JP2020065593A - Medical image processing device, x-ray diagnostic device and medical image processing program - Google Patents

Abstract

To enhance the effect of image processing to an X-ray image.SOLUTION: A medical image processing device according to an embodiment includes an addition unit and an image processing unit. The addition unit adds information corresponding to a position to each position on two-dimensional X-ray image data obtained by imaging a subject with an X-ray on the basis of three-dimensional medical image data of the subject. The image processing unit performs image processing according to the information added to the position to each position of the two-dimensional X-ray image data.SELECTED DRAWING: Figure 1

Description

  Embodiments of the present invention relate to a medical image processing apparatus, an X-ray diagnostic apparatus, and a medical image processing program.

  Conventionally, various image processings used for X-ray images are known. As one example, there are known image processing that emphasizes high-frequency components to make blood vessels and devices visible, and image processing that removes noise by suppressing low-frequency components.

  Here, the effect of the image processing on the X-ray image can be enhanced by switching the image processing according to the object (blood vessel, bone, organ, device, etc.) included in the X-ray image. For example, when a blood vessel is included in the X-ray image, the blood vessel can be made visible easily by emphasizing the high frequency component. However, a plurality of objects are usually mixed in the X-ray image, and it is not easy to identify the objects and switch the image processing. In particular, for an X-ray image (perspective image) displayed in parallel with imaging, it is difficult to switch image processing depending on the object because the position and orientation of the object change during the procedure. .

Japanese Patent Publication No. 2015-503416

  The problem to be solved by the present invention is to enhance the effect of image processing on an X-ray image.

  The medical image processing apparatus according to the embodiment includes an addition unit and an image processing unit. The adding unit adds, to each position on the two-dimensional X-ray image data obtained by X-ray imaging the subject, based on the three-dimensional medical image data of the subject, information corresponding to the position. To do. The image processing unit performs, on each position of the two-dimensional X-ray image data, image processing according to the information added to the position.

FIG. 1 is a block diagram showing an example of the configuration of a medical image processing system according to the first embodiment. FIG. 2 is a block diagram showing an example of the configuration of the X-ray diagnostic apparatus according to the first embodiment. FIG. 3 is a diagram for explaining addition of the second label according to the first embodiment. FIG. 4 is a diagram for explaining addition of the second label according to the first embodiment. FIG. 5 is a flowchart for explaining a series of processing flows of the medical image processing apparatus according to the first embodiment. FIG. 6 is a diagram for explaining the addition of the second label according to the second embodiment. FIG. 7A is a diagram for explaining image processing according to the second embodiment. FIG. 7B is a diagram for explaining the image processing according to the second embodiment. FIG. 7C is a diagram for explaining the image processing according to the second embodiment. FIG. 8 is a diagram illustrating an example of the processing circuit according to the third embodiment. FIG. 9 is a diagram illustrating an example of the processing circuit according to the fourth embodiment.

  Hereinafter, a medical image processing apparatus, an X-ray diagnostic apparatus, and a medical image processing program according to embodiments will be described with reference to the drawings.

(First embodiment)
First, the first embodiment will be described. In the first embodiment, a medical image processing system 1 including an X-ray diagnostic apparatus 10, an image storage apparatus 20, and a medical image processing apparatus 30 will be described.

  FIG. 1 is a block diagram showing an example of the configuration of a medical image processing system 1 according to the first embodiment. As shown in FIG. 1, the medical image processing system 1 according to the first embodiment includes an X-ray diagnostic apparatus 10, an image storage apparatus 20, and a medical image processing apparatus 30. As shown in FIG. 1, the X-ray diagnostic apparatus 10, the image storage apparatus 20, and the medical image processing apparatus 30 are connected to each other via a network NW.

  The X-ray diagnostic apparatus 10 is an apparatus that collects two-dimensional X-ray image data from a subject. Specifically, the X-ray diagnostic apparatus 10 captures two-dimensional X-ray image data by subjecting the subject to X-ray imaging, and outputs the collected two-dimensional X-ray image data to the medical image processing apparatus 30. The configuration of the X-ray diagnostic apparatus 10 will be described later.

  The image storage device 20 is a device that stores various types of medical image data collected by the devices included in the medical image processing system 1. For example, the image storage device 20 receives the three-dimensional medical image data of the subject and stores it in a memory provided inside or outside the device. The three-dimensional medical image data of the subject will be described later. For example, the image storage device 20 is realized by a computer device such as a server device.

  The medical image processing apparatus 30 acquires the two-dimensional X-ray image data of the subject from the X-ray diagnostic apparatus 10 via the network NW, and executes various processes using the acquired two-dimensional X-ray image data. For example, the medical image processing apparatus 30 adds information based on the three-dimensional medical image data of the subject to each position on the two-dimensional X-ray image data, and executes image processing according to the added information. The processing performed by the medical image processing apparatus 30 will be described later. For example, the medical image processing apparatus 30 is realized by computer equipment such as a workstation.

  If the X-ray diagnostic apparatus 10, the image storage apparatus 20, and the medical image processing apparatus 30 can be connected via the network NW, any place can be installed. For example, the medical image processing apparatus 30 may be installed in a hospital different from the X-ray diagnostic apparatus 10. That is, the network NW may be a local network closed in the hospital or a network via the Internet. Further, although one X-ray diagnostic apparatus 10 is shown in FIG. 1, the medical image processing system 1 may include a plurality of X-ray diagnostic apparatuses 10.

  As shown in FIG. 1, the medical image processing apparatus 30 includes an input interface 31, a display 32, a memory 33, and a processing circuit 34.

  The input interface 31 receives various input operations from the operator, converts the received input operations into electric signals, and outputs the electric signals to the processing circuit 34. For example, the input interface 31 includes a mouse, a keyboard, a trackball, a switch, a button, a joystick, a touch pad for performing an input operation by touching an operation surface, a touch screen in which a display screen and a touch pad are integrated, and an optical sensor. It is realized by the non-contact input circuit and the voice input circuit used. The input interface 31 may be composed of a tablet terminal or the like that can wirelessly communicate with the main body of the medical image processing apparatus 30. Further, the input interface 31 is not limited to the one including physical operation parts such as a mouse and a keyboard. For example, an electric signal processing circuit that receives an electric signal corresponding to an input operation from an external input device provided separately from the medical image processing apparatus 30 and outputs the electric signal to the processing circuit 34 is also included in the input interface 31. Included in the example.

  The display 32 displays various information. For example, the display 32 displays a GUI (Graphical User Interface) for receiving various instructions and various settings from the operator via the input interface 31. Further, the display 32 displays various image data collected about the subject. For example, the display 32 displays the two-dimensional X-ray image data after the image processing by the processing circuit 34. For example, the display 32 is a liquid crystal display or a CRT (Cathode Ray Tube) display. The display 32 may be a desktop type, or a tablet terminal or the like capable of wireless communication with the main body of the medical image processing apparatus 30.

  The memory 33 is realized by, for example, a RAM (Random Access Memory), a semiconductor memory device such as a flash memory, a hard disk, an optical disk, or the like. For example, the memory 33 stores the three-dimensional medical image data of the subject acquired from the image storage device 20 and the two-dimensional X-ray image data of the subject acquired from the X-ray diagnostic device 10. In addition, for example, the memory 33 stores a program for a circuit included in the medical image processing apparatus 30 to realize its function. The memory 33 may be realized by a server group (cloud) connected to the medical image processing apparatus 30 via the network NW.

  The processing circuit 34 controls the overall operation of the medical image processing apparatus 30 by executing the control function 341, the additional function 342, the image processing function 343, and the display control function 344. Here, the additional function 342 is an example of an addition unit. The image processing function 343 is an example of an image processing unit.

  For example, the processing circuit 34 controls various functions of the processing circuit 34 based on the input operation received from the operator via the input interface 31 by reading the program corresponding to the control function 341 from the memory 33 and executing the program. To do. Further, the control function 341 controls transmission / reception of data via the network NW. For example, the control function 341 receives the three-dimensional medical image data of the subject from the image storage device 20 and stores it in the memory 33. Further, for example, the control function 341 receives the two-dimensional X-ray image data of the subject from the X-ray diagnostic apparatus 10 and stores it in the memory 33.

  In addition, for example, the processing circuit 34 reads out a program corresponding to the additional function 342 from the memory 33 and executes the program to execute the program for each position on the two-dimensional X-ray image data based on the three-dimensional medical image data. Add information corresponding to the position. In addition, for example, the processing circuit 34 reads a program corresponding to the image processing function 343 from the memory 33 and executes the program to convert the information added to the position for each position on the two-dimensional X-ray image data. Appropriate image processing is performed. The processing by the additional function 342 and the image processing function 343 will be described later. Further, for example, the processing circuit 34 causes the display 32 to display the two-dimensional X-ray image data after the image processing by the image processing function 343 by reading the program corresponding to the display control function 344 from the memory 33 and executing the program.

  In the medical image processing apparatus 30 shown in FIG. 1, each processing function is stored in the memory 33 in the form of a program executable by a computer. The processing circuit 34 is a processor that realizes a function corresponding to each program by reading the program from the memory 33 and executing the program. In other words, the processing circuit 34 in a state where each program is read has a function corresponding to the read program. Note that, in FIG. 1, it is described that the control function 341, the additional function 342, the image processing function 343, and the display control function 344 are realized by the single processing circuit 34, but the processing is performed by combining a plurality of independent processors. The circuit 34 may be configured so that each processor implements a function by executing a program. Further, each processing function of the processing circuit 34 may be implemented by being appropriately dispersed or integrated into a single or a plurality of processing circuits.

  Next, the X-ray diagnostic apparatus 10 will be described with reference to FIG. FIG. 2 is a block diagram showing an example of the configuration of the X-ray diagnostic apparatus 10 according to the first embodiment. As shown in FIG. 2, the X-ray diagnostic apparatus 10 includes an X-ray high voltage apparatus 101, an X-ray tube 102, an X-ray diaphragm 103, a top plate 104, a C arm 105, and an X-ray detector 106. A memory 107, a display 108, an input interface 109, and a processing circuit 110.

  The X-ray high voltage device 101 supplies a high voltage to the X-ray tube 102 under the control of the processing circuit 110. For example, the X-ray high-voltage device 101 has an electric circuit such as a transformer and a rectifier, and the X-ray tube 102 irradiates the high-voltage generator that generates a high voltage to be applied to the X-ray tube 102. And an X-ray control device that controls the output voltage according to the X-rays. The high voltage generator may be of a transformer type or an inverter type.

  The X-ray tube 102 is a vacuum tube having a cathode (filament) that generates thermoelectrons and an anode (target) that generates X-rays upon receiving collision of thermoelectrons. The X-ray tube 102 generates X-rays by irradiating thermoelectrons from the cathode to the anode using the high voltage supplied from the X-ray high voltage device 101.

  The X-ray diaphragm 103 has a collimator that narrows the irradiation range of the X-rays generated by the X-ray tube 102, and a filter that adjusts the X-rays emitted from the X-ray tube 102.

  The collimator in the X-ray diaphragm 103 has, for example, four slidable diaphragm blades. The collimator narrows the X-rays generated by the X-ray tube 102 and irradiates the subject P by sliding the diaphragm blades. Here, the diaphragm blade is a plate-shaped member made of lead or the like, and is provided near the X-ray irradiation port of the X-ray tube 102 for adjusting the X-ray irradiation range.

  The filter in the X-ray squeezer 103 changes the quality of the X-rays that are transmitted depending on the material and the thickness of the X-ray absorber for the purpose of reducing the exposure dose to the subject P and improving the image quality of the X-ray image data. The soft line component that is easily affected is reduced, or the high energy component that causes a reduction in the contrast of X-ray image data is reduced. Further, the filter changes the X-ray dose and irradiation range according to the material, thickness, position, etc., so that the X-rays irradiated from the X-ray tube 102 to the subject P have a predetermined distribution. To attenuate.

  For example, the X-ray diaphragm device 103 has a drive mechanism such as a motor and an actuator, and controls the X-ray irradiation by operating the drive mechanism under the control of the processing circuit 110 described later. For example, the X-ray diaphragm device 103 adjusts the opening of the diaphragm blade of the collimator by applying a driving voltage to the driving mechanism according to the control signal received from the processing circuit 110, and irradiates the subject P with the driving voltage. The irradiation range of X-rays to be controlled is controlled. Further, for example, the X-ray diaphragm device 103 irradiates the subject P by adjusting the position of the filter by applying a drive voltage to the drive mechanism according to the control signal received from the processing circuit 110. Control the distribution of X-ray dose.

  The top board 104 is a bed on which the subject P is placed, and is placed on a bed (not shown). The subject P is not included in the X-ray diagnostic apparatus 10. For example, the bed has a drive mechanism such as a motor and an actuator, and the movement / tilt of the top plate 104 is controlled by operating the drive mechanism under the control of the processing circuit 110 described later. For example, the bed moves or inclines the top plate 104 by applying a drive voltage to the drive mechanism according to the control signal received from the processing circuit 110.

  The C-arm 105 holds the X-ray tube 102, the X-ray diaphragm 103, and the X-ray detector 106 so as to face each other with the subject P interposed therebetween. For example, the C-arm 105 has a drive mechanism such as a motor and an actuator, and is rotated or moved by operating the drive mechanism under the control of the processing circuit 110 described later. For example, the C-arm 105 adds the drive voltage to the drive mechanism in accordance with the control signal received from the processing circuit 110, so that the X-ray tube 102, the X-ray diaphragm device 103, and the X-ray detector 106 are detected. The X-ray irradiation position and irradiation angle are controlled by rotating and moving the P. In FIG. 2, the case where the X-ray diagnostic apparatus 10 is a single plane has been described as an example, but the embodiment is not limited to this and may be a biplane case.

  The X-ray detector 106 is, for example, an X-ray flat panel detector (Flat Panel Detector: FPD) having detection elements arranged in a matrix. The X-ray detector 106 detects X-rays emitted from the X-ray tube 102 and transmitted through the subject P, and outputs a detection signal corresponding to the detected X-ray dose to the processing circuit 110. The X-ray detector 106 may be an indirect conversion type detector having a grid, a scintillator array, and an optical sensor array, or a direct conversion type detector having a semiconductor element that converts incident X-rays into electric signals. It may be a detector.

  The memory 107 is realized by, for example, a RAM, a semiconductor memory device such as a flash memory, a hard disk, an optical disk, or the like. For example, the memory 107 receives and stores the X-ray image data collected by the processing circuit 110. The memory 107 also stores programs corresponding to various functions read and executed by the processing circuit 110. The memory 107 may be implemented by a server group (cloud) connected to the X-ray diagnostic apparatus 10 via a network.

  The display 108 displays various information. For example, the display 108 displays a GUI for receiving an operator's instruction and various X-ray images under the control of the processing circuit 110. For example, the display 108 is a liquid crystal display or a CRT display. The display 108 may be a desktop type, or may be a tablet terminal or the like capable of wireless communication with the processing circuit 110.

  The input interface 109 receives various input operations from the operator, converts the received input operations into electric signals, and outputs the electric signals to the processing circuit 110. For example, the input interface 109 includes a mouse, a keyboard, a trackball, a switch, a button, a joystick, a touch pad for performing an input operation by touching an operation surface, a touch screen in which a display screen and a touch pad are integrated, and an optical sensor. It is realized by the non-contact input circuit and the voice input circuit used. The input interface 109 may be composed of a tablet terminal or the like that can wirelessly communicate with the processing circuit 110. Further, the input interface 109 is not limited to the one including physical operation parts such as a mouse and a keyboard. For example, an electric signal processing circuit that receives an electric signal corresponding to an input operation from an external input device provided separately from the X-ray diagnostic apparatus 10 and outputs the electric signal to the processing circuit 110 is also included in the input interface 109. Included in the example.

  The processing circuit 110 controls the overall operation of the X-ray diagnostic apparatus 10 by executing the control function 110a, the acquisition function 110b, and the display control function 110c.

  For example, the processing circuit 110 controls various functions of the processing circuit 110 based on an input operation received from an operator via the input interface 109 by reading a program corresponding to the control function 110a from the memory 107 and executing the program. To do. Further, the control function 110a controls transmission / reception of data via the network NW. For example, the control function 110a transmits the two-dimensional X-ray image data of the subject P collected by the collection function 110b to the medical image processing apparatus 30.

  Further, the processing circuit 110 reads out the program corresponding to the acquisition function 110b from the memory 107 and executes the program to acquire an X-ray image of the subject P and acquire two-dimensional X-ray image data. For example, the collection function 110b controls the X-ray high-voltage device 101 and adjusts the voltage supplied to the X-ray tube 102 to control the X-ray dose and ON / OFF to be irradiated to the subject P.

  In addition, for example, the collection function 110b controls the operations of the X-ray tube 102, the X-ray diaphragm 103, the top plate 104, the C-arm 105, and the X-ray detector 106, and thereby, the X-ray irradiation range and the X-ray radiation The dose distribution, X-ray irradiation angle, etc. are controlled. In the following, a mechanism (X-ray tube 102, X-ray diaphragm 103, top plate 104, C-arm 105 and X-ray detector 106) used for collecting two-dimensional X-ray image data in the X-ray diagnostic apparatus 10 will be described. , And imaging system.

  Specifically, the collection function 110b controls the operation of the X-ray diaphragm device 103 and adjusts the opening of the diaphragm blade of the collimator to determine the irradiation range of the X-rays irradiated to the subject P. Control. Further, the collection function 110b controls the operation of the X-ray diaphragm device 103 and adjusts the position of the filter to control the distribution of the X-ray dose. Further, the collection function 110b controls the X-ray irradiation range and irradiation angle by rotating or moving the C-arm 105. Further, the collection function 110b controls the irradiation range and irradiation angle of X-rays by moving or inclining the top plate 104. Further, the collection function 110b generates X-ray image data based on the detection signal received from the X-ray detector 106, and stores the generated X-ray image data in the memory 107. Further, the processing circuit 110 causes the display 108 to display a GUI and various X-ray images by reading out and executing a program corresponding to the display control function 110c from the memory 107.

  In the X-ray diagnostic apparatus 10 shown in FIG. 2, each processing function is stored in the memory 107 in the form of a program executable by a computer. The processing circuit 110 is a processor that realizes a function corresponding to each program by reading the program from the memory 107 and executing the program. In other words, the processing circuit 110 that has read the program has a function corresponding to the read program. Note that, in FIG. 2, it is described that the control function 110a, the collection function 110b, and the display control function 110c are realized by the single processing circuit 110, but the processing circuit 110 is configured by combining a plurality of independent processors. The functions may be realized by each processor executing a program. Further, each processing function of the processing circuit 110 may be realized by being appropriately dispersed or integrated into a single or a plurality of processing circuits.

  The word "processor" used in the above description is, for example, a CPU (Central Processing Unit), a GPU (Graphics Processing Unit), or an application specific integrated circuit (ASIC), a programmable logic device (for example, It means a circuit such as a simple programmable logic device (SPLD), a complex programmable logic device (CPLD), and a field programmable gate array (FPGA). The processor realizes the function by reading and executing the program stored in the memory 33 or the memory 107.

  1 and 2, the single memory 33 or the memory 107 has been described as storing a program corresponding to each processing function. However, the embodiment is not limited to this. For example, the plurality of memories 33 may be arranged in a distributed manner, and the processing circuit 34 may be configured to read the corresponding programs from the individual memories 33. Similarly, the plurality of memories 107 may be arranged in a distributed manner, and the processing circuit 110 may be configured to read the corresponding programs from the individual memories 107. Further, instead of storing the program in the memory 33 and the memory 107, the program may be directly incorporated in the circuit of the processor. In this case, the processor realizes the function by reading and executing the program incorporated in the circuit.

  Further, the processing circuit 34 and the processing circuit 110 may implement the function by using the processor of the external device connected via the network NW. For example, the processing circuit 34 reads out a program corresponding to each function from the memory 33 and executes the program, and uses a server group (cloud) connected to the medical image processing apparatus 30 via the network NW as a computing resource. , Realizes each function shown in FIG.

  The medical image processing system 1 including the X-ray diagnostic apparatus 10, the image storage apparatus 20, and the medical image processing apparatus 30 has been described above. With such a configuration, the medical image processing apparatus 30 in the medical image processing system 1 enhances the effect of image processing on the two-dimensional X-ray image data by the processing by the processing circuit 34.

  Specifically, first, the control function 341 in the medical image processing apparatus 30 acquires three-dimensional medical image data of the subject P. Here, examples of three-dimensional medical image data include CT image data acquired by an X-ray CT (Computed Tomography) apparatus, MR image data acquired by an MRI (Magnetic Resonance Imaging) apparatus, and an ultrasonic diagnostic apparatus. The ultrasonic image data and the like to be collected are included. Further, examples of the three-dimensional medical image data include three-dimensional X-ray image data collected by the X-ray diagnostic apparatus 10 rotating and imaging the subject P. The control function 341 receives the three-dimensional medical image data of the subject P from the medical image diagnostic apparatus such as the MRI apparatus, the X-ray CT apparatus, the ultrasonic diagnostic apparatus, and the X-ray diagnostic apparatus 10 via the network NW, and stores it in the memory. It is stored in 33.

  The CT image data I11 will be described below as an example of the three-dimensional medical image data of the subject P. In this case, the X-ray CT apparatus first performs a CT scan on the subject P and collects projection data by detecting the signal of the X-ray transmitted through the subject P. Here, the X-ray CT apparatus collects projection data in which the blood vessel of the subject P is imaged by performing a CT scan on the subject P in which a contrast agent is injected into the blood vessel.

  Further, the X-ray CT apparatus performs preprocessing such as logarithmic conversion processing, offset correction processing, interchannel sensitivity correction processing, and beam hardening correction on the collected projection data, and then the CT image data I11 (volume Data). For example, the X-ray CT apparatus generates CT image data I11 by performing a reconstruction process using a filtered back projection method, a successive approximation reconstruction method, or the like on the preprocessed projection data. Next, the X-ray CT apparatus transmits the generated CT image data I11 to the image storage apparatus 20 to store it. Then, the control function 341 receives the CT image data I11 of the subject P from the image storage device 20, and stores it in the memory 33.

  Next, the additional function 342 adds information corresponding to each position on the CT image data I11 of the subject P. For example, the additional function 342 adds information indicating the tissue or device corresponding to each position to each position on the CT image data I11 by the substance discrimination processing based on the voxel value (CT value or the like). In addition, below, the information added to each position on three-dimensional medical image data is described as a 1st label. The first label is an example of first information.

  As an example, the additional function 342 first reads out the CT image data I11 from the memory 33 and separates it into a blood vessel model I12 and a non-blood vessel model I13. That is, the additional function 342 separates the CT image data I11 into a region corresponding to the blood vessel and another region.

  For example, the additional function 342 separates the CT image data I11 into a blood vessel model I12 and a non-blood vessel model I13 by comparing the voxel value with a threshold for each voxel of the CT image data I11. Such a threshold may be a value set by the additional function 342 based on the CT image data I11 or a preset value. Alternatively, the threshold may be set by the operator. That is, the operator may manually separate the CT image data I11 by adjusting the threshold value via the input interface 31.

  The CT image data I11 may be separated by a device other than the medical image processing device 30 instead of the additional function 342. For example, the X-ray CT apparatus generates CT image data I11, separates the CT image data I11 into a blood vessel model I12 and a non-vascular model I13, and stores the blood vessel model I12 and the non-vascular model I13 in the image storage device 20. Send and store. Then, the control function 341 receives the blood vessel model I12 and the non-blood vessel model I13 from the image storage device 20, and stores them in the memory 33.

  Next, the adding function 342 adds the first label of “blood vessel” to each voxel of the blood vessel model I12. Further, the addition function 342 adds the first label to each voxel of the non-blood vessel model I13. For example, the additional function 342 compares each voxel value of the non-vascular model I13 with a threshold value for each voxel of the non-vascular model I13 so that each voxel of the non-vascular model I13 is “device”, “bone”, “soft tissue (organ etc.)”, It is classified into “air (air in the lungs, the extracorporeal region of the subject P, etc.)”.

  Next, the additional function 342 adds the first label of “device” to the voxels classified as “device”. Examples of the “device” include a stent left in the blood vessel of the subject P, an implant such as artificial bone, a cardiac pacemaker, and the like. Further, the addition function 342 adds the first label of “bone” to the voxels classified as “bone”. Further, the additional function 342 adds the first label of “soft tissue” to the voxels classified as “soft tissue”. Further, the additional function 342 adds the first label of “air” to the voxels classified as “air”.

  So far, the case where the first label is added to each position on the CT image data I11 by the substance discrimination processing based on the voxel value has been described. However, the embodiment is not limited to this.

  For example, the additional function 342 may add the first label to each position on the CT image data I11 by the material discrimination processing by the photon counting CT. That is, in the photon counting CT, the X-ray CT apparatus counts each X-ray incident on the detector and measures the energy of the incident X-ray to obtain the spectrum of the X-ray transmitted through the subject P. . Further, the X-ray CT apparatus discriminates the types of substances contained in the subject P from the obtained spectrum and also generates CT image data I11. Then, the adding function 342 adds the first label to each position on the CT image data I11 based on the result of the substance discrimination processing.

  Further, for example, the additional function 342 is configured to perform the first label for each position on the CT image data I11 by the material discrimination processing by dual-energy (DE) imaging or multi-energy (ME) imaging. May be added. That is, in dual energy imaging or multi-energy imaging, the X-ray CT apparatus collects a plurality of projection data using X-rays having different energies. In addition, the X-ray CT apparatus discriminates the types of substances contained in the subject P and generates CT image data I11 based on the fact that the X-ray absorption characteristics are different for each substance. Then, the adding function 342 adds the first label to each position on the CT image data I11 based on the result of the substance discrimination processing.

  Further, for example, the additional function 342 may add the first label to each position on the CT image data I11 by receiving an input operation by the operator. For example, the additional function 342 first separates the CT image data I11 into a blood vessel model I12 and a non-blood vessel model I13. Next, the adding function 342 adds the first label of “blood vessel” to each voxel of the blood vessel model I12. The display control function 344 also generates a display image from the non-blood vessel model I13 and causes the display 32 to display the image. Next, the operator inputs an operation of adding the first label to each position on the non-vascular model I13 via the input interface 31. For example, the operator, in the non-vascular model I13, an area to which the first label “device” is added, an area to which the first label “bone” is added, and an area to which the first label “soft tissue” is added. , And the area to which the first label of “air” is added is set.

  Further, the additional function 342 adds the first label of “device” not only to the position on the CT image data I11 where the device is already placed but also to the position where the device is to be inserted. May be. That is, in the treatment plan of the procedure for inserting the device into the body of the subject P, the additional function 342 displays the first label “device” for the position where the device is inserted among the positions on the CT image data I11. You may add. For example, the additional function 342 adds the first label of “device” to the position where the stent is to be placed in the intervention treatment in which the stent is placed in the blood vessel of the subject P.

  Although the case where the additional function 342 adds the first label to each position on the CT image data I11 has been described, the embodiment is not limited to this. For example, a device other than the medical image processing device 30 may add the first label to each position on the CT image data I11. In this case, the control function 341 receives the CT image data I11 to which the first label is added and stores it in the memory 33.

  After the CT image data I11 to which the first label is added is stored in the memory 33, the X-ray diagnostic apparatus 10 executes X-ray imaging of the subject P. For example, the collection function 110b in the X-ray diagnostic apparatus 10 captures the two-dimensional X-ray image data I21 by capturing an X-ray image of the subject P placed on the top plate 104. The control function 110a also transmits the collected two-dimensional X-ray image data I21 to the medical image processing apparatus 30.

  Next, the adding function 342 adds information corresponding to each position on the two-dimensional X-ray image data I21. Specifically, the additional function 342 adds information corresponding to each position on the two-dimensional X-ray image data I21 based on the CT image data I11 of the subject P. For example, the additional function 342 projects the first label added to each position on the CT image data I11 onto the two-dimensional X-ray image data I21, so that each position on the two-dimensional X-ray image data I21 is projected. Add a second label. Here, the second label is an example of the second information.

  Here, an example of adding the second label by the additional function 342 will be described with reference to FIG. FIG. 3 is a diagram for explaining addition of the second label according to the first embodiment. In FIG. 3, the CT image data I111 is shown as an example of the CT image data I11, and the two-dimensional X-ray image data I211 is shown as an example of the two-dimensional X-ray image data I21. In the following, the blood vessel model I12 based on the CT image data I111 will be referred to as a blood vessel model I121, and the non-blood vessel model I13 based on the CT image data I111 will be referred to as a non-blood vessel model I131.

  Further, in FIG. 3, for convenience of description, the CT image data I111 is shown two-dimensionally and the two-dimensional X-ray image data I211 is shown one-dimensionally. That is, the CT image data I111 shown in FIG. 3 shows one of the planes included in the CT image data I111. Further, the two-dimensional X-ray image data I211 shown in FIG. 3 shows pixels for one column included in the two-dimensional X-ray image data I211.

  As shown in FIG. 3, the additional function 342 first aligns the CT image data I111 and the two-dimensional X-ray image data I211. For example, when the blood vessel is not contrasted in the two-dimensional X-ray image data I211, the additional function 342 aligns the non-blood vessel model I131 and the two-dimensional X-ray image data I211, and thereby the two-dimensional CT image data I111. The X-ray image data I211 is aligned. Thus, the additional function 342 can accurately align the CT image data I111 and the two-dimensional X-ray image data I211 even when the blood vessel is not imaged in the two-dimensional X-ray image data I211.

  For example, the additional function 342 first extracts the contour data Lc of the region corresponding to the bone in the two-dimensional X-ray image data I211. As an example, the additional function 342 extracts the contour data Lc by performing edge extraction processing on the two-dimensional X-ray image data I211. The contour data Lc is represented, for example, as a set of vertices having two-dimensional coordinate values.

  It should be noted that the additional function 342 may emphasize the region corresponding to the bone in the two-dimensional X-ray image data I211 as a pre-process for extracting the contour data Lc. For example, the additional function 342 subtracts a plurality of two-dimensional X-ray image data I211 imaged by using X-rays having different energies from each other to determine an area corresponding to a bone in the two-dimensional X-ray image data I211. Emphasize. That is, when dual energy imaging or multi-energy imaging is performed on the subject P, the additional function 342 determines the type of substance contained in the subject P based on the fact that the X-ray absorption characteristics differ for each substance. Discriminate and emphasize the area corresponding to the bone.

  Then, the additional function 342 extracts the contour data Lc from the two-dimensional X-ray image data I211 after the region corresponding to the bone is emphasized. That is, the additional function 342 specifies the region corresponding to the bone in the two-dimensional X-ray image data I211 by using the plurality of two-dimensional X-ray image data I211 imaged using X-rays having different energies.

  Further, the additional function 342 generates a plurality of projection image data obtained by projecting the non-blood vessel model I131 on a plane. Here, the additional function 342 generates various projection image data by changing the position and the direction of the non-vascular model I131 through the plane. Next, the additional function 342 extracts the contour data Lv of the region corresponding to the bone in the projection image data for each of the plurality of projection image data. The contour data Lv is represented, for example, as a set of vertices having two-dimensional coordinate values.

  Next, the additional function 342 calculates, for each of the plurality of projection image data, the sum of the distance values between each vertex on the contour data Lc and the vertex of the contour data Lv located at the shortest distance from the vertex. Next, the additional function 342 identifies the projection image data for which the calculated sum of the distance values is the smallest. Then, the additional function 342 uses the position and orientation of the non-vascular model I131 at the time of generation of the specified projection image data as the position and orientation of the non-vascular model I131 with respect to the two-dimensional X-ray image data I211, and the non-vascular models I131 and 2 The three-dimensional X-ray image data I211 is aligned.

  That is, the additional function 342 defines the total sum of the distance values between the apex of the contour data Lc and the apex of the contour data Lv as an evaluation function having the position and orientation of the non-vascular model I131 as variables. Then, the additional function 342 aligns the non-vascular model I131 and the two-dimensional X-ray image data I211 by minimizing the evaluation function.

  The variables of the evaluation function are not limited to the position and orientation of the non-blood vessel model I131. For example, the additional function 342 may define the evaluation function using the position and orientation of the non-vascular model I131 and the degree of deformation of the non-vascular model I131 as variables. That is, the additional function 342 may align the non-vascular model I131 with the two-dimensional X-ray image data I211 as a rigid body, or align the non-vascular model I131 with the two-dimensional X-ray image data I211 while deforming the non-vascular model I131. Good.

  Further, the additional function 342 aligns the blood vessel model I121 and the two-dimensional X-ray image data I211. Here, since the positional relationship between the blood vessel model I121 and the non-blood vessel model I122 is clear, the additional function 342 uses the result of the alignment between the non-blood vessel model I131 and the two-dimensional X-ray image data I211. The I121 and the two-dimensional X-ray image data I211 can be aligned. For example, the additional function 342 sets the position and orientation of the non-blood vessel model I131 at the time of generating the projection image data having the minimum evaluation function as the position and orientation of the blood vessel model I121 with respect to the two-dimensional X-ray image data I211. The model I121 and the two-dimensional X-ray image data I211 are aligned.

  That is, the additional function 342 sequentially executes the alignment between the non-vascular model I131 and the two-dimensional X-ray image data I211, and the alignment between the blood vessel model I121 and the two-dimensional X-ray image data I211, thereby obtaining the CT image. The data I111 and the two-dimensional X-ray image data I211 are aligned. Thereby, the additional function 342 can align the CT image data I111 and the two-dimensional X-ray image data I211 even when the blood vessel is not imaged in the two-dimensional X-ray image data I211.

  It should be noted that the case where the region corresponding to the bone in the non-vascular model I131 and the region corresponding to the bone in the two-dimensional X-ray image data I211 are aligned has been described above, but the embodiment is not limited to this. Not something. For example, the additional function 342 is a region corresponding to a region other than the bone (the organ, a device placed in the body of the subject P, etc.) in the non-vascular model I131, and the region other than the bone in the two-dimensional X-ray image data I211. The CT image data I111 and the two-dimensional X-ray image data I211 may be aligned by aligning the region corresponding to the region.

  Further, although the case has been described where the contour of the part included in the non-vascular model I131 and the contour of the part included in the two-dimensional X-ray image data I211 are aligned, the embodiment is not limited to this. For example, the additional function 342 may align the non-blood vessel model I131 and the two-dimensional X-ray image data I211 based on a criterion other than the contour.

  For example, the additional function 342 extracts the thinned data by performing the thinning processing on the region corresponding to the bone in the two-dimensional X-ray image data I211. Further, the additional function 342 generates a plurality of projection image data obtained by projecting the non-blood vessel model I131 on a plane. Next, the additional function 342 extracts the thinned data by performing the thinning process on the region corresponding to the bone in the projected image data for each of the plurality of projected image data. The thinned data is represented as a set of vertices having two-dimensional coordinate values, for example. Then, the additional function 342 defines the sum of the distance values between the vertices between the thinned data based on the two-dimensional X-ray image data I211 and the thinned data based on the non-vascular model I131 as an evaluation function. By performing the minimization, the non-vascular model I131 and the two-dimensional X-ray image data I211 are aligned.

  Further, the case where the CT image data I111 and the two-dimensional X-ray image data I211 are aligned by aligning the non-vascular model I131 and the two-dimensional X-ray image data I211 has been described above. Is not limited to this. For example, the additional function 342 may directly align the CT image data I111 and the two-dimensional X-ray image data I211.

  For example, when the two-dimensional X-ray image data I211 is collected for the subject P into which the contrast agent is injected, the additional function 342 is to perform the alignment between the non-vascular model I131 and the two-dimensional X-ray image data I211. Instead, the CT image data I111 and the two-dimensional X-ray image data I211 are directly aligned. In this case, the additional function 342 may not generate the blood vessel model I121 and the non-blood vessel model I131 based on the CT image data I111. Further, in this case, the additional function 342 aligns the region corresponding to the blood vessel in the CT image data I111 with the region corresponding to the blood vessel in the two-dimensional X-ray image data I211 to obtain the CT image data I111. The two-dimensional X-ray image data I211 may be aligned.

  In addition, the additional function 342 may align the CT image data I111 and the two-dimensional X-ray image data I211 via another medical image data. For example, the additional function 342 aligns the CT image data I111 and the two-dimensional X-ray image data I211 using the three-dimensional ultrasonic image data I311 obtained by imaging the subject P. As an example, the additional function 342 aligns the CT image data I111 and the three-dimensional ultrasonic image data I311 and specifies the position and orientation of the three-dimensional ultrasonic image data I311 with respect to the CT image data I111. In addition, the additional function 342 specifies the position and orientation of the ultrasonic probe used for imaging the three-dimensional ultrasonic image data I311 in the two-dimensional X-ray image data I211, and thereby the 3D for the two-dimensional X-ray image data I211 is obtained. The position and orientation of the three-dimensional ultrasonic image data I311 are specified. For example, the additional function 342 matches the position and orientation of the ultrasonic probe in the two-dimensional X-ray image data I211 by matching the three-dimensional model showing the structure of the ultrasonic probe with the two-dimensional X-ray image data. Identify. The additional function 342 then performs CT based on the position and orientation of the three-dimensional ultrasonic image data I311 with respect to the CT image data I111 and the position and orientation of the three-dimensional ultrasonic image data I311 with respect to the two-dimensional X-ray image data I211. The image data I111 and the two-dimensional X-ray image data I211 are aligned.

  Further, the case where the additional function 342 executes the alignment between the CT image data I111 and the two-dimensional X-ray image data I211 has been described above. However, the embodiment is not limited to this. For example, the CT image data I111 and the two-dimensional X-ray image data I211 may be aligned by the operator. To give an example, the operator refers to the CT image data I111 and the two-dimensional X-ray image data I211 displayed on the display 32, and the CT image data for the two-dimensional X-ray image data I211 via the input interface 31. Change the position and orientation of I111. Then, the operator aligns the CT image data I111 and the two-dimensional X-ray image data I211 by inputting an operation for determining the position and orientation of the CT image data I111 with respect to the two-dimensional X-ray image data I211.

  Next, the additional function 342, in the state where the CT image data I111 and the two-dimensional X-ray image data I211 are aligned, adds the first label added to each position on the CT image data I111 to the two-dimensional X-ray image data. By projecting onto the I211, the second label is added to each position on the two-dimensional X-ray image data I211. For example, the additional function 342, as shown in FIG. 3, assigns a second label to each pixel (pixel P11, pixel P12, pixel P13, pixel P14, pixel P15, and pixel P16) of the two-dimensional X-ray image data I211. Add.

  Specifically, in the case shown in FIG. 3, the additional function 342 uses the first label attached to the CT image data I111 at a position overlapping the two-dimensional X-ray image data I211 as the second label. It is added to the data I211. As a result, the additional function 342 adds the first label of “soft tissue” to the pixel P11, the pixel P12, the pixel P13, and the pixel P14 in the two-dimensional X-ray image data I211. Further, the addition function 342 adds the first label of “bone” to the pixels P15 and P16 in the two-dimensional X-ray image data I211. When there is a pixel in the two-dimensional X-ray image data I211 that does not overlap with any voxel of the CT image data I111, the additional function 342 adds, for example, a first label of “air”.

In addition, in FIG. 3, the case where the first label attached to the position overlapping the two-dimensional X-ray image data I211 in the CT image data I111 is added to the two-dimensional X-ray image data I211 as the second label has been described. However, the embodiment is not limited to this.
For example, the additional function 342 adds the first label attached within the predetermined range from the position overlapping the two-dimensional X-ray image data I211 in the CT image data I111 to the two-dimensional X-ray image data I211 as the second label. May be. Hereinafter, this point will be described with reference to FIG. FIG. 4 is a diagram for explaining addition of the second label according to the first embodiment.

  In FIG. 4, CT image data I112 is shown as an example of the CT image data I11, and two-dimensional X-ray image data I212 is shown as an example of the two-dimensional X-ray image data I21. Further, in FIG. 4, for convenience of description, the CT image data I112 is shown two-dimensionally and the two-dimensional X-ray image data I212 is shown one-dimensionally. That is, the CT image data I112 shown in FIG. 4 shows one of the planes included in the CT image data I112. Further, the two-dimensional X-ray image data I212 shown in FIG. 4 shows pixels for one column included in the two-dimensional X-ray image data I212.

  As shown in FIG. 4, the additional function 342 first aligns the CT image data I112 and the two-dimensional X-ray image data I212. Next, the additional function 342, in a state in which the CT image data I112 and the two-dimensional X-ray image data I212 are aligned, adds the first label added to each position on the CT image data I112 to the two-dimensional X-ray image data. By projecting onto I212, the second label is added to each position on the two-dimensional X-ray image data I212. That is, as shown in FIG. 4, the additional function 342 assigns the second label to each pixel (pixel P21, pixel P22, pixel P23, pixel P24, pixel P25, and pixel P26) of the two-dimensional X-ray image data I212. Add.

  As an example, the additional function 342 first calculates a position in the CT image data I112 that overlaps the pixel P21 in a state where the CT image data I112 and the two-dimensional X-ray image data I212 are aligned. Hereinafter, the position overlapping the pixel P21 in the CT image data I112 will be referred to as position L1.

  Next, the additional function 342, in the CT image data I112, from the position L1, the first label attached to the position in the direction perpendicular to the two-dimensional X-ray image data I212 (hereinafter, simply referred to as the vertical direction), Project to pixel P21. For example, in the case shown in FIG. 4, the additional function 342 assigns the first label of “soft tissue” and the first label of “blood vessel” to the pixel P21 as the first label attached to the position in the vertical direction from the position L1. To project. That is, the plurality of first labels are projected on the pixel P21.

  Next, the adding function 342 adds any one of the plurality of first labels to the pixel P21 based on the label priority. Here, the label priority may be determined by the additional function 342, may be preset, or may be set by the operator. For example, the additional function 342 automatically determines the label priority based on the inspection information. For example, when the intervention treatment is performed on the blood vessel of the subject P, the additional function 342 sets the priority of the first label of “blood vessel” to be high.

  As an example, a case where the first label “blood vessel” has the highest priority will be described below. In this case, the addition function 342 adds the second label corresponding to the label having the higher priority among the plurality of first labels to the pixel P21. That is, the additional function 342 adds the second label “blood vessel” to the pixel P21, as shown by the arrow in FIG. Further, the additional function 342 similarly adds the second label of “blood vessel” to the other pixels (pixel P22, pixel P23, pixel P24, pixel P25, and pixel P26) other than the pixel P21.

  That is, the adding function 342 adds the second label corresponding to the label having the highest priority among the plurality of first labels to the position where the plurality of first labels are added in the two-dimensional X-ray image data I212. To do. Thereby, the additional function 342, for example, even if there is a distance between the blood vessel in the CT image data I112 and the two-dimensional X-ray image data I212, the additional function 342 determines that the “blood vessel” is not included in the two-dimensional X-ray image data I212. Two labels can be added preferentially.

  As described above, the adding function 342 adds the second label to each position on the two-dimensional X-ray image data I21. Next, the image processing function 343 performs image processing on each position on the two-dimensional X-ray image data I21 according to the second label attached to that position.

  For example, when the intervention treatment is performed on the blood vessel of the subject P, the image processing function 343 emphasizes the contrast at the position to which the second label “blood vessel” is added in the two-dimensional X-ray image data I21. As a result, the image processing function 343 can improve the visibility of the “blood vessel” that the operator focuses on in the intervention treatment.

  For example, the image processing function 343 executes the blood vessel enhancement processing by the density conversion on the position to which the second label “blood vessel” is added in the two-dimensional X-ray image data I21. As an example, the image processing function 343 expands the pixel value histogram at the position of the two-dimensional X-ray image data I21 to which the second label “blood vessel” is added. Further, for example, the image processing function 343 executes a filtering process using an edge enhancement filter or the like on the position to which the second label “blood vessel” is added in the two-dimensional X-ray image data I21.

  Further, for example, when the intervention treatment is performed, the image processing function 343 determines the pixel value of the position to which the second label “bone” is added in the two-dimensional X-ray image data I21 as the two-dimensional X-ray image. The pixel value of the background area in the data I21 is replaced. Thereby, the image processing function 343 can improve the visibility of the “blood vessel” by making the “bone” that is not usually noticed by the operator in the intervention treatment inconspicuous.

  The pixel value of the background area in the two-dimensional X-ray image data I21 is a pixel value of an area in the two-dimensional X-ray image data I21 that the operator does not pay attention to. For example, the image processing function 343 may use a pixel value indicating the outside of the subject P (that is, air) in the two-dimensional X-ray image data I21 as the pixel value of the background area, or use a preset value. May be. Further, for example, when the operator does not pay attention to the soft tissue, the image processing function 343 may use the pixel value indicating the soft tissue in the two-dimensional X-ray image data I21 as the pixel value of the background area.

  Further, for example, when the intervention treatment is performed, the image processing function 343 removes noise at the position to which the second label “soft tissue” is added in the two-dimensional X-ray image data I21. For example, the image processing function 343 suppresses the low-frequency component at the position where the second label “soft tissue” is added in the two-dimensional X-ray image data I21, or executes the filtering process using the noise removal filter. To do. Accordingly, the image processing function 343 can easily identify the blood vessel from the soft tissue and improve the visibility of the “blood vessel”.

  Further, for example, when the intervention treatment is performed, the image processing function 343 determines whether or not the “device” in the two-dimensional X-ray image data I21 is related to the treatment.

  As an example, when the intervention treatment is performed on the cerebral blood vessels of the subject P and the “device” in the two-dimensional X-ray image data I21 is a dental implant, the image processing function 343 uses the two-dimensional X-ray. It is determined that the “device” in the image data I21 is not related to treatment. In this case, the image processing function 343 replaces the pixel value of the position to which the second label “device” is added in the two-dimensional X-ray image data I21 with the pixel value of the background area in the two-dimensional X-ray image data I21. To do. Accordingly, the image processing function 343 can make the “device” unrelated to the intervention treatment inconspicuous and improve the visibility of the “blood vessel”.

  As another example, in the case where an intervention treatment in which a second stent is additionally placed near the first stent placed in the blood vessel of the subject P is performed, “device” in the two-dimensional X-ray image data I21 is given. If “” is the first stent that has been placed, the image processing function 343 determines that the “device” in the two-dimensional X-ray image data I21 is related to treatment. In this case, the image processing function 343 emphasizes the high frequency component at the position of the two-dimensional X-ray image data I21 to which the second label “device” is added. For example, the image processing function 343 performs a filtering process using an edge enhancement filter or the like and a high-frequency side enhancement component on the position to which the second label of “device” is added in the two-dimensional X-ray image data I21. Execute the processing to add. Accordingly, the image processing function 343 can improve the visibility of the “device” that the operator pays attention to in the intervention treatment.

  Further, for example, when a plurality of two-dimensional X-ray image data I21 is collected in time series, the image processing function 343 adds the position to each position of the plurality of two-dimensional X-ray image data I21. Filtering processing in the time direction is performed according to the generated second label. For example, the image processing function 343 performs filter processing using a recursive filter on each position of each of the plurality of two-dimensional X-ray image data I21 according to the second label added to the position.

  As an example, first, the X-ray diagnostic apparatus 10 collects a plurality of two-dimensional X-ray image data I21 in time series, and collects the plurality of collected two-dimensional X-ray image data I21 to the medical image processing apparatus 30. To send. Next, the adding function 342 adds the second label to each position of the plurality of two-dimensional X-ray image data I21. Next, the image processing function 343 executes filter processing for each position of each of the plurality of two-dimensional X-ray image data I21 using a recursive filter having an intensity corresponding to the second label added to the position. . Here, the strength of the recursive filter is, for example, the number of frames used in the filtering process, a weighting coefficient, or the like. For example, the image processing function 343 determines the strength of the recursive filter so that the number of frames decreases as the position where the pixel value changes greatly between frames, such as the position where the second label “blood vessel” is added. Perform filtering. As an example, the image processing function 343 sets the pixel value of the corresponding position between the two-dimensional X-ray image data I21 having the number of frames corresponding to the second label based on the weighting coefficient corresponding to the second label. Perform addition processing.

  In addition, in the example described above, the case where the intervention treatment is performed on the blood vessel of the subject P has been described, but the embodiment is not limited to this. That is, the image processing function 343 can appropriately change the content of the image processing corresponding to the second label according to the type and purpose of the inspection.

  Then, the display control function 344 causes the display 32 to display the two-dimensional X-ray image data I21 after the image processing by the image processing function 343. Alternatively, the control function 341 outputs the two-dimensional X-ray image data I21 after image processing to an external device. For example, the control function 341 transmits the image-processed two-dimensional X-ray image data I21 to the X-ray diagnostic apparatus 10, and the X-ray diagnostic apparatus 10 displays the received two-dimensional X-ray image data I21 on the display 108. Display it.

  The two-dimensional X-ray image data I21 may be a perspective image. That is, the X-ray diagnostic apparatus 10 collects a plurality of two-dimensional X-ray image data I21 in time series, and sequentially transmits the collected two-dimensional X-ray image data I21 to the medical image processing apparatus 30. Next, the adding function 342 sequentially adds the second label to each position on the two-dimensional X-ray image data I21. Next, the image processing function 343 sequentially performs, on each position on the two-dimensional X-ray image data I21, image processing according to the second label added to the position. Next, the display control function 344 causes the display 32 to sequentially display the two-dimensional X-ray image data I21 after the image processing by the image processing function 343.

  Alternatively, the control function 341 sequentially transmits the image-processed two-dimensional X-ray image data I21 to the X-ray diagnostic apparatus 10. In this case, the control function 110a sequentially receives the two-dimensional X-ray image data I21, and the display control function 110c causes the display 108 to sequentially display the two-dimensional X-ray image data I21.

  Next, an example of a procedure of processing by the medical image processing apparatus 30 will be described with reference to FIG. FIG. 5 is a flowchart for explaining a series of processing flows of the medical image processing apparatus 30 according to the first embodiment. Step S101 is a step corresponding to the control function 341. Step S102, step S103, step S104, step S105, step S106, step S107, step S110, step S111, and step S112 are steps corresponding to the additional function 342. Step S108 is a step corresponding to the image processing function 343. Step S109 is a step corresponding to the display control function 344.

  First, the processing circuit 34 acquires the CT image data I11 from the image storage device 20 (step S101). Next, the processing circuit 34 separates the CT image data I11 into a blood vessel model I12 and a non-blood vessel model I13 (step S102). Next, the processing circuit 34 adds a first label to each position on the CT image data I11 (step S103). For example, the processing circuit 34 adds the first label of “vessel” to each voxel of the blood vessel model I12 and “device”, “bone”, “soft tissue”, “ Add a first label such as "air".

  Next, the processing circuit 34 determines whether fluoroscopy of the subject P has been started (step S104). Here, when the fluoroscopy is not started (No at step S104), the processing circuit 34 is in a standby state. On the other hand, when fluoroscopy is started (Yes at Step S104), the processing circuit 34 aligns the non-vascular model I13 with the two-dimensional X-ray image data I21 obtained by the X-ray imaging of the subject P (Step S14). S105). Next, the processing circuit 34 aligns the blood vessel model I12 with the two-dimensional X-ray image data I21 using the result of the alignment between the non-blood vessel model I13 and the two-dimensional X-ray image data I21 (step S106). .

  Next, the processing circuit 34, in a state where the CT image data I11 and the two-dimensional X-ray image data I21 are aligned, sets the first label added to each position on the CT image data I11 to the two-dimensional X-ray image data. By projecting onto I21, the second label is added to each position on the two-dimensional X-ray image data I21 (step S107). Next, the processing circuit 34 performs image processing on each position on the two-dimensional X-ray image data I21 according to the second label added to the position (step S108). Next, the processing circuit 34 displays the image-processed two-dimensional X-ray image data I21 on the display 32 (step S109).

  Here, the processing circuit 34 determines whether or not the fluoroscopy is completed (step S110). When the fluoroscopy is not completed (No at Step S110), the processing circuit 34 determines whether the arrangement of the imaging system has changed (Step S111). That is, the processing circuit 34 has changed at least one of the imaging position and the imaging angle between the last two-dimensional X-ray image data I21 and the next two-dimensional image data I21. Determine whether or not. Hereinafter, the two-dimensional X-ray image data I21 which is finally image-processed is also referred to as a processed image. Further, the two-dimensional X-ray image data I21 to be image-processed next is also referred to as an unprocessed image.

  For example, the processing circuit 34 determines whether or not the arrangement of the imaging system has changed from the processing circuit 110 that controls the imaging system of the X-ray diagnostic apparatus 10 to the imaging of the processed image to the imaging of the unprocessed image. Receives the indicated information. As an example, when the C-arm 105 rotates or moves between the image pickup of the processed image and the image pickup of the unprocessed image, the processing circuit 34 indicates that the arrangement of the image pickup system has changed. To receive. Further, as an example, when the top plate 104 moves or tilts between the image pickup of the processed image and the image pickup of the unprocessed image, the processing circuit 34 indicates that the arrangement of the image pickup system has changed. Receives the indicated information.

  When the arrangement of the imaging system has changed (Yes at Step S111), the processing circuit 34 returns to Step S107 and adds the second label to each position on the unprocessed image. Here, the processing circuit 34 performs processing based on the result of alignment between the CT image data I11 and the processed image and the change in the arrangement of the imaging system from the imaging of the processed image to the imaging of the unprocessed image. A second label can be added to each position on the previous image.

  For example, when the imaging position and the imaging angle change due to the rotation and movement of the C arm 105, the processing circuit 34 causes the processing circuit 110 to dispose the C arm 105 at the time of imaging the processed image and at the time of imaging the unprocessed image. And the placement of the C-arm 105 at. For example, the processing circuit 34 acquires, from the processing circuit 110, the amount of rotation and the amount of movement of the C arm 105 during the period from the capturing of the processed image to the capturing of the unprocessed image.

  Next, the processing circuit 34 calculates the positional relationship between the processed image and the unprocessed image based on the arrangement of the C arm 105. Then, the processing circuit 34 is added to each position on the CT image data I11 based on the result of alignment between the CT image data I11 and the processed image and the positional relationship between the processed image and the unprocessed image. By projecting the first label on the unprocessed image, the second label is added to each position on the unprocessed image. That is, the processing circuit 34 adds the second label to each position on the unprocessed image by projecting the first label on the unprocessed image based on the arrangement of the C arm 105.

  Further, for example, when the imaging position and the imaging angle change due to the tilt and movement of the top plate 104 in addition to the rotation and movement of the C arm 105, the processing circuit 34 causes the processing circuit 110 to take a processed image at the time of imaging. The arrangement of the C arm 105 and the top plate 104 and the arrangement of the C arm 105 and the top plate 104 at the time of capturing the unprocessed image are acquired. For example, the processing circuit 34 obtains from the processing circuit 110 the rotation amount and the movement amount of the C arm 105 and the inclination amount and the movement amount of the top plate 104 from the image pickup of the processed image to the image pickup of the unprocessed image. To do.

  Next, the processing circuit 34 calculates the positional relationship between the processed image and the unprocessed image based on the arrangement of the C arm 105 and the top plate 104. Then, the processing circuit 34 is added to each position on the CT image data I11 based on the result of alignment between the CT image data I11 and the processed image and the positional relationship between the processed image and the unprocessed image. By projecting the first label on the unprocessed image, the second label is added to each position on the unprocessed image. That is, the processing circuit 34 adds the second label to each position on the unprocessed image by projecting the first label on the unprocessed image based on the arrangement of the C arm 105 and the top plate 104.

  When the arrangement of the imaging system has not changed (No at Step S111), the processing circuit 34 determines whether or not there is body movement (Step S112). When there is a body movement (Yes at Step S112), the processing circuit 34 moves to Step S105 again and aligns the non-vascular model I13 with the unprocessed image. For example, when the operator determines that there is a body movement of the subject P between the image pickup of the processed image and the image pickup of the unprocessed image, the operator performs an input operation to the effect that there is a body movement via the input interface 31. Do. In this case, the processing circuit 34 determines that there is a body motion, and executes the alignment between the non-blood vessel model I13 and the unprocessed image.

  When there is no body movement of the subject P (No at Step S112), the processing circuit 34 again moves to Step S108 and executes image processing on the unprocessed image. Specifically, the processing circuit 34 adds the second label added to each position of the processed image to the corresponding position of the unprocessed image, and adds the second label to that position for each position on the unprocessed image. Image processing is performed according to the second label thus created. That is, when there is neither a change in the arrangement of the imaging system nor a body movement of the subject P, the processing circuit 34 causes the unprocessed image to inherit the second label added to each position of the processed image, Perform image processing. When the fluoroscopy is finished (Yes at Step S110), the processing circuit 34 finishes the process.

  As described above, according to the first embodiment, the additional function 342 projects the first label added to each position on the CT image data I11 of the subject P onto the two-dimensional X-ray image data I21. Then, the second label is added to each position on the two-dimensional X-ray image data I21. Further, the image processing function 343 performs image processing on each position on the two-dimensional X-ray image data I21 according to the second label added to the position. Therefore, the medical image processing apparatus 30 according to the first embodiment can enhance the effect of image processing on the two-dimensional X-ray image data I21.

  Further, as described above, according to the first embodiment, the additional function 342 is configured to add the plurality of first labels to the positions where the plurality of first labels of the two-dimensional X-ray image data I21 are projected. Of these, the second label corresponding to the label with the higher priority is added. That is, when a plurality of tissues or devices are overlapped on the CT image data I11, the additional function 342 is the second label of the tissue or device having a high priority for each position on the two-dimensional X-ray image data I21. Is added. For example, the medical image processing apparatus 30 preferentially adds the second label “blood vessel” when blood vessels, bones, soft tissues, air, devices, etc. overlap on the CT image data I11 during the intervention treatment, Image processing according to the second label of "blood vessel" is performed. Therefore, the medical image processing apparatus 30 according to the first embodiment can improve the visibility of the tissue or device of interest to the operator with respect to the two-dimensional X-ray image data I21.

  Further, as described above, according to the first embodiment, the additional function 342 separates the CT image data I11 into the blood vessel model I12 and the non-vascular model I13, and the non-vascular model I13 and the two-dimensional X-ray image data. The CT image data I11 and the two-dimensional X-ray image data I21 are aligned by aligning I21 and I21. Therefore, the medical image processing apparatus 30 according to the first embodiment uses the CT image data I11 and the two-dimensional X-ray image data I21 even when the blood vessel of the subject P is not contrasted in the two-dimensional X-ray image data I21. Alignment can be performed.

  Further, as described above, according to the first embodiment, the additional function 342 uses the plurality of two-dimensional X-ray image data I21 imaged using X-rays having different energies to generate a two-dimensional X-ray image. A region corresponding to the bone in the data I21 is specified. That is, the additional function 342 can accurately specify the region corresponding to the bone in the two-dimensional X-ray image data I21 by utilizing the difference in the X-ray absorption characteristics. Therefore, the medical image processing apparatus 30 according to the first embodiment aligns the region corresponding to the bone in the non-vascular model I13 with the region corresponding to the bone in the two-dimensional X-ray image data I21. , The CT image data I11 and the two-dimensional X-ray image data I21 can be accurately aligned.

  Further, as described above, according to the first embodiment, the additional function 342 causes the C arm 105 to operate when at least one of the imaging position and the imaging angle of the two-dimensional X-ray image data I21 with respect to the subject P changes. The second label is added to each position on the two-dimensional X-ray image data I21 by projecting the first label on the two-dimensional X-ray image data I21 based on the arrangement of. Alternatively, the additional function 342, based on the arrangement of the C arm 105 and the arrangement of the top plate 104 when at least one of the imaging position and the imaging angle of the two-dimensional X-ray image data I21 with respect to the subject P changes. By projecting the label on the two-dimensional X-ray image data I21, the second label is added to each position on the two-dimensional X-ray image data I21. Therefore, the medical image processing apparatus 30 according to the first embodiment can add the second label without requiring realignment when at least one of the imaging position and the imaging angle changes during fluoroscopy. it can. That is, the medical image processing apparatus 30 can reduce the calculation cost required for the alignment and quickly add the second label when at least one of the imaging position and the imaging angle changes during fluoroscopy.

  Further, as described above, according to the first embodiment, the additional function 342 realigns the CT image data I11 and the two-dimensional X-ray image data I21 when the subject P moves. Run. That is, the additional function 342 repeatedly performs the alignment of the CT image data I11 and the two-dimensional X-ray image data I21, and performs the alignment for each position on the two-dimensional X-ray image data I21 every time the alignment is performed. 2 Add a label. Also, the image processing function 343 performs image processing according to the newly added second label every time the second label is added. Therefore, the medical image processing apparatus 30 according to the first embodiment appropriately adds the second label even when the subject P has a body motion, and provides the image processing effect on the two-dimensional X-ray image data I21. Can be increased.

  In addition, in FIG. 5, it has been described that the CT image data I11 and the two-dimensional X-ray image data I21 are realigned when the subject P moves. However, the embodiment is not limited to this. For example, the additional function 342 may periodically perform alignment between the CT image data I11 and the two-dimensional X-ray image data I21 regardless of the presence or absence of body movement of the subject P. That is, the additional function 342 may periodically repeat the alignment between the CT image data I11 and the two-dimensional X-ray image data I21. Thereby, the medical image processing apparatus 30 according to the first embodiment appropriately adds the second label when the subject P has a body movement without determining whether or not the subject P has a body movement. The effect of image processing on the two-dimensional X-ray image data I21 can be enhanced.

  Further, the additional function 342 can reduce the calculation cost by repeatedly performing the alignment between the CT image data I11 and the two-dimensional X-ray image data I21. Specifically, when the CT image data I11 and the two-dimensional X-ray image data I21 are repeatedly aligned, the subject P between the last alignment and the next alignment is performed. Has little body movement. Here, when the CT image data I11 and the two-dimensional X-ray image data I21 are repeatedly aligned by minimizing the evaluation function described above, the additional function 342 determines that the movement amount of each site in the subject P is small. Therefore, the calculation range can be limited in the evaluation function. Thereby, the additional function 342 can reduce the calculation cost.

  Further, as described above, according to the first embodiment, the addition function 342 adds the first label to each position on the CT image data I11 by the substance discrimination processing. Therefore, the medical image processing apparatus 30 according to the first embodiment can automatically add the first label to each position of the CT image data I11.

  Further, as described above, according to the first embodiment, the image processing function 343 makes the contrast of the position on the two-dimensional X-ray image data I21 to which the second label “blood vessel” is added. Image processing that emphasizes is executed. Therefore, the medical image processing apparatus 30 according to the first embodiment can improve the visibility of blood vessels in the two-dimensional X-ray image data I21.

  Further, the medical image processing apparatus 30 according to the first embodiment can reduce the amount of the contrast agent used for the subject P by improving the visibility of blood vessels. For example, in the intervention treatment, the contrast agent may be repeatedly injected into the subject P. As an example, in the stent placement technique in which a stent is placed in a blood vessel, a 2D X-ray image data I21 in which a blood vessel is imaged is repeatedly injected by repeatedly injecting a contrast agent for confirmation after balloon expansion or stent placement. Collected repeatedly. Here, the medical image processing apparatus 30 performs image processing on the two-dimensional X-ray image data I21 so that the blood vessels can be visually recognized in the two-dimensional X-ray image data I21 even if the amount of the contrast agent used is reduced. Is possible. That is, the medical image processing apparatus 30 can use a small amount of contrast agent (such as a diluted contrast agent) and can reduce the burden on the subject P.

  Further, as described above, according to the first embodiment, the image processing function 343 causes the pixel value of the position to which the second label “bone” is added among the positions on the two-dimensional X-ray image data I21. Is executed with the pixel value of the background area in the two-dimensional X-ray image data I21. Further, the image processing function 343 sets the pixel value of the position to which the second label “device” is added among the positions on the two-dimensional X-ray image data I21 to the pixel of the background area in the two-dimensional X-ray image data I21. Executes image processing that replaces values. Therefore, the medical image processing apparatus 30 according to the first embodiment can improve the visibility of the site (the blood vessel or the like in the intervention treatment) of interest to the operator.

  Further, as described above, according to the first embodiment, the image processing function 343 causes the high frequency component of the position on the two-dimensional X-ray image data I21 to which the second label “device” is added. Image processing that emphasizes is executed. Therefore, the medical image processing apparatus 30 according to the first embodiment can improve the visibility of the device in the two-dimensional X-ray image data I21.

(Second embodiment)
In the above-described first embodiment, the second label corresponding to the label having the highest priority among the plurality of first labels with respect to the position where the plurality of first labels are projected in the two-dimensional X-ray image data I21. Has been described. That is, in the first embodiment, even when a plurality of first labels are projected, one second label is added to one position on the two-dimensional X-ray image data I21. did. On the other hand, in the second embodiment, a plurality of second labels corresponding to the plurality of first labels are added to the positions of the plurality of first labels projected in the two-dimensional X-ray image data I21. The case will be described.

  The medical image processing system 1 according to the second embodiment has the same configuration as the medical image processing system 1 according to the first embodiment shown in FIGS. 1 and 2, and has an additional function 342 and an image processing function 343. Part of the processing by is different. About the point which has the same structure as the structure demonstrated in 1st Embodiment, the same code | symbol as FIG. 1-2 is attached | subjected, and description is abbreviate | omitted.

  The CT image data I113 will be described below as an example of the CT image data I11. The two-dimensional X-ray image data I213 will be described as an example of the two-dimensional X-ray image data I21. First, the additional function 342 aligns the CT image data I113 with the two-dimensional X-ray image data I213.

  Next, the additional function 342, in a state in which the CT image data I113 and the two-dimensional X-ray image data I213 are aligned, adds the first label added to each position on the CT image data I113 to the two-dimensional X-ray image data. By projecting onto I213, the second label is added to each position on the two-dimensional X-ray image data I213. Here, the additional function 342 adds a plurality of second labels corresponding to the plurality of first labels to the positions where the plurality of first labels are projected in the two-dimensional X-ray image data I213.

  As an example, the additional function 342 first calculates a position overlapping the pixel P3 in the CT image data I113 in a state where the CT image data I113 and the two-dimensional X-ray image data I213 are aligned. Hereinafter, the position overlapping the pixel P3 in the CT image data I113 will be referred to as position L2. Next, the additional function 342 projects the first label attached to the pixel P3 from the position L3 in the direction perpendicular to the two-dimensional X-ray image data I213 (vertical direction) in the CT image data I113. For example, the additional function 342 projects the first label of “blood vessel” and the first label of “soft tissue” to the pixel P3. In this case, the additional function 342 provides the second label “blood vessel” and the second label “soft tissue” corresponding to the first label “blood vessel” and the first label “soft tissue” for the pixel P3. Is added.

  Next, the image processing function 343 performs image processing on the position, to which the plurality of second labels are added, of the two-dimensional X-ray image data I213 according to the label having the highest priority among the plurality of second labels. Give. Here, the priority of the label can be automatically determined by the additional function 342 based on the inspection information, for example.

  The label priority may be set by the operator. For example, first, the display control function 344 causes the display 32 to display information indicating “blood vessel”, “bone”, “soft tissue”, and “device” side by side. Next, the operator rearranges the information indicating “blood vessel”, “bone”, “soft tissue”, and “device” via the input interface 31 according to the degree of attention in the examination, and thereby the priority of the label. To decide.

  Here, for example, when the operator selects “blood vessel” as the highest priority label, the image processing function 343 causes the two-dimensional X-ray image data I213 to include a plurality of second labels including “blood vessel”. The image processing according to the second label of "blood vessel" is performed on the position to which is added. In addition, for example, when the operator switches the selection to “soft tissue”, the image processing function 343 causes the two-dimensional X-ray image data I213 to be assigned to a position to which a plurality of second labels including “soft tissue” are added. Then, image processing according to the second label of "soft tissue" is performed.

  As described above, the adding function 342 adds the plurality of second labels corresponding to the plurality of first labels to the positions where the plurality of first labels are projected in the two-dimensional X-ray image data I21. In addition, the image processing function 343 performs image processing on the position, to which the plurality of second labels have been added, of the two-dimensional X-ray image data I21, according to the information of high priority among the plurality of second labels. . Therefore, the medical image processing apparatus 30 according to the second embodiment can improve the visibility of the tissue or device of interest to the operator with respect to the two-dimensional X-ray image data I21.

  Next, another example of the processing by the additional function 342 will be described with reference to FIG. FIG. 6 is a diagram for explaining the addition of the second label according to the second embodiment. The CT image data I114 will be described below as an example of the CT image data I11. As an example of the two-dimensional X-ray image data I21, the two-dimensional X-ray image data I214a shown in FIG. 6 will be described.

  First, the control function 341 acquires the CT image data I114 via the network NW. Next, the adding function 342 adds a first label corresponding to each position to each position on the CT image data I114. For example, the addition function 342 adds the first label to each position on the CT image data I114 by the substance discrimination processing. Further, for example, the additional function 342 adds the first label to each position on the CT image data I114 by receiving the input operation by the operator.

  Specifically, the adding function 342 adds, to each position on the CT image data I114, a first label indicating a tissue or a device corresponding to the position. For example, the additional function 342 adds the first label of “device” to the voxel corresponding to the device placed in the body of the subject P among the voxels on the CT image data I114.

  In the following, as an example, a case will be described in which an intervention treatment in which a second stent is additionally placed near the first stent placed in the blood vessel of the subject P is performed. In this case, the additional function 342 adds the first label of “device” to the voxel corresponding to the first stent placed in the blood vessel of the subject P among the voxels on the CT image data I114. .

  Further, the additional function 342 adds the first label of “blood vessel” to the voxel corresponding to the blood vessel of the subject P. Further, the additional function 342 adds the first label of “soft tissue” to the voxels corresponding to the soft tissue of the subject P. Further, the additional function 342 adds the first label of “bone” to the voxel corresponding to the bone of the subject P.

  Further, the adding function 342 adds the first label of “device” to the position where the device is to be inserted from among the positions on the CT image data I114. For example, the additional function 342 adds the first label of “device” to the position where the second stent is to be placed (hereinafter, the planned placement position). Further, the additional function 342 adds the first label of “device” to the blood vessel (hereinafter referred to as “route”) through which the second stent passes before reaching the indwelling position. For example, the additional function 342 adds the first label of “blood vessel” and the first label of “device” to the planned indwelling position and route of the second stent in an overlapping manner. That is, the adding function 342 adds a plurality of first labels to one position in the CT image data I11.

  Next, the additional function 342, in a state where the CT image data I114 and the two-dimensional X-ray image data I214a are aligned, adds the first label added to each position on the CT image data I114 to the two-dimensional X-ray image data. By projecting onto the I214a, the second label is added to each position on the two-dimensional X-ray image data I214a. Here, the additional function 342 adds a plurality of second labels corresponding to the plurality of first labels to the positions where the plurality of first labels are projected in the two-dimensional X-ray image data I214a.

  For example, as shown in FIG. 6, the additional function 342 may select the “blood vessel” for the pixel on which the first label “blood vessel” and the first label “device” in the two-dimensional X-ray image data I214a are projected. The second label of “” and the second label of “device” are added. That is, as shown in FIG. 6, the additional function 342 indicates that for the pixel P31, the pixel P32, the pixel P33, the pixel P34, the pixel P35, the pixel P36, and the pixel P37, the second label of “blood vessel” and “device” are displayed. And a second label. In the following description, the pixels P31 to P36 correspond to the path of the second stent, and the pixel P37 corresponds to the planned indwelling position of the second stent.

  Also, if the first stent is located at pixel P38, the add function 342 adds a second label of "device" to pixel P38, as shown in FIG. Further, the addition function 342 adds the second label “blood vessel” to the pixel P39, the pixel P40, the pixel P41, and the pixel P42. Further, the adding function 342 adds the second label of "soft tissue" to the other pixels shown in FIG.

  In the intervention treatment, the operator first inserts the second stent into the blood vessel of the subject P. The second stent has, for example, a cylindrical wire frame, and is inserted into the blood vessel of the subject P while being in close contact with the outside of the balloon portion of the balloon catheter.

  Here, the image processing by the image processing function 343 will be described with reference to FIG. 7A. FIG. 7A is a diagram for explaining image processing according to the second embodiment. Note that FIG. 7A shows image processing performed on each position of the two-dimensional X-ray image data I214a. Further, FIG. 7A shows a case where the second stent in a state of being in close contact with the outside of the balloon portion of the catheter with a balloon is located at the pixel P31.

  In the case shown in FIG. 7A, the image processing function 343 responds to the position of the two-dimensional X-ray image data I214a to which the plurality of second labels are added with the label having the highest priority among the plurality of second labels. Image processing. That is, the image processing function 343, in the two-dimensional X-ray image data I214a, with respect to the position to which the second label of “blood vessel” and the second label of “device” are added, according to the priority, “blood vessel”. Either the image processing according to the second label of No. 1 or the image processing according to the second label of “Device” is performed.

  For example, the image processing function 343 performs image processing according to the second label of “device” on the pixel P31 where the second stent is located. Here, the image processing function 343 can specify the pixel P31 where the second stent is located based on the two-dimensional X-ray image data I214a. For example, the image processing function 343 identifies the pixel where the second stent is located by detecting the stent marker indicating the position of the second stent in the two-dimensional X-ray image data I214a. The stent marker is, for example, a radiopaque metal attached to the second stent or the balloon. Further, the image processing function 343, for the pixel (pixel P32, pixel P33, pixel P34, pixel P35, pixel P36 and pixel P37) where the second stent is not located, the image corresponding to the second label of “blood vessel”. Apply processing. Accordingly, the image processing function 343 can improve the visibility of both the second stent and the blood vessel that serves as the path of the second stent.

  As described above, the image processing function 343 determines, based on the two-dimensional X-ray image data I214a, the image processing to be performed on the positions of the two-dimensional X-ray image data I214a to which the plurality of second labels are added. That is, the image processing function 343 determines the priority based on the two-dimensional X-ray image data I214a, and determines a plurality of first positions for the positions to which the plurality of second labels are added in the two-dimensional X-ray image data I214a. Image processing is performed according to the label having the highest priority of the two labels.

  Further, in the case shown in FIG. 7A, the image processing function 343 performs image processing according to the second label of “device” on the pixel P38 where the first stent is located. Thereby, the image processing function 343 can improve the visibility of the first stent. Further, the image processing function 343 performs image processing on the pixels P39, P40, P41, and P42 according to the second label of “blood vessel”. As a result, the image processing function 343 can improve the visibility of blood vessels. Further, the image processing function 343 performs image processing according to the second label of “soft tissue” on the pixels other than the pixels P31 to P42. Thereby, the image processing function 343 can improve the visibility of the soft tissue.

  Here, the second stent may move after imaging the two-dimensional X-ray image data I214a. For example, the second stent may move to the position of the pixel P34 between the time when the two-dimensional X-ray image data I214a is imaged and the time when the two-dimensional X-ray image data I214b shown in FIG. 7B is imaged. . Note that FIG. 7B is a diagram for explaining the image processing according to the second embodiment. FIG. 7B shows image processing performed on each position of the two-dimensional X-ray image data I214b.

  For example, when there is no change in the arrangement of the imaging system or body movement of the subject P between the time when the two-dimensional X-ray image data I214a is imaged and the time when the two-dimensional X-ray image data I214b is imaged. The additional function 342 causes the two-dimensional X-ray image data I214b to inherit the second label added to each position of the two-dimensional X-ray image data I214a. If the arrangement of the imaging system changes between the time when the two-dimensional X-ray image data I214a is imaged and the time when the two-dimensional X-ray image data I214b is imaged, the additional function 342 is based on the arrangement of the imaging system. By projecting the first label on the two-dimensional X-ray image data I214b, the second label is added to each position on the two-dimensional X-ray image data I214b. Further, when there is a body movement of the subject P between the time when the two-dimensional X-ray image data I214a is imaged and the time when the two-dimensional X-ray image data I214b is imaged, the additional function 342 determines that the CT image data I114 is The second label is added to each position on the two-dimensional X-ray image data I214b by aligning the two-dimensional X-ray image data I214b and projecting the first label onto the two-dimensional X-ray image data I214b. . In the following description, it is assumed that the second label is added to each pixel of the two-dimensional X-ray image data I214b, as in FIG.

  Next, the image processing function 343 specifies the pixel P34 where the second stent is located in the two-dimensional X-ray image data I214b based on the two-dimensional X-ray image data I214b. Next, as shown in FIG. 7B, the image processing function 343, for the pixel P34 where the second stent is located among the pixels to which the plurality of second labels are added in the two-dimensional X-ray image data I214b, Image processing according to the second label of "device" is performed. In addition, the image processing function 343 is performed on the pixels (pixel P31, pixel P32, pixel P33, pixel P35, pixel P36, and pixel P37) where the second stent is not located among the pixels to which the plurality of second labels are added. , Image processing according to the second label of “blood vessel”. As a result, the image processing function 343 can improve the visibility of both the second stent and the blood vessel serving as the path of the second stent even when the second stent moves.

  Further, the image processing function 343 performs image processing according to the second label of “device” on the pixel P38 where the first stent is located in the two-dimensional X-ray image data I214b. Further, the image processing function 343 performs image processing on the pixels P39, P40, P41, and P42 according to the second label of “blood vessel”. Further, the image processing function 343 performs image processing according to the second label of “soft tissue” on the pixels other than the pixels P31 to P42.

  After the imaging of the two-dimensional X-ray image data I214b, the second stent further moves and is placed at the planned placement position. For example, in the second stent, the position of the pixel P37 corresponding to the planned indwelling position between the time when the two-dimensional X-ray image data I214b is imaged and the time when the two-dimensional X-ray image data I214c shown in FIG. 7C is imaged. To be detained. Note that FIG. 7C is a diagram for explaining the image processing according to the second embodiment. FIG. 7C shows image processing performed on each position of the two-dimensional X-ray image data I214c.

  For example, when there is no change in the arrangement of the imaging system or body movement of the subject P between the time when the two-dimensional X-ray image data I214b is imaged and the time when the two-dimensional X-ray image data I214c is imaged. The additional function 342 causes the two-dimensional X-ray image data I214c to inherit the second label added to each position of the two-dimensional X-ray image data I214b. If the arrangement of the imaging system changes between the time when the two-dimensional X-ray image data I214b is imaged and the time when the two-dimensional X-ray image data I214c is imaged, the additional function 342 determines whether or not the imaging system is arranged. By projecting the first label on the two-dimensional X-ray image data I214c, the second label is added to each position on the two-dimensional X-ray image data I214c. Further, when there is a body movement of the subject P between the time when the two-dimensional X-ray image data I214b is imaged and the time when the two-dimensional X-ray image data I214c is imaged, the additional function 342 determines that the CT image data I114 is the same as the CT image data I114. The second label is added to each position on the two-dimensional X-ray image data I214c by aligning with the two-dimensional X-ray image data I214c and projecting the first label on the two-dimensional X-ray image data I214c. . In the following description, as in FIG. 6, it is assumed that the second label is added to each pixel of the two-dimensional X-ray image data I214c.

  Next, the image processing function 343 specifies the pixel P37 where the second stent is located in the two-dimensional X-ray image data I214c based on the two-dimensional X-ray image data I214c. Next, as shown in FIG. 7C, the image processing function 343, for the pixel P37 where the second stent is located among the pixels to which the plurality of second labels are added in the two-dimensional X-ray image data I214c, Image processing according to the second label of "device" is performed. In addition, the image processing function 343 is performed on the pixels (pixel P31, pixel P32, pixel P33, pixel P34, pixel P35, and pixel P36) where the second stent is not located among the pixels to which the plurality of second labels are added. , Image processing according to the second label of “blood vessel”. Accordingly, the image processing function 343 can improve the visibility of the second stent placed at the scheduled placement position.

  Further, the image processing function 343 performs image processing according to the second label “device” on the pixel P38 where the first stent is located in the two-dimensional X-ray image data I214c. Further, the image processing function 343 performs image processing on the pixels P39, P40, P41, and P42 according to the second label of “blood vessel”. Further, the image processing function 343 performs image processing according to the second label of “soft tissue” on the pixels other than the pixels P31 to P42.

  As described above, the adding function 342 adds the plurality of second labels corresponding to the plurality of first labels to the positions where the plurality of first labels are projected in the two-dimensional X-ray image data I21. Further, the image processing function 343 determines the label priority based on the two-dimensional X-ray image data I21. In addition, the image processing function 343 performs image processing on the position, to which the plurality of second labels have been added, of the two-dimensional X-ray image data I21, according to the information of high priority among the plurality of second labels. .

  Therefore, the medical image processing apparatus 30 according to the second embodiment can improve the visibility of the tissue or device of interest to the operator with respect to the two-dimensional X-ray image data I21. Further, the medical image processing apparatus 30 can improve the visibility of the device even when the two-dimensional X-ray image data I21 is a perspective image and the device moves on the two-dimensional X-ray image data I21. . For example, in the case where an intervention treatment in which a second stent is additionally placed near the first stent placed in the blood vessel of the subject P is performed, the medical image processing apparatus 30 uses the first stent and the operator's It is possible to improve the visibility of both the second stent that moves by the operation.

(Third Embodiment)
In the above-described first embodiment, the processing circuit 34 having the control function 341, the additional function 342, the image processing function 343, and the display control function 344 has been described. On the other hand, in the second embodiment, as shown in FIG. 8, a case where the processing circuit 34 further has an update processing function 345 will be described. 8 is a diagram showing an example of the processing circuit 34 according to the third embodiment.

  The medical image processing system 1 according to the third embodiment has the same configuration as the medical image processing system 1 according to the first embodiment shown in FIGS. 1 and 2, and the processing circuit 34 has an update processing function 345. Is different in that it further has. About the point which has the same structure as the structure demonstrated in 1st Embodiment, the same code | symbol as FIG. 1-2 is attached | subjected, and description is abbreviate | omitted.

  In the following, as an example, a case will be described in which an intervention treatment in which a second stent is additionally placed near the first stent placed in the blood vessel of the subject P is performed. For example, the control function 341 acquires the CT image data I114 via the network NW. Next, the adding function 342 adds a first label corresponding to each position to each position on the CT image data I114.

  Next, as shown in FIG. 6, the adding function 342 adds a second label to each position on the two-dimensional X-ray image data I214a based on the CT image data I114. Further, as shown in FIG. 7A, the image processing function 343 performs image processing on each position of the two-dimensional X-ray image data I214a according to the second label attached to that position. Similarly, the adding function 342 sequentially adds the second label to each position on the two-dimensional X-ray image data I214b shown in FIG. 7B and the two-dimensional X-ray image data I214c shown in FIG. 7C, Image processing according to the second label is sequentially performed.

  Here, the update processing function 345 updates the first label added to each position on the CT image data I114 based on the two-dimensional X-ray image data I214c. For example, the update processing function 345 first determines based on the two-dimensional X-ray image data I214c that the second stent has been placed at the planned placement position. For example, the update processing function 345 determines that the second stent is placed at the position of the pixel P37 when the stent marker is detected at the pixel P37 corresponding to the planned placement position. Next, the update processing function 345 specifies the position (hereinafter, referred to as position L3) corresponding to the pixel P37 in the CT image data I114. For example, the update processing function 345 identifies the position L3 corresponding to the pixel P37 in the CT image data I114 based on the result of the alignment between the CT image data I114 and the two-dimensional X-ray image data I214c.

  Then, the update processing function 345 updates the first label added to the position L3. As an example, the update processing function 345 deletes the first label of “blood vessel” from the position L3 when the first label of “blood vessel” and the first label of “device” are added to the position L3. To do. As another example, when the first label “blood vessel” is added to the position L3, the update processing function 345 changes the first label added to the position L3 to the first label “device”. . As another example, when the first label of “blood vessel” is added to the position L3, the update processing function 345 additionally adds the first label of “device” to the position L3.

  When the two-dimensional X-ray image data I214d of the subject P is further collected after the collection of the two-dimensional X-ray image data I214c, the additional function 342 projects the updated first label onto the two-dimensional X-ray image data I214d. By doing so, the second label is added to each position on the two-dimensional X-ray image data I214d. Further, the image processing function 343 performs image processing on each position of the two-dimensional X-ray image data I214d according to the second label attached to that position. Here, the update processing function 345 may further update the first label added to each position on the CT image data I114 based on the two-dimensional X-ray image data I214d.

  As described above, according to the third embodiment, the update processing function 345 updates the first label added to each position on the CT image data I11 based on the two-dimensional X-ray image data I21. Therefore, the medical image processing apparatus 30 according to the third embodiment can improve the accuracy of the first label added to each position on the CT image data I11. As a result, the medical image processing apparatus 30 can improve the accuracy of the second label added to each position on the two-dimensional X-ray image data I214d and improve the accuracy of image processing according to the second label.

  The case where the first label is updated when the device is placed in the body of the subject P has been described, but the embodiment is not limited to this. For example, the update processing function 345 may be a case where the first label is updated so as to correct the mismatch between the first label attached to the CT image data I11 and the two-dimensional X-ray image data I21.

(Fourth Embodiment)
Now, the first to third embodiments have been described so far, but the embodiments may be implemented in various different modes other than the above-described embodiments.

  In the above embodiment, the CT image data I11 has been described as an example of the three-dimensional medical image data. However, the embodiment is not limited to this. For example, the additional function 342 may add information corresponding to each position on the two-dimensional X-ray image data I21 based on the three-dimensional X-ray image data I14 of the subject P.

  For example, first, the acquisition function 110b in the X-ray diagnostic apparatus 10 executes rotational imaging of the subject P. That is, the collection function 110b irradiates the subject P with X-rays at a predetermined frame rate while rotating the C-arm 105, and collects a plurality of projection data. Next, the collection function 110b reconstructs the three-dimensional X-ray image data I14 from the plurality of collected projection data. Next, the control function 341 transmits the reconstructed three-dimensional X-ray image data I14 to the image storage device 20. Here, the image storage device 20 stores the received three-dimensional X-ray image data I14.

  Next, the control function 341 acquires the three-dimensional X-ray image data I14 from the image storage device 20, and the additional function 342 separates the three-dimensional X-ray image data I14 into a blood vessel model I15 and a non-blood vessel model I16. As an example, the additional function 342 compares the voxel value with a threshold value for each voxel of the three-dimensional X-ray image data I14 to convert the three-dimensional X-ray image data I14 into a blood vessel model I15 and a non-vascular model I16. To separate.

  As another example, the acquisition function 110b executes rotational imaging on the subject P in which the contrast agent is not injected into the blood vessel, and acquires a mask image at a predetermined frame rate. Further, the acquisition function 110b executes rotational imaging of the subject P in which the contrast agent is injected into the blood vessel, and acquires a contrast image at a predetermined frame rate. Next, the control function 341 acquires the acquired mask image and contrast image via the network NW.

  Next, the additional function 342 reconstructs the blood vessel model I15 indicating the blood vessel region of the subject P using the difference image data obtained by subtracting the mask image and the contrast image as the projection data. In addition, the additional function 342 reconstructs the three-dimensional X-ray image data I14 using the contrast image as projection data and subtracts the three-dimensional X-ray image data I14 and the blood vessel model I15 from each other, so that the blood vessels other than the blood vessels of the subject P are extracted. A non-vascular model I16 indicating the region is generated. That is, the additional function 342 separates the three-dimensional X-ray image data I14 into the blood vessel model I15 and the non-blood vessel model I16 at the stage of the reconstruction processing.

  As another example, the additional function 342 reconstructs the three-dimensional X-ray image data I14 of the subject P using the contrast image as projection data. Further, the additional function 342 uses the mask image as projection data to generate a non-blood vessel model I16 indicating a region other than the blood vessel of the subject P. Next, the additional function 342 generates the blood vessel model I15 indicating the blood vessel region of the subject P by subtracting the three-dimensional X-ray image data I14 and the non-blood vessel model I16. That is, the additional function 342 separates the three-dimensional X-ray image data I14 into the blood vessel model I15 and the non-blood vessel model I16 at the stage of the reconstruction processing.

  Next, the adding function 342 adds the first label to each position on the three-dimensional X-ray image data I14. Next, the additional function 342 aligns the three-dimensional X-ray image data I14 and the two-dimensional X-ray image data I21 by aligning the non-vascular model I16 and the two-dimensional X-ray image data I21. Next, the additional function 342 projects the first label onto the two-dimensional X-ray image data I21 in a state where the three-dimensional X-ray image data I14 and the two-dimensional X-ray image data I21 are aligned with each other, and thereby the two-dimensional image is obtained. A second label is added to each position on the X-ray image data I21. Then, the image processing function 343 performs image processing on each position on the two-dimensional X-ray image data I21 according to the second label added to the position.

  Further, in the above-described embodiment, the case where the processing circuit 34 in the medical image processing apparatus 30 executes the addition of the second label and the image processing on the two-dimensional X-ray image data I21 has been described. However, the embodiment is not limited to this. For example, the processing circuit 110 in the X-ray diagnostic apparatus 10 may execute the addition of the second label and the image processing.

  For example, as shown in FIG. 9, the processing circuit 110 further includes an additional function 110d, an image processing function 110e, and an update processing function 110f in addition to the control function 110a, the collection function 110b, and the display control function 110c. Here, the additional function 110d is a function corresponding to the additional function 342. The image processing function 110e is a function corresponding to the image processing function 343. The update processing function 110f is a function corresponding to the update processing function 345. 9 is a diagram illustrating an example of the processing circuit 110 according to the fourth embodiment.

  For example, in the case shown in FIG. 9, the collection function 110b collects the three-dimensional X-ray image data I14 by executing rotational imaging of the subject P. Next, the additional function 110d adds a first label to each position on the three-dimensional X-ray image data I14. Next, the control function 110a transmits the three-dimensional X-ray image data I14 to which the first label is added to the image storage device 20.

  Next, the collection function 110b captures the two-dimensional X-ray image data I21 by imaging the subject P with X-rays. Further, the control function 110a acquires the three-dimensional X-ray image data I14 from the image storage device 20. Next, the additional function 110d projects the first label added to each position on the three-dimensional X-ray image data I14 onto the two-dimensional X-ray image data I21, and thereby each on the two-dimensional X-ray image data I21. Add a second label to the position. Next, the image processing function 110e performs image processing on each position on the two-dimensional X-ray image data I21 according to the second label added to the position. Then, the display control function 110c causes the display 108 to display the two-dimensional X-ray image data I21 after the image processing.

  In addition, the update processing function 345 updates the first label added to the three-dimensional X-ray image data I14 when it is determined that the device is newly placed based on the two-dimensional X-ray image data I21. Further, the update processing function 345 is added to the three-dimensional X-ray image data I14 when there is a mismatch between the first label attached to the three-dimensional X-ray image data I14 and the two-dimensional X-ray image data I21. Update the first label. When the two-dimensional X-ray image data I21 is newly acquired after the update of the first label, the additional function 110d projects the updated first label onto the two-dimensional X-ray image data I21 to thereby generate the two-dimensional image. A second label is added to each position on the X-ray image data I21.

  Each component of each device according to the first to fourth embodiments is functionally conceptual, and does not necessarily have to be physically configured as illustrated. That is, the specific form of distribution / integration of each device is not limited to the one shown in the figure, and all or part of the device may be functionally or physically distributed / arranged in arbitrary units according to various loads and usage conditions. It can be integrated and configured. Furthermore, all or arbitrary parts of the processing functions performed by each device can be realized by a CPU and a program that is analyzed and executed by the CPU, or can be realized as hardware by a wired logic.

  The medical image processing methods described in the first to fourth embodiments can be realized by executing a prepared medical image processing program on a computer such as a personal computer or a workstation. This medical image processing program can be distributed via a network such as the Internet. The medical image processing program is recorded on a computer-readable non-transitory recording medium such as a hard disk, a flexible disk (FD), a CD-ROM, an MO, or a DVD, and is read from the recording medium by the computer. It can also be run by.

  According to at least one embodiment described above, the effect of image processing on an X-ray image can be enhanced.

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

1 Medical Image Processing System 10 X-Ray Diagnostic Device 110 Processing Circuit 110a Control Function 110b Collection Function 110c Display Control Function 110d Additional Function 110e Image Processing Function 110f Update Processing Function 30 Medical Image Processing Device 34 Processing Circuit 341 Control Function 342 Additional Function 343 Image Processing function 344 Display control function

Claims (23)

An adding unit that adds information corresponding to the position to each position on the two-dimensional X-ray image data obtained by X-ray imaging the object based on the three-dimensional medical image data of the object. ,
An image processing unit that performs image processing on each position of the two-dimensional X-ray image data according to the information added to the position, the medical image processing apparatus.   The medical image processing apparatus according to claim 1, wherein the adding unit adds, to each position on the two-dimensional X-ray image data, the information indicating a tissue or a device corresponding to the position. The adding unit projects the first information added to each position on the three-dimensional medical image data onto the two-dimensional X-ray image data, and thereby, for each position on the two-dimensional X-ray image data. Add the second information,
The medical image processing according to claim 1 or 2, wherein the image processing unit performs, on each position of the two-dimensional X-ray image data, the image processing according to the second information added to the position. apparatus. The adding unit adds a plurality of the second information corresponding to the plurality of the first information to a position where the plurality of the first information is projected in the two-dimensional X-ray image data,
The image processing unit performs image processing on a position of the two-dimensional X-ray image data to which the plurality of pieces of second information are added, in accordance with information having a high priority among the plurality of pieces of second information. The medical image processing apparatus according to claim 3.   The medical image processing apparatus according to claim 4, wherein the image processing unit determines the priority based on the two-dimensional X-ray image data.   The addition unit outputs the second information corresponding to high priority information among the plurality of first information to a position where the plurality of first information is projected in the two-dimensional X-ray image data. The medical image processing apparatus according to claim 3, which is added.   The adding unit projects the first information onto the two-dimensional X-ray image data in a state in which the three-dimensional medical image data and the two-dimensional X-ray image data are aligned with each other, so that the two-dimensional X-ray image is obtained. The medical image processing apparatus according to claim 3, wherein the second information is added to each position on the data.   The adding unit separates the three-dimensional medical image data into a blood vessel model and a non-blood vessel model, and aligns the non-blood vessel model with the two-dimensional X-ray image data to obtain the three-dimensional medical image data. The medical image processing apparatus according to claim 7, which aligns with the two-dimensional X-ray image data.   The adding unit aligns the region corresponding to the bone in the non-vascular model and the region corresponding to the bone in the two-dimensional X-ray image data to thereby obtain the three-dimensional medical image data and the two-dimensional image data. The medical image processing apparatus according to claim 8, which aligns with X-ray image data.   10. The adding unit identifies a region corresponding to a bone in the two-dimensional X-ray image data, using the plurality of two-dimensional X-ray image data captured by using X-rays having different energies. The medical image processing apparatus according to item 1.   The adding unit aligns the contour of the part included in the non-vascular model with the contour of the part included in the two-dimensional X-ray image data, and thereby the three-dimensional medical image data and the two-dimensional X-ray. The medical image processing apparatus according to any one of claims 8 to 10, which aligns with image data. The adding unit repeatedly executes alignment between the three-dimensional medical image data and the two-dimensional X-ray image data, and performs the alignment for each position on the two-dimensional X-ray image data every time alignment is performed. Add the second information,
The medical image according to any one of claims 7 to 11, wherein the image processing unit performs the image processing according to the newly added second information every time the second information is added. Processing equipment.   The addition unit is based on the arrangement of arms in an imaging system that collects the two-dimensional X-ray image data when at least one of the imaging position and the imaging angle of the two-dimensional X-ray image data for the subject changes. 12. The second information is added to each position on the two-dimensional X-ray image data by projecting the first information onto the two-dimensional X-ray image data. The medical image processing apparatus according to item 1.   The addition unit determines an arrangement of the arm and an arrangement of a top plate on which the subject is placed when at least one of an imaging position and an imaging angle of the two-dimensional X-ray image data with respect to the subject changes. The medical image according to claim 13, wherein the second information is added to each position on the two-dimensional X-ray image data by projecting the first information on the two-dimensional X-ray image data based on the first information. Processing equipment.   The medical image processing apparatus according to claim 3, wherein the adding unit adds the first information to each position on the three-dimensional medical image data by a substance discrimination process.   In the treatment plan of the procedure for inserting the device into the body of the subject, the addition unit sets the device information as the first information with respect to the position where the device is inserted among the positions on the three-dimensional medical image data. The medical image processing apparatus according to any one of claims 3 to 15, which adds information.   The update processing unit for updating the first information added to each position on the three-dimensional medical image data based on the two-dimensional X-ray image data, further comprising: an update processing unit. The medical image processing apparatus described.   18. The image processing unit according to claim 1, wherein, as the image processing, the contrast of a position to which blood vessel information is added among positions on the two-dimensional X-ray image data is emphasized. Medical image processing device.   As the image processing, the image processing unit uses a pixel value of a position to which bone information is added among positions on the two-dimensional X-ray image data as a pixel value of a background area in the two-dimensional X-ray image data. The medical image processing apparatus according to claim 1, which is to be replaced.   As the image processing, the image processing unit sets a pixel value of a position to which device information is added among positions on the two-dimensional X-ray image data as a pixel value of a background area in the two-dimensional X-ray image data. The medical image processing apparatus according to claim 1, which is to be replaced.   The medical image according to any one of claims 1 to 19, wherein the image processing unit emphasizes, as the image processing, a high frequency component at a position to which device information is added in the two-dimensional X-ray image data. Processing equipment. A collection unit that captures two-dimensional X-ray image data by imaging the subject with X-rays;
An adding unit that adds information corresponding to each position on the two-dimensional X-ray image data based on the three-dimensional medical image data of the subject;
An X-ray diagnostic apparatus comprising: an image processing unit that performs image processing on each position of the two-dimensional X-ray image data according to the information added to the position. Based on the three-dimensional medical image data of the subject, for each position on the two-dimensional X-ray image data obtained by X-ray imaging the subject, information corresponding to the position is added,
A medical image processing program that causes a computer to execute, for each position of the two-dimensional X-ray image data, image processing according to the information added to the position.

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