JP5929965B6 - Medical image interpretation support apparatus, control method thereof, and program - Google Patents

Description

The present invention relates to a medical image interpretation support apparatus for assisting in interpretation of a medical image obtained by imaging a subject, and more specifically, a display capable of grasping the risk level of a region of interest at a glance. The present invention relates to a medical image interpretation support apparatus, a control method thereof, and a program.

  In recent years, mortality due to colorectal cancer has risen among the causes of death in cancer, and in response to this, a screening program using endoscopy or the like has been developed for early detection and treatment of colorectal cancer. Among them, a method for diagnosing the intestinal tract using a virtual endoscope function based on medical image data obtained by imaging the large intestine using CT (computed tomography) is called CT-Colonography (CTC). It is used in various facilities (see, for example, Patent Document 1).

  Interpretation in this method is generally performed by observing an image displayed by the virtual endoscope function to determine the presence or absence of an abnormal part, and if there is an abnormal part, record the position of the abnormal part. This is performed by examining the region with a CT image, and thereafter, the size of the lesion is measured using the distance measurement function of the analyzer. As can be seen from the fact that the possibility that cancer has progressed as the lesion becomes larger, the size of the lesion itself represents the degree of risk (possibility that cancer has progressed). Because it is. In the above determination and measurement process, it is also necessary to confirm that the abnormal site is not a residue but a lesion.

  In the interpretation performed by observing the virtual endoscopic image or CT image (primary image) described above, the interpreter enlarges / reduces the primary image so that the abnormal part is displayed in a size that is easy to interpret, An image is stored with a mark or the like as necessary, and the stored image (referred to as a secondary image or secondary capture) is sent to the treating physician. Then, the treating doctor makes a determination on the excision of the lesion (polypectomy) or the like based on the primary image or the secondary image created by the radiogram interpreter. Here, since the degree of risk of a lesion is important information for performing polypectomy, it is required to be accurately and reliably transmitted from a radiographer to a treating doctor using a secondary image or the like. Usually, when the size of the lesioned part is 5 to 7 mm or more, it is judged that the degree of risk is high, and colonoscopy is often performed to remove the lesioned part.

  By the way, because the secondary image may be created by enlarging or reducing the primary image as necessary, it is difficult to grasp the actual size of this based on the abnormal part displayed in the secondary image It is. For this reason, conventionally, the distance between two designated points (the length of the line connecting the two points) has been displayed according to the designation of the two end points at the abnormal part on the image by the image interpreter. (A secondary image may be obtained by adding such a display to a primary image). Thereby, the image interpreter and the treating doctor can grasp how to treat the abnormal site by reading the distance between the two displayed points.

JP 2011-088891 A

  However, when a large number of such abnormal sites are found and the treatment needs to be performed immediately, for example, information (risk level) on whether or not to excise is easy and clear for each abnormal site. There was a problem that an index to give to was required.

The present invention has been made in view of the above problems, and a medical image interpretation support apparatus capable of displaying at a glance the degree of risk of an abnormal site as a lesion different from the residue. An object of the present invention is to provide a control method and program thereof.

In order to achieve the above object, a medical image interpretation support apparatus, a control method thereof, and a program according to the present invention are configured as follows.

The present invention provides medical image interpretation support for identifying and displaying the degree of risk indicating the progress of a lesion at a specified site in order to support interpretation of a medical image obtained by imaging a subject with a medical image imaging apparatus. A device for storing a plurality of display modes according to different shapes of the profile curve, in order to identify and display the degree of risk indicating the progress of the lesion at the specified site, and specified on the image for interpretation and a line segment specifying means for specifying a line segment defined by two measuring reference position, a shape of the profile curve of the signal values of each pixel corresponding to the line component of the signal values obtained by the medical image imaging apparatus based on the shape of the profile curve, the determining means for determining whether to display any of the plurality of display modes stored in the storage means, in a display mode determined by the determining means, the risk of the site It characterized in that it comprises a display control means you identifiably displayed.

According to the present invention, it is possible to provide a medical image interpretation support apparatus, a control method thereof, and a program capable of causing a display where the abnormal part is a lesion part different from the residue part and the risk level can be grasped at a glance. It becomes possible.

It is a block diagram which shows schematic structure of the medical image interpretation assistance apparatus which concerns on this invention. It is a flowchart which shows the flow of the process performed in the medical image interpretation assistance apparatus shown in FIG. It is a figure which shows the image displayed on a display apparatus, Comprising: (a) is a figure which shows the image for interpretation (CT image) in which the lesion part appeared, (b) is between 2 points | pieces designated in (a). It is a figure which shows the profile curve of CT value. It is a figure which shows the image displayed on a display apparatus, Comprising: (a) is a figure which shows the image for interpretation (CT image) in which the residue part appeared, (b) is between 2 points | pieces designated in (a). It is a figure which shows the profile curve of CT value. It is a figure which shows CT value between two designated points, a horizontal axis is CT value and a vertical axis | shaft is frequency, (a) is a figure shown about CT value of FIG.3 (b), (b) is a figure. It is a figure shown about CT value of 4 (b). It is a figure which shows the secondary image which attached | subjected the line segment to CT image, Comprising: (a) is a figure which attached | subjected the line segment which shows a high risk degree, (b) is a line which shows a low risk degree FIG. It is a table | surface which shows the correspondence of the color attached to the line segment which ties 2 points | pieces, and a list | wrist. It is a figure which shows the line segment length list produced by the said medical image interpretation assistance apparatus.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the above-mentioned drawings. First, the apparatus configuration of the medical image interpretation support apparatus 1 according to the present invention will be described with reference to FIG. The medical image interpretation support apparatus 1 shown in FIG. 1 causes the display apparatus 2 to display an interpretation image that is easy to interpret based on the medical image data of the subject obtained by the medical image imaging apparatus 4 (for example, CT). Thus, the interpretation of the medical image by the interpreter is supported.

  The medical image interpretation support apparatus 1 includes a computer or the like, and includes a control unit 11, a data storage unit 12, a display data output interface 14, an operation input interface 15, and an image data input interface 16, as shown in FIG. Configured. The control unit 11 includes a CPU that performs various arithmetic processes and a memory that stores a predetermined program. The controller 11 includes a core line setting unit 20, an image interpretation display unit 21, a line segment length calculation unit 22, and a standard deviation calculation unit 23. , Line segment display means 24 and list creation means 25 (details will be described later). The data storage unit 12 is configured by a storage device such as a hard disk, RAM, or ROM, and is configured to be able to transmit and receive various data to and from the control unit 11.

  The display data output interface 14 is an interface that transmits display data output from the control unit 11 to the display device 2. The operation input interface 15 is an interface that transmits various operation signals input from the operation device 3 to the control unit 11. The image data input interface 16 is an interface that transmits medical image data from the medical image capturing apparatus 4 to the control unit 11. The operation device 3 includes a mouse, a keyboard, and the like. By operating the operation device 3, an operation signal corresponding to the operation is input to the control unit 11 via the operation input interface 15, and an interpretation part is designated. The position can be designated on the image (interpretation image) displayed on the display device 2.

  Next, the operation of the medical image interpretation support apparatus 1, that is, the control for displaying an image for interpretation on the display device 2 will be described with reference to the flowchart shown in FIG. 2 with reference to FIGS. 3 to 8.

  In the following, a tomographic image of a subject is taken by the medical image pickup device 4, and an image for interpretation is read in order to interpret the large intestine based on medical image data (for example, CT value) consisting of a group of tomographic images obtained by tomography. A case of displaying on the display device 2 will be described. The medical image interpretation support apparatus 1 according to the present invention enables accurate and efficient interpretation by displaying an image for interpretation that can grasp at a glance the risk level (possibility of cancer progression) of a lesion. It is characterized in that The procedure for displaying the image for interpretation on the display device 2 described below is executed according to the medical image interpretation support program according to the embodiment of the present invention.

  Here, the overall operation of the medical image interpretation support apparatus 1 will be schematically described. As shown in FIG. 2, first, medical image data is acquired (step S10), and then, based on the acquired medical image data. The image for interpretation is displayed (step S20), and then an operation for designating two points is performed as necessary (steps S30 and S35), and then the distance between the designated two points is calculated ( Step S40) Subsequently, the standard deviation of the CT value on the line connecting the two points is calculated (Step S50), then the color to be attached to the line is determined (Step S60), and then the two points are connected. The line segment is displayed (step S70), and finally, an operation for creating a line segment length list (step S80) is performed. Hereinafter, each step will be described in detail.

  <1> First, medical image data obtained by tomographic imaging of a subject is acquired from the medical image imaging device 4 (medical image data acquisition step; see step S10 in FIG. 2). The acquired medical image data is stored in the data storage unit 12. Here, since the colon folds are arranged at predetermined intervals in the core line direction inside the large intestine, if the medical image pickup apparatus 4 captures images with the colon folds being narrow, the interpretation between the colon folds is interpreted. It becomes difficult to do. Therefore, when the large intestine is interpreted as in the present embodiment, medical gas is injected into the large intestine in advance to expand the folds of the large intestine in the radial direction and the core line direction, and in this state, the medical image capturing apparatus 4 performs tomography Is done. In the present embodiment, it is assumed that the medical image data of the subject is acquired from the medical image capturing apparatus 4, but instead of this configuration, a medical image stored in an information storage medium such as a CD or a DVD is used. Data may be read and acquired as necessary.

  After acquiring the medical image data, the control unit 11 is stored in the data storage unit 12 based on an operation signal (in this case, an operation signal for selecting the large intestine) that selects an interpretation part input from the operation device 3. Medical image data corresponding to the large intestine is specified from the medical image data. Here, as a method of specifying medical image data corresponding to the large intestine, a method of specifying a threshold value for a CT value and comparing the CT value of the medical image data with the threshold value can be adopted.

  The core setting unit 20 of the control unit 11 sets the core of the large intestine based on the specified medical image data (medical image data corresponding to the large intestine). In this embodiment, non-patent literature `` Stephen R. Aylward, Member, IEEE and Elizabeth Bullitt, `` Initialization, Noise, Singularities, and Scale in Height Ridge Traversal for Tubular Object Centerline Extraction '' IEEE TRANSACTIONS ON MEDICAL IMAGING, VOL. 21, NO.2, FEBRUARY 2002 ", the core wire is set. Specifically, first, based on each data value (CT value) of medical image data, a point estimated to be located on the core of the large intestine in a local region in the image data space (hereinafter referred to as “via point”). Set. Next, the eigenvalue of the Hesse matrix in the local region including the via point is calculated, the main axis direction of the colon core (the direction in which the core line extends) is obtained based on the calculated eigen value, and a new via point is calculated in the main axis direction. Set. By repeating this procedure, a large number of via points are set sequentially, and the set core points are set by smoothly connecting the set via points.

  <2> Subsequently, the image interpretation display unit 21 of the control unit 11 displays an image for interpretation of the large intestine (primary image) on the display device 2 based on the medical image data specified in step S10 described above ( Image interpretation image display step; see step S20 in FIG. Here, the image for image interpretation assumes a viewpoint moving on the core line of the large intestine, and a virtual endoscopic image representing the inside of the large intestine that is assumed to be visible from this viewpoint, and the viewpoint position of the virtual endoscopic image. The corresponding CT image (tomographic image) is meant. The interpreter observes the virtual endoscopic image developed and displayed in accordance with the movement of the viewpoint while automatically or manually moving the viewpoint of the virtual endoscopic image along the core line, and inward from the inner wall of the intestinal tract. Check for elevated lesions and suspected areas. In general, it can be said that the size of the lesion part itself represents the degree of the risk, as can be seen from the fact that the possibility that the cancer progresses as the lesion part becomes larger. Therefore, when a protruding portion is confirmed by observing the image for interpretation, the size (the major axis of the protruding portion) is measured in order to grasp the degree of risk of the protruding portion as follows.

  <3> The image interpreter moves the viewpoint of the virtual endoscopic image to expand and display the image for interpretation, and operates the operation device 3 each time a raised portion appears to project the image on the image for interpretation. Two points corresponding to both ends of the major axis of the part are designated (two-point designation operation step; see steps S30 and S35 in FIG. 2). In response to the designation operation in step S35, an operation signal for designating two points is input to the control unit 11. In this way, the operation of designating two points is performed on all the images for interpretation that are displayed while the viewpoint of the virtual endoscopic image is moved from the start point to the end point. Performs an operation corresponding to the end of the two-point specifying operation on the controller device 3 (step S30). By this end operation, an operation signal corresponding to the end of the specified operation is input to the control unit 11, and the process proceeds from step S30 to step S40.

  <4> When the process proceeds from step S30 to step S40, the line segment length calculation means 22 of the control unit 11 determines the distance between the two points for each of the two points (a set of two points) designated in step S35 described above. That is, the length of a line segment (major axis) connecting two designated points is calculated (step for calculating a distance between two points; see step S40 in FIG. 2). By the way, if there is a residue portion such as residual stool in the intestinal tract, this residue portion is observed as a raised portion in the same manner as the lesion portion. In step S35 described above, not only the lesion portion but also the residue portion has two points. May be specified. Therefore, the process proceeds to the next step S50 in order to distinguish the part existing between the two points designated in step S35 described above from the lesioned part and the residual part.

  <5> When the process proceeds from step S40 to step S50, the standard deviation calculation means 23 of the control unit 11 performs medical image data between two points (on the line connecting the two points) for each of the two points designated in step S35. The CT value of each pixel located) is specified, a profile curve of this CT value is created and displayed on the display device 2 together with the image for interpretation. An example in which the profile curve is displayed together with a CT image as an image for interpretation is shown in FIGS. In order to compare the difference between the lesioned part and the residue part, FIG. 3 shows a part corresponding to the lesion part, and FIG. 4 shows a part corresponding to the residue part.

  3A shows a CT image 30 when two points corresponding to both ends of the major axis of the lesioned part 31 are designated, and FIG. 3B shows a line segment connecting the two designated points in the CT image 30. FIG. In the profile curve 33, the CT value of the pixel existing on 32 is represented by the horizontal axis as the position in the direction in which the line segment 32 extends and the vertical axis as the CT value. Since the lesioned part 31 (part consisting of cells) has a high degree of X-ray absorption with respect to moisture, fat, air, etc. and a relatively high CT value can be stably obtained, the profile curve 33 corresponding to the lesioned part 31 is obtained. As shown in FIG. 3B, the CT value is relatively high and substantially constant.

  On the other hand, FIG. 4A shows a CT image 40 when two points corresponding to both ends of the major axis of the residue portion 41 are designated, and FIG. 4B connects the two designated points in the CT image 40. This is a profile curve 43 in which the CT values of the pixels existing on the line segment 42 are represented with the horizontal axis as the position in the direction in which the line segment 42 extends and the vertical axis as the CT value. Since the residue portion 41 has a gap (air) inside, and the CT value rapidly decreases in the gap portion, the profile curve 43 corresponding to the residue portion 41 has a lesion portion as shown in FIG. Compared with the 31 profile curve 33, the CT value varies greatly.

  As described above, based on the CT value (profile curve shape) on the line segment connecting the two specified points, it is possible to distinguish a site (bump) between the two points into a lesion and a residue. is there. In the present embodiment, as shown in FIG. 5, a configuration is shown in which the shape of the CT value is digitized using the standard deviation of the CT value between two points, and the lesioned portion or the residual portion is distinguished based on the numerical value. doing. In FIG. 5, in order to compare the difference between the lesioned part and the residue part, FIG. 5 (a) shows the one corresponding to the lesioned part, and FIG. 5 (b) shows the one corresponding to the residual part. Is shown.

  Therefore, the standard deviation calculating means 23 of the control unit 11 calculates the standard deviation of the CT value between the two specified points (standard deviation calculating step; see step S50 in FIG. 2). First, the case where the standard deviation σ of the profile curve 33 corresponding to the lesioned part 31 shown in FIG. When the CT value of the profile curve 33 shown in FIG. 3 (b) is shown in a graph with the CT value on the horizontal axis and the frequency on the vertical axis, as shown in FIG. 5 (a), the average CT value m1 is the center. It becomes a convex graph in which CT values are concentrated. Therefore, when the standard deviation σ is calculated for the profile curve 33 of the lesioned part 31 shown in FIG. 3B, a relatively small σ1 is obtained.

  Next, the case where the standard deviation σ of the profile curve 43 corresponding to the residue portion 41 shown in FIG. 4B is calculated will be described. When the CT value of the profile curve 43 shown in FIG. 4B is shown in a graph with the CT value on the horizontal axis and the frequency on the vertical axis, as shown in FIG. 5B, the average CT value m2 is shown. A CT value is distributed over a wide range. Therefore, when the standard deviation σ is calculated for the profile curve 43 of the residue portion 41 shown in FIG. 4B, a relatively large σ2 (> σ1) is obtained.

  <6> When the process proceeds from step S50 to step S60, the line segment display means 24 of the control unit 11 performs the step based on the distance between the two points calculated in step S40 and the standard deviation calculated in step S50. The color attached to the line segment connecting the two points designated in S30 is determined (color determination step; see step S60 in FIG. 2). The determination of color by the line segment display means 24 will be described in detail below.

  The line segment display means 24 stores information related to the size of the lesion (reference size X) where it is considered that cancer may have progressed in order to determine the color. Further, it relates to a standard standard deviation value σX, which is a reference when distinguishing a lesion from a residue that is greater than or equal to a standard deviation of a profile curve corresponding to a lesion and less than a standard deviation of a profile curve corresponding to a residue. It also stores information. For this reason, the distance between the two points calculated in step S40 is compared with the reference size X. If the distance is less than the reference size X, it is considered that the cancer is unlikely to progress, and conversely the reference size X or more In this case, it is highly likely that the cancer has progressed. Further, the standard deviation calculated in step S50 is compared with the reference standard deviation value σX. If the standard deviation is less than the reference standard deviation value σX, it is considered that there is a high possibility of a lesion, and conversely, the reference standard deviation value σX or more. In the case, it is considered that there is a high possibility that it is a residue portion.

  From the above, as a comparison result of the line length and standard deviation, if the line length is less than X and the standard deviation is less than σX, the line length is less than X and the standard deviation is greater than or equal to σX, the line length is A total of four cases are assumed when the length is X or more and the standard deviation is less than σX, and when the line segment length is X or more and the standard deviation is σX or more. In each of these four cases, the following description will be given of the color to which the line segment connecting the two points is displayed.

  First, the case where the distance between two points is less than the reference size X and the standard deviation is less than the reference standard deviation value σX will be described. In this case, the region located between the two specified points is likely to be a living tissue rather than a residue, and it is considered that the possibility that cancer has progressed is low due to its size. It is considered that it is a part that does not need to be paid. Therefore, in this case, the degree of alerting is given to the part that is considered to have a high possibility of progressing cancer (particularly attention should be paid and displayed in red as described later). In order to obtain a lowered display, a determination is made to attach a blue color with a lower alertness level than the red color to the line segment connecting the two specified points.

  Next, the case where the distance between two points is less than the reference size X and the standard deviation is equal to or greater than the reference standard deviation value σX will be described. In this case, it is considered that there is a high possibility that the part located between the two designated points is a relatively small residue, and it is considered that the part need not pay more attention than necessary. For this reason, as in the case described above, two designated points are displayed so that the attention level is lowered with respect to the part where it is considered that there is a high possibility that the cancer to which special attention should be paid has progressed. A decision is made to attach a blue line with a lower level of alertness than red to the connecting line segments.

  Next, a case where the distance between two points is equal to or larger than the reference size X and the standard deviation is less than the reference standard deviation value σX will be described. In this case, since it is considered that there is a high possibility that the cancer is progressing in the region located between the two points, a determination is made to attach a red color with a high alerting degree to the line segment connecting the two specified points.

  Next, a case where the distance between two points is greater than or equal to the reference size X and the standard deviation is greater than or equal to the reference standard deviation value σX will be described. In this case, it is considered that the site located between the two specified points is likely to be a relatively large residue, so it is necessary to pay less attention to the lesion where the cancer is considered likely to have progressed. Is also considered a good site. However, there may be a case where the lesion part is hidden in the residue, so it is required to pay more attention than the part where the distance between the two points is less than the reference size X (the part where the line segment is displayed in blue). It is thought that it is a part. For this reason, it is a display in which the degree of alerting is lowered for a lesion (red display) that is considered to have a high possibility of progression of cancer, and the distance between the two points is less than the reference size X ( A determination is made to add an orange color to the line segment connecting the two points so that the alerting degree is higher than that of the blue display. FIG. 7 shows the correspondence between the line segment length and the standard deviation described above and the color attached to the line segment.

  <7> When the process proceeds from step S60 to step S70, the line segment display means 24 attaches the color determined in step S60 to the line segment connecting the two points specified in step S30 and displays it in the CT image. (Line segment display step; see step S70 in FIG. 2).

  An example of a CT image (secondary image) displayed in step S70 is shown in FIG. In FIG. 6A, two points are designated for the lesioned part 31 which is considered to have a high possibility of progression of cancer, and the line segment 32A overlapping the lesioned part 31 is displayed in red. A CT image (secondary image) 30A is shown. Thus, by displaying the line segment 32A corresponding to the major axis of the lesion part 31 considered to have a high possibility of progression of cancer in red, the lesion part 31 overlapping with the line segment 32A is It can be understood at a glance that the risk is particularly high. On the other hand, in FIG. 6B, two points are designated for the lesioned part 50 which is considered to have a low possibility that the cancer has progressed, and the line segment 51A overlapping the lesioned part 50 is colored blue. A CT image (secondary image) 50A to be displayed is shown. Thus, by displaying the line segment 51A corresponding to the major axis of the lesioned part 50 in blue, the lesioned part 50 overlapping the line segment 51A is considered to have a low risk. It can be grasped at a glance. As described above, according to the medical image interpretation support apparatus 1, the line segment is displayed with a color corresponding to the degree of risk, so that the viewpoint of the tissue type (lesion or residue) of the abnormal site is also obtained. Taking this into account, it is possible to display a risk level at a glance.

  <8> In the subsequent step S80, the position (measurement start point (for example, anus)) where the line segment on the core line of the intestinal tract exists in the line segment length measured in step S40 by the list creating means 25 of the control unit 11. A line segment length list corresponding to the distance along the core line) is created (line segment length list creation step; see step S80 in FIG. 2).

  Conventionally, a report such as a secondary image created by a radiogram interpreter is attached with a segment length list that records the size of the abnormal part and its position (position along the core of the large intestine). It may be sent to a doctor. However, since the line segment length list is a list of the sizes and positions of abnormal sites, an endoscopic operator or the like can detect the risk of lesions even if he / she sees the line segment length list. There was a problem that it was difficult to grasp at a glance.

  In contrast, the medical image interpretation support apparatus 1 (list creation means 25) is configured to create a line segment length list that solves this conventional problem. In order to specifically describe the line segment length list created by the list creating means 25, in step S35 described above, the following three operations for designating two points in total (first to third designation operations) Suppose that is performed. First, it is assumed that a line segment having a length of 3 mm (<reference size X) is designated at a position 26 cm from the measurement start point by the first designation operation. Next, by the second designation operation, a line segment having a length of 10 mm (> reference size X) is designated at a position 40 cm from the measurement start point, and σ3 ( <Reference standard deviation value σX) is assumed to be obtained. Next, by a third designation operation, a line segment having a length of 6 mm (> reference size X) is designated at a position 80 cm from the measurement start point, and σ4 ( > Reference standard deviation value σX) is obtained. A line segment length list 60 based on the above assumption is shown in FIG.

  In the line segment length list 60, as shown in FIG. 8, “item number”, “distance from the measurement start point”, and “the size of the lesion (line segment length) corresponding to the distance from the measurement start point”. ")" Are displayed side by side on the paper. At this time, the “item number”, “distance from the measurement start point”, and “lesion size” arranged side by side are displayed with colors according to the correspondence shown in the table of FIG. Therefore, in the above assumption, the numbers “1”, “26 cm” and “3 mm” arranged in the upper stage 61 are white, and the numbers “2”, “40 cm” and “10 mm” arranged in the middle stage 62 are red. The numbers “3”, “80 cm” and “6 mm” arranged in the lower row 63 are displayed with an orange color. In this way, by attaching a color according to the degree of danger and listing all the parts whose sizes have been measured in step S40, it is possible to transmit information without leakage, but the degree of danger It is possible to obtain a line segment length list 60 in which it is easy to grasp a lesion that is considered to be high.

  This line segment length list 60 is created at the end of interpretation and is sent from the interpreter to the treating physician. While seeing this line segment length list 60, the treating physician understands at a glance how much of the entire portion (including both the lesion and the residue) is raised from the inner wall of the intestinal tract. It is possible to grasp at a glance the presence of a lesion that is considered to have a high degree of risk and a high possibility that the cancer has progressed. Therefore, it is possible to improve the accuracy of the treatment strategy, shorten the time required for planning the treatment strategy, shorten the treatment time, and ensure the safety of the treatment.

  In addition, when an operation for specifying two points is not performed in step S35 (no abnormal part is found at all) and a specification end operation is performed in step S30, no line segment is displayed in step S70. In step S80, a line segment length list in which the display field is blank is created.

  In the following description, a change mode related to the medical image interpretation support apparatus 1 will be mainly described. However, this change mode can be similarly applied to the medical image interpretation support method and the medical image interpretation support program according to the present invention. is there.

  In the above-described embodiment, the configuration using medical image data obtained by CT has been described as an example. However, in addition to CT, for example, other medical imaging methods such as MRI (Magnetic Resonance Imaging) and capsule endoscopes are used. It is also possible to use the obtained medical image data.

  In the above-described embodiment, the case where the interpretation of the large intestine is performed has been described as an example. However, using the medical image interpretation support apparatus 1 according to the present invention, for example, a tubular tissue such as a contrasted blood vessel, a small intestine, a bronchus, and a spine It is also possible to interpret tissue that is not luminal. The creation of the line segment length list 60 is particularly effective when interpreting a tubular tissue.

  In the above-described embodiment, the method of determining the profile curve shape of the CT value on the line segment based on the standard deviation has been described as an example, but instead of this method, for example, a threshold value for the CT value is set in advance. It is also possible to make a determination based on the number of times the CT value profile curve crosses the threshold value from top to bottom or from bottom to top.

  In the above-described embodiment, as shown in FIG. 7, a case has been described in which a line segment and a list are displayed with blue (white), red, or orange according to the line segment length and the standard deviation. The colors attached to the line segments are not limited to this, and it is also possible to perform display with different degrees of alerting using other colors.

  In the above-described embodiment, as shown in FIG. 7, when the line segment length is less than the reference size X, the line segment and the list are displayed in blue (white) regardless of the standard deviation of the CT value (profile curve shape). Although the display example has been described, instead of this, when the line segment length is less than the reference size X, different colors may be attached according to the standard deviation of the CT value. In this way, it is possible to grasp at a glance whether the portion is considered to be a lesioned portion or a residual portion even for a portion that is considered to have a low possibility of progression of cancer in consideration of the size.

  Further, as a variation of the color shown in FIG. 7, when the line segment length is equal to or larger than the reference size X and the standard deviation is less than the reference standard deviation value σX, a color with a high alertness level is attached and displayed. In all other cases, a color with a low alerting degree may be added and displayed. As another modification, when the line segment length is greater than or equal to the reference size X and the standard deviation is less than the reference standard deviation value σX, the line segment length is less than the reference size X and the standard deviation is the reference standard deviation value. In the case of less than σX and the three cases where the standard deviation is greater than or equal to the reference standard deviation value σX, the colors may be displayed with colors with different degrees of attention. In the case where the color corresponding to these three cases is applied, a display in which a portion that is considered to have a high possibility of a lesion and a portion that is considered to be a high possibility of a residue is distinguished by color. Is possible. For this reason, for example, by comparing the sizes (line segment lengths) of lesions displayed in colors corresponding to parts that are considered to be highly likely to be lesions, it is easy to make an optimal treatment plan. Can stand up.

  As a display mode of the line segment length list 60 in the above-described embodiment, as disclosed in FIG. 4 of Japanese Patent Application No. 2013-245016, a mode in which items are displayed side by side at intervals corresponding to positions along the core line It is also possible.

  In the above-described embodiment, the color corresponding to the risk level is attached to the line segment, but the line segment display mode in which the risk level can be grasped at a glance may be used. Appropriate marks (◯ mark, Δ mark, X mark, etc.) may be attached to the line segment.

DESCRIPTION OF SYMBOLS 1 Medical image generation apparatus 2 Display apparatus 3 Operation apparatus 4 Image pick-up apparatus 11 Control part 12 Data storage part 14 Display data output interface 15 Operation input interface 16 Image data input interface 20 Data identification means 21 Core wire setting means 22 Line segment length calculation Means 23 Standard deviation calculation means 24 Line segment display means 25 List creation means 30 CT image 30A CT image (secondary image)
31 lesion part 32 line segment 32A line segment 33 profile curve 40 CT image 41 residue part 42 line segment 43 profile curve 50 lesion part 50A CT image 51A line segment 60 line segment length list 61 upper stage 62 middle stage 63 lower stage X reference size σX reference Standard deviation value

Claims (13)

A medical image interpretation support apparatus for identifying and displaying the degree of risk indicating the progress of a lesion at a specified site in order to support interpretation of a medical image obtained by imaging a subject with a medical image imaging apparatus. ,
Storage means for storing a plurality of display modes according to different shapes of the profile curve in order to identify and display the degree of risk indicating the progress of the lesion of the designated site;
A line segment specifying means for specifying a line segment determined at two measurement reference positions designated on the image for interpretation;
A shape of the profile curve of the signal values of each pixel corresponding to the line component, based on the shape of the profile curve of the signal values obtained by the medical image imaging apparatus, a plurality of display modes stored in said storage means Determining means for determining in which to display ,
In the display mode determined by the determining means, display control means you identifiably displayed the risk of the site,
A medical image interpretation support apparatus comprising: The medical image interpretation support apparatus according to claim 1 , wherein the storage unit stores the plurality of display modes in stages according to different shapes of the profile curves of the signal values . The storage means has a display mode according to the shape of the first profile curve of the signal value, and a display mode according to the shape of the second profile curve that is substantially constant than the shape of the first profile curve. medical image interpretation support apparatus according to claim 1 or 2, characterized in that it is stored as distinguishable display mode the low risk. The storage means stores the plurality of display modes as a display mode corresponding to a standard deviation indicating a shape of a profile curve of the signal value,
It said determining means standard deviation of the profile curve, according to any one of claims 1 to 3, wherein determining whether to correspond to any of the stored plurality of display modes in the storage means Medical image interpretation support device. The storage means stores a display mode when the standard deviation is less than a predetermined value as a display mode that can be identified with a higher degree of risk than a display mode when the standard deviation is greater than or equal to a predetermined value. medical image interpretation support apparatus according to claim 4, characterized in that there. A line segment length acquisition unit that acquires the length of the line segment specified by the line segment specifying unit;
The storage means stores a plurality of display modes according to the length of a line segment and different shapes of profile curves of signal values corresponding to the line segment,
The determination unit is configured to store a plurality of lines stored in the storage unit based on the length of the line segment acquired by the line segment length acquisition unit and the shape of the profile curve of the signal value obtained by the medical image capturing apparatus. medical image interpretation support apparatus according to any one of claims 1 to 5, characterized in that to determine whether to display one of the display mode. The storage means can identify the display mode when the length of the line segment is greater than or equal to a predetermined value with a higher degree of risk than the display mode when the length of the line segment is less than the predetermined value. The medical image interpretation support apparatus according to claim 6 , wherein the medical image interpretation support apparatus is stored as a display mode . The plurality of display modes stored in the storage means are display modes having different colors,
The medical image interpretation support according to any one of claims 1 to 7, wherein the display control means displays the degree of risk of the part in an identifiable manner in the display mode in which the color is changed. apparatus. The display control means displays the line segment in a display mode stored in the storage means, thereby displaying the risk level of the part in an identifiable manner. The medical image diagnosis support apparatus according to the item. The image for interpretation is an image of a tubular tissue of a subject,
Position information acquisition means for acquiring a position in the extending direction of the tubular tissue specified by the line segment specification means;
A list creation means for creating a list in which the position acquired by the position information acquisition means and the length of the line segment can be identified;
Further comprising
9. The display control unit according to claim 1, wherein the display control unit displays the degree of risk of the part in an identifiable manner on the list in the display mode determined by the determination unit. Medical image interpretation support device. The image for interpretation is an image of a tubular tissue of a subject,
The line segment specifying means designates the two measurement reference positions on a virtual endoscopic image of the tubular tissue assumed to be seen from a viewpoint moving along the core line of the tubular tissue. The medical image diagnosis support apparatus according to claim 1, wherein the line segment is specified. A medical image interpretation support apparatus for identifying and displaying the degree of risk indicating the progress of a lesion at a specified site in order to support interpretation of a medical image obtained by imaging a subject with a medical image imaging apparatus , A control method for a medical image interpretation support apparatus comprising storage means for storing a plurality of display modes corresponding to different shapes of profile curves in order to identify and display a risk level indicating the progress of a lesion at the designated site .
The medical image interpretation support apparatus is
A line segment identification step for identifying a line segment determined by two measurement reference positions designated on the image for interpretation;
A shape of the profile curve of the signal values of each pixel corresponding to the line component, based on the shape of the profile curve of the signal values obtained by the medical image imaging apparatus, a plurality of display modes stored in said storage means A decision step for deciding which to display ,
In the display mode determined by the determining step, and a display control step identifiably displayed the risk of the site,
The method of the medical image interpretation support apparatus comprising: a. A medical image interpretation support apparatus for identifying and displaying the degree of risk indicating the progress of a lesion at a specified site in order to support interpretation of a medical image obtained by imaging a subject with a medical image imaging apparatus , A program that can be executed by a medical image interpretation support apparatus that includes a storage unit that stores a plurality of display modes according to different shapes of profile curves in order to identify and display the degree of risk indicating the progress of a lesion at a specified site. And
The medical image interpretation support apparatus,
A line segment specifying means for specifying a line segment determined at two measurement reference positions designated on the image for interpretation;
A shape of the profile curve of the signal values of each pixel corresponding to the line component, based on the shape of the profile curve of the signal values obtained by the medical image imaging apparatus, a plurality of display modes stored in said storage means Determining means for determining in which to display ,
In the display mode determined by the determining means, identifiably displayed to that display control means the risk of the site
Features and to pulp programs that function as.