JP6646717B2 - Medical document creation device, control method therefor, and program - Google Patents

Description

  The present invention relates to a medical document creation device for creating a medical document such as a diagnostic report, a control method thereof, and a program.

  2. Description of the Related Art In recent years, the performance of medical imaging apparatuses has been remarkably improved, and in particular, CT (Computed Tomography) and MRI (Magnetic Resonance Imaging) can obtain high-definition three-dimensional image data in a short time. With the increase in the definition of image data, lesions that could not be found conventionally can now be found. On the other hand, as the image resolution, the imaging range / number of images per examination, and the number of imaging series increase, the amount of image data handled by medical staff increases. In addition, the number of inspections per facility per day has been increasing, and this has spurred an increase in the amount of image data.

  Therefore, in “Promotion of team medical care through collaboration and cooperation of medical staff” (Medical Policy, No. 0430 No. 1), one of the further roles of medical radiologists is “to assist in interpretation in image diagnosis”. Is required. As an aid for the interpretation by the medical radiologist, there is a so-called “pre-interpretation”, which is a check-up by the medical radiologist before the interpretation by the interpreter. In addition, development of image interpretation support technologies called CADe (Computer Aided Detection) and CADx (Computer Aided Diagnosis) is also underway. The interpreting doctor performs image interpretation with reference to the pre-interpretation described above, the findings picked up by CADe, and the findings picked up from the image, and makes an image diagnosis. Therefore, a system for efficiently creating a diagnostic report from collected findings is disclosed.

  In the medical report system of Patent Literature 1, an input area for inputting a plurality of findings and a check box for inputting an importance value which is an evaluation value of a subjective evaluation are provided for each finding. The findings for which the check boxes are turned on are displayed in a predetermined display format such that the display rank is higher in the report display screen. As a result, a medical report that can accurately convey the intention of the report creator can be easily created.

  The medical report system of Patent Literature 2 is a system similar to Patent Literature 1 and displays in a predetermined display format such that the display order of a finding of high importance is higher. In Patent Literature 2, the importance is determined by providing a table in which diagnosis names and importances are associated in advance, reading the diagnosis names from findings, and acquiring the corresponding importances. That is, the importance is determined from the diagnosis name.

  Further, the medical report creation support device of Patent Document 3 includes an input area for inputting a plurality of findings, and a finding sentence display area in which the findings are grouped, and arranges the order of the findings displayed in the finding sentence display area. It can be changed for each organ or each organ. This makes it easier to control the storage form and display form of each finding statement when integrating various finding statements from multiple organs and various types, and shorten the time required to create a medical report.

JP 2009-238038 A JP 2009-238039 A JP 2012-053632A

  However, when considering the possibility of various diagnoses from a combination of a plurality of findings, Patent Document 1 merely arranges important findings at the top, and arranges and confirms findings for each possibility of diagnosis. Is not suitable. In addition, the method disclosed in Patent Document 2 needs to have a diagnosis attached to a finding, and is not suitable for examining the possibility of diagnosis from a finding without a diagnosis. Further, the method of Patent Document 3 is not suitable for considering various diagnostic possibilities since the arrangement order of findings is defined by the preference of the interpreting physician.

  The present invention has been made in view of the above problems, and has as its object to make the creation of a diagnostic report more efficient.

In order to solve the above-mentioned problem, a medical document creation device according to one aspect of the present invention has the following configuration. That is,
A medical document creation device that supports creation of a diagnostic report,
Storage means for storing association information defining an association between attribute information;
Display control means for displaying, on a display unit, information on a first item to be interpreted and information on a second item different from the information on the first item ;
Acquiring means for acquiring attribute information included in the information of the first item in response to a user operation;
Specifying means for specifying attribute information related to the attribute information obtained by the obtaining means based on the association information,
Collecting means for collecting information of the second item including the attribute information specified by the specifying means,
The display control means arranges and displays the information of the second items collected by the collection means on the display unit.

  According to the present invention, creation of a diagnostic report can be made more efficient.

FIG. 1 is a diagram illustrating a configuration example of a medical document creation system according to first to third embodiments. FIG. 2 is a block diagram illustrating a hardware configuration example of the medical document creation apparatus. FIG. 4 is a diagram showing a display example of a viewer screen of the medical document creation device. 7A and 7B are diagrams illustrating display examples of a report screen of the medical document creation device. FIG. 2 is a block diagram showing a functional configuration example of the medical document creation device. The figure which shows the example of a data structure of diagnostic report information. FIG. 4 is a diagram illustrating an example of attribute association information according to the first embodiment. FIG. 4 is a view for explaining the concept of rearranging items according to the first embodiment. FIG. 4 is a view for explaining the concept of rearranging items according to the first embodiment. FIG. 4 is a view for explaining the concept of rearranging items according to the first embodiment. FIG. 4 is a view for explaining the concept of rearranging items according to the first embodiment. FIG. 4 is a view for explaining the concept of rearranging items according to the first embodiment. 5 is a flowchart illustrating main processing of the medical document creation device. 9 is a flowchart illustrating a process of rearranging items by the medical document creation apparatus. 9 is a flowchart showing a related item sorting process performed by the medical document creation apparatus. FIG. 9 is a diagram illustrating an example of attribute association information according to the second embodiment. The figure explaining the concept of the rearrangement of the item which concerns on 2nd Embodiment. The figure explaining the concept of the rearrangement of the item by 3rd Embodiment.

  Hereinafter, the present invention will be described in detail based on preferred embodiments with reference to the accompanying drawings. Note that the configurations shown in the following embodiments are merely examples, and the present invention is not limited to the illustrated configurations.

<First embodiment>
(System configuration)
FIG. 1 is a system configuration diagram of a medical document creation system including a medical document creation device that supports creation of a diagnostic report according to the first embodiment. In FIG. 1, the PACS server 120 includes an image database (hereinafter, image DB 121) and is connected to the network 110. PACS stands for "Picture Archiving and Communication System". The PACS server 120 provides a function for another apparatus connected to the network 110 to store / register an inspection image in the image DB 121 or read out the inspection image from the image DB 121 via the network 110. Here, the inspection image is an image in DICOM (Digital Imaging and Communications in Medicine) format captured by CT or MRI. The report server 130 includes a report database (hereinafter, report DB 131), and is connected to the network 110. The report server 130 provides a function in which another device connected to the network 110 stores a diagnostic report in the report DB 131 or reads out the diagnostic report from the report DB 131 via the network 110. The diagnostic report creation terminal 100 reads out and displays the examination image from the PACS server 120, and stores the diagnostic report input as a result of the interpretation in the report server 130.

(Hardware configuration)
FIG. 2 is a block diagram illustrating a hardware configuration example of the diagnostic report creation terminal 100 as the medical document creation device according to the first embodiment.

  In FIG. 2, a ROM 201 (ROM stands for Read Only Memory) stores a program for starting the OS, such as a BIOS (Basic Input Output System). The CPU 202 (CPU stands for Central Processing Unit) performs arithmetic processing when executing various programs. A RAM 203 (RAM stands for Random Access Memory) temporarily stores various information when the CPU 202 executes a program. The storage medium 204 is a storage medium such as an HDD (Hard Disk Drive) for storing an OS (Operating System), a processing program, and various information of the medical document creation apparatus. An input I / F 205 (I / F is an abbreviation for an interface) connects input devices such as a keyboard 210 and a mouse 220. The input I / F 205 is configured by a communication interface such as a USB (Universal Serial Bus). The display I / F 206 is an interface for displaying a screen on the first display 230-1 and the second display 230-2, and has a graphic board and the like. The network I / F 207 is an interface for performing communication via the network 110 in compliance with standards such as IEEE (Institute of Electrical and Electronics Engineers) 802.3ab. The internal bus 208 communicably connects the above-described components.

(Screen display)
Next, screen display on the first display 230-1 and the second display 230-2 in the diagnostic report creation terminal 100 of the present embodiment will be described. FIG. 3A shows a display example of a viewer screen displayed on the first display 230-1 according to the present embodiment. FIG. 3B shows a display example of a report screen displayed on the second display 230-2 according to the present embodiment.

  In FIG. 3A, a viewer screen 310 is a screen for displaying an inspection image. In the viewer screen 310, a patient information area 311 is an area for displaying patient information such as a patient name, a patient ID, a patient's age, and gender. The displayed patient information is not limited to these. The examination information area 312 is an area for displaying examination information such as an examination type, an examination part, an examination date, and a request purpose. The inspection information is not limited to these.

  The representative images 313-1 to 313-5 are images (reduced images) representing examination images (for example, series images) taken of the same patient. Medical images (for example, series images) corresponding to the representative image selected according to the selection operation using the mouse 220 or the like are displayed as examination images 314-1 to 314-4. The inspection images 314-1 to 314-4 are inspection images (for example, series images) corresponding to the representative images selected from the representative image group. In the display of the examination image 314, the slice position to be displayed can be moved and the image display conditions can be changed, and the doctor who interprets the image uses the displayed examination image 314 to perform image interpretation. Further, an image being displayed can be attached to a diagnostic report in accordance with an input operation of a specific key from the keyboard 210. An annotation 315 given to an image specifies a position of a lesion in the image and the like. In the input frame 316, a finding related to the image to which the annotation 315 is added or the image attached to the diagnostic report is input. The input frame 316 is displayed, for example, when an annotation 315 is added to an image or when an instruction to attach an image to a diagnostic report is given, and receives an input of a finding on the viewer screen 310. The findings input in the input frame 316 are used as findings corresponding to the pasted image on the report screen 320.

  In FIG. 3B (a), a report screen 320 displays a diagnostic report being created. In the patient information area 321, patient information such as a patient name, a patient ID, a patient's age, and gender are displayed. However, the displayed patient information is not limited to these. The inspection information area 322 is an area for displaying inspection information such as an inspection type, an inspection part, an inspection date, and a request purpose. Note that the displayed inspection information is not limited to these. The pasting images 323-1 to 323-3 are images pasted on the diagnosis report, and generally, the radiologist pastes an examination image representing a lesion on the diagnosis report. Note that the attachment of the image to the diagnosis report is executed in accordance with a predetermined operation on the viewer screen 310 or an operation of providing an annotation 315 or a ROI (Region of Interest).

  The findings 324-1 to 324-3 are findings relating to the pasted images 323-1 to 323-3, respectively. The finding can be input in association with the pasted image in accordance with the fact that the image has been pasted on the diagnostic report. Generally, an interpreter inputs objective facts that can be read from an image as findings. In addition, the findings include not only those found from the observation of the image by the radiologist, but also those found by the pre-interpretation by the medical radiologist and those found by image analysis (not shown) such as CADe. The diagnosis 325-1 and the diagnosis 325-2 are diagnosis related to the finding 324-1 and the finding 324-2, respectively. The diagnosis can be input in response to an operation of a predetermined key while inputting a finding. Generally, an interpreting physician inputs subjective information such as a disease determined from a finding as a diagnosis. In this example, the finding and the diagnosis are associated on a one-to-one basis, but a single finding may be associated with a plurality of diagnoses, a plurality of findings with a single diagnosis, or a combination thereof.

  The policy 326-1 is a policy associated with the diagnosis 325-1. The policy can be input according to the operation of a predetermined key during the input of the diagnosis. Generally, an interpreting physician inputs information such as a recommended test according to the result of diagnosis as a policy. The correspondence between the diagnosis and the policy may be one-to-many, many-to-one, or many-to-many similarly to the finding and the diagnosis. The suspend button 327 is selected when the diagnostic report is temporarily stored and the interpretation is interrupted. The confirm button 328 is selected when the diagnostic report is stored in a confirmed state.

  FIG. 3B (b) is a diagram illustrating an example of a finding display of the medical document creation device according to the first embodiment. In FIG. 3B (b), a finding 324-1 includes a folding button 331 for turning on / off the display of the folding, a title 332 which is a text expression representing the finding, a natural sentence notation 333 of the finding, and an attribute table notation 334 of the finding. Including. When the folding button 331 is clicked, a transition is made to a folding display in which a part of the finding information is hidden, as shown in the finding 324-1 '. In the folded display according to the present embodiment, the natural sentence notation 333 and the attribute table notation 334 of the finding 324-1 are not displayed. The attribute value displayed in the attribute table notation 334 may be automatically extracted from a natural sentence by a known language analysis method, or may be manually input by text input or menu selection. In addition, the folding display is an example of displaying the information in a reduced size, and another reduction method such as reducing the character size may be used.

(Function block)
FIG. 4 is a functional block diagram of the medical document creation device according to the first embodiment. In FIG. 4, an image display unit 411 and a report display unit 412 display image information to be interpreted, finding information, and diagnosis information and their correspondence on the first display 230-1 and the second display 230-2 on the display unit. It functions as a display control unit that causes the display to be controlled. The image display unit 411 reads patient information, examination information, and image data from the image DB 121 of the PACS server 120, creates a viewer screen 310, and displays the viewer screen 310 on the first display 230-1. Although not shown in FIG. 4, reading of image data from the image DB 121 is performed via the network 110. The report display unit 412 reads patient information, examination information, and diagnosis report information from the report DB 131 of the report server 130, creates a report screen 320, and displays the report screen 320 on the second display 230-2. The diagnostic report information will be described later with reference to FIG. Although not shown in FIG. 4, the reading of the diagnostic report information 500 from the report DB 131 is performed via the network 110. In the case of new creation, the diagnostic report information is empty. Further, the result of the pre-interpretation by the medical radiologist and the findings (image information and finding information) picked up by CADe are associated with the patient information and the examination information, and stored in the report DB 131 as diagnostic report information.

  The image pasting unit 413 pastes the image displayed on the viewer screen 310 on a report based on a predetermined operation input from the keyboard 210 or the mouse 220. The operation input is, for example, pressing an “Insert” key, selecting a menu (not shown), and giving an annotation 315. The finding input unit 414 enables text input of a finding associated with the image with the keyboard 210 or the like in accordance with the image pasting operation. The input of a finding is performed, for example, on the input frame 316 displayed on the viewer screen 310 or the input area of the finding 324 associated with the attached image on the report screen 320. The diagnosis input unit 415 displays a diagnosis input frame associated with the finding on the report screen 320 in response to a predetermined operation input during the input of the finding, and enables text input of the diagnosis 325 using the keyboard 210 or the like. . Here, the predetermined operation input is, for example, an operation of pressing a “TAB” key or selecting a menu (not shown). The policy input unit 416 displays an input frame of a policy associated with the diagnosis on the report screen 320 in response to a predetermined operation input during the input of the diagnosis, and enables text input of the policy 326 using the keyboard 210 or the like. . Here, the predetermined operation input is, for example, an operation of pressing a “TAB” key or selecting a menu (not shown).

  The report storage unit 423 stores the image pasted by the image pasting unit 413, the findings, diagnosis, and policy input by the finding input unit 414, the diagnosis input unit 415, and the policy input unit 416 in the report DB 131 as diagnostic report information. . Although not shown in FIG. 4, the storage of the diagnostic report information 500 as shown in FIG. 5, for example, in the report DB 131 is performed via the network 110.

  The item selection unit 417 selects at least one item, specifically, a finding or a diagnosis, input by the finding input unit 414 or the diagnosis input unit 415, based on a predetermined operation input on the report screen 320. The operation is, for example, a left-click operation on an item with the mouse 220. The attribute information acquisition unit 419 acquires the attribute information of the item selected by the item selection unit 417 from the report DB 131. The attribute information of the item will be described later with reference to FIG. The attribute association information storage unit 430 stores attribute association information 600 that defines the association between attributes. The attribute association information 600 will be described later with reference to FIG. The related attribute information acquisition unit 420 acquires an attribute related to the attribute acquired by the attribute information acquisition unit 419 based on the attribute association information 600 stored in the attribute association information storage unit 430.

  The sorting operation detection unit 418 detects a sorting operation based on a predetermined operation input on the report screen 320. Here, the predetermined operation input is, for example, a menu selection operation using an operation menu 701 described later with reference to FIGS. 7A to 7E. The sorting order determining unit 421 determines the sorting order of the items based on the attribute information acquired by the related attribute information acquiring unit 420 according to the sorting operation detected by the sorting operation detecting unit 418. The arrangement order is determined such that the item having the attribute information acquired by the related attribute information acquiring unit 420 is a display position arranged near the item selected by the item selecting unit 417. Note that the method of determining the arrangement order will be described later with reference to the flowcharts of FIGS. The item rearranging unit 422 changes the display position of the items displayed on the report screen 320 by the report display unit 412 based on the arrangement order determined by the arrangement order determining unit 421, and performs the rearrangement.

(Diagnostic report information)
FIG. 5 is an example of diagnostic report information of the medical document creation device according to the first embodiment. The diagnostic report information 500 as shown in FIG. 5 is stored in the report DB 131. In FIG. 5, the diagnosis report information 500 includes report information, patient information, examination information, a plurality of images, a plurality of findings, a plurality of diagnoses, a plurality of policies, and a plurality of related information. Further, the report information includes information on a report ID, a radiologist, and the date and time of imaging. In addition, the patient information includes patient name, patient ID, patient age and gender information. The inspection information includes an inspection type, an inspection part, an inspection date, and a request purpose. Further, the image includes a UID (Unique Identifier) for uniquely identifying an item, and ROI information indicating a position of a lesion. The finding includes a UID, a natural sentence of the finding, information on a site name as attribute information and a lesion type. The diagnosis includes a UID, a natural sentence, and a diagnosis name which is attribute information. Policies include UIDs and natural sentences. The related information is information that defines the relationship between an image and a finding, the relationship between a finding and a diagnosis, and the relationship between a diagnosis and a policy, and includes a related source UID and a related destination UID. Note that the annotation 315 in FIG. 3 is held as image attribute information, similarly to the ROI information. Further, in the present embodiment, the policy does not have attribute information, but may have attribute information such as an examination type.

(Attribute association information)
FIG. 6 is an example of attribute association information indicating a related structure in the medical document creation device according to the first embodiment. The attribute association information 600 as shown in FIG. 6 is stored in the attribute association information storage unit 430. The attribute association information defines an association between attribute information, and each attribute information includes a combination of an attribute type and an attribute value. As shown in FIG. 6, the attribute association information of the present embodiment defines an association between pieces of attribute information having different attribute types. For example, association between attribute information whose attribute type is a diagnosis name and attribute information whose attribute type is a part name is defined. According to the example of the attribute association information 600 illustrated in FIG. 6, the attribute whose diagnosis name is “multiple lung metastases” is associated with the attribute whose part name attribute value includes “lung”. In addition, an attribute whose diagnosis name is “lung cancer” is associated with an attribute whose attribute value of the site name includes “lung”, “brain”, “bone”, “liver”, and “adrenal gland”. As described above, the attribute association information 600 defines a diagnosis name and a part to be checked with respect to the diagnosis name when a certain diagnosis is suspected. For example, when the diagnosis name is “lung cancer”, a site where a primary lesion may exist and a site where a metastatic lesion may exist are associated with each other. In the present embodiment, the attribute association information 600 is defined in advance. However, the association between the diagnosis and the part is extracted from a diagnostic report, a paper, or the like created in the past by a technique such as machine learning. May be constructed.

(Sort items)
7A to 7E are views for explaining the concept of rearrangement of the medical document creation device according to the first embodiment. FIG. 7A shows an example of a report displayed on the report screen 320 when an item (any one of an image, a finding, and a diagnosis) is not selected and the parts are rearranged. By the rearrangement, the associated information is simultaneously displayed in the display area of the report screen 320. In FIG. 7A, pasted images 323-1 to 323-16 are images pasted on the diagnostic report, findings 324-1 to 324-16 are findings entered for each pasted image, and diagnosis 325-1 is finding 324-1. Is a diagnosis input in correspondence with. An operation menu 701 is a user interface for performing operation input such as rearrangement. The report on the left side of FIG. 7A shows the report before sorting and the right side shows the report after sorting. FIG. 7A shows that sorting of findings in order of parts (sorting (part order)) is selected in the operation menu 701. Note that the rearrangement operation is not limited to the operation menu 701, and the rearrangement may be performed based on the selection operation of the diagnosis 325-1.

  If “reorder (part order)” in the operation menu 701 is selected in a state where the item is not selected, the related attribute information acquisition unit 420 does not acquire the related attribute. Sort by site order. In the present embodiment, the arrangement order of the parts is based on the first appearance order in the arrangement before the rearrangement. However, the order of arrangement of the parts is not limited to this, and attribute information that defines the order of the parts may be provided, and the arrangement may be determined based on the information. Further, the arrangement of the site order may be determined using, for example, a dictionary having known anatomical information. First, the arrangement order determination unit 421 determines the arrangement order so that findings having attribute information in which the attribute value of the part name includes “lung” are displayed collectively as findings relating to “lung”. As a result, in the example of FIG. 7A, the finding 324-1 having the site name “left lung upper lobe”, the finding 324-2 having “upper lung field”, and the finding 324-13 having “left lung S1 + 2” are “lung”. Are displayed collectively as findings on " Subsequently, the arrangement order determination unit 421 determines the arrangement order such that the findings having the attribute information in which the attribute value of the part name includes “stomach” are collectively displayed as the findings relating to “stomach”. In the example of FIG. 7A, the findings 324-4, 324-12, and 324-15 having the “small stomach curve”, the “gastric cardia”, and the “stomach body anterior wall” are collectively referred to as the findings relating to the “stomach”. Is displayed. Similarly, findings 324-6 and 324-8 having "pancreas head" and "pancreas body" are collectively displayed as findings relating to "pancreas", and the same applies to other parts. Further, according to the change in the arrangement order of the findings, the images, diagnosis, and policies associated with the findings are also rearranged so as to follow the findings.

  FIG. 7B shows an example of the report displayed on the report screen 320 when the items are selected and the order of the parts is rearranged. In FIG. 7B, the same elements as those in FIG. 7A are denoted by the same reference numerals. The left side shows the report before sorting, and the right side shows the report after sorting. In addition, it shows that the rearrangement in the order of the parts is selected in the operation menu 701. The thick frame of the diagnosis 325-1 indicates that the item is selected.

  When “rearrangement (part order)” of the operation menu 701 is selected in a state where the item (diagnosis in FIG. 7B) is selected, the related attribute information acquisition unit 420 refers to the attribute association information 600 and selects the item. Get attributes associated with the item. Then, the arrangement order determining unit 421 collects and arranges the findings having the related attributes in the vicinity of the selected item, and rearranges the collected and arranged items in the order of the parts. The order of the site order is as described above, and may be determined using the order before the rearrangement, may be determined using attribute information that defines the order, or may be a known anatomical order. May be determined by using a dictionary having appropriate information.

  In the example of FIG. 7B, the diagnosis 325-1 is selected, and the diagnosis name “lung cancer” is obtained as the related attribute information. The related attribute information acquiring unit 420 acquires the site names “lung”, “brain”, “bone”, “liver”, and “adrenal gland” associated with the diagnosis name “lung cancer” with reference to the attribute association information 600. The arrangement order determining unit 421 determines the arrangement order of the findings based on the acquired part names. That is, the arrangement order determining unit 421 diagnoses the findings 324-2, 324-13, 324-3, 324-4, 324-12, and 324-15 related to the attribute acquired by the related attribute information acquiring unit 420. In the vicinity of No. 1, they are grouped and arranged for each part. Here, since the finding 324-1 associated with the diagnosis 325-1 is a finding of “lung”, the findings 324-2 and 324-13 of “lung” are arranged closest.

  FIG. 7C shows an example of a report displayed on the report screen 320 when items are selected and the lesions are sorted in the order of size. In FIG. 7C, pasted images 323-21 to 323-28 are images pasted on the diagnostic report, findings 324-21 to 324-28 are findings input for each pasted image, and diagnosis 325-21 is finding 324-21. Is a diagnosis input in correspondence with. As in FIG. 7A, the left side shows the report before sorting and the right side shows the report after sorting. FIG. 7C shows that “sorting (in order of size)”, that is, sorting in order of the size of lesions, is selected in the operation menu 701.

  When “rearrangement (in order of size)” in the operation menu 701 is selected in a state where the item is selected, the related attribute information acquisition unit 420 acquires the related attribute by referring to the attribute association information 600. Then, the sorting order determination unit 421 collects and arranges findings having related attributes in the vicinity of the selected item, and sorts them so that they are in the order of lesion size. When there is a lesion having no size, the arrangement order determination unit 421 arranges the lesion at a predetermined position, for example, a lower position.

  In the example of FIG. 7C, the diagnosis 325-21 is selected, and the diagnosis name “lung cancer” is obtained as the related attribute information. The related attribute information acquiring unit 420 acquires the site names “lung”, “brain”, “bone”, “liver”, and “adrenal gland” associated with the diagnosis name “lung cancer” with reference to the attribute association information 600. The arrangement order determining unit 421 determines the arrangement order of the findings based on the acquired part names. That is, the arrangement order determining unit 421 determines the findings 324-28, 324-27, 324-23, 324-22, 324-26, 324-24, and 324-25 related to the attribute acquired by the related attribute information acquiring unit 420. Is placed near the diagnosis 325-21. Here, the arrangement order determination unit 421 rearranges the findings in the order of the size of the lesion within the range of the findings having the related attributes. The arrangement order determination unit 421 also rearranges the findings having no related attribute in the range of the size of the lesion within the range. In the example of FIG. 7C, the finding 324-28 of “45 mm” having the largest lesion size among the related findings is placed closest to the diagnosis 325-21.

  FIG. 7D shows an example of a report displayed on the report screen 320 when the items are selected and the lesions are sorted in the order of the size of the lesion for each site. In FIG. 7D, the same elements as those in FIG. 7C are denoted by the same reference numerals. As in FIG. 7C, the left side shows the report before sorting, and the right side shows the report after sorting. In addition, this indicates that “rearrangement (part / size order)” is selected in the operation menu 701.

  When “rearrangement (part / size order)” of the operation menu 701 is selected with the item (diagnosis 325-21 in FIG. 7D) selected, the related attribute information acquisition unit 420 Get related attributes by reference. The arrangement order determination unit 421 collects and arranges findings having related attributes near the selected item, and arranges them in the order of the size of the lesion. The lesion having no size is arranged at a predetermined position, for example, at a lower position.

  In the example of FIG. 7D, as in FIG. 7C, the related attribute information acquisition unit 420 determines the part names “lung”, “brain”, “bone”, and “bone” as the attributes related to the diagnosis name “lung cancer” of the diagnosis 325-21. Get the attributes of "liver" and "adrenal gland". The arrangement order determining unit 421 diagnoses the findings 324-28, 324-27, 324-23, 324-22, 324-26, 324-24, and 324-25 related to the attribute acquired by the related attribute information acquiring unit 420. It is arranged near 325-21. Here, the arrangement order determination unit 421 rearranges the findings for each part and in the order of the size of the lesion within the range of the findings having the related attributes. Also, the arrangement order determination unit 421 rearranges the findings for each part and in the order of the size of the lesion within the range even for a finding having no related attribute. In the example of FIG. 7D, in a group of findings 324-27 and 324-22 of “lung”, and in a group of findings 324-28 and 234-25 of “adrenal gland”, the same applies to each region. The state in which the images are rearranged in order of size is shown.

  FIG. 7E shows an example of a report displayed on the report screen 320 when the items are selected and the lesions are sorted in the order of the size, as in FIG. 7C. However, in FIG. 7E, instead of the findings 324-23 (pasted image 323-23) and the findings 324-28 (pasted image 323-28) of FIG. -32 (pasted image 323-32) exists. The findings 324-31 and 324-32 have a cystic lesion as an attribute of the lesion type.

  In FIG. 7E, when sorting in order of size (“sorting (size order)” in the operation menu 701) is selected in a state where an item is selected, the related attribute information acquisition unit 420 as in FIG. 7C. Gets the attributes associated with. Then, the sorting order determining unit 421 collects and arranges the findings having the related attributes in the vicinity of the selected item, and sorts them so that they are in the order of the size of the lesion. The lesion having no size is arranged at a predetermined position, for example, at a lower position. In FIG. 7D, the findings are grouped by site and arranged in size order, whereas in FIG. 7E, the findings are grouped by lesion type and arranged in size order. That is, in the example of FIG. 7E, the attribute values of the lesion type are rearranged according to the size in the findings 324-27, 324-31, 324-26, 324-24, and 324-25 which are mass lesions. Have been done. In addition, rearrangement according to the size is performed among the findings 324-31 and 324-32 in which the attribute value for each lesion is a cystic lesion. As an item of the operation menu 701, an item "rearrangement (lesion type / size order)" for instructing rearrangement as shown in FIG. 7E may be added.

(Main processing flow)
FIG. 8 is a flowchart illustrating main processing of the medical document creation device according to the first embodiment. When the main processing is started, the image display unit 411 displays the viewer screen 310 (S801), and subsequently, the report display unit 412 displays the report screen 320 (S802). Thereafter, in S803 to S811, the presence or absence of various operations from the keyboard 210 or the mouse 220 is determined, and a process corresponding to the detected operation is executed.

  Upon detecting a display operation on the viewer screen 310 (YES in S803), the image display unit 411 updates the display on the viewer screen 310 based on the detected operation content (S821). Here, the display operation is, for example, a change of a slice or a series to be displayed, a change of a display condition of an image, a change of a layout of an image, or the provision of an annotation or an ROI.

  When detecting the image pasting operation (YES in S804), the image pasting unit 413 pastes the image on the report (S822), and the finding input unit 414 displays an input frame of the finding (S823). The input frame of the displayed findings is an input frame 316 of the viewer screen 310 and an input frame for inputting the finding 324 in the finding column of the report screen 320. When the finding input unit 414 detects a finding input operation (YES in S805), the finding input unit 414 displays the finding (text) entered in the finding input frame displayed in S823, and stores the entered finding in a report (S824). ). Here, "to store findings in a report" may be stored in a memory such as the RAM 203 or the storage medium 204 as a report being created, or may be stored in the report DB 131.

  When detecting the item selection operation (YES in S806), the item selection unit 417 stores the selected item (S825). In the item selection operation, an item is selected from any of the image, findings, diagnosis, and policy on the report screen 320. For example, when the diagnosis 325-1 is selected by the item selection operation using the mouse 220 as shown in FIG. 7B, the item selection unit 417 stores this as the selected item and indicates that the item is selected. Change the display format. When the rearranging operation detecting unit 418 detects a rearranging operation (YES in S807), the rearranging order determining unit 421 and the item rearranging unit 422 perform a rearranging process described later with reference to FIG. 9 (S826). By the rearrangement process, the rearrangement as illustrated in FIGS. 7A to 7E is performed. Note that the sorting operation is detected by detecting the designation of an item of the operation menu 701.

  When detecting a diagnosis input operation (YES in S808), the diagnosis input unit 415 stores the input diagnosis in a report (S827). When detecting a policy input operation (YES in S809), the policy input unit 416 stores the input policy in a report (S828). When the report saving unit 423 detects the confirmation operation (press of the confirmation button 328) (YES in S810), the report being created is stored in the report DB 131 as a confirmed state (S829), and the process ends. When detecting the interruption operation (pressing the interruption button 327) (YES in S811), the report saving unit 423 saves the report being created in the report DB 131 as a temporary saving state (S830), and ends the processing.

(Item sorting flow)
FIG. 9 is a flowchart of the item reordering process (S826) of the medical document creation device according to the first embodiment. When the item rearrangement process is started, the rearrangement operation detection unit 418 determines whether the type of the rearrangement operation is a region-based display operation (S901), a size-based display operation (S902), It is confirmed whether or not the display operation is in the size order (S903). The designation of “rearrangement (part order)”, “rearrangement (part size order)”, and “rearrangement (part / part size order)” in the operation menu 701 are the part order display operation and the size order display It corresponds to the operation and the display operation in the order of size for each part.

  When the site order display operation is detected (YES in S901), the arrangement order determination unit 421 confirms the presence / absence of a selection item (the presence / absence of an item selected from image, findings, and diagnosis information) (S911). If there is no selection item (NO in S911), the arrangement order is determined so that the display position is such that the same part is arranged in close proximity (S912), and the process proceeds to S904. As described above, the arrangement order is changed as shown in FIG. 7A. On the other hand, if there is a selection item (YES in S911), the arrangement order determination unit 421 performs a related item rearrangement process described later with reference to FIG. 10 (S921). In the related item sorting process, as described above with reference to FIG. 7B and the like, by referring to the attribute association information 600, the finding is held as a finding having an attribute related to the selected item (a group of items having related attributes). Classify into findings (items that do not have related attributes). Further, the arrangement order determination unit 421 determines the arrangement order such that the same part is located at a display position where the same part is arranged close to each other in the item group having the related attribute and the item group having no related attribute ( (S922), proceed to S904. As described above, the arrangement order is changed as shown in FIG. 7B.

  When the size order display operation is detected (YES in S902), the arrangement order determination unit 421 confirms whether or not there is a selection item (S931). When there is no selection item (NO in S931), the arrangement order is determined so that the size of the lesion is a display position arranged in descending order (S932), and the process proceeds to S904. When there is a selection item (YES in S931), the arrangement order determination unit 421 performs a related item rearrangement process described later with reference to FIG. 10 (S941). Further, the arrangement order determination unit 421 determines the arrangement order such that the size of the lesion is the display position where the size of the lesion is arranged in descending order in each of the item group having the related attribute and the item group having no related attribute. (S942), the process proceeds to S904. With the determination of the arrangement order in S941 and S942, the arrangement order is changed as shown in FIG. 7C.

  When a display operation in order of size for each part is detected (YES in S903), the arrangement order determination unit 421 confirms the presence or absence of a selection item (S951). If there is no selection item (NO in S951), the arrangement order determination unit 421 determines the arrangement order such that the display position is such that the same portion is arranged close to each other (S952). Further, the arrangement order determination unit 421 determines the arrangement order so that the size of the lesion is a display position where the size of the lesion is arranged in descending order in the adjacent items of the same site (S953), and the process proceeds to S904. When there is a selection item (YES in S951), the arrangement order determination unit 421 performs a related item rearrangement process described later with reference to FIG. 10 (S961). Further, the arrangement order determination unit 421 determines the arrangement order such that the same part is located at a display position where the same part is arranged close to each other in the item group having the related attribute and the item group having no related attribute ( S962). Furthermore, the arrangement order determination unit 421 sets the display position in which the size of the lesion is arranged in descending order in an item group having an associated attribute and an item group having no associated attribute in which the same site is close to each other. Is determined (S963), and the process proceeds to S904. With the determination of the arrangement order in S961 to S963, the arrangement order is changed as shown in FIG. 7D.

  The item reordering unit 422 changes the display position of the items based on the arrangement order determined as described above, and rearranges and displays the items (S904). At this time, the report display unit 412 simultaneously displays the collected finding information (a group of items having attributes related to the selected item) in a predetermined display area for displaying the relation between the image, the finding, the diagnosis, and the policy. Is controlled to be in a state of being closed. If all of the collected finding information (item groups having attributes related to the selected item) cannot be displayed simultaneously in one display area (NO in S905), the finding is changed to the folding display described in FIG. (S971), and ends the process. This will result in more collected findings being displayed at the same time. If all the items having the related attributes can be displayed on the display screen (YES in S905), the process ends without changing the display mode of the findings. Note that the item rearranging unit 422 may highlight an item group having an associated attribute. Further, a group of items having no related attribute may be hidden or folded. In addition, when all the items having the attribute related to the selected item cannot be displayed on one display screen, all the items of the items are displayed on one display screen by reducing the size of the items. Is also good. In this case, the reduction ratio may be limited, and if not all items can be displayed on one display screen even at the maximum reduction ratio, a portion that cannot be displayed may be displayed by scrolling. Alternatively, the items may be displayed by scrolling, and the display mode may not be particularly changed even if all the items having the attribute related to the selected item cannot be displayed on one display screen.

  FIG. 10 is a flowchart of the related item sorting process (S921, S941, S961) of the medical document creation device according to the first embodiment. In the related item sorting process, related attribute information is specified based on the attribute information acquired in response to a user operation and the association information 600, finding information including the specified attribute information is collected, and the collected finding information is collected. Are displayed side by side. When the related item sorting process is started, the attribute information acquisition unit 419 acquires attribute information (eg, diagnosis name: lung cancer) whose attribute type is a diagnosis name from the item (eg, diagnosis information) selected by the item selection unit 417. (S1001). The related attribute information acquiring unit 420 acquires attribute information related to the attribute information acquired by the attribute information acquiring unit 419 based on the acquired attribute information (diagnosis name: lung cancer) and the attribute association information 600 (S1002). For example, when the attribute information acquisition unit 419 acquires the diagnosis name “lung cancer”, the part names “lung”, “brain”, “bone”, “liver”, and “adrenal gland” are acquired as related attribute information. Subsequently, the arrangement order determination unit 421 arranges the item group having the related attribute information acquired in S1002 (the finding information including the related attribute information and the image information and the diagnostic information related thereto) near the selected item. (S1003), and the process ends.

  As described above, according to the first embodiment, findings that may have a relationship with the selection item diagnosis are collected and displayed in the vicinity of the selection item according to the selection item (eg, diagnosis). This has the effect of improving the ease of making a diagnosis and increasing the efficiency of creating a diagnosis report. In particular, it is possible to more efficiently make a diagnosis when a large amount of findings are picked up by a person other than the interpreting physician such as a medical radiologist or CADe. Furthermore, according to the present embodiment, the findings that may have a relationship are rearranged in the order of lesion size for each region, so that the visibility of findings and the ease of finding important lesions are improved. effective. In other words, the interpreting physician, who is the user, can sort the findings according to the situation in which the diagnosis is considered, so that the diagnosis can be easily determined and the creation of the diagnosis report is made more efficient. be able to.

<Second embodiment>
In the second embodiment, a description will be given of a medical document creation apparatus capable of expressing an attribute related to an attribute of a selection item by a product of a plurality of attributes. The system configuration related to the medical document creation device according to the second embodiment and the hardware configuration of the medical document creation device are the same as those in the first embodiment (FIGS. 1 and 2). Further, a viewer screen and a report screen of the medical document creation apparatus according to the second embodiment are the same as those in the first embodiment (FIGS. 3A and 3B (a)). Further, the functional blocks of the medical document creation apparatus according to the second embodiment and the data configuration of the diagnosis report information are the same as those of the first embodiment (FIGS. 4 and 5). Further, the main process, the item rearranging process, and the related item rearranging process of the medical document creating apparatus according to the second embodiment are the same as those of the first embodiment (FIGS. 8, 9, and 10). Items given the same reference numerals as those described in the first embodiment have the same operations and functions unless otherwise specified.

(Attribute association information in the second embodiment)
FIG. 11 is a diagram illustrating an example of attribute association information of the medical document creation device according to the second embodiment. In FIG. 11, the attribute association information 600a includes association source attribute information and a plurality of association destination attribute information. Further, each of the related source attribute information and the plurality of related destination attribute information includes an attribute type and an attribute value. The example illustrated in FIG. 11 indicates that an attribute having a diagnosis name of “multiple lung metastases” is associated with an attribute having a site name of “lung” and a lesion type of “mass lesion”. In addition, an attribute having a diagnosis name of “lung cancer”, an attribute having a site name of “lung” and a lesion type of “mass lesion”, and having a site name of “lung” and a lesion type of “nodular lesion” Indicates that attributes are related. The attribute association information 600a is defined based on, for example, a site and a lesion type to be confirmed when a certain diagnosis is suspected. In the present embodiment, the attribute association information 600a is defined in advance. However, the attribute association information 600a is automatically extracted from a diagnostic report or a paper created in the past by a method such as machine learning or data mining. Is also good.

(Sorting in the second embodiment)
FIG. 12 is a view for explaining the concept of rearrangement of the medical document creation device according to the second embodiment. FIG. 12 shows an example of a report displayed on the report screen 320 when items are selected and rearranged in order of parts. In FIG. 12, the pasted images 323-41 to 323-53 are images pasted on the diagnostic report, the findings 324-41 to 324-53 are the findings entered for each pasted image, and the diagnosis 325-41 is the finding 324-41. This is the diagnosis entered for. In FIG. 12, the left side shows the report before sorting and the right side shows the report after sorting. Also, FIG. 12 shows that the rearrangement in the order of the parts has been selected in the operation menu 701 (“rearrangement (the order of the parts)” has been designated). The thick frame of the diagnosis 325-41 indicates that the item is selected.

  When “rearrangement (part order)” in the operation menu 701 is selected in a state where an item is selected, the related attribute information acquisition unit 420 acquires related attributes by referring to the attribute association information 600a. Then, the arrangement order determination unit 421 collects and arranges the findings having the related attributes in the vicinity of the selected item, and rearranges them so that they are in the order of the parts. The order of the site order may be determined using the order before the rearrangement, may be determined using attribute information that defines the order, or may be determined using a dictionary having known anatomical information. May be determined.

  In the example of FIG. 12, the diagnosis 325-41 is selected, and the diagnosis name “lung cancer” is obtained as the related attribute information. In step S1002, the related attribute information acquiring unit 420 refers to the attribute association information 600a, and as an attribute associated with the diagnosis name “lung cancer”, an attribute or a site whose part name is “lung” and whose lesion type is “massic lesion” An attribute or the like whose name is “lung” and the lesion type is “nodular lesion” is acquired. The arrangement order determination unit 421 collectively arranges the findings 324-42, 324-49, and 324-52 related to the attributes thus acquired for each part in the vicinity of the diagnosis 325-41 which is the selected item. .

  As described above, according to the second embodiment, findings that may be related to the selected diagnosis are collected and displayed in the vicinity of the selected diagnosis according to the selected diagnosis. This has the effect of improving ease of operation and making diagnosis report creation more efficient. In particular, it is possible to more efficiently make a diagnosis when a large amount of findings are picked up by a person other than the interpreting physician such as a medical radiologist or CADe. Furthermore, according to the second embodiment, the attribute related to the attribute of the selection item can be expressed by the product of a plurality of attributes, and there is an effect that a more highly relevant finding can be arranged in the vicinity. In the above embodiment, “region” and “lesion type” are used as the product of the attributes, but the present invention is not limited to such a combination.

<Third embodiment>
In the third embodiment, a medical document creation apparatus capable of designating request information or the like as a selection item will be described. Note that the system configuration of the medical document creation system including the medical document creation device according to the third embodiment, the hardware configuration of the medical document creation device, the viewer screen, and the report screen are the same as those of the first embodiment (FIGS. 1, 2, and FIG. 3A and FIG. 3B (a)). The functional blocks, diagnostic report information, and attribute association information of the medical document creation device according to the third embodiment are the same as those of the first embodiment (FIGS. 4, 5, and 6). Further, the main processing, the item rearranging processing, and the related item rearranging processing of the medical document creating apparatus according to the third embodiment are the same as those of the first embodiment (FIGS. 8, 9, and 10).

(Reordering of items in the third embodiment)
FIG. 13 is a view for explaining the concept of sorting by the medical document creation device according to the third embodiment. FIG. 13 shows an example of a report displayed on the report screen 320 when items are selected and rearranged in order of parts. However, the selected item is the request purpose. In FIG. 13, pasted images 323-61 to 323-70 are images pasted on the diagnostic report, and findings 324-61 to 324-70 are findings input for each pasted image. The request purpose information 1301 is information that is input when a clinician makes a request for image interpretation. The request purpose information 1301 is described as a part of the examination information on the report screen 320 and is displayed in the examination information area 322. In FIG. 13, the left side shows the report before sorting, and the right side shows the report after sorting. In the operation menu 701, it is indicated that the rearrangement in the order of the parts is selected ("rearrangement (the order of the parts)" is selected). The thick frame of the request purpose information 1301 indicates that the item is selected, and further indicates that the shaded character string “suspicion of lung cancer” is selected.

  When “rearrangement (part order)” is selected from the operation menu 701 in a state where the character string of the request purpose information 1301 is selected, the part order is rearranged. At this time, in S1001, the attribute information acquisition unit 419 extracts and acquires an attribute from the character string selected from the request purpose information 1301. The extraction of the attribute can be realized by extracting from the natural sentence of the request purpose information 1301 by a known language analysis method. Based on the attributes thus obtained, the relevant attribute information obtaining unit 420 obtains relevant attributes (S1002), and collects and arranges findings having the relevant attributes near the selected item (S1002). Then, the arrangement order determination unit 421 rearranges them so that they are in the order of the parts (S922). The arrangement of the site order is determined using a dictionary having known anatomical information.

  In the example of FIG. 13, the related attribute information acquisition unit 420 refers to the association information 600 as the attribute related to the diagnosis name “lung cancer” acquired from the request purpose information 1301, and the part names “lung”, “brain”, Acquire the attributes of "bone", "liver", and "adrenal". The arrangement order determining unit 421 converts the findings 324-62, 324-68, and 324-69 related to the related attribute acquired by the related attribute information acquiring unit 420 into, for example, the vicinity of the request purpose information 1301 (for example, )), Put together and arrange for each part.

  As described above, according to the third embodiment, by designating request information and the like as selection items, findings that may have a relationship with the request purpose are collected, and diagnosis suitable for the request purpose is easily performed. effective.

  As described above, according to each of the above-described embodiments, according to the selected diagnosis, findings that may have a relationship with the selected diagnosis are collected and displayed near the selected diagnosis. This has the effect of improving ease of operation and making diagnosis report creation more efficient. In particular, it is possible to more efficiently make a diagnosis when a large amount of findings are picked up by a person other than the interpreting physician such as a medical radiologist or CADe.

  In the above embodiment, the case where the diagnosis is selected by the user operation and the rearrangement is performed is described. However, the finding may be selected by the user operation and the rearrangement is performed. In this case, the related attribute information acquiring unit 420 and the arrangement order determining unit 421 collect attribute information related to the attribute information included in the selected finding information in the processing of S1001 to S1003 in FIG. In the above embodiment, the related source attribute information and the related destination attribute information associated with each other in the attribute association information 600 have different attribute types (for example, a diagnosis name and a site name). Attribute information may be associated.

<Other embodiments>
As described above, the embodiments have been described in detail. However, the present invention can take embodiments as a system, an apparatus, a method, a program, a recording medium (storage medium), or the like. Specifically, the present invention may be applied to a system including a plurality of devices (for example, a host computer, an interface device, an imaging device, a web application, and the like), or may be applied to a device including a single device. good.

  In addition, the present invention supplies a program realizing one or more functions of the above-described embodiments to a system or an apparatus via a network or a storage medium, and one or more processors in a computer of the system or the apparatus execute the program. The processing can be implemented by reading and executing. Further, it can also be realized by a circuit (for example, an ASIC) that realizes one or more functions.

100: diagnosis report creation terminal, 120: PACS server, 130: report server, 310: viewer screen, 320: report screen, 323: pasted image, 324: finding, 325: diagnosis, 326: policy, 413: image pasting unit, 414: finding input section, 415: diagnosis input section, 416: policy input section, 417: item selection section, 418: rearrangement operation detection section, 419: attribute information acquisition section, 420: related attribute information acquisition section, 421: arrangement Order determining unit, 422: item rearranging unit, 430: attribute association information storage unit, 610, 1610: attribute association information, 500: diagnosis report information, 1301: request purpose information

Claims (7)

A medical document creation device that supports creation of a diagnostic report,
Storage means for storing association information defining an association between attribute information;
Display control means for displaying, on a display unit, information on a first item to be interpreted and information on a second item different from the information on the first item ;
Acquiring means for acquiring attribute information included in the information of the first item in response to a user operation;
Specifying means for specifying attribute information related to the attribute information obtained by the obtaining means based on the association information,
Collecting means for collecting information of the second item including the attribute information specified by the specifying means,
The medical document creating apparatus according to claim 1, wherein the display control unit arranges and displays the information of the second items collected by the collection unit on the display unit.   2. The medical document creating apparatus according to claim 1, wherein the information of the first item is diagnostic information of an image to be interpreted, and the information of the second item is finding information of an image to be interpreted.   2. The medical document creating apparatus according to claim 1, wherein the information of the first item is finding information of an interpretation target, and the information of the second item is diagnosis information of an interpretation target.   4. The medical document creating apparatus according to claim 2, wherein the attribute information included in the diagnosis information includes a diagnosis name, and the attribute information included in the finding information includes a site name.   The obtaining means obtains attribute information included in information of the first item selected by a user operation,
  The display control unit is configured to display the information of the second item including the attribute information specified by the specifying unit more than the information of the second item including the attribute information not specified by the specifying unit. The medical document creation device according to claim 1, wherein the medical document creation device is displayed at a position close to information on the first item selected by the operation. A method for controlling a medical document creation device that supports creation of a diagnostic report,
A display control step of displaying information of a first item to be interpreted and information of a second item different from the information of the first item on a display unit;
An obtaining step of obtaining attribute information included in the information of the first item in response to a user operation;
A specifying step of specifying attribute information related to the attribute information acquired in the acquiring step, based on association information defining a relationship between the attribute information,
A collecting step of collecting information of the second item including the attribute information specified in the specifying step,
In the display control step, the information of the second item collected in the collection step is arranged and displayed on the display unit. A program for causing a computer to execute each step of the method for controlling a medical document creation apparatus according to claim 6 .

Images