JP6842036B2 - Interpretation request system, its control method, and program - Google Patents

Description

The present invention relates to an image interpretation request system, a control method thereof, and a program.

Conventionally, a patient is imaged with a medical image diagnostic device such as a CT (Computed Tomography) device or an MRI (Magnetic Resonance Imaging) device, and the medical image obtained by the imaging is read and diagnosed.

However, since the number of doctors who can perform such interpretation (hereinafter referred to as "interpretation doctor") is limited, there are hospitals that cannot perform such interpretation. Therefore, there is a mechanism for requesting an image interpreter to interpret a medical image via the Internet.

Patent Document 1 discloses a mechanism capable of notifying the doctor by designating a portion of the medical image to be read that the doctor should pay attention to. As a result, it is possible to accurately inform the interpretation doctor of the contents of the request, and it is possible to prevent rework of the interpretation.

Japanese Unexamined Patent Publication No. 2008-278

In recent years, a large intestine CT examination (CT colonography, abbreviated as CTC) has been performed in which a two-dimensional medical image is acquired by imaging the large intestine with a CT device and the three-dimensional medical image generated from the two-dimensional medical image is interpreted. ing. A feature of colon CT examination is that the burden on the patient is lighter than that of conventional endoscopic examination.

The main flow of colon CT examination is as follows. First, a special gas or the like is injected into the patient's large intestine to inflate the large intestine for easy interpretation. Then, the large intestine of the patient is imaged to obtain a two-dimensional medical image. Here, it is desirable to image the patient in a plurality of positions (supine position, prone position, etc.). A three-dimensional medical image is generated from the two-dimensional medical image thus obtained, and the interpretation doctor interprets the three-dimensional medical image.

The purpose of imaging the patient in multiple positions is to move the residue and the like in the patient's large intestine. If the residue or the like is reflected in the two-dimensional medical image, the accuracy of interpretation is lowered. In order to suppress this, conventionally, a patient is imaged in a plurality of positions, a plurality of series of two-dimensional medical images are generated, and a three-dimensional medical image is generated for each series. That is, by interpreting the images while comparing the plurality of three-dimensional medical images generated in this way, it is possible to prevent erroneous interpretation due to the residue or the like.

It is necessary to take these points into consideration when requesting interpretation. That is, even if a two-dimensional medical image having only one series exists as a target of an image interpretation request for performing a large intestine CT examination, the image interpreting doctor may not be able to properly interpret the image. In addition, even at the requesting hospital, if there is a request from the interpreting doctor, the patient's large intestine must be imaged again, which is troublesome for the patient twice, which is not efficient.

An object of the present invention is to provide a mechanism capable of displaying a screen capable of appropriately performing an image interpretation request according to the number of series of a plurality of two-dimensional medical images acquired by a medical image diagnostic apparatus. To do.

In order to achieve the above object, the image interpretation request system of the present invention is an image interpretation request system capable of making an image interpretation request for a plurality of two-dimensional medical images acquired by a medical image diagnostic apparatus, and is one or a plurality of image interpretation request systems. Among the plurality of the two-dimensional medical images composed of the series, the control means for controlling the warning regarding the interpretation is provided on the condition that the number of the series of the two-dimensional medical images for which the interpretation request is made is 1. It is a feature.
Further, the image interpretation request system of the present invention is an image interpretation request system capable of making an image interpretation request for a plurality of two-dimensional medical images acquired by a medical image diagnostic apparatus, and is composed of one or a plurality of series. Among the two-dimensional medical images in the above, the two-dimensional medical image for which an image interpretation request is made is provided with a control means for controlling so that the image interpretation request cannot be performed, provided that the number of series of the two-dimensional medical images is one.
Further, the control method of the image interpretation request system of the present invention is a control method of the image interpretation request system capable of performing an image interpretation request for a plurality of two-dimensional medical images acquired by a medical image diagnostic apparatus, and is the image interpretation request system. Control means warns about interpretation on the condition that the number of series of the two-dimensional medical images for which interpretation is requested is one among the plurality of the two-dimensional medical images composed of one or a plurality of series. It is characterized by including a control step for controlling the system.
Further, the control method of the image interpretation request system of the present invention is a control method of the image interpretation request system capable of performing an image interpretation request for a plurality of two-dimensional medical images acquired by a medical image diagnostic apparatus, and is the image interpretation request system. The control means can perform the interpretation request on the condition that the number of series of the two-dimensional medical images for which the interpretation request is made is one among the plurality of the two-dimensional medical images composed of one or a plurality of series. It is characterized by including a control step for controlling the absence.
Further, the program of the present invention is characterized in that the computer functions as the interpretation request system described above.

According to the present invention, depending on the series number of the plurality of two-dimensional medical image obtained by a medical image diagnostic apparatus, it is possible to display the available screens appropriately perform that the interpretation request.

It is a figure which shows the system structure of the image interpretation request system in 1st Embodiment. It is a figure which shows the hardware configuration of a request terminal and an image interpretation request server. It is a figure which shows the functional structure of the request terminal and the interpretation request server. It is a flowchart which shows the flow of a series of processing for displaying an application waiting screen. It is a figure which shows an example of the screen composition of the application waiting screen. It is a figure which shows the table structure of the inspection management table, and the series management table. It is a figure which shows the data structure of a DICOM image. It is a figure which shows the screen composition of the screen which displays a list of DICOM images. It is a flowchart which shows the flow of a series of processing for displaying an application detail screen 1000. It is a figure which shows the screen composition of the application detail screen 1000. It is a flowchart which shows the flow of a series of processing on the application detail screen generated in step S906 of FIG. It is a flowchart which shows the flow of a series of processing on the application detail screen generated in step S907 of FIG. It is a figure which shows the screen composition of a warning dialog. FIG. 5 is a flowchart showing a flow of a series of processes on the application detail screen generated in step S907 of FIG. 9 in the second embodiment. It is a figure which shows an example of the warning message in 2nd Embodiment. It is a flowchart which shows the flow of a series of processing for displaying an application detail screen in 3rd Embodiment. It is a figure which shows the screen composition of the application detail screen in 3rd Embodiment. It is a flowchart which shows the flow of a series of processing for displaying an application detail screen 1900 in 4th Embodiment. It is a figure which shows the screen composition of the application detail screen 1900. FIG. 5 is a flowchart showing a flow of a series of processes on the application detail screen generated in step S1807 of FIG. 18 in the fourth embodiment. It is a figure which shows an example of the warning message in 4th Embodiment. It is a figure which shows an example of the image list screen 2200 in 4th Embodiment. It is a figure which shows an example of a warning message according to the type of a missing image.

Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. First, the first embodiment will be described.

FIG. 1 is a diagram showing an example of a system configuration of the interpretation request system of the present invention. In the image interpretation request system, the request facility (hospital), the data center, and the image interpretation center are connected to each other so as to be able to communicate with each other via the Internet 103. At the request facility, a medical image diagnostic device 101 such as a CT device or an MRI device and a request terminal 102 for requesting interpretation of a DICOM image generated by the medical image diagnostic device 101 can communicate with each other via a network such as a LAN. It is connected to the.

The data center has a network of a remote interpretation server 104 that manages the application for interpretation request from the request facility and the result of interpretation at the image interpretation center, and a storage server 105 that stores DICOM images transmitted from the request facility. It is connected so that it can communicate via. That is, the data center acts as an intermediary between the requesting facility and the interpretation center. Further, the image interpretation center is provided with an image interpretation terminal 106 for the image interpreter to generate a multi-section reconstructed image image or a virtual endoscopic image (three-dimensional medical image) from the DICOM image and perform image interpretation.

The configuration of various terminals or servers connected on the network of FIG. 1 is an example, and is not limited to this because there are various configuration examples depending on the application and purpose.

A series of steps from the application for interpretation request to the return of the interpretation result will be explained. First, a patient (subject) is imaged with a medical image diagnostic device. In the case of colon CT examination, a CT device is used as a medical image diagnostic device, and a plurality of DICOM images showing a cross section of a patient are obtained. Since a plurality of DICOM images obtained by one scan (imaging) are managed as one series, when they are imaged a plurality of times, they are managed as a plurality of series. Then, the information at the time of imaging and the patient information are stored in the incidental information (DICOM tag) of the DICOM image, and transmitted from the requesting facility to the data center. When the data center receives the DICOM image, the remote interpretation server 104 manages the information about the DICOM image received for each inspection, and further stores the DICOM image in the storage server 105. The examination referred to here refers to one examination such as a large intestine CT examination, and if one examination is in progress, the DICOM image of the result is linked to one examination even if images are taken for a plurality of series.

When applying for an image interpretation request, the remote image interpretation server 104 is accessed from the request terminal 102, an inspection is selected, and then an image interpretation request for a DICOM image associated with the inspection is performed. At this time, the remote interpretation server 104 generates a screen for making a request application and provides the screen to the request terminal 102. The request terminal 102 displays this screen and accepts the input of the request content from the user of the request facility.

Here, in the case of a large intestine CT examination, the accuracy of interpretation may decrease unless there are DICOM images for a plurality of series captured in a plurality of postures. Therefore, if the DICOM image associated with the examination to be requested is not a DICOM image composed of a plurality of series, that is, a DICOM image having only one series, a warning regarding a request for interpretation of a large intestine CT examination is issued. By doing so, it is possible to prevent the image interpretation doctor from deteriorating the image interpretation accuracy. This mechanism will be described with respect to the first embodiment and the second embodiment. Regarding the third embodiment, a mechanism for not accepting an image interpretation request application when such an inspection is selected will be described.

The image interpretation request applied in this way is managed by the remote image interpretation server 104. At the image interpretation center, the requested image interpretation is distributed to an appropriate image interpretation doctor, and the image interpretation doctor operates the image interpretation terminal 106 to perform image interpretation. In the case of a large intestine CT examination, one or a plurality of multi-section reconstructed image images or virtual endoscopic images are generated from a plurality of DICOM images of one or a plurality of series associated with the selected examination. This is interpreted, the interpretation result is summarized in a report, and the image is registered in the remote interpretation server 104. Then, the requesting facility acquires the interpretation result from the remote interpretation server 104 and confirms it. Interpretation is performed according to the above flow. As described above, in the present embodiment, a series of processes when applying for an image interpretation request will be described in particular.

FIG. 2 is a diagram showing an example of the hardware configuration of the request terminal 102 and the remote interpretation server 104. The hardware configuration shown in FIG. 2 is merely an example, and is not limited to this because there are various configuration examples depending on the application and purpose.

The CPU 201 comprehensively controls each device and controller connected to the system bus 204.

Further, the ROM 202 or the external memory 211 stores a BIOS (Basic Input / Output System) which is a control program of the CPU 201 and an operating system program (hereinafter, referred to as an OS). Further, the external memory 211 stores various programs and the like necessary for realizing the functions executed by the various devices. The RAM 203 functions as a main memory, a work area, and the like of the CPU 201.

The CPU 201 realizes various operations by loading a program or the like necessary for executing a process into the RAM 203 and executing the program.

Further, the input controller 205 controls the input from the input device 209 such as a pointing device such as a keyboard and a mouse.

The video controller 206 controls the display on a display such as the display 210. The display may be a CRT or a liquid crystal display.

The memory controller 207 controls access to an external memory 211 such as a card-type memory connected to a hard disk, a flexible disk, or a PCMCIA card slot via an adapter. The external memory 211 (storage means) stores a boot program, browser software, various applications, font data, user files, edit files, various data, and the like.

The communication I / F controller 208 connects and communicates with an external device via a network, and executes communication control processing on the network. For example, Internet communication using TCP / IP is possible.

The CPU 201 enables display on the display 210 by, for example, executing an outline font expansion (rasterization) process in the display information area in the RAM 203. Further, the CPU 201 enables a user instruction with a mouse cursor or the like (not shown) on the display 210.

Various programs and the like used by the various devices of the present invention to execute various processes described later are recorded in the external memory 211, and are executed by the CPU 201 by being loaded into the RAM 203 as needed. Further, the definition file and various information tables used by the program according to the present invention are stored in the external memory 211.

FIG. 3 is a diagram showing an example of the functional configuration of the request terminal 102 and the remote interpretation server 104. The functional configuration shown in FIG. 3 is merely an example, and is not limited to this because there are various configuration examples depending on the application and purpose.

The request terminal 102 includes a communication control unit 301, a display control unit 302, and an input reception control unit 303 as functional units. The communication control unit 301 is a functional unit for transmitting and receiving information to and from the remote interpretation server 104 and other various devices. The display control unit 302 is a functional unit for displaying the screen of the Web page received by the communication control unit 301 on the display 210. The display control unit 302 also renders the screen. The input reception control unit 303 is a functional unit for receiving input to the screen displayed by the display control unit 302. Accepts input from the user who operates the input device of the request terminal 102. Then, the communication control unit 301 transmits the content received by the input reception control unit 303 to the remote interpretation server 104.

The remote image interpretation server 104 includes a communication control unit 311 as a functional unit, a screen generation unit 312, a DICOM image management unit 313, and a request application management unit 314. The communication control unit 311 is a functional unit for transmitting and receiving information to and from the request terminal 102 and other various devices. The screen generation unit 312 is a functional unit for generating a screen to be displayed on the request terminal 102. The screen generated by the screen generation unit 312 is a Web page that can be displayed by a Web browser. The screen generation unit 312 can generate not only static Web pages but also dynamic Web pages. As a dynamic Web page, a dynamic Web page is generated by embedding a script language such as Javascript (registered trademark) in the Web page.

The DICOM image management unit 313 is a functional unit for managing DICOM images transmitted from the request terminal 102. When the DICOM image is received from the request terminal 102, information about the patient, information about the DICOM image, information about the examination, etc. are acquired from the incidental information included in the DICOM image, and this is registered in the database. Further, the DICOM image is transmitted to the storage server 105, and the storage destination thereof is also registered in the database.

The request application management unit 314 is a functional unit for managing the request application for interpretation transmitted from the request terminal 102. For request applications, the contents of the request application and information on the inspection that is the subject of the request are registered in the database.

FIG. 4 is a flowchart showing a flow of a series of processes for generating an application waiting screen. Each step of S401, S405, and S406 described below is a process executed by the CPU 201 of the requesting terminal 102 operating each functional unit. Further, each step of S402 to S404 is a process executed by the CPU 201 of the remote interpretation server 104 operating each functional unit.

In step S401, the communication control unit 301 of the request terminal 102 transmits a request for acquiring the application waiting screen to the remote interpretation server 104. In step S402, the communication control unit 311 of the remote interpretation server 104 receives the application waiting screen acquisition request transmitted from the request terminal 102, and in step S403, the application waiting screen is generated.

FIG. 5 shows an example of the screen configuration of the application waiting screen 500. The application waiting screen 500 is a screen in which information related to the inspection transmitted from the requesting facility is displayed in a list. On this screen, only the inspections waiting for an application for which an application for interpretation request has not been made are displayed. In the application waiting list 501, information on the application status, information on the patient, information on the examination, and information on the DICOM image are displayed in a list. Further, the application waiting list 501 is provided with a request button 502 for each inspection (for each record), and by accepting a press on the request button 502, an application details screen for inputting the contents of the request application can be displayed. it can.

The application waiting screen 500 is generated by acquiring various information from the inspection management table 600 managed by the remote interpretation server 104 and the incidental information included in the DICOM image. FIG. 6 shows an example of the table configuration of the inspection management table 600.

The inspection management table 600 is a data table stored in the external memory 211 of the remote interpretation server 104. The examination management table 600 includes examination ID 601, patient information 602, number of series 603, number of images 604, and series ID 605. The inspection ID 601 is information for uniquely identifying the inspection. The patient information 602 is information about the patient (patient number, patient name, age, gender, etc.). The number of series 603 is information indicating the number of times the image was taken in the examination. The number of images 604 is the total number of DICOM images obtained in the inspection. Series ID 605 is the ID of the series corresponding to the inspection. Regarding the series ID 605, if a plurality of series correspond to the inspection, there are as many items of the series ID 605 as the number of the corresponding series. Information based on the incidental information of the DICOM image transmitted from the requesting facility is stored in each item of the inspection management table 600.

The application waiting list 501 is further provided with an image button 503 for each inspection, and can display a screen on which a list of DICOM images associated with the inspection can be viewed. For the DICOM image associated with the inspection, the series ID 605 of the inspection management table 600 is used as a key to search the series management table 610 shown in FIG. 6, and the DICOM image is acquired from the save path 613 of the hit record to generate a thumbnail image. .. Then, the list of generated thumbnail images is displayed on the screen.

The series management table 610 is a data table stored in the external memory 211 of the remote interpretation server 104. The series management table 610 includes a series ID 611, an image ID 612, and a storage path 613. Series ID 611 is an item corresponding to series ID 605. The image ID 612 is an ID for uniquely identifying the image. The storage path 613 indicates the storage location of the DICOM image. When the DICOM image is transmitted from the requesting facility, the series management table 610 is generated by the remote interpretation server 104 based on the incidental information of the DICOM image transmitted.

Here, the data structure of the DICOM image (two-dimensional medical image) will be described. FIG. 7 is a data structure of a DICOM image. The DICOM image has incidental information 710 and image data 720. Ancillary information is information attached as a tag, such as information on a patient, information on an examination, and information on a DICOM image. In this embodiment, the patient position 711 (position information) and the number of series 712 are used in particular. This information is given by the medical image diagnostic device of the requesting facility.

The image data 720 is image data captured by a medical diagnostic imaging apparatus. In the present embodiment, it is referred to as image data for convenience, but the actual state is information indicating a CT value if it is a CT device. Therefore, in a viewer that displays a DICOM image, it is visualized by giving a color corresponding to the CT value.

A plurality of such DICOM images can be acquired by one imaging (scanning). That is, a plurality of DICOM images showing a cross section of the patient's body are generated by one imaging operation. A plurality of DICOM images acquired by this one imaging operation are managed as one series. For example, in the case of a large intestine CT examination, one series is imaged in the supine position and another series is imaged in the prone position, and a total of two series of DICOM images are generated in one examination.

A screen displaying a list of thumbnail images of the DICOM image is shown in FIG. FIG. 8 is a screen displayed on the display 210 when the image button 503 is pressed. Using the series ID 605 corresponding to the inspection selected by the image button 503 and the series management table 610, the DICOM image obtained by the inspection is specified, and the thumbnail images are listed for each series. It is desirable to generate thumbnail images in advance. The timing of generation is not particularly limited. By displaying such a screen, the user confirms that there is no mistake in the inspection for requesting the interpretation.

Next, a series of processes when the request button 502 is pressed will be described with reference to the flowchart shown in FIG. Each step of S901, S902, S909, and S910 described below is a process executed by the CPU 201 of the request terminal 102 operating each functional unit. Further, each step of S903 to S908 is a process executed by the CPU 201 of the remote interpretation server 104 operating each functional unit.

In step S901, the input reception control unit 303 of the request terminal 102 determines whether or not the request button 502 is pressed. If it is determined that the request button 502 has been pressed, the process proceeds to step S902. If not, just wait.

In step S902, the communication control unit 301 of the request terminal 102 transmits a request for acquiring the application details screen related to the inspection to the remote interpretation server 104 in order to request the interpretation of the inspection for which the request button 502 is pressed.

In step S903, the communication control unit 311 of the remote interpretation server 104 receives the acquisition request of the application details screen transmitted from the request terminal 102. In step S904, the DICOM image management unit 313 of the remote interpretation server 104 determines whether or not the inspection in which the request button 502 is pressed corresponds to a plurality of DICOM images composed of a plurality of series. More specifically, the number of inspection series selected by the request button 502 may be specified from the number of inspection series 603 (first identification means). Since the number of series 603 is information acquired from the incidental information (number of series 712) of the DICOM image obtained in the inspection, the number of series may be specified by directly referring to the number of series 712 of the DICOM image. .. In step S904, it is determined whether or not the number of series thus specified is plural. If it is determined that the number of series is plural, the process proceeds to step S906. If it is determined that the number of series is not plural, that is, the number of series is 1, the process proceeds to step S907.

In step S905, the DICOM image management unit 313 of the remote interpretation server 104 determines whether or not the plurality of DICOM images composed of the plurality of series specified in step S904 are captured in a plurality of different postures. More specifically, it is specified in what position the image was taken for each series corresponding to the inspection in which the request button 502 was pressed (second identification means). The patient's position at the time of imaging is included in the incidental information (patient position 711). The patient position 711 is a "Patient Position" in the DICOM tag. Patient positions include supine, prone, and lateral positions. The information indicated by the patient position 711 is specified for each series, and the specified information is compared with each other. As a result of comparison, if even one different patient position exists, it is determined that the images were taken in a plurality of types of positions. For example, in the case of a series imaged in the supine position and a series imaged in the prone position, it is determined that the images are taken in a plurality of types of postures. As a result of the comparison, if all the patient positions are the same, it is determined that the images are not taken in a plurality of types of positions, that is, the images are taken in one type of position. For example, when all the series are imaged in the supine position, it is determined that the series is not imaged in a plurality of types of postures. If it is determined that the images were taken in a plurality of types of postures, the process proceeds to step S906. If it is determined that the images are not taken in a plurality of types of postures, the process proceeds to step S907.

In step S906, the screen generation unit 312 of the remote image interpretation server 104 generates an application detail screen capable of requesting and applying for image interpretation of the large intestine CT examination for the examination for which the request button 502 is pressed (display control means). FIG. 10 is a diagram showing an example of the screen configuration of the application detail screen 1000. The application details screen 1000 is a screen for inputting the content of the request when applying for an image interpretation request. On this screen, information about the examination for which the request button 502 is pressed, information about the patient, and information about the DICOM image are also displayed. On the application details screen 1000, a button similar to the image button 503 may be provided so that the DICOM image associated with the inspection can be confirmed.

On the other hand, in step S907, the screen generation unit 312 of the remote image interpretation server 104 can request the image interpretation of the large intestine CT examination for the examination for which the request button 502 is pressed. Generate an application details screen that performs different actions. There is one series corresponding to the inspection in which the request button 502 is pressed, or there are a plurality of series but the inspection is not imaged in a plurality of types of postures. That is, when interpreting the large intestine CT examination, the accuracy of the interpretation may be lowered due to the residue or the like. Therefore, when an attempt is made to request an interpretation of a large intestine CT examination, an application detail screen for warning the user of the requesting facility is generated in step S907 (display control means).

In step S908, the communication control unit 311 of the remote interpretation server 104 transmits the application details screen 1000 generated in step S906 or step S907 to the request terminal 102.

In step S909, the communication control unit 301 of the request terminal 102 receives the application details screen 1000 transmitted from the remote interpretation server 104. Then, in step S910, the display control unit 302 of the request terminal 102 displays the received application detail screen 1000 on the display 210 (display control means).

Next, a series of processing flows for accepting the request application on the application details screen 1000 generated in step S906 will be described with reference to the flowchart shown in FIG. Each step of S1101 and S1102 described below is a process executed by the CPU 201 of the requesting terminal 102 operating each functional unit. Further, each step of S1103 and S1104 is a process executed by the CPU 201 of the remote interpretation server 104 operating each functional unit.

In step S1101, the input reception control unit 303 of the request terminal 102 receives the input of necessary items for each input field of the application detail screen 1000 generated in step S906, and then the request application button 1002 is pressed. Judge whether or not. As shown in FIG. 10, the application details screen 1000 is provided with a check box 1001 for the site. When requesting the interpretation of the large intestine CT examination, check "CTC" and then click the request application button. Press 1002. If it is determined that the request application button 1002 has been pressed, the process proceeds to step S1102. If not, just wait.

In step S1102, the communication control unit 301 of the request terminal 102 transmits the request application information including various information received on the application detail screen 1000 generated in step S906 to the remote interpretation server 104.

In step S1103, the communication control unit 311 of the remote interpretation server 104 receives the request application information transmitted from the request terminal 102. Then, in step S1104, the request application management unit 314 of the remote image interpretation server 104 registers the received request application information in the database provided in the remote image interpretation server 104, and manages the image interpretation request so that it can be distributed to the image interpretation doctor. In this way, on the application details screen 1000 generated in step S906, a request application for a large intestine CT examination can be made as before.

Next, a series of processing flows for accepting the request application on the application details screen 1000 generated in step S907 will be described with reference to the flowchart shown in FIG. Each step of S1201 to S1205 described below is a process executed by the CPU 201 of the requesting terminal 102 operating each functional unit. Further, each step of S1206 and S1207 is a process executed by the CPU 201 of the remote interpretation server 104 operating each functional unit.

In step S1201, the input reception control unit 303 of the request terminal 102 receives the input of necessary items for each input field of the application detail screen 1000 generated in step S907, and then the request application button 1002 is pressed. Judge whether or not. The operation of the check box 1001 is the same as in step S1101. If it is determined that the request application button 1002 has been pressed, the process proceeds to step S1202. If not, just wait.

In step S1202, the input reception control unit 303 of the request terminal 102 determines whether or not "CTC" indicating the large intestine CT examination is checked among the check boxes 1001 of the application details screen 1000 generated in step S907. .. If it is determined that "CTC" is checked, the process proceeds to step S1203. If it is determined that "CTC" is not checked, the process proceeds to step S1204.

In step S1203, the display control unit 302 of the request terminal 102 warns the user that the DICOM image of the selected inspection may reduce the accuracy of interpretation. An example of this warning is shown in FIG. As shown in FIG. 13, a dialog may be displayed to warn, or a voice may be reproduced to warn. Further, the content of the warning is not limited to the content shown in FIG. You may notify that rework may occur regarding the large intestine CT examination, or you may notify that the fee for the image interpretation request does not change even if accurate image interpretation is not possible.

In step S1204, the input reception control unit 303 of the request terminal 102 determines whether the YES button 1301 or the NO button displayed together with the warning performed in step S1203 is pressed. Even if there is a possibility that the image interpretation accuracy of the large intestine CT examination may be lowered, the user presses the YES button 1301 when he / she wants to apply for the image interpretation request. If not, press the NO button 1302 to cancel the application. If it is determined that the YES button 1301 has been pressed, the process proceeds to step S1205. When it is determined that the NO button 1302 is pressed, the warning is terminated and the input to the application details screen 1000 is accepted again.

In step S1205, the communication control unit 301 of the request terminal 102 transmits the request application information including various information received on the application detail screen 1000 generated in step S907 to the remote interpretation server 104.

In step S1206, the communication control unit 311 of the remote interpretation server 104 receives the request application information transmitted from the request terminal 102. Then, in step S1207, the request application management unit 314 of the remote interpretation server 104 registers the received request application information in the database provided in the remote interpretation server 104, and manages the image interpretation request so that it can be distributed to the image interpretation doctor. In this way, on the application detail screen 1000 generated in step S907, by notifying the user that the accuracy of the interpretation of the large intestine CT examination may decrease, the accuracy of the image interpretation is reduced and the large intestine CT examination is performed. Rework can be suppressed.

As described above, as described in the first embodiment, by using this mechanism, it is possible to appropriately perform image interpretation related to the large intestine CT examination.

Next, the second embodiment will be described. The second embodiment is a modification of FIG. Therefore, the same as the first embodiment except for the points described in the second embodiment, and thus the description thereof will be omitted.

In the first embodiment, a warning is given to the user after the request application button 1002 is pressed. The second embodiment is a mechanism for giving a warning to the user when "CTC" is checked in the check box 1001. This mechanism will be described with reference to FIGS. 14 and 15.

FIG. 14 is a flowchart showing a flow of a series of processes for accepting a request application on the application detail screen 1000 generated in step S907. Each step of S1401 to S1404 described below is a process executed by the CPU 201 of the requesting terminal 102 operating each functional unit. Further, each step of S1405 and S1406 is a process executed by the CPU 201 of the remote interpretation server 104 operating each functional unit.

In step S1401, the input reception control unit 303 of the request terminal 102 determines whether or not the check of "CTC" is switched to ON among the check boxes 1001 included in the application detail screen 1000 generated in step S907. If it is determined that the "CTC" check has been switched to ON, the process proceeds to step S1402. If not, the process proceeds to step S1403.

In step S1402, the display control unit 302 of the request terminal 102 warns the user that the DICOM image of the selected inspection may reduce the accuracy of interpretation. An example of this warning is shown in FIG. A balloon 1501 is displayed near the "CTC" check box, and a warning to the user is displayed in this balloon. By generating the application details screen 1000 for giving such a warning in step S907, it is possible to give a warning to the user before making the request application.

In step S1403, the input reception control unit 303 of the request terminal 102 receives the input of necessary items for each input field of the application detail screen 1000 generated in step S907, and then the request application button 1002 is pressed. Judge whether or not. If it is determined that the request application button 1002 has been pressed, the process proceeds to step S1404. If not, the process returns to step S1401.

In step S1404, the communication control unit 301 of the request terminal 102 transmits the request application information including various information received on the application detail screen 1000 generated in step S907 to the remote interpretation server 104.

In step S1405, the communication control unit 311 of the remote interpretation server 104 receives the request application information transmitted from the request terminal 102. Then, in step S1406, the request application management unit 314 of the remote interpretation server 104 registers the received request application information in the database provided in the remote interpretation server 104, and manages the image interpretation request so that it can be distributed to the image interpretation doctor.

As described above, as described in the second embodiment, it is possible to give a warning to the user at the timing when the check box 1001 of "CTC" is turned ON before accepting the press of the request application button 1002.

Next, the third embodiment will be described. The third embodiment is a modification of FIG. Therefore, the same as the first embodiment except for the points described in the third embodiment, and thus the description thereof will be omitted.

In the first embodiment and the second embodiment, a warning is given to the user. In the third embodiment, there is one series corresponding to the examination in which the request button 502 is pressed, or for an examination in which there are a plurality of series but are not imaged in a plurality of postures, a request for interpretation of a large intestine CT examination is requested. It is a mechanism to control not to accept. This mechanism will be described with reference to FIGS. 16 and 17.

FIG. 16 is a flowchart showing a series of processes when the request button 502 is pressed. Each step of S901, S902, S909, and S910 is a process executed by the CPU 201 of the request terminal 102 operating each functional unit. Further, each step of S903 to S908 and S1601 is a process executed by the CPU 201 of the remote interpretation server 104 operating each functional unit.

Further, since each step of step S901 to step S910 is the same as that in FIG. 9, the description thereof will be omitted.

In step S1601, the screen generation unit 312 of the remote image interpretation server 104 controls the image interpretation of the large intestine CT examination so that the request cannot be applied for the examination for which the request button 502 is pressed (the request application is not accepted). Generate. 17 (a) and 17 (b) are examples of the application details screen 1000 generated in step S1601. First, as shown in 1701, FIG. 17A is a grayed-out screen so that the “CTC” check box cannot be checked. As described above, for the examinations that do not satisfy the conditions of steps S904 and S905, the image interpretation request for the large intestine CT examination is not accepted. In FIG. 17B, the check box of "CTC" can be checked, but when it is checked, the request application button is grayed out as shown in 1702, and the press on the request application button is not accepted. In this way, the request for interpretation of the large intestine CT examination may not be accepted. In addition, as another form, the check box of "CTC" can be checked and the request application button can also be pressed, but after pressing the request application button, an error notification is issued so that the request application is not accepted. You may. Further, although the request application is transmitted to the remote interpretation server 104, the remote interpretation server 104 may be controlled so as not to accept the request application.

As described above, as described in the third embodiment, it is possible to control so as not to accept the pressing of the "CTC" check box or the request application button.

Next, a fourth embodiment will be described. In the first to third embodiments, it is possible to appropriately request the interpretation of the three-dimensional medical image generated from the two-dimensional medical image according to the number of a plurality of series acquired by the medical image diagnostic apparatus. The mechanism for displaying the screen was explained. A fourth embodiment describes a mechanism for appropriately performing an image interpretation request using a two-dimensional medical image when a three-dimensional medical image is not generated, which is a medical image acquired by a medical image diagnostic apparatus.

Since the first to third embodiments have been described mainly on the premise of a large intestine CT examination, it is premised on generating a three-dimensional medical image. In the fourth embodiment, a case where a plurality of medical images or medical images captured from different directions are required when interpreting a two-dimensional medical image without generating a three-dimensional medical image will be described. For example, this corresponds to the case of interpreting a medical image captured in a medical examination (hereinafter referred to as a medical examination). When requesting image interpretation for a medical examination, for example, when requesting image interpretation of an imaged chest X-ray (chest X-ray), image interpretation is performed using two-dimensional images captured by X-rays from a plurality of directions such as the front and side surfaces. This is because the organs or bones near the lungs overlap to create a blind spot, and it is difficult to determine the abnormal part only from the front image. For example, by interpreting the image together with the two-dimensional medical image captured from the side surface, it is possible to complement the interpretation of the front two-dimensional medical image and improve the detection accuracy of the abnormal portion. A series of processes for applying for a request in such a case will be described below. Each step of S1801, S1802, S1809, and S1810 of FIG. 18 described below is a process executed by the CPU 201 of the request terminal 102 operating each functional unit. Further, each step of S1803 to S1808 is a process executed by the CPU 201 of the remote interpretation server 104 operating each functional unit. Since the processing of steps S1801 to S1803 is the same as the processing of step S903 of FIG. 9, the description thereof will be omitted.

In step S1804 of FIG. 18, the DICOM image management unit 313 of the remote interpretation server 104 determines whether or not the inspection in which the request button 502 is pressed corresponds to a plurality of DICOM images. More specifically, the number of images for inspection selected by the request button 502 may be specified from the number of images 604. If it is determined that the number of specified images is a plurality, the process proceeds to step S1805. If it is determined that the number of images is not plural, that is, the number of images is 1, the process proceeds to step S1807.

In step S1805, the DICOM image management unit 313 of the remote interpretation server 104 determines whether or not the plurality of DICOM images identified in step S1804 are captured from a plurality of types of directions (positions). The direction of imaging includes the front surface, the side surface, and the like. This imaging direction is specified for each image, and the specified information is compared. As a result of comparison, if even one different imaging direction exists, it is determined that the image was taken from a plurality of types of directions. As a result of comparison, if all the patient positions are the same, it is determined that the images are not taken from a plurality of types of directions. If it is determined that the image was taken from a plurality of types of directions, the process proceeds to step S1806. If it is determined that the images are not taken from a plurality of types of directions, the process of step S1807 proceeds.

In step S1806, the screen generation unit 312 of the remote image interpretation server 104 generates an application detail screen capable of requesting image interpretation related to the medical examination for the examination for which the request button 502 is pressed.

FIG. 19 is a diagram showing an example of the application details screen 1900. On this screen, information on the examination for which the request button 502 is pressed, information on the patient, information on the medical examination site, and the like are also displayed.

On the other hand, in step S1807, the screen generation unit 312 of the remote image interpretation server 104 performs an operation different from the screen generated in step S1806, which can request the image interpretation related to the medical examination for the examination for which the request button 502 is pressed. Generate the application details screen to be executed. This screen is displayed when the number of images corresponding to the inspection in which the request button 502 is pressed is one, or when there are a plurality of images but the inspection is not imaged in a plurality of types of directions. In other words, this is the case of examination of the chest and the like when it is difficult to interpret the image near the blind spot consisting of overlapping organs and bones. Therefore, when there is no two-dimensional medical image taken from a different direction, an application detail screen is generated in step S1807 so that additional registration can be performed while warning the user.

Since steps S1808 to S1809 are the same processes as steps S908 to S910 of FIG. 9, description thereof will be omitted.

Next, a series of processing flows for accepting the request application on the application details screen 1900 generated in step S1806 will be described with reference to the flowchart shown in FIG. Each step of S2001 to S2006 described below is a process executed by the CPU 201 of the requesting terminal 102 operating each functional unit. Further, each step of S2007 and S2008 is a process executed by the CPU 201 of the remote interpretation server 104 operating each functional unit.

In step S2001, the input reception control unit 303 of the request terminal 102 receives the input of necessary items for each input field of the application details screen 1900 generated in step S1806, and then the request application button 1902 is pressed. Judge whether or not. As shown in FIG. 19, the application details screen 1900 is provided with a check box 1901 for a part, and when requesting an interpretation of a medical examination, check the corresponding part and then apply the request button 1902. Press. If it is determined that the request application button 1902 has been pressed, the process proceeds to step S2002. If not, just wait.

In step S2002, the input reception control unit 303 of the request terminal 102 determines whether or not the "chest" indicating the roentgen examination of the chest is checked in the check box 1901 of the application details screen 1900. If it is determined that the "chest" is checked, the process proceeds to step S2003. In other cases, the process proceeds to step S2005.

In step S2003, the display control unit 302 of the request terminal 102 warns the user that the interpretation system is reduced or the interpretation is not accepted only by the DICOM image of the selected inspection, and additionally registers the image. Display a screen that can be used. An example of the screen is shown in FIG. As shown in FIG. 21, a dialog may be displayed to warn, or a voice may be played to warn. Further, as shown in FIG. 21, the selection of whether or not to register the missing image may be accepted. When it is determined that the pressing of the YES button 2101 is accepted, that is, the additional registration of the image is accepted, the process proceeds to step S2004. When it is determined that the pressing of the NO button 2102 in FIG. 21 is accepted, that is, the additional registration of the image is not accepted, the process proceeds to step S2005. If the additional registration of the image is not accepted and the accuracy of the image interpretation is lowered, the image interpretation may be switched to the double image interpretation assigned to two image interpretation doctors instead of the single image interpretation assigned to one image interpretation doctor.

In step S2004, the input reception control unit 303 of the request terminal 102 accepts the selection of an image from the image candidate list when the additional registration of the image is received in step S2003.

FIG. 22 is a diagram showing an example of the image list screen 2200. On the image list screen 2200, information such as image information, patient information, and examination date and time is displayed, and an image search can be executed using each search condition. When the image selection is accepted on the image list screen 2200 and the pressing of the request addition button 2201 is detected, the image for which the selection is accepted is additionally registered in the request information. This makes it possible to additionally register images taken from different directions, which was insufficient in interpretation.

In step S2005, the input reception control unit 303 of the request terminal 102 determines whether or not the request application button 1902 has been pressed. More specifically, whether or not the request application button 1902 is pressed again after accepting the selection of whether or not to add an image in step S2004 and adding the image, or when making a request as it is without adding the image. Is determined. If it is determined that the request application button 1902 has been pressed, the process proceeds to step S2006. If it is not determined that the request application button 1902 has been pressed, the application is canceled and a series of processes is terminated.

Since the processing of steps S2006 to S2008 is the same as the processing of steps S1205 to S1207, the description ends. By these processes, even when requesting an image interpretation related to a medical examination using multiple two-dimensional medical images corresponding to the same examination, forgetting to attach the image, reducing the accuracy of the image interpretation, and performing the medical examination. It is possible to prevent the return and the like.

As described above, as described in the fourth embodiment, by using this mechanism, it is possible to appropriately interpret the image of the medical examination.

Further, the application details screen 2300 of FIG. 23 will be described. FIG. 23 shows an example of a dialog screen displayed at the time of requesting interpretation of PET / CT inspection. In the PET / CT examination, the image acquired by the PET (positron emission tomography) examination and the image acquired by the CT examination can be combined, and both images can be displayed in an overlapping manner in one examination. This makes it possible to improve the accuracy of diagnosis. When requesting the interpretation of PET / CT examination, if only the PET series image or only the CT series image is used, refer to the number of series of 2D medical images and warn of the excess or deficiency of the number of series. .. At that time, as shown in FIG. 23, which type of series is missing may be displayed as a dialog. Further, as described in the fourth embodiment, additional registration of the image may be accepted on the warning screen.

As described above, in the case of PET / CT examination, when the number of series of two-dimensional medical images is 1, it is possible to warn and appropriately interpret the image related to PET / CT examination.

As described above, according to the present embodiment, the interpretation request of the three-dimensional medical image generated from the two-dimensional medical image is requested according to the number of series of the plurality of two-dimensional medical images acquired by the medical image diagnostic apparatus. It becomes possible to display a screen that can be appropriately performed.

The present invention can be, for example, an embodiment as a system, an apparatus, a method, a program, a storage medium, or the like, and specifically, may be applied to a system composed of a plurality of devices, or 1 It may be applied to a device consisting of two devices.

The present invention includes a software program that realizes the functions of the above-described embodiments, which is directly or remotely supplied to a system or an apparatus. The present invention also includes cases where the computer of the system or device can also read and execute the supplied program code.

Therefore, in order to realize (execute) the functional processing of the present invention on a computer, the program code itself installed on the computer also realizes the present invention. That is, the present invention also includes a computer program itself for realizing the functional processing of the present invention.

In that case, as long as it has a program function, it may be in the form of an object code, a program executed by an interpreter, script data supplied to the OS, or the like.

Recording media for supplying programs include, for example, flexible disks, hard disks, optical disks, optical magnetic disks, MOs, CD-ROMs, CD-Rs, CD-RWs, and the like. There are also magnetic tapes, non-volatile memory cards, ROMs, DVDs (DVD-ROM, DVD-R) and the like.

In addition, as a program supply method, a browser of a client computer is used to connect to an Internet homepage. Then, the computer program itself of the present invention or a compressed file including the automatic installation function can be supplied from the homepage by downloading it to a recording medium such as a hard disk.

It can also be realized by dividing the program code constituting the program of the present invention into a plurality of files and downloading each file from different homepages. That is, the present invention also includes a WWW server that allows a plurality of users to download a program file for realizing the functional processing of the present invention on a computer.

In addition, the program of the present invention is encrypted, stored in a storage medium such as a CD-ROM, distributed to users, and the key information for decrypting the encryption is downloaded from the homepage to the user who clears the predetermined conditions. Let me. Then, by using the downloaded key information, it is possible to execute an encrypted program and install it on a computer.

Further, the function of the above-described embodiment is realized by the computer executing the read program. In addition, based on the instruction of the program, the OS or the like running on the computer performs a part or all of the actual processing, and the function of the above-described embodiment can be realized by the processing.

Further, the program read from the recording medium is written to the memory provided in the function expansion board inserted in the computer or the function expansion unit connected to the computer. After that, based on the instruction of the program, the function expansion board, the CPU provided in the function expansion unit, or the like performs a part or all of the actual processing, and the function of the above-described embodiment is also realized by the processing.

It should be noted that the above-described embodiments merely show examples of embodiment in carrying out the present invention, and the technical scope of the present invention should not be construed in a limited manner by these. That is, the present invention can be implemented in various forms without departing from the technical idea or its main features.

101 Medical image diagnostic device 102 Request terminal 103 Internet 104 Remote interpretation server 105 Storage server 201 CPU
202 ROM
203 RAM
204 System Bus 205 Input Controller 206 Video Controller 207 Memory Controller 208 Communication I / F Controller 209 Input Device 210 Display 211 External Memory

Claims (12)

It is an image interpretation request system that can request image interpretation for multiple two-dimensional medical images acquired by a medical image diagnostic device.
A control means for controlling to give a warning regarding image interpretation on condition that the number of series of the two-dimensional medical image for which image interpretation is requested is one among the plurality of the two-dimensional medical images composed of one or a plurality of series. An image interpretation request system characterized by being equipped with. A storage means for storing a plurality of the two-dimensional medical images composed of the one or a plurality of series, and
A display control means for displaying a screen for giving a warning regarding the interpretation is further provided.
Said control unit, among a plurality of the two-dimensional medical image composed of one or more series are stored in the storage means, the series number of the two-dimensional medical image to be interpretation request is 1 The image interpretation request system according to claim 1, wherein the display control means controls the display to give a warning regarding the image interpretation. The storage means further stores the position information indicating the type of the body position of the subject included in the two-dimensional medical image.
The interpretation request system is
A first specific means for specifying the number of series of the plurality of two-dimensional medical images stored in the storage means, and
A second specific means for specifying the number of types of the position included in the plurality of two-dimensional medical images stored in the storage means based on the position information stored in the storage means.
Further prepare
The second aspect of the present invention is the second aspect of the present invention, wherein the control means further controls to give a warning regarding the interpretation when the number of the types of the postures specified by the second specific means is 1. Interpretation request system. The image interpretation request system according to any one of claims 1 to 3, wherein the control means controls to give a warning regarding the image interpretation in response to an instruction of the image interpretation request for a specific inspection. It is an image interpretation request system that can request image interpretation for multiple two-dimensional medical images acquired by a medical image diagnostic device.
Control is performed so that the interpretation request cannot be performed on the condition that the number of series of the two-dimensional medical images for which the interpretation request is made is 1 among the plurality of the two-dimensional medical images composed of one or a plurality of series. An image interpretation request system characterized by having a control means. A storage means for storing a plurality of the two-dimensional medical images composed of the one or a plurality of series, and
Display control means for displaying the screen related to the interpretation and
Further prepare
Said control unit, among a plurality of the two-dimensional medical image composed of one or more series are stored in the storage means, the series number of the two-dimensional medical image to be interpretation request is 1 The image interpretation request system according to claim 5, wherein the display control means controls the display of the image interpretation request not to be accepted by displaying a screen that does not accept the image interpretation request. The storage means further stores the position information indicating the type of the body position of the subject included in the two-dimensional medical image.
The interpretation request system is
A first specific means for specifying the number of series of the plurality of two-dimensional medical images stored in the storage means, and
A second specific means for specifying the number of types of the position included in the plurality of two-dimensional medical images stored in the storage means based on the position information stored in the storage means.
Further prepare
6. The display control means is further controlled so as not to accept the interpretation request, provided that the number of types of the body positions specified by the second specific means is 1. Interpretation request system described in. The interpretation request system according to claim 3 or 7, wherein the body position information is incidental information given to the two-dimensional medical image by the medical image diagnostic apparatus. The image interpretation request system is an image interpretation request system capable of requesting image interpretation of a three-dimensional medical image generated from a plurality of two-dimensional medical images acquired by a medical image diagnostic apparatus.
The image interpretation request system according to any one of claims 1 to 8, wherein the control means controls to receive an image interpretation request for a three-dimensional medical image generated from the plurality of the two-dimensional medical images. It is a control method of an image interpretation request system capable of making an image interpretation request for a plurality of two-dimensional medical images acquired by a medical image diagnostic device.
The control means of the image interpretation request system interprets images on condition that the number of series of the two-dimensional medical images for which image interpretation is requested is one among the plurality of two-dimensional medical images composed of one or a plurality of series. A method of controlling an image interpretation request system, which comprises a control step that controls to give a warning about. It is a control method of an image interpretation request system capable of making an image interpretation request for a plurality of two-dimensional medical images acquired by a medical image diagnostic device.
Control means of the interpretation request system, among a plurality of the two-dimensional medical image composed of one or more series, series number of the two-dimensional medical image to be interpretation request on condition that it is a 1, the A control method for an image interpretation request system, which includes a control step for controlling the image interpretation request so that it cannot be performed. A program for operating a computer as the interpretation request system according to any one of claims 1 to 9.

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