor or the like required to specify the sampling position P can be reduced.

  Further, in the second embodiment, as described above, the generation unit 18a generates a plurality of information based on the imaging direction of the X-ray fluoroscopic image 30 and the state of the subject T when the X-ray fluoroscopic image 30 is captured. The DRR image 41 is configured to be generated from a plurality of three-dimensional images 40 each corresponding to a point in time. Thereby, even if the subject T (the collection position P and the blood vessel image V) moves due to periodic motion such as respiration and pulsation, the DRR image 41 corresponding to the X-ray fluoroscopic image 30 is accurately corrected. Can be generated. As a result, it can be further suppressed that the DRR image 41 and the X-ray fluoroscopic image 30 which do not correspond sufficiently to the X-ray fluoroscopic image 30 are combined. The remaining effects of the second embodiment are similar to those of the aforementioned first embodiment.

[Modification]
It should be understood that the embodiments disclosed herein are illustrative and non-restrictive in every respect. The scope of the present invention is indicated not by the description of the embodiments described above but by the claims, and further includes all modifications (modifications) within the meaning and scope equivalent to the claims.

  For example, although the example which simultaneously displays the X-ray fluoroscopic image 30 (1st image) and the synthetic | combination image 50 on the display part 16 was shown in said 1st and 2nd embodiment, this invention is not limited to this. For example, the display unit may be configured to switch and display the first image and the composite image. As a result, it is possible to easily confirm, in the first image displayed by switching the display, a portion that has become difficult to visually recognize on the composite image. In addition, the display unit may be configured to simultaneously display the second image as well as the first image and the composite image, or three of the first image, the composite image, and the second image. It may be configured to switch to any one of the images for display.

  Moreover, although the said, 1st and 2nd embodiment demonstrated the example for which the diagnostic imaging system 100 is used for adrenal vein sampling for a diagnosis of primary aldosteronism, this invention is not limited to this. The diagnostic imaging system of the invention may be used for applications other than adrenal vein sampling for the diagnosis of primary aldosteronism. For example, the diagnostic imaging system of the present invention may be used for the purpose of collecting cancer cells using a sample collection device. In this case, a second image (for example, a PET image) on which a marker or the like as a position reference unit for specifying a sampling position is displayed and a first image (for example, an X-ray fluoroscopic image) are synthesized and synthesized You may create

  Moreover, although the said 1st and 2nd embodiment demonstrated the example which pinpointed the front-end | tip part of the sample collection device 3 as the collection position P, this invention is not limited to this. In the present invention, when the puncture needle for sample collection is stored at the tip of the sample collection device, the tip of the puncture needle further protruding from the tip of the sample collection device at the time of sample collection is the sample It may be specified as a sample collection position. Even in this case, since the position reference part (the blood vessel image V in the first embodiment) is displayed in the composite image, it is possible to easily specify the collection position.

  In the first and second embodiments, the X-ray fluoroscopic image 30 (first image) is an image in which the collection position (blood collection position) P is displayed so as to be distinguishable, but the present invention is not limited thereto. It is not limited to. In the present invention, the first image may be an image in which the state of tissue around the collection position can be determined. For example, in the case of collecting a sample (for example, an organ tissue piece) using a puncture needle, an image capable of determining the state (whether or not it is sticking) of the surrounding tissue of the puncture needle may be used as the first image. In this case, the composite image generation unit displays a first image in which the state of the surrounding tissue of the puncture needle can be determined and a position reference unit (for example, an angiographically imaged blood vessel image) for specifying the collection position. A composite image is created by combining the image.

  In the first and second embodiments, the X-ray fluoroscopic image 30 (first image), the DRR image 41 (second image), the composite image 50, and the composite image 50 are used. Although the specification of the sampling position P is all performed in the diagnostic imaging system 100 performed in the X-ray imaging apparatus 1, the present invention is not limited to this. In the diagnostic imaging system of the present invention, only acquisition of the first image may be performed by the X-ray imaging apparatus, and generation of the second image, creation of a composite image, and specification of a collection position may be performed by another apparatus. For example, in a host computer connected to the X-ray imaging apparatus via a network, generation of a second image, creation of a composite image, and specification of a collection position using the composite image may be performed.

  In the first and second embodiments, the composite image creation unit 18b changes the DRR image 41 (second image) to a color different from that of the X-ray fluoroscopic image 30 (first image) and changes the color. Although an example in which the composite image 50 is created by superimposing the captured DRR image 41 on the X-ray fluoroscopic image 30, the present invention is not limited to this. In the present invention, as long as a composite image is formed by combining the first image and the second image by the composite image creation unit, the composition method is not limited to the method described above. For example, the composite image creation unit may create a composite image by superimposing the second image on the first image as it is. In addition, the combined image creation unit may combine with the first image after performing alignment and / or scaling of the second image. Furthermore, the composite image creation unit may create a composite image by replacing only a part of the first image (for example, the periphery of the blood vessel image (position reference part)) with the second image.

  In the first and second embodiments, an example is shown in which the DRR image 41 (second image) corresponding to the X-ray fluoroscopic image 30 (first image) is generated from the three-dimensional image 40. It is not restricted to this. For example, among the second images captured from a plurality of angles, the second image most similar to the first image may be used as the second image corresponding to the first image.

  In the first and second embodiments, an example is shown in which the composite image 50 is created from the X-ray fluoroscopic image 30 (first image) and the DRR image 41 (second image) captured using X-rays. However, the present invention is not limited to this. In the present invention, a composite image may be created from the first image and the second image captured using an imaging method other than X-rays (for example, ultrasound).

  In the first and second embodiments, an example has been described in which the composite image 50 corresponding to the X-ray fluoroscopic image 30 (first image) captured at any time is created at any time, but the present invention is not limited to this. For example, in the case of specifying the collection position after collecting the sample, the composite image corresponding to the first image may be created only when specifying the collection position. At this time, it is only necessary to create a second image and a composite image corresponding to the first image at the time of sample sample collection, and it is not necessary to create a corresponding second image and composite image for all the first images. . Thereby, it is possible to reduce the control processing burden of the image processing unit during collection of the sample.

1 X-ray imaging device (acquisition unit)
16 display unit 18a generation unit 18b composite image generation unit 30 X-ray fluoroscopic image (first image, non-contrast X-ray image)
40 Three-dimensional image 41 DRR image (second image, contrast X-ray image)
50 composite image 100 diagnostic imaging system A analysis result B blood sample (sample)
N Blood collection number P Collection position T Subject V Blood vessel image (position reference part)

Claims (8)

An acquisition unit configured to acquire a first image capable of determining a state of a tissue at a collection position when collecting a sample from the subject or the collection position;
And a composite image creation unit configured to create a composite image in which the first image and a second image corresponding to the first image and displayed with a position reference unit for specifying the collection position are composited. , Diagnostic imaging system.   The diagnostic image system according to claim 1, wherein the collection position is specified in the composite image based on a relative positional relationship between the position reference unit and the collection position.   The diagnostic image system according to claim 1, wherein the position reference unit is a blood vessel image of the subject.   The first image is a non-contrast X-ray image which is acquired by the acquisition unit in a state in which a contrast agent is not used for the subject, and which can determine the state of tissue at or near the collection position. The diagnostic image system according to claim 3, wherein the second image is a contrast X-ray image obtained by using the contrast agent with respect to the subject and displaying the blood vessel image.   5. The composite image creation unit according to claim 1, wherein the composite image creation unit is configured to create the composite image by superimposing the second image of a display color different from the first image on the first image. A diagnostic imaging system according to any one of the preceding claims. It further has a display unit capable of displaying an image,
The display unit according to any one of claims 1 to 5, wherein the display unit can simultaneously display the first image and the composite image, or can switch and display the first image and the composite image. The diagnostic imaging system according to claim 1.   The diagnosis according to any one of claims 1 to 6, further comprising: a generation unit that generates the second image from the displayed three-dimensional image based on the imaging direction of the first image. Imaging system.   The generation unit is configured to generate a plurality of three-dimensional images respectively corresponding to a plurality of time points based on the imaging direction of the first image and the state of the subject at the time when the first image is captured. A diagnostic imaging system according to claim 7, configured to generate two images.

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