JPH04307028A - Supporting method for remote physiological diagnosis - Google Patents

Abstract

PURPOSE:To achieve a supporting method for remote pathologica diagnosis. CONSTITUTION:A station 2 on the side of applying for diagnosis provide in a physiological inspection chamber where a physiological diagnosis is applied for is connected to a diagnosis-side station 4 provided on the side of pathlogic phsicians on by a communication means 8. In the application for the physiological diagnosis, a diagnosis application from by hand written graphics and characteris inputted into an input devices 26 and 27 on the station on the side of application for diagnosis is outputted from a print out device 49 of the diagnosis side station 4 through a communication means 8 to be transmitted as diagnosis application form by a written paper. In the physiological diagnosis, a pathologic physician observes a sample in the diagnosis side station 4 being put on a microscope remotely controlling the fully automatic microscope 30 through the communication means 8 using a microscope controller 45 and monitor devices 41 and 42. Hand written graphics and characters inputted into the input devices 46 and 47 of the diagnosis side station are outputted from a print out device 29 of the diagnosis form application side station to be transmited as diagnosis form by a written paper through the communication means 8.

Description

[Detailed description of the invention]

0001

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a system for supporting pathological diagnosis between remote locations using a microscope.

0002

BACKGROUND OF THE INVENTION There is a chronic shortage of pathologists in the medical industry in Japan, and it is difficult for hospitals without pathologists to receive prompt pathological diagnoses. Therefore, in recent years, the concept of remote pathological diagnosis has begun to attract attention, and several systems aimed at supporting this have been announced.

Conventional remote pathological diagnosis support systems include systems that make it possible to transmit images captured by a camera attached to a microscope to a remote location, or systems that enable magnification change, focusing, stage movement, illumination intensity adjustment, etc. At the time, we had only proposed a system that made it possible to remotely control a fully automatic microscope capable of electric operations such as optical path switching and photography, as well as voice transmission and reception over the telephone.

0004

[Problems to be Solved by the Invention] In the above-mentioned conventionally proposed systems, when a client requests a diagnosis to a pathologist, or based on transmitted image information, the pathologist Even when making a diagnosis, it has not yet been possible to provide something that can sufficiently respond to the numerous information transmission and recording needs required during actual pathological diagnosis. For example, even when an image of a microscopic specimen is transmitted to a pathologist, conventional systems do not provide "excision site information of the specimen" that indicates which part of the organ or tissue fragment that was removed during surgery corresponds to the microscopic specimen. It takes a lot of time to convey information about the specimen, and even when the diagnosis requester wants to point out the parts of the specimen that the pathologist would like to draw special attention to, conventional systems that rely only on audio and image monitors lack speed and accuracy. It was something lacking. In addition, conventional systems rely only on audio and original images when transmitting a patient's past symptoms and medical record contents to a pathologist, or when a pathologist explains diagnostic results to a client. It was necessary and inconvenient. In particular, obtaining written answers regarding diagnostic results is essential in pathological diagnosis, but it has not been taken into account. Furthermore, in the case of a pathological diagnosis request that involves a large amount of image data or document data, there is a procedure in which a diagnosis is made each time image data or document data is transmitted, and then the next image data or document data is transmitted. Because of this, it took a long time to diagnose a single request.

An object of the present invention is to solve these conventional problems and provide a practical method for supporting remote pathological diagnosis.

[0006]

[Means for Solving the Problems] The remote pathological diagnosis support method according to the present invention comprises a diagnosis requesting side station (2) installed in a pathology laboratory requesting a pathological diagnosis, and a diagnosis side station (2) installed in a pathologist side. 4) and a communication means (8) that connects them, the diagnosis requesting station (2) is equipped with a fully automatic microscope (2) capable of at least magnification and stage movement by remote control. 30), an imaging camera (31) that captures an image observed by the microscope and outputs it as image information, an input device (26, 27) having a function of inputting handwritten figures and characters, and inputting the image information and the handwritten figures and characters. The diagnostic station (4) includes a microscope control device (45) for remotely controlling the microscope, and a printing device (29) for displaying handwritten figures. and an input device with character input function (46,4
7), a monitor device (41, 42) for displaying the image information and the handwritten figures and characters, and a printing device (49).

[0007] When requesting a pathological diagnosis, a diagnosis request form consisting of handwritten figures and characters input into the input device (26, 27) of the diagnosis requesting station is sent to the communication means (8).
) to the printing device (
49) and transmitted as a written diagnosis request form. During pathological diagnosis, the pathologist uses the microscope control device (
45) and monitor devices (41, 42) to remotely control the microscope (30) via the communication means (8) and observe the specimen placed on the microscope at the diagnostic station (4).

[0008] The medical certificate is sent to the input device (
46, 47) are transmitted as a written medical certificate by outputting them from the printing device (29) of the diagnosis requesting station via the communication means (8).

[0009]

[Operation] By using the remote pathological diagnosis support method according to the present invention, pathological diagnosis at a remote location can be performed as follows. When a pathological diagnosis of an organ or tissue removed during a surgical operation is required, a laboratory technician receives it from a surgeon and prepares a microscopic specimen in a pathology laboratory equipped with a diagnosis requesting station (2). The laboratory technician uses the handwriting input device (26) to draw a sketch of the organ or tissue and draws specimen cutting lines thereon. Then, a diagnosis request statement is created using the keyboard input device (27), the above-mentioned sketch and the client's signature are entered therein using the handwriting input device (26), and the text is transmitted to a remote pathologist. The created microscopic specimen is placed on a microscope (30), and the microscopic image taken by the imaging camera (31) is transmitted to the communication means (8).
) is transmitted to the diagnostic station (4) and displayed on the image monitor (41).

[0010] The pathologist makes a diagnosis by operating the microscope (30) from a remote location by remote control while viewing the image on the monitor. The pathologist creates a medical certificate using the same procedure as creating a diagnostic request form. That is, a diagnostic sentence is created using the keyboard input device (47), and the diagnostic sentence is created using the handwritten input device (46).
), the necessary sketch and the pathologist's signature are written on the medical certificate and transmitted to the client.

[0011]

DESCRIPTION OF THE PREFERRED EMBODIMENTS An embodiment of the present invention will be described with reference to the accompanying drawings. In FIG. 1, an image transmitting station 2 is installed in a pathology laboratory on the diagnosis client side, and an image receiving station 4 is installed on the diagnostician side, which is a pathologist. Further, a monitor system 6 is installed in the operating room adjacent to the pathology review room, and this monitor system 6 is connected to a control device of the image receiving station 4, which will be described later. The image transmitting station 2 and the image receiving station 4 are connected to a coaxial cable, a fiber cable, a general telephone line, an integrated service digital network (I), which are known per se.
They are connected by communication means 8 such as SDN), microwave, and communication satellite lines.

As shown in FIG. 2, the image transmitting station 2 and the image receiving station 4 are respectively configured around system controllers 20 and 40. The image transmitting station 2 includes an image monitor 21, a graphic monitor 22, a microphone 23, and a speaker 24.
, remote control device 25, handwriting input device 26
, a keyboard input device 27, a data recording device 28, a printer 29, a fully automatic microscope 30, an imaging camera 31 and its control unit 32, a macro imaging stand 33, and an imaging camera 34 and its control unit 35. The monitor system 6 in the operating room includes
An image monitor 61, a microphone 63, and a speaker 64 are provided, and each is connected to the system control device 20 by a coaxial cable. The image receiving station 4 also includes an image monitor 41, a graphic monitor 42, a microphone 43, and a speaker 44.
, remote control device 45, handwriting input device 46
, a keyboard input device 47, a data recording device 48, and a printer 49. Transmitting/receiving device 36, 5
6 connects the control devices 20, 40 and the aforementioned communication means 8, respectively.

The fully automatic microscope 30 described above includes an electric revolver and an electric condenser for changing magnification, an autofocusing device, a scanning stage for moving the sample, an automatic light control device for adjusting illumination intensity, and an automatic optical path switching device. etc. This microscope 30 can be remotely controlled by the remote control device 25 of the image sending station 2, and can also be remotely controlled by the remote control device 45 of the image receiving station 4 via the communication means 8. An imaging camera 31 such as a TV camera mounted on the microscope 30 is also controlled by the remote control device 25 or 45 via the system control devices 20 and 40 and the control unit 32, and images the sample magnified by the microscope.

The macro photography stand 33 is provided for observing samples and specimens at a lower magnification than that of a microscope. This macro photography stand also has a control unit 35.
An imaging camera 34 controlled by is attached. Image signals from the imaging camera 31 or 34 are sent to the system control device 2 via the control unit 32 or 35.
0 and displayed on the image monitors 21 and 61, and is also output from the transmitting/receiving device 36 to the communication means and displayed on the image monitor 41 of the image receiving station 4.

The handwriting input devices 29 and 46 each have a tablet for inputting graphics, and output a locus drawn on the tablet using a stylus pen as a coordinate position signal. The graphic outputs from these handwriting input devices 29 and 46 are converted into still image signals and taken into the frame memories of the system control devices 20 and 40, and then displayed on the image monitors 21 and 41.
, 61 or displayed on the graphic monitors 22, 42. Character output input from the keyboard input devices 27 and 47 is also converted into a still image signal, taken into the frame memory of the system control device, and superimposed on the original image on the image monitor or displayed on the graphic monitor. .

The data recording devices 28 and 48 are large-capacity memories such as magneto-optical disk devices, and are capable of recording image data and graphic data in accordance with commands from the system control devices 20 and 40. Next, the operation of the remote pathological diagnosis support system according to this embodiment will be explained. When a pathological diagnosis is required, for example to determine whether cancerous cells are present in an organ or tissue removed by a surgeon in the operating room, the laboratory technician receives it from the surgeon and transmits it to the image transmitting station 2. The specimens are quickly frozen in a pathology laboratory equipped with a microscope, cut into thin sections, and stained to prepare microscopic specimens. Four to five microscopic specimens are usually prepared for one organ or tissue.

[0017] The laboratory technician further uses a stylus pen to draw a sketch of the organ or tissue on the tablet of the handwriting input device 26, draws a cutting line indicating the part of the microscopic specimen, and writes the corresponding specimen number. do. Then, a request for pathological diagnosis is created using the keyboard input device 27. Since the graphic output of the handwriting input device 26 and the character output of the keyboard input device 27 are displayed in a superimposed manner on the graphic monitor 22, the handwritten signature of the inspection technician who is the client is written there using the handwriting input device 26. .

In order to transmit the pathological diagnosis request form thus created to a remote pathologist, the client inputs a transmission command to the system control device 20. The system control device 20 outputs the image displayed on the graphic monitor 22 from the transmitting/receiving device 36 to the communication means, and transmits it to the transmitting/receiving device 56 of the image receiving station 4. The pathological diagnosis request form thus transmitted is printed by the printer 49 as shown in FIG. 3 and delivered to the pathologist. Figure 3
The pathological diagnosis request form 10 includes a sketch 101, a diagnosis request text and date 102, and the client's handwritten signature 103, and functions as an official request form.

On the other hand, the prepared microscopic specimen is placed on the fully automatic microscope 30 by a laboratory technician. Imaging camera 3
The microscope image taken in step 1 is displayed on image monitors 21 and 61 in the pathology laboratory and operating room. At the same time, the image is also transmitted to the image receiving station 4 via the communication means 8, and the same image is displayed on the image monitor 41. From this point on, discussion for pathological diagnosis becomes possible among the surgeon, laboratory technician, and pathologist through conversation using a microphone and speaker.

The pathologist can remotely control the microscope 30 by using the remote control device 45 provided in the image receiving station 4 while viewing the image on the monitor, so he can find the part he wants to see by himself and control the microscope. Pathologists can set observation conditions such as magnification and illumination by themselves to make a diagnosis. If there is a suspicious site in the specimen, the laboratory technician uses the handwriting input device 26 to mark it on the original image on the image monitor during diagnosis, and calls the pathologist's attention through voice communication. . Images and sounds at this time are recorded on an image monitor 61 located in the operating room awaiting the results of the pathological diagnosis.
Since the surgeon can listen to the video and participate in the conversation through the speaker 64, it becomes easier for the surgeon to understand the details of the diagnosis made by the pathologist. Diagnosis results are immediately communicated to the laboratory technician and surgeon via audio and image monitor, allowing surgery to be resumed in a short time.

[0021] After completing the diagnosis, the pathologist creates a medical certificate. A medical certificate is created using the same procedure as a pathological diagnosis request form. That is, the pathologist writes a diagnostic statement using the keyboard 47 and displays it on the graphic monitor 42. On the other hand, while superimposing the image from the handwriting input device 46 on the graphic monitor 42, the sketch necessary for the medical certificate and the pathologist's handwritten signature are written thereon. When a transmission command is input to the system control device 40, the image displayed on the graphic monitor 42 is outputted from the transmitter/receiver 56 to the communication means and transmitted to the transmitter/receiver 36. The medical certificate transmitted in this manner is printed by the printer 29 as the medical certificate 12 shown in FIG. 4, and delivered to the laboratory technician. The medical certificate 12 in FIG. 4 includes a diagnostic text, a date 121, a sketch 122, and a pathologist's handwritten signature 123, and functions as an official medical certificate.

[0022] According to the above embodiment, when performing a rapid diagnosis during surgery, a surgeon, a laboratory technician, and a pathologist who are located at separate locations can closely communicate with each other using audio, microscopic images, handwritten figures, and text information. We can communicate with each other. In other words, a pathologist can observe a specimen under a microscope from a remote location, and can also control the magnification and movement of the observation site, allowing the pathologist to make a diagnosis as if he or she were there.

Although one embodiment of the present invention has been described above, the present invention is not limited to such intraoperative diagnosis. For example, by using the data recording device 48 of the image receiving station 4, images of a number of specimens requiring pathological diagnosis can be transmitted and stored at a pathologist. This allows the pathologist to go to a remote hospital to perform specimen diagnosis, which has traditionally been done periodically by a pathologist, without having to travel. In addition, by combining a computer program for the system control device and a data recording device, it is possible to automatically transmit and record a large number of images, pathological diagnosis requests, medical certificates, etc. to the other party at night, for example. Therefore, it is also possible to perform a diagnosis all at once based on the information stored in the data recording device. This makes it possible to eliminate unnecessary waiting time during transmission. Furthermore, if pathologists are present at both stations, dialogue between specialized pathologists is also possible.

[0024]

Effects of the Invention According to the present invention, when making a pathological diagnosis, it becomes possible for a pathologist to communicate directly with a laboratory technician or a surgeon in real time. information can also be accurately communicated to the surgeon on site. Furthermore, since the official medical certificate and pathological diagnosis request form with handwritten signatures can be transmitted to the other party in real time, there is no need to send specimens, move the pathologist himself, issue and distribute medical certificates, etc. In addition, by selecting an appropriate means of communication, distance constraints can be virtually eliminated, and one-on-one to one-to-many and even many-to-many dialogues are possible, improving the quality of medical care. You can make a big contribution.

[Brief explanation of drawings]

FIG. 1 is a block diagram showing the configuration of a basic system of the present invention.

FIG. 2 is a block diagram showing a schematic configuration of an embodiment of the present invention.

FIG. 3 is an explanatory diagram showing an example of a pathological diagnosis request form.

FIG. 4 is an explanatory diagram showing an example of a medical certificate.

[Explanation of symbols]

2...Image sending station 4...Image receiving station 8...Communication means 10...Pathology diagnosis request form 12...Medical certificates 20, 40...System control Devices 21, 41, 61... Image monitors 25, 45...
...Remote control device 26, 46... Handwriting input device 27, 47... Keyboard input device 28, 48...
... Data recording device 29, 49 ... Printer 30 ... Fully automatic microscope 31, 34 ... Imaging camera

Claims (1)

[Claims] 1. A microscope capable of at least changing magnification and moving a stage by remote control, an imaging camera that captures an observed image of the microscope and outputs it as image information, an input device having a function of inputting handwritten figures and characters; A diagnosis requesting station including a monitor device for displaying image information and the handwritten figures and characters, and a printing device, a microscope control device for remotely controlling the microscope, and a handwritten figure and character input function. A diagnosis side station including an input device, a monitor device for displaying the image information and the handwritten figures and characters, and a printing device, and the diagnosis requesting station and the diagnosis station are coupled via a communication means. transmitting a diagnosis request form by outputting handwritten figures and characters inputted into the input device of the diagnosis request side station from the printing device of the diagnosis side station via the communication means; The specimen placed on the microscope is observed at the diagnostic station while remotely controlling the microscope via the communication means using the control device and the monitor device, and the specimen is input to the input device of the diagnostic station. 1. A remote pathological diagnosis support method, characterized in that a medical certificate is transmitted by outputting handwritten figures and characters from a printing device of the diagnosis requesting station via the communication means.