JP4460180B2 - Medical image interpretation support apparatus, medical image interpretation support processing program, and recording medium for the program - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
  The present invention provides a medical image interpretation support that realizes the clarity of past diagnosis processes and the efficiency of interpretation work when diagnosis is performed by interpreting a plurality of tomographic images.Support equipment and itsUsed to implement the deviceFor medical image interpretation support processingProgram andThatRecorded the programFor medical image interpretation support processingThe present invention relates to a program recording medium.
[0002]
[Prior art]
Diagnosis of lung cancer etc. is performed by interpreting computer tomography images.
[0003]
At the present time, in this diagnosis, what is given as a clue to know the situation that has been interpreted in the past is only a finding paper or an electronically written report.
[0004]
From now on, doctors have had to rely on observation papers and electronically written reports when they need to know the status of past interpretation when diagnosing lung cancer using computer tomography images.
[0005]
[Problems to be solved by the invention]
From now on, according to the prior art, doctors need to refer to the situation of interpretations that they have done in the past or the situation of interpretations that other doctors have done in the past. There was a problem of having to refer to the report.
[0006]
And if this interpretation situation is not recorded on the observation paper or electronically written report, there is a problem that it is impossible to know the basis of the diagnosis or the diagnosis. there were.
[0007]
According to the prior art, when diagnosis is performed by interpreting a plurality of tomographic images, there are problems that the past diagnosis process is not clear, and that interpretation work cannot be performed efficiently.
[0008]
The present invention has been made in view of such circumstances, and when making a diagnosis by interpreting a plurality of tomographic images, it is possible to clarify the past diagnosis process and improve the efficiency of the interpretation work. The purpose is to provide a new medical image interpretation support technology that realizes the above.
[0009]
[Means for Solving the Problems]
  To achieve this goalIn addition, a medical image interpretation recording apparatus related to the present invention, a medical image interpretation support apparatus related to the present invention, and a medical image interpretation support apparatus of the present invention are prepared.
  this bookinventionis connected withThe medical image interpretation recording apparatus includes a recording unit that records information including occurrence time information of an operation event of an interpretation operation, a type of the operation event, and an operation value of the operation event, and an interpretation operation. A storage unit that stores the time-series data of the recorded information as an interpretation work record in a storage device when the process ends.
[0010]
At this time, the storage means stores this interpretation work record in the form of incorporating it into the observation information stored in the standardization standard for medical information so that it can be transferred and received together with the observation information to the standardization compatible system. To process.
[0011]
  According to this configuration, the present inventionis connected withIf the medical image interpretation recording apparatus is described with an event instructing the change of the tomographic image to be subjected to the interpretation work, the paired data of the occurrence time information of the event and the information used for specifying the changed tomographic image When the interpretation work is completed, the time series data of the recorded information is stored in the storage device as the interpretation work record.
[0012]
  On the other hand, the present inventionis connected withThe medical image interpretation support apparatus is the present invention.is connected withWhen receiving the interpretation work record stored in the medical image interpretation recording device, the time of occurrence of the event that instructs the change of the tomographic image to be interpreted and the information used to identify the tomographic image An acquisition means for acquiring interpretation work record information composed of series data, a calculation means for calculating an interpretation time of each tomographic image from the acquired interpretation work record information, and a calculated interpretation time or information indicating it. Output means for outputting using a color chart or a bar graph.
[0013]
At this time, when the two interpretation tasks are to be processed, the calculation means explicitly outputs which tomographic image is focused on in the two interpretation tasks. The interpretation time of each tomographic image may be calculated by selecting the larger interpretation time.
[0014]
Then, the output means creates the calculated interpretation time or information indicating the interpretation time from the tomographic image so that it can be understood at a glance which portion of the tomographic image focused on in the interpretation work. There are cases where output is performed while corresponding to the projection image.
[0015]
  on the other hand,The medical image interpretation support apparatus of the present invention isis connected withWhen receiving the interpretation work record stored in the medical image interpretation recording device, the time of occurrence of the event that instructs the change of the tomographic image to be interpreted and the information used to identify the tomographic image An acquisition means for acquiring interpretation work record information composed of series data, a calculation means for calculating the interpretation time of each tomographic image from the acquired interpretation work record information, and sequentially selecting the tomographic images in the scroll direction, Scrolling means for scrolling out the tomographic image by outputting the selected tomographic image for a time corresponding to the calculated interpretation time;
[0016]
At this time, when the tomographic images corresponding to the two interpretation operations are output in comparison, it is possible to know how the tomographic image portion focused on in one interpretation operation was in the other interpretation operation. Therefore, setting means for setting which tomographic image should be used to execute scroll output may be provided.
[0017]
  In addition, the present inventionis connected withThe medical image interpretation support apparatus is the present invention.is connected withReceives the interpretation work record saved by the medical image interpretation recording device, and consists of time series data of the paired data of the operation event occurrence time information, the type of the operation event, and the operation value of the operation event. The acquisition means for acquiring the interpretation work record information, the reproduction means for reproducing the interpretation work in accordance with the acquired interpretation work record information, and the temporal flow of the tomographic image interpreted in accordance with the acquired interpretation work record information. Output means for outputting a graph.
[0018]
  The present invention configured as described aboveis connected withMedical image interpretation and recording deviceMedical image interpretation support apparatus related to the present inventionAccording to the medical image interpretation support system configured with the medical image interpretation support apparatus of the present invention, it is possible to record the interpretation operation of a medical image composed of a plurality of tomographic images. It is possible to confirm whether the diagnosis has been made.
[0019]
That is, when a plurality of doctors interpret the same medical image, it is possible to know where other doctors who have interpreted the same medical image have focused on the diagnosis.
[0020]
In addition, when the follow-up observation is performed by comparatively interpreting the current and past medical images, the progress of the portion focused on the past can be accurately observed.
[0021]
Furthermore, it is possible to know whether it is a newly generated shadow or a follow-up shadow by being able to know whether the same part has been focused on in the past for the part currently focused on become.
[0022]
As described above, according to the present invention, when diagnosis is performed by interpreting a plurality of tomographic images, it becomes possible to clarify the past diagnosis process and to improve the efficiency of interpretation work. Can be realized.
[0023]
DETAILED DESCRIPTION OF THE INVENTION
Hereinafter, the present invention will be described in detail according to an embodiment applied to interpretation of a chest X-ray CT image for lung cancer screening.
[0024]
FIG. 1 shows an embodiment of a medical image interpretation support apparatus 1 having the present invention.
[0025]
As shown in this figure, a medical image interpretation support apparatus 1 of the present invention includes a chest tomographic image database 10 that stores a chest X-ray CT image of a examinee, and an interpretation work support program 11 that performs processing characteristic of the present invention. And an operation event table 12 that is prepared as a work area of the interpretation work support program 11 and stores operation event information generated during the interpretation work, and is defined as time series data of the operation event information stored in the operation event table 12 An interpretation work record file 13 for storing the interpretation work record information to be read, and an input / output device 14 comprising a display and an interactive means such as a mouse.
[0026]
Here, the interpretation work support program 11 can be stored in a suitable recording medium such as a semiconductor memory readable by a computer.
[0027]
This chest tomographic image database 10 is made up of chest X-ray CT images for lung cancer screening as shown in FIG. 2 taken using helical CT (an image sequence of 25 to 30 images per person at 1 cm intervals). ), And the chest X-ray CT images of each examinee are stored as a series of chest X-ray CT images taken in one imaging.
[0028]
Although not shown, the chest tomographic image database 10 includes various attribute information (chest X-rays) such as which examinee each chest X-ray CT image of each series belongs to, and when. (Which is also recorded in the line CT image).
[0029]
The interpretation work support program 11 performs processing for supporting interpretation of a chest X-ray CT image performed by a doctor, and the doctor scrolls the chest X-ray CT image sequence up and down using a slider or a mouse wheel. When the instruction is issued, as shown in FIG. 3, the chest X-ray CT image sequence is continuously displayed as a moving image while scrolling up and down in accordance with the instruction (hereinafter referred to as cine display). When examining the chest X-ray CT image by stopping scrolling with the image focused on during the cine display, the chest X-ray CT image is displayed stationary, or when the doctor issues an instruction for comparison display, As shown in FIG. 4, while performing an interpretation operation such as displaying the current chest X-ray CT image and the past chest X-ray CT image in comparison, a process for supporting the interpretation operation is performed. .
[0030]
The operation event table 12 stores information on operation events that occur at the time of interpretation work. As shown in FIG. 5, the operation time of the operation event that occurred (defined by the elapsed time from the start of interpretation), Stores operation event information including paired data of the type of operation event that has occurred and the operation value of the operation event that has occurred.
[0031]
In the embodiment described below, as an operation event type, an event (operation type: 0) instructing to change a slice cross-section of an interpreting chest X-ray CT image and a chest X-ray CT displayed in contrast. An event (operation type: 1) for instructing a change in slice slice of an image, an event (window level change instruction event / operation type: 2) for instructing a change in the display center density position of a chest X-ray CT image, and a chest An event for instructing to change the display density width of the X-ray CT image (window width change instruction event / operation type: 3), and an event to instruct the start of contrast display of the chest X-ray CT image (operation type: 4) , An event (operation type: 5) instructing the end of the comparison display is assumed.
[0032]
The interpretation work record file 13 stores interpretation work record information defined as time-series data of operation event information stored in the operation event table 12, as shown in FIG.
[0033]
In the example of FIG. 6, it is assumed that the interpretation work record information for a series “0” chest X-ray CT image (interpreter: Taro Nihon, interpretation date and time: January 31, 2001, 10:34:38). ing.
[0034]
FIG. 7 illustrates an embodiment of a functional configuration of the interpretation work support program 11.
[0035]
As shown in this figure, the interpretation work support program 11 includes an interpretation work execution unit 110, an interpretation work record storage unit 111, an interpolation image generation unit 112, an interpretation work record display unit 113, an automatic scroll unit 114, A playback unit 115 and a slice reference scale creation unit 116 are provided.
[0036]
When an examinee to be interpreted is selected from the examinee list, the interpretation work execution unit 110, as shown in FIG. 8, displays the latest chest X-ray CT image of the selected examinee (in the figure). (1)), a front projection image (shown in (2) in the figure) used for changing the slice cross section generated from the chest X-ray CT image, and a window level / window width change. An image for window change to be used (shown in (3) in the figure) and a window for displaying information on the examinee (shown in (4) in the figure) are displayed on the display, and a chest X-ray CT image is displayed. Execute the interpretation work.
[0037]
For example, when the doctor moves the bar displayed on the front projection image (the chest X-ray CT image at this bar position is displayed on the display), the chest X-ray displayed on the display according to the movement. When the slice section of the CT image is changed, and the doctor moves the window level bar displayed on the window changing image, the window level value is changed according to the movement, and the doctor changes the window changing image. When the window width bar to be displayed is moved, the window width value is changed according to the movement.
[0038]
Then, when the doctor operates the “finding input button” provided on the screen, as shown in FIG. 9, the finding input screen is displayed to input the findings, and the doctor provides the “comparison start” provided on the screen. When the “button” is operated, as shown in FIG. 10, a process of comparing and displaying the chest X-ray CT image of the same examinee taken before the chest X-ray CT image during the interpretation work is performed.
[0039]
When the moving destination of the bar to be displayed on the front projection image is not the original slice section of the chest X-ray CT image taken at 1 cm intervals, the interpolation image generation unit 112 displays the chest X-ray CT image of the destination slice section. In order to be able to display, the chest X-ray CT image stored in the chest tomographic image database 10 is subjected to an interpolation process to generate a chest X-ray CT image having an interval of 1 mm, for example.
[0040]
  FIG. 11 shows a processing flow executed by the interpretation work execution unit 110.One caseFIG. 12 to FIG. 15 show the processing flow executed by the interpretation work record storage unit 111.One caseFIG. 16 and FIG. 17 show the processing flow executed by the slice reference scale creation unit 116.One caseFIG. 18 shows a processing flow executed by the interpretation work record display unit 113.One caseFIG. 19 and FIG. 20 show the processing flow executed by the automatic scroll unit 114.One caseFIG. 21 shows the processing flow executed by the playback unit 115.One caseIs illustrated.
[0041]
Next, the interpretation work support processing of the present invention executed by the interpretation work support program 11 according to these processing flows will be described in detail.
[0042]
First, processing executed by the interpretation work execution unit 110 will be described.
[0043]
When the interpretation work execution unit 110 designates the examinee and is issued an instruction to perform the interpretation work, first, as shown in the processing flow of FIG. The patient's chest X-ray CT image (the latest photographed image) is read, and in the next step 2, the interpretation work record storage unit 111 is instructed to execute the interpretation work record start process.
[0044]
When this preparatory process is completed, the process waits for an event to occur in response to a doctor's operation in step 3, and when an event occurs, the process proceeds to step 4 to specify the operation event that has occurred. Execute the process.
[0045]
For example, when an operation event for instructing a change in the slice cross section of the chest X-ray CT image being interpreted occurs, the chest X-ray CT image displayed on the display is changed (at this time, an interpolated image is generated if necessary) The unit 112 is called to generate an interpolated image).
[0046]
Subsequently, in step 5, it is determined whether or not the generated event is an interpretation event (an operation event of the above-described operation types “0” to “5”), and is an interpretation event. When judging this, the process proceeds to step 6 to instruct the interpretation work record storage unit 111 to execute the operation event recording process, and when judging that the operation event is not the operation event of the interpretation work, The process in step 6 is omitted.
[0047]
Subsequently, in step 7, it is determined whether or not an instruction to end the interpretation work has been issued from the doctor. If not issued, the process returns to step 3, and if issued, the process proceeds to step 8 to interpret the interpretation. The work record storage unit 111 is instructed to execute an interpretation work record end process, and the process ends.
[0048]
Next, processing executed by the interpretation work record storage unit 111 will be described.
[0049]
Upon receiving an instruction to execute the interpretation work record start processing from the interpretation work execution unit 110, the interpretation work record storage unit 111 initializes the operation event table 12 and acquires the interpreter information as shown in the processing flow of FIG. Record, acquire and record the interpretation target series information, acquire the interpretation recording start time, and record it (this interpretation recording start time is milliseconds to record operation events that occur continuously within 1 second. Recording unit), recording the initial value of the slice cross-sectional position, recording the initial value of the window level value, and recording the initial value of the window width value.
[0050]
Further, when the interpretation work record storage unit 111 receives an execution instruction for the operation event recording process from the interpretation work execution unit 110, first, as shown in the processing flow of FIG. 13 and FIG. Secure recording area. Subsequently, in step 2, the occurrence time of the operation event is acquired, and in the subsequent step 3, the elapsed time from the recorded interpretation recording start time to the occurrence time is calculated (calculated in milliseconds). Record in the secured recording area.
[0051]
Subsequently, in step 4, it is determined whether or not the generated operation event is an operation event for changing a slice section (as described above, there are two types of operation types “0” and “1”). When it is determined that the operation event is a cross-section change, the processing of steps 5 to 7 is executed, so that the elapsed time until the event occurs, the event type indicating the slice cross-section change, and the changed slice cross-section position Operation event table 12 is created by creating operation event information consisting of paired data with event operation values defined by a value of how many mm from the specified position of the body in consideration of the position of the interpolated image. To finish the process.
[0052]
On the other hand, when it is determined in step 4 that the generated operation event is not a slice section change operation event, the process proceeds to step 8 to determine whether or not the generated operation event is a window level value change operation event. When it is determined that the operation event is a window level value change operation, the processing of steps 9 to 11 is executed, so that the elapsed time until the event occurs, the event type indicating the window level value change, and the change The operation event information composed of the paired data with the event operation value defined by the window level value created is created, added to the operation event table 12, and the process is terminated.
[0053]
On the other hand, when it is determined in step 8 that the generated operation event is not a window level value change operation event, the process proceeds to step 12 to determine whether or not the generated operation event is a window width value change operation event. When it is determined that the operation event is a window width value change operation, the processing in steps 13 to 15 is executed, so that the elapsed time until the event occurs, the event type indicating the window width value change, Information on an operation event composed of paired data with the event operation value defined by the changed window width value is created, added to the operation event table 12, and the process is terminated.
[0054]
On the other hand, when it is determined in step 12 that the generated operation event is not a window width value change operation event, the process proceeds to step 16 to determine whether the generated operation event is a comparison start operation event or not. When it is determined that the operation event is a comparison start, the processing of steps 17 to 19 is executed, so that the elapsed time until the event occurs, the event type indicating that the comparison is started, and the chest X to be compared Operation event information composed of paired data with the event operation value defined by the series number of the line CT image is created, added to the operation event table 12, and the process ends.
[0055]
As a chest X-ray CT image to be compared, a chest X-ray CT image of the same examinee taken before the chest X-ray CT image being interpreted is automatically selected (if there are multiple images, The newest chest X-ray CT image is automatically selected, and older images can be selected by dialogue).
[0056]
On the other hand, when it is determined in step 16 that the generated operation event is not a comparison start operation event, that is, when it is determined that the generated operation event is a comparison end operation event, the processing of steps 20 to 21 is performed. By executing this, operation event information composed of paired data of the elapsed time until the event occurrence and the event type indicating the end of the comparison is created, added to the operation event table 12, and the process ends. .
[0057]
When the interpretation work record storage unit 111 receives an instruction to execute the interpretation work record end process from the interpretation work execution unit 110, as shown in the processing flow of FIG. After adding to the operation event table 12 as an operation event for slice slice change according to the work recording start process, information on all operation events recorded in the operation event table 12 is stored in the interpretation work record file 13 and the process is terminated. .
[0058]
In this way, according to the recording process of the interpretation work record storage unit 111, the interpretation work record file 13 stores time information (from the interpretation work record start time) when the operation event of the interpretation work occurred, as shown in FIG. Elapsed time), the type of operation event, and the operation value of the operation event, and the interpretation work record consisting of time series data of paired data is recorded.
[0059]
As the slice cross-section position information recorded in the interpretation work record file 13, the position information (recorded at the time of imaging) written in the DICOM header of the chest X-ray CT image to be interpreted can also be used. DICOM is a standard for storage and transmission of medical images, and information such as patient information and radiographing conditions is entered in the header.
[0060]
Further, by storing the interpretation work record recorded in the interpretation work record file 13 in the form of incorporating into the observation information in the standardized DICOM-SR format, the observation and the interpretation work record can be saved in the same file. . If this storage method is used, the interpretation work record can be managed in the same format as the chest X-ray CT image to be interpreted, so that it can be transferred and received together with the image to the standardized system.
[0061]
Next, processing executed by the slice reference scale creation unit 116 will be described.
[0062]
When a request to create a slice reference scale is issued from the interpretation work record display unit 113, the slice reference scale creation unit 116 first performs interpretation work in step 1 as shown in the processing flow of FIGS. The interpretation work record to be processed is read from the recording file 13. Subsequently, in step 2, a reference time recording area is prepared and initialized for each slice section (original slice section that does not include an interpolation image) in the series that is the creation source of the interpretation work record to be processed.
[0063]
Subsequently, in step 3, when selecting an operation event in order from the read interpretation work record, it is determined whether or not the next operation event exists, and it is determined that the next operation event exists. If so, the process proceeds to step 4 to acquire the next operation event.
[0064]
Subsequently, in Step 5, when it is determined whether or not the acquired operation event is a slice section change operation event (hereinafter referred to as a slice operation event), and it is determined that the operation event is not a slice operation event, Returning, when it is determined that the event is a slice operation event, the process proceeds to step 6 to determine whether or not the acquired slice operation event is the first slice operation event.
[0065]
When it is determined by this determination processing that the event is not the first slice operation event, the process proceeds to step 7 to calculate the elapsed time from the previous slice operation, and in step 8 the original slice section closest to the previous slice section (Slice cross section that is not an interpolation image) is acquired, and in the subsequent step 9, the calculated elapsed time is added to the reference time recording area of the acquired slice cross section. Then, when it is determined by the determination process in step 6 that the event is the first slice operation event, the processes in steps 7 to 9 are omitted.
[0066]
Subsequently, in step 10, the acquired slice operation event is recorded as the previous slice operation event, and then the process returns to step 3.
[0067]
On the other hand, when it is determined in step 3 that the next operation event does not exist when selecting an operation event in order from the read interpretation work record, the process proceeds to step 11 where the last operation event is a slice operation. Determine whether it is an event.
[0068]
When it is determined by this determination process that the last operation event is not a slice operation event, the process proceeds to step 12 to calculate the elapsed time from the previous slice operation, and in step 13 that is closest to the previous slice section. The original slice cross section is acquired, and in the subsequent step 14, the calculated elapsed time is added to the reference time recording area of the acquired slice cross section. When it is determined by the determination process in step 11 that the last operation event is a slice operation event, the processes in steps 12 to 14 are omitted in correspondence with the absence of the elapsed time of the slice operation event. To do.
[0069]
Subsequently, in step 15, the color of the scale is determined in accordance with the reference time of each slice section that has been cumulatively added, and the process is terminated.
[0070]
In this manner, as shown in FIG. 22, the slice reference scale creation unit 116 obtains the cumulative value of the reference time (interpretation time) of each slice cross section from the interpretation work record to be processed, and the color of the scale accordingly. The slice reference scale is created by determining.
[0071]
In response to the creation of the slice reference scale, the interpretation work record display unit 113, for example, displays the chest X-ray CT image being interpreted and the past chest X-ray CT image as shown in FIG. In addition, while referring to the front projection image generated from the past chest X-ray CT image, the reference time of each slice cross section when the past chest X-ray CT image is read is displayed using a color chart. Will be processed as follows.
[0072]
By referring to this color chart, the doctor can grasp at a glance which slice cross section is focused on when the past chest X-ray CT image is read.
[0073]
Here, as shown in FIG. 24A, the interpretation work record display unit 113 displays the reference time of each slice cross-section when the past chest X-ray CT image is interpreted using the difference in color. However, as shown in FIG. 24B, the reference time may be displayed using a bar graph. The reference time may be displayed based on an absolute value, a method of displaying after calculating a relative value, a method of displaying after performing threshold processing, or the like.
[0074]
Next, slice reference scale superimposed display processing executed by the slice reference scale creation unit 116 will be described according to the processing flow of FIG.
[0075]
Currently, in order to avoid oversight in lung cancer screening, it is decided that two doctors will interpret (Japanese Society for Lung Cancer "Clinical and Pathological Lung Cancer Handling Rules" p.161). In addition, a joint interpretation by a plurality of doctors may be performed on an image that has been determined that a close examination is necessary after the interpretation by two doctors.
[0076]
In dual interpretation, when referring to the findings of other doctors, the interpretation work records of other doctors are also referred to, so that the difference from the part of interest can be known, and oversight can be prevented. Further, in joint interpretation, a color chart that combines interpretation work records of two doctors is displayed, so that it is possible to immediately know where to focus attention.
[0077]
The interpretation work record display unit 113 performs a process of displaying a color chart in which the interpretation work records of the two doctors are combined by executing the processing flow of FIG.
[0078]
That is, when a request for slice reference scale superimposed display processing is issued, the interpretation work record display unit 113 first sets the slice reference scale creation unit 116 in step 1 as shown in the processing flow of FIG. The slice reference scale of the first interpreter is created by calling, and the slice reference scale of the second interpreter is created by calling the slice reference scale creating unit 116 in the subsequent step 2.
[0079]
Subsequently, in step 3, a superimposition reference time recording area is prepared and initialized for each slice section (original slice section not including an interpolation image) in the series that is the creation source of the interpretation interpretation work record to be processed.
[0080]
Subsequently, in step 4, the first slice section is set as a slice section to be processed. Subsequently, in step 5, the reference times of the two image readers are compared for the slice slice to be processed in accordance with the created slice reference scale. In step 6, the reference time of the first image reader is determined by this comparison process. It is determined whether or not the result of the longer is obtained.
[0081]
When it is determined that the result that the reference time of the first interpreter is longer is obtained by this determination process, the process proceeds to step 7 where the reference time of the first interpreter is written in the superimposed reference time region. When it is determined that the result that the reference time of the second interpreter is longer is obtained, the process proceeds to step 8 and the reference time of the second interpreter is written in the superimposed reference time region.
[0082]
Subsequently, in step 9, it is determined whether or not processing has been performed up to the last slice cross section, and when it is determined that processing has not been performed up to the last slice cross section, the process proceeds to step 10 to process the next slice cross section. When it is determined that processing has been performed up to the last slice cross section, the process proceeds to step 11 where the color of the scale is determined according to the superimposed reference time of each slice cross section that has been cumulatively added. To end the process.
[0083]
Here, it is conceivable to add the reference times of the two persons as the superimposed reference time. In this case, however, there is a possibility of being buried when only one of them is focused. The one with the larger reference time is taken.
[0084]
By using this superimposed color chart of reference time, comparing with individual color charts, the part that only one doctor focused on became clear, and I read it slowly, but I did not record it in the findings Since the information is also reflected on the portion, the interpreting doctor can hear the opinions of other doctors at the time of joint interpretation.
[0085]
In addition, in order to observe the progress, comparative interpretation with the past chest X-ray CT image is performed. At this time, it is possible to know where the doctor who interpreted the past image has focused, Follow-up is facilitated by comparing the points with the current image.
[0086]
Furthermore, after knowing the point of interest in the current image, it is possible to know whether it was a newly-occurring lesion or a lesion that was being followed up in the past interpretation by knowing whether or not it was focused on.
[0087]
Next, processing executed by the automatic scroll unit 114 will be described.
[0088]
As shown in the processing flow of FIG. 19, the automatic scroll unit 114 monitors the occurrence of an event, and when the event occurs, determines whether the event is an event that instructs the start of automatic scrolling. When it is determined that the event is an automatic scroll start event, an automatic scroll start process shown in the process flow of FIG.
[0089]
That is, after acquiring the original slice section closest to the current slice section (a slice section that is not an interpolation image), the reference time (slice reference scale) of the acquired original slice section is obtained using a conversion table as shown in FIG. The automatic scroll waiting time corresponding to the reference time described in (2) is acquired, and the automatic scroll start process is executed in which the slice cross-section change timer is generated with the acquired automatic scroll waiting time.
[0090]
Then, as shown in the processing flow of FIG. 19, the occurrence of an event is monitored, and when the event occurs, it is determined whether the event is a slice section change timer event, and a slice section change timer event is determined. When determining that this is the case, an automatic scroll start process shown in the process flow of FIG.
[0091]
That is, when the slice cross-section to be displayed is moved by a predetermined scroll distance and does not reach the upper end or the lower end defined by the scroll direction, the original slice cross-section closest to the destination slice cross-section (not an interpolation image) After acquiring the slice section, an automatic scroll wait time corresponding to the reference time (reference time described in the slice reference scale) of the acquired original slice section is acquired using a conversion table as shown in FIG. Then, an automatic scroll start process of generating a slice section change timer with the acquired automatic scroll waiting time is executed.
[0092]
By using this automatic scroll function, the doctor can prevent oversight by reflecting the work record on the scroll speed, such as slowly scrolling the slice cross section focused by other doctors.
[0093]
Further, in the above-described double interpretation, by performing automatic scrolling based on interpretation work records read by other doctors, it is possible to know the difference from the part of interest and to prevent oversight.
[0094]
Also, in joint interpretation, the point of interest at the time of interpretation becomes clear by performing automatic scrolling based on interpretation work records of two doctors. Since the automatic scrolling function also reflects the part that was read slowly but was not recorded in the findings, the interpreting doctor can hear the opinions of other doctors during the joint reading.
[0095]
Furthermore, in the case of comparative interpretation using the automatic scroll function in the form as shown in FIG. 26, the doctor who has read the past image by simultaneously scrolling the current image and the past image based on the interpretation work record of the past image. Since the point of interest is slowly scrolled, it is easier to observe the past point of interest compared to the current image.
[0096]
In the case of comparative interpretation using the automatic scroll function in the form as shown in FIG. 26, the current image and the past image are simultaneously scrolled based on the interpretation work record of the current image, so that the point of interest in the current image is You can follow up on what happened in the past interpretation.
[0097]
Here, in the case of comparative interpretation using the automatic scroll function in the form as shown in FIG. 26, there is a function for performing processing for setting which image should be simultaneously scrolled based on the interpretation work record. Has been. This function performs a process of determining an interpretation work record as a reference in accordance with a dialogue process with a doctor.
[0098]
Next, processing executed by the playback unit 115 will be described.
[0099]
When the doctor gives an instruction to reproduce the interpretation work, the reproduction unit 115 first reads the interpretation work record information to be reproduced from the interpretation work record file 13 in step 1 as shown in the processing flow of FIG. In the subsequent step 2, a chest X-ray CT image to be reproduced is read from the chest tomographic image database 10.
[0100]
Subsequently, in step 3, the timer is initialized, and in step 4, the interpretation work described in the first operation event of the read interpretation work record information is reproduced. Subsequently, in step 5, it is determined whether or not the next operation event remains in the read interpretation work record information.
[0101]
When it is determined by this determination process that the next operation event exists, the process proceeds to step 6 where the next operation event is set as a processing target, and in the subsequent step 7, the read interpretation work record information is referred to. Then, the elapsed time until the operation event to be processed is acquired.
[0102]
Subsequently, in step 8, after waiting for the acquired elapsed time to be reached and determining that the acquired elapsed time is reached, the process proceeds to step 9 to reproduce the interpretation operation of the operation event to be processed. Return to step 5.
[0103]
When it is determined in step 5 that all operation events of the read interpretation work record information have been processed, the processing is terminated.
[0104]
In this way, the reproduction unit 115 reproduces the interpretation work, and in order to know at a glance which slice section has been referenced for a long time in this reproduction, FIG. 27 shows. As described above, processing is performed so that the temporal flow of the referenced slice cross section acquired from the interpretation work record to be reproduced is output as a graph.
[0105]
By using this playback function, it is possible to understand the previous interpretation process in more detail, such as whether the window conditions have been changed and comparative interpretation, and can be used to analyze how the doctor is interpreting. It can also be expected to have an effect on medical education.
[0106]
Although the present invention has been described according to the illustrated embodiment, the present invention is not limited to this. For example, in the embodiment, the configuration in which the slice reference scale is created on the basis of the original slice cross section is adopted, but the configuration in which the slice reference scale is created in a form including the interpolation image can also be adopted.
[0107]
In the embodiment, the configuration in which the original slice is set as the scroll target is adopted, but the configuration in which the interpolation image is also set as the scroll target can be adopted.
[0108]
【The invention's effect】
As described above, according to the present invention, it is possible to record the interpretation operation of a medical image composed of a plurality of tomographic images, and to confirm where the diagnosis is performed by the doctor who interprets the image later. can do.
[0109]
That is, when a plurality of doctors interpret the same medical image, it is possible to know where other doctors who have interpreted the same medical image have focused on the diagnosis.
[0110]
In addition, when the follow-up observation is performed by comparatively interpreting the current and past medical images, the progress of the portion focused on the past can be accurately observed.
[0111]
Furthermore, it is possible to know whether it is a newly generated shadow or a follow-up shadow by being able to know whether the same part has been focused on in the past for the part currently focused on become.
[0112]
As described above, according to the present invention, when diagnosis is performed by interpreting a plurality of tomographic images, it becomes possible to clarify the past diagnosis process and to improve the efficiency of interpretation work. Can be realized.
[0113]
In addition, an interpretation reproduction function is provided, which can be a means for analyzing interpretation. By reconstructing the judgment grounds that have been known only from the findings so far, it can be understood without having to ask the interpreting doctor directly. Such interpretation reproduction can also be expected to have an effect on medical education.
[Brief description of the drawings]
FIG. 1 is an example embodiment of the present invention.
FIG. 2 is an explanatory diagram of a chest X-ray CT image.
FIG. 3 is an explanatory diagram of interpretation work.
FIG. 4 is an explanatory diagram of image interpretation work.
FIG. 5 is an example embodiment of an operation event table.
FIG. 6 is an example of interpretation work record information stored in an interpretation work record file.
FIG. 7 is an example of a functional configuration of an interpretation work support program.
FIG. 8 is an explanatory diagram of a display screen.
FIG. 9 is an explanatory diagram of a display screen.
FIG. 10 is an explanatory diagram of a display screen.
FIG. 11 is a flowchart of processing executed by an interpretation work execution unit.One caseIt is.
FIG. 12 is a flowchart of processing executed by the interpretation work record storage unit.One caseIt is.
FIG. 13 is a flowchart of processing executed by the interpretation work record storage unit.One caseIt is.
FIG. 14 is a flowchart of processing executed by the interpretation work record storage unit.One caseIt is.
FIG. 15 is a flowchart of processing executed by an interpretation work record storage unit.One caseIt is.
FIG. 16 is a flowchart of processing executed by the slice reference scale creation unit.One caseIt is.
FIG. 17 is a flowchart of processing executed by the slice reference scale creation unit.One caseIt is.
FIG. 18 is a flowchart of processing executed by the interpretation work record display unit.One caseIt is.
FIG. 19 is a flowchart of processing executed by the automatic scroll unit.One caseIt is.
FIG. 20 is a flowchart of processing executed by the automatic scroll unit.One caseIt is.
FIG. 21 shows a processing flow executed by the playback unit.One caseIt is.
FIG. 22 is an explanatory diagram of slice reference scale creation processing;
FIG. 23 is an explanatory diagram of contrast display of a chest X-ray CT image.
FIG. 24 is an explanatory diagram of reference time display processing;
FIG. 25 is an explanatory diagram of conversion processing to automatic scroll waiting time.
FIG. 26 is an explanatory diagram of contrast display of a chest X-ray CT image.
FIG. 27 shows the playback screen.One caseIt is.
[Explanation of symbols]
  1 Medical image interpretation support device
  10 chest tomographic image database
  11 Interpretation work support program
  12 Operation event table
  13 Interpretation work record file
  14 I / O devices
  110 Interpretation work execution part
  111 Interpretation work record storage
  112 Interpolated image generator
  113 Interpretation work record display section
  114 Automatic scroll part
  115 Playback unit
  116 Slice reference scale creation unit

Claims (4)

A medical image interpretation support apparatus for assisting interpretation of a medical image composed of a plurality of tomographic images,
Means for acquiring interpretation work record information composed of time-series data of paired data with occurrence time information of an event instructing change of a tomographic image to be subjected to interpretation work and information used for specifying the tomographic image; ,
From the acquired interpretation work record information, and means for calculating the interpretation time of each tomographic image,
Means for sequentially selecting the tomographic images in the scroll direction, and outputting the selected tomographic images for a time corresponding to the calculated interpretation time, thereby scrolling out the tomographic images.
A medical image interpretation support device as a feature. A medical image interpretation support apparatus for assisting interpretation of a medical image composed of a plurality of tomographic images,
Means for acquiring interpretation work record information composed of time-series data of paired data with occurrence time information of an event instructing change of a tomographic image to be subjected to interpretation work and information used for specifying the tomographic image; ,
From the acquired interpretation work record information, and means for calculating the interpretation time of each tomographic image,
Means for sequentially selecting the tomographic images in the scroll direction, and outputting the selected tomographic images for a time corresponding to the calculated interpretation time, thereby scrolling out the tomographic images ;
Comprising means for setting which of the tomographic images has the interpretation time to execute the scroll output when the tomographic images corresponding to the two interpretation operations are output in comparison .
A medical image interpretation support device as a feature. Claim 1 or the medical image interpretation support processing program for causing a co Npyu data as means constituting the medical image interpretation support equipment according to 2. Medical image interpretation support processing program in the recording medium in which the program was recorded for causing a co Npyu data as means constituting the medical image interpretation support equipment according to claim 1 or 2.

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