JP2024037685A - Medical image processing apparatus, x-ray diagnostic system, and medical image processing program - Google Patents

Abstract

PROBLEM TO BE SOLVED: To perform support so as to allow an operator to properly move an ultrasonic catheter.

SOLUTION: A medical image processing apparatus includes a first acquisition unit, a second acquisition unit, a detection unit and a calculation unit. The first acquisition unit acquires an ultrasonic image generated from a signal that is acquired by a detector of an ultrasonic catheter inserted into an object's body. The second acquisition unit acquires an X-ray image depicting the detector of the ultrasonic catheter and an imaging target that is at least one of a medical device inserted into the object's body and a region of interest inside the object's body. The detection unit detects a position of the detector of the ultrasonic catheter depicted in the X-ray image and a position of the imaging target depicted in at least one of the ultrasonic image and the X-ray image. The calculation unit calculates moving support information for moving the ultrasonic catheter in a manner such that the imaging target is included within a field of view of the detector on the basis of the detected positions of the detector of the ultrasonic catheter and the imaging target.

SELECTED DRAWING: Figure 7

COPYRIGHT: (C)2024,JPO&INPIT

Description

Embodiments disclosed in this specification and drawings relate to a medical image processing device, an X-ray diagnostic system, and a medical image processing program.

Conventionally, different types of medical image diagnostic equipment such as X-ray diagnostic equipment, ultrasound diagnostic equipment, X-ray CT (Computed Tomography) equipment, and magnetic resonance imaging equipment have been used to improve treatment accuracy and They may be used together to improve efficiency. One example is the combined use of an X-ray diagnostic device and an ultrasound diagnostic device in image-guided therapy (IVR: Interventional Radiology) using a catheter.

An X-ray diagnostic device is a device that transmits X-rays into a subject and converts the transmitted image into an image. For example, in IVR using a catheter, a doctor inserts a catheter into a subject while confirming the position of the catheter in a blood vessel from a fluoroscopic image or a captured image by an X-ray diagnostic device such as an X-ray angiography device. After the catheter has advanced to the treatment target site (or diagnosis target site) of the subject, ultrasound images are used to visualize tissues that are difficult to identify from X-ray fluoroscopic images and photographed images, such as soft tissue. May be used together.

Transesophageal echocardiography (TEE) has also been used for catheter treatment of structural heart disease (SHD) such as left atrial appendage obstruction, and for observation of the anatomical structure and physiological function of the heart and large blood vessels. Transesophageal echocardiography) is known to be useful. However, since TEE is a test in which an ultrasound endoscope is inserted into the esophagus through the mouth and the heart is observed through the esophagus, general anesthesia of the subject is generally required. In contrast, intracardiac catheter echocardiography (ICE), which is a type of ultrasound catheter with a built-in phased array element at its tip that transmits and receives ultrasound waves, can be performed under local anesthesia, so TEE It is less invasive to the subject. Therefore, ICE used in combination with an X-ray diagnostic device is attracting attention in SHD treatment and the like.

However, in general, the area of the ultrasound image generated from the signals collected by ICE, that is, the imaging area of ICE (hereinafter referred to as the field of view), is narrower than that of TEE, so it cannot be used as an area of interest in SHD treatment, etc. Part or all of an affected area, such as a certain left atrial appendage, or a medical device, such as a left atrial appendage closure device, may be out of the field of view of the ICE. When part or all of the region of interest is out of the field of view of the ICE, the operator needs to advance the ICE appropriately so that the region of interest is drawn within the field of view of the ICE.

In addition, even if the treatment target area or medical device, which is the area of interest, is depicted in a part of the field of view of the ICE, it is possible to check the placement status of the medical device from the field of view of the ICE in a two-dimensional manner. Searching and displaying ultrasound images is a tedious task. Furthermore, if part or all of the region of interest is not visualized within the field of view of the ICE, a two-dimensional ultrasound image of the region of interest must be searched while the ICE is advanced, which is a burden to the operator. is large.

On the other hand, in recent years, catheter procedure support robots have also been developed to support procedures using catheters. Catheter procedure support robots have been developed with the aim of making it possible to perform catheter procedures from a remote location, or with the aim of fully or semi-automating catheter procedures. That is, the above-mentioned operator may become a catheter operation support robot.

Japanese Patent Application Publication No. 2020-005785

One of the problems that the embodiments disclosed herein and in the drawings seek to solve is to assist an operator in properly navigating an ultrasound catheter. However, the problems to be solved by the embodiments disclosed in this specification and the drawings are not limited to the above problems. Problems corresponding to the effects of each configuration shown in each embodiment described later can also be positioned as other problems.

A medical image processing apparatus according to one embodiment includes a first acquisition section, a second acquisition section, a detection section, and a calculation section. The first acquisition unit acquires an ultrasound image generated from signals collected by a detector of an ultrasound catheter inserted into the body of the subject. The second acquisition unit includes a detector of the ultrasound catheter, a medical device inserted into the body of the subject, and an imaging target that is at least one of a region of interest in the body of the subject. Get the image. The detection unit detects (a) the position of the detector of the ultrasound catheter depicted in the X-ray image; (b) the position of the imaging target depicted in at least one of the ultrasound image and the X-ray image; Detect. The calculation unit provides advancement support for advancing the ultrasound catheter so that the imaging target enters the field of view of the detector, based on the detected position of the detector of the ultrasound catheter and the position of the imaging target. information or advancement support information for advancing the ultrasound catheter so that the imaging target approaches the center of the field of view of the detector.

1 is a first schematic diagram showing a configuration example of an X-ray diagnostic system including a medical image processing apparatus according to a first embodiment; FIG. FIG. 2 is a second schematic diagram showing a configuration example of an X-ray diagnostic system including the medical image processing apparatus according to the first embodiment. FIG. 3 is a diagram for explaining an example of a surgical site according to the first embodiment. The first diagram for explaining an example of the procedure according to the first embodiment. The second diagram for explaining an example of the procedure according to the first embodiment. FIG. 1 is a schematic diagram for explaining a configuration example of a medical image processing apparatus according to a first embodiment. FIG. 2 is a flowchart illustrating an example of the operation of the medical image processing apparatus according to the first embodiment. FIG. 3 is a diagram for explaining X-ray image capturing according to the first embodiment. FIG. 3 is a diagram for explaining position information of an ultrasound detector and a field of view in an ultrasound image according to the first embodiment. An example of (a) before advancement support and (b) after advancement support will be explained regarding advancement support for an ultrasound catheter when all of the medical devices according to the first embodiment are out of the field of view of the detector of the ultrasound catheter. A perspective view for Regarding the advancement support of the ultrasound catheter when a part of the medical device according to the first embodiment is out of the field of view of the detector of the ultrasound catheter, an example of (a) before advancement support and (b) after advancement support is shown below. A perspective view for explaining. FIG. 7 is a diagram showing, as a flowchart, an example of the operation of the medical image processing apparatus according to Modification 1 of the first embodiment. FIG. 2 is a schematic diagram for explaining a configuration example of a medical image processing apparatus according to a second embodiment. FIG. 7 is a diagram showing, as a flowchart, an example of the operation of the medical image processing apparatus according to the second embodiment. FIG. 7 is a diagram for explaining an example of ultrasound images and their output order according to the second embodiment. FIG. 6 is a perspective view for explaining an example of (a) before advancement support and (b) after advancement support in which the ultrasound catheter 3 is advanced based on the ultrasound image according to the second embodiment. FIG. 3 is a schematic diagram showing a configuration example of an X-ray diagnostic system in which a medical image processing device and a support robot according to a third embodiment are provided. FIG. 7 is a schematic diagram for explaining a configuration example of a medical image processing apparatus according to a third embodiment.

Hereinafter, embodiments of a medical image processing device, an X-ray diagnostic system, and a medical image processing program will be described in detail with reference to the drawings.

(First embodiment)
FIG. 1 is a first schematic diagram showing a configuration example of an X-ray diagnostic system 1 including a medical image processing apparatus according to the first embodiment. For example, as shown in FIG. 1, an X-ray diagnostic system 1 includes a medical image processing device 100 and an X-ray diagnostic device 200. The medical image processing apparatus 100 and the X-ray diagnostic apparatus 200 are connected to each other via a network 2. Further, an ultrasound diagnostic apparatus 300 is also connected to the network 2 .

FIG. 2 is a second schematic diagram showing a configuration example of the X-ray diagnostic system 1 including the medical image processing apparatus according to the first embodiment. FIG. 2 shows a schematic diagram of a configuration example of an X-ray diagnostic apparatus 200 according to the first embodiment and an ultrasound diagnostic apparatus 300 connected to the X-ray diagnostic system 1.

As shown in FIG. 2, the X-ray diagnostic apparatus 200 according to the first embodiment includes a gantry device 210, a bed 220, a controller 230, and an image processing device 240. The gantry device 210, bed 220, and controller 230 are generally installed in a procedure room (examination/treatment room), while the image processing device 240 is installed in a control room adjacent to the procedure room.

The gantry device 210 includes an X-ray high voltage generator 211, an X-ray irradiation device 212, a top plate (catheter table) 221, a C-arm 214, an X-ray detection device 215, a C-arm drive control mechanism 231, and a bed drive control mechanism 232. have.

X-ray irradiation device 212 is provided at one end of C-arm 214. The X-ray irradiation device 212 is provided so as to be movable back and forth under the control of a controller 230. The X-ray irradiation device 212 includes an X-ray source 216 (for example, an X-ray tube) and a movable aperture device 217. The X-ray tube receives supply of high voltage power from the X-ray high voltage generator 211 and generates X-rays according to the conditions of the high voltage power. The movable aperture device 217 movably supports aperture blades made of a substance that blocks X-rays at the X-ray irradiation port of the X-ray tube. Note that a radiation quality adjustment filter may be provided on the front surface of the X-ray tube to adjust the radiation quality of the X-rays generated by the X-ray tube.

The X-ray detection device 215 is provided at the other end of the C-arm 214 so as to face the X-ray irradiation device 212 . The X-ray detection device 215 is provided so as to be movable back and forth under the control of the controller 230. The X-ray detection device 215 includes an FPD (Flat Panel Detector) 218 and an ADC (Analog to Digital Converter) 219.

FPD 218 has a plurality of detection elements arranged two-dimensionally. Between each detection element of FPD218, it is arranged so that a scanning line and a signal line may cross at right angles. Note that a grid may be provided on the front surface of the FPD 218.
The ADC 219 converts projection data of a time-series analog signal (video signal) output from the FPD 218 into a digital signal, and outputs the digital signal to the image processing device 240.

The C-arm 214 arranges an X-ray irradiation device 212 and an X-ray detection device 215 to face each other with the subject at the center. Under the control of a controller 230, the C-arm 214 moves the X-ray irradiation device 212 and the X-ray detection device 215 together in an arc in the arc direction of the C-arm 214 by a C-arm drive control mechanism 231. In addition, although the X-ray diagnostic apparatus 200 includes a C-arm 214 and the C-arm 214 operates the X-ray irradiation apparatus 212 and the X-ray detection apparatus 215 as an example, the present invention is not limited to this case. do not have. For example, the X-ray diagnostic apparatus 200 may not include the C-arm 214, and the X-ray irradiation apparatus 212 and the X-ray detection apparatus 215 may be operated independently.

FIG. 2 shows an example of the configuration of a single-plane type X-ray diagnostic apparatus 200 having only one C-arm. The X-ray diagnostic apparatus 200 may be a plain type.

The bed 220 is supported on the floor and supports the top plate 221. The bed 220 can slide (in the X and Z axis directions), move up and down (in the Y axis direction), and roll the top plate 221 by the bed drive control mechanism 232 under the control of the controller 230 . Note that the case where the gantry device 210 is an undertube type in which the X-ray irradiation device 212 is located below the top plate 221 will be described, but it is an overtube type in which the X-ray irradiation device 212 is located above the top plate 221. It may be a case.

The controller 230 includes a CPU (Central Processing Unit) and memory (not shown). The controller 230 controls the driving of the X-ray irradiation device 212, the X-ray detection device 215, and the C-arm 214 of the gantry device 210, and the driving of the bed 220 for positioning according to the control of the image processing device 240. . The controller 230 also operates the X-ray irradiation device 212, the X-ray detection device 215, the C-arm drive control mechanism 231, etc. for X-ray photography and X-ray fluoroscopy for procedures according to the control of the image processing device 240. control.

The image processing device 240 is configured based on a computer, and includes a processing circuit 241, a storage circuit 242, an input interface 243, a network interface 244, and a display 250.

The processing circuit 241 has a dedicated or general-purpose processor, and is a circuit that controls the operation of the entire X-ray diagnostic apparatus 200 through software processing by executing a program stored in the storage circuit 242. The controller 230 is controlled based on input from an operator via the controller 230, execution of various programs read from the storage circuit 242, and various data. Furthermore, the processing circuit 241 generates an X-ray image (a fluoroscopic image or a photographed image) of the subject P based on the signal acquired by the gantry device 210, and generates an X-ray image for display stored in the storage circuit 242. The X-ray diagnostic apparatus 200 is controlled to display information on the display 250 or the like.

The storage circuit 242 stores various programs for controlling the controller 230, image processing, display processing, etc., diagnostic information, various data such as diagnostic protocols, image data, and the like. The storage circuit 242 is realized by, for example, a semiconductor memory element such as a RAM (Random Access Memory) or a flash memory, a hard disk, an optical disk, or the like.

The network interface 244 is an interface for communicating with various devices connected to the network 2 by wire or wirelessly. For example, the X-ray diagnostic apparatus 200 can exchange various data and images with the medical image processing apparatus 100, the ultrasound diagnostic apparatus 300, and the like via the network interface 244.

The input interface 243 includes an input device that can be operated by an operator and an input circuit that inputs signals from the input device. Input devices include mice, keyboards, touchpads that perform input operations by touching the operating surface, touchscreens that integrate the display screen and touchpad, non-contact input circuits using optical sensors, voice input circuits, etc. Realized.

The display 250 displays a GUI for receiving instructions from an operator using the input interface 243, an X-ray image generated by the image processing device 240, and the like. Further, the display 250 displays various messages and display information in order to notify the operator of the processing status and processing results of the X-ray diagnostic apparatus 200. Further, the display 250 may have a speaker and may be able to output audio. The display 250 can also display various support images and support information generated by the medical image processing device 100 to support the procedure, such as data and images received from various devices connected to the network 2. You can also do it.

On the other hand, as shown in FIG. 2, the ultrasonic diagnostic apparatus 300 includes an ultrasonic catheter 3 in addition to an ultrasonic apparatus main body 310, an input interface 320, and a display 330. The ultrasound catheter 3 is communicably connected to the ultrasound device main body 310.

The ultrasound device main body 310 is configured based on a computer, and includes a transmitting/receiving circuit 311, a processing circuit 312, a storage circuit 313, and a network interface 314.

The transmitting/receiving circuit 311 supplies an ultrasonic drive signal to the ultrasound catheter 3 and generates reflected wave data from the reflected wave signal received by the ultrasound catheter 3.

The processing circuit 312 is a circuit that has a dedicated or general-purpose processor and controls the overall operation of the ultrasound diagnostic apparatus 300 through software processing by executing a program stored in the storage circuit 313. The processing of the transmitting/receiving circuit 311 is controlled based on the input from the operator via the memory circuit 313, the execution of various programs read from the storage circuit 313, and various data. Furthermore, the processing circuit 312 generates ultrasound image data based on the reflected wave signal received by the ultrasound catheter 3, and generates an ultrasound image for display from the generated ultrasound image data. Furthermore, the processing circuit 312 controls the ultrasound diagnostic apparatus 300 to display the display ultrasound image stored in the storage circuit 313 on the display 330 or the like.

The storage circuit 313 stores various programs for transmitting and receiving ultrasonic waves, image processing, and display processing, various data such as diagnostic information and diagnostic protocols, reflected wave data, image data, and the like. The storage circuit 120 is realized by, for example, a semiconductor memory element such as a RAM (Random Access Memory) or a flash memory, a hard disk, an optical disk, or the like.

The network interface 314 is an interface for communicating with various devices connected to the network 2 by wire or wirelessly. For example, the ultrasonic diagnostic apparatus 300 can exchange various data with the medical image processing apparatus 100, the X-ray diagnostic apparatus 200, etc. via the network interface 314.

The input interface 320 includes an input device that can be operated by an operator and an input circuit that inputs signals from the input device. Input devices include mice, keyboards, touchpads that perform input operations by touching the operating surface, touchscreens that integrate the display screen and touchpad, non-contact input circuits using optical sensors, voice input circuits, etc. Realized.

The display 330 displays a GUI for receiving instructions from an operator using the input interface 320, an ultrasound image generated in the ultrasound apparatus main body 310, and the like. Further, the display 330 displays various messages and display information in order to notify the operator of the processing status and processing results of the ultrasound apparatus main body 310. Further, the display 330 may include a speaker and may be able to output audio. The display 330 can also display various support images and support information generated by the medical image processing device 100 to support the procedure, such as data and images received from various devices connected to the network 2. You can also do it.

In FIG. 2, an ultrasound catheter 3 used for the procedure is also illustrated. In this specification, the ultrasound probe inserted into the heart chamber of the subject P and communicably connected to the ultrasound device main body 310 is mainly referred to as the ultrasound catheter 3. For example, the ultrasound catheter 3 may be inserted into a body cavity from the femoral vein, advanced into the heart, and scan the left atrium, left atrial appendage, aorta, mitral valve, aortic valve, etc. to generate ultrasound images. There are ICEs etc. that can do this. In addition, the ultrasound catheter 3 may be a device that is inserted into a tubular tissue such as a blood vessel of the subject P and scans the tubular tissue or the like to generate an ultrasound image.

The ultrasound catheter 3 is inserted into the body cavity of the subject P and operated within the body cavity. As shown in FIG. 9, the ultrasound catheter 3 has a detector 30 at its tip, and an array surface 31 of the detector 30 has a plurality of piezoelectric elements. The plurality of piezoelectric elements generate ultrasonic waves based on a drive signal supplied from the ultrasound device main body 310 via the cable 32, and also receive reflected waves from the subject P and convert them into electrical signals. The array surface 31 is a two-dimensional array that can scan a three-dimensional space. Further, the array surface 31 may be a one-dimensional array that can scan a two-dimensional space.

In FIG. 2, a catheter 4 for a procedure according to the first embodiment used for a procedure is also illustrated. In this specification, the term ``procedure'' refers to a thin medical device that is inserted into a body cavity of a subject P or into a tubular tissue such as a blood vessel to support treatment, diagnosis, or treatment (i.e., a treatment process). It shall be referred to as catheter 4. The procedure catheter 4 includes, for example, a thin tube called a catheter, a guide wire for guiding the catheter to a treatment target site, and a medical device 40 attached to the distal end of the catheter.

The device operation section 41 is an instrument that a medical technician such as a doctor manually operates to insert the surgical catheter 4 into the blood vessel of the subject P and advance it to a predetermined target site. Here, the predetermined target site is a site that performs treatment, diagnosis, or supports the treatment process, and can also be referred to as a region of interest within the body of the subject P.
The medical device 40 is a member used at a predetermined target site where treatment is performed after the surgical catheter 4 is inserted into the body of the subject P. Examples of the medical device 40 include devices such as occlusion devices, balloons, and stents (eg, medical device 40a in FIG. 5).

The medical device 40 may also be a member that is used at a predetermined target site in the treatment process after the procedure catheter 4 is inserted into the body of the subject P. The medical device 40 may be a puncture needle (for example, the medical device 40b in FIG. 4) or the like. Note that one surgical catheter 4 may be equipped with a plurality of medical devices 40.

3 to 5 are diagrams for explaining an example of a surgical site according to the first embodiment, and a septal puncture and a left atrial appendage occlusion technique, which are examples of the surgical procedure according to the first embodiment, respectively. It is. In the left atrial appendage occlusion procedure, the ultrasound catheter 3 and the procedure catheter 4 are generally inserted into the body of the subject P through a blood vessel, and then inserted into the right atrium, the left atrium, and the vicinity of the left atrial appendage, which is the treatment target site. will proceed to.

Specifically, as shown in FIG. 4, septal puncture is performed in order for the ultrasound catheter 3 and the procedure catheter 4 to proceed to the vicinity of the left atrial appendage, which is the treatment target site. Core puncture is a procedure in which a hole is made in the atrial septum with a puncture needle during the treatment process. The operator observes the medical device 40b and/or a predetermined target site to be treated during the treatment process. For this purpose, the operator operates both the ultrasound catheter 3 and the procedure catheter 4 to move the ultrasound catheter to a position where both the medical device 40 and the target area to be treated in the treatment process can be visualized well. 3 will proceed. For example, in septal puncture, the vicinity of the atrial septum is observed with the ultrasound catheter 3 as a region of interest within the body of the subject P.

Subsequently, after the septal puncture, as shown in FIG. 5, first, the size of the left atrial appendage, which is the treatment target site, is measured using the ultrasound catheter 3 in order to determine the size of the occlusion device. Second, an occlusion device appropriate to the size of the left atrial appendage is navigated into the left atrium. Third, a contrast agent is flushed to observe the shape of the left atrial appendage on the X-ray image just before the occlusion device is placed. Fourth, the occlusion device at the tip of the procedure catheter 4 is deployed and placed so that the left atrial appendage is occluded. In the fourth step, the operator observes the condition of the treatment target site, such as the state of close contact between the left atrial appendage and the occlusion device, and performs measures such as re-indwelling the occlusion device depending on the observation situation.

That is, in the fourth step, the operator operates both the ultrasound catheter 3 and the procedure catheter 4 in order to observe the medical device 40 and/or the predetermined target site to be treated. , the ultrasound catheter 3 is advanced to a position where both the medical device 40 and the treatment target site are well visualized. For example, in a left atrial appendage occlusion procedure, the vicinity of the left atrial appendage is observed with the ultrasound catheter 3 as a region of interest within the body of the subject P.

Note that in FIGS. 3 to 5, the left atrial appendage occlusion technique and the occlusion device have been described as an example of the procedure according to the first embodiment, but the present embodiment describes intracardiac procedures other than the left atrial appendage occlusion technique, for example, It does not exclude other procedures or course of treatment procedures, such as atrial septal defect occlusion, mitral valve occlusion, balloon aortic valvuloplasty. Furthermore, medical devices 40 other than puncture needles and occlusion devices are not excluded. Further, although the treatment process and treatment using the medical device 40 have been described as an example of a procedure according to the first embodiment, this embodiment does not exclude diagnosis and the like using the medical device 40.

FIG. 6 is a schematic diagram for explaining a configuration example of a medical image processing apparatus according to the first embodiment. As shown in FIG. 6, the medical image processing apparatus 100 according to the first embodiment can be connected to an X-ray diagnostic apparatus 200 and an ultrasound diagnostic apparatus 300, and is connected to a computer such as a workstation or a personal computer. Constructed as. The medical image processing apparatus 100 provides images and information for supporting a surgical procedure to a medical technician.

The medical image processing apparatus 100 includes at least a processing circuit 110, a storage circuit 120, an input interface 130, and a network interface 140.

Furthermore, the medical image processing apparatus 100 may further include a display 150. The display 150 provides the operator with progress support information for the ultrasound catheter 3 generated by the medical image processing apparatus 100. The display 150 may be, for example, a large display device placed in a position that is easily visible to the operator, and may have a speaker and be able to output progress support information in audio form. In addition to data such as progress support information generated by the processing circuit 110, the display 150 also displays various images such as images generated by the medical image processing device 100 to support a procedure, and images connected to the network 2. It is also possible to display data, images, etc. received from various devices.

The network interface 140 is an interface for communicating with various devices connected to the network 2 by wire or wirelessly. For example, the medical image processing apparatus 100 can exchange various data with an X-ray diagnostic apparatus 200, an ultrasound diagnostic apparatus 300, etc. via the network interface 140.

The input interface 130 includes an input device that can be operated by an operator and an input circuit that inputs signals from the input device. Input devices include mice, keyboards, touchpads that perform input operations by touching the operating surface, touchscreens that integrate the display screen and touchpad, non-contact input circuits using optical sensors, voice input circuits, etc. Realized.

The memory circuit 120 is configured by, for example, a semiconductor memory element such as a RAM (Random Access Memory), a flash memory, a hard disk, an optical disk, or the like. The storage circuit 120 stores various processing programs used in the processing circuit 110 (including an OS (Operating System) and the like in addition to application programs) and data necessary for executing the programs. Furthermore, the storage circuit 120 can store various data such as image data input via the input interface 130 and the network interface 140.

The processing circuit 110 has a dedicated or general-purpose processor, and implements various functions described below through software processing by executing a program stored in the storage circuit 120.

The processing circuit 110 realizes each function of a first acquisition function F01, a second acquisition function F02, a detection function F03, a determination function F04, and a calculation function F05.

Each of these functions will be explained using the flowchart shown in FIG. 7 and the explanatory diagrams shown in FIGS. 8 to 11. FIG. 7 is a flowchart showing an example of the operation of the medical image processing apparatus 100 or a medical image processing program according to the first embodiment.

In step ST10, the detector 30 of the ultrasound catheter 3 inserted into the body of the subject P to be diagnosed or treated acquires an ultrasound image generated from signals collected by the ultrasound diagnostic apparatus 300. The process of acquiring the ultrasound image of the subject P in step ST10 is performed by the first acquisition function F01.

In step ST11, an X-ray image of the subject P to be diagnosed or treated is acquired using the X-ray diagnostic apparatus 200. The X-ray image acquired in step ST11 is obtained by imaging at least one of the detector 30 of the ultrasound catheter 3, the medical device 40 inserted into the body of the subject P, and the region of interest inside the body of the subject P. This is an X-ray image depicting an object.
Further, FIG. 8 is a diagram for explaining X-ray image capturing according to the first embodiment. As shown in FIG. 8, the X-ray image in step ST11 is a captured image (still image) or a fluoroscopic image (video) that is captured by irradiating X-rays from at least two directions so as to include the same region. be. The process of acquiring the X-ray image data of the subject P in step ST11 is performed by the second acquisition function F02.

In step ST12, the position of the detector 30 of the ultrasound catheter 3 depicted in the X-ray image acquired in step ST11 is detected. From the plurality of X-ray images including the same region acquired in step ST11, the position of the detector 30 of the ultrasound catheter 3 in, for example, the X-ray coordinate system is specified, for example, based on the principle of a stereo camera. The process of detecting the position of the detector 30 of the ultrasound catheter 3 in step ST12 is performed by the detection function F03. As shown in Figure 2, the X-ray coordinate system here refers to the three body axes: the X-axis is the left-right axis of the subject, the Y-axis is the dorsal-ventral axis, and the head-foot axis is the X-axis. Let be right-handed coordinates with the Z axis as the Z axis.

FIG. 9 is a diagram for explaining the position information of the ultrasound detector and the field of view in the ultrasound image according to the first embodiment. As shown in FIG. 9, the position information of the detector 30 of the ultrasound catheter 3 includes, for example, the barycenter position of the detector 30 of the ultrasound catheter 3 in the X-ray coordinate system, and the array of the detectors 30 extending from the barycenter position. There is a normal vector of the surface 31.

Further, in FIG. 9, the array surface 31 of the detector 30 of the ultrasound catheter 3 is a two-dimensional array. In this specification, a plurality of fan-shaped two-dimensional ultrasound waves are generated from collected ultrasound data while the position of the detector 30 of the ultrasound catheter 3 and the angle of the array surface 31 of the detector 30 are fixed. Each image is called a "view." Further, a range corresponding to a three-dimensional ultrasound image obtained by superimposing all the multiple "views", that is, a range corresponding to a set of all "views" is called a "field of view".
The "field of view" can be calculated if the scanning range of the detector 30 is determined while the position of the detector 30 of the ultrasound catheter 3 and the angle of the array surface 31 of the detector 30 are fixed.

Returning to FIG. 7, in step ST13, the ultrasound catheter 3 is detected as the imaging target, which is at least one of the medical device 40 and the region of interest inside the subject's body, using the ultrasound image acquired in step ST10. It is determined whether the object is within the field of view of the device 30. Specifically, when the imaging target that is at least one of the medical device 40 and the region of interest inside the subject's body is depicted in the ultrasound image acquired in step ST10, the imaging target is located on the detector 30. It is determined that it is within the field of view. Further, when the imaging target, which is at least one of the medical device 40 and the region of interest inside the subject's body, is not depicted in the ultrasound image acquired in step ST10, the imaging target is within the field of view of the detector 30. It is determined that it is not included. The process of determining whether or not the object to be imaged in step ST13 is within the field of view of the detector 30 of the ultrasound catheter 3 is performed by the determination function F04.

Also, when the "field of view" is composed of one "view", that is, when the field of view of the detector 30 is two-dimensional, the object to be imaged in step ST13 is within the field of view of the detector 30 of the ultrasound catheter 3. It is possible to perform processing to determine whether or not the

Step ST14 is performed when step ST13 is YES, that is, a part or all of the imaging target, which is at least one of the medical device 40 and the region of interest inside the subject's body, is detected by the detector 30 of the ultrasound catheter 3. This is done when it is within the field of view. In step ST14, from at least one of the ultrasound image acquired in step ST10 and the X-ray image acquired in step ST11, the imaging target, which is at least one of the medical device 40 and the region of interest inside the subject's body, is determined. Detect the position of. The process of detecting the position of the object to be imaged in step ST14 is performed by the detection function F03.

When detecting the position of the medical device 40 in step ST14 from the ultrasound image acquired in step ST10, the position of the medical device 40 depicted in the ultrasound image, for example, the position of the medical device 40 within the field of view. From this, the center of gravity position of the medical device 40 in the X-ray coordinate system is detected.

For example, when the medical device 40 depicted in the ultrasound image does not include its center of gravity, such as when only the end portion of the medical device 40 is depicted in the ultrasound image, the medical device 40a in FIG. 5 is used as an example. Explain. As shown in FIG. 5, the size of the treatment target region that can be the diameter L of the medical device 40a (40) and the shape of the medical device 40a (40) after deployment (for example, a sphere, an ellipsoid, a donut shape, a cylindrical shape, etc.) are shown. ), the center of gravity position of the medical device 40a (40) in the X-ray coordinate system may be estimated. The size of the treatment target region can be determined using, for example, data measured when determining the size of the medical device 40a (40), or an X-ray image taken to see the shape of the treatment target region immediately before placing the medical device 40a (40). etc. can be used.

When detecting the position of the imaging target, which is at least one of the medical device 40 and the region of interest inside the subject's body in step ST14, from the X-ray image acquired in step ST11, The position of the center of gravity in the X-ray coordinate system of the imaging target, which is at least one of the medical device 40 and the region of interest inside the subject's body, may be detected from a plurality of X-ray images, for example, using the principle of a stereo camera. good.

Step ST15 is performed if step ST13 is NO, that is, the imaging target, which is at least one of the medical device 40 and the region of interest inside the subject's body, is within the field of view of the detector 30 of the ultrasound catheter 3. It is done if there is no. In step ST15, the position of the imaging target, which is at least one of the medical device 40 and the region of interest inside the subject's body depicted in the X-ray image acquired in step ST11, is detected. From the plurality of X-ray images acquired in step ST11, for example, based on the principle of a stereo camera, the position of the imaging target, which is at least one of the medical device 40 and the region of interest inside the subject's body, is determined. The position of the center of gravity in the X-ray coordinate system is detected. The process of detecting the position of the object to be imaged in step ST15 is performed by the detection function F03.

In step ST16, the normal vector calculated from the position of the center of gravity of the array surface 31 constituting the detector 30 and the direction of the array surface 31, which is the position of the detector 30 of the ultrasound catheter 3 detected in step ST12, and The field of view of the detector 30 is calculated from a predetermined scanning range (ie, a known scanning range) of the detector 30. As shown in FIG. 9, the field of view of the detector 30 is from the scanning range of the detector 30 when the position of the detector 30 of the ultrasound catheter 3 and the angle of the array surface 31 of the detector 30 are fixed. Calculable. The process of calculating the field of view of the detector 30 of the ultrasound catheter 3 in step ST16 is performed by the calculation function F05.

In step ST17, based on the position of the detector 30 of the ultrasound catheter 3 and the imaging target that is at least one of the medical device 40 and the region of interest inside the subject's body, it is determined that the imaging target is the ultrasound catheter. Progress support information for advancing the ultrasound catheter 3 so as to enter the field of view of the detector 30 of No. 3 is calculated. Alternatively, the ultrasound catheter 3 is advanced so that the imaging target, which is at least one of the medical device 40 and the region of interest inside the subject's body, approaches the center of the field of view of the detector 30 of the ultrasound catheter 3. Calculate support information. The process of calculating the advancement support information for the ultrasound catheter 3 in step ST17 is performed by the calculation function F05.

FIGS. 10 and 11 respectively show assistance in advancing the ultrasound catheter 3 when part or all of the medical device 40 according to the first embodiment is visible from the field of view of the detector 30 of the ultrasound catheter 3. It is a perspective view for explaining an example (a) before progress support, and (b) after progress support.

Hereinafter, with reference to FIGS. 10 and 11, step ST17 will be described for the case where the imaging target is the medical device 40. However, the object to be imaged is not limited to the medical device 40. The object to be imaged may be a region of interest within the body of the subject, or may include both the medical device 40 and the region of interest within the body of the subject; Alternatively, even if the entire ultrasound catheter 3 is out of the field of view of the detector 30 of the ultrasound catheter 3, the ultrasound catheter 3 can be supported in its advancement.

As shown in FIGS. 10(a) and 11(a), in step ST17, if a part or all of the medical device 40 is out of the field of view of the detector 30 of the ultrasound catheter 3, the medical device 40 is within the field of view of the detector 30 of the ultrasound catheter 3, or the medical device 40 approaches the center of the field of view of the detector 30 of the ultrasound catheter 3. , the traveling direction, and the angle of the array surface 31 of the detector 30 are calculated. In addition, in this specification, the amount of advance and the direction of advance may be the amount of retreat and the direction of retreat. In other words, the amount of movement and the direction of movement can be said to be the amount of movement and the direction of movement.

Further, in step ST17, even if the medical device 40 is moved from a state where the entire medical device 40 is within the field of view of the detector 30 of the ultrasound catheter 3, some or all of the medical device 40 is The amount and direction of travel of the ultrasound catheter 3 or the angle of the array surface 31 of the detector 30 can be calculated so that the ultrasound catheter 3 does not go out of the field of view of the detector 30 .

As shown in FIGS. 10(a) and 11(a), the amount of movement and direction of movement of the ultrasonic catheter 3 are determined by, for example, the position of the center of gravity of the detector 30 of the ultrasonic catheter 3 in the X-ray coordinate system. This is the amount of movement from (x1, y1, z1) to position (x2, y2, z2). Further, the angle of the array surface 31 of the detector 30 is the amount of rotation around the axis of the detector 30.

If part or all of the medical device 40 is not within the field of view of the detector 30, for example, the center of gravity position of the medical device 40 in the X-ray coordinate system known in step ST14 or step ST15 and the medical device 40 and the shape of the medical device 40 after deployment, the overlap between the field of view of the detector 30 and the entire medical device 40 in three-dimensional space can be determined. From the overlap, the amount and direction of movement of the ultrasound catheter 3 required to overlap all of the medical devices 40 in the field of view of the detector 30 in three-dimensional space, and the angle of the array surface 31 of the detector 30 are calculated. can.

The amount and direction of movement of the ultrasonic catheter 3 and the angle of the array surface 31 of the detector 30 are determined so that the entire medical device 40 can be "maximally accommodated" within the field of view of the detector 30 of the ultrasonic catheter 3. It is preferable that the amount is . As used herein, "to the maximum extent" means that the entire medical device 40 is within the field of view of the detector 30 of the ultrasound catheter 3, and furthermore, the medical device 40 is within the field of view of the detector 30 as much as possible. This is a state that is greatly depicted.

When a part of the medical device 40 is within the field of view of the detector 30 of the ultrasound catheter 3, the direction of movement of the ultrasound catheter 3 is determined by which view in the plurality of ultrasound images acquired in step ST10. It may be determined based on whether the medical device 40 is depicted in the image. For example, if the field of view of the detector 30 of the ultrasound catheter 3 is comprised of 10 views from view V1 to view V10, and the medical device 40 is depicted only in view V1 and view V2, then , assuming that the medical device 40 is outside the field of view of the detector 30 on the view V1 side, the direction in which the view V2, the view V1, and the outside of the field of view of the detector 30 on the view V1 side are depicted is taken as the traveling direction of the ultrasound catheter 3. Good too. Note that the number of views is not limited to ten.

Further, the advancement support information of the ultrasound catheter 3 includes information for determining the advancement speed of the ultrasound catheter 3 suitable for the tissue or organ of the subject P at the position of the tip of the ultrasound catheter 3, and the determined advancement speed. Information regarding a recommended route for advancing the ultrasound catheter 3 based on the speed, or for advancing the ultrasound catheter 3 in a detour manner so as not to collide with the tissues or organs of the subject P may be included.

Returning to FIG. 7, in step ST18, the advancement support information for the ultrasound catheter 3 calculated in step ST17 is output. The advancement support information for the ultrasound catheter 3 is output to and displayed on the display 150. Further, the advancement support information for the ultrasound catheter 3 is output to at least one of the display 250 provided in the X-ray diagnostic apparatus 200 and the display 330 provided in the ultrasound diagnostic apparatus 300, and is displayed on these displays. It's okay.

The output of the advancement support information of the ultrasound catheter 3 that is output to the display includes at least one of the advancement support information calculated in step ST17.
By providing the procedure support information for the ultrasound catheter 3 to the operator, the number of operations on the ultrasound catheter 3 is reduced, and it is expected that the workflow will be improved so that the operator can concentrate on operating the procedure catheter 4 more.

In the first embodiment, step ST10, step ST11, and step ST12 may be performed in the order in which step ST12 is performed after step ST11, and are not limited to the order in which step ST10, step ST11, and step ST12 are performed. The order may be ST12, step ST10, or step ST11, step ST10, step ST12.

(Modification 1 of the first embodiment)
FIG. 12 is a flowchart showing an operation example of the medical image processing apparatus or a medical image processing program according to the first modification of the first embodiment. As shown in FIG. 12, the step following step ST12 may be set as step ST15 without performing step ST13.

(Second embodiment)
FIG. 13 is a diagram showing a configuration example of a medical image processing apparatus 100 according to the second embodiment. The difference between the second embodiment (FIG. 13) and the first embodiment (FIG. 7) is that the processing circuit 110 of the medical image processing apparatus 100 shown in FIG. 13 has an image output function F06. It is. The image output function F06 is a function to output an ultrasound image.

Further, FIG. 14 is a flowchart showing an example of the operation of the medical image processing apparatus 100 or a medical image processing program according to the second embodiment. As shown in FIG. 14, step ST20 is a step performed after step ST18, and in step ST20, the medical device 40 and the region of interest inside the subject's body are selected from among the plurality of ultrasound images acquired in step ST10. An ultrasound image in which a part or all of at least one of the imaging targets is depicted is extracted, and the extracted ultrasound image is output. The process of outputting the ultrasound image in step ST20 is performed by the image output function F06.

The ultrasonic image extraction method in step ST20 extracts an ultrasonic image in which part or all of the object to be imaged, which is at least one of the medical device 40 and the region of interest inside the subject's body, is depicted. good. For example, from the viewpoint of outputting an ultrasound image focused on the treatment target site, the ultrasound image in step ST20 may be an ultrasound image in which both the treatment target site and the medical device 40 are depicted.

FIG. 15 is a diagram for explaining an example of an ultrasound image according to the second embodiment. In the case of the left atrial appendage occlusion technique illustrated in FIG. 15, for example, the left atrial appendage and the occlusion device (medical device 40) (in FIG. 15, the range of views from view V4 to view V8) is the ultrasound image in step ST20. Observations that focus on specific parts become easier.

Further, in step ST20, although there is no particular restriction on the output order of the plurality of extracted ultrasound images, the output order may be set in order to make it easier to recognize the situation of the treatment target region. FIG. 15 is also a diagram for explaining an example of the output order of ultrasound images according to the second embodiment. The output order of the ultrasound images may be outputted back and forth from the ultrasound image at one end of the extracted view range to the ultrasound image at the other end. Explaining according to FIG. 15, for example, the output order is repeated as view V4, view V5, view V6, view V7, view V8, view V7, view V6, view V5, view V4, view V5, . . . . Furthermore, although the view from which the output is started is arbitrary, the ultrasonic image near the center of the extracted view range may be used as the starting point, and the ultrasonic images at both ends may be reciprocated and output. To explain according to FIG. 15, for example, view V6, view V7, view V8, view V7, view V6, view V5, view V4, view V5, view V6, view V7, view V8, view V7, etc. are repeated. This is the output order.

FIG. 16 is a perspective view for explaining an example of (a) before advancement support and (b) after advancement support in which the ultrasound catheter 3 is advanced based on an ultrasound image according to the second embodiment. FIG. 16(a) is the same diagram as FIG. 15, and depicts a plurality of extracted ultrasound images. As described above, the amount and direction of movement of the ultrasound catheter 3 and the angle of the array surface 31 of the detector 30 are determined based on the imaging target, which is at least one of the medical device 40 and the region of interest inside the body of the subject. It is preferable that a part or all of the amount is such that it "maximally fits" within the field of view of the detector 30 of the ultrasound catheter 3.

Therefore, as shown in FIG. 16(b), advancement support information for advancing the ultrasound catheter 3 so that the object to be imaged falls within the field of view of the detector 30 may be calculated. Further, advancement support information for advancing the ultrasound catheter 3 so that the object to be imaged approaches the center of the field of view of the detector 30 may be calculated. In this case, the progress support information is, for example, an ultrasound image that is extracted by extracting an ultrasound image in which a part or all of the object to be imaged is depicted from among the plurality of ultrasound images acquired in step ST10. Calculated based on.

The output of the ultrasound image in step ST20 may be performed on the display 150, which is at least one of the display 250 provided in the X-ray diagnostic apparatus 200 and the display 330 provided in the ultrasound diagnostic apparatus 300. It may be done in
For example, by extracting and outputting an ultrasound image in which part or all of the medical device 40 is depicted, the burden on the operator of searching for ultrasound images of the medical device 40 and the treatment target region is reduced. be done. Furthermore, for example, by extracting and outputting an ultrasound image depicting a region of interest inside the body of a subject, observation of a target region during treatment or treatment process becomes easier.

(Third embodiment)
FIG. 17 is a block diagram showing a configuration example of an X-ray diagnostic system 1 including a medical image processing apparatus according to the third embodiment. The medical image processing apparatus 100 according to the third embodiment has a function of controlling the support robot 6. Here, the support robot 6 inserts the ultrasonic catheter 3 and the procedure catheter 4 into the subject P and advances them to the treatment target area of the subject, for example, through an operation installed at a remote location. This is a device that can perform operations based on user operations via a desk or based on control data from a remote location.
As shown in FIG. 17, the support robot 6 includes a robot body 60 in addition to an operation console. The robot main body 60 is disposed near the bed 220, inserts the ultrasound catheter 3 and the procedure catheter 4 into the subject P, and advances these to the treatment target site of the subject. The operation console of the support robot 6 may be placed in a remote location different from the procedure room, or may be placed within the procedure room. The support robot 6 may be connected to the X-ray diagnostic system 1 via the network 2.

FIG. 18 is a diagram showing a configuration example of a medical image processing apparatus 100 according to the third embodiment. The difference between the first embodiment (FIG. 6) and the second embodiment (FIG. 13) is that the processing circuit 110 of the medical image processing apparatus 100 according to the third embodiment has a robot control function F07. The point is that The robot control function F07 is a function that controls the operation of the support robot 6 by exchanging control data between the medical image processing apparatus 100, the X-ray diagnostic apparatus 200, and the support robot 6, which is a separate configuration.

The robot control function F07 of the third embodiment converts the calculated advancement support information of the ultrasound catheter 3 into control data for the support robot 6 and outputs the control data to the support robot 6. Thereby, the operation of the support robot 6 is controlled to advance the ultrasound catheter 3 based on the advancement support information.

The robot control function F07 further determines the advancement speed of the ultrasound catheter 3 suitable for the tissue or organ of the subject P located at the tip of the ultrasound catheter 3 based on the advancement support information regarding the recommended route; The operation of the support robot 6 may be controlled by advancing the ultrasound catheter 3 based on the determined advancement speed, or by causing it to advance in a detour so as not to collide with the tissues or organs of the subject P. For example, in the case of a moving organ such as the heart, the operation of the support robot 6 may be controlled to reduce the advancement speed of the medical device.

According to at least one embodiment described above, it is possible to assist the operator in appropriately advancing the ultrasound catheter.

In the above embodiments, the term "processor" refers to, for example, a dedicated or general-purpose CPU (Central Processing Unit), GPU (Graphics Processing Unit), or Application Specific Integrated Circuit (ASIC). ), programmable logic devices (e.g., Simple Programmable Logic Device (SPLD), Complex Programmable Logic Device (CPLD), and Field Programmable Gate Array (FPGA)), etc. circuit. When the processor is, for example, a CPU, the processor realizes various functions by reading and executing a program (medical image processing program) stored in a storage circuit. Further, when the processor is, for example, an ASIC, instead of storing the program in a storage circuit, the function corresponding to the program is directly incorporated into the processor circuit as a logic circuit. In this case, the processor implements various functions through hardware processing that reads and executes programs built into the circuit. Alternatively, the processor can also realize various functions by combining software processing and hardware processing.

Furthermore, in the above embodiment, an example is shown in which a single processor of the processing circuit realizes each function, but a processing circuit may be configured by combining multiple independent processors, and each processor realizes each function. Good too. Furthermore, when multiple processors are provided, a memory circuit for storing programs may be provided individually for each processor, or a single memory circuit may collectively store programs corresponding to the functions of all processors. Good too.

In addition, in each embodiment, the first acquisition function, the second acquisition function, the detection function, the determination function, the calculation function, the image output function, and the robot control function are the first acquisition section, the second acquisition section, and the detection function, respectively. This is an example of a unit, a determination unit, a calculation unit, an image output unit, and a robot control unit.

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

Regarding the above embodiments, the following additional notes are disclosed as one aspect and optional features of the invention.

(Additional note 1)
A medical image processing apparatus according to an embodiment acquires an ultrasound image generated from a signal collected by a detector of an ultrasound catheter inserted into a subject's body, Obtain an X-ray image in which at least one of a medical device inserted into the body of the subject and an imaging target that is a region of interest in the body of the subject are depicted, and (a) Detecting the position of the detector of the ultrasound catheter and (b) the position of the imaging target depicted in at least one of the ultrasound image and the X-ray image, and the detected position of the detector of the ultrasound catheter , and advancement support information for advancing the ultrasound catheter so that the imaging target is within the field of view of the detector based on the position of the imaging target, or when the imaging target is in the center of the field of view of the detector. A processing circuit is provided that calculates advancement support information for advancing the ultrasound catheter so as to approach the ultrasound catheter.

(Additional note 2)
The processing circuit further determines whether or not the imaging target is within the field of view of the detector, and when the imaging target is depicted in the acquired ultrasound image, the imaging target is is determined to be within the field of view of the detector, and when the imaging target is not depicted in the acquired ultrasound image, it is determined that the imaging target is not within the field of view of the detector. You may.

(Additional note 3)
When the imaging target is within the field of view of the detector, the processing circuit detects the position of the imaging target within the field of view from the ultrasound image, and detects the ultrasound from the X-ray image. The position of the detector on the catheter may be detected.

(Additional note 4)
If the imaging target is not within the field of view of the detector, the processing circuit detects the position of the detector of the ultrasound catheter and the position of the imaging target from the X-ray image. You may.

(Appendix 5)
If the object to be imaged is not within the field of view of the detector, the processing circuit determines, from the X-ray image, the center of gravity position of the array surface constituting the detector of the ultrasound catheter and the position of the center of gravity of the array surface. The field of view of the detector may be calculated from the position of the center of gravity of the array surface, a normal vector calculated from the orientation of the array surface, and a predetermined scanning range of the detector.

(Appendix 6)
The advancement support information calculated by the processing circuit includes the amount of advancement of the ultrasound catheter, the direction of travel of the ultrasound catheter, the angle of the array surface of the ultrasound catheter, and recommended route information of the ultrasound catheter. It may include at least one.

(Appendix 7)
The ultrasound catheter may further include a display for providing progress support information for the ultrasound catheter to an operator.

(Appendix 8)
The processing circuit may further control an assistance robot that assists in manipulating the ultrasound catheter.

(Appendix 9)
The processing circuit extracts an ultrasound image in which part or all of the object to be imaged is depicted from among the plurality of acquired ultrasound images, and further outputs the extracted ultrasound image to the display. You may.

(Appendix 10)
The processing circuit extracts an ultrasound image in which a part or all of the object to be imaged is depicted from among the plurality of acquired ultrasound images, and based on the extracted ultrasound image, the image to be imaged is Advancement support information for advancing the ultrasound catheter so that an object enters the field of view of the detector, or advancing the ultrasound catheter so that the object to be imaged approaches the center of the field of view of the detector. You may also calculate progress support information for this purpose.

(Appendix 11)
The processing circuit may output the plurality of extracted ultrasound images by reciprocating them in the order from an ultrasound image at one end of the extracted range to an ultrasound image at the other end, or The ultrasonic image near the center of the range may be used as a starting point, and the ultrasonic images at both ends may be reciprocated and output.

(Appendix 12)
The region of interest within the subject's body may be a site for treatment, diagnosis, or assistance in a treatment process.

(Appendix 13)
The processing circuit may further include a network interface capable of communicating with an X-ray diagnostic device via a network, and the processing circuit may acquire the X-ray image from the X-ray diagnostic device.

(Appendix 14)
The apparatus may further include a network interface capable of communicating with a support robot via a network, and the processing circuit may control the support robot that supports operation of the ultrasound catheter.

(Additional note 15)
obtaining an ultrasound image generated from signals collected by a detector of an ultrasound catheter inserted into the body of the subject;
An X-ray image in which the detector of the ultrasound catheter, an imaging target that is at least one of a medical device inserted into the body of the subject and a region of interest in the body of the subject are depicted. Steps to obtain
(a) the position of the detector of the ultrasound catheter depicted in the X-ray image; and (b) the object to be imaged depicted in at least one of the ultrasound image and the X-ray image. a step of detecting the position;
Based on the detected position of the detector of the ultrasound catheter and the position of the imaging target, advancing the ultrasound catheter so that the imaging target enters the field of view of the detector. calculating advancement support information or advancement support information for advancing the ultrasound catheter so that the imaging target approaches the center of the field of view of the detector;
A medical image processing program that allows a computer to execute

(Appendix 16)
A computer-readable storage medium storing the medical image processing program.

1... X-ray diagnostic system 3... Ultrasonic catheter 4... Manipulation catheter 6... Support robot 30... Detector 31... Array surface 40... Medical device 100... Medical image processing device 110... Processing circuit 120... Memory circuit 130... Input interface 140...Network interface 150...Display 200...X-ray diagnostic device 300...Ultrasonic diagnostic device F01...First acquisition function F02...Second acquisition function F03...Detection function F04...Judgment function F05...Calculation function F06...Image output function F07... Robot control function

Claims (15)

a first acquisition unit that acquires an ultrasound image generated from signals collected by a detector of an ultrasound catheter inserted into the body of the subject;
An X-ray image in which the detector of the ultrasound catheter, an imaging target that is at least one of a medical device inserted into the body of the subject and a region of interest in the body of the subject are depicted. a second acquisition part to acquire;
(a) the position of the detector of the ultrasound catheter depicted in the X-ray image; and (b) the object to be imaged depicted in at least one of the ultrasound image and the X-ray image. a detection unit that detects the position;
Based on the detected position of the detector of the ultrasound catheter and the position of the imaging target, advancing the ultrasound catheter so that the imaging target enters the field of view of the detector. a calculation unit that calculates advancement support information or advancement assistance information for advancing the ultrasound catheter so that the imaging target approaches the center of the field of view of the detector;
A medical image processing device comprising: a determination unit that determines whether the imaging target is within the field of view of the detector;
Furthermore,
The determination unit determines that the imaging target is within the field of view of the detector when the imaging target is depicted in the acquired ultrasound image, and the determination unit determines that the imaging target is within the field of view of the detector, and determining that the imaging target is not within the field of view of the detector when the imaging target is not depicted;
The medical image processing device according to claim 1. When the imaging target is within the field of view of the detector,
The detection unit detects the position of the imaging target within the field of view from the ultrasound image, and detects the position of the detector of the ultrasound catheter from the X-ray image.
The medical image processing device according to claim 2. If the imaged object is not within the field of view of the detector,
The detection unit detects the position of the detector of the ultrasound catheter and the position of the imaging target from the X-ray image.
The medical image processing device according to claim 2. If the imaged object is not within the field of view of the detector,
The detection unit detects, from the X-ray image, a center of gravity position of an array surface constituting the detector of the ultrasound catheter and a direction of the array surface,
The calculation unit calculates the field of view of the detector from a center of gravity position of the array surface, a normal vector calculated from the orientation of the array surface, and a predetermined scanning range of the detector.
The medical image processing device according to claim 2. The advancement support information calculated by the calculation unit includes the amount of advancement of the ultrasound catheter, the direction of travel of the ultrasound catheter, the angle of the array surface of the ultrasound catheter, and the recommended route information of the ultrasound catheter. containing at least one piece of information;
A medical image processing apparatus according to claim 1 or 2. further comprising a display for providing advancement support information for the ultrasound catheter to an operator;
A medical image processing apparatus according to claim 1 or 2. further comprising a robot control unit for controlling a robot that supports the ultrasound catheter;
A medical image processing apparatus according to claim 1 or 2. A display for providing advancement support information for the ultrasound catheter to an operator, and a part or all of the object to be imaged is depicted from within the plurality of ultrasound images acquired by the first acquisition unit. further comprising an image output unit that extracts an ultrasound image and outputs the extracted ultrasound image;
The medical image processing device according to claim 1. The calculation unit extracts an ultrasound image in which part or all of the object to be imaged is depicted from among the plurality of ultrasound images acquired by the first acquisition unit,
Progress support information for advancing the ultrasound catheter so that the imaging target is within the field of view of the detector based on the extracted ultrasound image, or advancement support information for advancing the ultrasound catheter so that the imaging target is within the field of view of the detector. calculating advancement support information for advancing the ultrasound catheter so as to approach the center of the ultrasound catheter;
The medical image processing device according to claim 1. The image output unit outputs the plurality of extracted ultrasound images by reciprocating them in the order from an ultrasound image at one end of the extracted range to an ultrasound image at the other end, or outputs the extracted ultrasound images at the center of the extracted range. Outputs a nearby ultrasound image as a starting point and outputs a round trip to ultrasound images at both ends.
The medical image processing device according to claim 9. The region of interest within the subject's body is a site for treatment, diagnosis, or support in a treatment process;
The medical image processing device according to claim 1. An X-ray diagnostic system comprising a medical image processing device and a network interface capable of communicating with the medical image processing device via a network,
The medical image processing device includes:
a first acquisition unit that acquires an ultrasound image generated from signals collected by a detector of an ultrasound catheter inserted into the body of the subject;
An X-ray image in which the detector of the ultrasound catheter, an imaging target that is at least one of a medical device inserted into the body of the subject and a region of interest in the body of the subject are depicted. a second acquisition part to acquire;
(a) the position of the detector of the ultrasound catheter depicted in the X-ray image; and (b) the object to be imaged depicted in at least one of the ultrasound image and the X-ray image. a detection unit that detects the position;
Based on the detected position of the detector of the ultrasound catheter and the position of the imaging target, advancing the ultrasound catheter so that the imaging target enters the field of view of the detector. a calculation unit that calculates advancement support information or advancement assistance information for advancing the ultrasound catheter so that the imaging target approaches the center of the field of view of the detector;
An X-ray diagnostic system equipped with further comprising a robot control unit for controlling a robot that supports operation of the ultrasound catheter;
The X-ray diagnostic system according to claim 13. computer,
a first acquisition means for acquiring an ultrasound image generated from signals collected by a detector of an ultrasound catheter inserted into the body of the subject;
An X-ray image in which the detector of the ultrasound catheter, an imaging target that is at least one of a medical device inserted into the body of the subject and a region of interest in the body of the subject are depicted. a second acquisition means for acquiring;
(a) the position of the detector of the ultrasound catheter depicted in the X-ray image; and (b) the object to be imaged depicted in at least one of the ultrasound image and the X-ray image. a detection means for detecting the position;
Based on the detected position of the detector of the ultrasound catheter and the position of the imaging target, advancing the ultrasound catheter so that the imaging target enters the field of view of the detector. Calculating means for calculating advancement support information or advancement support information for advancing the ultrasound catheter so that the imaging target approaches the center of the field of view of the detector;
A program to make it work.