JP6953974B2 - Diagnostic imaging system - Google Patents

Description

The present invention relates to a diagnostic imaging system.

Conventionally, it has been known that a disease caused by a tumor in the body or organ is diagnosed by collecting a sample such as blood or a tissue piece from the body of the subject (patient). Here, conventionally, a doctor or the like sends a collection device for collecting a sample sample to a collection position in the subject while checking a fluoroscopic image of the subject with a radiographic image diagnostic device, and the sample sample is collected. It is known (see Non-Patent Document 1).

In Non-Patent Document 1, for the diagnosis of primary aldosteronism, various parts of the adrenal gland are inserted by inserting a catheter to the collection position while confirming the X-ray fluoroscopic image of the subject by a radiographic image diagnostic device in real time. It is disclosed that a blood sample (sample sample) is collected from the vein of the patient. Here, Non-Patent Document 1 discloses that the collection position is entered in the medical record together with the sketch of the adrenal vein in order to manage the correspondence between the collected blood sample and the collection position (collection position). Has been done.

Kozo Makita, "Adrenal Vein Blood Collection in Primary Aldosteronism-Tips for Successful Adrenal Vein Sampling Techniques-", Journal of the Japan Interventional Radiology Society, 2013, Vol. 28, No. 2, p. 204-210

However, in the method of entering the collection position together with the sketch of the adrenal vein in the medical record described in Non-Patent Document 1, the collection position tends to be inaccurate, and the work load of a doctor or the like required to specify the collection position is increased. growing. Therefore, there is a demand for a system that can more accurately specify the collection position and reduce the work load of a doctor or the like required to specify the collection position.

The present invention has been made to solve the above-mentioned problems, and one object of the present invention is that it is possible to specify the collection position more accurately and it is necessary to specify the collection position. It is to provide a diagnostic image system capable of reducing the work load of doctors and the like.

In order to achieve the above object, the diagnostic image system in one aspect of the present invention provides a first image capable of determining the collection position or the state of the tissue around the collection position when the sample sample is collected from the subject. A composite image creation unit that creates a composite image in which the acquisition unit to be acquired and the second image corresponding to the first image and the first image and displaying the position reference unit for specifying the collection position are combined. , and a display unit for displaying a composite image, the sampling position in the displayed composite image on the display unit that is configured to be registered.

In the diagnostic image system according to one aspect of the present invention, by configuring the composite image creation unit as described above, the state of the collection position or the tissue around the collection position and the position reference unit for specifying the collection position Can be included in the composite image, so that the sampling position can be accurately specified by using the composite image. Further, since the composite image is automatically created on the diagnostic image system, doctors and the like do not need to sketch the medical record. As a result, it is possible to reduce the work load of a doctor or the like required to specify the collection position. As a result, it is possible to specify the collection position more accurately, and it is possible to reduce the work load of a doctor or the like required to specify the collection position.

In the diagnostic image system according to the above one aspect, the collection position is preferably specified in the composite image based on the relative positional relationship between the position reference unit and the collection position. With this configuration, the collection position can be more accurately specified based on the relative positional relationship between the position reference unit and the collection position included in the composite image.

In the diagnostic imaging system according to the above one aspect, the position reference portion is preferably a blood vessel image of the subject. With this configuration, the collection position and the blood vessel image can be included in the composite image, so that the blood collection position can be accurately specified when blood is collected.

In this case, preferably, the first image is a non-contrast X-ray image obtained by the acquisition unit without using a contrast medium for the subject, and the state of the collection position or the tissue around the collection position can be discriminated. The second image is a contrast-enhanced X-ray image obtained by using a contrast medium on the subject and displaying a blood vessel image. With this configuration, the blood vessel image is not displayed because the contrast medium is not used, while the non-contrast X-ray image that can determine the state of the collection position or the tissue around the collection position and the blood vessel image using the contrast medium. By synthesizing the contrast-enhanced X-ray image in which is displayed, it is possible to create a composite image in which both the collection position and the blood vessel image can be discriminated. This makes it possible to more accurately identify the blood collection position.

In the diagnostic image system according to the above one aspect, preferably, the composite image creation unit is configured to create a composite image by superimposing a second image having a display color different from that of the first image on the first image. There is. With this configuration, it is possible to easily recognize that the second image is superimposed on the first image, and in the composite image, a doctor or the like can visually recognize the position reference portion for specifying the collection position. It can be made easier.

In diagnostic imaging system according to the aforementioned aspect preferably, Table radical 113 is the first image and the synthetic image at the same time can be displayed, or is capable of displaying by switching between a first image combined image. With this configuration, the doctor or the like can confirm the first image displayed at the same time or switched to be displayed while confirming the composite image displayed on the display unit. As a result, it is possible to easily confirm the portion that is difficult to see on the composite image by using the first image.

The diagnostic image system according to the above one aspect preferably further includes a generation unit that generates a second image from the three-dimensional image on which the position reference unit is displayed based on the shooting direction of the first image. Here, by cutting out the three-dimensional image at a predetermined position, a two-dimensional second image corresponding to the predetermined position can be generated. Therefore, if a three-dimensional image is cut out based on the shooting direction of the first image, the second image corresponding to the first image can be accurately generated, so that the second image does not sufficiently correspond to the first image. It is possible to suppress the composition of the two images and the first image.

In this case, preferably, the generation unit has a second from a plurality of three-dimensional images corresponding to the plurality of time points, based on the shooting direction of the first image and the state of the subject at the time when the first image is taken. It is configured to generate an image. With this configuration, for example, even if the subject (collection position and position reference portion) moves due to periodic movements such as respiration and pulsation, the second image corresponding to the first image Can be generated accurately. As a result, it is possible to further suppress the composition of the second image and the first image, which do not sufficiently correspond to the first image.

According to the present invention, as described above, it is possible to specify the collection position more accurately, and it is possible to reduce the work load of a doctor or the like required to specify the collection position.

It is a schematic diagram which shows the whole structure of the diagnostic image system by 1st Embodiment. It is a block diagram for demonstrating the configuration example of the X-ray imaging apparatus. It is a figure for demonstrating the creation of a DRR image from a three-dimensional image. It is a figure for demonstrating the creation of a composite image, and the identification of a collection position. It is a figure for demonstrating the blood sampling data. It is a figure for demonstrating that the DRR image is created from a plurality of three-dimensional images in the diagnostic image system by 2nd Embodiment.

Hereinafter, embodiments embodying the present invention will be described with reference to the drawings.

[First Embodiment]
The configuration of the diagnostic image system 100 according to the first embodiment of the present invention will be described with reference to FIGS. 1 to 4. In the first embodiment, an example in which the diagnostic imaging system 100 is used for adrenal vein sampling for the diagnosis of primary aldosteronism will be described.

(Configuration of diagnostic image system)
As shown in FIG. 1, the diagnostic image system 100 includes an X-ray imaging apparatus 1 and a sample analyzer 2. The X-ray imaging apparatus 1 captures an X-ray fluoroscopic image 30 (see FIG. 4) of the subject T when collecting a blood sample B from the subject T using a sample collection device 3 such as a catheter inserted into a blood vessel. It is configured to be generated and displayed on the display unit 16. Further, the X-ray imaging apparatus 1 is configured to specify the collection position P when the blood sample B is collected from the subject T. The X-ray imaging apparatus 1 is an example of the "acquisition unit" in the claims. Further, the blood sample B is an example of the "sample sample" in the claims.

The sample analyzer 2 is configured to analyze the blood sample B collected from the subject T. Then, the X-ray imaging apparatus 1 is configured to associate the specified collection position P with the analysis result A of the blood sample B based on the blood collection number N for identifying the blood sample B. The blood collection number N is, for example, a value (001, etc., see FIG. 5) assigned to each collection position P in order, and has a one-to-one correspondence with each of the plurality of blood samples B.

The subject T is a subject to be diagnosed, and a blood sample B for diagnosis is collected from the subject T by a doctor or the like. The subject T is not limited to the human shown in FIG. 1, and may be an animal other than human.

The X-ray imaging apparatus 1 and the sample analyzer 2 are connected to each other via a network 4 based on the DICOM (Digital Imaging and Communications in Medicine) standard. Further, the X-ray imaging apparatus 1 and the sample analyzer 2 are connected to the host computer (server) 5 via the network 4. The host computer 5 can acquire electronic medical record information via the network 4, and includes information on the subject T (ID, name, age, gender, etc.), a three-dimensional image 40 of the subject T, which will be described later, and the like. It is possible to hold.

(Configuration of X-ray imaging device)
As shown in FIG. 2, the X-ray imaging apparatus 1 includes an imaging unit 11 and a top plate driving unit 12. The photographing unit 11 includes an irradiation unit 11a, a detection unit 11b, an arm 11c (see FIG. 1), and an arm driving unit 11d. The irradiation unit 11a includes an X-ray source (not shown) and irradiates the subject T with X-rays. The detection unit 11b detects X-rays (transmitted X-rays) irradiated by the irradiation unit 11a and transmitted through the subject T, and outputs a detection signal according to the intensity to the control unit 13. Further, the control unit 13 (image processing unit 18) acquires the X-ray fluoroscopic image 30 based on the received detection signal. The detection unit 11b is composed of, for example, an FPD (Flat Panel Detector).

The arm 11c is formed in a C shape. An irradiation unit 11a and a detection unit 11b are attached to one end and the other end of the C-shape of the arm 11c, respectively. At this time, the irradiation unit 11a and the detection unit 11b are attached to the arm 11c so as to face each other with the subject T (top plate 12a) interposed therebetween. The arm driving unit 11d moves the arm 11c in the horizontal direction and the vertical direction to irradiate the subject T with X-rays from the irradiating unit 11a and the irradiation direction (in other words, the imaging position of the X-ray fluoroscopic image 30 and the imaging direction). It is configured to change the shooting direction).

The top plate driving unit 12 is configured to be able to move the top plate 12a on which the subject T is placed in the horizontal direction.

The X-ray imaging apparatus 1 further includes a control unit 13, a storage unit 14, a communication unit 21, a display unit 16, and an operation unit 17. The control unit 13, the storage unit 14, and the communication unit 21 are provided in the X-ray imaging apparatus main body 1a.

The control unit 13 controls the entire X-ray imaging device 1. The control unit 13 includes a processor such as a CPU (Central Processing Unit) and a GPU (Graphics Processing Unit), and a memory such as a RAM. Further, the control unit 13 is configured to perform a predetermined control process by executing a predetermined control program stored in the memory. Specifically, the control unit 13 performs image processing that executes a generation unit 18a that generates a DRR (Digitally Reconstructed Radiography) image 41 from a three-dimensional image 40 and a composite image creation unit 18b that creates a composite image 50. It is configured so that it can function as a unit 18. The details of the control process of the image processing unit 18 will be described later. Further, the DRR image 41 is an example of the "second image" and the "contrast-enhanced X-ray image" in the claims.

A three-dimensional image 40 (see FIG. 3) is stored in the storage unit 14. The three-dimensional image 40 is an image acquired by using an X-ray CT apparatus (not shown), and is configured by combining a plurality of X-ray slice images. Here, the three-dimensional image 40 is acquired in a state where a contrast agent (angiographic agent) is used for the subject T, and when it is displayed as an image on the display unit 16 or the like, it can be used as a bone and an organ. The adrenal gland (indicated by the dotted line in the figure) is displayed, and the blood vessel image V is clearly displayed. The blood vessel image V is an example of the "position reference portion" in the claims.

Further, the storage unit 14 is configured to be able to store the X-ray fluoroscopic image 30 (see FIG. 4) taken by the X-ray imaging apparatus 1 (imaging unit 11) in a state where no contrast medium is used for the subject T. Has been done. When the X-ray fluoroscopic image 30 is displayed as an image on the display unit 16 or the like, the bone and adrenal gland (indicated by hatching in the figure) are displayed, and the sample collection device 3 (catheter) and the collection position (blood collection position) are displayed. ) P is displayed in a distinguishable manner. In the fluoroscopic image 30, the tip portion of the sample collection device 3 (catheter) for collecting the blood sample B is displayed as the collection position P so as to be discriminateable. Further, the X-ray fluoroscopic image 30 is an example of the "first image" and the "non-contrast X-ray image" in the claims.

Further, the X-ray fluoroscopic image 30 is stored in the storage unit 14 in association with the imaging position information 30a including the imaging position and the imaging direction when the X-ray fluoroscopic image 30 is photographed. The X-ray fluoroscopic image 30 stored in the storage unit 14 may be stored as a moving image, or may be stored as a still image when operated by a doctor or the like via the operation unit 17.

Here, the X-ray fluoroscopic image 30 is taken at a time zone different from that of the three-dimensional image 40. When the three-dimensional image 40 is photographed in advance of the X-ray perspective image 30, it is possible to continuously create the composite image 50 while continuously photographing the X-ray perspective image 30. be. This allows doctors and the like to collect blood sample B while checking the synthetic image 50. On the other hand, when the three-dimensional image 40 is taken after the X-ray perspective image 30, only the DRR image 41 corresponding to the X-ray perspective image 30 from which the collection position P can be determined needs to be generated, so that the control unit It is possible to reduce the control load of 13.

Further, the storage unit 14 stores a composite image 50 in which the X-ray perspective image 30 (see FIG. 4) and the three-dimensional image 40 are combined. The details of the composite image 50 will be described later.

The communication unit 21 is connected to the network 4. The communication unit 21 receives the analysis result A of the blood sample B corresponding to the blood collection number N from the sample analyzer 2 in a state associated with the blood collection number N according to the instruction of the control unit 13. Further, the communication unit 21 receives information about the subject T, a three-dimensional image 40, and the like from the host computer 5 according to the instruction of the control unit 13.

The display unit 16 is, for example, a monitor such as a liquid crystal display, and is configured to be capable of displaying an image such as an X-ray fluoroscopic image 30. The operation unit 17 includes, for example, a keyboard and a mouse, and is configured to receive an input operation to the X-ray imaging apparatus 1 by a doctor or the like.

The sample analyzer 2 includes, for example, a liquid chromatograph mass spectrometer. The sample analyzer 2 analyzes a predetermined amount of components (for example, the amount of aldosterone and the amount of cortisol, etc.) in the blood sample B, and converts the analysis result A of the blood sample B into the blood collection number N corresponding to the blood sample B. In the associated state, it is output to the X-ray imaging device 1 via the network 4.

Next, with reference to FIGS. 3 and 4, the composite image creation process and the sampling position identification in the control unit 13 (image processing unit 18) of the X-ray imaging apparatus 1 according to the first embodiment will be described. In the first embodiment, when the blood sample B is collected by the sample collection device 3, the X-ray fluoroscopic image 30 is photographed at any time with a moving image (predetermined frame rate), and the composite image 50 is taken from the X-ray fluoroscopic image 30. An example of creating as needed will be described.

(Creation of composite image)
First, the X-ray fluoroscopic image 30 is photographed at any time and stored in the storage unit 14 in association with the imaging position information 30a. Then, as shown in FIG. 3, the generation unit 18a of the image processing unit 18 corresponds to the X-ray perspective image 30 from the three-dimensional image 40 stored in the storage unit 14 based on the shooting direction of the X-ray perspective image 30. It is configured to generate a DRR image 41 to be used. Specifically, the generation unit 18a refers to the imaging position information 30a corresponding to the fluoroscopic image 30 and cuts out the three-dimensional image 40 at the position corresponding to the imaging position information 30a. As a result, the DRR image 41 corresponding to the X-ray perspective image 30 is generated from the three-dimensional image 40. Similar to the three-dimensional image 40, the DRR image 41 displays the bone and adrenal gland (shown by hatching in the figure), and the blood vessel image V is clearly displayed.

The generation of the DRR image 41 from the three-dimensional image 40 is not limited to the method of referring to the imaging position information 30a, and is based on, for example, the bones and adrenal gland included in both the X-ray perspective image 30 and the three-dimensional image 40. , The DRR image 41 corresponding to the X-ray perspective image 30 may be generated from the three-dimensional image 40. In this case, the image processing unit 18 performs image processing on the X-ray fluoroscopic image 30 to recognize the position of the bone and the position of the adrenal gland in the X-ray fluoroscopic image 30, and to the recognized bone position and the adrenal position. Based on this, it is possible to generate a DRR image 41 corresponding to the X-ray fluoroscopic image 30 by cutting out the three-dimensional image 40 so that the positions of the bones and the positions of the adrenal glands coincide with each other.

After that, the composite image creation unit 18b of the image processing unit 18 creates the composite image 50 by synthesizing the X-ray perspective image 30 and the created DRR image 41. At this time, the composite image creation unit 18b changes the DRR image 41 to a color different from that of the X-ray fluoroscopic image 30 (for example, when the X-ray fluoroscopic image 30 is a black-and-white image, a color such as blue) (FIG. The composite image 50 is created by superimposing the color-changed DRR image 41 on the X-ray fluoroscopic image 30 together with (shown by fine hatching). In addition, in the composite image 50, in order to suppress the deterioration of the visibility of the X-ray fluoroscopic image 30, the DRR image 41 is superimposed in a state where the brightness of the DRR image 41 is smaller than the brightness of the X-ray fluoroscopic image 30. However, the X-ray fluoroscopic image 30 and the DRR image 41 may have the same brightness.

Then, as shown in FIG. 1, the control unit 13 causes the display unit 16 to display the created composite image 50. At this time, the control unit 13 simultaneously displays the composite image 50 and the X-ray fluoroscopic image 30 being photographed on the display unit 16. Thereby, it is possible to accurately confirm the relationship between the sample collection device 3 and the blood vessel image V when the blood sample B is collected by the sample collection device 3. As a result, the tip portion (collection position P) of the sample collection device 3 can be easily visually recognized based on the blood vessel image V. Further, the created composite image 50 is stored in the storage unit 14 at any time in a state associated with the corresponding X-ray fluoroscopic image 30.

(Specification of collection position)
After that, the X-ray imaging apparatus 1 identifies the sampling position P using the composite image 50 during the imaging of the X-ray fluoroscopic image 30 (during the collection of the blood sample B) or after the imaging (after the collection of the blood sample B). The composite image of FIG. 5 (after specifying the collection position) is specified by the arrow shown in 50). When the collection position P is specified during the acquisition of the fluoroscopic image 30, a doctor or the like performs an operation to specify the collection position P for the operation unit 17 while collecting the blood sample B. The identification of the collection position P is started based on the fact that the collection position P has been identified. Here, since the positions of the blood vessel image V and the collection position P (the tip end portion of the sample collection device 3) are mutually displayed on the composite image 50 displayed on the display unit 16, the blood vessel image V and the collection position are displayed on each other. The sampling position P is specified based on the position relative to P. The collection position P may be specified by the image processing unit 18 performing image processing on the composite image 50. In this case, the tip of the sample collection device 3 may be identified as the collection position P by recognizing the tip of the sample collection device 3 in the composite image 50. Further, for example, the position of the collection position P may be specified as a relative position (coordinates) with respect to the branch point with the branched branch point in the blood vessel image V as a position reference.

Further, the position designated (specified) by the doctor or the like is collected based on the input operation on the composite image 50 by the doctor or the like via the operation unit 17 (for example, a mouse) without performing the image processing by the image processing unit 18. It may be specified as P.

When the sampling position P is specified after the X-ray fluoroscopic image 30 is taken, the composite image 50 suitable for specifying the sampling position P is selected from the composite images 50 stored in the storage unit 14 at any time. NS. Then, with the selected composite image 50 and the corresponding X-ray fluoroscopic image 30 displayed on the display unit 16, an operation was performed by a doctor or the like to specify the collection position P with respect to the operation unit 17. Based on this, the collection position P is specified.

Then, the collection position P, the blood sample B collected at the collection position P, and the blood collection number N are associated with each other on a one-to-one basis. Further, when blood samples B are obtained at a plurality of collection positions P, different blood collection numbers N are associated with each other.

(Creation of blood sampling data)
After acquiring the blood sample B and identifying the collection position P, as shown in FIG. 1, the analysis result A of the blood sample B analyzed by the sample analyzer 2 is X-rayed in a state associated with the blood collection number N. It is transmitted to the device 1. Therefore, the control unit 13 of the X-ray imaging apparatus 1 sets the blood collection number N, the composite image 50 in which the collection position P is specified, and the blood vessel name corresponding to the collection position P for each blood collection number N (blood sample B). , Blood sampling data D (D1, D2, D3 ...) In which the analysis result A and the information about the subject T (not shown) are associated with each other are created. Then, the blood sampling data D created from the X-ray imaging apparatus 1 is transmitted to the host computer 5 and the like. Thereby, the doctor or the like can easily confirm the collection position P of the blood sample B and the analysis result A by referring to the blood collection data D.

Further, in the blood collection data D, for example, an image such as an MRI image or a PET image including the collection position P may be associated with the blood collection data D, or may be associated with other data (such as blood component data).

(Effect of the first embodiment)
In the first embodiment, the following effects can be obtained.

In the first embodiment, as described above, the composite image creating unit 18b is displayed with a blood vessel image V corresponding to the X-ray perspective image 30 and the X-ray perspective image 30 and for specifying the position of the collection position P. It is configured to create a composite image 50 in which the DRR image 41 is combined. As a result, the collection position P and the blood vessel image V for specifying the position of the collection position P can be included in the composite image 50. Therefore, the collection position P can be accurately specified by using the composite image 50. Can be done. Further, since the composite image 50 is automatically created on the diagnostic image system 100, the doctor or the like does not need to sketch the medical record. As a result, it is possible to reduce the work load of a doctor or the like required to specify the collection position P. As a result, it is possible to specify the collection position P more accurately, and it is possible to reduce the work load of a doctor or the like required to specify the collection position P.

Further, in the first embodiment, as described above, the collection position P is specified in the composite image 50 based on the relative positional relationship between the blood vessel image V and the collection position P. Thereby, the collection position P can be more accurately specified based on the relative positional relationship between the blood vessel image V included in the composite image 50 and the collection position P.

Further, in the first embodiment, as described above, the composite image 50 is created using the DRR image 41 in which the blood vessel image V of the subject T for specifying the position of the collection position P is displayed. As a result, since the collection position P and the blood vessel image V can be included in the composite image 50, the collection position P of the blood sample B can be accurately specified when the blood sample B is collected.

Further, in the first embodiment, as described above, the X-ray fluoroscopic image 30 is acquired by the X-ray imaging apparatus 1 in a state where no contrast medium is used for the subject T, and the collection position P can be determined. It is a contrast-enhanced X-ray image, and the DRR image 41 is a contrast-enhanced X-ray image obtained by using a contrast agent on the subject T and displaying a blood vessel image V. As a result, the blood vessel image V is not substantially displayed by not using the contrast medium, while the non-contrast X-ray image in which the collection position P can be discriminated and the contrast-enhanced X-ray image in which the blood vessel image V is displayed by using the contrast medium. By synthesizing the above, it is possible to create a composite image 50 in which both the collection position P and the blood vessel image V can be discriminated. As a result, the blood collection position P can be specified more accurately.

Further, in the first embodiment, as described above, the composite image creation unit 18b creates the composite image 50 by superimposing the DRR image 41 having a display color different from that of the X-ray perspective image 30 on the X-ray perspective image 30. Configure to do. As a result, it is possible to easily recognize that the DRR image 41 is superimposed on the X-ray fluoroscopic image 30, and the doctor or the like is provided with a blood vessel image V for specifying the position of the collection position P in the composite image 50. It can be made easier to see.

Further, in the first embodiment, as described above, the display unit 16 is configured so that the X-ray fluoroscopic image 30 and the composite image 50 can be displayed at the same time. As a result, the doctor or the like can confirm the X-ray fluoroscopic image 30 displayed at the same time while confirming the composite image 50 displayed on the display unit 16. As a result, the portion that is difficult to see on the composite image 50 can be easily confirmed by using the fluoroscopic image 30.

Further, in the first embodiment, as described above, the generation unit 18a generates the DRR image 41 from the three-dimensional image 40 on which the blood vessel image V is displayed based on the imaging direction of the X-ray fluoroscopic image 30. Constitute. As a result, the DRR image 41 corresponding to the X-ray perspective image 30 can be accurately generated, so that the DRR image 41 and the X-ray perspective image 30 that do not sufficiently correspond to the X-ray perspective image 30 are combined. It can be suppressed.

[Second Embodiment]
A second embodiment of the present invention will be described with reference to FIGS. 1, 2 and 4 to 6. In the second embodiment, unlike the first embodiment, an example in which a DRR image 41 is generated from a plurality of three-dimensional images 40 corresponding to a plurality of time points will be described. The configuration of the diagnostic image system 100 in the second embodiment is substantially the same as the configuration of the diagnostic image system 100 in the first embodiment, except that a plurality of three-dimensional images 40 are stored in the storage unit 14. Since there is, the explanation is omitted.

In the subject T (see FIG. 1), the same position (region of interest) of the subject T is captured by the imaging unit 11 (see FIG. 1) due to periodic movements such as respiration and / or pulsation of the subject T itself. ), The internal blood vessel image V and the organ (adrenal gland) may move periodically. Therefore, the positions of the sample collection device 3 such as a catheter inserted into the blood vessel and the adrenal gland may change periodically for each X-ray fluoroscopic image 30 taken.

Therefore, in the second embodiment, a plurality of three-dimensional images 40 (see FIG. 3) acquired in a state where a contrast agent (angiography) is used for the subject T are stored in the storage unit 14. There is. The plurality of three-dimensional images 40 (also referred to as four-dimensional images) are images acquired in advance at a plurality of time points using an X-ray CT apparatus (not shown). Specifically, a plurality of three-dimensional images 40 are acquired in advance at each of the plurality of time points corresponding to at least one cycle of the changing cycle. As a result, any one of the plurality of three-dimensional images 40 corresponds to the state of the subject T which is substantially the same as the state of the subject T when the X-ray fluoroscopic image 30 is taken.

Then, a plurality of generation units 18a of the image processing unit 18 are stored in the storage unit 14 based on the photographing direction of the X-ray perspective image 30 and the state of the subject T at the time when the X-ray perspective image 30 is photographed. The DRR image 41 corresponding to the X-ray perspective image 30 is generated from the three-dimensional image 40 of the above. Specifically, first, the generation unit 18a selects a corresponding three-dimensional image 40 from a plurality of three-dimensional images 40 based on the state of the subject T at the time of being photographed. In this case, for example, image processing is performed to select a three-dimensional image 40 having the most similar positional relationship between the bone and the adrenal gland in the X-ray fluoroscopic image 30.

The selection of the three-dimensional image 40 is not limited to the above method. For example, when a plurality of three-dimensional images 40 are photographed, respiration and / or pulsation are separately measured using a measuring device in parallel with the photographing of the three-dimensional images 40. Similarly, in parallel with the acquisition of the fluoroscopic image 30, respiration and / or pulsation are separately measured using a measuring device. Then, the three-dimensional image 40 most similar to the respiration and / or pulsation of the X-ray perspective image 30 is selected as the three-dimensional image 40 corresponding to the state of the subject T at the time when the X-ray perspective image 30 is taken. It is possible to do.

Then, the generation unit 18a refers to the imaging position information 30a corresponding to the fluoroscopic image 30 and cuts out the selected three-dimensional image 40 at the position corresponding to the imaging position information 30a, as in the first embodiment. .. As a result, the DRR image 41 corresponding to the X-ray perspective image 30 is generated from the plurality of three-dimensional images 40 corresponding to the plurality of time points. Since the subsequent control processing (creation of the composite image 50, identification of the collection position P, and creation of blood collection data D) is the same as that of the first embodiment, the description thereof will be omitted.

(Effect of the second embodiment)
In the second embodiment, the following effects can be obtained.

In the second embodiment, the composite image creation unit 18b has a DRR image 41 that corresponds to the X-ray perspective image 30 and the X-ray perspective image 30 and displays a blood vessel image V for specifying the position of the collection position P. The composite image 50 is configured to be created. As a result, as in the first embodiment, the collection position P can be specified more accurately, and the work load of a doctor or the like required to specify the collection position P can be reduced.

Further, in the second embodiment, as described above, the generation unit 18a has a plurality of generation units 18a based on the photographing direction of the X-ray fluoroscopic image 30 and the state of the subject T at the time when the X-ray fluoroscopic image 30 is photographed. The DRR image 41 is configured to be generated from a plurality of three-dimensional images 40 corresponding to each time point. As a result, even when the subject T (collection position P and blood vessel image V) moves due to periodic movements such as respiration and pulsation, the DRR image 41 corresponding to the X-ray fluoroscopic image 30 is accurately obtained. Can be generated in. As a result, it is possible to further suppress the synthesis of the DRR image 41 and the X-ray fluoroscopic image 30 which do not sufficiently correspond to the X-ray fluoroscopic image 30. The other effects of the second embodiment are the same as the effects of the first embodiment.

[Modification example]
It should be noted that the embodiments disclosed this time are exemplary in all respects and are not considered to be restrictive. The scope of the present invention is shown by the scope of claims rather than the description of the above-described embodiment, and further includes all modifications (modifications) within the meaning and scope equivalent to the scope of claims.

For example, in the first and second embodiments, the display unit 16 shows an example in which the fluoroscopic image 30 (first image) and the composite image 50 are displayed at the same time, but the present invention is not limited to this. For example, the display unit may be configured to switch between the first image and the composite image for display. As a result, it is possible to easily confirm a portion that is difficult to see on the composite image in the first image displayed by switching the display. Further, the display unit may be configured to display not only the first image and the composite image but also the second image at the same time, and the first image and the composite image as well as the second image may be displayed. It may be configured to switch to any of the images for display.

Further, in the first and second embodiments, the example in which the diagnostic image system 100 is used for adrenal vein sampling for the diagnosis of primary aldosteronism has been described, but the present invention is not limited to this. The diagnostic imaging system of the present invention may be used for applications other than adrenal vein sampling for the diagnosis of primary aldosteronism. For example, the diagnostic imaging system of the present invention may be used for collecting cancer cells using a sample collection device. In this case, a composite image is obtained by synthesizing a second image (for example, a PET image) in which a marker or the like as a position reference portion for specifying a sampling position is displayed and a first image (for example, an X-ray fluoroscopic image). May be created.

Further, in the first and second embodiments, an example in which the tip end portion of the sample collection device 3 is specified as the collection position P has been described, but the present invention is not limited to this. In the present invention, when the puncture needle for sample collection is stored in the tip of the sample collection device, the tip of the puncture needle that further protrudes from the tip of the sample collection device at the time of sample collection is used as a sample. It may be specified as the sampling position of the sample. Even in this case, since the position reference unit (blood vessel image V in the first embodiment) is displayed on the composite image, the collection position can be easily specified.

Further, in the first and second embodiments, an example is shown in which the X-ray fluoroscopic image 30 (first image) is an image in which the collection position (blood collection position) P is discriminatively displayed. Not limited to. In the present invention, the first image may be an image in which the state of the tissue around the collection position can be discriminated. For example, when a sample sample (for example, an organ tissue piece) is collected using a puncture needle, an image capable of determining the state of the tissue surrounding the puncture needle (whether or not it is punctured) may be used as the first image. In this case, in the composite image creation unit, the first image in which the state of the tissue surrounding the puncture needle can be determined and the position reference unit (for example, a contrast-enhanced blood vessel image) for specifying the collection position are displayed in the second image. A composite image is created by combining with the image.

Further, in the first and second embodiments, the X-ray fluoroscopic image 30 (first image) is created, the DRR image 41 (second image) is generated, the composite image 50 is created, and the composite image 50 is used. Although the diagnostic image system 100 in which the sampling position P is specified entirely in the X-ray imaging apparatus 1, the present invention is not limited to this. In the diagnostic image system of the present invention, only the acquisition of the first image may be performed by the X-ray imaging apparatus, and the generation of the second image, the creation of the composite image, and the identification of the sampling position may be performed by another apparatus. For example, in a host computer connected to the X-ray imaging apparatus via a network, a second image may be generated, a composite image may be created, and a collection position may be specified using the composite image.

Further, in the first and second embodiments, the composite image creation unit 18b changes the DRR image 41 (second image) to a color different from that of the X-ray fluoroscopic image 30 (first image), and changes the color. An example of creating a composite image 50 by superimposing the DRR image 41 on the X-ray fluoroscopic image 30 has been shown, but the present invention is not limited to this. In the present invention, the compositing method is not limited to the above-mentioned method as long as the compositing image is formed by compositing the first image and the second image by the compositing image creating unit. For example, the composite image creation unit may create a composite image by superimposing the second image on the first image as it is. In addition, the composite image creation unit may align the second image and / or enlarge / reduce the second image, and then composite the second image with the first image. Further, the composite image creation unit may create a composite image by replacing only a part of the first image (for example, the periphery of the blood vessel image (position reference portion)) with the second image.

Further, in the first and second embodiments, an example of generating a DRR image 41 (second image) corresponding to the X-ray perspective image 30 (first image) from the three-dimensional image 40 has been shown. Not limited to this. For example, among the second images taken from a plurality of angles, the second image most similar to the first image may be the second image corresponding to the first image.

Further, in the first and second embodiments, an example of creating a composite image 50 from an X-ray perspective image 30 (first image) and a DRR image 41 (second image) taken by using X-rays is shown. However, the present invention is not limited to this. In the present invention, a composite image may be created from the first image and the second image taken by using a photographing method other than X-rays (for example, ultrasonic waves).

Further, in the first and second embodiments, an example in which a composite image 50 corresponding to an X-ray fluoroscopic image 30 (first image) taken at any time is created at any time has been described, but the present invention is not limited to this. For example, when the collection position is specified after the sample sample is collected, the composite image corresponding to the first image may be created only when the collection position is specified. At this time, it is only necessary to create the second image and the composite image corresponding to the first image at the time of collecting the sample sample, and it is not necessary to create the second image and the composite image corresponding to all of the first images. .. This makes it possible to reduce the burden of control processing on the image processing unit during the collection of the sample sample.

1 X-ray imaging device (acquisition unit)
16 Display unit 18a Generation unit 18b Composite image creation unit 30 X-ray fluoroscopic image (first image, non-contrast X-ray image)
40 Three-dimensional image 41 DRR image (second image, contrast-enhanced X-ray image)
50 Synthetic image 100 Diagnostic image system A Analysis result B Blood sample (sample sample)
N Blood collection number P Collection position T Subject V Blood vessel image (position reference part)

Claims (8)

An acquisition unit that acquires a first image that can determine the collection position when a sample sample is collected from a subject or the state of the tissue around the collection position, and
A composite image creation unit that creates a composite image in which the first image and a second image corresponding to the first image and displaying a position reference unit for specifying the collection position are combined.
A display unit for displaying the composite image is provided .
Wherein said sampling position on the displayed said composite image on the display unit has been configured to be registered, the diagnostic imaging system. The diagnostic image system according to claim 1, wherein the collection position is specified in the composite image based on the relative positional relationship between the position reference unit and the collection position. The diagnostic imaging system according to claim 1 or 2, wherein the position reference unit is a blood vessel image of the subject. The first image is a non-contrast X-ray image acquired by the acquisition unit without using a contrast medium for the subject, and the state of the collection position or the tissue around the collection position can be discriminated. The diagnostic image system according to claim 3, wherein the second image is a contrast X-ray image obtained by using the contrast agent on the subject and displaying the blood vessel image. The composite image creating unit is configured to create the composite image by superimposing the second image having a display color different from that of the first image on the first image. The diagnostic imaging system according to any one item. Prior Symbol display unit, and the first image the composite image at the same time can be displayed, or the first image and the being capable of displaying by switching and synthesizing images, any one of claims 1 to 5 The diagnostic imaging system according to item 1. The diagnosis according to any one of claims 1 to 6, further comprising a generation unit that generates the second image from a three-dimensional image on which the position reference unit is displayed based on the shooting direction of the first image. Image system. The generation unit is based on the shooting direction of the first image and the state of the subject at the time when the first image is shot, from the plurality of three-dimensional images corresponding to the plurality of time points. 2. The diagnostic imaging system according to claim 7, which is configured to generate two images.

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