JP5438634B2 - Electronic endoscope system - Google Patents

Description

  The present invention relates to an electronic endoscope system that images an inside of a subject with an electronic endoscope, and more particularly to an electronic endoscope system that irradiates an affected area with a therapeutic laser beam.

  In the medical field, many diagnoses and treatments using an electronic endoscope are performed. In recent years, images taken by irradiating a subject with white light (hereinafter referred to as normal light) can be observed naturally within the subject, but it may be difficult to grasp tumor tissue, etc. 2. Description of the Related Art There is known an electronic endoscope system that makes it easy to grasp a tumor tissue and the like by photographing the inside of a subject while irradiating the subject with light of a specific narrow wavelength band (hereinafter referred to as special light). For example, such an electronic endoscope system that performs PDD (Photodynamic Diagnosis) is known. Furthermore, a system that performs PDT (Photodynamic Therapy) on a lesion such as a tumor tissue diagnosed by PDD is also known.

  PDD accumulates a photosensitizer that emits fluorescent light by irradiating excitation light of a predetermined wavelength in the tumor tissue in advance, so that the position and size of the tumor tissue can be grasped by the fluorescent light emitted by the photosensitizer. This is a diagnostic method that can be performed. As a photoaffinity substance having affinity for tumor, a hematoporphyrin derivative that generates red fluorescent light (for example, wavelength 635 nm) by irradiating blue light around 405 nm as excitation light is known.

  A photosensitive substance used in PDD may generate active oxygen in tumor tissue by irradiating light with a predetermined wavelength different from excitation light (for example, red light of 630 nm to 680 nm, hereinafter referred to as therapeutic light). Are known. PDT is a treatment method that utilizes the cytocidal action of active oxygen generated in this way, and extinguishes tumor tissue by irradiating treatment light on the tumor tissue in which a photosensitive substance is accumulated. Although PDT depends on the size of the tumor tissue and the power of the treatment light, the treatment using an electronic endoscope requires a relatively long treatment time of about 10 minutes.

  The treatment light emitted by the PDT is extremely high in output compared to the normal light. Therefore, when the inside of the subject is imaged by irradiating the normal light while irradiating the treatment light, A phenomenon (so-called halation) in which the periphery is blurred is generated. For this reason, it is difficult to observe the inside of the subject during treatment with PDT. Moreover, since the fluorescent light observed with PDD is in the same wavelength band as the treatment light, it is difficult to perform PDD and PDT simultaneously. However, it is desired to be able to observe the inside of a subject during treatment with PDT in order to confirm the irradiation position of the treatment light and the treatment effect.

  For this reason, normal light observation and PDD are performed during treatment by PDT by synchronizing the irradiation timing of treatment light and normal light and the drive timing of the image sensor well, and alternately performing PDT and normal light imaging and PDD. Electronic endoscope systems that make this possible are known (Patent Documents 1 and 2). Japanese Patent Application Laid-Open No. 2004-228561 discloses a technique for performing both PDT and PDD in one frame by performing PDT in the first field and performing PDD in the second field. Patent Document 2 discloses a technique for performing photographing with reduced halation by performing normal light photographing, PDD, and PDT in order for each frame, and resetting accumulated charges in the middle of one frame in a frame in which PDT is performed. .

JP 2006-130183 A JP 2006-094907 A

  When the tumor tissue is extinguished by PDT, the total amount of treatment light necessary for treatment is determined according to the size of the tumor tissue and the like. Further, as the characteristics of the light source, the amount of treatment light per unit time is constant. For this reason, the time required for PDT is determined by the light amount of the treatment light and the total irradiation light amount required until the treatment is completed.

  However, the treatment light is not always efficiently irradiated to the tumor tissue depending on the irradiation position and direction of the treatment light to the tumor tissue. When the treatment light is not efficiently irradiated, when the treatment with PDT is terminated by irradiating the treatment light for a specified time, the tumor tissue may not be completely extinguished due to insufficient treatment light irradiation. There is a problem that the burden on the subject is large because there is no coping method other than irradiating treatment light longer than the prescribed time in order to surely eliminate the tumor tissue.

  When an image in which halation has occurred is displayed on the monitor as it is, the therapeutic effect cannot be confirmed by halation. In addition, when halation is prevented by interrupting treatment light irradiation in units of frames and performing normal light photography, the image taken with normal light is displayed on the monitor. However, since it is a visual judgment, depending on the skill of the operator, even if there is a portion where the treatment light irradiation is insufficient, it may be overlooked. In particular, it is difficult to accurately grasp the progress status and therapeutic effect in the course of treatment by PDT.

  The present invention has been made in view of the above-described problems, and an object of the present invention is to support an operator by displaying the progress of treatment (treatment effect) during treatment by PDT.

  The electronic endoscope system of the present invention acts on white light irradiation means for irradiating white light into a subject, and a photosensitive substance accumulated in the treatment target region in the subject, Treatment light irradiation means for irradiating treatment light to be treated, an image sensor for imaging the inside of the subject by photoelectrically converting light incident from within the subject, and sequentially irradiating the treatment light together with the white light By adding the pixel value of each pixel of the image being treated, the total irradiation light amount calculating means for calculating the total irradiation light amount of the treatment light for each pixel, and the total irradiation light amount calculated for each pixel A treatment effect image generating means for generating the treatment effect image, a display means for displaying the in-treatment image, and a display control means for displaying the treatment effect image together with the in-treatment image on the display means. Preparation It is characterized in.

  A region-of-interest designating unit that designates a region of interest for the image during treatment, the total irradiation light amount calculating unit calculates the total irradiation light amount for pixels in the region of interest, and the treatment effect image generating unit includes the treatment effect image generating unit, Preferably, the therapeutic effect image is generated for the region of interest.

  The therapeutic effect image is preferably an image obtained by mapping the total irradiation light amount according to a predetermined color map.

  The display control means preferably displays the treatment effect image superimposed on the treatment-in-progress image.

  Preferably, the display control means enlarges and displays the region of interest on which the therapeutic effect image is superimposed on the display means.

  The therapeutic effect image is preferably an image that displays the total irradiation light amount as a three-dimensional histogram.

A discriminating means for discriminating whether the image under treatment is an image with halation in which halation has occurred or an image without halation in which no halation has occurred, and storage means for storing the image under treatment for a plurality of frames, When the captured image being treated is the image with halation, the display control means selects the image without halation from the past images being treated stored in the storage means, and displays the display means. Is preferably displayed.

  The discriminating means compares the pixel value of each pixel of the image under treatment with a predetermined threshold value, counts pixels having a pixel value larger than the threshold value, and more than a predetermined number of pixels having a pixel value larger than the threshold value. Preferably, the image being treated is determined to be the image with halation when there are many images, and the image being treated is determined to be the image without halation when the number of pixels having a pixel value larger than the threshold is equal to or less than a predetermined number.

By reducing the amount of pre-Symbol therapeutic light, it is preferable to provide a control means for forcibly taking the halation without image.

Wherein, prior to the treatment in the image said halation there images next photographing stored in the storage means to be taken are all the halation there image, in the subsequent shooting, prior Symbol therapeutic light It is preferable to reduce the amount of light.

  ADVANTAGE OF THE INVENTION According to this invention, the treatment progress (effect of treatment) can be displayed and the operator can be supported during the treatment by PDT.

It is an external view which shows the structure of an electronic endoscope system. It is a block diagram which shows the electric constitution of an electronic endoscope system. It is explanatory drawing which shows the structure of an aperture mechanism. It is a graph which shows the characteristic of a double notch filter. It is a flowchart which shows the effect | action of an electronic endoscope system. It is explanatory drawing which shows the aspect of the various images image | photographed with an electronic endoscope system. It is explanatory drawing which shows the aspect which replaces with an image without a halation and displays, when an image with a halation is image | photographed. It is explanatory drawing which shows the aspect which forcibly acquires an image without a halation. It is a timing chart which shows the relationship between lighting of normal light and treatment light, and imaging. It is a timing chart which shows the mode which makes PDT and PDD compatible. It is a block diagram which shows the electric constitution of the electronic endoscope system of 2nd Embodiment. It is explanatory drawing which shows the aspect which displays the outline etc. of halation. It is explanatory drawing which shows another aspect which displays the outline etc. of halation. It is a block diagram which shows the electric constitution of the electronic endoscope system of 3rd Embodiment. It is explanatory drawing which shows the example of the aspect which displays the irradiation efficiency of treatment light on a monitor. It is explanatory drawing which shows the aspect which adjusts direction etc. of a front-end | tip part. It is a block diagram which shows the electric constitution of the electronic endoscope system of 4th Embodiment. It is explanatory drawing which shows the aspect which displays a therapeutic effect during PDT. It is explanatory drawing which shows the other aspect which displays a therapeutic effect during PDT. It is a block diagram which shows the example which produces | generates all the normal light, excitation light, and treatment light by LD. It is sectional drawing which shows the structure of a light projection unit. It is a figure which shows arrangement | positioning of the light projection unit in a front end surface. It is a table | surface which shows the corresponding | compatible relationship between the chemical | medical agent used as a photosensitive substance, and the wavelength of excitation light, fluorescence light, and treatment light.

[First Embodiment]
First, as a first embodiment, an electronic endoscope system 11 capable of preventing halation and shortening treatment time will be described. As shown in FIG. 1, the electronic endoscope system 11 includes an electronic endoscope 12, a processor device 13, and a light source device 14. The electronic endoscope 12 is connected to a flexible insertion portion 16 that is inserted into the body of a subject, an operation portion 17 that is connected to a proximal end portion of the insertion portion 16, a processor device 13, and a light source device 14. Connector 18 and a universal cord 19 that connects between the operation unit 17 and the connector 18. A distal end (hereinafter referred to as the distal end portion) 20 of the insertion portion 16 is provided with a CCD image sensor (refer to FIG. 2; hereinafter referred to as a CCD) 21 for imaging within the subject.

  The operation unit 17 includes an angle knob for bending the tip 20 up and down, left and right, an air / water feed button for ejecting air and water from the tip of the insertion unit 16, and a release for recording a still image. Operation members such as a button, a zoom button for instructing enlargement / reduction of the observation image displayed on the monitor 22, and a switching button for switching between observation with normal light and PDD are provided. In addition, a forceps port 74 through which a treatment tool such as a treatment probe for guiding treatment light from an electric knife or PDT is inserted is provided on the distal end side of the operation unit 17. The forceps port 74 communicates with a forceps outlet 76 provided at the distal end portion 20 via a forceps channel 75 (see FIG. 2) in the insertion portion 16.

  The processor device 13 is electrically connected to the light source device 14 and comprehensively controls the operation of the electronic endoscope system 11. The processor device 13 supplies power to the electronic endoscope 12 via the universal cord 19 and a transmission cable inserted into the insertion portion 16 and controls the driving of the CCD 21. In addition, the processor device 13 acquires an imaging signal output from the CCD 21 via a transmission cable, and performs various image processing to generate image data. The image data generated by the processor device 13 is displayed as an observation image on a monitor 22 connected to the processor device 13 by a cable.

  As shown in FIG. 2, the distal end portion 20 is provided with an observation window 23 and an illumination window 24. A timing generator (hereinafter referred to as TG) 26, an analog signal processing circuit (hereinafter referred to as AFE) 27, a VRAM 28, and a CPU 29 are provided on the operation unit 17, the connector 18 of the universal cord 19, and the like. In the back of the observation window 23, the CCD 21 is arranged so that an image in the subject is formed on the imaging surface by an objective optical system 31 including a lens group and a prism. Illumination light is emitted from the illumination window 24 into the subject. Illumination light is supplied from the light source device 14 to the electronic endoscope 12, guided by the light guide 32 inserted through the universal cord 19 and the insertion portion 16, and passed through the illumination window 24 by the illumination lens 33 disposed at the exit end. Through the subject.

  The CCD 21 photoelectrically converts an image in the subject formed on the imaging surface by the objective optical system 31. The CCD 21 has a plurality of pixels, and each pixel outputs an imaging signal having a pixel value corresponding to the amount of incident light. The imaging surface includes a central light receiving portion and optical black provided so as to surround the light receiving portion. The light receiving portion is an area where the opened pixels are arranged, and a color filter including a plurality of color segments is formed in each pixel. The color filter is, for example, a Bayer array primary color (RGB) or complementary color (CMY or CMYG) color filter. The optical black is an area composed of pixels shielded by a light shielding film, and outputs an imaging signal corresponding to dark current noise. Therefore, the imaging signal output from the CCD 21 includes the imaging signal output from the optical black pixel as well as the imaging signal output from the pixel of the light receiving unit. The imaging signal output from the pixel of the light receiving unit is used for generating an observation image, and the imaging signal output from the optical black pixel is used for dark current correction of the imaging signal output from the pixel of the light receiving unit.

  The image pickup signal output from the CCD 21 is an analog signal, subjected to noise removal processing and gain correction processing by the AFE 27, and after A / D conversion, the DSP 42 (described later) of the processor device 13 through the universal code 19 and the connector 18. ).

  The TG 26 gives a clock signal to the CCD 21. The CCD 21 performs an imaging operation according to the clock signal input from the TG 26 and outputs an imaging signal. After the electronic endoscope 12 and the processor device 13 are connected, the CPU 29 drives the TG 26 based on an operation signal from the CPU 41 of the processor device 13.

  The AFE 27 includes a correlated double sampling (CDS) circuit, an automatic gain adjustment (AGC) circuit, and an A / D converter. The CDS performs a correlated double sampling process on the imaging signal output from the CCD 21 to remove noise generated by driving the CCD 21. The AGC amplifies the imaging signal from which noise has been removed by CDS. The A / D converter converts the imaging signal into a digital imaging signal having a predetermined number of bits by AGC. The driving of the AFE 27 is controlled by the CPU 29. For example, the CPU 29 adjusts the gain (gain) of the imaging signal by the AGC circuit based on the operation signal input from the CPU 41 of the processor device 13.

  The processor device 13 includes a CPU 41, a digital signal processing circuit (DSP) 42, a digital image processing circuit (DIP) 43, a display control circuit 44, an operation unit 51, and the like.

  The CPU 41 is connected to each unit via a data bus, an address bus, and a control line (not shown), and comprehensively controls the operation of the entire processor device 13. The ROM 52 stores various programs (OS, application programs, etc.) and various data (graphic data, etc.) for controlling the operation of the processor device 13. The CPU 41 reads out necessary programs and data from the ROM 52, develops them in the RAM 53, which is a working memory, and sequentially processes the read programs. Further, the CPU 41 obtains information that changes for each examination, such as examination date and time, character information such as subject and operator information, from the operation unit 51 and a network such as a LAN, and stores the information in the RAM 53.

  The DSP 42 performs various signal processing such as color separation, color interpolation, gain correction, white balance adjustment, and gamma correction on the image pickup signal input from the CCD 21 to generate image data. The image data generated by the DSP 42 is input to the working memory of the DIP 43. Further, the DSP 42 generates ALC control data necessary for automatic control (ALC control) of the amount of illumination light, such as an average luminance value obtained by averaging the luminance of each pixel of the generated image data, and inputs the generated data to the CPU 41.

  The DIP 43 performs various types of image processing such as electronic scaling, color enhancement processing, and edge enhancement processing on the image data generated by the DSP 42. Image data that has been subjected to various types of image processing by the DIP 43 is temporarily stored as an observation image in the VRAM 28 and then input to the display control circuit 44.

  In addition, the DIP 43 includes a halation detection unit 55 that detects the presence or absence of halation in the observation image. The halation detection unit 55 compares each pixel value of the observation image with a predetermined threshold value, and counts pixels having a pixel value larger than the threshold value. If the number of pixels having a pixel value greater than the threshold value is greater than the predetermined number, the halation detection unit 55 determines that halation has occurred in the observed image. On the other hand, when the number of pixels having a pixel value greater than the threshold value is equal to or less than the predetermined number, the halation detection unit 55 determines that no halation has occurred in the observation image. Thereby, the halation detection part 55 detects the presence or absence of halation every time an observation image is taken.

  Hereinafter, an observation image in which halation is detected by the halation detection unit 55 is referred to as an image with halation, and an observation image in which no halation is detected is referred to as an image without halation.

  The determination result of the presence or absence of halation by the halation detector 55 is input to the CPU 41. Based on the determination result input from the halation detection unit 55, the CPU 41 determines an observation image to be displayed on the monitor 22 from among a plurality of observation images stored in the VRAM 28 and is determined to be displayed on the monitor 22. An image selection signal is input to the display control circuit 44 so as to selectively acquire the observed image.

  The VRAM 28 is a memory that temporarily stores an observation image input from the DIP 43, and simultaneously stores observation images for a plurality of frames (for example, five frames). In addition, when the DIP 43 inputs a new observation image in a state where the upper limit (5 frames) of the observation image is already stored in the VRAM 28, the DIP 43 discards the oldest observation image by overwriting update or the like. The new observation image is stored in the VRAM 28. Therefore, the observation image for the upper limit of the storage capacity is stored in the VRAM 28 from the latest observation image. An observation image for one frame among the observation images for a plurality of frames stored in the VRAM 28 is selected and acquired by the display control circuit 44 and displayed on the monitor 22.

  The display control circuit 44 selects and acquires an observation image from the VRAM 28 and displays it on the monitor 22. At this time, the display control circuit 44 acquires an observation image for one frame from the plurality of observation images stored in the VRAM 28 based on the image selection signal input from the CPU 41, and this is obtained on the monitor 22. indicate. In particular, when treatment by PDT is performed, the latest image without halation is acquired from the observation images stored in the VRAM 28 and displayed on the monitor 22. In addition, the display control circuit 44 receives graphic data and the like stored in the ROM 52 and the RAM 53 from the CPU 41. Examples of the graphic data include a display mask for displaying only an effective pixel region in which an object is photographed in an observation image, character information such as examination date and time, information on a subject and an operator, and GUI. The display control circuit 44 performs superimposing processing of graphic data or the like on the observation image acquired from the VRAM 28 and converts it into a video signal (component signal, composite signal, etc.) according to the display format of the monitor 22 to the monitor 22. Output. Thereby, an observation image is displayed on the monitor 22.

  The operation unit 51 is a known input device such as an operation panel, a mouse, or a keyboard provided in the housing of the processor device 13 and includes a pedal switch that instructs irradiation and stop of treatment light in the PDT. CPU41 operates each part of the electronic endoscope system 11 according to the operation signal from the operation part 51 or the operation part 17 of the electronic endoscope 12. FIG.

  In addition to the above, the processor device 13 also includes a compression processing circuit that performs image compression processing on image data in a predetermined compression format (for example, JPEG format), and a removable image in conjunction with the operation of the release button. A network I / F for performing transmission control of various data with a network such as a media I / F to be recorded on the medium and a LAN is provided. These are connected to the CPU 41 via a data bus or the like.

  The light source device 14 includes an illumination light unit 61 and a treatment light unit 62. The illumination light unit 61 is a unit that generates illumination light for imaging that is irradiated into the subject, and includes a light source 63, a diaphragm mechanism 64, a wavelength selection filter 65, and the like.

  The light source 63 generates light having a broad wavelength from red to blue (for example, light mainly in a wavelength band of 400 nm to 800 nm, hereinafter referred to as normal light). The light source 63 is composed of, for example, a xenon lamp, and emits normal light having a constant light amount. The amount of normal light generated by the light source 63 is adjusted by the diaphragm mechanism 64. Further, the normal light generated by the light source 63 is light in a wavelength band (hereinafter referred to as excitation light) that generates fluorescent light from a photosensitive substance that is previously administered to the subject for PDD and PDT by the wavelength selection filter 65. In some cases, the irradiation is performed within the subject. Thus, the illumination light (normal light or excitation light) emitted from the light source 63 is condensed by the condenser lens 67 and guided to the incident end of the light guide 32.

  For example, the light guide 32 is formed by bundling a plurality of quartz optical fibers with a wound tape or the like. The illumination light guided to the exit end of the light guide 32 is diffused by the illumination lens 33 and irradiated into the subject.

  As will be described later, the diaphragm mechanism 64 includes a diaphragm opening 91 (see FIG. 3), a diaphragm blade 92 (see FIG. 3) that opens and closes the diaphragm opening 91, and adjusts the amount of illumination light. The diaphragm mechanism 64 is automatically controlled by the CPU 66.

  The wavelength selection filter 65 is a filter that limits normal light emitted from the light source 63 to excitation light. The wavelength selection filter 65 has, for example, a semicircular shape in which half of a disk is cut out, and is rotated by driving a motor so as to cross between the light source 63 and the condenser lens 67. Further, the wavelength selection filter 65 is provided with a sensor for detecting the rotational position. While the wavelength selection filter 65 crosses between the light source 63 and the condensing lens 67, excitation light is irradiated into the subject as illumination light, and a notch portion of the wavelength selection filter 65 is formed between the light source 63 and the condensing lens 67. While crossing, normal light is irradiated into the subject as illumination light. The CPU 31 switches the illumination light between the normal light and the excitation light by controlling the wavelength selection filter 65 when the operation unit 17 is instructed to switch the observation method.

  The treatment light unit 62 is a unit that generates treatment light irradiated to a tumor tissue in which a photosensitive substance is accumulated for PDT, and includes a light source 71 and a diaphragm mechanism 72.

  The light source 71 generates red light of 630 nm to 680 nm. The red light generated by the light source 71 functions as therapeutic light by being irradiated to the tumor tissue in which the photosensitive substance is accumulated. Hereinafter, red light generated by the light source 71 is referred to as treatment light. The light source 71 is composed of an LD, for example, and pulse-oscillates a laser beam having a higher light quantity than normal light or PDD excitation light. The amount of treatment light generated by the light source 71 is adjusted by the diaphragm mechanism 72, collected by the condenser lens 77, and guided to the treatment probe 73.

  The diaphragm mechanism 72 is configured similarly to the diaphragm mechanism 64 of the illumination light unit 61, and opens and closes the diaphragm opening 91 with the diaphragm blades 92. As a result, the amount of treatment light incident on the treatment probe 73 from the light source 71 is adjusted. The operation of the diaphragm mechanism 72 is automatically controlled by the CPU 66.

  The treatment probe 73 is a treatment tool used for PDT, guides the treatment light from the light source device 14, and irradiates the treatment light from the tip toward the tumor tissue in which the photosensitive substance is accumulated in advance. The proximal end portion of the treatment probe 73 is connected to the light source device 14, and treatment light is incident from the treatment light unit 62. The other end (tip) of the treatment probe 73 is inserted into the electronic endoscope 12 from the forceps port 74, is inserted through a forceps channel 75 provided along the insertion portion 16, and the forceps provided at the tip portion 20. Projected from the outlet 76. The forceps outlet 76 is the end of the forceps channel 75. The protruding amount of the treatment probe 73 from the forceps outlet 76 can be freely adjusted by moving the treatment probe 73 in the direction in which the treatment probe 73 is advanced and retracted at the forceps port 74.

  The CPU 66 communicates with the CPU 41 of the processor device 13 and controls the operation of the aperture mechanisms 64 and 72 and the wavelength selection filter 65. The control of the diaphragm mechanisms 64 and 72 by the CPU 66 is ALC (Auto Light Control) control that automatically adjusts the amount of illumination light in accordance with the mode of photographing. The ALC control performed by the CPU 66 is performed based on the ALC control data generated by the DSP 42.

  The hood 81 is an attachment that is attached to the distal end portion 20 when performing PDD and PDT. The hood 81 is provided with an observation window 82, an illumination window 83, and a forceps outlet 84 corresponding to the positions of the observation window 23, the illumination window 24, and the forceps outlet 76 of the distal end portion 20.

  The observation window 82 is provided with a neutral density filter 85. The neutral density filter 85 is a filter (so-called notch filter) that attenuates the excitation light for PDD and the treatment light for PDT (so-called notch filter), and transmits light of a wavelength band other than the excitation light and the treatment light almost 100%. For this reason, at the time of PDD, fluorescent light generated from the photosensitive substance and reflected light of the excitation light enter the observation window 82, but only the excitation light is attenuated. As a result, an image in the subject can be taken with fluorescent light having a small amount of light.

  Further, during PDT, a high amount of treatment light is used to shorten the treatment time. However, since the reflected light is attenuated by the neutral density filter 85, the amount of treatment light reaching the CCD 21 is reduced.

  Since normal light is broadband light and includes excitation light for PDD and treatment light for PDT, the inside of the subject is imaged while being illuminated with normal light with the hood 81 attached (hereinafter referred to as normal light imaging). ), The information in the same wavelength band as the excitation light and the treatment light is reduced by the neutral density filter 85, but most of the other wavelength bands are transmitted through the neutral density filter 85. For this reason, an observation image (hereinafter referred to as a normal light image) captured by normal light illumination is a substantially normal light image regardless of the presence or absence of the hood 81.

  The illumination window 83 is fitted with a transparent member (for example, a glass plate) that transmits at least normal light and excitation light. For this reason, even when the hood 81 is attached to the distal end portion 20, normal light or excitation light is irradiated into the subject as in the case where the hood 81 is not attached.

  The forceps outlet 84 is an opening, and when the hood 81 is attached to the distal end portion 20, the forceps outlet 84 exposes the entire forceps outlet 76 of the distal end portion 20. Therefore, even when the hood 81 is attached to the distal end portion 20, the treatment instrument such as the treatment probe 73 can be protruded from the distal end portion 20.

  As shown in FIG. 3, the stop mechanism 64 of the illumination light unit 61 includes a stop blade 92 that opens and closes the stop opening 91 and a spring 93 that biases the stop blade 92 to a position where the stop opening 91 is closed. The diaphragm blade 92 rotates in a direction (clockwise) in which the aperture amount of the diaphragm opening 91 increases against the urging force of the spring 93 by the torque applied from the motor 94, and the magnitude of the torque and the urging force of the spring 93 are reduced. Stop at a balanced position. If the torque is large, the force against the urging force of the spring 93 also increases, so that the opening amount of the aperture opening 91 also increases. When the torque is small, the force against the urging force of the spring 93 is small, so the opening amount of the aperture 91 is small. The torque of the motor 94 increases as the PWM value (described later) increases, and decreases as the PWM value decreases.

  The CPU 66 of the light source device 14 controls the aperture adjustment mechanism 95 including the aperture blades 92 and the springs 93 based on the ALC control data calculated by the DSP 42. The CPU 66 calculates a PWM (pulse width modulation) value that determines the torque of the motor 94 in accordance with the ALC control data, and generates a drive pulse corresponding to the PWM value by a motor driver (not shown). To drive. The PWM value determines the duty ratio of the drive pulse of the motor 94 (value obtained by dividing the pulse width by the pulse period). When the ALC control data is a signal requesting an increase, the CPU 66 increases the PWM value according to the increase, and when the ALC control data is a signal requesting a decrease, the CPU 66 decreases the PWM value according to the decrease. To perform ALC control.

  The diaphragm mechanism 72 of the treatment light unit 62 is configured in the same manner as the diaphragm mechanism 64 of the illumination light unit 61 and is controlled by the CPU 66. However, when an interruption signal instructing the interruption of treatment light irradiation is input from the CPU 41 of the processor device 13, the CPU 66 closes the aperture 91 for one frame and interrupts the treatment light irradiation. During this period, the aperture opening 91 is fully opened.

  The interruption signal is output from the CPU 41 to the CPU 66 when four observation images from the newest one among the five observation images stored in the VRAM 28 continuously become images with halation. The CPU 41 counts the number of times that the determination signal indicating that the halation is detected is continuously input from the halation detection unit 55, and determines whether or not to input the interruption signal to the CPU 66 accordingly.

  Accordingly, when four observation images from the newest one stored in the VRAM 28 are images with halation, treatment light irradiation is temporarily interrupted in the next frame, and an image without halation is captured. Thereby, even during treatment with PDT, at least one image without halation is always stored in the VRAM 28.

As shown in FIG. 4, the neutral density filter 85 has low transmittance near the wavelength λ ₁ of the excitation light and near the wavelength λ ₂ of the treatment light, and transmits light of other wavelengths almost 100%. The neutral density filter 85 is formed by overlapping a first notch filter having a low transmittance near the wavelength λ ₁ of the excitation light and a second notch filter having a low transmittance near the wavelength λ ₂ of the treatment light. . For this reason, the transmittance of the wavelength λ ₁ of the excitation light depends on the amount of excitation light used during PDD and the generated fluorescent light, and the transmittance of the treatment light λ ₂ depends on the amount of treatment light used during PDT, Each is determined. Here, an example in which two types of notch filters are combined has been described. However, the neutral filter 85 only needs to be able to attenuate excitation light and treatment light, so a specific configuration of an optical thin film or the like is arbitrarily determined. be able to.

  The operation of the electronic endoscope system 11 configured as described above will be described. When performing PDD and PDT by the electronic endoscope system 11, the operator administers a photosensitive substance to the subject in advance. When a certain period of time has elapsed after administration of the photosensitive substance, the photosensitive substance is sufficiently accumulated in the tumor tissue, and when the examination and treatment are started, the operator uses the electronic endoscope 12, the processor device 13, and the light source. The device 14 is connected, and the processor device 13 and the light source device 14 are turned on. In addition, the proximal end portion of the treatment probe 73 is connected to the light source device 14, and the distal end of the treatment probe 73 is inserted from the forceps port 74 into the electronic endoscope 12. Then, the operation unit 51 is operated to input information on the subject, the hood 81 is attached to the distal end portion 20, the insertion unit 16 is inserted into the subject, and examination and treatment are started. The insertion unit 16 is inserted while illuminating normal light and observing the inside of the subject (hereinafter referred to as normal light observation).

  As shown in FIG. 5, when the distal end portion 20 reaches the vicinity of the tumor tissue, the operation unit 17 is operated to switch the observation method from normal light observation to PDD. When an instruction to switch from normal light observation to PDD is input by the operation unit 17, the CPU 41 rotates the wavelength selection filter 65 and causes the excitation light for PDD to enter the subject. Thereby, an observation image by PDD (hereinafter referred to as a PDD image) is displayed on the monitor 22. Since fluorescent light is generated from the photosensitive substance by irradiation with the excitation light, the tumor tissue in which the photosensitive substance is accumulated is displayed on the PDD image. The surgeon grasps the position, size, shape, etc. of the tumor tissue while observing the PDD image (step S11).

  Thereafter, the insertion portion 16 is moved forward and backward according to the position, size, shape, and the like of the tumor tissue, and the insertion portion 16 is rotated, so that the position of the distal end portion 20 relative to the tumor tissue and the forceps outlets 76 and 84 are changed. Adjust the position. Then, the treatment probe 73 is protruded from the forceps outlets 76 and 84, and the distance and orientation of the treatment probe 73 with respect to the tumor tissue are adjusted so that the tumor tissue is within the irradiation range of the treatment light (step S12).

  When the adjustment of the position and the like of the therapeutic light probe 73 is completed, the operator presses the pedal switch of the operation unit 51 to irradiate the therapeutic light from the distal end of the therapeutic probe 73 and starts treatment of the tumor tissue by PDT. At this time, when receiving the treatment light irradiation start signal from the pedal switch of the operation unit 51, the CPU 41 of the processor device 13 inputs this to the CPU 66 of the light source device 14. The CPU 66 of the light source device 14 generates the treatment light from the light source 71 of the treatment light unit 62 and controls the diaphragm mechanism 72 so that the diaphragm opening 91 is fully opened to irradiate the treatment light with the maximum light amount. At the same time, the CPU 66 of the light source device 14 rotates the wavelength selection filter 65 so that the normal light enters the light guide 32 from the illumination light unit 61 and irradiates the subject with the normal light. Therefore, when the surgeon depresses the pedal switch of the operation unit 51 and starts PDT, treatment light is irradiated toward the tumor tissue, and normal light is irradiated into the subject as imaging illumination light. Optical photographing is performed (step S13).

  The reflected light of the treatment light is attenuated by the neutral density filter 85. However, since the therapeutic light is a high amount of light, halation may occur even with a small amount of light transmitted through the neutral density filter 85. For this reason, halation may occur around the tumor tissue in a normal light image (hereinafter referred to as a PDT image) taken under normal light illumination during PDT. Therefore, the halation detection unit 55 compares the pixel value of each pixel with a predetermined threshold for the PDT image input from the DSP 42, and counts the number of pixels having a pixel value larger than the predetermined threshold. Then, it is determined whether or not halation has occurred in the input PDT image depending on whether or not the counted number of pixels is equal to or less than a predetermined number, and the determination result is input to the CPU 41 (step S14).

  When the PDT image is a non-halation image, the CPU 41 selects and acquires the latest PDT image that has been photographed in the display control circuit 44 while the PDT image for all five frames including the PDT image is held in the VRAM 28. Then, an image selection signal is inputted so as to be displayed on the monitor 22. The display control circuit 44 displays the newest PDT image that has been taken on the monitor 22 in accordance with the image selection signal input from the CPU 41 (step S15).

  On the other hand, when the PDT image is an image with halation, the PDT image is temporarily stored in the VRAM 28, but the CPU 41 captures the previous frame from the images of all five frames stored in the VRAM 28. An image selection signal is input to the display control circuit 44 so as to select and acquire the newest non-halation image from among the non-halation images. The display control circuit 44 displays the newest image among the images without halation on the monitor 22 in accordance with the image selection signal input from the CPU 41 (step S16).

  As described above, the electronic endoscope system 11 continuously captures the PDT image without interrupting the irradiation of the treatment light during the treatment with the PDT, and always displays the non-halation image on the monitor 22. (Step S17).

  As shown in FIG. 6A, in the normal light image 101 that is captured by irradiating only normal light, such as when the insertion portion 16 is inserted, the state in the subject can be clearly observed. However, since the amount of fluorescent light generated from the tumor tissue is smaller than the amount of light in a wavelength band other than the excitation light, the normal light image 101 clearly grasps the position, size, shape, etc. of the tumor tissue. Is difficult.

  On the other hand, as shown in FIG. 6 (B), the PDD image 102 displayed on the monitor 22 in step S12 was attenuated to a fluorescent light generated from the tumor tissue 103 and to a light quantity equivalent to or less than this. Since the image is taken by the reflected light of the excitation light, the tumor tissue 103 is clearly observed. When the treatment probe 73 is projected from the distal end portion 20 while observing the PDD image 102, the distal end of the treatment probe 73 is reflected in the PDD image 102, so that the tumor tissue 103 is placed in the treatment light irradiation range 104. The position and distance between the tip 73 and the tumor tissue 103 can be adjusted.

  The PDT image captured by illuminating the inside of the subject with normal light together with the treatment light in Steps S13 to S16 is the position of the subject inner wall and the treatment probe 73, such as the PDT image 105 shown in FIG. Depending on the orientation, a halation-free image similar to the normal light image 101 is captured. However, like the PDT image 106 shown in FIG. 6D, in most PDT images, the treatment light irradiation range 104 and the surrounding halation 107 are generated, and the main part around the tumor tissue is blown out. It becomes an image with halation unsuitable for observation or confirmation of the therapeutic effect by PDT.

  The relationship between the PDT image (captured image) captured in steps S13 to S16 and the image (display image) displayed on the monitor 22 is schematically shown in FIG.

  Assume that a PDT image P06 is captured in the frame at time T01. The PDT image P06 is an image with halation. At this time, in the VRAM 28, PDT images P01 to P05 photographed in five frames before time T01 are stored in the photographing order. PDT images P01 to P03 and PDT image P05 are images with halation, and PDT image P04 is an image without halation.

  When the PDT image P06 is captured at the frame at time T01, the DIP 43 determines whether or not halation has occurred in the PDT image P06 by the halation detection unit 55, and at the same time, among the PDT images P01 to P05 stored in the VRAM 28. The oldest PDT image P01 is discarded, and the PDT image P06 photographed in the frame at time T01 is newly stored in the VRAM 28. Therefore, when the PDT image P06 is captured, the PRAM images P02 to P06 are stored in the VRAM 28.

  At this time, the CPU 41 selects one of the PDT images P02 to P06 stored in the VRAM 28 based on the determination result input from the halation detection unit 55 when each of the PDT images P02 to P06 stored in the VRAM 28 is captured. Then, an image selection signal is input to the display control circuit 44 so as to select the PDT image P04 which is an image without halation. For this reason, the PDT image P06 photographed at time T01 is an image with halation, but the PDT image P04, which is an image without halation previously photographed, is displayed on the monitor 22.

  When the PDT image P07 is captured in the subsequent frame at time T02, the oldest PDT image P02 is discarded from the VRAM 28, and the PDT image P07 is newly stored in the VRAM 28. Assuming that the PDT image P07 taken at time T02 is an image with halation, the CPU 41 selects again the PDT image P04 that is an image without halation from the PDT images P03 to P07 stored in the VRAM 28. An image selection signal is input to the display control circuit 44. Thus, following the time T01, the PDT image P04, which is an image without halation, is used as the display image even in the frame at the time T02.

  Further, when the PDT image P08 is captured in the frame at time T03, the oldest PDT image P03 is discarded from the VRAM 28, and the PDT image P08 is newly stored in the VRAM 28. Assuming that the PDT image P08 taken in the frame at time T03 is an image without halation, the VRAM 28 stores two images without halation, the PDT image P04 and the PDT image P08 at the same time. At this time, the CPU 41 inputs an image selection signal to the display control circuit 44 so as to select the newest image among the non-halation images among the PDT images stored in the VRAM 28. Therefore, the display control circuit 44 causes the monitor 22 to display the PDT image P08 that is the latest non-halation image among the two non-halation images of the PDT image P04 and the PDT image P08. Therefore, although the PDT image P04 that is a non-halation image is displayed following the times T01 and T02, the display image is updated to the PDT image P08 in the frame at the time T03.

  When the PDT image P09 is captured in the subsequent frame at time T04, the oldest PDT image P04 is discarded from the VRAM 28, and the PDT image P09 is newly stored in the VRAM 28. Therefore, if the PDT image P09 is an image with halation, the PDT image P08 captured in the previous frame is displayed on the monitor 22 at time T04.

  As shown in FIG. 8, when the PDT image P25 is captured in the frame at time T21, the PDT image P25 is stored in the VRAM 28 together with the PDT images P21 to P24 for four frames before time T21. Assume that the PDT image P21 is an image without halation, and the PDT images P22 to P25 are images with halation. In this case, in the frame at time T21, the PDT image P21 that is an image without halation is displayed on the monitor 22, so that the surgeon can observe the image without halation at least at time T21.

  However, when an image with halation is captured in the next frame after time T21, the PDT image P21, which is the only non-halation image stored in the VRAM 28 at time T21, is discarded from the VRAM 28, and there is a newly captured halation. The image is stored in the VRAM 28. In this case, since no image with no halation is stored in the VRAM 28, an image with halation must be used as a display image.

  For this reason, the CPU 41 counts the number of times that a determination signal indicating that halation has been detected is continuously input from the halation detection unit 55. And when the image without a halation is image | photographed 4 times continuously like time T21, CPU41 inputs an interruption signal into CPU66 of the light source device 14, and the irradiation of treatment light is interrupted at the next frame (step S21).

  Thereby, in the frame of time T22 following time T21, PDT image P26 is image | photographed on the illumination of normal light in the state which is not irradiated with treatment light. Since the PDT image P2 is not irradiated with treatment light, no halation occurs, and the PDT image P2 is an image without halation similar to the normal light image. When the PDT image P26 is stored in the VRAM 28, among the PDT images P22 to P26 stored in the VRAM 28, the PDT image P26 that is an image without halation is displayed on the monitor 22.

  Since the electronic endoscope system 11 interrupts the irradiation of the treatment light in the next frame and forcibly shoots the image without the halation at the stage where the images with the halation are continuously captured as described above, the image without the halation is captured in the VRAM 28. The stored PDT image does not become an image with halation, and an image without halation is always displayed on the monitor 22.

  As shown in FIG. 9A, the electronic endoscope system 11 irradiates the subject with normal light while irradiating the treatment light to the tumor tissue in all frames when performing the treatment by PDT. Take a picture. These PDT images are stored in the VRAM 28 for five frames, and the newest halation-free image among the PDT images stored in the VRAM 28 is displayed on the monitor 22. Therefore, according to the electronic endoscope system 11, during the treatment with PDT, the occurrence of halation is apparently prevented, and normal light observation within the subject in the PDT becomes possible.

  On the other hand, in the comparative example in which all of the captured images are displayed on the monitor 22 in the order in which they were captured, as shown in FIG. And a frame for performing normal light imaging without irradiating treatment light, and imaging without treatment and halation are alternately repeated.

  Comparing FIG. 9A and FIG. 9B, the electronic endoscope system 11 irradiates treatment light in all frames during treatment by PDT, whereas in the comparative example, treatment is performed every other frame. Cannot irradiate light. Therefore, both the electronic endoscope system 11 and the comparative example prevent the image with halation from being displayed on the monitor 22, but the electronic endoscope system 11 irradiates twice as much therapeutic light as the comparative example per unit time. Treatment time is reduced by half.

  In addition, the electronic endoscope system 11 always monitors the image by suspending treatment light irradiation in the next one frame and forcibly taking the image without halation when images with halation are taken for 4 consecutive times. It is ensured that an image without halation is displayed on 22. For this reason, in the case where only images with halation are captured, in the electronic endoscope system 11, there is a frame in which treatment light is not irradiated once every 5 frames in a case where an image with halation is most difficult to be captured. Even in this case, the electronic endoscope system 11 can irradiate treatment light 8/5 times that of the comparative example per unit time, and the treatment time can be suppressed to 5/8. Since the treatment with PDT takes about 10 minutes and takes a long time, the burden on the subject is greatly reduced by reducing the treatment time to about half.

  In the first embodiment described above, an example in which a PDT image is taken when performing treatment with PDT has been described. However, a PDT image without halation is substantially the same as a normal light image, and a tumor tissue is fluorescent. Cannot be observed. For this reason, it is preferable that PDD observation can be performed during treatment with PDT. However, the wavelength of the fluorescent light generated from the photosensitive substance (tumor tissue) by irradiating the excitation light is close to the wavelength of the therapeutic light, and the therapeutic light is much larger than the fluorescent light, so PDT and PDD should be performed simultaneously. I can't. Therefore, in order to achieve both PDT image capturing and PDD image capturing, for example, as shown in FIG. 10, the frame for capturing the PDT image, the normal light and the treatment light are turned off, and the excitation light is irradiated. What is necessary is just to perform alternately with the frame which image | photographs a PDD image. Thus, even when PDT image shooting and PDD image shooting are performed alternately, treatment time is longer than when normal light shooting, PDT image shooting, and PDD image shooting are performed separately in separate frames. Can be suppressed. In order to achieve both PDT image shooting and PDD image shooting, the PDT image and the PDD image are preferably displayed side by side on the monitor 22.

  Further, as described in the first embodiment, the VRAM 28 has to hold a plurality of frames of PDT images in order to prevent the images with halation from being displayed on the monitor 22. In order to achieve compatibility, for example, a spare area for one frame is secured in the VRAM 28 such that the VRAM 28 has a storage capacity for six frames, and a PDD image is displayed on the monitor 22 through this spare area. A frame memory for holding a PDD image may be provided and used as a spare area.

  In the first embodiment described above, an example in which the treatment light irradiation is interrupted to forcibly shoot a no-halation image has been described. However, the treatment light irradiation is interrupted to forcibly shoot a no-halation image. For the four frames after the frame, the forcibly acquired non-halation image is always stored in the VRAM 28. Therefore, in one of these four frames, the amount of the treatment light is increased by increasing the output of the light source 71 or the like. It is preferable to increase the amount of normal treatment light. As described above, when the amount of the treatment light is increased in the frame in which the image without the halation is forcibly taken, a short treatment time can be maintained even if the irradiation of the treatment light is interrupted.

  In the first embodiment described above, since an image without halation is always displayed on the monitor 22, whether or not the treatment light is emitted, whether or not the treatment light is correctly applied to the tumor tissue, etc. It is difficult to observe itself, and it is necessary to infer from the change in the tumor tissue displayed on the PDT image. For this reason, it is preferable to display information on treatment light such as the irradiation position of treatment light, as in the electronic endoscope system 121 described below as the second embodiment.

[Second Embodiment]
As shown in FIG. 11, the electronic endoscope system 121 includes a halation detection unit 122 in the DIP 43. The halation detection unit 122 is similar to the halation detection unit 55 of the first embodiment in that it detects the halation of the observation image. However, when detecting the halation of the observation image, the halation detection unit 122 extracts feature data such as a contour of a pixel group having a pixel value larger than a predetermined threshold. The feature data such as the contour extracted by the halation detection unit 122 is input to the display control circuit 123. In addition, the halation detection unit 122 inputs the latest feature data extracted from the previous observation image to the display control circuit 123 when no halation is detected in the observation image. The display control circuit 123 acquires the latest non-halation image from the PDT images stored in the VRAM 28 based on the image selection signal input from the CPU 41 and displays it on the monitor 22. At this time, the display control circuit 123 superimposes the feature data input from the halation detection unit 122 on the image without halation and displays it on the monitor 22.

  For example, as illustrated in FIG. 12A, when a PDT image 131 with halation is captured, the halation detection unit 122 is used for detecting the presence or absence of halation as illustrated in FIG. A pixel group having a pixel value larger than the threshold value is detected as halation 132, and its contour 133 is extracted. When the display control circuit 123 acquires from the VRAM 28 the latest PDT image in which halation has not occurred based on the image selection signal from the CPU 41, the contour composite image 134 in which the contour 133 input as feature data from the halation detection unit 122 is superimposed. Is displayed on the monitor 22. The contour composite image 134 can observe the tip of the treatment probe 73 and the tumor tissue, and the contour 133 of the halation 132 is displayed, so that it is easy to guess the irradiation position and range of the treatment light.

  Further, the feature data extracted from the PDT image 131 may extract the contour of the treatment light irradiation spot 135 as shown in FIG. For the extraction of the outline of the irradiation spot 135, for example, a second threshold for extraction of an irradiation spot that is larger than a predetermined threshold used for detecting halation is prepared, and when the halation detecting unit 122 detects the halation 132, This is performed by simultaneously detecting a pixel group having a pixel value exceeding the second threshold and extracting the contour.

  Then, as shown in FIG. 12D, the display control circuit 123 displays on the monitor 22 an irradiation spot composite image 136 in which the contour of the extracted irradiation spot 135 is superimposed on the non-halation image acquired from the VRAM 28. According to the irradiation spot composite image 136, the irradiation position and irradiation range of the treatment light can be grasped more clearly than when the contour 133 of the halation 132 is superimposed.

  Treatment light is emitted from the treatment probe 73 by superimposing and displaying the outline 133 of the halation 132 and the irradiation spot 135 of the treatment light on the non-halation image displayed on the monitor 22 during PDT, as in the above-described electronic endoscope system 121. It is difficult to know directly from images without halation, such as whether or not it is applied, whether or not the treatment light is accurately applied to the tumor tissue, and whether or not the entire tumor tissue is within the irradiation range of the treatment light The information accompanying the treatment light itself can be easily confirmed.

  Although an example in which the contour 133 of the halation 132 and the contour of the irradiation spot 135 are extracted as feature data from the captured PDT image 131 and superimposed on the image displayed on the monitor 22 has been described here, the present invention is not limited thereto. For example, as shown in FIG. 13, a mixed image 143 is generated by mixing the latest PDT image 142 at a certain ratio with the PDT image 141 acquired by the display control circuit 123 from the VRAM 28 and displayed on the monitor 22. You may let them. Also in this case, from the mixed image 143 displayed on the monitor 22, it is possible to simultaneously grasp the information in the subject, the tumor tissue, and the treatment light itself.

  In the mixed image 143, for example, the total pixel value of the PDT image 141 is set to 90%, the total pixel value of the PDT image 142 is set to 10%, and the pixel value of each corresponding pixel is added as the pixel value of each pixel. It is an image. The generation of the mixed image 42 may be performed by causing the display control circuit 123 to input the latest PDT image 142 from the halation detection unit 122 and the display control circuit 123 to generate the mixed image 142. It may be provided separately. In addition, the mixed image 142 is not the entire latest PDT image 142 but a PDT image obtained by the display control circuit 123 acquiring a part of the PDT image 142 including the entire treatment light irradiation spot such as a part of the center of the image from the VRAM 28. 141 may be mixed and generated.

  In the second embodiment described above, an example of superimposing a halation outline and a treatment light irradiation spot on a PDT image has been described. However, as in a comparative example (FIG. 9B), a so-called normal light image is captured. In this case, the outline of halation and the irradiation spot of treatment light may be superimposed on the normal light image. Further, when a PDD image is taken during treatment by PDT (see FIG. 10), the outline of halation or the irradiation spot of treatment light may be superimposed on the PDD image.

  In the above-described first embodiment, the PDD image is confirmed to grasp the position, size, shape, etc. of the tumor tissue. Moreover, in 2nd Embodiment, the example which alert | reports the irradiation position and irradiation range of treatment light was demonstrated by superimposing the outline of a halation and an irradiation spot on a PDT image. However, since whether or not the treatment light is efficiently irradiated to the tumor tissue is determined by the operator's technique, depending on the operator's skill, the treatment light may be insufficiently irradiated or excessive to prevent the treatment light from being insufficiently irradiated. It is necessary to irradiate treatment light. For this reason, in an electronic endoscope system that performs PDT, it is preferable to display so that it can be objectively determined whether or not the treatment light is efficiently applied to the tumor tissue, thereby supporting the operator. This example will be described below as a third embodiment.

[Third Embodiment]
As shown in FIG. 14, the electronic endoscope system 301 displays a display image on the monitor 22 when an image with halation is captured during PDT, as with the electronic endoscope system 11 of the first embodiment. The electronic endoscope system displays an image that is replaced with a halation-free image, but is different from the electronic endoscope system 11 in that it includes an irradiation light amount estimation unit 303 and a display control circuit 304 and includes a PDT preparation mode as an operation mode.

  The PDT preparation mode is an operation mode for adjusting the positions and orientations of the distal end portion 20 and the treatment probe 73 with respect to the tumor tissue prior to the start of treatment by PDT, and is started by input from the operation unit 51. When the PDT preparation mode is started, the CPU 41 inputs a PDT preparation mode start signal to the CPU 66. When the PDT preparation mode start signal is input, the CPU 66 controls the diaphragm mechanism 72 to irradiate the subject with a low amount of treatment light to the extent that halation does not occur. The reflected light of the low-light treatment light causes the treatment light irradiation spot corresponding to the current position and orientation of the distal end portion 20 and the treatment probe 73 to be displayed on the normal light image taken in the PDT preparation mode. In the PDT preparation mode, a region of interest (hereinafter referred to as ROI) is designated. The ROI is specified in a rectangular range, for example, so as to include the tumor tissue grasped by the PDD image.

  The irradiation light amount estimation unit 303 operates under the PDT preparation mode. The irradiation light amount estimation unit 30 calculates the pixel coordinates at the center of the designated ROI, and the normal light image captured along the two directions of the horizontal direction (x direction) and the vertical direction (y direction) passing therethrough is calculated. The pixel value of the red pixel is extracted. The irradiation light amount estimation unit 30 inputs the extracted pixel value data string of the red pixels to the display control circuit 304 as the estimated irradiation light amount of the treatment light. The display control circuit 304 converts the estimated irradiation light amount of the treatment light input from the irradiation light amount estimation unit 303 into a histogram, displays the histogram together with the normal light image, and displays it on the monitor 22. Further, the display control circuit 304 colors and displays the columns for the pixels in the designated ROI.

  As shown in FIG. 15, when the electronic endoscope system 301 is operated in the PDT preparation mode and the ROI 313 is specified using the operation unit 51, the histogram 311 and the histogram 312 are displayed on the monitor 22 together with the normal light image 310. Is done. A histogram 311 is an estimated irradiation amount of the treatment light in the lateral direction of the normal light image 310 passing through the center of the ROI 313, and a histogram 312 is an estimated irradiation of the treatment light in the longitudinal direction of the slow-moving image 310 passing through the center of the ROI 313. The amount of light. In addition, the position where the low-intensity treatment light hits the normal light image 310 can be identified as the irradiation spot 314. The surgeon adjusts the irradiation position and direction of the treatment light on the tumor tissue, the irradiation range of the treatment light, and the like while observing the peak positions and peak values of the histograms 311 and 312 and the position of the irradiation spot 314.

  For example, as shown in FIG. 16A, when the distal end portion 20 is in a sleeping state (a state parallel to the subject inner wall 321), even if the tumor tissue 322 is within the irradiation spot 314, Since the reflected light of the low-light treatment light 323 is difficult to enter the CCD 21, the histograms 311 and 312 show a low value as a whole. This indicates that the irradiation efficiency of the treatment light is poor. In addition, there is a lot of reflected light from the front side of the protuberance of the tumor tissue 322 in the near side perpendicular to the distal end portion 20 (side closer to the distal end portion 20), and the far side of the protuberance of the tumor tissue 322 (far from the distal end portion 20) The peak positions of the histograms 311 and 312 are shifted from the center position of the ROI 313. While observing this, as shown in FIG. 16B, when the operator operates the angle knob of the operation unit 17 to change the direction of the distal end 20 to a direction close to the subject inner wall 312, The amount of reflected light of the low-light treatment light 323 from the tumor tissue 322 becomes large, and the histograms 311 and 312 show a high value as a whole. The fact that the histograms 311 and 312 show a high value as a whole indicates that the treatment light is efficiently applied to the tumor tissue 322. Further, the irradiation range of the treatment light is adjusted by moving the insertion portion 16 and the treatment probe 73 in the advancing / retreating direction while observing the position of the irradiation spot 314. Actually, since the subject inner wall 321 moves, even if the subject inner wall 312 moves, the histograms 311 and 312 show as high values as possible, and the distal end portion 20 so that the peak position is located at the center of the ROI 313. And the position and direction of the treatment probe 73 are adjusted.

  In the PDT preparation mode, the electronic endoscope system 301 displays the treatment light irradiation efficiency on the tumor tissue as histograms 311 and 312 so that it can be objectively determined. For this reason, the position and orientation of the distal end portion 20 and the treatment probe 73 can be easily adjusted so that the treatment light is efficiently irradiated onto the tumor tissue. Thereby, the treatment by PDT can be performed more efficiently. Also, insufficient treatment light irradiation is unlikely to occur.

  In the third embodiment described above, the example in which the ROI 313 is specified based on the position and size of the tumor tissue confirmed by the surgeon with the PDD image in the PDT preparation mode has been described. However, the present invention is not limited to this. For example, when a PDD image is captured, feature points representing the position, size, shape, and the like of the tumor tissue 322 are extracted from the PDD image, and the normal light image is surrounded so as to surround the tumor tissue 322 based on the extracted feature points. The ROI 313 may be automatically set in 310. In this case, the extraction of the feature amount of the tumor tissue from the PDD image may be provided with a dedicated circuit or the like, or the DIP 43 or the DSP 42 may function as a feature point extraction unit. When the ROI 313 is automatically set as described above, it is preferable to follow the position of the ROI 313 according to the movement of the subject inner wall 321, the movement of the distal end portion 20, and the like.

  In the above-described third embodiment, the histograms 311 and 312 are displayed by extracting the pixel value of the red pixel in response to the treatment light being red. However, light sensitivity that requires treatment light of other colors is displayed. In the case of using a substance, a pixel value of a corresponding color may be extracted or a sum of pixel values of a plurality of colors may be calculated to generate a histogram indicating the amount of irradiation light.

  In the above-described third embodiment, the description has been made on the assumption that an image without halation captured in the past when an image with halation was captured during PDT (first embodiment), but a comparative example (FIG. 9 (B)), when PDT and normal light imaging are alternately performed, the treatment efficiency by PDT can be improved by providing the PDT preparation mode.

  In the above-described third embodiment, an example of improving the treatment efficiency by PDT by performing the PDT preparation mode before the treatment by PDT has been described. However, a request to confirm the treatment effect during the treatment by PDT. There is also. For this reason, in an electronic endoscope system capable of performing PDT, it is preferable that the therapeutic effect can be objectively shown during treatment with PDT. Hereinafter, an example showing the therapeutic effect during PDT will be described as a fourth embodiment.

[Fourth Embodiment]
As shown in FIG. 17, the electronic endoscope system 401 is an electronic endoscope system that replaces the display image on the monitor 22 with an image without halation when an image with halation is captured during PDT. In addition, similarly to the electronic endoscope system 301 of the third embodiment described above, an irradiation light amount estimation unit 403 that functions to estimate the estimated irradiation light amount of the ROI treatment light in the PDT preparation mode and a display control circuit 404 are provided. However, the irradiation light amount estimation unit 403 of the electronic endoscope system 401 operates not only in the PDT preparation mode but also during the treatment by PDT, and uses the PDT images that are sequentially photographed, The amount of irradiation light is calculated. The irradiation light amount estimation unit 403 calculates the cumulative pixel value for each pixel by sequentially adding the pixel values of the pixels at the same position in the sequentially captured PDT images. Usually, since the amount of treatment light is extremely large compared to normal light, the cumulative pixel value of each pixel generally represents the total amount of treatment light irradiated. Therefore, hereinafter, the cumulative pixel value calculated by the irradiation light amount estimation unit 403 is referred to as the total irradiation light amount of the treatment light.

  The calculation of the total irradiation light amount of the treatment light by the irradiation light amount estimation unit 403 is performed for each pixel included in the ROI designated in the operation preparation mode, and whether the captured PDT image is an image with halation or an image without halation. Regardless, it is calculated by adding the pixel values of all PDT images. Further, the total irradiation light amount of the treatment light by the irradiation light amount estimation unit 403 is continued as long as the treatment light is irradiated when the treatment by the PDT is started. Therefore, when the surgeon releases the pedal switch during the PDT treatment and temporarily stops the irradiation of the treatment light, the irradiation light amount estimation unit 403 interrupts the addition of each pixel value, but the surgeon again presses the pedal switch. When the treatment light irradiation is resumed, each pixel value is further added to the value calculated before the treatment light irradiation is interrupted. Further, the irradiation light amount estimation unit 403 sequentially generates treatment effect images obtained by mapping the total irradiation light amount of the treatment light according to a predetermined color map for the ROI. The color map may be gray scale. The therapeutic effect image is input to the display control circuit 404.

  The display control circuit 404 displays the histograms 311 and 312 in the PDT preparation mode. Further, during the treatment by PDT, the display control circuit 404 superimposes and displays the treatment effect images sequentially input from the irradiation light amount estimation unit 403 on the non-halation image selected and acquired from the VRAM 28. At this time, the therapeutic effect image is superimposed on the ROI.

  As shown in FIG. 18, the electronic endoscope system 401 displays a PDT image 410 in which a therapeutic effect image is superimposed on the ROI 313 specified in the operation preparation mode on the monitor 22. The PDT image 410 can grasp the total irradiation light amount of the treatment light, that is, the progress of treatment, by superimposing the treatment effect image. For example, a predetermined color (the darkest part in FIG. 18) in the ROI 313 is a criterion for indicating that the tumor tissue 411 has been irradiated with sufficient therapeutic light. Since the progress of treatment is shown in the PDT image 410, the positions and orientations of the distal end portion 20 and the treatment probe 73 are adjusted so that the tumor tissue 411 is filled with a predetermined color early while observing the PDT image 410. You can also fine-tune. FIG. 18 illustrates an example of the PDT image 410 on which the treatment effect image is superimposed (upper stage) and an enlarged view of the ROI 313 (lower stage) of the PDT image 410, but actually generates an enlarged view of the ROI 313, An enlarged display mode may be provided in which the enlarged view PDT image 410 of the ROI 313 is displayed on the monitor 22 side by side or only the enlarged view of the ROI 313 is displayed on the entire surface of the monitor 22.

  As described above, the electronic endoscope system 401 creates a therapeutic effect image having a pixel value as a value based on an accumulated pixel value obtained by adding the pixel values of sequentially captured PDT images, and superimposes this on the display image. And display. For this reason, the electronic endoscope system 401 can grasp the progress status during the treatment by PDT.

  In the fourth embodiment described above, the therapeutic effect image is created by mapping the total irradiation light amount of the treatment light according to a predetermined color map, but the method of displaying the progress of treatment based on the total irradiation light amount of the treatment light Is not limited to this example. For example, as shown in FIG. 19, a three-dimensional histogram image 420 may be created based on the total irradiation light amount of treatment light instead of a planar treatment effect image. In this case, when displaying on the monitor 22, it is preferable to display the PDT image 410 and the three-dimensional histogram image 420 side by side. Further, the superimposed display of the treatment effect image on the PDT image 410 and the three-dimensional histogram image 420 may be used in combination.

  In the fourth embodiment described above, an example in which a treatment effect image is created for the ROI and the progress of treatment in the ROI is displayed on the monitor 22 is described. However, a treatment effect image is created for the entire PDT image. The progress of treatment may be indicated for the entire surface of the non-halation image displayed on the monitor 22.

  In the above-described fourth embodiment, description has been made on the assumption that an image without halation captured in the past when an image with halation was captured during PDT, but a typical example (FIG. 9B). As described above, when the PDT and the normal light photographing are alternately performed, if the PDT image is photographed, the above-described fourth embodiment can be suitably applied. Further, the PDT preparation mode may be omitted.

  In the above-described fourth embodiment, the manner in which the therapeutic effect of PDT is displayed on the monitor 22 has been described. However, the PDT image 410 displayed on the monitor 22 further includes the electronic endoscope described in the second embodiment. Similar to the system 121, it is preferable to display the outline of the irradiation spot of halation or treatment light.

  In the first to fourth embodiments described above, the example in which the DIP 43 functions as the halation detection unit has been described, but the present invention is not limited to this. For example, the DSP 42 may function as a halation detection unit. A dedicated circuit or the like that functions as the halation detection unit 55 may be provided separately from the DIP 43 and the DSP 42. In such a case, depending on each case, the specific value of the threshold value to be compared with the pixel value, the criterion for determining the presence or absence of halation (the number of pixels having a pixel value larger than the threshold value), etc. Determine.

  In the first to fourth embodiments described above, when images with halation are captured for four consecutive times, the aperture opening 91 is closed in the next frame, and the treatment light is temporarily suspended to forcibly halate. Although an example of capturing a no-image has been described, the manner of forcibly capturing an image without halation is not limited to this example. For example, when an image without halation is forcibly taken during treatment with PDT, the amount of the aperture 91 may be reduced to reduce the treatment light.

  In the first to fourth embodiments described above, an example in which the VRAM 28 has a storage capacity for five frames has been described. However, if the VRAM 28 can store PDT images for a plurality of frames, the storage capacity is arbitrary. is there. However, when the storage capacity of the VRAM 28 is small, such as when the VRAM 28 has a storage capacity for two frames, the treatment light irradiation is often interrupted, and the effect of shortening the treatment time is reduced. In addition, when the storage capacity of the VRAM 28 is increased and all of this is used to hold a PDT image, the case of forcibly capturing an image without halation is excessively suppressed, and an old image without halation is displayed on the monitor 22. Continuing, it may be difficult to observe actual changes in the tumor tissue or subject. For this reason, in order to naturally observe the inside of the subject and the tumor tissue being treated by PDT, it is preferable to set the storage capacity of the VRAM 28 to a storage capacity of about 5 to 15 frames.

  In the first to fourth embodiments described above, the example in which the CCD 21 is used as the imaging device has been described. However, a CMOS image sensor may be used. Further, as an image pickup element used in the electronic endoscope systems 11 and 121, a system (so-called frame sequential type) that obtains an image pickup signal of each color for each frame by sequentially switching the color of illumination light to RGB. However, in order to further shorten the treatment time, it is preferable to use a method in which each pixel is provided with a color filter such as RGB and obtains a color imaging signal (so-called simultaneous method).

  In the first to fourth embodiments described above, an example in which therapeutic light is irradiated at the center of each frame when the pulse period of irradiation of therapeutic light coincides with the driving period (imaging period) of the CCD 21 (FIG. 9), the drive cycle of the CCD 21 and the pulse cycle of the treatment light may not match. If the drive period of the CCD 21 does not match the pulse period of the treatment light, frames that are not irradiated with the treatment light occur at regular intervals, so that an image without halation can be acquired naturally.

  In the first to fourth embodiments described above, the example in which the treatment light is pulsed has been described. However, the treatment light may be continuously emitted during the treatment by the PDT.

  In addition, the photosensitive substance used for PDD and PDT accumulates in the site | part (tumor tissue etc.) used as a treatment object, emits fluorescence light by irradiation of excitation light, and treats the site | part used as treatment object by irradiating treatment light. If possible, any can be used. The wavelength of the excitation light for PDD and the wavelength of the treatment light for PDT may be determined according to the photosensitive substance to be used. In addition, when a plurality of types of photosensitive substances having different wavelengths of excitation light and treatment light may be used, a light source or the like may be provided according to each.

  In the first to fourth embodiments described above, the example in which the normal light or the excitation light for PDD is emitted from the illumination light unit 61 by the wavelength selection filter 65 has been described, but the present invention is not limited thereto. For example, the wavelength selection filter 65 is a filter having a function of limiting normal light, PDD excitation light, and normal light emitted from the light source 63 to light of a specific short wavelength band (hereinafter referred to as special light). It is also good. In this case, for example, a disk that is divided into a plurality of fan-shaped areas and each area transmits normal light, PDD excitation light, and special light may be rotationally controlled as in the above-described embodiment. Examples of the special light include light having wavelengths in the vicinity of 450 nm, 500 nm, 550 nm, 600 nm, and 780 nm.

  Imaging with special light in the vicinity of 450 nm is suitable for observing different fine structures on the surface of the observed site such as blood vessels and pit patterns on the surface layer. With illumination light in the vicinity of 500 nm, it is possible to observe a macro uneven structure such as a depression or a bulge in the observation site. Illumination light in the vicinity of 550 nm has a high absorption rate by hemoglobin, and is suitable for observation of fine blood vessels and redness. Illumination light in the vicinity of 650 nm is suitable for observation of thickening. For observation of deep blood vessels, a fluorescent substance such as indocyanine green (ICG) is injected intravenously and can be clearly observed by using illumination light in the vicinity of 780 nm.

  In the first and second embodiments described above, the example in which the normal light is used as the excitation light for PDD using the wavelength selection filter 65 has been described. However, the PDD is separate from the light source 63 that emits normal light. A light source that emits excitation light may be provided, and illumination light incident on the light guide 32 by an optical system such as a mirror may be switched between normal light and excitation light.

  In the first to fourth embodiments described above, an example in which a halogen lamp is used as the light source 63 has been described. However, an LED or an LD may be used as the light source 63. In this case, a plurality of LEDs, LDs, and the like that emit light having different wavelength bands may be provided, and normal light and excitation light may be switched by controlling lighting and extinguishing of these. Ordinary light may be generated using a blue laser light source and a phosphor that emits green to red fluorescent light when irradiated with blue laser light. Furthermore, you may use together the light source used for another use. Hereinafter, an example in which LDs are used for all light sources will be described.

  For example, as shown in FIG. 20, the light source device 501 of the electronic endoscope system 500 includes laser light sources LD1 to LD12 having different center wavelengths. The laser light sources LD1 to LD12 are individually dimmed and controlled by the CPU 66, and each laser beam can be generated individually or simultaneously. Further, the light emission timing and the light quantity ratio of each laser light source can be arbitrarily changed, and the spectrum of light from the illumination window from which each laser light is emitted can be individually changed.

  The LD 1 is a light source for narrowband light observation that emits laser light having a center wavelength of 405 nm. The LD 2 is a light source that emits laser light having a central wavelength of 445 nm and generates white light (normal light) using a phosphor that is a wavelength conversion member described later. LD3 and LD4 are light sources that emit laser light having a wavelength of 405 nm, and are used for fluorescence observation of PDD or the like. LD5 and LD6 are light sources that emit laser light having a central wavelength of 472 nm, and are used to extract information on oxygen saturation and blood vessel depth in blood. LD7 and LD8 are light sources that emit laser light having a center wavelength of 665 nm, and are used for PDT. LD9 and LD10 are light sources that emit laser light having a central wavelength of 785 nm, and are used for observing infrared light of IGC injected into blood vessels. LD11 and LD12 are light sources that emit laser light having a center wavelength of 375 nm, and are light sources for performing fluorescence observation using luciferase. Each laser light source only needs to be within a range of ± 10 nm of the central emission wavelength.

  Laser light emitted from each of the laser light sources LD1 to LD12 is introduced into the optical fibers 502A to 502D by condenser lenses (not shown). Laser light from LD1 and LD2 is transmitted to the phosphor 503 disposed at the tip 20 through optical fibers 502B and 502C, and laser light from LD3 to LD12 is transmitted to the light diffusion member 504 through optical fibers 502A and 502D. Then, it is emitted toward the subject as illumination light, excitation light, or treatment light.

  The laser beams from LD1 and LD2 are combined by a combiner 506 to form a single optical path, and then demultiplexed by a coupler 507 to form two optical paths, which are transmitted to the connector 18, respectively. As a result, the laser light from LD1 and LD2 is uniformly transmitted to the optical fibers 502B and 502C with reduced variations in emission wavelength and speckle due to individual differences between the laser light sources. Here, the combiner 506 and the coupler 503 are used. However, a simplified configuration in which the laser beams from the laser light sources LD1 and LD2 are sent to the connector 18 without using them may be used.

  The optical fiber 502B and the phosphor 503 constitute a light projecting unit 511B, and the optical fiber 502C and the light diffusion member 504 constitute a light projecting unit 511C. The optical fiber 502A and the phosphor 503 constitute a light projecting unit 511A, and the optical fiber 502D and the phosphor 503 constitute a light projecting unit 511D.

  As shown in FIG. 21A, each of the light projecting units 511B and 511C has the same configuration, and includes a phosphor 503, a cylindrical sleeve member 513 that covers the outer periphery of the phosphor 503, and a sleeve member 513. A protective glass (illumination window) 514 that seals one end side, and a ferrule 515 that holds the optical fiber 502B (502C) inserted into the sleeve member 513 on the central axis are provided. Further, the optical fiber 502B (, 502C) produced by being covered with the outer skin from the rear end side of the ferrule 515 is inserted between the flexible sleeve 516 covering the outer side of the outer skin.

The phosphors 503 of the light projecting units 511B and 511C absorb a part of the blue laser light from the laser light source LD2 and excite and emit green to yellow light (for example, YAG phosphor or BAM (BaMgAl ₁₀ O ₁₇ )). Etc.). As a result, the green to yellow excitation light emitted from the blue laser light as the excitation light and the blue laser light transmitted without being absorbed by the phosphor 503 are combined to generate white (pseudo white) normal light.

  Further, as shown in FIG. 21B, the light projecting units 511A and 511D have the same configuration, and a light diffusing member 504 is provided in place of the phosphor 503 of the light projecting units 511B and 511C, and the optical fibers 502B and The configuration is the same as that of the light projecting units 511B and 511C except that the light is guided from 502D.

  As shown in FIG. 22, the pair of light projecting units 511A and 511D and the pair of light projecting units 511B and 511C are arranged as a pair on both sides of the distal end surface of the distal end portion 20 with the objective optical system 31 in between. The For example, by introducing blue laser light from the LD 2 to the light projecting units 511B and 511C, white light (normal light) is generated and irradiated into the subject from the light projecting units 511B and 511C. In addition, laser light (excitation light for PDD) having a central wavelength of 405 nm from LD3 and LD4 and laser light (treatment light) having a central wavelength of 665 nm from LD7 and LD8 are selectively used for the light projecting units 511A and 511D. In this case, either the excitation light or the treatment light is irradiated into the subject from the light projecting units 511A and 511D.

  FIG. 23 shows the wavelengths of excitation light for PDD, fluorescence light (PDD fluorescence) generated by irradiation of excitation light, and treatment light for PDT for each drug. As the excitation light of PDD, laser light having a central wavelength of 350 to 450 nm can be used even when any of fluorescent agents such as photofrin, resaphyrin, bisdyne, and 5-ALA (aminolevulinic acid) is used, and the central wavelength is 405 nm. Laser light is preferably used. 5-ALA is due to accumulation of protoporphyrin IX, and the wavelength ratio of fluorescence changes with the progression of the lesion.

11, 121, 301, 401, 500 Electronic endoscope system 12 Electronic endoscope 13 Processor device 14,501 Light source device 16 Insertion unit 17,51 Operation unit 18 Connector 19 Universal code 20 Tip unit 21 CCD
22 Monitor 23, 82 Observation window 24, 83 Illumination window 26 TG
27 AFE
28 VRAM
29, 41, 66 CPU
31 Objective Optical System 32 Light Guide 33 Illumination Lens 42 DSP
43 DIP
44, 123, 304, 404 Display control circuit 52 ROM
53 RAM
55, 122 Halation detector 61 Illumination light unit 62 Treatment light unit 63, 71 Light source 64 Aperture mechanism 65 Wavelength selection filter 67, 77 Condensing lens 72 Aperture mechanism 73 Treatment probe 74 Forceps port 75 Forceps channel 76, 84 Forceps outlet 81 Hood 85 Attenuating filter 91 Aperture opening 92 Aperture blade 93 Spring 94 Motor 95 Aperture adjustment mechanism 101, 310 Normal light image 102 PDD image 103, 322, 411 Tumor tissue 104 Irradiation range 105, 106, 131 PDT image 107, 132 Halation 133 Contour 134 Outline composite image 135, 314 Irradiation spot 136 Irradiation spot composite image 141, 142, 410 PDT image 143 Mixed image 303, 403 Irradiation light quantity estimation unit 311, 312 Histogram 313 ROI
321 Subject inner wall 323 Low light treatment light 420 Histogram image 502A to 502D Optical fiber 503 Phosphor 504 Light diffusion member 506 Combiner 507 Coupler 511A to 511D Projection unit 513 Sleeve member 514 Protective glass 515 Ferrule 516 Flexible sleeve

Claims (10)

White light irradiation means for irradiating the subject with white light;
Therapeutic light irradiation means for irradiating therapeutic light for treating the treatment target site by acting on a photosensitive substance accumulated in the treatment target site in the subject;
An image sensor that images the inside of the subject by photoelectrically converting light incident from within the subject; and
A total irradiation light amount calculating means for calculating the total irradiation light amount of the treatment light for each pixel by adding the pixel values of the pixels of the image being treated that are sequentially photographed while irradiating the treatment light together with the white light;
A therapeutic effect image generating means for generating the therapeutic effect image based on the total irradiation light amount calculated for each pixel;
Display means for displaying the in-treatment image;
Display control means for causing the display means to display the treatment effect image together with the treatment-in-progress image;
An electronic endoscope system comprising: A region of interest designating unit that designates a region of interest for the image under treatment is provided,
The total irradiation light amount calculation unit calculates the total irradiation light amount for pixels in the region of interest, and the treatment effect image generation unit generates the treatment effect image for the region of interest. The electronic endoscope system described.   The electronic endoscope system according to claim 1, wherein the therapeutic effect image is an image obtained by mapping the total irradiation light amount according to a predetermined color map.   The electronic endoscope system according to any one of claims 1 to 3, wherein the display control means displays the therapeutic effect image superimposed on the in-treatment image.   The electronic endoscope system according to any one of claims 2 to 4, wherein the display control unit enlarges and displays the region of interest on which the therapeutic effect image is superimposed on the display unit.   The electronic endoscope system according to claim 1, wherein the therapeutic effect image is an image that displays the total irradiation light amount as a three-dimensional histogram. Discriminating means for discriminating whether the image under treatment is an image with halation with halation or an image without halation without halation,
Storage means for storing the image during treatment for a plurality of frames,
The display control means selects and displays the non-halation image from the past treatment images stored in the storage means when the photographed image being treated is the image with halation. The electronic endoscope system according to claim 1, wherein the electronic endoscope system is displayed on a means.   The discriminating means compares the pixel value of each pixel of the image under treatment with a predetermined threshold value, counts pixels having a pixel value larger than the threshold value, and has a pixel value larger than the threshold value than a predetermined number. The image being treated is determined to be the image with halation when there are many, and the image being treated is determined to be the image without halation when the number of pixels having a pixel value larger than the threshold is equal to or less than a predetermined number Item 8. The electronic endoscope system according to Item 7. By reducing the amount of pre-Symbol therapeutic light, an electronic endoscope system according to claim 7 or 8, characterized in that it comprises a control means for forcibly taking the halation without image. Wherein, prior to the treatment in the image said halation there images next photographing stored in the storage means to be taken are all the halation there image, in the subsequent shooting, prior Symbol therapeutic light The electronic endoscope system according to any one of claims 7 to 9, wherein the amount of light is reduced.

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