JP6529750B2 - Medical diagnostic imaging system - Google Patents

Description

  Embodiments of the present invention relate to a medical diagnostic imaging apparatus.

  The X-ray diagnostic apparatus supports observation of the positional relationship between a blood vessel and a stent or the like by an operator such as a doctor by imaging a subject during treatment in a blood vessel, for example. During such intravascular treatment, the X-ray diagnostic apparatus emits X-rays to a specific region of the subject from a specific direction for a relatively long time.

  For this reason, there is a DTS (Dose Tracking System) that manages an X-ray dose to which the surface of a subject is exposed as a skin exposure dose at the time of X-ray imaging with an X-ray diagnostic apparatus. For example, the DTS calculates the exposure dose of the subject from the irradiation condition by the X-ray diagnostic apparatus. Then, the DTS generates a pseudo human body model based on the body information of the subject, and displays an exposure image in which the exposure amount is associated with the generated human body model on the monitor. However, in the above-mentioned prior art, there were cases where it was difficult to grasp the state of exposure regarding a predetermined organ.

JP, 2000-152924, A

  The problem to be solved by the present invention is to provide a medical image diagnostic apparatus capable of easily grasping the state of exposure regarding a predetermined organ.

  The medical image diagnostic apparatus according to the embodiment includes an acquisition unit, a determination unit, and a notification unit. The acquisition unit acquires three-dimensional position information of a predetermined organ in a subject. The determination unit determines, based on the position information, whether or not the predetermined organ is present in the irradiation direction of the X-ray in the procedure in which the X-ray is irradiated to the subject. The notification unit notifies, when it is determined that the predetermined organ is present in the irradiation direction of the X-ray, information on exposure information of the predetermined organ.

FIG. 1 is a diagram showing an example of the configuration of a medical information processing system according to the first embodiment. FIG. 2 is a diagram showing an example of the configuration of the DTS according to the first embodiment. FIG. 3 is a view showing an example of a dose image generated by the data generation unit according to the first embodiment. FIG. 4 is a diagram showing an example of the configuration of the X-ray diagnostic apparatus according to the first embodiment. FIG. 5 is a diagram for explaining an example of organ specification according to the first embodiment. FIG. 6 is a diagram illustrating an example of notification information notified by the notification unit according to the first embodiment. FIG. 7 is a diagram illustrating an example of notification information notified by the notification unit according to the first embodiment. FIG. 8 is a diagram illustrating an example of notification information notified by the notification unit according to the first embodiment. FIG. 9A is a diagram showing an example of notification information notified by the notification unit according to the first embodiment. FIG. 9B is a diagram showing an example of notification information notified by the notification unit according to the first embodiment. FIG. 10 is a diagram showing an example of numerical value information displayed on the display unit according to the first embodiment. FIG. 11 is a flowchart showing the procedure of processing by the X-ray diagnostic apparatus according to the first embodiment. FIG. 12 is a diagram for explaining an example of the allowable exposure dose of the organ according to the second embodiment. FIG. 13 is a diagram illustrating an example of notification information notified by the notification unit according to the second embodiment. FIG. 14A is a diagram showing an example of information on the remaining exposure amount notified by the notification unit according to the second embodiment. FIG. 14B is a diagram showing an example of remaining exposure dose information notified by the notification unit according to the second embodiment. FIG. 15 is a flowchart showing the procedure of processing by the X-ray diagnostic apparatus according to the second embodiment.

  Hereinafter, a medical image diagnostic apparatus according to an embodiment will be described with reference to the attached drawings. Although a medical information processing system including an X-ray diagnostic apparatus as a medical image diagnostic apparatus and a DTS will be described below as an example, the embodiment is not limited to this.

First Embodiment
First, the configuration of the medical information processing system according to the first embodiment will be described. FIG. 1 is a diagram showing an example of the configuration of the medical information processing system 1 according to the first embodiment. As shown in FIG. 1, the medical information processing system 1 according to the first embodiment includes an X-ray diagnostic apparatus 100, a DTS (Dose Tracking System) 200, and an image storage apparatus 300. The respective devices illustrated in FIG. 1 can communicate with each other directly or indirectly by, for example, an in-hospital LAN (Local Area Network) installed in a hospital. For example, PACS (Picture Archiving and Communication System) is introduced into the medical information processing system 1, and each device mutually transmits and receives an X-ray image and an exposure image according to the DICOM (Digital Imaging and Communications in Medicine) standard. Do.

  The medical information processing system 1 shown in FIG. 1 is merely an example, and various other devices may be connected to the network. For example, a terminal device that acquires an image from the image storage device 300 based on an instruction operation by a user such as a doctor (operator) and displays various images with various general-purpose viewers or dedicated viewers, X-rays A medical information processing apparatus that performs various types of image processing on an X-ray image acquired by the diagnostic apparatus 100 and an exposure image generated by the DTS 200 may be connected. In addition, another modality such as an X-ray CT (Computed Tomography) apparatus may be connected to the network.

  The image storage apparatus 300 stores the X-ray image received from the X-ray diagnostic apparatus 100 and the exposure image received from the DTS 200. The DTS 200 generates information on the dose to which the subject is exposed by the X-ray irradiation of the X-ray diagnostic apparatus 100. Specifically, the DTS 200 is exposed based on the control information of the C-arm 15 and the top 14 during the procedure received from the X-ray diagnostic apparatus 100 and the information such as the X-ray dose irradiated to the subject. Generate information such as quantitative images. FIG. 2 is a diagram showing an example of the configuration of the DTS 200 according to the first embodiment. As shown in FIG. 2, for example, the DTS 200 includes an input unit 210, a display unit 220, a human body model generation unit 230, and a data generation unit 240.

  The input unit 210 receives various instructions from the operator who manages the dose to which the subject P is exposed. For example, the input unit 210 receives an instruction to display information such as a dose image from the operator. The display unit 220 is, for example, a monitor, and displays the exposure image generated by the data generation unit 240.

  The human body model generation unit 230 is a human body model of the subject P or a diagnosis target site based on personal information (sex, age, height, weight, rough systematic classification, etc.) of the subject P input from the input unit 210. Generate The human body model generation unit 230 may generate a human body model that approximately represents the subject P or the like by an ellipse, a sphere, or the like, or may generate a human body model that faithfully represents the human body or the like. In addition, the human body model generation unit 230 automatically selects a profile closest to the subject P from a plurality of human body tomographic profiles based on the physical information of the subject P, and uses the selected profile for the whole body. Generate a human model of

  The data generation unit 240 calculates the exposure dose based on the human body model generated by the human body model creation unit 230 and the information received from the X-ray diagnostic apparatus 100, and shows the distribution of the exposure dose of the subject P. Generate a quantitative image. For example, the data generation unit 240 may receive the X-ray dose received from the X-ray diagnostic apparatus 100, the position of the C-arm 15, the position of the top 14, the SID (Source Image Distance), the X-ray tube 12 and the X-ray detector 16 The exposure dose for each pixel of the human body model is calculated based on the angle between the axis connecting the two and the body axis of the subject P or an arbitrary reference axis, or the like to generate an exposure dose image.

  FIG. 3 is a view showing an example of a dose image generated by the data generation unit 240 according to the first embodiment. For example, as illustrated in FIG. 3, the data generation unit 240 generates an exposure image that indicates the distribution of exposure for each pixel of the human body model in the region R1. Here, as shown in FIG. 3, the data generation unit 240 generates an exposure image showing the exposure dose of the beam 30 indicating the irradiation position of the X-ray to the subject P at the present time and the position irradiated with the X-ray. . That is, the data generation unit 240 changes the position of the beam 30 according to the change of the position of the C-arm 15 and the position of the top 14, etc., while showing the exposure condition at the position irradiated with X-rays. Generate a quantitative image. For example, as illustrated in FIG. 3, the data generation unit 240 generates a dose image in which the color bar is shown in the region R2 and the difference in the dose is shown in color. As an example, the data generation unit 240 sets a color bar that changes from blue to red as the exposure dose increases, and indicates the exposure dose for each pixel by color. In such a case, in the exposure image, an area to which the exposure dose is increased due to X-ray irradiation during the procedure gradually changes to red.

  In addition, the data generation unit 240 generates an exposure image in which the value of the current exposure dose and the value of the total amount (time integral value) of the exposure dose are shown in the region R3. Here, while receiving the information from the X-ray diagnostic apparatus 100, the data generation unit 240 continuously generates the exposure image described above. For example, while receiving information from the X-ray diagnostic apparatus 100, the data generation unit 240 generates an exposure image at a frame rate of 30 frames / second in real time. Then, the data generation unit 240 transmits the exposure dose image to the X-ray diagnostic apparatus 100 or the like in real time each time it is generated.

  While performing various procedures, the X-ray diagnostic apparatus 100 receives an exposure image from the DTS 200 and displays the image on a monitor, thereby allowing the operator performing the procedure to grasp the state of the skin exposure. Here, as described above, the exposure image received from the DTS 200 is information on the exposure of the skin of the subject P and does not include information on various organs. However, there is also a need to manage the state of exposure in order to reduce organ damage, even for organs sensitive to X-rays, such as the lens, thyroid gland and genital organs. Therefore, the X-ray diagnostic apparatus 100 according to the present application can manage the exposure of organs by outputting the exposure information of various organs, and can easily grasp the exposure situation of various organs.

  In the first embodiment, an example in which exposure information of an organ is determined using information generated by the DTS 200 and radiation information is output will be described. FIG. 4 is a diagram showing an example of the configuration of the X-ray diagnostic apparatus 100 according to the first embodiment. As shown in FIG. 4, the X-ray diagnostic apparatus 100 according to the first embodiment includes an apparatus main body 110 and an operation terminal 120. As shown in FIG. 4, the device body 110 includes a high voltage generator 11, an X-ray tube 12, an X-ray diaphragm device 13, a top plate 14, a C-arm 15, an X-ray detector 16, and C. The arm rotation / movement mechanism 17, the top moving mechanism 18, the C-arm / top mechanism control unit 19, and the aperture control unit 20 are disposed, for example, in a procedure room where various procedures are performed. Here, in the procedure room, the display unit 23a to be observed by the operator performing the procedure is disposed.

  As shown in FIG. 4, the operation terminal 120 includes a system control unit 21, an input unit 22, a display unit 23b, an image data generation unit 24, an image data storage unit 25, and an image processing unit 26. For example, it is disposed in an operation room for performing various operations. Here, the DTS 200 is also disposed in the operation room, and the operator operates the X-ray diagnostic apparatus 100 and also operates the DTS 200 based on an instruction of the operator.

  The high voltage generator 11 generates a high voltage under the control of the system control unit 21 and supplies the generated high voltage to the X-ray tube 12. The X-ray tube 12 generates X-rays using the high voltage supplied from the high voltage generator 11.

  The X-ray diaphragm apparatus 13 narrows down the X-ray generated by the X-ray tube 12 so that the region of interest of the subject P is selectively irradiated under the control of the diaphragm control unit 20. For example, the X-ray diaphragm device 13 has four slidable diaphragm blades. Under the control of the diaphragm control unit 20, the X-ray diaphragm device 13 slides these diaphragm blades to narrow down the X-ray generated by the X-ray tube 12 and irradiate the object P with the X-ray. Incidentally, the X-ray tube 12 and the X-ray stop device 13 are collectively referred to as an X-ray tube device. The top 14 is a bed on which the subject P is placed, and is disposed on a bed (not shown). The subject P is not included in the apparatus main body 110.

  The X-ray detector 16 detects X-rays transmitted through the subject P. For example, the X-ray detector 16 has detection elements arranged in a matrix. Each detection element converts the X-rays transmitted through the subject P into an electrical signal and accumulates the signal, and transmits the accumulated electrical signal to the image data generation unit 24.

  The C-arm 15 holds the X-ray tube 12, the X-ray iris 13 and the X-ray detector 16. The X-ray tube 12 and the X-ray stop device 13 and the X-ray detector 16 are disposed to face each other across the subject P by the C-arm 15.

  The C-arm rotation and movement mechanism 17 is a mechanism for rotating and moving the C-arm 15, and the top moving mechanism 18 is a mechanism for moving the top 14. The C arm / top mechanism control unit 19 controls the C arm rotation / moving mechanism 17 and the top plate moving mechanism 18 under the control of the system control unit 21 to rotate or move the C arm 15, or the top plate 14. Adjust the movement of The diaphragm control unit 20 controls the irradiation range of the X-ray irradiated to the subject P by adjusting the opening degree of the diaphragm blade of the X-ray diaphragm device 13 under the control of the system control unit 21. .

  The image data generation unit 24 generates image data using the electrical signal converted from the X-ray by the X-ray detector 16, and stores the generated image data in the image data storage unit 25. For example, the image data generation unit 24 performs current-voltage conversion, A (Analog) / D (Digital) conversion, parallel-serial conversion on the electrical signal received from the X-ray detector 16 to generate image data. Do.

  Then, the image data generation unit 24 generates an X-ray image from the generated image data, and stores the generated X-ray image in the image data storage unit 25. The image data storage unit 25 stores the image data generated by the image data generation unit 24.

  The image processing unit 26 performs various image processing on the image data stored in the image data storage unit 25. For example, the image processing unit 26 generates a moving image by processing a plurality of X-ray images in time series stored in the image data storage unit 25.

  The input unit 22 receives various instructions from the operator. For example, the input unit 22 includes a mouse, a keyboard, a button, a trackball, a joystick, and the like. The input unit 22 transfers the instruction received from the operator to the system control unit 21.

  The display unit 23a and the display unit 23b display a graphical user interface (GUI) for receiving an instruction of the operator, image data stored in the image data storage unit 25, and the like. For example, the display unit 23a is an examination room display, and the display unit 23b is an operation room display. The display unit 23a and the display unit 23b may each have a plurality of displays. For example, the display unit 23a and the display unit 23b display real-time fluoroscopic images, exposure dose images generated by the DTS 200, exposure information of predetermined organs, and the like.

  The system control unit 21 controls the overall operation of the X-ray diagnostic apparatus 100. For example, the system control unit 21 controls the high voltage generator 11 according to the instruction of the operator transferred from the input unit 22 and adjusts the voltage supplied to the X-ray tube 12 to irradiate the subject Control X-ray dose and ON / OFF. Further, for example, the system control unit 21 controls the C-arm / top mechanism control unit 19 according to the instruction of the operator, and adjusts the rotation and movement of the C-arm 15 and the movement of the top 14. Further, for example, the system control unit 21 controls the aperture control unit 20 according to the instruction of the operator, and adjusts the opening degree of the aperture blade of the X-ray aperture device 13 to irradiate X with the subject. Control the irradiation range of the line.

  In addition, the system control unit 21 controls image data generation processing by the image data generation unit 24, image processing by the image processing unit 26, analysis processing, and the like according to an instruction of the operator. Further, the system control unit 21 controls to display a GUI for receiving an instruction of the operator, an image stored in the image data storage unit 25 and the like on the displays of the display unit 23a and the display unit 23b. In addition, the system control unit 21 communicates with the DTS 200, and transmits to the DTS 200, in real time, information such as control information of the C arm 15 and the top 14 during the procedure and X dose irradiated to the subject P. Do. In addition, the system control unit 21 communicates with the image storage device 300, and transmits an X-ray image captured by the device main body 110.

  Here, as shown in FIG. 4, the system control unit 21 according to the first embodiment includes an acquisition unit 21 a, a determination unit 21 b, and a notification unit 21 c, and uses information generated by the DTS 200. Report the exposure information of a given organ. Specifically, the system control unit 21 notifies the exposure information of the organ designated by the operator. Here, the system control unit 21 reports exposure information on an organ including at least one of a lens, a thyroid, a bone marrow, a testis and an ovary as a predetermined organ. FIG. 5 is a diagram for explaining an example of organ specification according to the first embodiment. For example, when the subject P is placed on the tabletop and diagnosis or treatment is started, the system control unit 21 causes the display unit 23a and the display unit 23b to display a GUI for organ designation shown in FIG. Then, the system control unit 21 notifies, via the input unit 22, the exposure information of the organ designated by the operator.

  For example, as shown in FIG. 5, the system control unit 21 causes the display unit 23a and the display unit 23b to display a GUI for specifying an organ, and the "lens", "thyroid", "bone marrow", "testis", When the "lens" is checked in the check boxes corresponding to the organs such as "ovary" and "small intestine", the information generated by the DTS 200 is used to notify the exposure information of the "lens". Note that the target organ is not only specified by the operator as described above, but may be, for example, preset for each procedure. In such a case, the system control unit 21 refers to the information set in advance to determine the target organ.

  As described above, when the target organ is designated, the acquisition unit 21a of the system control unit 21 acquires three-dimensional positional information of the organ in the subject. For example, the acquiring unit 21a acquires the human body model of the subject P generated by the DTS 200 and the position information of the subject P on the top 14 to obtain three-dimensional position information of the organ relative to the top 14 get. As an example, first, the acquiring unit 21a acquires position information on the top 14 of the subject P by acquiring the distance from the position of the top of the top 14 to the top of the head of the subject P. The distance from the position of the top of the top 14 to the top of the head of the subject P may be measured by a measuring instrument provided with a light emitting unit and a light receiving unit, or may be measured manually.

  When the position information of the subject P on the top 14 is acquired, the acquiring unit 21a specifies the position of the human body model with respect to the top 14 by arranging the human body model at the position of the subject P. The human body model is generated based on personal information of the subject P, and has three-dimensional positional information of each organ in the subject P. Therefore, by specifying the position of the human body model with respect to the top 14, it is possible to specify the three-dimensional position of each organ with respect to the top 14. When the acquisition unit 21a specifies the position of the human body model with respect to the top 14 as described above, the acquisition unit 21a sends three-dimensional positional information of a designated organ (for example, a lens) to the top 14 to the determination unit 21b. In the example described above, the case where the positional information of the subject P on the top 14 is obtained by obtaining the distance from the position of the top of the top 14 to the top of the head of the subject P has been described. The embodiment is not limited to this, and any method may be used as long as the method can acquire position information on the top 14 of the subject P.

  Based on the position information acquired by the acquisition unit 21a, the determination unit 21b determines whether or not there is a predetermined organ in the irradiation direction of the X-ray in the procedure in which the object P is irradiated with the X-ray. Specifically, the determination unit 21b determines whether or not the geometrical arrangement is such that a predetermined organ is located between the X-ray tube 12 and the X-ray detector 16. For example, the determination unit 21 b arranges the lens between the X-ray tube 12 and the X-ray detector 16 from the three-dimensional position information of the lens with respect to the top 14 and the position information of the C arm 15 with respect to the top 14 It is judged whether it is done or not. Here, the determination unit 21 b continuously acquires the positional information of the C-arm 15 during the procedure and determines whether the crystalline lens is between the X-ray tube 12 and the X-ray detector 16. The position information of the C-arm 15 may be acquired each time the C-arm 15 moves.

  Here, the determination unit 21b is configured to position a predetermined organ between the X-ray tube 12 and the X-ray detector 16 not only while X-rays are being irradiated from the X-ray tube 12 but also when not being irradiated. It is determined whether or not it is in the geometrical arrangement to be performed. That is, from the start of the procedure to the end of the procedure, the determination unit 21b does not emit X-rays based on the position of the X-ray tube 12 that emits X-rays and the position of a predetermined organ based on the position information. It is determined whether or not there is a predetermined organ in the irradiation direction of X-rays at the time and irradiation. Then, the determination unit 21b sends the determination result to the notification unit 21c. For example, the determination unit 21b sends the determination result on the crystalline lens to the notification unit 21c.

  When it is determined that the predetermined organ is present in the X-ray irradiation direction, the notification unit 21 c notifies the exposure information of the predetermined organ. Specifically, when the notification unit 21c has a geometrical arrangement in which a predetermined organ is located between the X-ray tube 12 and the X-ray detector 16, the notification unit 21c notifies the exposure information. Here, even when it is determined that the predetermined organ is present in the irradiation direction of the X-ray when the X-ray is not irradiated, the notification unit 21 c notifies the exposure information of the predetermined organ. For example, the notification unit 21c notifies, as exposure information, at least one of warning information indicating that a predetermined organ is present in the X-ray irradiation direction, and numerical information indicating an exposure dose of the predetermined organ.

  FIG. 6 is a diagram illustrating an example of notification information notified by the notification unit 21c according to the first embodiment. For example, as illustrated in FIG. 6, when the determining unit 21b determines that the lens is present in the X-ray irradiation direction, the notification unit 21c emphasizes the lens of the human body model in the exposure image generated by the DTS 200. Display on the display unit 23a and the display unit 23b. That is, as illustrated in FIG. 6, the notification unit 21 c highlights and displays the crystalline lens when the crystalline lens is present in the direction of the beam 30 in the dose image.

  Here, the notification unit 21 c not only highlights the crystalline lens, but also emphasizes a pixel at a position corresponding to the crystalline lens on the display surface. That is, as shown in the human body model on the left side of FIG. 6, the notification unit 21 c highlights the pixels at the position corresponding to the crystalline body even in the human body model facing backward in the depth direction of the display surface. The human body model of the exposure image can be manipulated freely, and is oriented to be easy to observe by the procedure. Therefore, the notification unit 21c highlights the pixel at the position corresponding to the organ so that the highlighted display of the organ can be observed regardless of the orientation of the human body model.

  For example, when the operator who is performing a procedure referring to the exposure dose image displayed on the display unit 23a highlights the display when the C-arm 15 is moved to the irradiation position without irradiating the X-ray It can be understood that X-rays are irradiated to the crystalline lens. In addition, when the crystalline lens is highlighted in the state of being irradiated with X-rays, the operator can grasp that the crystalline body is being irradiated with X-rays. Thereby, the operator can reduce the exposure dose of the lens by moving the C-arm 15 to a position where the X-ray is not irradiated to the lens.

  In addition to emphasizing and displaying the target organ on the human body model, the notification unit 21c can also notify the exposure information by other information. For example, in the case of a small organ such as a lens, it may be difficult for the operator to notice even if the position on the human body model is emphasized. Therefore, the notification unit 21c displays various information in the exposure dose image. FIG. 7 is a diagram illustrating an example of notification information notified by the notification unit according to the first embodiment. For example, as illustrated in (A) of FIG. 7, the notification unit 21 c causes the beam 30 to be displayed in a normal color (for example, white or the like) when there is no lens in the X-ray irradiation direction. Here, for example, when the C-arm 15 and the top plate 14 are moved and the lens enters in the X-ray irradiation direction, the notification unit 21c, as shown in (B) of FIG. By changing (for example, changing from white to yellow), the operator is informed that the X-ray is being irradiated (or being irradiated) to the lens.

  Further, when the crystal enters in the irradiation direction of the X-ray, the notification unit 21c displays a warning display "ALERT" 31 on the exposure dose image as shown in FIG. Thereby, the operator can grasp that the organ (for example, the lens) designated by the operator is in the X-ray irradiation direction. Here, the notification unit 21c can use voice information as the warning information in addition to the above-described warning display. For example, when the crystal enters in the irradiation direction of the X-ray, the notification unit 21c indicates audio information (for example, a warning sound, a sound notifying that the X-ray is irradiated to the target organ, etc.) Output

  Furthermore, when the organ is in the X-ray irradiation direction, the notification unit 21 c not only highlights and displays the organ of the human body model of the exposure image described above, but also enlarges and highlights the target organ. Is also possible. FIG. 8 is a diagram illustrating an example of the exposure information notified by the notification unit 21c according to the first embodiment. For example, as illustrated in FIG. 8, the notification unit 21 c generates a model in which the head including the lens that is the target organ is enlarged, and highlights and displays the generated lens of the model. In such a case, for example, the notification unit 21c receives specification information of the target organ, generates a model based on the specification information, and highlights and displays the target organ based on the determination result of the determination unit 21b. . Here, the enlarged model shown in FIG. 8 may be displayed in the exposure image, or may be displayed in a window different from the exposure image.

  In addition, the notification unit 21c can notify that the target organ is in the X-ray irradiation direction by various other display information. FIG. 9A and FIG. 9B are diagrams showing an example of the exposure information notified by the notification unit 21c according to the first embodiment. For example, when the crystalline lens is in the X-ray irradiation direction, the notification unit 21c causes the radiation image to display the character “crystalline lens” 32 and the pictogram 33 indicating the crystalline lens, as illustrated in FIG. 9A. That is, when the C-arm 15 and the top plate 14 are moved and the lens enters in the irradiation direction of the X-ray, the notification unit 21c causes the characters “lens” 32 and the pictogram 33 to be displayed on the dose image.

  In addition, as illustrated in FIG. 9B, the notification unit 21c can also display character information on a plurality of organs and emphasize and display the organs that have entered the X-ray irradiation direction. For example, as illustrated in FIG. 9B, the notification unit 21c causes the characters “lens”, “thyroid”, “bone marrow”, “testis”, and “ovary” to be displayed on the exposure dose image, and in the irradiation direction of X-rays. Emphasize and display the letter "Glass" entered. The notification information shown in FIGS. 9A and 9B can accurately notify, for example, whether or not the target organ is in the irradiation direction of the X-ray for each designated organ when a plurality of target organs are designated.

  Furthermore, the notification unit 21c can also display numerical information indicating the exposure dose of a predetermined organ. Here, the notification unit 21c displays numerical information indicating the exposure dose of the predetermined organ separately from the numerical information indicating the exposure dose of the skin. As described above, the exposure image includes, for example, the value of the exposure dose of the skin, and is displayed on the display unit 23a and the display unit 23b. Therefore, the notification unit 21c causes the display unit 23a and the display unit 23b to display the value of the radiation dose of the organ separately from the value of the radiation dose of the skin included in the radiation dose image.

  FIG. 10 is a diagram showing an example of numerical value information displayed on the display unit 23a and the display unit 23b according to the first embodiment. For example, as shown in FIG. 10, the display unit 23a and the display unit 23b display a region 34 for displaying the value of the radiation dose of the skin and a region 35 for displaying the value of the radiation dose of the organ. Here, in the region 34, for example, "Peak Skin Dose: ... mGy" indicating the maximum value of the total exposure in the whole body, and "FOV Peak Skin Dose:... Indicating the maximum value of the total exposure in the FOV.・ ・ “MGy” etc. are displayed.

  On the other hand, in the area 35, for example, the value “Peak Dose:... MGy,... MSv” of the total exposure dose of the target organ is displayed. Here, when the display unit 23a and the display unit 23b display the exposure dose of the organ, as shown in FIG. 10, in addition to the gray (in the figure, milli gray: mGy) indicating the absorbed dose of X-ray A sievert (in the figure, millisievert: mSV) showing the magnitude (dose equivalent) of the biological effect is displayed. In such a case, the notification unit 21c calculates the dose equivalent by multiplying the gray value by the coefficient for each target organ, and causes the display unit 23a and the display unit 23b to display the dose equivalent. Thereby, the operator can grasp the exposure situation of various organs having different sensitivities to X-rays in consideration of biological effects.

  Next, processing by the X-ray diagnostic apparatus 100 according to the first embodiment will be described using FIG. FIG. 11 is a flowchart showing the procedure of processing by the X-ray diagnostic apparatus 100 according to the first embodiment. In the X-ray diagnostic apparatus 100 according to the first embodiment, as shown in FIG. 11, when the procedure is started (Yes at step S101), the input unit 22 designates an organ to be a target of exposure dose management. It receives (step S102).

  When the input unit 22 receives designation of an organ, the acquisition unit 21a acquires position information of the designated organ (step S103). For example, the acquiring unit 21a specifies the three-dimensional position of the designated organ with respect to the top 14 from the human body model generated by the DTS 200 and the position information of the subject relative to the top 14. Then, the determination unit 21b determines whether or not there is an organ designated in the X-ray irradiation direction from the positions of the C-arm 15 and the top 14 and the position information of the designated organ (step S104). .

  Here, when the designated organ is in the X-ray irradiation direction (Yes at step S104), the notification unit 21c indicates warning information (notification information) indicating that the designated organ is in the X-ray irradiation direction. Is notified (step S105), and it is determined whether or not the procedure has ended (step S106). On the other hand, when the designated organ is not in the X-ray irradiation direction (No at Step S104), the notification unit 21c proceeds to Step S106, and determines whether the procedure is completed (Step S106). The determination unit 21b and the notification unit 21c continue the processing from step S104 to step S106 until the procedure ends, and ends the process when the procedure ends (Yes at step S106). Here, even in the report output after the end of the procedure, the exposure information on the skin and the exposure information on the organ are separately output.

  As described above, according to the first embodiment, the acquiring unit 21a acquires three-dimensional positional information of a predetermined organ in a subject. Based on the position information, the determination unit 21b determines whether or not a predetermined organ is present in the X-ray irradiation direction in the procedure in which the subject P is irradiated with the X-rays. When it is determined that the predetermined organ is present in the X-ray irradiation direction, the notification unit 21 c notifies the exposure information of the predetermined organ. Therefore, the X-ray diagnostic apparatus 100 according to the first embodiment can provide the exposure information for each organ, and can easily grasp the exposure situation of a predetermined organ. As a result, the X-ray diagnostic apparatus 100 can reduce the dose of an organ sensitive to X-rays to suppress the occurrence of organ damage. In addition, the X-ray diagnostic apparatus 100 can easily notice that X-rays are being irradiated even in a small important organ.

  Further, according to the first embodiment, the determination unit 21b determines the position of an X-ray generation unit (such as the X-ray tube 12) that emits X-rays in the procedure and the position of a predetermined organ based on the position information. When the X-ray is not irradiated, it is determined whether or not there is a predetermined organ in the X-ray irradiation direction. When it is determined that the predetermined organ is present in the irradiation direction of the X-ray when the X-ray is not irradiated, the notification unit 21c notifies the exposure information of the predetermined organ. Therefore, the X-ray diagnostic apparatus 100 according to the first embodiment can suppress unnecessary exposure of a predetermined organ, and can minimize the exposure of the organ.

  Further, according to the first embodiment, the notification unit 21 c includes, as the exposure information, warning information indicating that a predetermined organ is present in the X-ray irradiation direction, and numerical information indicating an exposure dose of the predetermined organ. Report at least one of them. Therefore, the X-ray diagnostic apparatus 100 according to the first embodiment can notify that the organ of interest is irradiated (or irradiated) with X-rays or the degree of exposure, Allows you to easily grasp the situation.

  Further, according to the first embodiment, the notification unit 21 c notifies at least one of display information indicating that a predetermined organ is present in the X-ray irradiation direction and sound information as the warning information. Therefore, the X-ray diagnostic apparatus 100 according to the first embodiment makes it easy to notice that a predetermined organ is present in the X-ray irradiation direction.

  Further, according to the first embodiment, the notification unit 21c displays, as display information, character information indicating a predetermined organ, the position of the predetermined organ on the model indicating the object P, and a model obtained by enlarging the predetermined organ. Highlight at least one of them. Therefore, the X-ray diagnostic apparatus 100 according to the first embodiment makes it possible to easily identify an organ that has entered the X-ray irradiation direction.

  Further, according to the first embodiment, the notification unit 21 c further notifies the exposure information of the skin of the subject P in addition to the exposure information of the predetermined organ. Therefore, the X-ray diagnostic apparatus 100 according to the first embodiment makes it possible to grasp the exposure condition of the skin in addition to the exposure of the organ.

  Further, according to the first embodiment, the predetermined organ to which the exposure information is notified includes at least one of a lens, a thyroid, a bone marrow, a testis and an ovary. Therefore, the X-ray diagnostic apparatus 100 according to the first embodiment makes it possible to report exposure information to an organ sensitive to X-rays.

Second Embodiment
In 1st Embodiment, the case where alerting | reporting information was alert | reported by whether the target organ exists in the irradiation direction of X-ray was demonstrated. In the second embodiment, an allowable value of exposure is set for each organ, and an example in which notification is given when the allowable value is exceeded will be described. In the X-ray diagnostic apparatus 100 according to the second embodiment, the processing contents of the determination unit 21 b and the notification unit 21 c are different. These will be mainly described below.

  The determination unit 21b according to the second embodiment further determines whether or not the exposure dose of the predetermined organ reaches the exposure tolerance of the predetermined organ at the time of X-ray irradiation. Here, first, the allowable dose in the organ will be described with reference to FIG. FIG. 12 is a diagram for explaining an example of the allowable exposure dose of the organ according to the second embodiment. For example, as shown in FIG. 12, the allowable dose of an organ is “total dose (Gy)”, “multiple / continuous” in “one short exposure” for each tissue (organ) and each effect. For example, there is an allowance "total dose (Gy)" in the case of "exposure", and "an annual dose rate in many years (Gy / year)" in the "many doses / continuous exposure".

  Here, “one short exposure” shown in FIG. 12 indicates exposure by one procedure, and “multiple / continuous exposure” indicates exposure by multiple procedures received in a predetermined period. , “Multiple annual / Continuous exposure” indicates annual exposure. Note that, in FIG. 12, the exposure allowable amount is set in gray (Gy), but may be set in seabelt (Sv).

  For example, in the case of a crystalline lens, as shown in FIG. 12, there are “diagnostic cloudiness” and “visual acuity disorder (cataract)” as the influence by X-ray, and the exposure dose in each period until reaching each condition The capacity is set. These allowances are set, for example, to values lower than the exposure dose estimated to have an influence as illustrated in each organ. That is, the determination unit 21b determines whether the exposure dose of the designated organ reaches the exposure tolerance with reference to the exposure tolerance as shown in FIG.

  Here, the determination unit 21b performs determination using not only the allowable dose for one procedure but also the allowable dose for a predetermined period. That is, the determination unit 21b calculates the cumulative value of the dose of the predetermined organ in a predetermined period, and determines whether the calculated cumulative value reaches the allowable dose in the predetermined period. In such a case, the determination unit 21b acquires information of the past exposure dose for the designated organ, accumulates the present exposure dose to the acquired past exposure dose, and the cumulative value reaches the exposure tolerance amount. It is determined whether or not. Here, the determination unit 21 b calculates not only the exposure dose by the X-ray diagnostic apparatus 100 but also the exposure dose by the X-ray CT apparatus or the like as the information of the past dose, and calculates the cumulative value.

  The notification unit 21c according to the second embodiment notifies the exposure information that the exposure dose of the predetermined organ reaches the exposure tolerance when it is determined that the exposure dose of the predetermined organ reaches the exposure tolerance. . In addition, when it is determined that the cumulative value of the exposure reaches the exposure tolerance in the predetermined period, the notification unit 21c notifies the exposure information that the exposure dose in the predetermined period of the predetermined organ reaches the exposure tolerance. Do. FIG. 13 is a diagram illustrating an example of notification information notified by the notification unit 21c according to the second embodiment.

  For example, in the case of determination of the exposure dose in one procedure, when the lens is designated as the target organ and the procedure is started, the determination unit 21b determines the exposure dose of the lens in one procedure (for example, FIG. It is determined whether or not the exposure dose of the lens after the procedure is started reaches the exposure tolerance amount with reference to “the value of“ one-time short exposure ”shown in 12). Here, as shown in (A) of FIG. 13, while it is determined in the determination by the determination unit 21 b that the exposure dose of the lens after the start of the procedure has not reached the allowable exposure dose, as shown in FIG. 21c continues the state where the notification information is not notified.

  Then, when it is determined in the determination by the determination unit 21b that the exposure dose of the lens after the start of the procedure has reached the exposure allowable amount, the notification unit 21c is, for example, as illustrated in FIG. , Change the color of the beam 30, or display a warning display "ALERT" 31. The notification information illustrated in FIG. 13 is merely an example, and the notification unit 21c can appropriately notify the notification information described in the first embodiment.

  Also, for example, in the case of determination of the exposure allowable amount in a predetermined period, when the lens is designated as the target organ and the procedure is started, the determination unit 21b determines the dose of the previous lens contained in the predetermined period. get. Then, the determination unit 21b refers to the allowable exposure amount of the lens in a predetermined period (for example, the value of “multiple / continuous exposure” or “multiple times / continuous exposure” shown in FIG. 12), the past. It is determined whether the cumulative value of the exposure dose of the lens and the exposure dose of the lens after the procedure is started reaches the exposure tolerance. Here, while the determination by the determination unit 21 b determines that the cumulative value has not reached the exposure allowable amount, as illustrated in (A) of FIG. 13, the notification unit 21 c does not notify the notification information. To continue.

  Then, if it is determined in the determination by the determination unit 21b that the cumulative value has reached the exposure allowable amount, the notification unit 21c changes the color of the beam 30, for example, as illustrated in (B) of FIG. Or displays a warning display "ALERT" 31. The notification unit 21 c can appropriately notify the notification information described in the first embodiment, as in the above-described example.

  As described above, since the X-ray diagnostic apparatus 100 according to the second embodiment does not notify notification information until reaching the allowable exposure dose, the operator can concentrate on the procedure. For example, when notification information is notified each time a designated organ enters the X-ray irradiation direction, the operator may be distracted and may not be able to concentrate on the procedure. The X-ray diagnostic apparatus 100 according to the second embodiment can avoid the occurrence of such a situation and concentrate the operator on the procedure.

  Furthermore, the X-ray diagnostic apparatus 100 according to the second embodiment can also present the remaining allowable amount to the operator. In such a case, the determination unit 21b calculates, for each of the predetermined organs, the remaining exposure dose until the exposure tolerance amount of the predetermined organ is reached. Then, the notification unit 21c notifies the remaining exposure dose for each predetermined organ calculated by the determination unit 21b. For example, the notification unit 21c notifies the remaining exposure dose by at least one of a graph showing the allowable remaining dose, the ratio of the current exposure dose to the allowable exposure dose, and the allowable exposure dose and the current exposure dose. Do.

  FIG. 14: A and 14B is a figure which shows an example of the information of the remaining exposure dose alert | reported by the alerting | reporting part 21c which concerns on 2nd Embodiment. For example, as shown in FIG. 14A, when displaying the numerical information of the exposure of the skin and the numerical information of the exposure of the target organ, the notification unit 21c displays the area 35 of the numerical information of the exposure of the organ. The remaining exposure dose "remain: ... mGy, ... mSv" is displayed. Also, for example, as illustrated in FIG. 14A, the notification unit 21c is a ratio (%) of the value “Peak Dose:... MGy,... MSv” to the value of the allowable exposure amount for the target organ, as shown in FIG. 14A. Is displayed.

  Further, as illustrated in FIG. 14B, the notification unit 21c causes the display unit 23a and the display unit 23b to display a graph in which the vertical axis indicates "mSv" and the horizontal axis indicates various organs. If an example is given, the alerting | reporting part 21c will display the graph which showed the value 36 of the exposure allowable amount of a lens, and the value 37 of the present total exposure amount, as shown to FIG. 14B. That is, the notification unit 21c displays a graph in which the value 37 of the total amount of exposure increases as the exposure dose increases. As described above, the notification unit 21c can grasp the status of exposure at a glance by displaying various remaining exposure dose information.

  14A and 14B show the case where the information on the remaining exposure dose for one allowable exposure dose is displayed, the notification unit 21c displays the information on the remaining exposure dose for a plurality of allowable exposure doses, respectively. It is also possible to That is, the notification unit 21c can also simultaneously display information on the remaining exposure dose to the allowable exposure dose in one procedure and the information on the remaining exposure dose to the allowable exposure dose in a predetermined period. In such a case, the determination unit 21b calculates the remaining exposure dose for each exposure allowance.

  Next, processing by the X-ray diagnostic apparatus 100 according to the second embodiment will be described using FIG. FIG. 15 is a flowchart showing the procedure of processing by the X-ray diagnostic apparatus 100 according to the second embodiment. In the X-ray diagnostic apparatus 100 according to the second embodiment, as shown in FIG. 15, when the procedure is started (Yes at step S201), the input unit 22 designates an organ to be a target of exposure dose management. It receives (step S202).

  When the input unit 22 receives designation of an organ, the acquisition unit 21a acquires position information of the designated organ (step S203). Then, the determination unit 21b acquires the exposure tolerance value of the designated organ (step S204). Thereafter, the determination unit 21b determines whether the exposure dose of the designated organ reaches the allowable value (step S205).

  Here, when the exposure dose of the designated organ reaches the allowable value (Yes at step S205), the notification unit 21c notifies alert information (notification information) indicating that the exposure dose reaches the exposure allowable amount. (Step S206), it is determined whether the procedure is finished (step S207). On the other hand, when the exposure dose of the designated organ does not reach the allowable value (No at Step S205), the notification unit 21c proceeds to Step S207, and determines whether the procedure is completed (Step S207). The determination unit 21b and the notification unit 21c continue the processing from step S205 to step S207 until the procedure ends, and ends the process when the procedure is ended (Yes at step S207).

  As described above, according to the second embodiment, the determination unit 21b further determines whether the exposure dose of the predetermined organ reaches the exposure tolerance of the predetermined organ at the time of X-ray irradiation. When it is determined that the exposure dose of the predetermined organ reaches the exposure tolerance amount, the notification unit 21c notifies the exposure information that the exposure dose of the predetermined organ reaches the exposure tolerance amount. Therefore, the X-ray diagnostic apparatus 100 according to the second embodiment can change the irradiation direction so as not to exceed the exposure limit, and can reduce organ damage.

  As described above, according to the second embodiment, the determination unit 21b calculates the cumulative value in the predetermined period for the dose of the predetermined organ, and the calculated cumulative value reaches the allowable dose in the predetermined period. It is determined whether or not. When it is determined that the cumulative value reaches the exposure allowable amount in the predetermined period, the notification unit 21c notifies the exposure information that the exposure dose in the predetermined period of the predetermined organ reaches the exposure allowable amount. Therefore, the X-ray diagnostic apparatus 100 according to the second embodiment makes it possible to perform the determination in consideration of the period of exposure.

  As described above, according to the second embodiment, the determination unit 21b calculates, for each of the predetermined organs, the remaining exposure dose until the exposure tolerance amount of the predetermined organ is reached. The notification unit 21 c notifies the remaining exposure dose for each predetermined organ calculated by the determination unit 21 b. Therefore, the X-ray diagnostic apparatus 100 according to the second embodiment makes it possible for the operator to grasp the situation of exposure at a glance.

  As described above, according to the second embodiment, the notification unit 21c indicates the allowable remaining dose, the ratio of the present exposure amount to the allowable exposure amount, and the allowable exposure amount and the present exposure amount. The remaining exposure dose is reported by at least one of the graphs. Therefore, the X-ray diagnostic apparatus 100 according to the second embodiment makes it possible to present an easy-to-see residual exposure dose.

Third Embodiment
Now, although the first and second embodiments have been described, the present invention may be implemented in various different forms other than the above first and second embodiments.

  In the embodiment described above, the case where the X-ray diagnostic apparatus 100 and the DTS 200 are connected via a network and the X-ray diagnostic apparatus 100 acquires a human body model and an exposure image from the DTS 200 has been described. However, the embodiment is not limited to this, and the X-ray diagnostic apparatus 100 may generate a human body model or an exposure image. In such a case, the X-ray diagnostic apparatus 100 includes a human body model generation unit 230 and a data generation unit 240, and generates a human body model and an exposure image.

  Moreover, in the embodiment described above, the case of acquiring three-dimensional positional information of an organ using information of a human body model generated by the DTS 200 has been described. However, the embodiment is not limited to this, and three-dimensional positional information of an organ may be acquired without using a human body model. For example, when the diagnosis or treatment is performed by the X-ray diagnostic apparatus 100, the diagnosis is often performed in advance by an X-ray CT apparatus or the like. That is, in many cases, three-dimensional data (volume data) of the subject has already been collected.

  Therefore, the acquiring unit 21a reads out volume data of the subject P collected by the X-ray CT apparatus and stored in the image storage device 300, extracts an organ to be included in the volume data, and extracts the organ in the volume data. Identify the location of Then, the acquiring unit 21a specifies the position of the organ with respect to the top 14 by acquiring the positional information of the subject P relative to the top 14 and arranging the volume data at the corresponding position of the object P. Thus, the determination unit 21b can perform the above-described determination based on the position information of the organ with respect to the identified top 14.

  Moreover, in the embodiment described above, the case where the exposure information of the organ is notified using the exposure image generated by the DTS 200 has been described. However, the embodiment is not limited to this, and may be a case where the exposure information of the organ is notified without using the exposure image. In such a case, for example, the notification unit 21c generates a model of the designated organ, and notifies the exposure information using the generated model.

  Moreover, in the embodiment described above, the case of using the X-ray diagnostic apparatus as the medical image diagnostic apparatus has been described as an example. However, the embodiment is not limited to this, and for example, an X-ray CT apparatus may be used. In such a case, the control unit of the X-ray CT apparatus includes the acquisition unit 21a, the determination unit 21b, and the notification unit 21c, and executes the respective processes described above.

  Further, each component of each device illustrated in the first embodiment is functionally conceptual, and does not necessarily have to be physically configured as illustrated. That is, the specific form of the distribution and integration of each device is not limited to the illustrated one, and all or a part thereof may be functionally or physically dispersed in any unit depending on various loads, usage conditions, etc. It can be integrated and configured. Furthermore, all or any part of each processing function performed in each device may be realized by a CPU and a program analyzed and executed by the CPU, or may be realized as wired logic hardware.

  The control method described in the first embodiment can be realized by executing a control program prepared in advance on a computer such as a personal computer or a work station. This control program can be distributed via a network such as the Internet. The control program can also be recorded on a computer-readable recording medium such as a hard disk, a flexible disk (FD), a CD-ROM, an MO, and a DVD, and can be executed by being read from the recording medium by a computer.

  As described above, according to the first to third embodiments, it is possible to easily grasp the state of exposure regarding a predetermined organ.

  While certain embodiments of the present invention have been described, these embodiments have been presented by way of example only, and are not intended to limit the scope of the invention. These embodiments can be implemented in other various forms, and various omissions, replacements, and modifications can be made without departing from the scope of the invention. These embodiments and modifications thereof are included in the invention described in the claims and the equivalents thereof as well as included in the scope and the gist of the invention.

100 X-ray diagnostic apparatus 21a acquisition unit 21b determination unit 21c notification unit

Claims (12)

An acquisition unit that acquires three-dimensional position information of a predetermined organ in a subject;
A determination unit that determines whether or not the predetermined organ is present in the irradiation direction of the X-ray in the procedure in which the X-ray is irradiated to the subject based on the position information;
A notification unit which reports exposure information of the predetermined organ when it is determined that the predetermined organ is present in the irradiation direction of the X-ray;
A medical diagnostic imaging apparatus comprising: The acquisition unit acquires three-dimensional positional information of the predetermined organ based on a human body model or three-dimensional data of the subject.
The determination unit determines whether or not the predetermined organ is present in the irradiation direction of the X-ray based on the position information and the position of the X-ray generation unit that emits the X-ray to the subject. The medical image diagnostic apparatus according to claim 1. The determination unit determines the irradiation direction of the X-ray when the X-ray is not irradiated based on the position of the X-ray generation unit that irradiates the X-ray in the procedure and the position of the predetermined organ based on the position information. To determine whether the predetermined organ is present,
The notification unit, when it is determined that the irradiation direction of the X-ray at the time of non-irradiated of the X-ray is the predetermined organ, notifying exposure information of the predetermined organ, according to claim 1 or 2, wherein Medical diagnostic imaging system. The determination unit further determines whether or not the exposure dose of the predetermined organ reaches the exposure tolerance amount of the predetermined organ at the time of irradiation of the X-ray;
When it is determined that the exposure dose of the predetermined organ reaches the allowable exposure dose, the notification unit reports exposure information indicating that the exposure dose of the predetermined organ reaches the allowable exposure dose. The medical image diagnostic apparatus according to any one of 1 to 3 . The determination unit calculates an accumulation value in a predetermined period for the exposure dose of the predetermined organ, and determines whether the calculated accumulation value reaches an exposure allowable amount in the predetermined period,
The notification unit determines that the exposure dose of the predetermined organ in the predetermined period reaches the exposure allowable amount when it is determined that the cumulative value reaches the exposure allowable amount in the predetermined period. The medical image diagnostic apparatus according to claim 4 , wherein the medical image diagnostic apparatus reports information. The determination unit calculates, for each of the predetermined organs, the remaining exposure dose until reaching the exposure allowable amount of the predetermined organs,
The medical image diagnostic apparatus according to any one of claims 1 to 5 , wherein the notification unit notifies the remaining exposure dose for each of the predetermined organs calculated by the determination unit. The notification unit determines the remaining exposure dose according to at least one of a graph showing an allowable remaining dose, a ratio of a current exposure dose to the exposure allowable dose, and the exposure allowable dose and the current exposure dose. The medical image diagnostic apparatus according to claim 6, wherein: The notification unit reports, as the exposure information, at least one of warning information indicating that the predetermined organ is present in the irradiation direction of the X-ray, and numerical information indicating an exposure dose of the predetermined organ. The medical image diagnostic apparatus according to any one of claims 1 to 7 . The medical image diagnostic apparatus according to claim 8 , wherein the notification unit notifies at least one of display information indicating that the predetermined organ is present in the irradiation direction of the X-ray and audio information as the warning information. The notification unit emphasizes, as the display information, at least one of character information indicating the predetermined organ, a position of the predetermined organ on a model indicating the subject, and a model obtained by enlarging the predetermined organ. The medical image diagnostic apparatus according to claim 9 , wherein the display is displayed. The medical image diagnostic apparatus according to any one of claims 1 to 10 , wherein the notification unit further notifies exposure information of the skin of the subject in addition to the exposure information of the predetermined organ. The medical image diagnostic apparatus according to any one of claims 1 to 11 , wherein the predetermined organ includes at least one of a lens, thyroid, bone marrow, testis and ovaries.