JP6116893B2 - X-ray diagnostic imaging equipment - Google Patents

Description

  Embodiments described herein relate generally to an X-ray diagnostic imaging apparatus in which an X-ray fluoroscope and a CT apparatus operate in cooperation.

  Conventionally, when CT (Computed Tomography) imaging is performed under angiography, it is necessary to reciprocate between the angiography room and the CT room with a catheter or the like placed in the subject. In recent years, in order to solve this problem, an X-ray image diagnostic apparatus has been developed in which an X-ray Angio (Angiography) apparatus and a CT apparatus are arranged in the same examination room and configured to share a bed, thereby accelerating diagnosis and treatment. It is illustrated.

  In other words, since the imaging with both apparatuses can be switched in a short time while the subject is placed on the bed, it is possible to carry out examination and treatment while alternately acquiring X-ray imaging images and CT images. is there. This X-ray image diagnostic apparatus is called an IVR-CT (Interventional Radiology-Computed Tomography) apparatus.

  For example, in interventional treatment of the abdomen (hepatocellular carcinoma) using an IVR-CT apparatus, not only DSA images (Digital Subtraction Angiography) by contrast from arteries, but also CT imaging of arteriography for definitive diagnosis is performed. . In radiofrequency ablation treatment for hepatocellular carcinoma, a lesion site is identified with a CT apparatus, ablation probe is punctured with an X-ray image, and a needle tip is confirmed with a CT apparatus. In these diagnosis and treatment, CT imaging and X-ray fluoroscopic imaging are alternately performed a plurality of times.

  In the current IVR-CT apparatus, each of the CT apparatus and the X-ray fluoroscopic apparatus functions independently. For this reason, when performing CT imaging, a scano image for determining the CT imaging position is captured. However, since the X-ray fluoroscopic apparatus normally performs imaging before CT imaging, a two-dimensional fluoroscopic image equivalent to a scanogram has already been captured.

  This is not only redundant in acquiring image information, but also has problems in terms of time spent for imaging and exposure dose. For this reason, there is a technique for reducing the exposure dose by replacing the scanogram with an X-ray image (see, for example, Patent Document 1).

  However, this technique mainly replaces the scano image with an X-ray image. Therefore, the optimal CT imaging position for reducing the exposure dose has not been considered.

JP-A-9-276264

  The problem to be solved by the present invention is to solve the above problems and to provide an X-image diagnostic apparatus capable of setting an optimal CT imaging position for reducing exposure dose.

In order to achieve the above object, the X-ray diagnostic imaging apparatus according to the present embodiment is disposed so as to face an X-ray generator that generates X-rays on a subject placed on a bed, and the X-ray generator. An X-ray fluoroscopic apparatus including an imaging system including an X-ray detection unit, a CT apparatus controlled by a coordinate system common to the X-ray fluoroscopic apparatus, and an X-ray image captured by the imaging system A region-of-interest position estimation unit that estimates a spatial position of the region of interest of the subject from the depth information of the region of interest of the subject region and the designated region and parts, on the basis of the estimated position of the region of interest have a, a photographing position calculation unit for calculating the imaging position of the CT apparatus, the depth information from CT images reconstructed taken with pre-said CT apparatus Using the obtained distance between the region of interest and the bed It is calculated.

The block block diagram of the whole X-ray-image diagnostic apparatus in 1st Embodiment. The flowchart figure which shows operation | movement of the X-ray-image diagnostic apparatus in 1st Embodiment. Explanatory drawing of the CT imaging position calculation method in embodiment. Explanatory drawing in the case of using object thickness for the depth information for estimating a region of interest. Explanatory drawing in the case of using a table value for the depth information for estimating a region of interest. Explanatory drawing in the case of using the X-ray image from a Y-axis direction for the depth information for estimating a region of interest. Explanatory drawing in the case of using the X-ray image which moved to the longitudinal direction for the depth information for estimating a region of interest. Explanatory drawing in the case of using the X-ray imaging image moved to the perpendicular direction for the depth information for estimating a region of interest. The block block diagram of the whole X-ray image diagnostic apparatus in 2nd Embodiment. The flowchart figure which shows operation | movement of the X-ray-image diagnostic apparatus in 2nd Embodiment. Explanatory drawing in the case of using puncture route information for the depth information for estimating a region of interest.

  Hereinafter, embodiments will be described in detail with reference to FIGS. 1 to 11. In the following description, components having substantially the same function and configuration are denoted by the same reference numerals, and redundant description will be given only when necessary.

(First embodiment)
The X-ray diagnostic imaging apparatus according to the present embodiment shown in FIG. 1 has an X-ray Angio apparatus (hereinafter referred to as an X-ray fluoroscopy apparatus) and a CT (Computed Tomography) apparatus arranged in the same examination room so as to share a bed. It is a block block diagram which shows the comprised X-ray image diagnostic apparatus.

  As shown in FIG. 1, the X-ray diagnostic imaging apparatus according to the present embodiment is largely divided into an X-ray fluoroscopic apparatus, a CT apparatus, and a common system control unit. The X-ray fluoroscopic apparatus includes an X-ray generator 2 that generates X-rays for a subject P placed on a common bed 1, and an X-ray that detects X-rays transmitted through the subject P on a two-dimensional plane. The detection unit 3, the X-ray generation unit 2, and the X-ray detection unit 3 are opposed to each other, the holding arm 4 that rotatably holds the imaging system, and the high voltage generation that generates a high voltage to be applied to the X-ray generation unit 2. The imaging data output from the X-ray detection unit 3 and the holding arm control unit 6 that controls the position of the apparatus 5 and the holding arm 4 in the X, Y, and Z axis directions and the rotation direction are subjected to image storage processing. An image calculation / storage unit 7 is provided.

  The CT apparatus also includes a gantry 8, a gantry control unit 9 that controls the position of the gantry 8 in the longitudinal direction of the common bed 1, and an X-ray generation unit that generates X-rays on the subject P placed on the bed 1. 10. An X-ray detection unit 11 that detects X-rays transmitted through the subject P, a DAS (Data Acquisition System) unit 12 that collects and transmits Raw data acquired by the X-ray detection unit 11 in a non-contact manner, and a DAS unit 12 An image reconstruction unit 13 that reconstructs the collected raw data to generate various tomographic images, an image storage unit 14 that performs storage processing of various data such as tomographic images, and a high voltage applied to the X-ray generation unit 10. A high voltage generator 15 is provided.

  The bed control unit 16 controls the height of the bed 1 to the optimum position of both devices in image capturing in the X-ray fluoroscope and the CT apparatus, and moves the bed 1 or the top of the bed 1 in the longitudinal direction as necessary. To do.

  The X-ray fluoroscopic apparatus and the CT apparatus are controlled by a common system control unit 17, and the system control unit 17 controls both apparatuses in an integrated manner.

  The system control unit 17 controls each block in FIG. 1 and includes an operation unit 18 that performs various operations, a storage unit 19 that stores various medical image data, and a monitor unit 20 that displays various medical images. Yes. The arrows shown in FIG. 1 represent the main signal flow between the blocks, but the system control unit 17 controls the blocks not shown by the arrows in an integrated manner.

  Further, in carrying out this embodiment, the X-ray diagnostic imaging apparatus performs various medical images from the region-of-interest setting unit 21 that sets a designated region in the vicinity of the region of interest on the X-ray image, the in-hospital network 22, or within its own device. An image acquisition unit 23 for acquiring data, an image display processing unit 24 for displaying medical images of the X-ray fluoroscopic apparatus and the CT apparatus, a table unit 25 for storing a table in which the distance from the bed 1 to the region of interest is described for each part, A region-of-interest position estimation unit 26 that estimates the spatial position of the region of interest based on the specified region and further based on the depth information, and a CT imaging position calculation that calculates the imaging position of the CT apparatus based on the spatially estimated position of the region of interest. A portion 27 is provided.

  The operation of the X-ray image diagnostic apparatus configured as described above will be described with reference to the flowchart of FIG. 2 and the explanatory diagram of the CT imaging position calculation method of FIG.

  In the following clinical cases, interventional treatment for abdominal hepatocellular carcinoma will be described as an example. In FIG. 3, the same components as those in FIG. Reference numeral 31 indicates a region of interest (generally indicates a lesion, but is not limited), and reference numeral 32 indicates an X-ray image. X-rays generated from the tube focus XA of the X-ray generator 2 pass through the region of interest 31 in the liver of the subject P and form an image on the X-ray detector 3. At this time, a projected image 34 of the liver 33 and the region of interest is obtained on the X-ray image 32 by inserting a contrast medium into the liver 33. Here, for the X-rays spreading from the tube focal point XA, the left end point of the X-ray detector 3 is FL, the right end point is FR, the point intersecting the X-ray image central axis is FS, and the projection point of the region of interest 31 is FE. Here, the spatial coordinate axes X, Y, and Z are defined as shown in FIG. The longitudinal direction of the bed 1 and the moving direction of the gantry 8 are defined as the X-axis direction, and the vertical direction is defined as the Z-axis direction. Then, CT imaging is performed by adjusting the height of the bed 1 and moving the gantry 8 so that the CT imaging position estimated from the X-ray imaging image is obtained.

  First, in step ST201, the subject P lies on the bed 1 and treatment is started. In interventional treatment of abdominal hepatocellular carcinoma, the catheter is advanced by an X-ray image in order to place the catheter in the artery. Then, DSA (Digital Subtraction Angiography) imaging is performed with an X-ray fluoroscope to confirm the running state of the blood vessel to the tumor. As a result, the X-ray image 32 of FIG. 3 is obtained.

  Then, CT imaging is performed in order to make a more accurate diagnosis from the X-ray imaging image, and the process proceeds to a step of calculating the CT imaging position for this CT imaging.

  In step ST202, the projection image 34 of the region of interest for which CT imaging is to be performed on the X-ray imaging image 32, or the vicinity thereof is designated by a point or region using a pointing device such as a mouse or a trackball connected to the operation unit 18. To do. Here, an area designated on the X-ray image 32 is defined as a designated area. At this time, the designated region of the region of interest on the X-ray image 32 is sent to the region of interest position estimation unit 26.

  In step ST203, depth information for estimating the position of the region of interest is set. In step ST202, the position of the projected image 34 of the region of interest on the X-ray image 32 or its vicinity is set as the designated region. However, since the X-ray image 32 is a projection image of X-rays generated from the tube focus XA, the position of the region of interest in the depth direction cannot be accurately specified. In order to perform accurate position estimation, it is necessary to obtain depth information that can estimate the position of the region of interest.

  FIG. 3 is an explanatory diagram of a CT imaging position calculation method when depth information cannot be acquired. In this case, if the point SS obtained by projecting the X-ray image center point FS on the X axis is set as the scan start position and the point SE obtained by projecting the projection point FE of the region of interest 31 on the X axis is set as the scan end position, the region of interest 31 is obtained. It is possible to shoot including.

  If the distance (depth information) from the tube focus XA to the region of interest 31 is known in the line segment connecting the tube focus XA point and the projection point FE of the region of interest 31, the scan range (range from the scan start position to the scan end position) ) Can be further reduced. However, it is difficult to actually measure the depth position. Therefore, in this embodiment, a certain known value or estimated value is used as depth information. As depth information, (1) body thickness of the subject (hereinafter referred to as subject thickness), (2) a statistical distance from the bed to the region of interest, (3) an estimated height of the region of interest taken from the Y-axis direction, Etc. can be used.

  In step ST204, the designated region of the region of interest on the X-ray image 32 and the depth information are used to obtain the spatially estimated position of the region of interest 31, and the scan imaging position range in the CT apparatus is determined from the spatially estimated position. calculate. For the sake of explanation, the tube focal point XA is set as the common coordinate axis origin of the X-ray fluoroscopic apparatus and the CT apparatus. This step ST204 is performed by the CT imaging position calculator 27.

  FIG. 4 is an explanatory diagram of the scan range when the subject thickness is used for the depth information of the region of interest. That is, it is considered that the region of interest of the subject P exists below the subject thickness. Here, the subject thickness is K1, the distance between the tube focus XA and the bed 1 (S point) is H, the distance between the tube focus XA and the X-ray detector 3 is SID, and the X-ray transmission image center point FS When the distance from the projection point FE of the region of interest 31 is D, the scan start position SS1 and the scan end position SE1 are given by the equations (1) and (2). At this time, a value obtained by actually measuring the subject P is input from the operation unit 18 as the subject thickness K1.

SS1 = H × D / SID (1)
SE1 = (H + K1) × (D / SID) (2)
Thus, by setting the subject thickness K1 as depth information, it is possible to make it smaller than the scan range defined by the scan start position SS and the scan end position SE without depth information.

  FIG. 5 is an explanatory diagram when a table value is used for depth information. The position of the region of interest 31 is acquired from the medical statistical information, and an estimated value K2 of the height from the bed 1 is set. This medical statistical information is classified into categories such as part, sex, height, weight, and body shape, and stored in the table unit 24. The scan start position SS2 and the scan end position SE2 are obtained by replacing K1 with K2 in the equations (1) and (2).

  Further, the X coordinate of the intersection of the straight line passing through the XA point and the FE point shown in FIG. 5 and the straight line representing Z = K2 is obtained as the scan center position SC2, and the scan is started including the estimation position estimation error and the size of the region of interest. A point SS2 and a scan end point SE2 may be set. In this embodiment, the scan range can be calculated with higher accuracy than when the object thickness is used as the depth information.

  FIG. 6 is an explanatory diagram when an X-ray image captured from the Y-axis direction is used for depth information. That is, in order to obtain the height of the region of interest 31, the imaging system of the X-ray fluoroscopic apparatus is rotated, and the height K3 of the region of interest 31 is obtained by photographing from the lateral direction. This K3 is read from the acquired X-ray image.

  As another method, the position of the region of interest 31 may be obtained as an intersection coordinate between a straight line passing through the tube focal point XA and the projection point FE shown in FIG. 5 and a straight line passing through the XA point and the FE point shown in FIG. . This intersection is obtained as the scan center position SC3, and the scan start point SS3 and the scan end point SE3 are set including the estimation error and the size of the region of interest.

  This method does not necessarily need to be an X-ray image captured from the Y direction, and the spatial position of the region of interest 31 can be estimated if there are at least two X-ray images having different imaging angles. At this time, the input of the designated area to be included on the X-ray image having the imaging angle changed is similarly performed from the operation unit 18 and set in the region-of-interest setting unit 21.

  FIG. 7 is an explanatory diagram for obtaining the estimated position of the region of interest from two X-ray images having different relative positions of the bed and the imaging system in the longitudinal direction. FIG. 8 is an explanatory diagram for obtaining the estimated position of the region of interest when the relative positions of the bed and the imaging system are different in the vertical direction.

  When performing interventional treatment on the X-ray fluoroscopic apparatus side, the position of the subject P is moved in the longitudinal direction so that the region of interest 31 is imaged at an appropriate position, or the height of the bed 1 is adjusted, thereby the region of interest. In some cases, an X-ray image is acquired by moving 31 to the isocenter of the imaging system. In such a case, since two X-ray images having different relative positions between the bed 1 and the imaging system have already been acquired, the estimated position of the region of interest 31 is calculated using these.

  As shown in FIG. 7, when the relative position of the bed 1 and the imaging system is moved by a distance M in the longitudinal direction, the projection point of the region of interest projected on the X-ray detector 3 moves from FE1 to FE2. To do. At this time, the projection points FE1 and FE2 are set as designated areas. Here, it is assumed that the distance between the X-ray image center FS and the projection point FE1 is D1, and the distance between the X-ray image center FS and the projection point FE2 is D2. At this time, the scan center position SC4 of the region of interest 31 is (3) from the relationship between the line segment connecting the tube focus XA and the projection point FE1 of the X-ray generator 2 and the line segment connecting the tube focus XA and the projection point FE2. ).

SC4 = M × D1 / (D1 + D2) (3)
Then, the scan start point SS4 and the scan end point SE4 including the estimation position estimation error and the size of the region of interest are set.

  As shown in FIG. 8, when the relative position of the bed and the imaging system is moved by a distance V in the vertical direction, the projection point of the region of interest 31 projected on the X-ray detector 3 is from FE1 to FE2. And move. At this time, similarly to FIG. 7, the projection points FE1 and FE2 are set as designated areas. Here, the distance between the X-ray transmission image center point FS and the projection point FE1 is D1, and the distance between the X-ray transmission image center FS and the projection point FE2 is D2. At this time, from the relationship between the line segment connecting the tube focus XA and the projection point FE1 of the X-ray generation unit and the line segment connecting the tube focus XA and the projection point FE2, the scan center position SC5 of the region of interest 31 is (4 ).

SC5 = V * D1 * D2 / (SID * (D1-D2)) (4)
Then, the scan start point SS5 and the scan end point SE5 including the estimation position estimation error and the size of the region of interest are set. Further, in the case where they are simultaneously moved in the longitudinal direction and the vertical direction, the equations (3) and (4) may be obtained in combination. In the above description, the projection point of the region of interest has been described as the designated region. However, it is also possible to easily obtain the CT imaging position by designating a predetermined projection region including the projection point.

  In step ST205, the bed 1 is moved in the vertical direction so as to have an optimal height for inserting the subject P into the gantry 8, and the CT imaging position calculated using any of the methods described in step ST204. The gantry of the CT apparatus is moved to (or the top plate of the bed 1 is moved). In step ST206, CT imaging is performed from the scan start point to the scan end point.

  As described above, according to the first embodiment, it is possible to accurately obtain the CT imaging position using the designated area specified on the X-ray imaging image and the depth information. Conventionally, since it was assumed that the region of interest is approximately at the center of the gantry, for example, when performing CT imaging of a subject with a large physique, the height of the bed for entering the gantry differs from the height of the bed for intervention. There is a problem that the scan position is located away from the region of interest. In the present embodiment, it is possible to accurately calculate the CT imaging position, and the exposure dose is reduced accordingly.

(Second Embodiment)
In this embodiment, a radiofrequency ablation with puncture in abdominal intervention will be described as an example. FIG. 9 is an overall block diagram of the X-ray image diagnostic apparatus according to this embodiment. In the present embodiment, a puncture route planning unit 91 is added in addition to FIG. The puncture route planning unit 91 sets a puncture route for determining a route for puncturing the needle to the lesion based on a CT image (volume data) taken in advance before treatment. The puncture route information set by the puncture route planning unit 91 is sent to the region-of-interest position estimation unit 26 and used for estimating the spatial position of the region of interest. The CT imaging position calculation unit 27 calculates the CT imaging position from the estimated position of the region of interest. The image reconstruction unit 13 reconstructs a CT image captured in advance based on the calculated CT imaging position and visualizes and displays the CT scan range. The image display processing unit 24 performs data processing for displaying an X-ray image, a CT image, a puncture route, a CT scan range, and the like on the monitor unit 20.

  FIG. 10 is a flowchart showing the operation of the X-ray image diagnostic apparatus according to the present embodiment. FIG. 11 is an explanatory diagram when puncture route information is used as depth information for estimating a region of interest. The present embodiment will be described according to the flowchart of FIG. 10 with reference to FIGS.

  In step ST101, the subject P lies on the bed 1 and treatment is started. First, CT imaging is performed on the subject device P in order to confirm the lesion and plan the puncture route. Is called. The volume data collected by the X-ray detector 11 on the CT apparatus side is reconstructed by the image reconstruction unit 13 via the DAS unit 12 and then temporarily stored in an image data memory such as the storage unit 19.

  In step ST102, a puncture route is planned. When the operator presses the puncture route plan start button installed on the operation unit 18, the CT image stored in the image data memory such as the storage unit 19 is read and sent to the puncture route plan unit 91. The CT image 110 is displayed on the monitor unit 20 via the image display processing unit 24. The operator designates a lesion part to be a needle puncture start position and an end position based on a three-dimensional CT image displayed on the monitor unit 20 (two-dimensional display in the figure for the purpose of description later). When the puncture start position and the puncture end position are designated, the puncture route planning unit 91 calculates a straight line connecting two points as the puncture route 111.

  In step ST103, the imaging system of the X-ray fluoroscopic apparatus is set on the lesioned part of the subject P in order to perform puncturing. The operator performs X-ray transmission imaging and advances the puncture needle while confirming the X-ray imaging image 112. At this time, the image display processing unit 24 detects the spatial position information of the imaging system and the bed 1 at the time when the X-ray image 112 is captured, and also the spatial position information and the puncture of the CT image 110 captured in step ST102. Based on the plan information of the route 111b, the puncture route 111a and preferably a pseudo X-ray CT image in which the X-ray fluoroscopic range is reconstructed are displayed as an overlay on the X-ray image 112. The operator advances the needle along the planned puncture route 111a displayed as an overlay (for example, advances from the PS point to the PE point in FIG. 11).

  In step ST104, it is necessary to confirm whether or not the tip of the puncture needle has really reached the target lesion PE point when performing radiofrequency ablation treatment. If cauterization is performed at an incorrect location, the normal site will be damaged. Therefore, when the operator advances the puncture needle and thinks that it has reached the vicinity of the lesioned PE point, CT imaging is performed to check whether the puncture needle is in the correct position. The operator designates the needle point PE point to be confirmed as the designated area in the X-ray photographed image 112 photographed last. At this time, the position information of the designated area designated on the X-ray image 112 is sent to the region of interest position estimation unit 26.

  In step ST105, the CT imaging position calculation unit 27, from the holding arm control unit 6 and the bed control unit 16, from the holding arm 4, the spatial position information of the bed 1, and the puncture route planning unit 91, as shown in FIG. Based on the puncture route information, the intersection 113 of the puncture route 111c and the straight line 113 connecting the PE (FE1) point designated on the X-ray image 112 and the tube focus XA (if there is no intersection, The position at which the straight line is closest is set as the estimated position of the region of interest 31, and the scan center position SC6 obtained from this estimated position is calculated. Thus, by using the puncture route information as depth information, it can be assumed that the needle tip is on the puncture route. In addition, this method functions effectively in the process until the puncture needle reaches the affected part, for example, whether or not other organs are damaged at the PS point.

  In step ST106, the computed CT imaging position information is visually confirmed. For example, consider a case where the holding arm 4 supporting the imaging system advances puncture at a position in front of the subject P and designates the CT imaging position as shown in FIG. The image display processing unit 24 creates a cross-sectional image 110 in the side surface direction (longitudinal cross section) from the CT image in which the puncture route 111 is planned. At this time, based on the spatial position information of the holding arm control unit 6 and the holding arm 4 and the bed 1 obtained from the bed control unit 16, the display range of this cross-sectional image is currently being photographed by an X-ray fluoroscope. Display in line with the irradiation range. That is, the X-ray image 112 of the area surrounded by the one-dot chain line and the corresponding CT cross-sectional image 110 can be simultaneously displayed on the monitor unit 20.

  Further, the information on the straight line 113 connecting the PE (FE1) point designated on the X-ray imaging image 112 from the CT imaging position calculation unit 27 and the tube focus XA, and the puncture route 111b acquired from the puncture route planning unit 91 are overlaid. indicate. Further, based on the CT imaging position information acquired from the CT imaging position calculator 27, the calculated CT imaging positions (scan center position SC6, scan start position SS6, scan end position SE6) are displayed. Intuitive grasping is facilitated by displaying the X-ray irradiation range, puncture route information, and CT imaging position information in this manner on the monitor unit 20 in cooperation.

  In step ST107, the CT imaging position calculated by the CT imaging position calculation unit 27 is sent to the gantry control unit 9, and the gantry 8 is moved to the CT imaging position by the operation of the operator. In step ST108, the operator performs CT imaging to check whether or not the needle tip is accurately located at the lesioned part.

  As described above, according to the second embodiment, puncture route information obtained from a CT image captured in advance is used as depth information. Since it can be assumed that the needle tip is on the puncture route, it is possible to accurately calculate the three-dimensional position of the lesion, that is, the position where CT imaging is desired. In addition, since the computed CT imaging position and puncture route information are displayed on a CT image previously captured in conjunction with the X-ray irradiation range, accurate treatment can be grasped.

  According to the X-ray image diagnostic apparatus of the embodiment described above, since an accurate CT imaging position can be calculated using an X-ray imaging image, an optimal CT imaging position for reducing the exposure dose can be set.

  Although several embodiments of the present invention have been described, these embodiments are presented by way of example and are not intended to limit the scope of the invention.

  In the embodiment, the intervention treatment for hepatocellular carcinoma and the radiofrequency ablation have been described as examples. However, the applied diagnosis is not limited to these. Moreover, it is not limited to the flowchart mentioned above. Further, although an X-ray CT apparatus has been described as an example of the CT apparatus, the present invention can also be applied to an MRI (Magnetic Resonance Imaging), PET (Positron Emission Tomography) apparatus using a computer tomography technique.

  These novel embodiments can be implemented in various other forms, and various omissions, replacements, and changes can be made without departing from the scope of the invention. These embodiments and modifications thereof are included in the scope and gist of the invention, and are included in the invention described in the claims and the equivalents thereof.

1 ... sleeper,
2, 10 ... X-ray generator,
3, 11 ... X-ray detector,
4 ... holding arm,
5, 15 ... high voltage generator,
6 ... holding arm control unit,
7: Image calculation / storage unit,
8 ... Gantry,
9 ... Gantry control unit,
12 ... DAS department,
13: Image reconstruction unit,
14: Image storage unit,
16 ... Sleeper control unit,
17 ... System control unit,
18 ... operation part,
19 ... Storage section,
20 ... monitor section,
21 ... Region of interest setting section,
22 ... In-hospital network,
23. Image acquisition unit,
24. Image display processing unit,
25 ... Table part,
26 ... Region of interest position estimation unit,
27. CT imaging position calculation unit,
91 ... Puncture route planning department.

Claims (7)

An X-ray fluoroscopic apparatus including an imaging system including an X-ray generation unit that generates X-rays on a subject placed on a bed, and an X-ray detection unit disposed opposite to the X-ray generation unit; ,
A CT apparatus controlled by a coordinate system common to the X-ray fluoroscopic apparatus;
A region-of-interest setting unit that sets a designated region in the vicinity of a region of interest projected on an X-ray image captured by the imaging system;
A region-of-interest position estimation unit that estimates a spatial position of the region of interest from the depth information of the designated region and the region of interest of the subject;
An imaging position calculator that calculates the imaging position of the CT device based on the estimated position of the region of interest;
I have a,
The depth information is an X-ray diagnostic imaging apparatus that is calculated using a distance between the region of interest and a bed obtained from a CT image that has been captured and reconstructed in advance by the CT apparatus. An X-ray fluoroscopic apparatus including an imaging system including an X-ray generation unit that generates X-rays on a subject placed on a bed, and an X-ray detection unit disposed opposite to the X-ray generation unit; ,
A CT apparatus controlled by a coordinate system common to the X-ray fluoroscopic apparatus;
A region-of-interest setting unit that sets a designated region in the vicinity of a region of interest projected on an X-ray image captured by the imaging system;
A region-of-interest position estimation unit that estimates a spatial position of the region of interest from the depth information of the designated region and the region of interest of the subject;
An imaging position calculator that calculates the imaging position of the CT device based on the estimated position of the region of interest;
Have
The depth information is an X-ray diagnostic imaging apparatus that is calculated using a puncture route set in a CT image that has been previously captured and reconstructed by the CT apparatus. The region-of-interest position estimation unit is based on an intersection position or a closest position of a line segment connecting the puncture route and the designated region set in the X-ray image and the X-ray generation source of the X-ray generation unit, The X-ray diagnostic apparatus according to claim 2, wherein the depth information is calculated. The X-ray image diagnostic apparatus according to any one of claims 1 to 3, wherein an imaging position of the CT apparatus calculated by the imaging position calculation unit is displayed on an image based on the CT image. The X-ray diagnostic imaging apparatus according to claim 4, wherein the image based on the CT image is a cross-sectional image of the CT image by a plane parallel to a longitudinal direction. The X-ray diagnostic imaging apparatus according to claim 5, wherein the image based on the CT image is displayed so as to coincide with an X-ray irradiation range by the imaging system based on position information of the imaging system. The X-ray image diagnostic apparatus according to any one of claims 1 to 3 , wherein an imaging position of the CT apparatus calculated by the imaging position calculation unit is displayed on the X-ray imaging image.

Images