JP2019088553A - Endoscopic image observation support system - Google Patents

Abstract

To provide a technology to support image reading of an endoscopic image.SOLUTION: A display processing unit 62 reproduces and displays an endoscopic image on an image reading screen. An observation content recording unit 90 records past finding information and a finding image associated with the finding information. A progress rate acquisition unit 58 acquires a progress rate indicating a position in a predetermined section in which the finding image is taken. A distribution derivation unit 60 derives a distribution state of the past finding information based on the acquired progress rate. A display processing unit 62 displays the distribution state of the past finding information on the image reading screen.SELECTED DRAWING: Figure 2

Description

  The present invention relates to a system for supporting observation of an endoscopic image taken by a capsule endoscope.

  Patent Document 1 compares the imaging time or feature amount acquired from the image group of the current examination with the imaging time or feature amount acquired from the image group of the past examination, and the difference between the two is at least the reference value. An image processing apparatus is disclosed that performs display control based on the result of comparison on an image group of the current examination in some cases.

International Publication No. 2014/061553

  In capsule endoscopy, tens of thousands to hundreds of thousands of images are captured, so the burden on an image reader is much greater than that of other types of image reading. In order to reduce the possibility of oversight, double reading by two reading doctors may be carried out, but in recent years, the doctor has completed double reading reports while assisting the image diagnosis. Implementation of interpretation has also been proposed.

  However, not all doctors and technicians are used to reading, and even in the case of double reading, there is a possibility of oversighted findings. Therefore, it is preferable to provide a system that can support image interpretation especially for inexperienced doctors and technologists. In addition, it is preferable that a mechanism capable of supporting the interpretation as well is constructed even in the case where one reading person interprets images instead of double interpretation.

  The present invention has been made in view of these circumstances, and an object thereof is to provide a technique for supporting interpretation of endoscopic images.

  In order to solve the above-mentioned subject, an endoscope image observation support system of an embodiment of the present invention is an observation support system which supports observation of a plurality of endoscope images which a capsule endoscope photographed the inside of a subject. , A display processing unit for reproducing and displaying an endoscopic image on an interpretation screen, an observation content recording unit for recording past findings information, and a findings image associated with the findings information, and a predetermined imaging of the findings image And a distribution deriving unit that derives a distribution state of past observation information based on the acquired progress rate. The display processing unit displays the distribution state of the past finding information on the interpretation screen.

  It is to be noted that any combination of the above-described constituent elements, one obtained by converting the expression of the present invention between a method, an apparatus, a system, a recording medium, a computer program and the like is also effective as an aspect of the present invention.

  According to the present invention, it is possible to provide a technique for supporting interpretation of endoscopic images.

It is a figure for demonstrating the outline | summary of an image observation assistance system. It is a figure which shows the structure of a management server and a recording device. It is a figure which shows the example of an interpretation screen. It is a figure which shows the example of an overview screen. It is a figure which shows the findings image displayed on the interpretation screen.

  FIG. 1 is a view for explaining an outline of an image observation support system of a capsule endoscope according to an embodiment. The endoscopic image observation support system 1 supports observation of a capsule endoscopic image by a reader. In an examination using a normal endoscope, a doctor observes an image taken by the endoscope inserted into a patient's body in real time on a display to make a diagnosis. However, in a capsule endoscopy, a reader reads a capsule This is different from ordinary endoscopy in that a large number of images captured in the past by the endoscope are collectively observed.

  In capsule endoscopy, a patient (subject) has a plurality of receiving antennas (not shown) attached to the abdomen, and the receiving device 4 is attached to the waist by a belt. Swallow the endoscope 3 from the mouth. The capsule endoscope 3 is an image obtained by A / D-converting an imaging signal output from an imaging unit that is a microminiature camera, an illumination unit that illuminates the inside of a subject, and the imaging unit, and adding an image ID and imaging time information. A signal processing unit that generates data, a memory that temporarily stores image data, a communication module that transmits image data stored in the memory, and a battery that supplies power to each unit are provided. The capsule endoscope 3 periodically captures a still image while moving the digestive tract, and transmits image data to the receiving device 4 via an antenna.

  The receiving device 4 incorporates a recording medium 5, and the receiving device 4 adds related information including radio wave intensity information at the time of reception at each reception antenna to the image data received by each reception antenna, Record 5 When the capsule endoscope 3 captures an image of the body every 0.5 seconds, when imaging in the body is completed in about 8 hours, about 60,000 pieces of endoscopic image data are recorded on the recording medium 5.

  The image ID is information for identifying an image, and may be information to which a serial number indicating the imaging order is added. For example, “1” may be added to the image ID of the endoscope image captured first, and “2” may be added to the image ID of the endoscope image captured second. By generating the image ID in this manner, the serial number included in the image ID expresses the photographing order, and the duplication of the image ID can be avoided. The image ID and the photographing time information may be added to the photographed image as related information by the receiving device 4 when the receiving device 4 receives the photographed image. In any case, the image captured by the capsule endoscope 3 is recorded in the recording medium 5 in association with related information such as an image ID, shooting time information and received radio wave intensity.

  When the antenna and the receiving device 4 are recovered from the patient, the data terminal of the receiving device 4 is connected to the data reading device connected to the management server 10, and the data reading device is about 60,000 sheets recorded on the recording medium 5. The endoscope image data and the related information are read out and transmitted to the management server 10. The data reading device may be an external device connected to the management server 10 by a USB cable or the like. The recording medium 5 may be a memory card that can be attached to and detached from the receiving device 4, and the recording medium 5 is removed from the receiving device 4 and mounted on a data reading device to read endoscope image data and related information. It may be done. The recording medium 5 may be attached to a data reading slot provided in the management server 10 to read endoscope image data and related information.

  The management server 10 performs predetermined image processing on the endoscope image read from the recording medium 5 and records the image in the recording device 12. The recording device 12 may be configured by an HDD (hard disk drive) or may be configured by a flash memory. The endoscopic image recorded in the recording medium 5 is an uncompressed RAW (raw) image or a RAW image subjected to only lossless compression, so the data size is very large. Therefore, the management server 10 performs predetermined lossy compression processing on the endoscopic image which is the RAW image, reduces the data size, and records the result in the recording device 12. In the embodiment, the management server 10 takes charge of the image processing of the endoscope raw image, but another apparatus, for example, the terminal device 20 performs the image processing on the endoscope raw image and records it in the recording device 12 The recording device 12 may be provided in the terminal device 20.

  The plurality of terminal devices 20 are connected to the management server 10 by a network 2 such as a LAN (local area network). The terminal device 20 is a personal computer or the like assigned to an image reading person such as a doctor or an engineer (hereinafter may be simply referred to as “user”) and is connected to the display device 22 so as to allow screen output. 20 may be a laptop computer integrated with a display device, or may be a portable tablet. The terminal device 20 accesses the management server 10 and displays the endoscopic image recorded in the recording device 12 on the display device 22.

  When compressing the endoscopic RAW image, the management server 10 has a function of executing an analysis application to analyze the endoscopic image. Image analysis by the analysis application is performed on all endoscopic RAW images captured in one capsule endoscopy, and the result of the image analysis is added as additional information to the compressed endoscopic image .

  One of the purposes of capsule endoscopy is to look for a source of bleeding in the digestive tract. When the management server 10 acquires the endoscope RAW image from the recording medium 5, the management server 10 executes the analysis application to perform image processing, thereby specifying the endoscope RAW image which may have taken a bleeding state. For example, when the redness of the endoscopic image exceeds a predetermined threshold value, the management server 10 determines that the image is likely to have taken a bleeding state, and compresses the endoscopic RAW image, Flag information indicating that the image is red is added.

  In addition, there is a difference in the moving speed of the capsule endoscope 3 in the digestive tract, and the change in the endoscopic image to be captured is small at the place where the moving speed is slow. Therefore, it is inefficient and burdensome for the image reader to observe all the images including a plurality of substantially unchanged images equally. Therefore, the analysis application performs a process of specifying an image (similar image) with a small change by comparing endoscopic RAW images captured continuously in time. Hereinafter, this process is referred to as "image summarizing process".

  In the image summarizing process, a reference image is set, and the ratio of the covered area of the reference image to the determination target image to be determined to be similar to the reference image is calculated as the coverage. The determination target image is an image captured later than the reference image. The analysis application determines the determination target image as a similar image of the reference image when the coverage is equal to or greater than the threshold. When compressing the endoscopic RAW image which is the reference image, the management server 10 adds flag information indicating that it is the reference image, and when compressing the endoscopic RAW image which is the similar image, the similar image And flag information indicating that the

  The reproduction application executed in the management server 10 or the terminal device 20 has a reproduction mode for shortening the reproduction time of the endoscope image with reference to the flag information added by the image summarizing process, and the reader By selecting this reproduction mode, shortening of the observation time can be realized.

The playback application of the embodiment is configured to have four playback modes.
(First playback mode)
The first reproduction mode is a manual reproduction mode using an operation of a user interface connected to the terminal device 20. In the first reproduction mode, the endoscope image can be frame-by-frame displayed one by one by rotating the wheel of the mouse. Therefore, the first reproduction mode is used when specifying the image in which the lesion is most clearly imaged among a plurality of images in which the lesion is imaged. When the user rotates the wheel backward, the endoscopic image is continuously reproduced and displayed in the forward direction (direction from the old image to the new image at the photographing time), and when the user rotates the wheel forward, the endoscopic view The mirror image is continuously reproduced and displayed in the reverse direction (direction from the new image at the shooting time to the old image).

(2nd playback mode)
The second reproduction mode is an automatic reproduction mode in which the endoscope image is continuously reproduced and displayed in the forward or reverse direction at the set reproduction speed. The second reproduction mode is used for normal endoscopic image observation.

(3rd playback mode)
In the third playback mode, similar images are forward-directed at a speed higher than the preset playback speed while continuously playing back and displaying the reference image specified by the image summarizing process in the forward or reverse direction at the preset playback speed. This is an automatic playback mode in which continuous playback display is performed in the reverse direction. The third reproduction mode realizes shortening of the observation time as compared to the second reproduction mode by reproducing at high speed a similar image having a small change with respect to the reference image.

(4th playback mode)
The fourth reproduction mode is an automatic reproduction mode in which the display of the similar image specified by the image summarizing process is omitted, and only the reference image is reproduced and displayed in the forward or reverse direction at the set reproduction speed. The fourth reproduction mode realizes shortening of the observation time as compared with the third reproduction mode by omitting the display of the similar image. A fourth back reproduction mode which is a back mode may be set to the fourth reproduction mode. The fourth reverse reproduction mode is an automatic reproduction mode in which the display of the reference image is omitted and only the similar image is reproduced and displayed in the forward direction or the reverse direction at the set reproduction speed. The fourth back reproduction mode is used to confirm that there is no observation omission after the observation in the fourth reproduction mode.

  The first to third reproduction modes are continuous reproduction modes for reproducing and displaying temporally continuous endoscopic images in order, and the fourth reproduction mode (fourth back reproduction mode) is a temporally continuous endoscopic view This is a thinning reproduction mode in which a mirror image is thinned and reproduced and displayed. The reproduction application carries out an endoscope image reproduction process according to the reproduction mode selected by the user. The reproduction application may be executed by the management server 10 or may be executed by the terminal device 20.

  The terminal device 20 is connected to a user interface such as a keyboard and a mouse. The terminal device 20 has a function of cooperating with the management server 10 to support the image interpretation work by the image reader. The terminal device 20 causes the display device 22 to display the interpretation screen of the endoscope image, and the user observes the endoscope image reproduced and displayed on the interpretation screen and captures the endoscope image obtained by imaging a lesion or the like. .

  FIG. 2 shows the configuration of the management server 10 and the recording device 12. The management server 10 includes an acquisition unit 30, an image processing unit 40, a screen generation unit 50, an operation reception unit 52, a section setting unit 54, a trajectory processing unit 56, a progress rate acquisition unit 58, a distribution derivation unit 60, and a display processing unit 62. Prepare. The acquisition unit 30 includes a RAW image acquisition unit 32 and a related information acquisition unit 34. The image processing unit 40 includes a redness determination unit 42, an image summary processing unit 44, and a compression processing unit 46. Each function of the management server 10 may be realized by executing various applications such as an analysis application and a reproduction application. In the embodiment, the management server 10 executes various applications, but the terminal device 20 may execute various applications.

  The recording device 12 includes an endoscope image recording unit 80, a related information recording unit 82, a position information recording unit 84, a trajectory image recording unit 86, an examination information recording unit 88, and an observation content recording unit 90. The endoscopic image recording unit 80 records the endoscopic image subjected to the image processing by the image processing unit 40. The examination information recording unit 88 records information on endoscopy. The observation content recording unit 90 records the observation content registered for the past examination of the capsule endoscope, for example, finding information, a finding image associated with the finding information, and the like.

  The configuration of the management server 10 can be realized as hardware in any processor, memory, or other LSI, and software can be realized as a program loaded in the memory, etc. Here, it is realized by cooperation of them. Are drawing functional blocks. Therefore, it is understood by those skilled in the art that these functional blocks can be realized in various forms by hardware only, software only, or a combination thereof.

  The RAW image acquisition unit 32 acquires approximately 60,000 sheets of endoscope RAW images transmitted from the data reading device and causes the recording device 12 to temporarily store them. The related information acquisition unit 34 acquires related information transmitted from the data reading device and records the related information in the related information recording unit 82. The image processing unit 40 performs the following image processing on all endoscopic raw images. In addition, image ID is matched with endoscopic raw image data.

<Identification of reddish image>
The redness determination unit 42 searches for a reddish endoscopic RAW image by image analysis, and identifies an image whose redness is stronger than a predetermined threshold. The redness determination unit 42 provides the compression processing unit 46 with the image ID of the specified redness image.

<Image summary processing>
The image summarization processing unit 44 performs an image summarization process that classifies all endoscopic images into a reference image and a similar image similar to the reference image. First, the image summary processing unit 44 sets an image captured first as a reference image. The image summary processing unit 44 performs similarity determination as to whether or not the determination target image captured next to the reference image is similar to the reference image. The image summarizing processing unit 44 obtains a covered area including a deformed image obtained by deforming the reference image in the determination target image, and calculates a ratio of the covered area in the determination target image as a coverage.

  The image summary processing unit 44 determines the determination target image as a similar image of the reference image when the coverage is equal to or greater than the threshold. The image summary processing unit 44 performs similarity determination as to whether or not it is similar to the reference image, with the image captured next to the image determined as the similar image as the determination target image. If the moving speed of the capsule endoscope 3 is low, several dozen images taken after the reference image may be determined as similar images.

  On the other hand, when the coverage is less than the threshold value, the image summarizing processing unit 44 determines the determination target image as a dissimilar image. The image summary processing unit 44 sets an image determined as a non-similar image as a new reference image, and performs similarity determination using an image captured next as a determination target image. The image summarization processing unit 44 performs this image summarization processing on all about 60,000 sheets of images and classifies them into a reference image and a similar image.

  The number ratio of the reference image to the similar image is adjusted by setting of the threshold. When the threshold is increased, the number of reference images is increased, and when the threshold is decreased, the number of reference images is decreased. In the fourth reproduction mode, since only the reference image is reproduced and displayed, the setting of the threshold is important for suppressing the oversight of the lesion and the like, but according to the results so far, about 60,000 endoscopic images Among them, it has been found that the interpretation of only the reference image prevents the oversight of the lesion image by setting a threshold value to extract about 20,000 sheets as the reference image. The image summary processing unit 44 provides the compression processing unit 46 with the image ID of the classified reference image and the image ID of the similar image.

<Compression process of endoscopic RAW image>
The image analysis processing by the redness determining unit 42 and the image summarizing processing unit 44 is performed when the compression processing unit 46 compresses the endoscopic RAW image. The compression processing unit 46 performs irreversible compression processing on the endoscopic RAW image to generate an image file to which the image ID and photographing time information are added, and records the image file in the endoscopic image recording unit 80. For example, the compression processing unit 46 may compress the endoscopic RAW image in an image format such as JPEG.

  The compression processing unit 46 adds information indicating the analysis result provided from the redness determination unit 42 and the image summary processing unit 44 to the compressed image file. Specifically, the compression processing unit 46 adds, to the compressed image having the image ID provided from the redness judging unit 42, information indicating that the image is a reddish image. This information may be added as flag information. Further, the compression processing unit 46 adds flag information indicating that it is a reference image to the reference image based on the result of the image summarization processing by the image summarization processing unit 44, and indicates that the similar image is a similar image. Add flag information to indicate. Since it is in the relation of front and back whether it is a reference image or a similar image, flag value 1 may express a reference image and flag value 0 may express a similar image.

  In the embodiment, the redness determination unit 42 and the image summarization processing unit 44 perform image processing on the endoscopic RAW image before the compression processing on the endoscopic raw image by the compression processing unit 46. In a modification, the redness determination unit 42 and the image summarization processing unit 44 may perform image analysis on the compressed image, and information indicating the analysis result may be added to the compressed image. In the endoscopic image recording unit 80, an image file subjected to image processing by the image processing unit 40 is recorded, and the user uses the image file recorded in the endoscopic image recording unit 80 to Conduct observation.

<Tracking process of capsule endoscope>
The related information acquisition unit 34 acquires related information transmitted from the data reading device and records the related information in the related information recording unit 82. The locus processing unit 56 executes processing for specifying the movement locus of the capsule endoscope 3 from the reception intensity information recorded in the related information recording unit 82.

  The locus processing unit 56 detects the position of the capsule endoscope 3 when the endoscopic image is taken based on the reception intensity information when the plurality of reception antennas receive the image data among the related information of the image data. Get the position information to represent. This position is a three-dimensional position in the subject and represents a position when the capsule endoscope 3 captures an image. The method of detecting the imaging position of the capsule endoscope 3 is not limited to the method based on the reception intensity of the wireless signal, and a method using a magnetic field or other known method may be used. For example, the trajectory processing unit 56 derives the amount of movement and the direction of movement within the subject from the difference between the endoscopic image and the endoscopic image taken before and after the endoscopic image, and combines it with the reception intensity information at a plurality of receiving antennas. Position information representing the position of the capsule endoscope 3 at the time of imaging may be derived. This position information may be position coordinates in a three-dimensional space. The locus processing unit 56 records the acquired position information in the position information recording unit 84 in association with the image ID.

  The trajectory processing unit 56 generates trajectory image data representing the movement trajectory of the capsule endoscope 3 in the subject based on the position information recorded in the position information recording unit 84. The trajectory processing unit 56 may generate three-dimensional trajectory image data by connecting the position information recorded in the position information recording unit 84 in the order of the image ID. In addition, when connecting, trajectory image data may be generated so that connected line segments are connected smoothly. The trajectory processing unit 56 records the generated trajectory image data in the trajectory image recording unit 86.

Hereinafter, the screen displayed on the display device 22 at the time of image interpretation will be described.
The doctor B who is a user inputs a user ID and a password to the terminal device 20 and logs in. When the user logs in, the management server 10 provides the examination information recorded in the examination information recording unit 88 to the terminal device 20, and the display device 22 displays a list of capsule endoscope examinations. On the examination list screen, examination information such as patient ID, patient name, examination ID, examination date and time, and the like are displayed, and the user selects an examination to be subjected to the interpretation report creation. When an examination having a patient ID “1111”, a patient name “A”, and an examination ID “0001” is selected from the examination list, the screen generation unit 50 reads an interpretation screen for the user to interpret an endoscopic image. It is generated and displayed on the display device 22.

  FIG. 3 shows an example of an interpretation image screen of an endoscopic image. At the upper center of the image interpretation screen, a reproduction area 100 for switching and reproducing an endoscopic image is provided. The diagnostic reading screen is displayed on the display device 22 with the playback mode selection button 102a at the upper left corner of the screen selected. When the overview mode selection button 102 b is selected, the screen generation unit 50 generates an overview screen shown in FIG. 4 and causes the display device 22 to display the overview screen.

  The number-of-reproductions switching button 108 is an operation button for switching the number of images displayed in the reproduction area 100. Although FIG. 3 shows an example in which single-image display is selected, the user can select two-image display or four-image display by operating the reproduction number switching button 108.

  In the reproduction mode selection area 130, operation buttons for selecting a reproduction mode are arranged. The second reproduction mode selection button 110 is an operation button for selecting a second reproduction mode. The third reproduction mode selection button 112 is an operation button for selecting the third reproduction mode. The fourth reproduction mode selection button 114 is an operation button for selecting a fourth reproduction mode in which only the reference image is reproduced and displayed. The fourth back reproduction mode selection button 116 is an operation button for selecting a fourth back reproduction mode in which only the similar image is reproduced and displayed. In the fourth reproduction mode, since the reproduction display of similar images is omitted, when the user selects the fourth reproduction mode and interprets, all the endoscopic images are read in the fourth reverse reproduction mode as well. It is recommended to observe.

  The user selects one of the second reproduction mode selection button 110, the third reproduction mode selection button 112, the fourth reproduction mode selection button 114, and the fourth back reproduction mode selection button 116 to set the reproduction mode. In the default state, the second reproduction mode selection button 110 is selected. The reproduction button 104 a and the reverse reproduction button 104 b are displayed in the reproduction button display area 104 provided below the reproduction area 100, and when the reproduction button 104 a is selected, the endoscopic image is displayed in the forward direction in the reproduction area 100 ( When the reverse playback button 104b is selected, the endoscopic image is displayed in the reverse direction (from the new image at the shooting time toward the old image) when the reverse playback button 104b is selected. Is displayed on the screen). The reproduction speed adjustment unit 106 includes a slider for adjusting the reproduction speed (display time of one endoscopic image). The playback speed adjustment unit 106 sets the playback speed, that is, the display frame rate of the endoscopic image, according to the position of the slider.

  The display processing unit 62 reproduces and displays the endoscopic image in the reproduction area 100 in accordance with the reproduction mode selected in the reproduction mode selection area 130 and the reproduction speed (display frame rate) set by the reproduction speed adjustment part 106. . When the play button 104a or the reverse play button 104b is selected, the display processing unit 62 starts the playback display, but a pause button is displayed instead at the selected play button 104a or the reverse play button 104b. Ru. If the user operates the pause button during playback display of the endoscope image, the display processing unit 62 pauses playback display of the endoscope image. When the user operates the mouse wheel in this state, the display processing unit 62 displays the endoscope image frame-by-frame in the first reproduction mode according to the rotation of the mouse wheel.

  When the user places the mouse pointer on the image displayed in the playback area 100 and double-clicks the left button of the mouse, the image is captured and displayed in the captured image display area 128. The captured image displayed in the captured image display area 128 is an option of an image to be attached to the interpretation report later. In this example, it is shown that five captured images 128a to 128e are selected.

  The screen generation unit 50 displays the mark display area 120 below the reproduction area 100, one end of which is the shooting start time and the other end of which is the shooting end time. In the embodiment, the mark display area 120 is displayed as a time bar with the left end as the imaging start time and the right end as the imaging end time, and the slider 122 sets the temporal position of the endoscopic image displayed in the reproduction area 100. Show. The time position represented by the slider 122 is also displayed in the time display area 124 as relative time information from the shooting start time. When the user places the mouse pointer on any part of the mark display area 120 and clicks the left button of the mouse, an endoscopic image at that time position is displayed in the reproduction area 100. Further, even if the user drags the slider 122 and drops it at an arbitrary position in the mark display area 120, an endoscopic image at that time position is displayed in the reproduction area 100.

  The red image display button 126 is a button for displaying a red mark at the photographing time of the reddish image in the mark display area 120. When the red image display button 126 is operated, the display processing unit 62 displays a red mark at the photographing time of the reddish image. By displaying a red mark in the mark display area 120, the user can recognize the presence of an image highly likely to have taken a bleeding.

  The enlarged display button 118 is a button for enlarging the playback area 100. When the enlarged display button 118 is operated, the capture image display area 128 is hidden, and the reproduction area 100 is enlarged by that amount.

  The user can add a mark to the mark display area 120 to indicate the start position of the site. The user operates the marking button (not shown) when a new part image is reproduced while observing the endoscopic image reproduced and displayed in the reproduction area 100, and marks the start position of each part as a mark display area Mark on the 120. The section setting unit 54 receives a marking operation and sets a section of each part. By performing this marking process, when the endoscopic image is reviewed, the start position of the site can be easily known. In particular, when a user different from the doctor B observes the endoscopic image, the marking process is performed, so that the start position of the region can be easily recognized, and the image observation can be smoothly performed. Marking is generally performed on an image taken at the entrance of the stomach, small intestine, or large intestine. Marking information is added to the endoscope image displayed in the reproduction area 100 when the marking button is operated.

  The display processing unit 62 divides the mark display area 120 into upper and lower parts, and adds a part mark to the lower part. Here, the stomach start mark 134a indicates the stomach start position, the small intestine start mark 134b indicates the small intestine start position, and the large intestine start mark 134c indicates the large intestine start position. The display processing unit 62 sets different colors for the stomach section between the stomach start mark 134a and the small intestine start mark 134b, the small intestine section between the small intestine start mark 134b and the large intestine start mark 134c, and the large intestine section after the large intestine start mark 134c. You may put on and display. Thereby, the user can confirm each region at a glance. The endoscopic image thus marked is recorded in the observation content recording unit 90 together with the captured image and the like.

  The display processing unit 62 displays a trajectory image in the trajectory display area 150. The locus display area 150 is displayed as a window, and the display processing unit 62 can enlarge the locus display area 150 by a user operation and move it to any position. The display processing unit 62 displays a three-dimensional trajectory image in the trajectory display area 150 using the trajectory image data recorded in the trajectory image recording unit 86. The user can rotate the trajectory image by operating the mouse in the trajectory display area 150.

  When the overview mode selection button 102b in the upper left corner of the screen is selected, the screen generation unit 50 generates an overview screen and causes the display device 22 to display the overview screen. In the overview screen, an image extracted from a plurality of reference images specified by the image summarizing process is displayed.

  FIG. 4 shows an example of an overview screen of an endoscopic image. In the image display area 132, images extracted from a plurality of reference images are displayed in a grid form. For example, when about 20,000 reference images are specified from about 60,000 endoscope images, the display processing unit 62 extracts an image extracted at a predetermined interval from about 20,000 reference images, Display on the overview screen. The number of extracted sheets may be freely set by the user, with the upper limit of two thousand sheets. Assuming that the number of reference images is N and the number of images included in the overview screen is M, the display processing unit 62 extracts one image every (N / M) sheets of reference images arranged in time series. . For example, when N = 20000 and M = 22,000, the display processing unit 62 extracts one reference image every 10 sheets in the order of photographing time, and arranges them on the overview screen. The extracted images are arranged in a grid in the image display area 132, and the user can switch the image by operating the page switching buttons 140a and 140b.

  The endoscopic images displayed on the overview screen are reference images and limited to non-similar ones, so that the user can efficiently grasp the outline of the entire examination. Further, since the overview screen comprehensively shows the entire examination, it is convenient when specifying the start position of each part, that is, when performing the marking process. In the overview screen, when the user selects one image and performs a predetermined operation, a function is displayed in which a plurality of still images temporally preceding and succeeding the image are displayed. Therefore, the user can specify an image indicating the start position of each site and efficiently perform the marking process by selecting an image near the entrance of each site and displaying an image before and after the image. The user may first perform marking processing on the overview screen shown in FIG. 4 and then perform image observation on the radiogram interpretation screen shown in FIG. 3.

  It returns to the interpretation screen shown in FIG. In the interpretation screen of the embodiment, the display processing unit 62 presents information on findings found in the past capsule endoscopy in order to support interpretation of the endoscopic image. Capsule endoscopy has one purpose of finding a small intestine disease. Therefore, in the following examples, findings information of the small intestine is described, but it is not intended to limit the present invention to the small intestine.

  The observation content recording unit 90 records the past observation content input by the doctor, and records at least the finding information in the examination and the finding image associated with the finding information. At the time of preparing an interpretation report, the doctor registers, in the observation content recording unit 90, the observation image and the endoscopic image obtained by imaging the lesion in association with the finding information regarding the lesion found by observing the endoscopic image. Here, the endoscopic image associated with the finding information is referred to as a "finding image". The observation content recording unit 90 according to the embodiment is, for each examination, information indicating examination contents such as imaging start time and imaging end time by the capsule endoscope 3, an endoscope image with a site marking, a captured image, etc. The information registered in is also recorded.

  When the user interprets the small intestine section, the display processing unit 62 of the embodiment displays the distribution state in the small intestine section of the finding information found in the small intestine section in the past examination on the interpretation screen. As a result, in the small intestine section, the position where the lesion is likely to be generated is represented statistically. For example, if the displayed distribution indicates that the lesion is likely to be found near the entrance and exit of the small intestine section, the user is more cautious about endoscopic images at least near the entrance and exit of the small intestine section. Come to observe. Specific examples are shown below.

  The progress rate acquisition unit 58 refers to the observation content recording unit 90 recording the past observation content, and acquires the progress rate indicating the position in the small intestine section in which the finding image was captured in the past examination. Here, the small intestine section is defined as a section between the small intestine start position and the large intestine start position designated in the past examination, and the progress rate acquisition unit 58 is added to the images of the small intestine start position and the large intestine start position. Using the photographing time information and the photographing time information added to the finding image, the progress rate indicating the position in the small intestine section where the finding image is photographed is calculated.

In a certain past capsule endoscopy, it is assumed that the photographing time of the endoscopic image at the small intestine starting position is “1:00” and the photographing time of the endoscopic image at the large intestine starting position is “6:00”. In this case, the imaging time of the small intestine section is 5 hours. In the small intestine section, it is assumed that a finding image is associated with each of two findings, the shooting time of one finding image is “2:00”, and the shooting time of another finding image is “3:30”. . The progress rate acquisition unit 58 calculates the progress rate from the photographing time of the small intestine start position by the following equation.
(Progress rate) = 100 × (T−A) / (B−A)
T: Finding image photographing time A: Small intestine start image photographing time B: Large intestine start image photographing time (small intestine end image photographing time)
In this formula, (B-A) is the total time of imaging the small intestine, and (T-A) is the elapsed time from the start of imaging of the small intestine to the imaging of the finding image. Therefore, the progress rate is expressed by the ratio of the elapsed time from the start of small intestine imaging to the observation image imaging in the total small intestine imaging time.

  Thus, the progress rate acquisition unit 58 calculates the progress rate in the small intestine section in which the past small intestine finding image is captured. When the progress rate in the small intestine section of each small intestine finding image is already recorded in the observation content recording unit 90, the progress rate acquiring unit 58 acquires the progress rate of the small intestine finding image from the observation content recording unit 90. . The distribution deriving unit 60 derives the distribution state of the past finding information based on the progress rate acquired by the progress rate acquiring unit 58.

  The display processing unit 62 displays the distribution state of the past finding information on the interpretation screen. In the radiogram interpretation screen shown in FIG. 3, a distribution state display area 160 is provided above the mark display area 120, and the display processing unit 62 is a distribution curve 162 showing the relationship between the distribution of the past finding information and the progress rate and frequency. Display as. Here, the display processing unit 62 displays the distribution curve 162 of the past finding information in accordance with the small intestine section in the time bar of the mark display area 120. Therefore, the horizontal axis in the distribution state display area 160 represents the progress rate in the small intestine section, the position corresponding to the small intestine start mark 134b is "0", and the position corresponding to the large intestine start mark 134c is 100 ". ".

  The vertical axis in the distribution state display area 160 represents the frequency at each progress rate, and indicates that there is more past observation information as the height direction is higher. Therefore, according to the distribution curve 162 shown in FIG. 3, the past results of capsule endoscopy show that the lesion is likely to be found immediately after the start of the small intestine section and immediately before the end of the small intestine section. , It is shown that less lesions have been found.

  The user understands the past actual trend tendency by looking at the distribution curve 162, and recognizes the current reproduction display position at the position of the slider 122, thereby recognizing whether the lesion is a region where the lesion is easily found or not in the small intestine section it can.

  The user can specify any point on the distribution curve 162 with the mouse pointer. This designation corresponds to designation of the progression rate in the small intestine section, and when the progression rate in the small intestine section is designated, the display processing unit 62 displays a finding image corresponding to the progression rate on the radiogram interpretation screen.

  FIG. 5 shows a finding image 168 displayed on the radiogram interpretation screen. In this example, the progress rate "70" is designated by the mouse pointer 164, and a plurality of findings images 168 corresponding to the progress rate are displayed. The finding image 168 corresponding to the progress rate is an endoscopic image associated with the finding found at the progress rate.

  Here, the display processing unit 62 may display the finding image 168 for each type of finding. For example, there are various types of small intestine findings such as “ulcer”, “sore”, “redness”, “bleeding”, “submucosal tumor-like elevated lesion”, “polyp”, “diverticulum”, etc. When ten types of findings have been found in the past in the progress rate, the display processing unit 62 displays a finding image 168 of each finding. The finding image 168 may be an image acquired in the latest examination, or may be registered as a finding image representing each finding. In addition, it is preferable that the display processing unit 62 add and display the type of each finding as text on each finding image 168. This allows the user to confirm what kind of finding has been found in the past and what kind of image was taken at a specified progress rate.

  The present invention has been described above based on the embodiments. It is understood by those skilled in the art that this embodiment is an exemplification, and that various modifications can be made to the combination of each component and each processing process, and such a modification is also within the scope of the present invention. . For example, the distribution state display area 160 may be displayed on the radiogram interpretation screen by operating a predetermined button (not shown).

  Although the embodiment has been described to display the distribution state of the past finding information in the small intestine section, the present invention is not limited to the small intestine section, and may be another section or the entire digestive tract.

  The distribution deriving unit 60 may derive the distribution state of past finding information for each type of finding. For example, when the user selects any of “ulcer”, “sore”, “redness”, “bleeding”, “submucosal tumor-like elevated lesion”, “polyp”, and “diverticulum”, the distribution deriving unit 60 Derive a distribution about the selected finding type. Thereby, for example, when the user observes the presence or absence of a specific finding, by selecting the finding to be observed, it is possible to confirm at a glance which part of the small intestine section the relevant finding is likely to appear .

1 ... endoscopic image observation support system, 10 ... management server, 12 ... recording device, 20 ... terminal device, 22 ... display device, 30 ... acquisition unit, 32 · · · RAW image acquisition unit 34: related information acquisition unit 40: image processing unit 42: redness determination unit 44: image summary processing unit 46: compression processing unit 50 ··· Screen generation unit, 52 · · · Operation reception unit, 54 · · · Section setting unit 56 · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · Screen generation unit Display processing unit 80 Endoscope image recording unit 82 Related information recording unit 84 Position information recording unit 86 Track image recording unit 88 Examination information recording Part 90: Observation content recording part.

Claims (6)

An observation support system for supporting observation of a plurality of endoscopic images obtained by photographing the inside of a subject with a capsule endoscope,
A display processing unit that reproduces and displays an endoscopic image on a radiogram interpretation screen;
An observation content recording unit that records past finding information and a finding image associated with the finding information;
A progress rate acquisition unit that acquires a progress rate indicating a position in a predetermined section in which a finding image is captured;
And a distribution deriving unit that derives the distribution state of past finding information based on the acquired progress rate.
The display processing unit displays the distribution state of the past finding information on the interpretation screen.
An endoscopic image observation support system characterized in that. The predetermined section is a small intestine section,
The endoscopic image observation assistance system of Claim 1 characterized by the above-mentioned. The progress rate acquisition unit calculates a progress rate indicating a position in a predetermined section, using imaging time information added to a finding image.
The endoscopic image observation assistance system of Claim 1 or 2 characterized by the above-mentioned. It further comprises a screen generation unit that displays a time bar with one end being the shooting start time and the other end being the shooting end time,
The display processing unit displays a distribution state of past finding information in accordance with a predetermined section in a time bar.
The endoscopic image observation assistance system in any one of the Claims 1 to 3 characterized by the above-mentioned. The distribution deriving unit derives the distribution state of past finding information for each type of finding.
The endoscopic image observation assistance system in any one of the Claims 1 to 4 characterized by the above-mentioned. The display processing unit displays a finding image corresponding to the progress rate when the progress rate in the predetermined section is designated.
The endoscopic image observation assistance system in any one of the Claims 1-5 characterized by the above-mentioned.

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