JP5148678B2 - Inspection support device and inspection support program - Google Patents

Description

  Embodiments described herein relate generally to an examination support apparatus and an examination support program that support a medical examination performed based on an image acquired by an examination apparatus.

  A GUI (Graphical User Interface) -based viewer that supports interpretation, examination, or patient explanation is known. In the viewer, image data collected by the inspection apparatus and stored in the image server can be acquired and displayed as necessary. An examiner such as a doctor interprets the image displayed by the viewer. In this interpretation, the inspector obtains necessary information while performing image processing using a viewer and changing the arrangement of images and information displayed as images.

Japanese Patent Application No. 2004-267273

  When the inspector needs to create or record a report of the inspection result, the inspector creates a report using a report viewer other than the above viewer or another software on the same viewer. . Many facilities do not have a report viewer. In such facilities, the inspector must write the inspection result on a recording sheet with a writing instrument.

  In a GUI-based viewer, the display form of an image can be changed, but interpretation has only been performed manually by an inspector.

  In addition, when conducting an inspection while creating a report, the inspector interprets the image using a GUI-based viewer, interrupts the image interpretation, and uses a report terminal to perform the report using several operations using the keyboard and mouse. Must be created or filled out on a record sheet. Therefore, the time required for the inspector is added to the time for reading or determining the result of interpretation in addition to the time for interpreting the actual image. In a system or the like that must interpret a large amount of images per unit time, this time becomes relatively long.

  Under these circumstances, there has been a problem that medical examination based on images is a heavy burden on the examiner.

  Under such circumstances, there has been a demand for an examination support apparatus and an examination support program that can support medical examination based on images in order to reduce the burden on the examiner.

Test support device is intended to support the medical examination to derive the test result by performing a plurality of decisions regarding medical abnormalities that appear in the image in a predetermined execution order, the and the execution order of the plurality of judgment plurality It is possible to access storage means for storing in association with at least one determination result that can be input in each of the determinations . Test support apparatus includes result input means, determining means, selecting means and presenting means. RESULTS input means inputs the inspection results. The determination means includes a determination to be made in order to derive an inspection result input by the result input means among the plurality of determinations stored in the storage means and an execution order of the corresponding determinations. The determination is made based on the information stored by Selection means, said determination at least one of the result input unit determination result may be selected to derive the test result inputted by the out of the determination result may be entered at the determined judged by means as to be performed Is elected. The presenting means presents the option selected by the selecting means to the user.

  ADVANTAGE OF THE INVENTION According to this invention, it becomes possible to support the medical examination based on an image in order to reduce an examiner's burden.

The figure which shows the structure of the test | inspection assistance apparatus which concerns on one Embodiment of this invention. The figure which shows an example of the setting information database memorize | stored in the setting information storage part in FIG. The flowchart which shows the process sequence of the information processing part in FIG. The figure which shows the flow of the test | inspection regarding the tumor in mammogram interpretation. The figure which shows an example of the confirmation screen produced by the information processing part in FIG. The figure which shows an example of the structure report information produced by the information processing part in FIG. The figure which shows an example of the report produced by the report production part in FIG.

Hereinafter, an embodiment of the present invention will be described with reference to the drawings.
FIG. 1 is a diagram illustrating a configuration of an inspection support apparatus 1 according to the present embodiment.
The inspection support apparatus 1 is connected to a LAN (Local Area Network) 2 as shown in FIG. Inspection equipment such as CT (Computed Tomography) 3, MG (Mammography) 4, MR (Magnetic Resonance) 5, CR (Computed Radiography) 6 and DR (Digital Radiography) 7 is appropriately connected to the LAN 2. Although not shown in the drawings, as an inspection apparatus, an endoscope, an ultrasonic inspection apparatus, a flat detector, an angiography apparatus, an electrocardiograph, a fundus imaging apparatus, a digital microscope for cytology or histopathology, or other These known devices can be used as appropriate. A server 8 is connected to the LAN 2. The server 8 stores image data collected by the inspection apparatus. In response to the request from the examination support apparatus 1, the server 8 sends the stored image data to the examination support apparatus 1. The server 8 may store not only image data but also examination related information, order information, report information, and the like.

  As shown in FIG. 1, the examination support apparatus 1 includes a user interface unit 11, a setting information storage unit 12, an information collection unit 13, an information processing unit 14, an information file storage unit 15, a CAD (Computer Aided Diagnosis) processing unit 16, an image. A data storage unit 17, a report creation unit 18 and a communication unit 19 are included.

  The inspection support apparatus 1 can use, for example, a general-purpose server apparatus or computer apparatus as basic hardware. The information collection unit 13, the information processing unit 14, the CAD processing unit 16, and the report creation unit 18 can be realized by causing a processor mounted on the server device or the computer device to execute a program. At this time, the inspection support apparatus 1 may be realized by installing the above-described program in a server apparatus or a computer apparatus in advance, or may be recorded on a removable recording medium such as a CD-ROM or via a network. The above-described program may be distributed, and this program may be appropriately installed on a server device or a computer device. The setting information storage unit 12, the information file storage unit 15, and the image data storage unit 17 are externally attached to a storage device such as a memory or a hard disk device built in the server device or computer device, or to the server device or computer device. Further, it can be realized by appropriately using a storage device such as a memory or a hard disk device, or a removable recording medium such as an optical disk.

  The user interface unit 11 includes an input device such as a mouse, a keyboard, a joystick, or a pen, or can be connected to a similar separate input device. As the input device, a device that inputs an instruction given by the user's line of sight, hand shape, voice, or the like can be applied. The user interface unit 11 inputs a user instruction based on a signal output from the input device. The user interface unit 11 includes a display device such as a liquid crystal display or can be connected to a similar separate display device. The user interface unit 11 displays various images to be presented to the user on the display device. The user interface unit 11 provides a user with a GUI, for example.

  The setting information storage unit 12 stores, for example, a setting information database as shown in FIG. The setting information database can be added, modified, or deleted by the processing of the information processing unit 14 according to a user instruction.

  Based on the information stored in the setting information storage unit 12, the information collection unit 13 determines which conditions and which tools are displayed in the order of interpretation, and collects information on those conditions and tools To do.

  The information processing unit 14 presents the information collected by the information collecting unit 13 to the user. The information processing unit 14 inputs a determination result in the middle of an interpretation procedure and an inspection result derived by interpretation. The information processing unit 14 creates information representing the input history of the determination result, and writes this information in the information file storage unit 15. The information processing unit 14 further presents to the user a determination result that is necessary for deriving the input inspection result but is not input. The information processing unit 14 adds the above-mentioned non-input determination result to the history information automatically or in response to an addition instruction from the user. When there are a plurality of determination results that are necessary for deriving the input inspection result but are not input, the determination results are presented to the user as options. The information processing unit 14 inputs the designation of one of the above options, and adds the designated determination result to the history information. The information processing unit 14 also creates information representing the tool usage history, and writes this information in the information file storage unit 15. Then, the information processing unit 14 confirms whether or not the tool is used at the timing when the determination to use the tool is made based on the usage history, and presents the fact to the user when it is not used. To do.

  The information file storage unit 15 stores viewer-related information, examination-related information, order information, report information, or information on the input history or usage history.

  The CAD processing unit 16 processes the image data into a time-difference image (however, current and past images are required under the same examination and data of the same condition) or a nodule analysis according to a user instruction. Further, the CAD processing unit 16 can determine a problematic location, and when several candidates are found, the CAD processing unit 16 divides the image in order to select one of them. Of course, there is a case where the image data is transmitted to the information processing unit 14 as it is without performing such processing in accordance with a user instruction.

  The image data storage unit 17 stores the image data acquired from the server 8.

  The report creation unit 18 creates report information about the examination performed using this examination support apparatus 1.

  The communication unit 19 performs communication via the LAN 2.

Next, the operation of the inspection support apparatus 1 configured as described above will be described.
For example, in mammogram interpretation, an inspection is performed by making a determination such as “distinguishing between a mass, calcification, or other” and “determining whether the breast is overlapping or a true tumor” by a predetermined inspection procedure. When such an inspection is performed, the information processing unit 14 executes a process as shown in FIG.

  In step Sa1, the information processing section 14 advances the process target procedure by one. When step Sa1 is executed for the first time, the information processing section 14 sets the process target procedure as the first procedure related to the examination being performed. In step Sa2, the information processing unit 14 requests the information collecting unit 13 to collect information related to the processing target procedure. In response to this request, the information collection unit 13 collects information regarding the corresponding procedure from the setting information storage unit 12 and sends the information to the information processing unit 14. In step Sa3, the information processing unit 14 acquires information sent from the information collecting unit 13 and displays the information through the user interface unit 11. Note that the display here indicates the contents of the judgment to be made by the user in each procedure, tools used for the judgment, and the like.

  Next, in steps Sa4 to Sa6, the information processing unit 14 waits for a tool to be used, a determination result to be input, or an inspection result to be input.

  When the tool is used, the information processing section 14 proceeds from step Sa4 to step Sa7. In step Sa7, the information processing unit 14 updates the usage history. The usage history indicates which tool is used in which procedure of which inspection. After this, the information processing section 14 repeats the processing after step Sa1.

  When the determination result regarding the current process target procedure is input, the information processing unit 14 proceeds from step Sa5 to step Sa8. In step Sa8, the information processing unit 14 updates the input history. The input history indicates what judgment result is input in which procedure of which inspection. Subsequently, in step Sa9, the information processing unit 14 confirms whether or not the result of the inspection is derived by inputting the determination result of the current process target procedure. If the inspection result has not yet been derived, the information processing section 14 repeats the processes after step Sa1.

  When the examination result is input instead of the determination result regarding the current process target procedure, the information processing unit 14 proceeds from step Sa6 to step Sa10. In step Sa10, the information processing unit 14 checks whether there is a determination that is necessary for deriving the input examination result but the determination result is not input. This confirmation can be performed based on the input history, for example. When it is confirmed that there is such a determination, the information processing section 14 proceeds from step Sa10 to step Sa11. In step Sa <b> 11, the information processing unit 14 requests the information collection unit 13 to collect information regarding a procedure for which a determination result is not input. In step Sa <b> 12, the information processing unit 14 acquires information sent from the information collecting unit 13. In step Sa13, the information processing unit 14 creates a confirmation screen based on the information acquired in step Sa12 and displays the confirmation screen via the user interface unit 11.

  For example, in the case of an examination relating to a tumor mass in mammogram interpretation, the examination results of categories 1 to 6 are derived by various judgments as shown in FIG.

  When “Category 2” is entered as the test result only when “Considering a true tumor” is entered as the judgment result for the judgment of “overlapping mammary gland or true tumor?” The determination result regarding the determination of “contains fat” has not been entered. In order to derive “category 2” as the test result, the determination result regarding the determination of “contains fat” should be “a tumor containing fat”. Therefore, in this case, the information processing unit 14 creates a confirmation screen indicating that “this lesion is a mass containing fat”. For example, when the character string “mass containing fat” is underlined and this “mass containing fat” is clicked, the information processing unit 14 determines whether or not it contains fat. It is assumed that “mass containing fat” is input as the determination result of the above. However, when there is only one candidate for the determination result as described above, the determination result may be input without receiving a user operation.

  On the other hand, when “category 3” is suddenly input as an inspection result without inputting any determination result, this is one of the inspection results indicated by reference numerals 41, 42, and 43 in FIG. But it can be. Therefore, the information processing unit 14 creates a confirmation screen as shown in FIG. In FIG. 5, choices are represented by underlined character strings. That is, the character strings “candidate 1”, “1. boundary clear and smooth”, and “2. boundary fine lobed fine sawtooth boundary unclear” are options. When “candidate 1” is clicked, the information processing unit 14 is input “what is confused as to whether it is an overlap or a true tumor” as a determination result for the determination of “overlapping mammary gland or true tumor?” Suppose. When “1. Clear border smoothness” is clicked, the information processing unit 14 receives “when considered to be a true tumor” as a determination result regarding the determination of “overlapping mammary gland or true tumor?” Further, it is assumed that “border clear and smooth” is input as the determination result of “edge diagnosis”. When “2. Boundary fine lobed fine serrated boundary indistinct” is clicked, the information processing unit 14 determines that “the mammary gland overlaps or a true tumor?” It is assumed that “when considered” is input, and “boundary fine lobed fine sawtooth boundary ambiguity” is input as a determination result for “edge diagnosis”.

  In step Sa14, the information processing unit 14 waits for a determination result to be input as described above. If the determination result is input, the information processing section 14 proceeds from step Sa14 to step Sa15. In step Sa15, the information processing unit 14 updates the input history to reflect the input of the determination result.

  The information processing section 14 proceeds from step Sa15 to step Sa16. If it is determined in step Sa9 that the inspection result has been derived, the information processing section 14 proceeds from step Sa9 to step Sa16. Furthermore, when it is determined in step Sa10 that there is no determination that the determination result has not been input, the information processing section 14 proceeds from step Sa10 to step Sa16. In step Sa16, the information processing section 14 creates structure report information as shown in FIG. 6, for example, based on the input history, and stores this structure report information in the information file storage section 15. Note that the information processing unit 14 confirms whether or not the tool is correctly used in all the procedures in which the tool should be used based on the usage history. When there is a procedure in which the tool is not used correctly, the information processing unit 14 adds a character string that warns to that effect to the determination result regarding the procedure. FIG. 6 shows an example in which a character string “* Measurement tool is not used!” Is added because a measurement tool for measuring fat mass was not used in the determination of “contains fat”. ing.

  Now, the report creation unit 18 creates report information in response to a request from the user. The report creation unit 18 arranges the information included in the above structure report information and the image used for the inspection in a predetermined layout, thereby, for example, report information indicating a report as shown in FIG. create.

  As described above, according to the present embodiment, when an inspection result is input after skipping a procedure, a determination result to be input in the skipped procedure is displayed. Thereby, it is possible to make the user confirm whether or not the input inspection result is derived under correct judgment.

  According to the present embodiment, the determination result to be input in the skipped procedure is added to the input history as input. Thereby, based on the input history, it is possible to create a report that correctly represents the progress of the determination according to the procedure.

  In addition, according to the present embodiment, even when there is only one determination result to be input in the skipped procedure, it is added to the input history in accordance with an instruction from the user. Thereby, it is possible to prompt the user to surely confirm whether or not the input inspection result is derived under correct judgment.

  Further, according to the present embodiment, when there are a plurality of judgment results to be input in the skipped procedure as described above for the same judgment, these judgment results are displayed as options and any one is selected by the user. Let As a result, an unknown determination result can be input.

  Further, according to the present embodiment, the usage status of the tool is monitored, and when the tool is not used correctly at the timing at which the tool should be used, this is indicated in the report. Therefore, the person who reads the report can recognize that there is a possibility that the correct judgment is not made.

This embodiment can be variously modified as follows.
If there is only one determination result to be input in the skipped procedure, the determination result may be added to the input history without user confirmation.
A report may be created based on the determination result to be input in the skipped procedure, the input history, and the input inspection result. When there are a plurality of judgment results to be input in the skipped procedure for the same judgment, a plurality of reports that adopt the judgment results may be created.
Presentation that the tool is not being used correctly may be performed separately from the report display, such as by display via the user interface unit 11.

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

  DESCRIPTION OF SYMBOLS 1 ... Examination assistance apparatus, 11 ... User interface part, 12 ... Setting information storage part, 13 ... Information collection part, 14 ... Information processing part, 15 ... Information file storage part, 16 ... CAD processing part, 17 ... Image data storage part , 18 ... report creation unit, 19 ... communication unit.

Claims (4)

A medical examination for deriving a test result by executing a plurality of judgments regarding medical abnormalities appearing in an image in a predetermined execution order, and in each of the execution order of the plurality of judgments and each of the plurality of judgments in the inspection support apparatus capable of accessing at least one decision result storage means for storing in association with that can be input,
A result input means for inputting the inspection result;
Of the plurality of judgments stored in the storage means, judgments to be made in order to derive the inspection result input by the result input means and the execution order of the relevant judgments are stored by the storage means. Determining means for determining based on the information;
Selection for selecting a determination result that can be selected to derive the inspection result input by the result input means from at least one determination result that can be input in the determination determined by the determination means as to be performed Means,
An examination support apparatus comprising: a presentation unit that presents a determination result selected by the selection unit to a user. It intended to support the medical examination to derive the test result by performing a plurality of decisions regarding medical abnormalities that appear in the image in a predetermined execution order, to each of the plurality of determining the execution order of the plurality of judgment In the examination support apparatus accessible to the storage means for associating and storing at least one determination result that can be inputted in
A result input means for inputting the inspection result;
Of the plurality of judgments stored in the storage means, judgments to be made in order to derive the inspection result input by the result input means and the execution order of the relevant judgments are stored by the storage means. Determining means for determining based on the information;
Selection for selecting a determination result that can be selected to derive the inspection result input by the result input means from at least one determination result that can be input in the determination determined by the determination means as to be performed Means,
An inspection support apparatus, comprising: a means for generating a report including the determination result selected by the selection means and the inspection result input by the result input means . A process for supporting a medical examination for deriving a test result by executing a plurality of judgments regarding medical abnormalities appearing in an image in a predetermined execution order, and performing the plurality of judgment execution orders and the plurality of judgments in test support program for causing each of the at least one decision result storage means for storing in association with can be Oite input to the conducted accessible computer,
The computer,
A result input means for inputting the inspection result;
Of the plurality of judgments stored in the storage means, judgments to be made in order to derive the inspection result input by the result input means and the execution order of the relevant judgments are stored by the storage means. Determining means for determining based on the information;
Selection for selecting a determination result that can be selected to derive the inspection result input by the result input means from at least one determination result that can be input in the determination determined by the determination means as to be performed Means,
An inspection support program which causes a judgment result selected by the selection means to function as a presentation means for presenting to a user. A process for supporting a medical examination for deriving a test result by executing a plurality of judgments regarding medical abnormalities appearing in an image in a predetermined execution order, and performing the plurality of judgment execution orders and the plurality of judgments in test support program for causing each of the at least one decision result storage means for storing in association with can be Oite input to the conducted accessible computer,
The computer,
A result input means for inputting the inspection result;
Of the plurality of judgments stored in the storage means, judgments to be made in order to derive the inspection result input by the result input means and the execution order of the relevant judgments are stored by the storage means. Determining means for determining based on the information;
Selection for selecting a determination result that can be selected to derive the inspection result input by the result input means from at least one determination result that can be input in the determination determined by the determination means as to be performed Means,
An inspection support program that functions as means for creating a report including the determination result selected by the selection means and the inspection result input by the result input means .

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