JP6014352B2 - Ultrasound system - Google Patents

Description

  The present invention relates to an ultrasound system, and relates to a technique for performing a needle biopsy on the prostate or a brachytherapy treatment for prostate cancer.

  When prostate cancer is suspected, an ultrasound probe is inserted into the subject, and a prostate needle biopsy is performed using a tomographic image based on the ultrasound.

  Prostate needle biopsy includes transrectal prostate needle biopsy that performs puncture from within the rectum of the subject and transperinetal prostate needle biopsy that performs puncture from the perineum of the subject (between scrotum and anus) For transperineal prostate needle biopsy, transperineal needle biopsy may be performed by placing a grid template in the perineum and using the grid engraved in the grid template as a guide.

  In addition, as one of the treatment methods after the prostate cancer is confirmed, there is a treatment method called prostate cancer brachytherapy permanent treatment (Brachy therapy treatment). This treatment method is a treatment method in which a small amount of radiation source is placed in a puncture needle, and a small amount of radiation source is placed in the periphery of prostate cancer using a grid engraved in a grid template as a guide.

  For example, Patent Document 1 discloses prior art related to a permanent treatment method for prostate cancer sealed brachytherapy.

JP 2006-320590 A

  When performing needle biopsy or prostate cancer sealed brachytherapy permanent treatment (hereinafter, brachytherapy), the surgeon imagines the structure in the body cavity and the position of the organ. The surgeon then imagines the structure of the body cavity and the position of the organ in a three-dimensional manner, examines the position or angle at which the ultrasound probe is brought into contact with the affected area, and determines the puncture route To do. Puncturing is performed while observing the puncture route displayed on the image display unit or the brachytherapy grid. The puncture route and the brachytherapy grid displayed on the image display unit are two-dimensional displays, and skill is required before puncturing the puncture route or indwelling portion as intended by the operator.

The present invention aims to provide an ultrasonic system capable of accurately and safely carrying out the needle biopsies and brachytherapy. Alternatively, an object of the present invention is to provide an ultrasonic system capable of recognizing the inclination of the scan plane with respect to the grid template.

In order to solve the above problem, a template image including a grid corresponding to a scan plane of a tomographic image is displayed. More specifically, the present invention has a plurality of transducers that transmit and receive ultrasonic waves to and from a subject, and an intracorporeal insertion type ultrasonic probe that forms a scan surface, and is attached to the ultrasonic probe. A position sensor for acquiring coordinate information of the scan plane, a tomographic image generation section for generating a tomographic image representing the scan plane based on the received ultrasonic wave, and an image display section for displaying the tomographic image And, when a grid template having a needle insertion hole for inserting a puncture needle into the subject is installed according to the treatment site of the subject, for ultrasonic diagnosis of the subject An ultrasonic diagnostic system, which is three-dimensional template data generated based on the position of the grid template and is stacked in a direction along the insertion direction of the ultrasonic probe A three-dimensional template data generation unit that generates three-dimensional template data including a two-dimensional template; and the scan plane from the three-dimensional template data generated by the three-dimensional template data generation unit based on the coordinate information of the scan plane A template image generation unit that cuts out template data corresponding to the above and generates a template image, the template display is superimposed on the tomographic image in the image display unit, and the scan plane is positioned on the grid template. When parallel, any one of the plurality of two-dimensional templates is cut out as the template data from the three-dimensional template data, and when the scan plane is inclined with respect to the grid template, the cubic Former template Template data inclined as the template data from Todeta is cut out, characterized in that.

According to the present invention can recognize an inclination and the like of the scan surface with respect to the grid templates, it is possible to more accurately and safely carrying out the needle biopsy and brachytherapy.

The figure which shows the whole structure of the ultrasonic system of this invention. The figure which shows schematic structure of the ultrasonic probe of the body insertion type used for the ultrasonic system of this invention. Explanatory drawing of the three-dimensional template data generation part of the ultrasonic system of this invention. FIG. 3 is a diagram showing one display form of the image display unit of the ultrasonic system of the present invention. The figure which shows the example of operation which operates the display form of the template image of this invention. FIG. 3 is a diagram showing one display form of the image display unit of the ultrasonic system of the present invention.

  The ultrasonic system of the present invention will be described with reference to the drawings.

  FIG. 1 is a diagram showing an overall configuration of an ultrasonic system according to the present invention. The ultrasound system is divided into a system for generating a tomographic image, a system for generating a reference image, a system for generating a body mark, and a system for generating a template image. The components that perform processing related to each system are included in the main body 10 of the ultrasonic system.

  The ultrasound system includes an ultrasound probe 20 that transmits and receives ultrasound to and from a subject, a tomographic image generator 22 that generates a tomographic image based on the received ultrasound, and an image such as a tomographic image. An image processing unit 24 that performs image processing for display on the display unit 26 and an image display unit 26 that displays an image such as a tomographic image are provided. The tomographic image generation unit 22 may generate a tomographic image based on the ultrasonic waves acquired by the ultrasonic probe 20 in real time, or may generate a tomographic image from volume data acquired in the past. .

  In addition, the ultrasonic system includes a position sensor 30 that detects the position and inclination, a source 32 that generates a magnetic signal in a three-dimensional space to detect the position and inclination of the position sensor 30, and the same as the ultrasonic tomographic image. The scan plane calculation unit 34 that calculates the scan plane coordinates of the position and inclination of the scan plane, the volume data storage unit 42 that stores the volume data configured by the image diagnostic device 40, and the volume data storage unit 42 are stored. From the volume data, a reference image generation unit 36 that generates a reference image of the same scan plane position and inclination as the ultrasonic tomographic image, and a body mark generation that generates a body mark that can specify the scan plane position and inclination A plurality of two-dimensional templates based on a grid template having a needle insertion hole for inserting a portion 44 and a puncture needle into a subject. By superimposing the 3D template data generating unit 46 for generating 3D template data, and the 3D template data generated by the 3D template data generating unit 46, the template image having the same scan plane position and inclination as the tomographic image A template image generation unit 48 for generating the image data and an operation unit 50 for operating each component.

  FIG. 2 is a diagram showing a schematic configuration of an intracorporeal ultrasound probe 20 used in the ultrasound system of the present invention. The ultrasonic probe 20 transmits and receives ultrasonic waves to and from the subject, and has a plurality of transducers that generate ultrasonic waves and receive reflected echoes.

  As shown in FIG. 2 (a), the ultrasound probe 20 is provided with the transducer 16 along the circumferential direction. A tomographic image called a convex image can be generated by the tomographic image generator 22 by the vibrator 16 along the circumferential direction. A scan plane 12 of this tomographic image is shown.

  Further, as shown in FIG. 2 (b), the ultrasound probe 20 is provided with the transducer 18 along the longitudinal direction of the ultrasound probe orthogonal to the circumferential direction of the transducer 16. . A tomographic image called a linear image can be generated by the tomographic image generation unit 22 by the vibrator 18 along the longitudinal direction of the ultrasonic probe. A scan plane 14 of this tomographic image is shown.

  Note that the ultrasonic probe 20 can be used while appropriately switching the scan planes 12 and 14 shown in FIGS. 2 (a) and 2 (b).

  The position sensor 30 is attached to the ultrasonic probe 20, and detects the three-dimensional position and inclination of the ultrasonic probe 20. Also, a coordinate system source 32 including the subject is installed near the bed on which the subject lies. The principle of detecting the three-dimensional position and tilt of the ultrasonic probe 20 is that a magnetic signal generated in a three-dimensional space from the source 32 is detected by the position sensor 30, and the three-dimensional in the reference coordinate system formed by the source 32 The position and tilt are detected. The position sensor system including the position sensor 30 and the source 32 is not limited to the magnet type, and a known position sensor system such as a system using light can be used.

  The scan plane calculation unit 34 obtains the position and tilt of the ultrasonic probe 20 in the reference coordinate system based on the output signals of the position sensor 30 and the source 32, and includes the position and tilt corresponding to the scan plane with respect to the subject. Scan plane coordinates are calculated.

  The volume data is acquired from the image diagnostic apparatus 40. Volume data is multi-slice data obtained by imaging the inside of a subject on a plurality of slice planes. Volume data picked up by the diagnostic imaging apparatus 40 is input to the ultrasonic system and stored in the volume data storage unit 42. As the diagnostic imaging apparatus 40, for example, an X-ray computed tomography apparatus (X-ray CT apparatus) or a magnetic resonance imaging apparatus (MRI apparatus) can be applied.

  The image diagnostic apparatus 40 may be the ultrasonic system illustrated in FIG. 1 or another ultrasonic diagnostic apparatus. For example, volume data configured by stacking a plurality of tomographic images generated by the tomographic image generation unit 22 can be stored in the volume data storage unit.

  The reference image generation unit 36 extracts a cross section corresponding to the scan plane coordinates calculated by the scan plane calculation unit 34 from the volume data storage unit 42, and generates a reference image having the same scan plane position and inclination as the tomographic image. .

  The tomographic image generated by the tomographic image generation unit 22 and the reference image generated by the reference image generation unit 36 are displayed in parallel on the image display unit 26 via the image processing unit 24.

  The body mark generation unit 44 uses the volume data stored in the volume data storage unit 42 to draw a three-dimensional visualized image, and a body mark obtained by superimposing the scan plane of the tomographic image on the three-dimensional visualized image in a translucent color. Generate. As the three-dimensional visualization processing, for example, a known method such as volume rendering or surface rendering can be applied. The body mark generated by the body mark generation unit 44 is displayed on the image display unit 26 via the image processing unit 24. By displaying the body mark on the image display unit 26, the operator can grasp the positional relationship between the subject and the scan plane of the tomographic image.

  Although not shown, a grid template (puncture needle insertion jig) having a needle insertion hole for inserting a puncture needle into a subject is formed in a matrix on a surface orthogonal to the axial direction (insertion direction) of the ultrasonic probe 20. A plurality of arranged insertion holes are provided. The grid template is installed according to the treatment site of the subject. A puncture needle can be inserted into the needle insertion hole of the grid template, and the puncture needle can be moved in the axial direction (insertion direction) of the ultrasonic probe 20 using the grid template as a guide. Note that a capsule containing a radiation source is arranged at the tip of the puncture needle. This is because the capsule remains in a predetermined organ of the subject.

  Here, the three-dimensional template data generation unit 46 will be specifically described with reference to FIG. The three-dimensional template data generation unit 46 three-dimensionally stacks a plurality of two-dimensional templates that match the position of a grid template (puncture needle insertion jig) having a needle insertion hole for inserting a puncture needle into a subject. Generate 3D template data. Specifically, the three-dimensional template data generation unit 46 is arranged in one direction for a two-dimensional template provided with, for example, 13 × 13 grids in a matrix, along the axial direction (insertion direction) of the ultrasonic probe 20. 3D template data is generated as 3D volume data.

  The three-dimensional volume data also includes position information based on the position of the grid template. For example, the position where the radiation source is placed is specified from the position of the grid template with respect to the subject and the position of the scan plane of the tomographic image. Then, the position of the three-dimensional volume data is determined so that the position where the radiation source is placed is included.

  As shown in FIG. 3, the two-dimensional template is labeled according to the grid template installed on the subject. The two-dimensional template is similar to the grid template placed on the subject, for example, A, a, B, b,..., F, f, G, or skipping one column, A, B, Labeled as C, ..., F, G, and 1_5, 1.5_5, 2_5, 2.5_5, ..., 7_5 or 1_5, 2_5, ..., 7_5 by skipping one line in the column direction Are labeled in the same way. The label “_5” is a subscript indicating the fifth sheet of the two-dimensional template. When the two-dimensional template is the first one, the label is “_1”.

  The three-dimensional template data generation unit 46 stacks N two-dimensional templates in the axial direction (insertion direction) of the ultrasonic probe 20 (N is a natural number), so that the axial direction of the ultrasonic probe 20 (insertion direction). 3D template data with depth can be generated.

  That is, the three-dimensional template data includes a grid of two-dimensional templates stacked in accordance with the position of the grid template having a needle insertion hole for inserting a puncture needle into the subject. The grid includes several stacked 2D templates. For example, when N two-dimensional templates provided with 13 × 13 grids are stacked, 13 × 13 × N grids are included in the three-dimensional template data. Note that the three-dimensional template data can also include a label attached in accordance with the grid.

  The template image generation unit 48 extracts a cross section corresponding to the scan plane coordinates calculated by the scan plane calculation unit 34 from the three-dimensional template data having a depth in the axial direction (insertion direction) of the ultrasonic probe 20. Generate a template image. The template image is a two-dimensional image. The template image generation unit 48 generates a grid corresponding to the scan plane as a template image in the three-dimensional template data. If the label given to the grid is included in the three-dimensional template data, the label is generated according to the grid of the template image.

  The template image generated by the template image generation unit 48 is displayed on the image display unit 26 via the image processing unit 24.

  FIG. 4 shows a display form of the image display unit 26. The image display unit 26 includes an ultrasonic tomographic image 62 generated by the tomographic image generation unit 22, a reference image 64 generated by the reference image generation unit 36, and a body mark 66 generated by the body mark generation unit 44. indicate.

  Here, for simplification of description, a display form of the image display unit 26 in which the ultrasonic probe 20 is brought into contact with the subject so as to cut out an image of a plane parallel to the grid template placed on the subject is shown. This is a state in which the scan surface 12 by the transducers 16 of the ultrasonic probes 20 arranged along the circumferential direction is parallel to the grid template placed on the subject.

  FIG. 4 (a) is an ultrasonic tomographic image 62 generated by the tomographic image generation unit 22. FIG. The image processing unit 24 performs a process of superimposing the template image 70 generated by the template image generation unit 48 on the ultrasonic tomographic image 62. Therefore, the template image 70 including the grid generated by the template image generation unit 48 is superimposed on the ultrasonic tomographic image 62 together with the label.

  FIG. 4B shows a reference image 64 generated by the reference image generation unit 36. The image processing unit 24 performs processing for superimposing the template image 70 generated by the template image generating unit 48 on the reference image 64. Therefore, the template image 70 including the grid generated by the template image generation unit 48 is superimposed on the reference image 64 together with the label.

  FIG. 4C shows a body mark 66 generated by the body mark generation unit 44. The body mark 66 includes a 3D visualization image 76 generated using volume data, a 3D template image 60 of 3D template data generated by the 3D template data generation unit 46, and a scan plane calculation unit 34. A scan plane 78 corresponding to the calculated scan plane coordinates is superimposed. Although not shown, the image processing unit 24 superimposes the template image 70 including the grid generated by the template image generation unit 48 on the scan plane 78 corresponding to the scan plane coordinates calculated by the scan plane calculation unit 34. be able to. Therefore, the template image 70 corresponding to the scan plane 78 of the three-dimensional template image 60 of the three-dimensional template data can be displayed on the image display unit 26. The scan surface 78 may be a translucent image.

  The template image 70 displays a plurality of grids 72 that match the grid template installed on the subject. The operator can grasp the position of the grid 72 with respect to the tomographic image 62 or the reference image 64.

  In addition, a label indicating the position of the two-dimensional template is provided around the template image 70 in accordance with the grid template installed on the subject. From the labels in the row direction and the column direction, the position of the grid 72 of the template image 70 can be grasped. For example, since the label “_5” is a subscript indicating that it is the fifth piece of the two-dimensional template, the operator can recognize the depth of the template image 70 with respect to the three-dimensional template data 60. it can. Since the image of the plane parallel to the grid template placed on the subject is cut out, all the labels “_5” are the same.

  If the template image 70 of the scan surface 12 tilted with respect to the grid template placed on the subject is cut out, that is, if the scan surface 12 is not parallel to the grid template placed on the subject, the label “_5 Are not all the same. That is, the surgeon can recognize the inclination of the template image 70 (scanning surface 12) from the label.

  When the surgeon moves the ultrasound probe 20 in the depth direction, the labels “_1”, “_2”, “_3”,..., “_N”, or “_N”,. Updated as “_3”, “_2”, “_1”. That is, the label serves as an address in the depth direction of the template image 70. The surgeon can recognize the depth of the template image 70 (scanning surface 12) from the label.

  The operation unit 50 is a pointing device such as a mouse or a trackball, an input device such as a keyboard, or a voice input device (not shown). When the operator designates an address corresponding to the grid via the operation unit 50, the designated address is output to the three-dimensional template data generation unit 46. The three-dimensional template data generation unit 46 generates a mark 74 for the grid of the three-dimensional template data corresponding to the address specified by the operation unit 50.

  A template image 70 generated by the template image generation unit 48 is given a mark 74 corresponding to the address specified by the operation unit 50. A grid corresponding to the address designated by the operation unit 50 is displayed on the image display unit 26 together with the mark 74.

  FIG. 5 is a diagram illustrating an operation example of manipulating the display form of the template image 70. When displaying a grid corresponding to a puncture needle inserted into a subject to place a capsule containing a radiation source on a template image, the surgeon displays a tomographic image 62 and a reference image displayed on the image display unit 26. While observing 64, an address is designated via the operation unit 50.

  As shown in FIG. 5A, the operator designates the address (eg, D4_5) of the three-dimensional template data 60 in the dialog 80. The three-dimensional template data generation unit 46 reflects the address specified by the operation unit 50 in the three-dimensional template data 60.

  The template image generation unit 48 extracts a cross section corresponding to the scan plane coordinates calculated by the scan plane calculation unit 34 together with 3D template data having a depth in the axial direction (insertion direction) of the ultrasonic probe 20 and an address. Then, a template image is generated. As shown in FIGS. 4 (a) and 4 (b), a mark 74 is assigned to a portion corresponding to the designated address. It should be noted that the location corresponding to the designated address may be changed in the color of the grid or highlighted so as to stand out.

  As shown in FIG. 5B, a menu 82 of “display other than specified address” and “hide other than specified address” can be displayed on the image display unit 26. When the surgeon selects “Hide non-designated addresses” on the operation unit 50, the template image 70 in which the grid 72 other than the designated addresses is hidden can be displayed. That is, as shown in FIG. 5 (a), the grid 72 is displayed for the portion corresponding to the designated address designated by the operation unit 50, and the grids 72 other than the designated address are hidden.

  As described above, according to the present embodiment, three-dimensional template data for generating three-dimensional template data by stacking a plurality of two-dimensional templates based on a grid template having a needle insertion hole for inserting a puncture needle into a subject. A template that generates a template image corresponding to the scan plane of the tomographic image (same scan plane position and inclination as the tomographic image) from the three-dimensional template data generated by the generating unit 46 and the three-dimensional template data generating unit 46 An image generation unit 48, and the image display unit 26 displays a template image.

  The image processing unit 24 superimposes the template image generated by the template image generation unit 48 on the tomographic image generated by the tomographic image generation unit 22. The volume data storage unit 42 that stores the volume data of the subject, the reference image generation unit 36 that generates a reference image corresponding to the scan plane of the tomographic image from the volume data, and the reference image generated by the reference image generation unit 36 An image processing unit 24 that superimposes the template image generated by the template image generation unit 48.

  Therefore, the operator can three-dimensionally observe the insertion path of the puncture needle (puncture needle for placement of the brachytherapy source) from the template image including the same scan plane position and inclination grid as the tomographic image. Inspection and brachytherapy can be performed more accurately and safely.

  Example 2 will be described with reference to FIG. A difference from the first embodiment is that a puncture guideline indicating a path through which the puncture needle passes is displayed.

  FIG. 6 shows a display form of the image display unit 26. This is a state in which the scan surface 14 by the transducer 18 of the ultrasonic probe 20 arranged along the axial direction (insertion direction) of the ultrasonic probe 20 is orthogonal to the grid template installed on the subject.

  FIG. 6A shows an ultrasonic tomographic image 62 generated by the tomographic image generation unit 22. FIG. The image processing unit 24 performs a process of superimposing the template image 70 generated by the template image generation unit 48 on the ultrasonic tomographic image 62. FIG. 6B shows a reference image 64 generated by the reference image generation unit 36. The image processing unit 24 performs processing for superimposing the template image 70 generated by the template image generating unit 48 on the reference image 64. FIG. 6C shows a body mark 66 generated by the body mark generation unit 44.

  The image processing unit 24 generates a puncture guideline 96 indicating a route through which the puncture needle passes for a line corresponding to the mark 74 corresponding to the address designated by the operation unit 50. An address 98 is displayed in the puncture guideline 96 corresponding to the mark 74 corresponding to the address designated by the operation unit 50. When the address (for example, D4_5) of the three-dimensional template data 60 is designated in the dialog 80, the address 98 is displayed as D4.

  Therefore, the surgeon can grasp the insertion position of the puncture needle of the grid template installed in the subject by the address 98. In addition, the image processing unit 24 can also give an end mark 100 to the grid in the template image 70 that has been treated using the puncture needle.

  Therefore, the operator can observe the insertion path of the puncture needle (the puncture needle for indwelling the brachytherapy source) three-dimensionally.

  10 main body, 20 ultrasound probe, 22 tomographic image generation unit, 24 image processing unit, 26 image display unit, 30 position sensor, 32 source, 34 scan plane calculation unit, 36 reference image generation unit, 40 image diagnostic device, 42 Volume data storage unit, 44 Body mark generation unit, 46 3D template data generation unit, 48 Template image generation unit, 50 Operation unit.

Claims (5)

A plurality of transducers that transmit and receive ultrasonic waves to and from the subject , and an in-body type ultrasonic probe that forms a scan surface ;
A position sensor attached to the ultrasonic probe for acquiring coordinate information of the scan surface;
A tomographic image generation unit that generates a tomographic image representing the scan plane based on the received ultrasonic waves;
An image display unit for displaying the tomographic image ;
Equipped with a,
An ultrasonic diagnostic system for ultrasonically diagnosing the subject when a grid template having a needle insertion hole for inserting a puncture needle into the subject is installed according to a treatment site of the subject. There,
3D template data generated based on the position of the grid template, and generating 3D template data composed of a plurality of 2D templates stacked in a direction along the insertion direction of the ultrasonic probe. A three-dimensional template data generation unit;
A template image generating unit for generating a template image is cut out the template data corresponding to the three-dimensional template data or al the scan surface generated by the three-dimensional template data generating unit based on the coordinate information of the scan plane,
With
In the image display unit , the template image is superimposed and displayed on the tomographic image ,
If the scan plane is parallel to the grid template, one of the two-dimensional templates is cut out as the template data from the three-dimensional template data,
When the scan plane is tilted with respect to the grid template, the tilted template data is cut out as the template data from the three-dimensional template data.
An ultrasonic system characterized by that. Each of the two-dimensional templates includes a matrix-like grid, a plurality of labels arranged in a row direction, and a plurality of labels arranged in a column direction ,
Each label includes an address in the stacking direction,
The ultrasonic system according to claim 1.   The ultrasound system according to claim 1, further comprising an image processing unit that superimposes the template image generated by the template image generation unit on the tomographic image generated by the tomographic image generation unit. A volume data storage unit for storing volume data of the subject;
A reference image generation unit that generates a reference image by cutting out the surface data corresponding to the previous kiss scan plane from the volume data based on the coordinate information of the scan plane,
An image processor that superimposes the template image generated by the template image generator on the reference image generated by the reference image generator;
The ultrasonic system according to claim 1, further comprising: The template picture image includes marks given to the address specified by the operation unit,
The ultrasonic system according to claim 1.