JP6108932B2 - Image management apparatus, image management method, and image management system - Google Patents

Description

  The present invention relates to an image management technique, and more particularly to a technique for managing transmission of a medical image generated by a modality such as an endoscope system.

  DICOM (Digital Imaging and Communication in Medicine) has been established as a global standard for storage and communication of medical image data. DICOM (Dicom) defines the format of medical image files taken in clinical practice such as CT (Computed Tomography), MRI (Magnetic Resonance Imaging), endoscopes and ultrasound, and the communication protocol between devices that transmit and receive medical image files. Define. Medical image data is generally transmitted and received in accordance with the DICOM communication standard between the modality and PACS (Picture Archiving and Communication Systems).

JP 2008-36353 A

  In the DICOM communication standard, the C-STORE protocol is generally used at the time of image transmission, but the C-STORE protocol does not define deletion of an image. Therefore, when an image is transmitted from the modality to the PACS, it is difficult to delete the image from the modality side. Usually, the image is deleted by directly operating the PACS. However, in general, the modality and the PACS are different systems, and the managers of the respective systems are often different, and the deletion of images is complicated.

  The present invention has been made in view of these problems, and an object of the present invention is to provide a technique for deleting an image without using a unique protocol for deletion when storing or communicating medical image data.

  In order to solve the above-described problems, an image management apparatus according to an aspect of the present invention transmits a medical image to a medical image image storage communication system using a predetermined communication protocol, and transmits the medical image to the image storage communication system. The deletion candidate storage unit that stores the identifier of the medical image and the deletion candidate information indicating whether or not the medical image is a deletion target in association with each other, and the deletion candidate information in the deletion candidate storage unit is referred to as a deletion target. And an extraction unit for extracting an identifier of the medical image. The transmission unit transmits the medical image to be transmitted in association with the identifier extracted by the extraction unit.

  Another aspect of the present invention is an image management method. This method includes a step of transmitting a medical image to a medical image storage system using a predetermined communication protocol, an identifier of the medical image transmitted to the medical image storage system, and whether the medical image is to be deleted. Storing the deletion candidate information indicating whether or not in the deletion candidate storage unit in association with each other, referring to the deletion candidate information in the deletion candidate storage unit, extracting the identifier of the medical image to be deleted, And causing the processor to execute the step of associating the extracted identifier with the medical image to be transmitted.

  Yet another embodiment of the present invention is an image management system. The image management system includes a first image management device and a second image management device. The first image management apparatus corresponds to a receiving unit that receives a medical image transmitted from the second image management apparatus using a predetermined communication protocol, a medical image received by the receiving unit, and an identifier that identifies the medical image. And a first storage unit for storing the information. The second image management apparatus associates and stores a medical image identifier transmitted to the first image management apparatus and deletion candidate information indicating whether or not the medical image is a deletion target; An extraction unit that extracts an identifier of a medical image to be deleted with reference to deletion candidate information in the storage unit, and a transmission unit that transmits medical image data to the first image management apparatus using a protocol. . The transmission unit transmits the medical image to be transmitted in association with the identifier extracted by the extraction unit, and the first storage unit of the first image management device is associated with the medical image and the medical image from the second image device. The identifier is received, and the medical image specified by the received identifier is overwritten with the received medical image.

  It should be noted that any combination of the above-described constituent elements and a representation of the present invention converted between a method, an apparatus, a system, etc. are also effective as an aspect of the present invention.

  According to the present invention, it is possible to provide a technique for providing a technique for deleting an image without using a unique protocol for deletion when storing or communicating medical image data.

It is a figure which shows the structure of the medical information management system which concerns on embodiment of this invention. It is a figure which shows the structure of the transmitter which concerns on embodiment of this invention. It is a figure which shows the format structure of the image file based on DICOM standard. It is a figure which shows typically the internal structure of the image management part which concerns on embodiment of this invention. It is a figure which shows typically the data structure of the deletion candidate memory | storage part which concerns on embodiment. It is a flowchart explaining the flow of the image management process which the image management part which concerns on embodiment performs. It is a flowchart explaining the flow of the deletion candidate image selection process which the image management part which concerns on embodiment performs.

  FIG. 1 is a diagram showing a configuration of a medical information management system 1 according to an embodiment of the present invention. The medical information management system 1 includes a medical image transmission system 10, an image storage communication system 30, a client device 40, and an MWM (Modality Worklist Management) server 50, and can communicate via a network such as an intranet or a local area network (LAN). Connected to. In the medical information management system 1, at least data transmission / reception between the medical image transmission system 10 and the image storage communication system 30 is performed in accordance with specifications defined in the DICOM standard. The medical image transmission system 10 includes an endoscope system 12 and a transmission device 20.

  The endoscope system 12 includes an endoscope device, an image processing device, and a display device. An endoscope apparatus is inserted into a body cavity of a patient, captures an internal image by a solid-state image sensor such as a CCD (Charge Coupled Device) at the tip, and outputs the captured image to the image processing apparatus as an imaging signal. The image processing apparatus performs amplification, noise removal, analog / digital conversion, gain adjustment, brightness ratio adjustment, filter processing, and the like on the imaging signal input from the endoscope apparatus, and captures the solid-state imaging device. The image is displayed on the display device as a live image. When the doctor operates the operation unit of the endoscope device to generate a captured image capture instruction while viewing a live image displayed on the screen of the display device, the image processing device, based on the image capture instruction, Captured image data is generated and transmitted to the transmission device 20.

  The transmission device 20 is a DICOM converter, which converts captured image data generated by the endoscope system 12 into image data that conforms to the DICOM standard, and that uses an image storage communication system (PACS) according to a communication protocol that conforms to the DICOM standard. : Picture Archiving and Communication System) 30. In the medical image transmission system 10, the image data conversion function by the transmission device 20 may be provided in the endoscope system 12, but when the endoscope system 12 does not support the DICOM standard, a DICOM converter is used. A certain transmitting device 20 acquires captured image data from the endoscope system 12, converts it into image data that conforms to the DICOM format, and transmits the image data to the image storage communication system 30.

  In the present embodiment, the endoscope system 12 is an example of a modality that outputs medical image data. In the medical information management system 1, instead of the endoscope system 12, a computer tomography apparatus, a magnetic resonance diagnostic apparatus, a digital X-ray imaging apparatus, a computer radiography, an angiographic X-ray diagnostic apparatus, an ultrasonic diagnostic apparatus, etc. Modalities may be provided.

  The image storage communication system 30 has a database 32 and stores medical image data transmitted from the medical image transmission system 10. The client device 40 is a terminal device that is used by medical personnel such as doctors and browses and uses medical images stored in the database 32.

  Note that the transmission device 20 in the medical image transmission system 10 also includes an image data storage unit that stores a medical image transmitted to the medical image transmission system 10. A medical worker creates a report using the medical image transmission system 10 while referring to the image stored in the image data storage unit.

  The endoscopic examination is performed according to an examination order that specifies patient identification information (hereinafter referred to as “patient ID”), examination type, and the like. The order is not limited to the endoscopic examination, but defines the contents of medical practice including other types of examinations and operations, and the doctor performs the medical practice on the premise of the presence of the order. Inspection orders are issued by an ordering system and managed by a hospital information system (HIS). When the examination order is notified to the endoscope system 12, the display device displays the patient name, patient ID, sex, age, examination type, examination room name, scheduled examination start time, scheduled examination end time included in the examination order. Such information is displayed and confirmed by a doctor, and then a test according to the contents of the test order is performed.

  The MWM server 50 acquires the inspection order from the HIS, and transmits the inspection order to the transmission device 20 in response to an inquiry from the transmission device 20. A plurality of tags that require input are defined in the DICOM image format, and the transmission device 20 associates the medical image data provided from the endoscope system 12 with the examination order so that the tag information is obtained. Acquired from the inspection order and embedded in the DICOM image file. The transmission device 20 determines correspondence between the patient ID transmitted together with the medical image data from the endoscope system 12 and the patient ID included in the examination order, thereby associating the medical image data with the examination order. Do. As a result, the transmission device 20 generates a medical image file in a format compliant with the DICOM standard and transmits it to the image storage communication system 30.

  FIG. 2 is a diagram illustrating a configuration of the transmission device 20 according to the embodiment. The transmission device 20 includes an examination information acquisition unit 100, an order acquisition unit 132, a medical image generation unit 134, a storage management unit 136, an image management unit 144, and a storage device 150. The examination information acquisition unit 100 includes a time information acquisition unit 102, a patient ID acquisition unit 104, and an image data acquisition unit 106, and has a function of acquiring examination information from the endoscope system 12. The storage device 150 is a large-capacity auxiliary storage device configured by a hard disk drive (HDD) or the like.

  Each configuration of the transmission device 20 can be realized by an arbitrary processor, memory, and other LSI (Large Scale Integration) in hardware, and can be realized by a program loaded in the memory in software. Here, functional blocks realized by the cooperation are depicted. Therefore, those skilled in the art will understand that these functional blocks can be realized in various forms by hardware only, software only, or a combination thereof.

  First, the basic operation of the transmission device 20 as a DICOM converter will be described. The transmission device 20 generates a medical image file having a data format conforming to the DICOM standard from the medical image data acquired from the endoscope system 12, and transfers the medical image file to the image storage communication system 30 using a communication protocol conforming to the DICOM standard. Details are shown below.

  Prior to the start of the examination in the endoscope system 12, the order obtaining unit 132 obtains an examination order for endoscopic examination from the MWM server 50. For example, the order acquisition unit 132 acquires the inspection order for one day from the MWM server 50 before starting the first inspection. The order acquisition unit 132 stores the acquired plurality of inspection orders for one day in the order storage unit 152. Each examination order includes the order ID, patient name, patient ID, patient gender, patient age, examination type, examination room name, attending doctor name, attending doctor identification information (hereinafter referred to as "in-charge doctor ID"), examination It includes information such as scheduled start time and scheduled test end time.

  When the examination is started in the endoscope system 12, the time information acquisition unit 102 receives information indicating the start time of the examination from the endoscope system 12, and the examination is started at the time specified by the information. Judge that. Note that the time information acquisition unit 102 may receive information indicating the start of an endoscopic examination and determine that the examination has been started at the accepted time. The patient ID acquisition unit 104 acquires the patient ID of the patient to be examined from the endoscope system 12.

  The medical image generation unit 134 receives the examination start time from the time information acquisition unit 102 and receives the patient ID from the patient ID acquisition unit 104. When receiving the patient ID, the medical image generation unit 134 searches the examination order stored in the order storage unit 152 and extracts the examination order including the received patient ID. Thereby, the medical image generation unit 134 can specify the order of the examination performed in the endoscope system 12. The medical image generation unit 134 refers to the scheduled examination start time included in the extracted examination order, and the time difference from the examination start time received from the time information acquisition unit 102 is within a predetermined time (for example, 1 hour). In addition, it may be confirmed that there is no mistake in the extracted inspection order.

  The image data acquisition unit 106 acquires digital data of a captured endoscopic image from the endoscope system 12. The endoscope system 12 may transmit endoscopic image data to the transmission device 20 each time an image is taken, or may transmit a plurality of images collectively to the transmission device 20. The image data acquisition unit 106 provides the acquired image data to the medical image generation unit 134.

The DICOM image data format will be described below. The DICOM data format holds meta information related to medical images in the header portion. DICOM meta information and image data are managed using tags, and the contents of the tags are specified by a Group number and an Element number. The relationship between the 4-digit group number and the information content of the group is illustrated.
(0008) -Information about image (0010) -Information about patient (0018) -Information about collection (0020) -Information associated with image (0040) -Information about procedure

Hereinafter, typical DICOM tags and their contents will be exemplified. The tag number is expressed by (Group number, Element number).
(0008, 0020)-Inspection date (0008, 0030)-Inspection time (0008, 0050)-Order ID
(0008, 0060)-Modality (0010, 0010)-Patient Name (0010, 0016)-SOP Class UID
(0010, 0018)-SOP Instance UID
(0010, 0020)-Patient ID
(0010, 0030)-patient's birthday (0010, 0040)-patient's gender (0010, 1010)-patient's age (0018, 0015)-examination site (0020, 000D)-examination ID
(0020, 0011)-Series number (0040, 0006)-Name of doctor in charge

  SOP means Service Object Pair, and UID means Unique IDentifier. The SOP Instance UID is stored in the header of the image as a unique identification number in the world when the DICOM image is generated.

  FIG. 3 is a diagram showing a format configuration of an image file conforming to the DICOM standard. The image file includes a header and image data (Image Data), and the header includes a plurality of data elements (Data Elements). Each data element is composed of a tag representing a tag number, a VR indicating a data format (value expression) such as a numerical value, a character string, and a time included in the value field, a value length indicating the byte length of the value field, and a value field indicating the value area. Is done. In the image file, meta information to be input is determined in advance, and which tag needs to be input may be determined for each hospital facility.

  The medical image generation unit 134 generates a medical image file with the data format shown in FIG. If necessary, the medical image generation unit 134 converts the image data acquired by the image data acquisition unit 106 into a format conforming to the DICOM standard. The medical image generation unit 134 extracts information necessary for the image data format, that is, information specified by the tag, from the examination order extracted from the order storage unit 152, and adds the information to the image file. As a result, an image file in DICOM format is generated. When the medical image generation unit 134 generates an image file, the storage management unit 136 stores the generated image file in the image data storage unit 160 in association with the examination order. This association may be performed by associating the storage location of the image file with the inspection order.

  The image management unit 144 transmits the image file stored in the image data storage unit 160 to the image storage communication system 30. When the image storage communication system 30 receives the image file, the image storage communication system 30 stores the image file in the database 32 and returns an ACK signal indicating the reception to the transmission device 20. As a result, the image storage communication system 30 can store the medical image data captured with the modality in the database 32. Since the order ID is included in the image file, the image storage communication system 30 refers to the order ID of the image file so that a plurality of image files having the same order ID are stored together in the database 32. To do. The image storage communication system 30 can uniquely identify each image file by referring to the SOP Instance UID included in the image file.

  If the ACK signal is not received from the image storage communication system 30 after transmitting the image file, the image management unit 144 retransmits the same image file after a predetermined time. The above is the procedure for the transmission apparatus 20 to operate as a DICOM converter.

  Here, the medical image transmission system 10 uses a predetermined communication protocol when transmitting an image to the image storage communication system 30. Hereinafter, in the present embodiment, it is assumed that the DICOM communication protocol, which is a standard for communication protocols between medical image devices, is used as the predetermined communication protocol.

  In the DICOM communication protocol, when an image is transmitted from the medical image transmission system 10 as a modality to the image storage communication system 30, a communication protocol called C-STORE is often used. C-STORE is sometimes called DICOM Push, and the current C-STORE does not define a protocol for deleting an image stored in the image storage communication system 30 from the medical image transmission system 10. Therefore, when a user or administrator of the medical image transmission system 10 desires to delete an image transmitted to the image storage communication system 30 for some reason, the image storage communication system 30 is directly operated.

  However, for example, when the administrator of the medical image transmission system 10 and the administrator of the image storage communication system 30 are different, the administrator of the medical image transmission system 10 deletes an image from the administrator of the image storage communication system 30. The procedure will be complicated and the procedure may be complicated. In addition, there is a possibility that the risk of mistaken images to be deleted is increased. For this reason, if the image stored in the image storage communication system 30 can be deleted from the medical image transmission system 10, it is considered that the usability of the medical image transmission system 10 is improved. On the other hand, the DICOM communication protocol is a standard and is not of a nature that can be freely changed by the manufacturer of the medical image transmission system 10.

  Therefore, the image management unit 144 according to the embodiment realizes substantially deleting the image stored in the image storage communication system 30 without changing the C-STORE of the DICOM communication protocol. Hereinafter, this principle will be described.

  FIG. 4 is a diagram schematically showing the internal configuration of the image management unit 144 according to the embodiment of the present invention. The image management unit 144 includes a transmission unit 170, a deletion candidate storage unit 172, an extraction unit 174, an identifier generation unit 176, a user interface 178, and a deletion candidate setting unit 184. The user interface 178 includes a display unit 180 and an input unit 182.

  The deletion candidate storage unit 172 stores the SOP Instance UID that is an identifier for identifying the medical image transmitted to the image storage communication system 30 and the deletion candidate information indicating whether or not the medical image is a deletion target in association with each other. To do. The extraction unit 174 refers to the deletion candidate information in the deletion candidate storage unit 172, and extracts the identifier of the medical image to be deleted. The transmission unit 170 transmits the medical image file stored in the image data storage unit 160 to the image storage communication system 30 using a predetermined communication protocol such as DICOM. Here, the transmission unit 170 transmits the SOP Instance UID of the medical image to be deleted extracted by the extraction unit 174 in the header of the medical image to be transmitted.

  As described above, the SOP Instance UID is an identifier generated as a unique identification number in the world when a DICOM image is generated. Therefore, the image storage communication system 30 can identify an image using the SOP Instance UID. In that case, when the image is transmitted with the same SOP Instance UID as the SOP Instance UID added to the image already transmitted to the image storage communication system 30, the image storage communication system 30 is the original image transmitted later. The image will be overwritten. Therefore, substantially the same effect as deleting an image stored in the image storage communication system 30 can be obtained. Thereby, it is possible to delete the image stored in the image storage communication system 30 without changing the C-STORE.

  The image management unit 144 also includes an identifier generation unit 176 that generates a new SOP Instance UID. When the extraction unit 174 does not extract the identifier of the medical image to be deleted, the image management unit 144 transmits the medical image to be transmitted. The image is transmitted in association with the new SOP Instance UID generated by the identifier generation unit 176. As a result, when there is no image to be deleted in the image storage communication system 30, a new image is additionally stored in the image storage communication system 30.

  Next, the data structure of the deletion candidate storage unit 172 used when extracting the SOP Instance UID to be overwritten by the image storage communication system 30 will be described.

  FIG. 5 is a diagram schematically illustrating a data structure of the deletion candidate storage unit 172 according to the embodiment. As shown in FIG. 5, the data structure of the deletion candidate storage unit 172 includes an examination ID field 190 for storing an examination ID, a series number field 192 for storing a series number, an imaging date / time field 194 for storing an imaging date / time, and a deletion target. A deletion candidate flag field 196 for storing a deletion candidate flag indicating whether or not deletion, a deletion execution flag field 198 for storing a deletion execution flag indicating whether or not deletion has been performed, and an SOP Instance UID field 200 for storing an SOP Instance UID. Including.

  The transmission unit 170 stores, for all images to be transmitted to the image storage communication system 30, the examination ID, series number, shooting date, deletion candidate flag, deletion execution flag, and SOP Instance UID assigned to the image as deletion candidates. Stored in the unit 172.

  Here, the deletion candidate flag is information indicating whether or not the image specified by the SOP Instance UID is a deletion target, that is, whether or not it is a target of overwriting. Specifically, it is 0 (off) or 1 (on ) Is a binary value. An image having a deletion candidate flag of 0 indicates that it is not a deletion target, and that an image of 1 is a deletion target image. The deletion execution flag is information indicating whether or not the image specified by the SOP Instance UID has already been deleted (that is, overwritten), and is a binary value that takes a value of 0 or 1 like the deletion candidate flag. An image with a deletion execution flag of 0 indicates that it has not been deleted yet, and an image of 1 indicates that it has already been deleted. Therefore, an image with a deletion candidate flag of 0 also has a deletion execution flag of 0.

  After transmitting the image to the image storage communication system 30, the transmission unit 170 stores the deletion candidate flag value as 0 and the deletion execution flag value as 0 as the default setting values of each flag. The case where the value of the deletion candidate flag or the value of the deletion execution flag is changed from 0 to 1 will be described later.

  In the example shown in FIG. 5, two inspection IDs 100 and 101 are stored in the inspection ID field 190, indicating that there are two inspections. The series number field 192 is assigned a serial number for each inspection image, and it can be seen that both inspections include two images. The SOP Instance UID field 200 stores the SOP Instance UID created using the examination ID, the series number, and the shooting date and time.

  The extraction unit 174 refers to the deletion candidate storage unit 172 and searches for an SOP Instance UID having a deletion candidate flag of 1 and a deletion execution flag of 0. If such an SOP Instance UID exists, the extraction unit 174 determines that the image specified by the SOP Instance UID is an image to be deleted.

  FIG. 6 is a flowchart illustrating a flow of image management processing executed by the image management unit 144 according to the embodiment. The processing in this flowchart starts when the transmission unit 170 transmits an image.

  The extraction unit 174 refers to the deletion candidate storage unit 172 and searches for a deletion target image in which the value of the deletion candidate flag field 196 is 1 and the value of the deletion execution flag field 198 is 0. (S2). When the deletion target image exists (Y in S4), the extraction unit 174 changes the value of the deletion execution flag field 198 of the deletion target image to 1 (S6). The transmission unit 170 sets the SOP Instance UID of the deletion target image acquired by the extraction unit 174 as the image to be transmitted (S8). Subsequently, the transmission unit 170 stores the information of the image to be transmitted to the deletion candidate storage unit 172, and sets the values of the deletion candidate flag field 196 and the deletion execution flag field 198 to 0 (S10).

  When the deletion target image does not exist (N in S4), the identifier generation unit 176 generates a new SOP Instance UID (S12). The transmission unit 170 sets the SOP Instance UID generated by the identifier generation unit 176 as an image to be transmitted (S14).

  The transmission unit 170 transmits an image in which the SOP Instance UID of the image to be deleted or the SOP Instance UID newly generated by the identifier generation unit 176 is set to the image storage communication system 30 (S16). When the transmission unit 170 does not receive an ACK signal indicating that an image has been received from the image storage communication system 30, that is, when image transmission has failed (N in S18), the transmission unit 170 is searched by the extraction unit 174. The value of the deletion execution flag field 198 of the deletion target image is returned from 1 to 0 (S20). Next, the transmission unit 170 resets the SOP Instance UID set in the image to be transmitted (S22), and returns to Step S2.

  When an ACK signal indicating that an image has been received from the image storage communication system 30 is received and transmission is successful (Y in S18), the processing in this flowchart ends. If the transmission unit 170 does not receive an ACK signal indicating that an image has been received from the image storage communication system 30, that is, if image transmission has failed, the transmission unit 170 sets the deletion candidate flag value to 1 for the image. The execution flag value is set to 0 and stored in the deletion candidate storage unit 172. The transmission unit 170 resends the image when the image transmission fails, but the image is stored when the image is stored in the image storage communication system 30 but the ACK signal is not received for some reason. This is to prevent the images from being stored in the communication system 30 redundantly. If the value of the deletion candidate flag is 1, since the SOP Instance UID is reused, the image stored in the image storage communication system 30 is overwritten, and it is possible to prevent the image from being stored redundantly.

  Next, the setting of the deletion candidate flag and the deletion execution flag will be described. The user of the medical image transmission system 10 can confirm the image displayed on the display unit 180 and can specify whether or not to delete the image from the input unit 182.

  As shown in FIG. 4, the image management unit 144 according to the embodiment includes a user interface 178 including a display unit 180 and an input unit 182. Here, the display unit 180 is a liquid crystal monitor, for example, and can present a medical image stored in the image data storage unit 160 to the user. The input unit 182 is a pointing device such as a mouse or a keyboard.

  The deletion candidate setting unit 184 changes the deletion candidate information stored in the deletion candidate storage unit 172 to information indicating a deletion target, that is, changes the value of the deletion candidate flag from 0 to 1. More specifically, the deletion candidate setting unit 184 sequentially displays medical images stored in the image data storage unit 160 on the display unit 180. At this time, the deletion candidate setting unit 184 may refer to the deletion candidate storage unit 172 to skip an image having an SOP Instance UID with the deletion execution flag field 198 set to 1. This is because the image of the SOP Instance UID in which the deletion execution flag field 198 is 1 is an image that has already been deleted from the image storage communication system 30.

  When the user of the medical image transmission system 10 desires to delete the image displayed on the display unit 180 from the image storage communication system 30, the user instructs the deletion candidate setting unit 184 to that effect via the input unit 182. The deletion candidate setting unit 184 identifies the SOP Instance UID of the image displayed on the display unit 180 and refers to the deletion candidate storage unit 172 to change the value of the corresponding deletion candidate flag field 196 to 1. The deletion candidate setting unit 184 updates the image displayed on the display unit 180 after changing the value of the deletion candidate flag field 196. By repeating the above operation, an image desired to be deleted among images transmitted to the image storage communication system 30 can be set as an overwriting target image when the image is next transmitted.

  FIG. 7 is a flowchart illustrating the flow of the deletion candidate image selection process executed by the image management unit 144 according to the embodiment. The process in this flowchart starts when the user instructs the deletion candidate setting unit 184 to start selecting a deletion candidate image via the input unit 182, for example.

  The deletion candidate setting unit 184 sequentially displays the medical images stored in the image data storage unit 160 on the display unit 180 (S30). When an instruction to delete is received from the user (Y in S32), the deletion candidate setting unit 184 refers to the deletion candidate storage unit 172 and sets the value of the deletion candidate flag field 196 of the image that the user has instructed to delete to “1”. (S34). When no instruction to delete is received from the user (N in S32), the deletion candidate setting unit 184 does not perform any special operation on the image displayed on the display unit 180.

  The deletion candidate setting unit 184 updates the image displayed on the display unit 180 (S38) until all the image data in the image data storage unit 160 is displayed (N in S36), and continues the above-described processing. When the deletion candidate setting unit 184 displays all the image data in the image data storage unit 160 on the display unit 180 (Y in S36), the processing in this flowchart ends.

  As described above, the medical image transmission system 10 according to the embodiment of the present invention provides a technique for deleting an image without using a unique protocol for deletion when storing or communicating medical image data. can do.

  The present invention has been described based on the embodiments. The present invention is not limited to the above-described embodiment, and an appropriate combination of the elements of the embodiment is also effective as an embodiment of the present invention. A new embodiment generated by a combination of the embodiments has the effects of the combined embodiments. Various modifications such as design changes can be added to the embodiments based on the knowledge of those skilled in the art, and the embodiments to which such modifications are added can be included in the scope of the present invention. .

  In the above description, a case has been described in which the user of the medical image transmission system 10 explicitly instructs the deletion candidate setting unit 184 of an image to be deleted via the input unit 182. In addition, the deletion candidate setting unit 184 may automatically select an image to be deleted under a predetermined condition. Such a case will be described below as a modification.

  For example, in an endoscopic examination, when a doctor or a nurse erroneously presses the end key of the endoscopic system 12 during the examination, the order under examination is closed. In this case, it is necessary to issue additional orders. Since the additionally issued order is an order different from the original order, it is necessary to perform confirmation work between the orders and integration of the orders. In one endoscopic examination, the scope of the endoscope may be exchanged during the examination. The replacement of the scope may require the endoscope system 12 to be terminated once, and an additional order is required after the replacement of the scope.

  As described above, when additional orders are issued in one inspection, the integration work of those orders is performed. Here, “order integration” is an operation of combining a plurality of examinations which are originally one examination but are treated as different examinations on the medical image transmission system 10 into one examination. Specifically, what is originally an examination is that a plurality of examinations assigned different examination IDs on the medical image transmission system 10 are integrated into the same examination ID, and the image series number is changed from 1 again. Refers to the work to be assigned.

  FIG. 5 shows that there are two images each having an inspection ID of 100 and two images having an inspection ID of 101. Now, an inspection with an inspection ID of 100 and an inspection with an inspection ID of 101 are essentially one inspection, and consider the case of order integration of these inspections. At this time, an order integration unit (not shown) in the medical image transmission system 10 changes, for example, the examination ID of the image group whose examination ID is 101 to 100, and changes the image of the series number 1 to 3 and the image of 2 to 4. To do. Thereby, the inspection with the inspection ID of 100 and the inspection with the inspection ID of 101 are integrated as images with the inspection ID of 100 and the series numbers of 1 to 4.

  Alternatively, as another method, the order integration unit assigns a new common inspection ID (for example, 102) to both the inspection with the inspection ID 100 and the inspection with the inspection ID 101, and the series number images are arranged in the order of the imaging time. You may assign in ascending order. As a result, the images with the inspection ID 102 and the series numbers 1 to 4 are integrated. In any case, the order integration unit stores the inspection ID or series number after integration in the header area of each image after integration.

  The transmission unit 170 transmits each image integrated by the order integration unit to the image storage communication system 30, so that each image data after integration is stored in the image storage communication system 30. Here, the transmission unit 170 autonomously converts the image data transmitted from the modality into a DICOM data format and transmits it to the image storage communication system 30. For example, every time image data is transmitted from the modality, the transmission unit 170 converts the image data into a DICOM data format and transmits the converted data to the image storage communication system 30. Alternatively, the transmission unit 170 converts the image included in the audit into a DICOM data format and transmits it to the image storage communication system 30 every time the inspection is completed.

  In any case, at the time when the order integration unit integrates, the image included in the inspection whose inspection ID is 100 and the image included in the inspection whose inspection ID is 101 are already transmitted to the image storage communication system 30. Has been. Therefore, when the transmission unit 170 transmits each image after order integration to the image storage communication system 30, the same image is stored in the image storage communication system 30 with different examination IDs. This puts pressure on the storage capacity of the database 32 of the image storage communication system 30 and may be confusing for users who want to create reports using the image storage communication system 30.

  Therefore, the deletion candidate setting unit 184 stores the one or more medical images that the transmission unit 170 has already transmitted to the image storage communication system 30 in a case where the deletion candidate storage unit 172 stores one or more medical images in duplicate. The value of the deletion candidate flag field 196 of the identifier associated with the above medical image is changed to 1. Thus, when retransmitting the image after order integration to the image storage communication system 30, the transmission unit 170 uses the SOP Instance UID used when the image is transmitted first as the SOP Instance UID of the image to be retransmitted. Will turn. Thereby, the image before order integration stored in the image storage communication system 30 is overwritten with the image after order integration, and the same image can be prevented from being stored repeatedly.

  DESCRIPTION OF SYMBOLS 1 Medical information management system, 10 Medical image transmission system, 12 Endoscope system, 20 Transmission apparatus, 30 Image storage communication system, 32 Database, 40 Client apparatus, 50 MWM server, 100 Examination information acquisition part, 102 Time information acquisition part 104 Patient ID acquisition unit 106 Image data acquisition unit 132 Order acquisition unit 134 Medical image generation unit 136 Storage management unit 144 Image management unit 150 Storage device 152 Order storage unit 160 Image data storage unit 170 Transmission unit, 172 deletion candidate storage unit, 174 extraction unit, 176 identifier generation unit, 178 user interface, 180 display unit, 180 sequential display unit, 182 input unit, 184 deletion candidate setting unit.

Claims (8)

A transmission unit for transmitting a medical image using a predetermined communication protocol to the medical image storage system;
A deletion candidate storage unit that stores an identifier of a medical image transmitted to the image storage communication system and deletion candidate information indicating whether or not the medical image is a deletion target;
An extraction unit that refers to deletion candidate information in the deletion candidate storage unit and extracts an identifier of a medical image to be deleted;
The image transmitting apparatus, wherein the transmitting unit transmits the medical image to be transmitted in association with the identifier extracted by the extracting unit. The identifier is an identifier for the image storage communication system to identify a medical image,
The image management apparatus further includes an identifier generation unit that generates the identifier,
The transmission unit, when there is no identifier of a medical image to be deleted in the deletion candidate storage unit, transmits a new identifier generated by the identifier generation unit in association with a medical image to be transmitted. The image management apparatus according to claim 1.   The image management apparatus according to claim 1, further comprising a deletion setting unit that sets deletion candidate information stored in the deletion candidate storage unit to information indicating a deletion target. An image data storage unit for storing a medical image transmitted by the transmission unit to the image storage communication system;
A display unit for displaying an image stored in the image data storage unit;
The deletion setting unit includes an instruction to set deletion candidate information associated with an identifier of a medical image displayed on the display unit as information indicating a deletion target, among deletion candidate information stored in the deletion candidate storage unit. The image management apparatus according to claim 3, wherein the image management apparatus acquires the image management apparatus.   The deletion setting unit, when transmitting one or more medical images that the transmission unit has already transmitted to the image storage communication system to the image storage communication system in duplicate, stores the one or more deletion candidate storage units. The image management apparatus according to claim 3 or 4, wherein deletion candidate information associated with an identifier associated with a medical image is set as information indicating a deletion target. The medical image is an image of DICOM (Digital Imaging and Communication in Medicine) standard,
The predetermined communication protocol is a DICOM standard communication protocol;
6. The image management apparatus according to claim 1, wherein the identifier is an SOP (Service Object Pair) instance UID (Unique IDentifier). Transmitting a medical image using a predetermined communication protocol to the medical image storage system;
Storing the identifier of the medical image transmitted to the image storage communication system for medical images in the deletion candidate storage unit in association with the deletion candidate information indicating whether or not the medical image is a deletion target;
Extracting an identifier of a medical image to be deleted with reference to deletion candidate information in the deletion candidate storage unit;
An image management method, characterized by causing a processor to execute a step of associating an extracted identifier with a medical image to be transmitted. In an image management system comprising a first image management device and a second image management device,
The first image management device includes:
A receiving unit for receiving a medical image transmitted from the second image management apparatus using a predetermined communication protocol;
A first storage unit that stores the medical image received by the receiving unit and an identifier for identifying the medical image in association with each other;
The second image management device includes:
A second storage unit for storing the identifier of the medical image transmitted to the first image management apparatus and deletion candidate information indicating whether or not the medical image is a deletion target;
An extraction unit that extracts an identifier of a medical image to be deleted with reference to deletion candidate information in the second storage unit;
A transmission unit that transmits medical image data to the first image management apparatus using the protocol,
The transmitting unit transmits the medical image to be transmitted in association with the identifier extracted by the extracting unit,
The first storage unit of the first image management device receives a medical image and an identifier associated with the medical image from the second image device, and overwrites the medical image specified by the received identifier with the received medical image. An image management system characterized by:

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