JP7160559B2 - MEDICAL IMAGE PROCESSING APPARATUS, MEDICAL IMAGE DIAGNOSTIC APPARATUS, AND MEDICAL IMAGE PROCESSING PROGRAM - Google Patents

Description

The embodiments of the present invention relate to a medical image processing apparatus, a medical image diagnostic apparatus, and a medical image processing program.

2. Description of the Related Art Conventionally, in a procedure using a catheter, a simulation technique for proposing a movement route of the catheter is used. This simulation technique, for example, calculates the shortest route connecting a certain target site and the insertion start position of the catheter from the blood vessel bifurcation structure depicted in the contrast image, and displays this as the recommended movement route. Such a simulation technique is used, for example, in hepatic artery embolization in which a liver tumor is necrotic by embolizing feeding vessels.

JP 2014-171908 A

The problem to be solved by the present invention is to present a recommended movement route for a catheter that allows efficient movement between a plurality of target sites.

A medical image processing apparatus according to an embodiment includes an acquisition unit, an extraction unit, a setting unit, a calculation unit, and an output control unit. The acquisition unit acquires volume data in which a blood vessel including a plurality of vascular branches connected to each of a plurality of target sites is imaged. The extraction unit extracts the blood vessel structure of the blood vessel included in the volume data. The setting unit sets a plurality of target sites for the volume data. The calculation unit administers a drug to the target site from a catheter that moves inside the blood vessel based on the vascular structure of the blood vessel and the positional relationship between each target site and each vascular branch in the volume data. A plurality of administration positions are obtained. The output control section outputs the administration position.

FIG. 1 is a block diagram showing an example configuration of an X-ray diagnostic apparatus according to the first embodiment. FIG. 2 is a diagram for explaining the workflow of conventional hepatic artery embolization. FIG. 3 is a flow chart showing processing procedures by the X-ray diagnostic apparatus according to the first embodiment. FIG. 4 is a diagram for explaining processing by the X-ray diagnostic apparatus according to the first embodiment. FIG. 5 is a diagram for explaining processing by the X-ray diagnostic apparatus according to the first embodiment. FIG. 6 is a diagram for explaining processing by the X-ray diagnostic apparatus according to the first embodiment. FIG. 7 is a diagram for explaining processing by the X-ray diagnostic apparatus according to the first embodiment. FIG. 8A is a diagram for explaining processing by the X-ray diagnostic apparatus according to the first embodiment; FIG. 8B is a diagram for explaining processing by the X-ray diagnostic apparatus according to the first embodiment; FIG. 9 is a diagram for explaining processing by the X-ray diagnostic apparatus according to the first embodiment. FIG. 10 is a diagram for explaining processing by the X-ray diagnostic apparatus according to the first embodiment; 11A is a diagram for explaining processing by the X-ray diagnostic apparatus according to the first embodiment; FIG. 11B is a diagram for explaining processing by the X-ray diagnostic apparatus according to the first embodiment; FIG. FIG. 12 is a diagram for explaining processing of the X-ray diagnostic apparatus according to Modification 1 of the first embodiment. FIG. 13 is a diagram for explaining processing of the X-ray diagnostic apparatus according to Modification 2 of the first embodiment. FIG. 14 is a diagram for explaining processing of the X-ray CT apparatus according to the second embodiment. FIG. 15 is a diagram for explaining processing of the X-ray CT apparatus according to the third embodiment. FIG. 16 is a diagram for explaining processing by an X-ray diagnostic apparatus according to another embodiment. FIG. 17 is a block diagram showing an example configuration of a medical image processing apparatus 200 according to another embodiment.

Hereinafter, embodiments of a medical image processing apparatus, a medical image diagnostic apparatus, and a medical image processing program will be described in detail with reference to the drawings. In addition, the embodiment described below is not limited to the following description. Further, the embodiments can be combined with other embodiments and conventional techniques as long as there is no contradiction in the processing content.

Also, in the following embodiments, a case in which the technology disclosed herein is applied to an X-ray diagnostic apparatus will be described, but the embodiments are not limited to this. For example, the technology disclosed is applicable to other medical image diagnostic apparatuses. Other medical image diagnostic devices include, for example, X-ray CT (Computed Tomography) devices, MRI (Magnetic Resonance Imaging) devices, ultrasonic diagnostic devices, SPECT (Single Photon Emission Computed Tomography) devices, and PET (Positron Emission computed Tomography) devices. A device, a SPECT-CT device in which a SPECT device and an X-ray CT device are integrated, a PET-CT device in which a PET device and an X-ray CT device are integrated, or a group of these devices can be applied.

In addition, the technology disclosed herein is applicable not only to medical image diagnostic apparatuses, but also to medical image processing apparatuses such as workstations and PACS (Picture Archiving Communication System) viewers, which have a function of processing medical images.

(First embodiment)
First, an example of the configuration of an X-ray diagnostic apparatus 1 according to the first embodiment will be described using FIG. FIG. 1 is a block diagram showing an example configuration of an X-ray diagnostic apparatus 1 according to the first embodiment. As shown in FIG. 1, the X-ray diagnostic apparatus 1 according to the first embodiment includes a high voltage generator 101, an X-ray source 102, a top board 103, a flat detector 104, a holding arm 105, It comprises a display 106 , an input circuit 107 , a memory circuit 108 and a processing circuit 110 .

The high voltage generator 101 is, for example, a device that generates a high voltage under the control of a processing circuit 110 and supplies the generated high voltage to the X-ray source 102 . The X-ray source 102 is a device that includes an X-ray tube 102a and an X-ray restrictor 102b. The X-ray tube 102a uses the high voltage supplied from the high voltage generator 101 to generate X-rays. The X-ray diaphragm 102b controls the irradiation field of X-rays for the purpose of reducing the dose of exposure to the subject P and improving the quality of the image. The top plate 103 is, for example, a bed on which the subject P is placed, and is arranged on a bed (not shown).

The flat panel detector 104 is a detector that has a plurality of X-ray detection elements and detects X-rays that have passed through the subject P. FIG. For example, the flat panel detector 104 detects distribution data indicating the signal intensity of X-rays that have passed through the subject P, and transmits the detected distribution data to the processing circuitry 110 . The holding arm 105 is a supporting member that holds the X-ray source 102 and the flat panel detector 104 so as to face each other with the top plate 103 interposed therebetween.

The display 106 is, for example, a monitor that is referred to by the operator, and under the control of the processing circuit 110, X-ray images acquired using a contrast agent, fluoroscopic images sequentially generated during the procedure, and superimposed on the fluoroscopic images. display various x-ray images such as mask images displayed by The displayed mask image will be described in detail later. The input circuit 107 has a mouse, keyboard, trackball, switches, buttons, joystick, etc. used for inputting various instructions and various settings, and receives instructions and settings from the operator.

The storage circuit 108 is, for example, a storage device such as a memory or a HDD (Hard Disk Drive), and stores data used when the processing circuit 110 controls the entire processing by the X-ray diagnostic apparatus 1 . For example, the storage circuit 108 stores various setting information used in acquisition processing of X-ray images and various image processing. Also, the storage circuit 108 stores each program executed by the processing circuit 110 . Also, the storage circuit 108 stores various X-ray images.

The processing circuit 110 is, for example, a processor that controls the entire processing in the X-ray diagnostic apparatus 1 . For example, the processing circuit 110 executes, as processing in the X-ray diagnostic apparatus 1, acquisition processing of X-ray images, various image processing, and the like.

The processing circuitry 110 also performs a collection function 111 , an image generation function 112 , a calculation function 113 and an output control function 114 . Here, the collection function 111 is an example of a collection unit. Also, the image generation function 112 is an example of an image generation unit. Also, the calculation function 113 is an example of a calculation unit. Also, the output control function 114 is an example of an output control unit.

The acquisition function 111 controls imaging system equipment including the high voltage generator 101, the X-ray source 102, the tabletop 103, the flat detector 104, and the holding arm 105 to acquire X-ray projection data. Specifically, the acquisition function 111 irradiates the subject P with X-rays and detects the X-rays transmitted through the subject P as a plane by controlling imaging equipment according to various acquisition conditions. Detected by device 104 . The acquisition function 111 then generates projection data using the electric signal converted from the X-rays by the flat panel detector 104 and stores the generated projection data in the storage circuit 108 . For example, the acquisition function 111 performs current/voltage conversion, A (Analog)/D (Digital) conversion, and parallel/serial conversion on the electrical signal received from the flat panel detector 104 to generate projection data. It should be noted that the acquisition function 111 is an example of an acquisition unit that acquires volume data in which blood vessels including multiple blood vessel branches connected to multiple target sites are imaged.

The image generation function 112 performs image processing on the projection data stored in the storage circuit 108 to generate various X-ray images. For example, the image generation function 112 generates a photographed image and a fluoroscopic image. In addition, the image generation function 112 generates a DSA (Digital Subtraction Angiography) image by subtracting image data acquired while injecting a contrast medium into the blood vessel and image data acquired without injecting the contrast medium into the blood vessel. . That is, the image generation function 112 subtracts and eliminates the background such as bones from the blood vessel image in which the contrast agent in the blood vessel is drawn using the contrast agent, so that the blood vessel in which the contrast agent flowing through the blood vessel region is more emphasized. image can be generated.

In the embodiment in FIG. 1, each processing function performed by the collection function 111, the image generation function 112, the calculation function 113, and the output control function 114 of the component is recorded in the storage circuit 108 in the form of a computer-executable program. It is The processing circuit 110 is a processor that reads a program from the storage circuit 108 and executes it to realize a function corresponding to each program. In other words, the processing circuit 110 in a state where each program is read has each function shown in the processing circuit 110 of FIG. In FIG. 1, it is assumed that a single processing circuit realizes the processing functions performed by the collection function 111, the image generation function 112, the calculation function 113, and the output control function 114. Processors may be combined to form a processing circuit, and each processor may implement a function by executing a program. Processing in the calculation function 113 and the output control function 114 will be described later.

The overall configuration of the X-ray diagnostic apparatus 1 according to the first embodiment has been described above. With this configuration, the X-ray diagnostic apparatus 1 according to the first embodiment can present a recommended movement route for a catheter that allows efficient movement between a plurality of target sites.

Here, the workflow of conventional hepatic artery embolization will be described with reference to FIG. FIG. 2 is a diagram for explaining the workflow of conventional hepatic artery embolization. In addition, hepatic artery embolization is a procedure to necrotize a liver tumor by embolizing feeding blood vessels of the liver tumor. For example, a doctor who performs hepatic artery embolization embolizes a feeding blood vessel by administering a drug for closing the blood vessel (vascular embolizing agent) into the feeding blood vessel using a catheter.

As shown in FIG. 2, in conventional hepatic artery embolization, first, an X-ray CT image is taken (S1). Subsequently, the liver tumor and its feeding vessels are extracted from the X-ray CT image taken (S2, S3). Then, an administration simulation is performed using the extracted positional information of the liver tumor and feeding vessels (S4). In the administration simulation, for example, the shortest route connecting the position of the liver tumor and the insertion start position of the catheter is presented as the recommended movement route.

Then, the doctor moves the catheter through the presented recommended movement route to the feeding blood vessel of the liver tumor (S5), and administers a drug (vascular embolization drug) (S6). Then, the doctor observes the effect of embolization (S7), and if the feeding vessel is embolized, the procedure ends (S8). If the feeding vessel is not embolized, the catheter is moved again and the procedure is continued until the feeding vessel is embolized.

In such a simulation, the present inventors have come to the conclusion that it would be useful if a recommended movement route for a catheter that allows efficient movement between multiple liver tumors could be presented. In other words, in hepatic artery embolization, there may be multiple liver tumors. For this reason, we thought that it would be useful to present a recommended movement route for a catheter that can be moved efficiently between multiple liver tumors. The inventor also thought that it would be more useful if a feeder vessel capable of necrosis of several tumors at the same time could be presented.

Therefore, the X-ray diagnostic apparatus 1 according to the first embodiment executes each processing function described below in order to present a recommended movement route for a catheter that allows efficient movement between a plurality of target sites. That is, the acquisition function 111 as an acquisition unit acquires volume data in which a blood vessel including a plurality of vascular branches connected to each of a plurality of target sites is imaged. A calculation function 113 as an extraction unit extracts the blood vessel structure of blood vessels included in the volume data. The calculation function 113 as a setting unit sets a plurality of target sites for the volume data. In the volume data, the calculation function 113 calculates, based on the vascular structure of the blood vessel and the state of connection between each target site and each vascular branch, a position where a drug is administered to the target site from a catheter that moves inside the blood vessel. A plurality of certain administration locations are determined, and a recommended travel path for the catheter is calculated based on the plurality of administration locations. The output control function 114 outputs a recommended moving route.

In this embodiment, as an example, a case where the technology disclosed herein is applied to hepatic artery embolization will be described, but the present invention is not limited to this. For example, the technology disclosed may be applied to other procedures (surgery). Also, in this embodiment, as an example, a case where the target site of the procedure using a catheter is a liver tumor will be described, but the present invention is not limited to this. For example, the disclosed technique can target any site, not just a tumor, as long as it is a target site for a procedure using a catheter.

A processing procedure by the X-ray diagnostic apparatus 1 according to the first embodiment will be described with reference to FIG. FIG. 3 is a flow chart showing a processing procedure by the X-ray diagnostic apparatus 1 according to the first embodiment. In FIG. 3, processing procedures by the X-ray diagnostic apparatus 1 will be described with reference to FIGS. 4 to 11B. 4 to 11B are diagrams for explaining processing by the X-ray diagnostic apparatus 1 according to the first embodiment. The processing procedure shown in FIG. 3 is started, for example, when the operator (doctor) inputs an instruction to start the simulation.

Note that FIG. 3 illustrates a case where the X-ray diagnostic apparatus 1 calculates the recommended movement route of the catheter and performs hepatic artery embolization while displaying the calculated recommended movement route. In this case, the doctor can perform the procedure while confirming the recommended movement route on the monitor of the X-ray diagnostic apparatus 1, for example. However, embodiments are not so limited. For example, it is possible to display on the monitor of the X-ray diagnostic apparatus 1 a recommended movement route calculated in advance by another medical image processing apparatus.

As shown in FIG. 3, in step S101, the processing circuitry 110 determines whether processing has started. For example, the operator inputs an instruction to start the simulation. When the instruction is input by the operator, the processing circuit 110 starts processing and executes processing from step S102 onward. Note that if step S101 is negative, the processing circuit 110 does not start processing and is in a standby state.

If step S101 is affirmative, in step S102, the calculation function 113 extracts the blood vessel core line from the volume data. Here, the volume data is, for example, three-dimensional medical image data obtained by imaging the liver of the subject P in advance. For example, the operator causes the storage circuit 108 to store volume data captured in advance by an X-ray CT apparatus. The calculation function 113 reads volume data from the storage circuit 108 and executes processing.

As shown in FIG. 4, for example, the calculation function 113 extracts the blood vessel image of the hepatic artery from the blood vessel image drawn in the volume data. For example, the calculation function 113 extracts a blood vessel extending from the base of the hepatic artery (origin position) to the tip (end) as the blood vessel image of the hepatic artery. The hepatic artery root represents the branching point from the abdominal aorta to the hepatic artery and is detected by pattern matching, for example. That is, the calculation function 113 detects the position of the hepatic artery root using pattern matching, and extracts the blood vessel image extending from the detected hepatic artery root to the distal end as the hepatic artery blood vessel image. Then, the calculation function 113 extracts the blood vessel core line of the hepatic artery by performing contraction processing on the extracted blood vessel image of the hepatic artery. That is, the calculation function 113 as an extraction unit extracts the blood vessel structure of blood vessels included in the volume data.

Note that the content described with reference to FIG. 4 is merely an example, and the present invention is not limited to this. For example, any conventional technique may be applied as a technique for extracting the blood vessel center line of the hepatic artery from the volume data. Also, in FIG. 4, the case where the base of the hepatic artery is used as the origin position has been described, but the present invention is not limited to this. For example, the origin position may be the tip position of the catheter currently inserted into the subject P. FIG. For example, the tip position of the catheter can be calculated by aligning a fluoroscopic image captured by the X-ray diagnostic apparatus 1 with volume data in advance and detecting a projection image of the catheter from the fluoroscopic image.

Also, the volume data is preferably captured under angiography, but is not limited to this, and may be captured under non-contrast. Moreover, the volume data is not limited to data captured by an X-ray CT device, and may be captured by any medical image diagnostic device such as an MRI device. In other words, the volume data may be any image data as long as it includes blood vessels connected to the target site.

In step S103, the calculation function 113 identifies line segment regions corresponding to vascular branches from the vascular center line. Here, the line segment region is a region corresponding to a plurality of line segments obtained by dividing the center line of the blood vessel at branch points.

For example, the calculation function 113 detects start points, branch points, and end points from the line segment area. Here, the starting point is, for example, the hepatic artery root, which is detected by pattern matching. A branch point is a position where the hepatic artery branches, and is detected as a point where one core line branches into two or more. Also, the end point is the end of the hepatic artery and is detected as the position where the core line breaks. Then, the calculation function 113 identifies a line segment between the start point and the branch point, a line segment between the branch points, or a line segment between the branch point and the end point as the line segment area. Then, the calculation function 113 assigns a tag (identification information) to the specified line segment area.

As shown in FIG. 5, for example, the calculation function 113 identifies the first line segment passing through the hepatic artery root as the line segment area a1. The calculation function 113 also identifies two line segments branching from the line segment area a1 as a line segment area b1 and a line segment area b2. The calculation function 113 also identifies two line segments branching from the line segment area b1 as a line segment area c1 and a line segment area c2. The calculation function 113 also identifies two line segments branching from the line segment area c2 as a line segment area d1 and a line segment area d2. The calculation function 113 also identifies two line segments branching from the line segment region d1 as a line segment region e1 and a line segment region e2.

The calculation function 113 also identifies two line segments branching from the line segment region b2 as a line segment region c3 and a line segment region c4. The calculation function 113 also identifies two line segments branching from the line segment region c3 as a line segment region d3 and a line segment region d4. The calculation function 113 also identifies two line segments branching from the line segment region d4 as a line segment region e3 and a line segment region e4.

The calculation function 113 also identifies two line segments branching from the line segment region c4 as a line segment region d5 and a line segment region d6. The calculation function 113 also identifies two line segments branching from the line segment region d5 as a line segment region e5 and a line segment region e6. The calculation function 113 also identifies two line segments branching from the line segment region d6 as a line segment region e7 and a line segment region e8.

In addition, the calculation function 113 calculates the specified line segment areas a1, b1, b2, c1, c2, c3, c4, d1, d2, d3, d4, d5, d6, e1, e2, e3, e4, e5, e6, Measure the lengths of e7 and e8. Note that the content described with reference to FIG. 5 is merely an example, and the present invention is not limited to this. For example, any conventional technique may be applied as the technique for extracting the blood vessel core line.

In step S104, the calculation function 113 extracts multiple tumor regions corresponding to the tumor from the volume data. For example, the calculation function 113 extracts multiple tumor regions corresponding to tumors from the volume data. For example, the calculation function 113 extracts a plurality of tumor regions from the volume data by pattern matching using tumor features.

As shown in FIG. 6, for example, the calculation function 113 extracts five tumor regions from the volume data. Then, the calculation function 113 as a setting unit sets each extracted tumor region as a target site.

Note that the content described with reference to FIG. 6 is merely an example, and the present invention is not limited to this. For example, any conventional technique may be applied as a technique for extracting a tumor region. Moreover, although the case where all the extracted tumor regions are automatically set as the target site has been described here, the embodiment is not limited to this. For example, the calculation function 113 as the setting unit may set an arbitrary number of tumor regions designated by the operator among the five extracted tumor regions as target regions.

In step S105, the calculation function 113 identifies a line segment area connecting multiple tumor areas and the starting point position. Here, the origin position is, for example, the base of the hepatic artery. That is, the calculation function 113 identifies the branch of the feeding vessel that supplies blood to each tumor region.

As shown in FIG. 7, the calculation function 113 calculates line segment areas a1, b1, b2, c2, c3, c4, d1, d4, d5, d6, e2, e3, e4, Identify e6 and e7 (bold lines in FIG. 7). Specifically, the calculation function 113 identifies line segment regions a1, b1, c2, d1, and e2 as feeding vessels of the tumor region on the right end of FIG. Similarly, the calculation function 113 identifies a plurality of line segment regions representing feeding vessels for each tumor region for other tumor regions as well. Note that the content described with reference to FIG. 7 is merely an example, and the present invention is not limited to this.

In step S106, the calculation function 113 calculates the tumor point and tip point of each line segment area. Here, the tumor point represents an evaluation value according to the number of tumors reached via each blood vessel branch. Also, the tip point represents an evaluation value according to the number of tip parts (terminal parts) reached via each blood vessel branch.

Processing when the calculation function 113 calculates a tumor point will be described with reference to FIG. 8A. In FIG. 8A, the numerical values in parentheses illustrated beside the tags of the line segment represent the tumor points calculated for the line segment.

As shown in FIG. 8A, for example, the calculation function 113 traces back from the vascular branch at the end, and calculates the total value of the tumor points of the plurality of vascular branches every time the plurality of vascular branches are integrated into the vascular branch at the branch source. of blood vessel branches.

First, the calculation function 113 calculates tumor points in order from the line segment area at the end. Specifically, the calculation function 113 calculates a tumor point “1” for a line segment area directly connected to the tumor area. That is, the calculation function 113 calculates a tumor point "1" for five line segment regions e2, e3, e4, e6, and e7 directly connected to the tumor region.

Next, the calculation function 113 traces back from the line segment area of the tumor point "1" and calculates the tumor points of the line segment area branched from the line segment area of the tumor point [1]. For example, the calculation function 113 calculates the tumor point for the line segment region d1 that is the branching source of the line segment region e2. A line segment region d1 is a vascular branch branching into a line segment region e1 and a line segment region e2. Here, no tumor point is assigned to the line segment e1 (in other words, the tumor point is "0"), and a tumor point "1" is assigned to the line segment e2. In this case, the calculation function 113 calculates the total value "1" of the tumor points of the line segment region e1 and the line segment region e2 as the tumor point of the line segment region d1. This indicates that the number of tumors to which blood is supplied via line segment d1 is "one".

Similarly, the calculation function 113 goes back from the line segment region d1 to the line segment region c2 and calculates the tumor point "1" in the line segment region c2. Further, the calculation function 113 traces back from the line segment region c2 to the line segment region b1 and calculates the tumor point “1” of the line segment region b1.

Also, for example, the calculation function 113 calculates a tumor point for a line segment region d4 that is a branching source of the line segment region e3. A line segment region d4 is a vascular branch branching into a line segment region e3 and a line segment region e4. Here, a tumor point "1" is assigned to each of the line segment regions e3 and e4. In this case, the calculation function 113 calculates the total value "2" of the tumor points of the line segment region e3 and the line segment region e4 as the tumor point of the line segment region d4. This means that the number of tumors to which blood is supplied via line segment d4 is "two".

Similarly, the calculation function 113 goes back from the line segment region d4 to the line segment region c3 and calculates the tumor point "2" in the line segment region c3. Furthermore, the calculation function 113 calculates a tumor point "1" for each of the segment regions e6, d5, e7, and d6. Further, the calculation function 113 calculates the tumor point "2" for the segment region c4. Further, the calculation function 113 calculates a tumor point "4" for the segment region b2. Then, the calculation function 113 calculates the tumor point "5" for the segment area a1.

In this way, the calculation function 113 traces back from the vascular branch at the end, and calculates the total value of the tumor points of the plurality of vascular branches every time a plurality of vascular branches are integrated (merged) with the vascular branch at the branching source. By assigning to the branch, the tumor point of the blood vessel branch is calculated.

Next, the processing when the calculation function 113 calculates the tip point will be described with reference to FIG. 8B. In FIG. 8B, the numerical values in parentheses illustrated beside the tags of the line segment represent the tip points calculated for the line segment.

As shown in FIG. 8B, for example, the calculation function 113 traces back from the vascular branch at the end, and each time a plurality of vascular branches are integrated into a branching source vascular branch, the total value of the tip points of the plurality of vascular branches is calculated as the branching source. of blood vessel branches.

First, the calculation function 113 calculates tip points in order from the line segment area at the end. Specifically, the calculation function 113 calculates the tip point “1” for the line segment area including the end portion. That is, the calculation function 113 calculates the tip point "1 ” is calculated.

Next, the calculation function 113 traces back from the line segment area of the tip point "1" and calculates the tip point of the line segment area from which the line segment area of the tip point "1" branches. For example, the calculation function 113 calculates the tip point of the line segment region d1 that is the branching source of the line segment region e1. A line segment region d1 is a vascular branch branching into a line segment region e1 and a line segment region e2. Here, the tip point "1" is assigned to each of the segment regions e1 and e2. In this case, the calculation function 113 calculates the total value "2" of the tumor points of the line segment region e1 and the line segment region e2 as the tip point of the line segment region d1. This means that the number of terminal parts (peripheral parts) to which blood is supplied via the segment area d1 is "two".

Similarly, the calculation function 113 goes back from the line segment area d1 to the line segment area c2 and calculates the tip point "3" (total value of the line segment areas d1 and d2) of the line segment area c2. Further, the calculation function 113 calculates the tip point "4" of the segment area b1 (total value of the segment areas c1 and c2).

Similarly, for the remaining line segments, the calculation function 113 traces back from the vascular branch at the end, and calculates the total value of the tip points of the multiple vascular branches each time the multiple vascular branches are integrated into the vascular branch at the branching source. Assign to the original vessel branch. Then, the calculation function 113 finally calculates the tip point "11" of the line segment area a1 (total value of the line segment areas b1 and b2).

Note that the contents described with reference to FIGS. 8A and 8B are merely examples, and the present invention is not limited to these. For example, in FIGS. 8A and 8B, for the convenience of explanation, the case where the evaluation values (tumor point and tip point) are calculated going back from the terminal vascular branch has been explained, but the present invention is not limited to this. For example, the calculation function 113 counts the number of end portions to which blood is supplied via the line segment area for each arbitrary line segment area (for example, randomly selected line segment area). , it is also possible to calculate the tip point.

Moreover, although FIG. 8A and FIG. 8B describe the case where the number of tumors or the number of extremities is directly obtained as an evaluation value, the embodiment is not limited to this. For example, it may be a value (eg, a proportional value) depending on the number of tumors or the number of extremities. Also, for example, the calculation function 113 may calculate tumor points by weighting according to the size of the tumor supplied by each blood vessel branch. Further, the calculation function 113 may calculate the tip point by weighting according to at least one of the length and thickness of each blood vessel branch.

In step S107, the calculation function 113 calculates the administration efficiency of each segment area. For example, the calculation function 113 calculates the administration efficiency representing the efficiency with which the drug administered from the catheter reaches each target site based on the branching state of blood vessels and the target connection state. For example, the calculation function 113 uses at least one of the tumor point and the tip point to calculate the administration efficiency of the drug administered from the catheter.

As shown in FIG. 9, for example, the calculation function 113 calculates a value obtained by dividing the tumor point by the tip point as the administration efficiency. As an example, the tumor point of line segment a1 is "5" and the tip point is "11". In this case, the calculation function 113 calculates the value "0.45" obtained by dividing "5" by "11" as the administration efficiency of the segment area a1.

Thus, the calculation function 113 calculates the administration efficiency by dividing the tumor point by the tip point for each line segment area. Note that the content described with reference to FIG. 9 is merely an example, and the present invention is not limited to this. In other words, the calculation function 113 is based on the percentage of the number of ends of the blood vessel that are connected to the target site (tumor points) out of the number of ends of the blood vessel supplied by each location on the blood vessel (tip points). to calculate the dosing efficiency.

In step S108, the calculation function 113 determines a recommended administration region in which the administration efficiency is equal to or higher than the threshold. For example, the calculation function 113 receives specification of a threshold for administration efficiency from the operator. The calculation function 113 determines the line segment area of the administration efficiency equal to or greater than the received threshold as the recommended administration area.

In the example shown in FIG. 10, a case will be described in which the operator designates the administration efficiency threshold "0.67". The operator, for example, considers the type of medicine and the symptoms of the subject P and specifies the threshold of administration efficiency. Here, the line segment areas where the administration efficiency is equal to or greater than the threshold "0.67" are seven line segment areas e2, c3, d4, e3, e4, e6, and e7 (bold lines in FIG. 10). In this case, the calculation function 113 determines seven line segment areas e2, c3, d4, e3, e4, e6, and e7 as recommended administration areas.

Note that the recommended administration area is not limited to a single area in which a plurality of line segment areas are connected together, and may include a group of several areas. In the example shown in FIG. 10, the administration recommendation area includes four groups. Specifically, the recommended administration areas are group G1 consisting of line segment area e2, group G2 consisting of four line segment areas c3, d4, e3, and e4, group G3 consisting of line segment area e6, and line segment area e7. contains a group G4 consisting of This means that if the drug is administered to groups G1, G3, and G4, tumors can be necrotized one by one, and if the drug is administered to group G2, two tumors can be necrotized simultaneously. represents In other words, the calculation function 113 can perform suitable grouping for efficient necrosis of a plurality of tumors by determining the recommended administration region. In FIG. 10, the calculation function 113 classifies the multiple blood vessel branches drugged to necrotic five tumors into four groups.

In this way, the calculation function 113 classifies a plurality of vascular branch regions in which the administration efficiency is equal to or higher than the threshold into one or more groups. Note that the content described with reference to FIG. 10 is merely an example, and the present invention is not limited to this. For example, the administration efficiency threshold may be automatically set based on the type of drug and the symptoms of the subject P.

In step S109, the calculation function 113 determines a recommended moving route. For example, the calculation function 113 calculates the volume data based on the vascular structure of the blood vessel and the target connection state between each target site and each vascular branch in volume data in which a blood vessel including a plurality of vascular branches connected to each of a plurality of target sites is imaged. Then, a plurality of administration positions, which are positions at which the drug is administered to the target site from the catheter that moves inside the blood vessel, are obtained. Calculation function 113 then calculates a recommended travel path for the catheter based on the plurality of administration locations. For example, the calculation function 113 calculates a recommended travel route based on administration efficiency.

For example, the calculation function 113 identifies branching states of a plurality of vascular branches that form the vascular structure of a blood vessel, and calculates a recommended movement route based on the identified branching states and target connection states. Specifically, the calculation function 113 calculates, as a recommended movement route, a route along which the catheter is to be moved in order from the group closest to the origin position of the catheter among the groups classified in the recommended administration region.

As shown in FIG. 11A, the calculation function 113 identifies positions P2, P3, P4, and P5 closest to the origin position P1 in the recommended administration region. Here, the position P2 corresponds to the administration position where the drug is administered to the tumor region (target site) of the group G1. Position P3 corresponds to the administration position, which is the position where the drug is administered to the tumor region of group G2. Position P4 corresponds to the administration position, which is the position where the drug is administered to the tumor region of group G3. Position P5 corresponds to the administration position, which is the position where the drug is administered to the tumor region of group G4. Then, as shown in FIG. 11B, the calculation function 113 calculates a recommended movement path (arrow in FIG. 11B) for moving the catheter in the order of starting point P1, position P3, position P4, position P5, and position P2. Calculate as

Thus, the calculation function 113 calculates the recommended travel route. Note that the contents described with reference to FIGS. 11A and 11B are merely examples, and the present invention is not limited to these. For example, they do not necessarily have to be moved in order from the closest position. However, for the farthest position (position P2 in the example of FIGS. 11A and 11B), it is preferred to administer last. This is because the time to remove the catheter after the end of the procedure can be omitted by placing the far position last. In other words, the drug administration to each tumor can be finished early by making the far position last.

Also, the method of calculating the recommended moving route described above is merely an example. For example, the calculation function 113 may use the distance traveled by the catheter or the number of doses of the drug to calculate the recommended travel route. In this case, for example, conditions are set manually or automatically with respect to the moving distance or the number of administrations. As the conditions, for example, the movement distance and the number of times of administration, which are the upper limit or the lower limit, are set. The calculation function 113 calculates the recommended travel route so that the administration efficiency is maximized within the range that satisfies the set conditions.

Alternatively, the route may be calculated based on the movement speed of the catheter and the procedure time. For example, the moving speed is set to, for example, one of "fast", "normal", and "slow" depending on the skill level of the operator. This is the upper limit of the time.In this case, when the procedure is performed at the set moving speed, the moving distance is set so as to be within the procedure time.Then, administration is performed within the range that satisfies the set moving distance A recommended travel route is calculated to maximize efficiency.

In step S110, the output control function 114 outputs the recommended moving route. For example, the output control function 114 causes the display 106 to display the recommended travel route shown in FIG. 11B. At this time, the output control function 114 can display the blood vessel branch (nutrition blood vessel) that supplies blood to the liver tumor and other blood vessel branches in different display modes. Specifically, the output control function 114 changes the display mode according to the thickness of the line, the type of line (solid line, dashed line, etc.), the color of the line, and a combination thereof.

In addition, the output control function 114 may display image data indicating the administration efficiency of each line segment area, as shown in FIG. In this case, it is preferable that the output control function 114 displays each line segment area in a color corresponding to the administration efficiency. In addition, the output control function 114 may display regions of blood vessel branches in which the administration efficiency is equal to or higher than the threshold.

In addition, the output control function 114 stores information indicating the recommended moving route in a storage device inside and outside the device. For example, the output control function 114 stores information indicating a recommended travel route in the storage circuit 108 . Alternatively, the output control function 114 may transmit information indicating the recommended moving route to other information processing apparatuses connected by the hospital network.

In this way, the X-ray diagnostic apparatus 1 calculates and displays the recommended moving route. Note that the processing procedure described with reference to FIG. 3 is merely an example, and is not limited to this. For example, each process shown in FIG. 3 may be rearranged in order within a range in which there is no contradiction in the contents of the process. For example, the process of calculating the tip point can be executed at any timing after the process of step S103 is executed.

4 to 11B illustrate the outline of the liver for convenience of explanation, but the process of extracting the outline of the liver is unnecessary in the process of calculating the recommended movement path. However, when displaying the recommended movement route, it is preferable to display it on the screen together with the outline of the liver.

As described above, in the X-ray diagnostic apparatus 1 according to the first embodiment, the calculation function 113 calculates the volume data obtained by imaging a blood vessel including a plurality of vascular branches connected to a plurality of target regions. Based on the structure and target connections between each target site and each vessel branch, a recommended travel path for the catheter to travel inside the vessel is calculated. Also, the output control function 114 outputs a recommended moving route. According to this, the X-ray diagnostic apparatus 1 can present a recommended movement route for a catheter that allows efficient movement between a plurality of target sites. In addition, the X-ray diagnostic apparatus 1 can present feeding vessels capable of necrosis of several tumors out of a plurality of tumors at the same time.

(Modification 1 of the first embodiment)
For example, the X-ray diagnostic apparatus 1 can further display a slider bar on the screen displaying the administration efficiency of each line segment area. FIG. 12 is a diagram for explaining processing of the X-ray diagnostic apparatus 1 according to Modification 1 of the first embodiment. FIG. 12 shows an example of the display screen of the display 106. As shown in FIG.

For example, the output control function 114 displays a GUI (Graphical User Interface) for specifying a threshold of administration efficiency, and displays vascular branches that are equal to or greater than the threshold specified by the GUI in a different display mode from other vascular branches. to display.

As shown in FIG. 12, for example, the operator uses the slider bar B1 to specify an arbitrary administration efficiency value. FIG. 12 illustrates a case where the operator designates "0.67". In this case, the output control function 114 displays the line segment region where the administration efficiency is "0.67" or more with a thick line. Specifically, the output control function 114 displays line segment areas c3, d4, e2, e3, e4, e6, and e7 with thick lines.

Further, in FIG. 12, when the operator changes the administration efficiency from "0.67" to "1", the output control function 114 causes the line segment area where the administration efficiency is "0.67" or higher to be displayed with a thick line. In this case, the output control function 114 displays line segment areas c3 and d4 with normal lines and line segment areas e2, e3, e4, e6 and e7 with thick lines.

Further, in FIG. 12, when the operator changes the administration efficiency from "0.67" to "0", the output control function 114 causes the line segment area where the administration efficiency is "0" or higher to be displayed with a thick line. In this case, the output control function 114 displays all line segment areas with thick lines.

In this way, further displaying the slider bar B1 makes it easier for the operator to specify an arbitrary administration efficiency, and allows the operator to specify an appropriate administration efficiency threshold while appropriately changing the threshold.

(Modification 2 of the first embodiment)
Also, for example, the X-ray diagnostic apparatus 1 may present a plurality of recommended movement routes. FIG. 13 is a diagram for explaining processing of the X-ray diagnostic apparatus 1 according to Modification 2 of the first embodiment. FIG. 13 shows an example of the display screen of the display 106. As shown in FIG.

For example, the calculation function 113 calculates a plurality of recommended movement routes for each of a plurality of different administration efficiencies. Then, the output control function 114 displays information indicating the relationship between the calculated administration efficiency for each of the plurality of recommended travel routes and the total travel distance of the recommended travel routes.

The upper diagram in FIG. 13 is a graph showing the relationship between the recommended travel route according to administration efficiency and the total travel distance of each route. For example, for seven dosing efficiencies "0.25", "0.33", "0.45", "0.50", "0.57", "0.67", "1.00", individual Calculate and display the recommended movement route for Here, it can be seen from the graph that the higher the administration efficiency, the longer the total moving distance. Then, when the operator selects the recommended route of movement with the administration efficiency of "0.67", the selected recommended route of movement is displayed below the graph as an image R1 (lower diagram in FIG. 13).

This makes it easier for the operator to select a recommended movement route according to any administration efficiency. Note that the content described with reference to FIG. 13 is merely an example, and the present invention is not limited to this. For example, when displaying a plurality of recommended travel routes, the output control function 114 may further display the number of branch points on each recommended travel route. Thereby, for example, the operator can determine the recommended moving route to be adopted based on the number of displayed branch points.

(Modification 3 of the first embodiment)
Further, for example, when displaying a plurality of recommended travel routes, the X-ray diagnostic apparatus 1 may display an index value obtained by dividing the administration efficiency of each recommended travel route by the total travel distance.

For example, when displaying a plurality of recommended travel routes, the output control function 114 displays an index value obtained by dividing the administration efficiency of each recommended travel route by the total travel distance. For example, the output control function 114 calculates the index value based on the following formula (1).

In other words, this index value represents the administration efficiency with respect to the total distance traveled on each recommended travel route. It can be said that a recommended travel route with a higher index value has a shorter total travel distance and a higher administration efficiency. Note that the output control function 114 can output not only the index value calculated by the formula (1) as a numerical value, but also a graph of the administration efficiency against the total moving distance.

(Modification 4 of the first embodiment)
Further, for example, when displaying a plurality of recommended travel routes, the X-ray diagnostic apparatus 1 may display the difficulty level of each recommended travel route.

For example, when displaying a plurality of recommended travel routes, the output control function 114 displays the difficulty level of each recommended travel route. For example, the output control function 114 calculates the difficulty based on Equation (2) below.

In Equation (2), the distance is the distance of the recommended travel route, and the volume is the volume of each blood vessel branch included in the recommended travel route. In other words, "distance/volume" represents the degree of difficulty in passing the catheter through each vascular branch, and by multiplying this value by the distance, the degree of difficulty corresponding to the total movement distance is represented. Note that the calculation function 113 may calculate the degree of difficulty based on at least one of the thickness of blood vessel branches and the number of branch points on each of the plurality of recommended movement routes. For example, equation (2) may be adjusted so that the difficulty level decreases as the thickness of the blood vessel increases. Also, for example, Equation (2) may be adjusted so that the difficulty increases as the number of branch points increases.

(Second embodiment)
In the first embodiment, the case of presenting one or more recommended travel routes has been described, but it is also possible to present a recommended dose of a drug to be administered along the presented recommended travel routes.

For example, the calculation function 113 calculates a recommended dosage of a drug to be administered along the recommended travel route. Specifically, the calculation function 113 measures the volume of the vascular branch included in the recommended movement route and the volume of the liver tumor connected to the vascular branch from the volume data. Then, the calculation function 113 uses the measured volume to calculate the recommended dosage for the recommended movement route. The output control function 114 then outputs the recommended dosage for the recommended movement route.

FIG. 14 is a diagram for explaining the processing of the X-ray CT apparatus 1 according to the second embodiment. FIG. 14 illustrates an enlarged view of the periphery of the line segment region e2 described in the first embodiment.

As shown in FIG. 14, by the processing described in the first embodiment, it is presented that the medicine is administered from the position P2 in the direction of the segment area e2. In this case, the calculation function 113 further calculates the recommended dose to be administered at the position P2 based on the volume of the vascular branch corresponding to the segmented area e2 and the volume of the liver tumor connected to the segmented area e2. do.

For example, the calculation function 113 calculates the volume of the vascular branch corresponding to the line segment e2 and the volume of the liver tumor connected to the line segment e2 from the volume data. Here, when the volume of the vascular branch corresponding to the line segment e2 is "1 mL" and the volume of the liver tumor connected to the line segment e2 is "20 mL", the calculation function 113 A total value of "21 mL" is calculated as the recommended dose.

Note that the content described with reference to FIG. 14 is merely an example, and the present invention is not limited to this. For example, FIG. 14 describes the case where the total value of the volume of the vascular branch and the volume of the liver tumor is used as the recommended dose, but the present invention is not limited to this. That is, the calculation function 113 can calculate a value based on the volume of the vascular branch and the liver tumor, such as a value proportional to the volume of the vascular branch and the liver tumor, as the recommended dose. The calculation function 113 may also calculate the recommended dosage for each recommended route of travel using the volume, minimum diameter, average diameter, and the like of blood vessel branches included in the recommended route of travel.

(Third Embodiment)
In the above-described embodiment, as an example, the case where one liver tumor is fed by one vascular branch was described, but the present invention is not limited to this. It is also possible that it is nourished by Therefore, in the third embodiment, a process when one liver tumor is nourished by a plurality of blood vessel branches will be described.

For example, when multiple blood vessel branches are connected to one target site, the calculation function 113 integrates the multiple blood vessel branches to calculate the recommended movement route. For example, when calculating the tumor points of different blood vessel branches, the calculation function 113 does not total the tumor points of multiple blood vessel branches connected to a common tumor, but obtains the tumor points.

FIG. 15 is a diagram for explaining the processing of the X-ray CT apparatus 1 according to the third embodiment. FIG. 15 illustrates a case where a certain liver tumor T1 is nourished by line segments f1, f2, and f3. In FIG. 15, the numerical values in parentheses illustrated beside the tags of the line segment represent the tumor points calculated for the line segment. Here, this tumor point is information that can identify which liver tumor the tumor point is based on. Specifically, “1-T1” in FIG. 15 indicates that the tumor point based on the liver tumor T1 is “1”.

As shown in the upper part of FIG. 15, the calculation function 113 does not add up the values based on common liver tumors when calculating the tumor points of each line segment area. For example, the tumor points of line segments f1, f2, and f3 are respectively "1-T1".

Here, when the calculation function 113 calculates the tumor points, if the tumor points are based on the same liver tumor, they are treated as one tumor point without summation. For example, a line segment area f4 is a blood vessel branch that branches into line segment areas f1 and line segment areas f2. Here, the tumor point of line segment f1 is "1-T1", and the tumor point of line segment f2 is also "1-T1". In this case, the calculation function 113 assigns the tumor point "1-T1" to the line segment f4 instead of the total value "2" of the tumor points of the line segment f1 and the line segment f2.

Further, for example, the line segment area f5 is a blood vessel branch that branches into the line segment area f3 and the line segment area f4. Here, the tumor point of line segment f3 is "1-T1", and the tumor point of line segment f4 is also "1-T1". In this case, the calculation function 113 assigns the tumor point "1-T1" to the segment area f5 instead of the total value "2" of the tumor points of the segment areas f3 and f4.

Thus, the calculation function 113 aggregates tumor points based on the same tumor. Therefore, as shown in the lower part of FIG. 15, the calculation function 113 can handle the line segment areas f1, f2, f3, f4, and f5 as if they were one line segment area F1.

As described in the second embodiment, when using the volume of the blood vessel branch, the volume of the integrated line segment area is the sum of the volumes of the line segment areas to be integrated. For example, the volume of the line segment area F1 is the sum of the volumes of the line segment areas f1, f2, f3, f4, and f5.

(Other embodiments)
Various different forms may be implemented in addition to the embodiments described above.

(Use of parameters other than the number of end portions of blood vessels)
In the above-described embodiment, the case where the administration efficiency is calculated using the number of end portions of blood vessels has been described, but the embodiment is not limited to this. For example, the calculation function 113 can calculate the administration efficiency using the length, area, or volume of the vascular region or tumor region, in addition to the number of end portions of the blood vessel.

FIG. 16 is a diagram for explaining processing by an X-ray diagnostic apparatus according to another embodiment. FIG. 16 illustrates a case where administration efficiency is calculated using volume. FIG. 16 illustrates a blood vessel branching into line segment areas e1 and e2 and a liver tumor connected to line segment area e2. In FIG. 16, the volume of the liver tumor is V1 mL, the volume of line segment e2 is V2 mL, and the volume of line segment e1 is V1 mL.

As shown in FIG. 16, the calculation function 113 calculates the administration efficiency based on the ratio of the target site to which blood is supplied from each position to the tissue to which blood is supplied from each position on the blood vessel. For example, the calculation function 113 calculates the administration efficiency for each of the four positions P11 to P14.

A position P11 is a position connected to the liver tumor in the line segment e2. Therefore, the tissue to which blood is supplied from position P11 is a liver tumor, and the volume of the liver tumor is "V1". Also, the volume of the liver tumor to which blood is supplied from position P11 is "V1". That is, the calculation function 113 calculates "V1/V1" as the administration efficiency at the position P11.

A position P12 is a position corresponding to the midpoint of the segment area e2. Therefore, the volume of the tissue to which blood is supplied from the position P12 corresponds to the sum of the volume of the liver tumor "V1" and the volume "V2/2" which is half the volume of the line segment e2, "V1+V2/2". do. Also, the volume of the liver tumor to which blood is supplied from position P12 is "V1". That is, the calculation function 113 calculates "V1/(V1+V2/2)" as the administration efficiency at the position P12.

The position P13 is the position closest to the origin position of the catheter in the line segment area e2. Therefore, the volume of the tissue to which blood is supplied from the position P13 corresponds to the sum of the volume "V1" of the liver tumor and the volume "V2" of the segment area e2, "V1+V2". Also, the volume of the liver tumor to which blood is supplied from position P13 is "V1". That is, the calculation function 113 calculates "V1/(V1+V2)" as the administration efficiency at the position P13.

A position P14 is a branch position where the blood vessel branches into line segment regions e1 and e2. Therefore, the volume of the tissue to which blood is supplied from the position P14 is the sum of the volume "V1" of the liver tumor, the volume "V2" of the line segment e2, and the volume "V3" of the line segment e1, "V1+V2+V3 ” corresponds to Also, the volume of the liver tumor to which blood is supplied from position P14 is "V1". That is, the calculation function 113 calculates "V1/(V1+V2+V3)" as the administration efficiency at the position P14.

Thus, the calculation function 113 is based on the ratio of the volume of the target site to which blood is supplied from each location to the volume of the tissue (vascular region and target site) to which blood is supplied from each location on the blood vessel. to calculate the dosing efficiency.

Note that FIG. 16 illustrates the case of calculating administration efficiency using volume, but embodiments are not limited to this. For example, the calculation function 113 can calculate the administration efficiency using the length of the tissue (the length of the core line of the blood vessel region, the diameter of the liver tumor, etc.) or the area of the tissue (the cross-sectional area of the blood vessel region, the liver tumor, etc.). It is calculable. In other words, the number, length, area, or volume of the terminal part is a value representing the size of the tissue to which blood is supplied from each position on the blood vessel and the size of the target site to which blood is supplied from that position. etc. can be used arbitrarily. That is, the calculation function 113 calculates the administration efficiency based on the ratio of the target site to which blood is supplied from each position to the tissue to which blood is supplied from each position on the blood vessel.

Moreover, when the drug infiltrates from a blood vessel or liver tumor, the volume can also be calculated based on the infiltration distance. For example, when the drug infiltrates approximately 5 mm outside the blood vessel, the calculation function 113 calculates the volume after adding 5 mm to the radius of the blood vessel, thereby calculating the volume based on the blood vessel and the infiltration area. can be done. In other words, the ratio for calculating the administration efficiency described above is not limited to only the "divided value", but after performing various corrections (calculations) to more accurately reflect the patient and disease conditions. It is good if it is a ratio of

(Weight setting)
In the above-described embodiments, it is also possible to calculate the index value using weights preset by a skilled doctor, for example.

That is, the calculation function 113 performs preset weighting on each parameter related to each recommended travel route for each of the plurality of recommended travel routes, and calculates the index value of each recommended travel route based on the weighted parameters. calculate. Then, the output control function 114 displays the index value of each recommended travel route.

For example, the calculation function 113 calculates a plurality of recommended travel routes as shown in FIG. Here, the calculation function 113 calculates an index value for each recommended travel route. For example, the calculation function 113 appropriately weights arbitrary parameters such as administration efficiency, total travel distance, number of bifurcations, procedure time, drug dose, minimum blood vessel diameter, etc. in each recommended travel route, and the index value Calculate It should be noted that known techniques can be appropriately applied to the types of parameters and calculation method used to calculate the index value. For example, the above formula (1) is an example of a formula for obtaining an index value.

Here, the weighting used for calculating the index value is set in advance by a skilled doctor. For example, a physician sets a weighting of 0-1 for various parameters. Here, the doctor assigns higher weights to parameters that are more important, and lower weights to less important parameters. Then, the calculation function 113 multiplies each parameter by the weighting of each parameter set by the doctor. Then, the calculation function 113 calculates an index value using the multiplied parameters. Then, the output control function 114 displays the index value of each recommended travel route together with each recommended travel route.

In the above process, the calculation function 113 causes the weighting of each parameter set by the doctor to be stored in a storage device such as the storage circuit 108 or the like. As a result, the calculation function 113 can use the weighting of each parameter set last time even when another doctor (operator) calculates the index value of each recommended movement route from the next time onward. Note that the output control function 114 can also compare the index values of the recommended travel routes with each other and present the most recommended recommended travel route.

(medical image processing device)
For example, the processing functions of the processing circuit 110 described in the above-described embodiment are not limited to medical image diagnostic apparatuses, but can also be applied to medical image processing apparatuses such as workstations, PACS viewers, etc., which are equipped with functions for processing medical images. Applicable.

FIG. 17 is a block diagram showing an example configuration of a medical image processing apparatus 200 according to another embodiment. The medical image processing apparatus 200 corresponds to, for example, an information processing apparatus such as a personal computer or workstation, or an operating terminal of a medical image diagnostic apparatus such as a console apparatus included in an X-ray CT apparatus.

As shown in FIG. 17, the medical image processing apparatus 200 includes an input interface 201, a display 202, a memory circuit 210, and a processing circuit 220. FIG. The input interface 201, the display 202, the storage circuit 210, and the processing circuit 220 are communicably connected to each other.

The input interface 201 is an input device such as a mouse, keyboard, touch panel, etc., for receiving various instructions and setting requests from the operator. The display 202 is a display device that displays medical images and a GUI for the operator to input various setting requests using the input interface 201 .

The storage circuit 210 is, for example, a NAND (Not AND) type flash memory or an HDD (Hard Disk Drive), and stores various programs for displaying medical image data and GUIs, and information used by the programs.

The processing circuit 220 is an electronic device (processor) that controls the entire processing in the medical image processing apparatus 200 . Processing circuitry 220 performs a calculation function 221 and an output control function 222 . Each processing function executed by the processing circuit 220 is recorded in the storage circuit 210 in the form of a computer-executable program, for example. The processing circuit 220 reads out and executes each program to realize the function corresponding to each read program. The calculation function 221 and the output control function 222 can execute basically the same processing as the calculation function 113 and the output control function 114 shown in FIG.

For example, the calculation function 221 functions as an acquisition unit that acquires volume data. For example, the calculation function 221 reads volume data from a storage circuit that stores volume data captured by a medical image diagnostic apparatus. Further, the calculation function 221 functions as an extraction unit that extracts the blood vessel structure of blood vessels included in the volume data. Also, the calculation function 221 functions as a setting unit that sets a plurality of target sites for the volume data. In addition, the calculation function 221 administers the drug to the target site from the catheter that moves inside the blood vessel based on the vascular structure of the blood vessel and the target connection state between each target site and each vascular branch in the volume data. A plurality of administration positions, which are positions where the catheter is to be placed, are obtained, and a recommended movement route of the catheter is calculated based on the plurality of administration positions. Also, the output control function 222 outputs a recommended moving route. According to this, the medical image processing apparatus 200 can present a recommended movement route of a catheter that can efficiently move between a plurality of target sites.

Each processing function of the processing circuit 110 described in the above embodiments can also be realized by software. For example, each processing function of the processing circuit 110 is realized by causing a computer to execute a program defining the procedure of the processing described as being performed by each processing function of the processing circuit 110 in the above embodiment. This program (medical image processing program) is stored in, for example, a hard disk or a semiconductor memory device, and read and executed by a processor such as a CPU or MPU. Also, this program can be recorded on a computer-readable recording medium such as a CD-ROM (Compact Disc-Read Only Memory), MO (Magnetic Optical disk), DVD (Digital Versatile Disc) and distributed.

The term "processor" used in the above description is, for example, a CPU (Central Processing Unit), a GPU (Graphics Processing Unit), or an application specific integrated circuit (ASIC), a programmable logic device (e.g., Circuits such as Simple Programmable Logic Device (SPLD), Complex Programmable Logic Device (CPLD), and Field Programmable Gate Array (FPGA)). A processor achieves its functions by reading and executing a program embedded in the circuitry of the processor. Instead of incorporating the program into the circuit of the processor, the program may be stored in the memory circuit of the console. In this case, the processor implements its functions by reading and executing the program stored in the memory circuit. Note that each processor of the present embodiment is not limited to being configured as a single circuit for each processor, and may be configured as one processor by combining a plurality of independent circuits to realize its function. good. Furthermore, a plurality of components in FIG. 1 may be integrated into one processor to realize its functions.

Also, each component of each device illustrated in the above-described embodiment is functionally conceptual, and does not necessarily need to be physically configured as illustrated. In other words, the specific form of distribution and integration of each device is not limited to the illustrated one, and all or part of them can be functionally or physically distributed and integrated in arbitrary units according to various loads and usage conditions. Can be integrated and configured. Further, all or any part of each processing function performed by each device can be implemented by a CPU and a program analyzed and executed by the CPU, or implemented as hardware based on wired logic.

Further, among the processes described in the above embodiments, all or part of the processes described as being automatically performed can be manually performed, or the processes described as being manually performed can be performed manually. can also be performed automatically by known methods. In addition, information including processing procedures, control procedures, specific names, and various data and parameters shown in the above documents and drawings can be arbitrarily changed unless otherwise specified.

According to at least one embodiment described above, it is possible to present a recommended movement route for a catheter that allows efficient movement between a plurality of target sites.

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

1 X-ray diagnostic device 113 calculation function 114 output control function

Claims (32)

an acquisition unit that acquires volume data in which a blood vessel including a plurality of vascular branches connected to each of a plurality of target sites is imaged;
an extraction unit that extracts the blood vessel structure of the blood vessel included in the volume data;
a setting unit that sets a plurality of target sites for the volume data;
In the volume data, based on the vascular structure of the blood vessel and the positional relationship between each target site and each vascular branch, it is a position where a drug is administered to the target site from a catheter that moves inside the blood vessel. a calculation unit that obtains a plurality of administration positions;
an output control unit that outputs the administration position;
with
The calculation unit calculates a recommended movement route of the catheter based on the plurality of administration positions.
Medical image processing equipment. The calculation unit calculates, based on the ratio of the target sites to which blood is supplied from each position on the blood vessel, the ratio of the target sites to which blood is supplied from each position on the blood vessel. Calculate the administration efficiency, which represents the efficiency of reaching
The medical image processing apparatus according to claim 1. The calculation unit calculates, as the ratio, the ratio of the number of terminal portions connected to the target site to the number of terminal portions of the blood vessel to which blood is supplied from each position on the blood vessel.
The medical image processing apparatus according to claim 2. The calculation unit calculates, as the ratio, the ratio of the length of the target region to the length of the target region and the blood vessel region to which blood is supplied from each position on the blood vessel.
The medical image processing apparatus according to claim 2. The calculation unit calculates, as the ratio, the ratio of the area of the target site to the area of the target site and the blood vessel area to which blood is supplied from each position on the blood vessel.
The medical image processing apparatus according to claim 2. The calculation unit calculates, as the ratio, the ratio of the volume of the target site to the volume of the target site and the blood vessel area to which blood is supplied from each position on the blood vessel.
The medical image processing apparatus according to claim 2. The calculation unit identifies branching states of a plurality of vascular branches that form the vascular structure of the blood vessel, and calculates the recommended movement based on the identified branching states and target connection states between each target site and each vascular branch. calculate a route,
The medical image processing apparatus according to any one of claims 1-6 . The calculation unit calculates an administration efficiency representing an efficiency with which a drug administered from the catheter reaches each target site based on the branching state and the target connection state, and based on the calculated administration efficiency , calculating the recommended travel route;
The medical image processing apparatus according to claim 7 . The calculation unit
classifying a plurality of vascular branch regions in which the administration efficiency is equal to or higher than a threshold into one or more groups;
Among the classified groups, a route for moving the catheter in order from the group closest to the starting point position of the catheter is calculated as the recommended movement route;
The medical image processing apparatus according to claim 8 . The output control unit displays a plurality of vascular branch regions where the administration efficiency is equal to or greater than a threshold;
The medical image processing apparatus according to claim 8 or 9 . The output control unit displays the region of each blood vessel branch in a color corresponding to the administration efficiency.
The medical image processing apparatus according to any one of claims 8-10 . The calculation unit calculates a plurality of recommended movement routes for each of a plurality of administration efficiencies that are different from each other,
The output control unit displays information indicating the relationship between the calculated administration efficiency for each of the plurality of recommended travel routes and the total travel distance of the plurality of recommended travel routes.
The medical image processing apparatus according to any one of claims 8-11 . For each of the plurality of recommended travel routes, the calculation unit performs preset weighting on each parameter related to each recommended travel route, and calculates an index value for each recommended travel route based on the weighted parameters. death,
The output control unit displays an index value for each recommended movement route,
The medical image processing apparatus according to claim 12 . When displaying a plurality of recommended travel routes, the output control unit displays an index value obtained by dividing the administration efficiency of each recommended travel route by the total travel distance.
The medical image processing apparatus according to claim 12 . When displaying a plurality of recommended travel routes, the output control unit displays the difficulty level of each recommended travel route.
The medical image processing apparatus according to any one of claims 8-14 . The calculation unit calculates the difficulty level based on at least one of the thickness of blood vessel branches and the number of branch points on each of the plurality of recommended movement routes.
The medical image processing apparatus according to claim 15 . When displaying a plurality of recommended travel routes, the output control unit displays the number of branch points in each recommended travel route.
The medical image processing apparatus according to any one of claims 8-16 . The calculation unit uses at least one of a first evaluation value corresponding to the number of tumors reaching through each vascular branch and a second evaluation value corresponding to the number of terminal parts reaching through each vascular branch. to calculate the dosing efficiency;
The medical image processing apparatus according to any one of claims 8-17. The calculation unit calculates the first evaluation value by weighting according to the size of the tumor arriving via each vascular branch.
The medical image processing apparatus according to claim 18 . The calculation unit weights according to at least one of the length and thickness of each vascular branch to calculate the second evaluation value.
The medical image processing apparatus according to claim 18 or 19 . wherein the calculation unit calculates a value obtained by dividing the first evaluation value by the second evaluation value as the administration efficiency;
The medical image processing apparatus according to any one of claims 18-20 . The calculation unit calculates the recommended movement route using the movement distance of the catheter or the number of drug administrations.
The medical image processing apparatus according to any one of claims 1-21. The calculation unit calculates the recommended movement route based on the movement speed of the catheter and the procedure time.
The medical image processing apparatus according to any one of claims 1-22. The output control unit displays vascular branches that supply blood to the target site and other vascular branches in different display modes.
The medical image processing apparatus according to any one of claims 1-23 . The output control unit displays a GUI (Graphical User Interface) for specifying an administration efficiency threshold representing the efficiency with which the drug administered from the catheter reaches each target site, and displays the threshold specified by the GUI. displaying the above vascular branches in a display mode different from other vascular branches,
The medical image processing apparatus according to any one of claims 1-24 . The calculation unit calculates a recommended dosage of a drug to be administered along the recommended movement route,
The output control unit outputs the recommended dosage on the recommended movement route,
The medical image processing apparatus according to any one of claims 1-23. When a plurality of vascular branches are connected to one target site, the calculation unit integrates the plurality of vascular branches to calculate the recommended movement route.
The medical image processing apparatus according to any one of claims 1-23. an acquisition unit that acquires volume data in which a blood vessel including a plurality of vascular branches connected to each of a plurality of target sites is imaged;
an extraction unit that extracts the blood vessel structure of the blood vessel included in the volume data;
a setting unit that sets a plurality of target sites for the volume data;
In the volume data, based on the vascular structure of the blood vessel and the positional relationship between each target site and each vascular branch, it is a position where a drug is administered to the target site from a catheter that moves inside the blood vessel. a calculation unit that obtains a plurality of administration positions;
an output control unit that outputs the administration position;
with
The output control unit displays a GUI (Graphical User Interface) for specifying an administration efficiency threshold representing the efficiency with which the drug administered from the catheter reaches each target site, and displays the threshold specified by the GUI. displaying the above vascular branches in a display mode different from other vascular branches,
Medical image processing equipment. an acquisition unit that acquires volume data in which a blood vessel including a plurality of vascular branches connected to each of a plurality of target sites is imaged;
an extraction unit that extracts the blood vessel structure of the blood vessel included in the volume data;
a setting unit that sets a plurality of target sites for the volume data;
In the volume data, based on the vascular structure of the blood vessel and the positional relationship between each target site and each vascular branch, it is a position where a drug is administered to the target site from a catheter that moves inside the blood vessel. a calculation unit that obtains a plurality of administration positions;
an output control unit that outputs the administration position;
with
The calculation unit calculates a recommended movement route of the catheter based on the plurality of administration positions.
Medical diagnostic imaging equipment. an acquisition unit that acquires volume data in which a blood vessel including a plurality of vascular branches connected to each of a plurality of target sites is imaged;
an extraction unit that extracts the blood vessel structure of the blood vessel included in the volume data;
a setting unit that sets a plurality of target sites for the volume data;
In the volume data, based on the vascular structure of the blood vessel and the positional relationship between each target site and each vascular branch, it is a position where a drug is administered to the target site from a catheter that moves inside the blood vessel. a calculation unit that obtains a plurality of administration positions;
an output control unit that outputs the administration position;
with
The output control unit displays a GUI (Graphical User Interface) for specifying an administration efficiency threshold representing the efficiency with which the drug administered from the catheter reaches each target site, and displays the threshold specified by the GUI. displaying the above vascular branches in a display mode different from other vascular branches,
Medical diagnostic imaging equipment. Acquiring volume data in which a blood vessel including a plurality of vascular branches connected to each of a plurality of target sites is imaged,
extracting the vascular structure of the blood vessel included in the volume data;
setting a plurality of target sites for the volume data;
In the volume data, based on the vascular structure of the blood vessel and the positional relationship between each target site and each vascular branch, it is a position where a drug is administered to the target site from a catheter that moves inside the blood vessel. Finding multiple administration positions,
outputting the dosing location;
Let the computer execute each process ,
In the process of determining the administration position, a recommended movement route of the catheter is calculated based on the plurality of administration positions.
A medical image processing program. Acquiring volume data in which a blood vessel including a plurality of vascular branches connected to each of a plurality of target sites is imaged,
extracting the vascular structure of the blood vessel included in the volume data;
setting a plurality of target sites for the volume data;
In the volume data, based on the vascular structure of the blood vessel and the positional relationship between each target site and each vascular branch, it is a position where a drug is administered to the target site from a catheter that moves inside the blood vessel. Finding multiple administration positions,
outputting the dosing location;
Let the computer execute each process,
In the process of outputting the administration position, a GUI (Graphical User Interface) for specifying a threshold of administration efficiency representing the efficiency with which the drug administered from the catheter reaches each target site is displayed and specified by the GUI. displaying a vascular branch that is equal to or greater than the determined threshold in a display mode different from that of other vascular branches;
A medical image processing program.

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