JP5462596B2 - Fluorescence imaging device - Google Patents

Description

  The present invention relates to a fluorescence image capturing apparatus that receives fluorescence emitted from a fluorescent agent in an observed part and shoots a fluorescent image by irradiating the observed part to which the fluorescent agent is administered with excitation light. .

  Conventionally, endoscope systems for observing tissue in a body cavity are widely known, and a normal image is obtained by imaging a portion to be observed in a body cavity by irradiation with white light, and this normal image is displayed on a monitor screen. Electronic endoscope systems are widely put into practical use.

  Moreover, as an endoscope system as described above, for example, in Patent Document 1 and Patent Document 2, a fluorescent agent such as ICG (Indocyanine Green) is administered in advance in a living body, and excitation light is irradiated to an observation part. A fluorescence endoscope system that acquires a fluorescence image of a blood vessel by detecting the fluorescence of ICG in the blood vessel has also been proposed.

  By the way, since ICG has a fast clearance from blood, there is a problem that the ICG concentration in blood decreases with time, and a clear fluorescent image cannot be obtained.

  Therefore, in Patent Document 3, the concentration of the fluorescent agent is constantly measured, and when the concentration falls below a certain value, the ICG is automatically administered by the automatic administration device, or the display prompts the administration of the fluorescent agent. Has been proposed for outputting to a monitor.

JP 2001-299676 A JP 2007-244746 A JP 2007-125355 A Special table 2008-520287

  However, if the fluorescent agent is automatically administered so that the concentration of the fluorescent agent is always above a certain level as in the method described in Patent Document 3, there is a risk that the fluorescent agent will be administered beyond the allowable amount. There is.

In addition, when performing a method of imaging the first circulation (a method of imaging the process in which the mass of the drug is dispersed in the blood by reducing the amount of the drug administered at one time to about 1/10 of the usual amount) However, since the number of administrations is remarkably increased as compared with a method for photographing normal drug fluorescence, there is a problem that the management of the number of times is complicated.
Furthermore, Patent Document 4 proposes a method for limiting the allowable amount of a fluorescent drug by time, but this method is used when the clearance of the fluorescent drug is long and a long time can be observed by a single drug administration. Although effective, it is not suitable for the method of photographing the initial circulation as described above.

  The present invention has been made in view of the above problems, and is a fluorescence image capturing apparatus that captures a fluorescence image by receiving fluorescence emitted from an observed part to which a fluorescence drug is administered. An object of the present invention is to provide a fluorescence imaging apparatus capable of avoiding administration to a patient exceeding an allowable amount.

  The fluorescent imaging device of the present invention receives an excitation light irradiation unit that irradiates an observation part to which a fluorescent agent is administered with excitation light, and fluorescence emitted from the fluorescent agent in the observation part by irradiation of the excitation light. A patient information receiving unit for receiving input of patient information in a fluorescence imaging apparatus having an imaging device for photoelectric conversion, and an imaging unit for capturing a fluorescent image by accumulating charges in a predetermined charge accumulation period by the imaging device And an administration allowable number acquisition unit for acquiring a fluorescent drug administration allowable number set based on the dose of the fluorescent drug according to the patient information and the dose per administration, and administration start information of the fluorescent drug. An administration start information receiving unit for receiving, and an administration possible number acquiring unit for acquiring the remaining number of possible administrations based on the number of times of receiving administration start information and the allowable number of administrations are provided.

  In the fluorescence imaging apparatus of the present invention, a display unit for displaying the number of administrations can be further provided.

  In addition, the administration possible number acquisition unit shall re-acquire the administration possible number of times set based on a dose smaller than the dose per administration from the time when the administration possible number reaches a predetermined number. Can do.

  Moreover, when the administration possible number acquisition part reacquires the administration possible number, the excitation light control part which controls the excitation light irradiation part so that the intensity | strength of excitation light becomes large can be provided.

  In addition, when the administration possible number acquisition unit reacquires the administration possible number, an imaging element control unit that controls the imaging element so that the charge accumulation period of the imaging element becomes long can be provided.

  According to the fluorescence imaging apparatus of the present invention, the input of patient information is accepted, and the number of times of administration of the fluorescent agent that is set based on the amount of administration of the fluorescent agent according to the patient information and the dose per administration. And receiving the administration start information of the fluorescent agent, and acquiring the remaining administration possible number of times based on the number of times of accepting the administration start information and the allowable number of administrations. In this case, it is possible to avoid that the fluorescent agent is administered to the patient beyond the allowable amount.

  In addition, when the possible number of times set based on a dose smaller than the dose per time is reacquired from the time when the possible number of times reaches a predetermined number, for example, the operator When the imaging of the predetermined number of fluorescent images is completed, if it is desired to capture fluorescent images more than the remaining number of administrations, the fluorescent images can be further acquired for the number of administrations that can be re-acquired. it can.

  In addition, when the number of possible administrations is reacquired as described above, when the intensity of excitation light is controlled to be increased, or when the image sensor is controlled so that the charge accumulation period of the image sensor is increased, Appropriate fluorescent images can be taken according to a small dose.

1 is a schematic configuration diagram of a rigid endoscope system using an embodiment of a fluorescence imaging apparatus of the present invention. Schematic configuration diagram of hard insertion part Schematic configuration diagram of the imaging unit The block diagram which shows schematic structure of an image processing apparatus and a light source device The figure which shows schematic structure of a chemical | medical agent automatic injection apparatus The flowchart for demonstrating the effect | action of the rigid endoscope system using one Embodiment of the fluorescence imaging device of this invention. The figure which shows the example of a display of a fluorescence image, a normal image, and the frequency | count of possible administration The figure which shows the relationship between the dosage per time and the frequency | count of administration tolerance

  Hereinafter, a rigid endoscope system using an embodiment of the fluorescence image capturing apparatus of the present invention will be described in detail with reference to the drawings. FIG. 1 is an external view showing a schematic configuration of a rigid endoscope system 1 of the present embodiment.

  As shown in FIG. 1, the rigid endoscope system 1 according to the present embodiment guides the normal light and special light emitted from the light source device 2 and the light source device 2 that emits white normal light and special light. A rigid mirror imaging device that irradiates the observation unit and captures a normal image based on reflected light reflected from the observed portion by irradiation of normal light and a fluorescent image based on fluorescence emitted from the observed portion by irradiation of special light 10, an image processing device 3 that performs a predetermined process on the image signal captured by the rigid endoscope imaging device 10, and a normal image and a fluorescence image of the observed portion based on the display control signal generated in the image processing device 3. And a monitor 4 for display.

  As shown in FIG. 1, the rigid endoscope imaging apparatus 10 includes a hard insertion portion 30 that is inserted into the abdominal cavity and an imaging unit 20 that captures a normal image and a fluorescence image of the observed portion guided by the hard insertion portion 30. And.

  In addition, as shown in FIG. 2, the rigid endoscope imaging apparatus 10 has a hard insertion portion 30 and an imaging unit 20 that are detachably connected. The hard insertion portion 30 includes a connection member 30a, an insertion member 30b, a cable connection port 30c, and an irradiation window 30d.

  The connection member 30a is provided on one end side 30X of the hard insertion portion 30 (insertion member 30b). For example, the connection member 30a is fitted into an opening 20a formed on the imaging unit 20 side, so that the imaging unit 20 and the hard insertion portion 30 are fitted. Are detachably connected.

  The insertion member 30b is inserted into the abdominal cavity when photographing inside the abdominal cavity, and is formed of a hard material and has, for example, a cylindrical shape with a diameter of approximately 5 mm. An objective lens group for forming an image of the observed portion is accommodated inside the insertion member 30b. The normal image and the fluorescent image of the observed portion incident from the other end 30Y are the objective lens group. And is emitted toward the imaging unit 20 side of the one end side 30X.

  A cable connection port 30c is provided on the side surface of the insertion member 30b, and the optical cable LC is mechanically connected to the cable connection port 30c. Thereby, the light source device 2 and the insertion member 30b are optically connected via the optical cable LC.

  The irradiation window 30d is provided on the other end 30Y of the hard insertion portion 30, and irradiates the observed portion with normal light and special light guided by the optical cable LC. The insertion member 30b accommodates a light guide (not shown) for guiding normal light and special light from the cable connection port 30c to the irradiation window 30d. The irradiation window 30d is guided by the light guide. The target part is irradiated with normal light and special light.

  FIG. 3 is a diagram illustrating a schematic configuration of the imaging unit 20. The imaging unit 20 includes a first imaging system that captures a fluorescent image of the observed portion formed by the lens group in the hard insertion portion 30 and generates a fluorescent image signal of the observed portion, and the hard insertion portion 30. And a second imaging system that generates a normal image signal by capturing a normal image of the observed portion formed by the objective lens group. These imaging systems are divided into two optical axes orthogonal to each other by a dichroic prism 21 having a spectral characteristic that reflects a normal image and transmits a fluorescent image.

  The first imaging system includes a special light cut filter 22 that cuts off the special light reflected by the observed portion and transmitted through the dichroic prism 21, and the dichroic prism 21 and the special light cut filter 22 emitted from the hard insertion portion 30. A first imaging optical system 23 that images the transmitted fluorescent image L4 and a high-sensitivity imaging element 24 that images the fluorescent image L4 imaged by the first imaging optical system 23 are provided.

  The second imaging system is a normal image formed by the second imaging optical system 25 and a second imaging optical system 25 that forms a normal image L3 emitted from the hard insertion portion 30 and reflected by the dichroic prism 21. An image sensor 26 that captures the image L3 is provided.

  The high-sensitivity imaging device 24 detects light in the wavelength band of the fluorescent image with high sensitivity, converts it into a fluorescent image signal, and outputs it. The high sensitivity image sensor 24 is a monochrome image sensor.

  The image sensor 26 detects light in the wavelength band of the normal image, converts it into a normal image signal, and outputs it. On the image pickup surface of the image pickup element 26, color filters of three primary colors red (R), green (G) and blue (B), or cyan (C), magenta (M) and yellow (Y) are arranged in a Bayer array or a honeycomb. It is provided in an array.

  In addition, the imaging unit 20 includes an imaging control unit 27. The imaging control unit 27 controls the operations of the high-sensitivity imaging device 24 and the imaging device 26, and the fluorescence image signal output from the high-sensitivity imaging device 24 and the normal image output from the imaging device 26. The signal is subjected to CDS / AGC (correlated double sampling / automatic gain control) processing and A / D conversion processing, and is output to the image processing device 3 via the cable 7 (see FIG. 1). Further, the imaging control unit 27 starts an imaging operation of the high-sensitivity imaging device 24 based on a pressing signal of the foot pedal 6 described later. In the present embodiment, the high-sensitivity image sensor 24 captures a fluorescent image at 10 fps, and the image sensor 26 captures a normal image at 30 fps.

  As shown in FIG. 4, the image processing apparatus 3 includes a normal image input controller 31, a fluorescence image input controller 32, an image processing unit 33, a memory 34, a video output unit 35, an input receiving unit 36, a TG (timing generator) 37, and A control unit 38 is provided.

  The normal image input controller 31 and the fluorescence image input controller 32 include a line buffer having a predetermined capacity, and temporarily store the normal image signal and the fluorescence image signal for each frame output from the imaging control unit 27 of the imaging unit 20. To remember. Then, the normal image signal stored in the normal image input controller 31 and the fluorescent image signal stored in the fluorescent image input controller 32 are stored in the memory 34 via the bus.

  The image processing unit 33 receives a normal image signal and a fluorescence image signal for each frame read from the memory 34, performs predetermined image processing on these image signals, and outputs them to the bus.

  The video output unit 35 receives the normal image signal and the fluorescence image signal output from the image processing unit 33 via the bus, performs predetermined processing to generate a display control signal, and outputs the display control signal to the monitor 4. Output.

  The input receiving unit 36 receives input by the operator such as patient information regarding the patient (subject) and various operation instructions and control parameters. The TG 37 outputs a driving pulse signal for driving the high-sensitivity imaging device 24, the imaging device 26 of the imaging unit 20, and the LD driver 45 of the light source device 2 described later.

  The control unit 38 controls the entire apparatus, and further, obtains the number of permitted administrations of the fluorescent agent set based on the administration amount of the fluorescent agent according to the patient information and the dose per administration. Based on the allowable number acquisition unit 38a, the administration start information reception unit 38b that receives the administration start signal of the fluorescent drug output from the foot pedal 6 to be described later, the number of times the administration start signal is received, and the allowable administration number The administration possible number acquisition part 38c which acquires the administration possible number of times is provided.

  As shown in FIG. 4, the light source device 2 condenses the normal light source 40 that emits normal light (white light) L <b> 1 having a broadband wavelength of about 400 nm to 700 nm and the normal light L <b> 1 emitted from the normal light source 40. And the normal light L1 collected by the condensing lens 42 is transmitted, the special light L2 described later is reflected, and the normal light L1 and the special light L2 are incident on the incident end of the optical cable LC. And a dichroic mirror 43. For example, a xenon lamp is used as the normal light source 40. A diaphragm 41 is provided between the normal light source 40 and the condenser lens 42, and the amount of the diaphragm is controlled based on a control signal from ALC (Automatic light control).

  The light source device 2 includes an LD light source 44 that emits special light L2 in the visible to near-infrared band of 700 nm to 800 nm, an LD driver 45 that drives the LD light source 44, and special light L2 emitted from the LD light source 44. And a mirror 47 that reflects the special light L2 collected by the condenser lens 46 toward the dichroic mirror 43.

  In the present embodiment, since ICG is used as the fluorescent dye, near infrared light of 750 nm to 790 nm is used as the special light L2. Further, the special light L2 is not limited to light in the above-mentioned wavelength range, and is appropriately determined depending on the type of fluorescent dye or the type of living tissue to be autofluorescent.

  The LD driver 45 drives the LD light source 44 based on the control signals output from the control unit 38 and the TG 37 of the image processing apparatus 3, and the control unit 38 of the image processing apparatus 3 is connected to the image processing apparatus 3. A control signal is output to the TG 37 based on the pressed foot pedal 6 signal, and the TG 37 outputs a drive pulse signal to the LD driver 45 so that the special light L2 is emitted from the LD light source 44 when the foot pedal 6 is depressed. Is output.

  In addition, the rigid endoscope system of the present embodiment includes an automatic medicine injection device 5 that automatically injects medicine into the body of a subject. FIG. 5 shows a schematic configuration of the automatic medicine injection device 5. The automatic medicine injection device 5 includes a syringe 50 filled with medicine, an automatic medicine injection device main body 51 in which the syringe 50 is set, and a drive control unit 52. The automatic medicine injection device main body 51 includes a feed screw 54 for moving the pusher 53 of the syringe 50, a carriage 55, and a pulse motor 56. The drive control unit 52 outputs a drive pulse signal for driving the pulse motor 56 based on a control signal indicating the dose of the fluorescent agent from the control unit 38 of the image processing apparatus 3.

  When the syringe 50 filled with the fluorescent drug is set in the automatic drug injection device main body 51 and the pulse motor 56 is driven by the drive pulse signal from the drive control unit 52, the carriage 55 is moved by the feed screw 54, As a result, the pusher 53 moves, and the fluorescent agent is delivered from the syringe 50 toward the body of the subject.

  The control unit 38 of the image processing device 3 outputs a control signal to the drive control unit 52 based on a pressing signal of the foot pedal 6 connected to the image processing device 3, and the foot control 6 presses the drive control unit 52. A drive pulse signal is output so that the fluorescent agent is delivered when it is released.

  In addition, the image processing device 3 of the rigid endoscope system according to the present embodiment is provided with a timer 39, and the timer 39 inputs a fluorescent agent based on a pressing signal of a foot pedal 6 connected to the image processing device 3. The elapsed time from the start time is measured.

  Then, the control unit 38 of the image processing device 3 outputs a control signal to the imaging unit 20 via the TG 37 when the elapsed time measured by the timer 39 reaches a predetermined time. The imaging of the fluorescence image by the element 24 is stopped.

  Next, the operation of the rigid endoscope system of the present embodiment will be described with reference to the flowchart shown in FIG.

  First, after the hard insertion portion 30 and the cable 7 to which the optical cable LC is connected are attached to the imaging unit 20, the light source device 2, the imaging unit 20, and the image processing device 3 are powered on and driven.

  Then, in the input receiving unit 36 of the image processing apparatus 3, patient (subject) information is set and input by the operator (S10). Specifically, the patient information includes age, weight, and observation site. Then, the patient information input in the input receiving unit 36 is input to the administration allowable number acquiring unit 38a of the control unit 38.

そして、投与許容回数取得部３８ａは、上表１の設定情報と入力された患者情報とに基づいて投与許容量と１回あたりの投与量を取得し、これらに基づいて投与許容回数を取得する（Ｓ１２）。具体的には、本実施形態においては、蛍光薬剤を注射用水で溶解して１ｍｇ/ｍｌの濃度とした水溶液を使用するものとし、たとえば、患者情報が１６歳以上の成人で観察部位が腹部である場合には、１回あたりの投与量が１ｍｇ（水溶液の容量は１ｍｌ）であり投与許容量が１０ｍｇであるので、投与許容回数としては１０ｍｇ/１ｍｇ＝１０回が取得される。 Here, in the administration allowance number obtaining unit 38a, an administration allowance corresponding to patient information as shown in Table 1 below and a dose per administration are set in advance. The dose tolerance is the total dose of the fluorescent drug that can be administered to a patient (subject). Further, Table 1 below is an example when information on age and observation site is received as patient information.

Then, the administration allowable number obtaining unit 38a obtains the administration allowable amount and the dose per administration based on the setting information in Table 1 and the input patient information, and obtains the administration allowable number based on these. (S12). Specifically, in the present embodiment, an aqueous solution in which a fluorescent drug is dissolved in water for injection to a concentration of 1 mg / ml is used. For example, the patient information is an adult aged 16 years or older and the observation site is the abdomen. In some cases, the dose per dose is 1 mg (the volume of the aqueous solution is 1 ml), and the allowable dose is 10 mg. Therefore, the allowable dose is 10 mg / 1 mg = 10 times.

  Also, if the patient information is an adult over 16 years old and the observation site is the chest, the dose per dose is 0.8 mg (the volume of the aqueous solution is 0.8 ml) and the allowable dose is 10 mg. As the allowable administration frequency, 10 mg / 0.8 mg≈12 times is acquired.

  In addition, when the patient information is a child under 15 years old and the observation site is the abdomen, the dose per dose is 0.5 mg (the volume of the aqueous solution is 0.5 ml), and the allowable dose is 5 mg. As the allowable number of times of administration, 5 mg / 0.5 mg = 10 times is obtained.

  In addition, when the patient information is a child under 15 years old and the observation site is the chest, the dose per dose is 0.4 mg (the volume of the aqueous solution is 0.4 ml), and the allowable dose is 5 mg. As the allowable number of times of administration, 5 mg / 0.4 mg≈12 times is acquired.

  When the patient information is a child under 15 years old, the concentration of the aqueous solution of the fluorescent drug may be 0.5 mg / ml. However, in this case, the volume of the aqueous solution of the fluorescent agent per one time will be doubled.

そして、蛍光薬剤の水溶液濃度を１ｍｇ/ｍｌとした場合には、たとえば、患者情報が１６歳以上の体重６０ｋｇの成人であり、観察部位が腹部である場合には、１回あたりの投与量が１ｍｇ（水溶液の容量は１ｍｌ）であり投与許容量が０．５ｍｇ/ｋｇ×６０ｋｇ＝３０ｍｇであるので、投与許容回数としては３０ｍｇ/１ｍｇ＝３０回が取得される。 Moreover, when acquiring age, a body weight, and an observation site | part as patient information, the dosage tolerance corresponding to patient information as shown in the following table 2, and the dosage per time are preset.

And, when the concentration of the aqueous solution of the fluorescent agent is 1 mg / ml, for example, when the patient information is an adult with a body weight of 60 kg over the age of 16 and the observation site is the abdomen, the dose per time is Since 1 mg (the volume of the aqueous solution is 1 ml) and the allowable dose is 0.5 mg / kg × 60 kg = 30 mg, 30 mg / 1 mg = 30 times is acquired as the allowable dose.

  In addition, when the patient information is a child with a body weight of 30 kg under the age of 15 and the observation site is the abdomen, the dose per dose is 0.5 mg (the volume of the aqueous solution is 0.5 ml) and the dose tolerance Since 0.25 mg / kg × 30 kg = 7.5 mg, 7.5 mg / 0.5 mg = 15 times is acquired as the allowable number of times of administration.

  For each patient information, the allowable number of times of administration is acquired in the same manner as described above. In the present embodiment, the patient allowable number of times is acquired based on age, weight, and observation site as patient information. However, patient information is not limited to this, and the allowable dose of the fluorescent drug and the per-time Any information may be used as long as it is patient information related to the dose.

  Table 1 is an example of doses in clinical studies of ICG fluorescence. ICG has received regulatory approval for liver function tests and circulatory function tests, but since the ICG fluorescence method deviates from this usage, it is currently used at a dose approved by the ethics committee of each medical institution. Yes. Basically, the dose per time is set so as to satisfy the regulations of the drug. The dose per administration at the time of chest observation in Table 1 is set to be 20% less than that at the time of abdominal observation because visceral fat covering blood vessels is small.

  Next, the operator inserts the hard insertion portion 30 into the body cavity, and the tip of the hard insertion portion 30 is placed in the vicinity of the observed portion.

  First, a normal image is captured (S14). Specifically, the normal light L1 emitted from the normal light source 40 of the light source device 2 is incident on the hard insertion portion 30 via the condenser lens 42, the dichroic mirror 43, and the optical cable LC, and the irradiation window of the hard insertion portion 30 is obtained. Irradiates the observed part from 30d.

  And the normal image based on the reflected light reflected from the to-be-observed part by irradiation of the normal light L1 is imaged. Specifically, when capturing the normal image, the normal image L3 based on the reflected light reflected from the observed portion by the irradiation of the normal light L1 is incident from the distal end 30Y of the insertion member 30b, and the inside of the insertion member 30b. The light is guided by the objective lens group and emitted toward the imaging unit 20.

  The normal image L3 incident on the image pickup unit 20 is reflected by the dichroic prism 21 toward the image pickup device 26 in a right angle direction, and formed on the image pickup surface of the image pickup device 26 by the second image forming optical system 25. Then, the image sensor 26 accumulates charges in a predetermined charge accumulation period for each frame, and a normal image signal corresponding to the accumulated charges is output for each frame.

  The normal image signal output from the image sensor 26 is subjected to image processing via the cable 7 after being subjected to CDS / AGC (correlated double sampling / automatic gain control) processing and A / D conversion processing in the imaging control unit 27. It is output to the device 3.

  The normal image signal input to the image processing device 3 is temporarily stored in the normal image input controller 31 and then subjected to gradation correction processing and sharpness correction processing in the image processing unit 33 and stored in the memory 34. . Then, the normal image signal for each frame read from the memory 34 is output to the video output unit 35 (S16).

  Then, the video output unit 35 performs a predetermined process on the input normal image signal to generate a display control signal, and outputs the display control signal to the monitor 4. Then, the monitor 4 displays a normal image based on the input display control signal (S18).

  As described above, the normal image is captured and displayed at all times. On the other hand, the fluorescent image is captured when the operator depresses the foot pedal 6 (S20). Specifically, when the foot pedal 6 is pressed, the pressing signal is output to the control unit 38, and the control unit 38 sets the allowable number of times of administration set in the allowable number of times acquisition unit 38a before the administration of the fluorescent drug. And the possible number of times of administration is acquired based on the allowable number of times of administration (S22). The number of possible administrations is the number of times obtained by subtracting the actual number of administrations of the fluorescent agent from the allowable number of administrations.

  When the number of possible administrations> 0 (S24, YES), the control unit 38 starts the administration of the fluorescent agent (S26). In a state where the fluorescent drug has not been administered yet, the number of possible administrations = the number of allowable administrations> 0, and the administration of the fluorescent drug is started. Specifically, a control signal indicating the capacity of the fluorescent drug is output from the control unit 38 to the drive control unit 52 of the automatic drug injection device 5, and the drive control unit 52 outputs a drive pulse to the pulse motor 56 based on the control signal. Output a signal. Here, the volume of the fluorescent agent is an amount obtained based on the dose (mg) per administration acquired by the administration allowable number acquisition unit 38a and the aqueous concentration of the fluorescent agent (mg / ml). is there.

  Then, the pulse motor 56 is driven in accordance with the drive pulse signal, whereby the pusher 53 is moved, and a fluorescent drug of a capacity (ml) per time is sent from the syringe 50 toward the body of the subject. .

  In this embodiment, the amount of the fluorescent drug to be administered at one time is reduced to about 1/10 of the normal, and initial circulation imaging is performed to image the process in which the drug mass is dispersed in the blood. And The first circulation imaging has an advantage in that a fluorescence image of a blood vessel before the drug is dispersed can be captured, so that the signal intensity can be increased and the background light is small, so that a fluorescence image with high contrast can be captured.

  Then, along with the introduction of the fluorescent agent as described above, the control unit 38 subtracts 1 from the administration possible number acquired in S22 and updates the administration possible number (S28).

  On the other hand, with the introduction of the fluorescent agent as described above, the control unit 38 starts the operation of the fluorescence image capturing system in response to the depression of the foot pedal 6. Specifically, the control unit 38 outputs a control signal to the TG 37 according to the input foot pedal 6 depression signal, and the TG 37 is driven to the LD driver 45 of the light source device 2 according to the input control signal. While outputting a pulse signal, a drive pulse signal is output to the high sensitivity image sensor 24 of the imaging unit 20.

  Then, the LD driver 45 drives the LD light source 44 in accordance with the input drive pulse signal to start emission of the special light L2 from the LD light source 44, and image pickup by the high sensitivity image pickup device 24 of the image pickup unit 20 is performed. Is started (S30, S32).

  At this time, the control unit 38 also outputs a control signal to the timer 39, and starts measuring the elapsed time from the start of charging the fluorescent agent by the timer 39.

  That is, when the operator depresses the foot pedal 6 as described above, the fluorescent agent is inserted, the special light L2 is irradiated onto the observed portion, the fluorescent image is captured by the high-sensitivity image sensor 24, and the elapsed time by the timer 39 is reached. Measurements are started almost simultaneously.

  Then, a fluorescence image L4 based on the fluorescence emitted from the observed portion by irradiation with the special light L2 is incident from the tip 30Y of the insertion member 30b, guided by the objective lens group in the insertion member 30b, and directed toward the imaging unit 20. And injected.

  The fluorescent image L4 incident on the imaging unit 20 passes through the dichroic prism 21 and the special light cut filter 22, and is then imaged on the imaging surface of the high-sensitivity imaging element 24 by the first imaging optical system 23. In the high-sensitivity image sensor 24, charges are accumulated in a predetermined charge accumulation period for each frame, and a fluorescence image signal corresponding to the accumulated charges is output for each frame.

  Then, the fluorescent image is captured until the elapsed time of 60 seconds is measured by the timer 39, and when the 60 seconds have elapsed, the control unit 38 stops the irradiation of the special light L2 and the imaging by the high-sensitivity image sensor 24.

The fluorescence image signal output from the high-sensitivity imaging device 24 until the elapsed time of 60 seconds is measured by the timer 39 is subjected to CDS / AGC (correlated double sampling / automatic gain control) processing or A in the imaging control unit 27. After being subjected to the / D conversion process, it is output to the image processing device 3 via the cable 7 and temporarily stored in the fluorescence image input controller 32.
The image processing unit 33 performs predetermined image processing and stores it in the memory 34 (S34, S36). In the present embodiment, since the fluorescent image is captured at 10 fps, the fluorescent image for a total of 600 frames can be stored in the memory 34.

  The reason for setting the fluorescent image capturing time to 60 seconds is as follows. The circulating blood volume of an adult male is 75 ml / kg, and when the body weight is 60 kg, it is 4500 ml. On the other hand, since the cardiac output of an adult male at rest is 70 ml / s to 80 ml / s, the time required for blood to circulate once throughout the body is about 54 seconds to 60 seconds. Therefore, the fluorescent agent introduced into the blood passes through the observed portion between 54 seconds and 60 seconds from the start of injection.

  Therefore, it is sufficient to shoot even during the period of 54 to 60 seconds. If the special light L2 is continuously irradiated after that, damage to the observed portion due to the special light L2 is increased. This is because the amount of data is also increased.

  Further, as described above, while sequentially capturing fluorescent images, the fluorescent images may be designated and acquired at a predetermined time point set in advance. For example, it is possible to acquire a fluorescent image of the artery of the observed portion by specifying and acquiring a fluorescent image at a predetermined time before the elapsed time from the time when the fluorescent agent is added 10 seconds, By acquiring a fluorescence image at a predetermined time after the elapsed time of 10 seconds has elapsed, a fluorescence image of the vein of the observed portion can be acquired. It has been confirmed by experiments that the vein of the observed part emits fluorescence after the artery of the observed part emits fluorescence for several seconds.

  Then, the fluorescent image signal for each frame is sequentially read from the memory 34 and output to the video output unit 35. The video output unit 35 performs a predetermined process on the input fluorescent image signal to generate a display control signal. The display control signal is output to the monitor 4. The monitor 4 displays a fluorescent image based on the input display control signal (S18).

  As described above, a fluorescent image photographed between 60 s and 60 seconds after the start of injection of the fluorescent agent is displayed on the monitor 4, and a normal image is displayed on the monitor 4. Note that it is desirable to display a fluorescent image captured during 60 seconds as a still image even after 60 seconds, and a normal image as a moving image.

  As a fluorescent image to be displayed as a still image, for example, a fluorescent image having the maximum luminance information or contrast is acquired as a fluorescent image of an artery among a plurality of fluorescent images captured for 10 seconds from the start of injection of a fluorescent agent. What is necessary is just to acquire the fluorescence image from which the brightness | luminance information or contrast becomes the maximum as a fluorescence image of a vein among the several fluorescence images imaged after 10 second progress. As the luminance information, for example, the maximum luminance value and the average luminance value of each pixel of the fluorescent image can be used.

  In addition, the fluorescence image of the vein and the fluorescence image of the artery may be displayed separately, or a fluorescence image obtained by combining both of them may be displayed. FIG. 7 shows an example of a screen in which the normal image and the fluorescence image are displayed side by side on the monitor 4.

  Here, in this embodiment, as shown in FIG. 7, while displaying a normal image and a fluorescence image on the monitor 4, the frequency | count of possible administration of a fluorescent agent is also displayed (S18). The administration possible number displayed on the monitor 4 is the administration possible number updated in S28. By displaying the possible number of administrations in this way, the operator can determine whether or not the fluorescent agent can be administered again to take a fluorescent image.

  Then, when the operator thinks that the photographing of the fluorescent image is to be finished, the input accepting unit 36 accepts that fact and finishes the photographing of the fluorescent image (S38, YES). When it is desired to perform the shooting (NO in S38), the foot pedal 6 is pressed again by the operator (S20). Then, the same operation as described above is repeated, and the fluorescent image, the normal image, and the possible number of administrations of the fluorescent drug are displayed on the monitor 4. become.

  Then, every time the foot pedal 6 is pressed by the operator, photographing of the fluorescent image is repeated. When the possible number of administrations becomes 0 in S24, a warning is displayed on the monitor 4 on the control unit 38 (S40). ). With this warning display, the operator can be informed that the permissible dose of the fluorescent agent has been reached.

  Moreover, in the said embodiment, although the dosage per time of the fluorescent agent was made constant, it is not restricted to this, For example, you may make it reduce the dosage per time in the middle of repeating the imaging of a fluorescence image. . Specifically, for example, when the dose of the fluorescent drug is 10 mg and the dose per dose is constant at 1 ml (the concentration of the aqueous solution of the fluorescent drug is 1 mg / ml), the number of allowable doses is 10 times. However, as shown in FIG. 8, if the dose of the fluorescent drug after the sixth time is 0.5 ml, the allowable number of times of administration can be increased to 15 times.

  Thus, by making it possible to change the dose of the fluorescent agent per time, for example, when the operator has finished taking five fluorescent images, the remaining number of possible administrations is five times or more. If the user wants to take an image, the setting input for halving the dose of the fluorescent agent at the input reception unit 36 is performed, so that 10 more fluorescent images can be taken.

  In addition, as described above, instead of accepting a change in the dose of the fluorescent drug per time during the shooting of the fluorescent image, the dose of the fluorescent drug is kept constant at the time of starting the shooting of the fluorescent image. If it is selected whether to change the dose of the fluorescent agent per time, and whether to change from the point of time when the predetermined number of times of shooting is completed, the predetermined number of times of shooting is ended. At that time, the dose of the fluorescent drug per time may be automatically changed.

  Further, as described above, when the dose of the fluorescent agent per time is changed to a small dose during the photographing of the fluorescence image, the control unit 38 determines that the intensity of the special light L2 output from the LD light source 44 is high. You may make it control so that it may become large. At this time, the control unit 38 may perform control so that the charge accumulation period of each frame of the high-sensitivity image sensor 24 is extended. Specifically, when the dose of the fluorescent agent per time is changed to half, the intensity of the special light L2 or the charge accumulation period of the high-sensitivity image sensor 24 may be doubled.

  In the above embodiment, the warning display is output when the possible number of administrations becomes zero. However, the present invention is not limited to this. For example, the control unit 38 controls the fluorescent drug from the automatic drug injection device 5. Automatic injection may be forcibly stopped.

  Moreover, although the said embodiment applies the fluorescence imaging device of this invention to a rigid endoscope system, it is not restricted to this, For example, it applies to the other endoscope system which has a flexible endoscope apparatus. Also good. Further, the present invention is not limited to an endoscope system, and may be applied to a so-called video camera type medical image capturing apparatus that does not include an insertion portion that is inserted into the body.

DESCRIPTION OF SYMBOLS 1 Rigid endoscope system 2 Light source apparatus 3 Image processing apparatus 4 Monitor 5 Drug automatic injection apparatus 6 Foot pedal 10 Rigid endoscope imaging apparatus 20 Imaging unit 24 High sensitivity imaging element 26 Imaging element 30 Hard insertion part 36 Input reception part 38 Control part 38a Administration Allowable frequency acquisition unit 38b Administration start information reception unit 38c Administration possible frequency acquisition unit 39 Timer 40 Normal light source 44 LD light source

Claims (4)

An excitation light irradiating unit that irradiates the observed part to which the fluorescent agent is administered with an excitation light, and an imaging device that receives and photoelectrically converts the fluorescence emitted from the fluorescent agent of the observed part by the excitation light irradiation. And a fluorescence image capturing apparatus including an imaging unit that captures a fluorescence image by accumulating charges in a predetermined charge accumulation period by the image sensor,
A patient information reception unit for receiving input of patient information;
An administration allowable number acquisition unit for acquiring the administration allowable number of the fluorescent agent set based on the administration allowable amount of the fluorescent agent according to the patient information and the dose per administration;
An administration start information receiving unit for receiving administration start information of the fluorescent agent;
Based on the number of times the administration start information has been received and the allowable number of times of administration, the administration is possible number of times acquisition unit for acquiring the remaining number of times of administration,
The administrable frequency acquisition unit reacquires the administrable frequency set based on a dose smaller than the dose per administration from the time when the administrable frequency reaches a predetermined frequency. A fluorescent imaging device characterized by that.   The fluorescence image capturing apparatus according to claim 1, further comprising a display unit that displays the number of administrations possible. If the administration can count acquisition unit has reacquired the administrable number claim 1, characterized in that it comprises an excitation light control unit the intensity of the excitation light to control the excitation light emitter to be larger Or the fluorescent image capturing apparatus according to 2; If the administration can count acquisition unit has reacquired the administrable number claim 1, characterized in that the charge accumulation period of the image sensor including an image pickup device control unit for controlling the imaging device to be longer 4. The fluorescence image capturing device according to any one of items 1 to 3 .

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