JPH04333972A - Medical diagnosis supporting system - Google Patents

Abstract

PURPOSE:To improve the degree of exactness for diagnosis by supporting the diagnosis of an image reading doctor by comparing the processed result of a CAD with the notice of an inputted image reading report, outputting the compared result and informing it of the image reading doctor. CONSTITUTION:A CRT screen 61 is provided as an image reading report preparing screen at a character display device 4d. In this case, the plural kinds of diagnostic information such as the diagnostic information of plural doctors, the plural kinds of diagnostic information obtained by a computer processing, the diagnostic information of the doctor or the diagnostic information obtained by the computer processing are compared, it is judged whether the result are same or not and when the results are different, it is informed. Thus, in comparison with the case of processing medical inspection data, especially, of reading medical images by a single doctor, the action of medical diagnosis can be supported, the degree of exactness for image reading can be improved and efficiency for image reading can be improved.

Description

[Detailed description of the invention]

[Object of the invention]

0002

[Industrial Application Field] The present invention compares and contrasts a plurality of pieces of diagnostic information such as doctors' findings and computer analysis on medical test data such as medical images, thereby improving medical test data obtained by doctors.
The present invention relates to a medical diagnosis support system that can be used to improve diagnostic efficiency.

0003

2. Description of the Related Art Until now, diagnosis of medical images (a type of medical examination data) in many medical institutions has been carried out in the following procedure.

(1) A doctor in an examination requesting department (for example, internal medicine) requests, for example, a radiology department to examine a patient (take medical images such as X-rays and CT). This request is made by issuing a test request form, which includes a) patient information; patient ID number (identification number), name,
Date of birth, gender, b) Information on the person requesting the test; name of the department requesting the test, name of the doctor requesting the test, c) Contents of the test; modality of test (type of X-ray, CT, etc.), site, method, d) Others; test purpose, clinical information, etc. should be described.

(2) A laboratory technician in the radiology department performs an examination on a patient according to the contents of the examination request form and develops the photographic film.

(3) An interpreter (for example, a radiologist) interprets the developed film. At this time, images from past examinations of the patient are often referred to, and this is important in improving the quality of image interpretation. After the interpretation doctor finishes reading the image, he or she creates an interpretation report. The information that the interpreting doctor writes in the interpretation report includes findings, conclusions, and
This information includes the name of the interpreting doctor and the date of interpretation.

(4) The interpretation report is sent to the doctor requesting the examination.

By the way, compared to analog images such as photographic film, digital images do not deteriorate in image quality due to copying or aging, and are easy to process using a computer. Attempts have been made to detect abnormalities in patients by analyzing them using computers, and these efforts have been successful. This technology is computer-aided diagnostics (Computer-Aided Diagnosis).
Diagnosis; hereinafter referred to as "CAD". ), and is expected to improve the accuracy of image diagnosis and reduce the burden on doctors.

[0009] Algorithms for detecting patient abnormalities in CAD are introduced, for example, in the following literature.

(1) Katsuragawa S.
et al: lmage feature anal
ysis and computer-aided
diagnosis in digital rad
iography: Classification
of normal and abnormal
gs with interstitial dise
ase in chest images. Medi
cal Physics 16, pp. 38-44
(1989). (2) Giger M. L. et
al: lmage feature analysis
s and computer-aided diag
nosis in digital radiogra
phy: 3. Automated detect
ion of nodes in periphe
ral lung fields. Medical
Physics 15, pp. 158-166 (
1988). (3) Chan H. P. et al: lma
ge feature analysis compu
ter-aided diagnosis dig
ital radiography: 1. Au
tomated detection of micr
localization in mammogr
aphy. Medical Physics14,
pp. 538-548 (1987). (4) Kunio Doi et al.: “Possibilities of computer-assisted diagnosis in digital radiography” Journal of the Japanese Society of Radiological Technology,
Vol. 45, No. 5, pp. 653-663, 1989.

[0011] Also, regarding a system for detecting an abnormality using CAD, the technology is disclosed in, for example, the following document.

(1) JP-A-2-185240 (2) JP-A-2-152443 (3) JP-A-1-125675 In addition, with the progress of image digitization, medical picture archiving and communication systems (PACS: Picture Ar
Chiving and Communication
It has become possible to perform this image diagnosis using a computer system. PACS is a system that supports doctors in viewing medical images by storing, communicating, and displaying medical images (digital images such as X-ray images, CT images, and MR images) created within hospitals.

[0013] PACS stores image data of medical images sent from image acquisition devices such as X-ray imaging equipment, CT imaging equipment, and MRI equipment in a database, and when images are required, they are transferred from the database to an image workstation. Transfer image data to. The image workstation
The sent images are transferred to a cathode ray tube (CRT).
eRay Tube), etc. The doctor then views the images displayed on the image workstation, makes a diagnosis, and creates an interpretation report. Interpretation reports can also be created and stored on PACS.

[0014] This system eliminates the need to search for medical image film (analog images), carry the film, and hang and remove the film from the scanner.

[0015] Many technologies have been disclosed regarding the system configuration and functions of PACS. ) JP-A-64-17154 (5) JP-A-2-103668 (6) JP-A-2-119840, etc. are described in detail.

[0016]

[Problem to be Solved by the Invention] These days, both CAD and PACS are available, but since they are implemented separately, doctors have to use each system separately. , which poses a major problem in terms of convenience in medical diagnosis. Then, P the CAD
Currently, the system to be incorporated into ACS and its effective usage have not yet been discovered.

The present invention has been made in view of the above circumstances, and allows CAD and PACS to be integrated into one system, which supports medical diagnosis, especially the interpretation of medical images by doctors, and improves the accuracy of image interpretation. The purpose of the present invention is to provide a medical diagnosis support system that can improve image interpretation efficiency. [Structure of the invention]

[0018]

[Means for Solving the Problems] In order to solve the above problems, the present invention provides means for comparing a plurality of pieces of diagnostic information regarding the same kind of diagnostic items obtained from medical test data, and A medical diagnosis support system is provided that has means for creating a comparison result.

[0019]

[Operation] The medical diagnosis support system of the present invention can process multiple pieces of diagnostic information such as multiple doctors' diagnostic information, multiple pieces of diagnostic information obtained by computer processing, or doctors' diagnostic information and diagnostic information obtained by computer processing. By comparing the data to determine whether they are the same or not, and notifying you if they are different, medical diagnostic activities are easier than when a doctor processes medical test data alone, especially when interpreting medical images. It is possible to improve the accuracy and efficiency of image interpretation.

According to the medical diagnosis support system of the present invention,
In particular, it is possible to display medical image data while correlating the normal anatomical structure with the location of the abnormality, superimpose information on changes in the abnormal area over time, and display past images that are referenced in interpretation. When preparing images, images that are likely to be referenced can be prepared preferentially, making it possible for doctors to make diagnoses based on medical images more reliably and in a shorter time. so that we can assist you.

[0021] Furthermore, the medical diagnosis support system of the present invention includes:
PA is a system in which multiple components such as workstations and databases are connected via a network.
In CS, improvements in individual components can be achieved with desirable improvements that do not significantly affect other components.

[0022]

DESCRIPTION OF THE PREFERRED EMBODIMENTS Examples of the present invention will be described below with reference to the accompanying drawings.

In one embodiment of the present invention, CAD can be performed using PACS. A plain chest X-ray image will be used for diagnosis.

First, an example of the basic system configuration of PACS is shown in FIG. This system consists of: 1) System Manager (SM) 1, 2) Image Acquisition Device (IA) 2A, 2B (collectively referred to as 2), 3) Database (DB) 3, 4) Workstation (WS). ) 4A, 4B (collectively referred to as 4), and 5) network (NW) 5.

The network (NW) 5 is a transmission line for commands and data for communication between devices, and an optical fiber or the like is used as a transmission medium. Although the network in FIG. 1 is a ring-type local area network, other types such as a star-type local area network may be used.

The system manager (SM) 1, image acquisition devices (IA) 2A, 2B, database (DB) 3, and workstations (WS) 4A, 4B are as follows:
These devices have communication protocols and are connected to the network (NW) 5.
can communicate with each other via.

The PACS network (NW) 5 is connected via a gateway 6 to a test order system 7 that creates test request information, and the test order information is sent from the test order system 7 to the PACS system manager (NW) via the gateway 6. SM) sent to 1.

The image acquisition devices (IA) 2A and 2B are medical image acquisition devices for PACS, such as an X-ray diagnostic device, an X-ray CT device, an MRI device, and a film digitizer.
A plurality of devices (the same type of devices or different types of devices may be used) can be connected to one network (NW) 5.

The database (DB) 3 is a storage device for digital images created by the image acquisition devices (IA) 2A and 2B, and includes a low-speed medium (such as an optical disk) and a high-speed medium (such as a magnetic disk).

Next, the elements constituting the subsystems and their functions will be explained for each subsystem except for the network (NW) 1. As the image acquisition device 2, a film digitizer is taken up.

First, the main functions of the system manager 1 will be explained.

○Receives test request information from the test order system 7 and issues a test ID number. The types of data included in the test request information received from the test order system 7 are shown in Table 1 below.

[0033]

[Table 1]

[0034] Save test request information and test ID number.

[0035] Create and store the patient's test history.

○ Save the image interpretation report.

○ Interpretation reference image preparation rule information, which will be described later, is stored, and based on the information, instructions are given to the database to prepare images (read images from low-speed media to high-speed media).

[0038] Information regarding which examination images are to be interpreted at which workstation (WS) 4 is stored, and each workstation (WS) is notified of which examination is scheduled to be interpreted at that workstation (WS).

Next, the constituent elements and their functions of the system manager 1 will be explained. FIG. 2 shows an example of the configuration of the system manager 1, and each component has the following functions.

●Control unit (SM-CTRL) 1a Contains a central processing unit (CPU), system memory (semiconductor memory), etc., and controls the operation of the entire system manager.

●System disk (SM-SD) 1b The system disk 1b is a magnetic disk, and includes (a) a program for operating the system manager 1, (b) interpretation reference image preparation rule information, (c) WS-examination to be interpreted. Stores programs and data such as type information. These programs and data are read when the system manager is powered on and written to the system memory within the control device 1a.

The image interpretation reference image preparation rule information (b) is information indicating rules regarding which past examination images are to be referred to during image interpretation. This information is used when the system manager 1 instructs the database (DB) 3 to prepare past images of a specific patient. The types of general data included in the interpretation reference image preparation rule information are shown in Table 2 below in a table format.

[0043]

[Table 2]

[0044] In the table, images having attributes with low priority are highly likely to be referred to during image interpretation.

[0045] Furthermore, this information can be rewritten at any time. Specific data of the interpretation reference image preparation rule information in this embodiment is shown in Table 3 in a tabular format.

[0046]

[Table 3]

The data in Table 3 represents the following rules.

(a) First priority is given to a new examination with the same examination site, same modality, and examination date as the examination to be interpreted.

(b) Second priority is given to examinations with the same examination site, same modality, and old examination date as the examination to be interpreted.

(c) Examinations with the same examination site, different modality, and new examination date as the examination to be interpreted are given the third priority.

(d) Examinations with the same examination site, different modality, and old examination date as the examination to be interpreted have the fourth priority.

(e) Examination site different from the examination to be interpreted
Tests with the same modality and new test date are given 5th priority.

(f) Examination site different from the examination to be interpreted
Tests with the same modality and older test date are given 6th priority.

(g) Examination site different from the examination to be interpreted
Tests with different modalities and new test dates are the 7th priority.

(h) Examination site different from the examination to be interpreted
Tests with different modalities and older test dates are given 8th priority.

The WS-interpretation target examination type information in (c) is information about which workstation (WS) and what examination image is to be interpreted, and is stored in the format shown in Table 4.

[0057]

[Table 4]

In this embodiment, as shown in Table 4, each workstation displays only examination images of a specific modality for interpretation. In other words, the ID WS-1
On workstations with X-ray modality, only the unread images of the X-ray modality are displayed. However, as for past images of the patient, images of any modality can be referenced. This information is also rewritable.

●Inspection ID number issuing device (SM-EIDI
)1c This is a device that issues a test ID number for the test in response to reception of new test request information. Study ID numbers are issued differently within the system. The initial value of the inspection ID number is 0, and the control device (SM-CTRL) 1a
When instructed to issue a test ID number, the test ID number at that time is incremented by 1 and a new test ID number is returned to the control device (SM-CTRL) 1a. Therefore, the test ID number starts from 1.

●Test request information storage device (SM-EOIM
)1d A device (for example, a magnetic disk) that stores test request information sent from the test order system together with a test ID number.

Table 5 summarizes the types of data stored in the test request information storage device 1d in a table format.

[0062]

[Table 5]

The type of this data is the test request information shown in Table 1 with a test ID number attached.

●Examination history storage device (SM-EHM) 1e This is a device (for example, a magnetic disk) that stores the patient's examination history.

Table 6 summarizes the types of data included in the test history of one patient in tabular form.

[0066]

[Table 6]

● Interpretation report storage device (SM-IDRM
) 1f A device (for example, a magnetic disk) for storing an image interpretation report.

Table 7 summarizes the types of data included in the image interpretation report in a tabular format.

[0069]

[Table 7]

●Information retrieval device (SM-SRCH) 1g Based on instructions from the control device (SM-CTRL) 1a, searches for information stored in each information storage device using a given keyword, and controls the search results. Equipment (SM-CTR
L) It is a device that has a function of writing to the memory in 1a.

●Network interface (SM
-NWIF)1h This is an interface with the network 5, and communicates with other subsystems via this.

●Control bus (SM-CBUS) 1i This is a transmission path for various control information and data within the system manager.

Next, the main functions of the film digitizer (FDG) 2 (hereinafter referred to as reference numeral 2) as the image acquisition device (IA) will be explained.

A film digitizer (FDG) reads the film density of, for example, an X-ray film, digitizes it, and generates a digital image.

The film digitizer (FDG) requests the system manager (SM) 1 to transfer inspection request information, and receives the inspection request information sent from the system manager (SM) 1.

[0076] The film digitizer (FDG) inputs and displays information associated with examinations and images.

[0077] The film digitizer (FDG) transfers image data, examinations, and information accompanying images to the database 3.

Next, the components and functions of the film digitizer (FDG) will be explained. The configuration of a film digitizer (FDG) is shown in FIG.

●Control device (FDG-CTRL) 2a Contains a central processing unit (CPU), system memory (semiconductor memory), etc., and controls the entire operation of the film digitizer 2.

●System disk (FDG-SD) 2b
The system disk is a magnetic disk that stores programs for operating the film digitizer 2 and the like. The program and the like are read out when the film digitizer 2 is powered on and written into the system memory within the control device 2a.

●Film density reading device (FDG-F
R) 2c Optically read the density of the image on the film,
It is a device for digitizing. One piece of film is digitized as one image. The matrix size of the digitized image is 2,048×2,048 pixels, and the bit length of one pixel is 10 bits.

The film density reading device 2c is equipped with a mechanism for automatically detecting the size of the film, and the pixel size is automatically selected according to the size of the film. For example, 14 inches x 14 inches (35.56c
For a film with a size of 0.016 cm x 0.016 cm, the size of one pixel is set to 0.016 cm x 0.016 cm. The product of the pixel size (0.016 cm) and the matrix size (2,048) does not match the film size (35.56 cm), but this is due to the fact that towards the edges of the film 20, as shown in FIG. This is because there is an area 20a where the density cannot be read (the shaded area 20b is the area where the film density is to be read).

●Input device (FDG-INPUT) 2d This is a means for the operator to input information, and a keyboard, touch screen, etc. are used.

●Display device (FDG-DISP) 2e This is a device for displaying information input to the film digitizer 2 and digitized images, and a CRT display, liquid crystal panel display, etc. is used. 2 at most
,048×2,048 pixels can be displayed.

●Examination information/image accompanying information storage device (FD
G-EIIM) 2f A device (for example, a semiconductor memory) that temporarily stores inspection information and image accompanying information. Here, the test information is information that describes the test, and is attached to each test. Table 8 shows the types of data included in the inspection information in a tabular format.

[0086]

[Table 8]

On the other hand, image accompanying information is information that describes an image, and is attached to each image. Table 9 summarizes the types of data included in the image accompanying information in a tabular format.

[0088]

[Table 9]

[0089] The relationship between images and pixels, and Table 9
The meanings of pixel size 1 and pixel size 2 are as shown in FIGS. 5 and 6, respectively. That is, the image 22 in FIG. 5 consists of a plurality of pixels 23 arranged vertically and horizontally, and the horizontal length of the pixels 23 is defined as the pixel size 1.
, the length in the vertical direction is set to pixel size 2.

[0090] Part of the data of this image accompanying information is automatically created by the film digitizer 2. The type of data and the method for determining the data value are as follows.

(1) Image numbers are determined in the order in which they were digitized. The image number of the image obtained by digitizing the Nth film is N.

(2) Image pixel size 1 and image pixel size 2 As described above, appropriate values are selected during digitizing. In this example, it is 0.016 cm.

(3) Image matrix size 1 and image matrix size 2 As described above, 2,048 is selected in this embodiment.

(4) Image pixel bit length As described above, 10 is selected in this embodiment.

(5) Image data amount Image matrix size 1 and image matrix size 2
This is the product of the bit length of the pixel of the image and the bit length of the pixel of the image, and in this embodiment, it is approximately 40 Mbit (=5 MB).

●Image data storage device (FDG-IM) 2
g A device (for example, semiconductor memory) that temporarily stores the image digitized by the film density reading device 2c
It is.

●Image reduction device (FDG-IMIN) 2h
This is a device that reduces the matrix size of digitized images. The X-ray film is digitized as a matrix size of 2,048 x 2,048, but the display device (
When displaying on FDG-DISP) 2e, the image matrix size is reduced to approximately 512 x 512 in order to display multiple images on one screen. Reduction is performed by thinning out data.

●Network interface (FD
G-NWIF) 2i This is an interface with the network 5, and communicates with other subsystems via this.

●Control bus (FDG-CBUS) 2j This is a transmission line for various control information within the film digitizer 2.

●Image bus (FDG-IBUS) This is a transmission path for image data within the 2K film digitizer 2.

Although not shown in FIG. 3, the film digitizer (FDG) 2 has a built-in clock for referring to the date and time at the time of digitization.

Next, regarding database (DB) 3,
First, I will explain the main functions.

[0103] The database (DB) 3 stores image data, examination information, and image accompanying information.

According to an instruction from the system manager (SM) 1, an image of a specified inspection is read from a low-speed medium (in this embodiment, an optical disk) to a high-speed medium (in this embodiment, a magnetic disk).

o Supply data in response to requests from other devices.

Next, the components of the database (DB) 3 and their functions will be explained. Figure 7 shows the database (DB) 3
FIG.

●Control unit (DB-CTRL) 3a Contains a central processing unit (CPU), system memory (semiconductor memory), etc., and controls the operation of the entire database.

●System disk (DB-SD) 3b The system disk is a magnetic disk, and the database 3
It stores programs, etc. for operating the. Programs and the like are read out when the database 3 is powered on, and written into the system memory within the control device 3a.

●Inspection directory storage device (DB-DI
R) 3c A storage device (for example, a magnetic disk) that stores the test directory. Table 10 summarizes the types of data related to the directory information for one test included in the test directory in a tabular format.

[0110]

[Table 10]

In the table, from "Examination ID number" at the top row (first row) to "Storage address of image accompanying information of the first image (
The inspection information up to the stage ``Low speed medium)'' is the same as the inspection information previously explained in Table 8. Further, N in the table is the number of images included in this examination.

●Information retrieval device (DB-SRCH) 3d Searches information stored in the inspection directory storage device (DB-DIR) 3c using a given keyword according to instructions from the control device (DB-CTRL) 3a. This device has a function of writing search results into the system memory of the control device (DB-CTRL) 3a.

●Optical disk device for image storage (DB-IO
D) 3e The image storage optical disk device 3e is a storage device that stores image data, image accompanying information, and overlay data for images over a long period of time, and the storage medium is an optical disk.

●Magnetic disk device for image storage (DB-I
HD) 3f The image storage magnetic disk device 3f is a storage device that temporarily stores image data and image accompanying information, and the storage medium is a magnetic disk. The type of data stored in this image storage magnetic disk device 3f is the same as the data type stored in the image storage optical disk device 3e. Management information indicating what data is stored in the image storage magnetic disk device 3f (the storage address and data amount of each data are stored in the image storage magnetic disk device 3f itself in association with the examination ID number). Ru.

The image sent from the image acquisition device (IA) 2 is first stored in this image storage magnetic disk device 3f. On the other hand, past images read from the image storage optical disk device 3e and referred to during image interpretation are written to the image storage magnetic disk device 3f and stored until transferred in accordance with a request from the workstation (WS) 4. be done.

●Block memory (DB-BLKM) 3g
It is a storage device that is made up of semiconductor memory and temporarily stores image data, image accompanying information, etc.

●Network interface (DB
-NWIF) 3h This is an interface with the network 5, and communicates with other subsystems via this.

●Control bus (DB-CBUS) 3i This is a transmission path for various control information within the database 3.

●Image bus (DB-IBUS) 3j This is a transmission path for image data within the database 3.

Next, the main functions of the workstation (WS) 4 will be explained first.

[0121] Test request information, test history, images, interpretation reports, etc. can be displayed.

[0122] Input the image interpretation report.

[0123] Perform processing for computer-aided diagnosis (CAD). Hereinafter, this processing will be referred to as CAD processing.

[0124] The results of the CAD processing are stored and compared with the findings of the input interpretation report for each interpretation point.

[0125] If the meaning of the results of the CAD processing and the findings of the input image interpretation report are different, that fact is output.

[0126] If the result of CAD processing for a certain interpretation point indicates that there is an abnormality, and no findings have been entered in the interpretation report for that interpretation point,
Output the results of CAD processing.

○ Output the CAD processing results according to the doctor's request.

Next, the components of the workstation 4 and their functions will be explained. FIG. 8 is a configuration diagram of the workstation 4.

●Control unit (WS-CTRL) 4a Contains a central processing unit (CPU), system memory (semiconductor memory), etc., and controls the operation of the entire workstation.

●System disk (WS-SD) 4b The system disk is a magnetic disk, and contains (a) a program for operating the workstation, (b) abnormality detection method selection information, and (c) changes over time of abnormalities and display colors. Relationship information (d) Relationship information between the photographing direction and relative display position of the plain chest X-ray image (e) Stores programs and data such as interpretation doctor information table. These programs and data are read out when the workstation 4 is powered on and written into the system memory within the control device 4a.

[0131] The abnormality detection means selection information in (b) is a correspondence table between the type of image (examination site, modality, examination method, interpretation direction) and the type of abnormality that can be detected in that image. is the data shown in Table 11 below.

[0132]

[Table 11]

[0133] The data showing the types of abnormalities that can be detected ("pulmonary interstitial disease", "pulmonary nodule", "microcalcification") shown in this table is provided to the CAD processing device 4e by the abnormality detection means. Used as data for instructions. The abnormality detection means selection information can be rewritten.

[0134] (c) The relationship information between the change in abnormality over time and the display color is information that indicates which color to display when the change in abnormality over time is displayed superimposed on an image. An example is shown in Table 12 below. Shown below.

[0135]

[Table 12]

[0136] The meanings of the names of changes over time in the table will be described later. The relationship information between this abnormality change over time and the display color can also be rewritten.

[0137] The relationship information between the photographing direction and the relative display position of the plain chest X-ray image in (d) is information for automatically determining the display position of the image, and an example is shown in Table 1 below.
Shown in 3.

[0138]

[Table 13]

The meanings of the entries in this table are as follows.

"P→A": Indicates that the X-rays were incident from the patient's back. In this case, it will be a frontal image.

"L→R": Indicates that the X-rays were incident from the left side of the patient. In this case, it will be a right side view.

"R→L": Indicates that the X-rays were incident from the right side of the patient. In this case, it will be a left side view. C: Indicates display in the center.

L: Indicates display on the left side of the P→A image (front view).

R: Indicates display on the right side of the P→A image (front view).

[0145] Needless to say, the information shown in Table 13 can be rewritten.

The interpreting doctor information table (e) is a correspondence table between the interpreting doctor ID number and the interpreting doctor's name, and an example is shown in Table 14.

[0147]

[Table 14]

[0148] This interpretation doctor information table can also be rewritten.

[0149] If you wish to change each of the above-mentioned rewritable data, display the table corresponding to the data on the character display device (WS-CDISP) 4d, and use the input device (WS-CDISP) 4d.
-INPUT) 4c, and the updated data can be rewritten by overwriting the data before the update.

●Input device (WS-INPUT) 4c This is a means for the operator to input information such as commands and interpretation reports, and a keyboard, touch screen, etc. are used.

●Character display device (WS-CDISP) 4d
It is a device mainly for displaying text such as test request information, test history, image interpretation report, etc.
A liquid crystal panel display or the like is used.

●CAD processing device (WS-CADP) 4e
an image processing means for determining the position where a specified type of abnormality exists and the degree of the abnormality in the specified image;
This device includes a storage means for storing results obtained by CAD processing. The control device 4a can read the results obtained by the CAD processing.

The CAD processing device 4e includes a plurality of types of abnormality detection means. That is, in this example, (a)
(b) Means for detecting the shadow of a pulmonary interstitial disease in a front view of a plain chest X-ray image; (c) Means for detecting a shadow of a nodule in the lung in a front view of a plain chest X-ray image; Breast This is a means of detecting shadows of microcalcifications in the breast in line images. These detection means are described in Japanese Unexamined Patent Publication No. 2-18
Techniques are disclosed in JP-A No. 5240, JP-A-2-152443, and JP-A-1-125675.

[0154] When inputted with two types of data: (a) data indicating the type of abnormality to be detected, and (b) image data, the CAD processing device 4e analyzes the image data using the specified detection means and determines whether the abnormality is detected. If there is, its position on the image and degree of abnormality are determined and stored in internal storage means.

[0155] Regarding normal anatomical structures and regions for image diagnosis, the positions or regions of some of them are stored in the internal storage means according to instructions from the control device 4a. Recognition of this normal anatomical structure or region on image diagnosis is necessary to determine the region where abnormalities are detected.
For example, by using the technology disclosed in Japanese Patent Application Laid-Open No. 1-125675, the position of the lower edge of the clavicle, the upper edge of the diaphragm, and the ribs for each of the left and right lungs and the vertical center line of the mediastinum can be recognized. be able to.

According to the above-mentioned Japanese Patent Application Laid-Open No. 1-125675,
The CAD processing device 4e determines the regions of the upper lung field, middle lung field, and lower lung field based on the coordinates of the lower border of the clavicle and the upper border of the diaphragm on the image. The areas of the upper lung field, middle lung field, and lower lung field are originally determined in relation to the position of the tip of the rib, but since the position of the tip of the rib has not yet been accurately determined, as shown in Figure 9, It is determined from the positions of the lower edge of the clavicle 24a and the upper edge of the diaphragm 25a. Reference numeral 24 is the clavicle.

[0157] That is, the positions that roughly divide the line connecting the upper edge of the lung field to the lower edge of the lung field into three equal parts are the boundaries between the upper lung field 26 and the middle lung field 27, and the boundaries between the middle lung field 27 and the lower lung field 28. . The lower edge of the clavicle 24a is located approximately in the center of the upper lung field 26. Therefore, the following procedure will be used to determine.

(a) Find the position (horizontal coordinates) of the longitudinal center line of the mediastinum 30 in the X-ray film 29.

(b) Find the positions of the lower edge 24a of the clavicle and the upper edge 25a of the diaphragm for each of the left and right lungs 31a and 31b.

(c) Find the average value of the position (vertical coordinates) of the lower edge 24a of the clavicle of the left and right lungs 31a, 31b, and use it as the position of the lower edge 25a of the clavicle for the entire lung.

(d) Find the average value of the positions (vertical coordinates) of the upper edges 25a of the diaphragms of the left and right lungs 31a and 31b, and use this as the position of the upper edges 25a of the diaphragms of the entire lungs.

(e) Lower edge of clavicle 24a and upper edge of diaphragm 25
1/6 from the lower edge of the clavicle 24a on the line connecting the positions a
Let the position be the boundary position between the upper lung field 26 and the middle lung field 27.

(f) Lower edge of clavicle 24a and upper edge of diaphragm 25
3/6 from the lower edge of the clavicle 24a on the line connecting the positions a
The position (1/2) is defined as the boundary between the middle lung field 27 and the lower lung field 28.

● Image storage device (WS-IM) 4f (a
) Image interpretation reference priority information (b) Examination request information (c) Examination history (d) Image interpretation report (e) Image accompanying information (f) Image data (g) Overlay display information (h) Abnormal data table (i) Abnormal information A magnetic disk is a device that temporarily stores time-varying data tables and the like.

●Image frame memory (WS-IFM)
4g A device that temporarily stores image data for a large number of images, and is a semiconductor memory.

●Image display manager (WS-IDM) 4
h Controls operations for displaying images and overlay images. FIG. 10 is a configuration diagram of the image display manager 4h.

The image display manager 4h includes the following:

a) Control section 40. It controls each component of the image display manager 4h, which will be explained below.

b) An overlay data creation unit 41 that creates overlay data (in color) from overlay display information to be described later. The overlay data creation unit 41 also includes means for displaying designated data in the overlay display information in a blinking manner.

c) Image memory 4 for storing image data
2. The image memory 42 has a memory for one image (matrix size is 2,048×2,048).

d) Overlay memory 43 for storing overlay data. Since the overlay data is displayed in color, the overlay memory 43 for one screen is composed of three overlay memories 43a, 43b, and 43c for red, green, and blue, as shown in FIG. And overlay memories 43a, 43 for each color.
b, 43c has a matrix size of 2,048×2,0
There are 48 pixels, and the bit length of one pixel is 1 bit.

Table 15 shows the relationship between the display color and the bit value of each pixel.

[0173]

[Table 15]

For example, as shown in the second row of this table, the pixel value (pixel bit value) of the pixel coordinates (X, Y) of the overlay memory for red is 1, and the value of the pixel bit for green and blue is 1. If the pixel values at the same coordinate in the overlay memory are both 0, red is displayed for that coordinate. On the other hand, when the display color is black, it means that no color is displayed, and when displayed overlapping with an image, only the image is displayed.

e) An overlay section 44 that superimposes image data and overlay data.

f) Display memory 45 for storing display data. In FIG. 10, the display memory 45 for one image (matrix size is 2,048×2,048 pixels) is provided for four images. This is the same as the number of image display devices 4i. The display memory 45 is associated with each image display device 4i.

g) D/A converter 46 for converting display data from digital data to analog data. The same number of image display devices 4i are provided.

[0178] The image display manager 4h can receive the following information.

(a) Type of data to be displayed. image data
There are three types: data only, overlay data only, and image data and overlay data.

(b) Image display device 4 for displaying data
Specification information of i.

(c) Overlay display information.

[0182] For each figure, 1) Types of shapes 2) Size of figure 3) Coordinates 4) Display color 5) Flashing control information There are five.

(d) Image data.

[0184] Therefore, when displaying an image with an overlay, the following operation is performed.

(1) The control unit 40 of the image display manager 4h receives the following three pieces of information from the control device 4a of the workstation 4.

(a) "Image and overlay" as the type of data to be displayed.

(b) Image display device number of the image display device that displays the data.

(c) Overlay display information.

(2) The image display manager 4h receives image data and writes it into the image memory 42.

(3) In response to instructions from the control section 40, the overlay data creation section 41 creates overlay data based on the overlay display information. Then, the specified figure is created at the specified coordinates and with the specified color data.

(4) In response to instructions from the control unit 40, image data and overlay data are read out and input to the overlay unit 44, where the data is synthesized.

(5) The combined data is written to the display memory 45 of the designated image display device number.

(6) The synthesized data is converted into analog data by the D/A converter 46.

The above operations (4) to (6) are always repeated during display.

[0195] When the blinking control information indicates "blinking" for a figure at a certain coordinate, the overlay data creation unit 41 overlays that figure at a certain time interval (0.5 to 1 second). A blinking display is performed by writing to or erasing from the memory 43.

On the other hand, when displaying only images, in the above operation (1), (a) select "image only" as the type of data to be displayed (b)
) Receives the display device number of the display device that displays the data; no overlay display information is sent. In the above-mentioned operation (4), no overlay data is read out, and accordingly, no overlay of image data and overlay data is performed.

[0197] Note that 2) in the overlay display information
The size of a figure has different meanings depending on the type of figure. For example, if the type of figure is "arrow", the size of the figure means the length of the arrow.

●Image display device (WS-IDISP) 4i
It is mainly a device for displaying images, and is a color CR
It is a T display.

Images with a matrix size of up to 2,40 x 2,048 pixels can be displayed. In this embodiment, there are four units.

0200]●Network interface (WS
-NWIF) 4j This is an interface with the network 5, and communicates with other subsystems via this.

●Control bus (WS-CBUS) This is a transmission line for various control information within the 4k workstation 4.

●Image bus (WS-IBUS) 4l This is a transmission path for image data and overlay data within the workstation 4.

Note that the workstation 4 described above has a built-in clock (not shown) for referencing the date and time.

[0204] Now, next, the PA configured in this way
This section describes the flow of a series of system operations for performing image interpretation using CS. Let us take the interpretation of chest X-ray images as an example. System operations are performed, for example, in the following order.

0205]1. Receipt of test request information 2. Image collection and storage 3. Preparing images for interpretation 4. CAD processing and creation of diagnostic information5. Interpretation of images by interpretation doctor and input of interpretation report 6.
Comparison of diagnostic information and alerting the interpreting doctor 7. Reference of CAD processing results by interpretation doctor 8. Completion and storage of interpretation report By the way, in the case of plain chest X-ray images, two or more images are often taken in one examination. For example, three images are taken: a) one front image, b) one right side image, and c) one left side image.

Here, as shown in FIGS. 12(A), 12(B), and 12(C), the frontal image is an X-ray film 51 placed on the front of the patient P to capture the X-rays incident from the back of the patient P. The detected image, the right side image, is an image of X-rays incident from the left side of the patient P detected by the X-ray film 51 placed on the right side of the patient P, and the left side image is an image of the X-rays incident from the right side of the patient P. It is promised that the X-ray is an image detected by the X-ray film 51 placed on the left side of the patient P. Note that FIGS. 12(A), (B),
In (C), reference numeral 50 indicates an X-ray generator.

Now, when a doctor interpreting an image arranges the films on the Scherkasten in order to view the image, the arrangement shown in FIG. 13 is usually adopted. That is, (1) the doctor who interprets the image arranges the film so that the X-ray source is viewed from the position of the film at the time of imaging.

(2) When arranging the above three types of images,
The front image 53 is placed at the center, the right side image 54 is placed on the left side of the front image 53, and the left side image 55 is placed on the right side of the front image 53.

[0209] In the figure, the reference numeral 56 is a shark stencil.

[0210] Each of the series of system operations described above will be described in detail below.

0211 1. Receipt of test request form (1) Receipt of test request information from test order system 7 1-1-1) Test request information created by test order system 7 is transferred to the network of system manager 1.
It arrives at interface (SM-NWIF) 1h. 1-1-2) The control device (SM-CTRL) 1a is
Transfer test request information to network interface (SM)
- NWIF) 1h and control device (SM-CT)
RL) Transfer to system memory in 1a.

(2) Issuance of inspection ID number and storage of inspection request information 1-2-1) The control device (SM-CTRL) 1a:
The test ID number issuing device (SM-EIDI) 1c is instructed to issue a test ID number.

1-2-2) Inspection ID number issuing device (
SM-EIDI) 1c increments the current examination ID number by one and returns the new number to the control device (SM-CTRL) 1a. This test ID number is unique to this test.

1-2-3) Control device (SM-CTR
L) 1a combines the issued test ID number and test request information, and stores the test request information storage device (SM-EOIM) 1.
Write to d. An example of data that combines the written test ID number and test request information is summarized in table format in Table 1 below.
6.

[0215]

[Table 16]

[0216] In addition, a terminal (not shown in Fig. 1) connected to the network (NW) 5 shown in Fig. 1 above is installed in the examination room, and the testing technician can use the terminal to connect to the network (NW) 5 shown in Table 16. Test request information (including test ID number) can be displayed.

0217]2. Collection and storage of images (1) Collection of digital images 2-1-1) The operator transfers the X-ray film for one examination, which has been developed after imaging, to the film density reader (FDG-FR) 2c of the film digitizer 2. set,
Digitize from input device (FDG-INPUT) 2d.
Enter the command.

In this example, it is assumed that two plain chest X-ray photographs, a front view and a left side view, are set.

2-1-2) The control device (FDG-CTRL) 2a of the film digitizer 2 instructs the film density reading device (FDG-FR) 2c to digitize the film density.

2-1-3) The film density reading device (FDG-FR) 2c reads the density of each set film, digitizes it, and digitizes the density of each film.
,048 pixels x 2,048 pixels x 10 bits. The digitized image is written to the image data storage device (FDG-IM) 2g.

Digitization of the film density and writing of the digital image to the image data storage device (FDG-IM) 2g are performed for each film, and these two operations are repeated as many times as the number of films set. In this case, the number of repetitions is two.

2-1-4) The control device (FDG-CTRL) 2a of the film digitizer 2 automatically creates a part of the image accompanying information for each of the two images, and creates inspection information/image accompanying information. Storage device (FDG-EIIM) 2
Write to f. The types of data included in the image accompanying information of the image obtained from the second film and the values of the automatically created data are summarized in table format and shown in Table 17 below.

[0223]

[Table 17]

[0224] The type of data for which the data value is blank indicates that the data value cannot be determined automatically.

(2) Input of examination information and image accompanying information 2
-2-1) Film digitizer 2 control device (FD
G-CTRL) 2a displays necessary inspection information items on the screen of the display device (FDG-DISP) 2e of the film digitizer 2.

2-2-2) According to instructions from the control device (FDG-CTRL) 2a of the film digitizer 2, the two digitized images are stored in the image data storage device (FDG-CTRL).
-IM) 2g, image reduction device (FDG-
IMIN) 2h, and the image reduction device (FDG-I
MIN)2h, display device (FDG-D
ISP) 2e.

2-2-3) The control device (FDG-CTRL) 2a of the film digitizer 2 associates necessary image incidental information items with images and displays them on the display device (FDG-D
ISP) 2e screen. An example of the display screen at this time is shown in FIG. Reference numeral 58 indicates a display device (FDG-D
This is a display screen of ISP) 2e.

[0228] Since many tests are digitized on the day of the test, the date is read from the clock built into the film digitizer (FDG) 2, and the date of the test is automatically displayed. Furthermore, since two sheets of film were digitized, "2" is displayed as the number of images.

2-2-4) The operator first inputs the inspection ID number from the input device (FDG-INPUT) 2d. The control device (FDG-CTRL) 2a stores the input test ID number in the test information/image ancillary information storage device (FDG-CTRL).
Write to EIIM) 2f, and then write to the display device (FDG-
DISP) 2e.

2-2-5) Next, the control device (FDG-CTRL) 2a of the film digitizer 2 communicates with the system manager (SM) 1 via the network interface (FDG-NWIF) 2i,
The input test ID number is sent to the system manager (SM) 1 to request transfer of the test request information.

2-2-6) Upon receiving the request from the film digitizer 2, the system manager (SM) 1 passes the sent inspection ID number to the information retrieval device (SM-SRCH) 1g and retrieves the inspection request information. Instruct to search for.

2-2-7) System Manager (S
M) The information retrieval device (SM-SRCH) 1g accesses the test request information storage device (SM-EOIM) 1d, searches for test request information having the same test ID number as the passed test ID number, The corresponding test request information is read out and the control device (SM-C) of the system manager (SM) 1
TRL) Write to system memory in 1a.

2-2-8) System Manager (S
The control device (SM-CTRL) 1a of M) 1 transfers the read inspection request information to the network interface (SM-NWIF) 1h, and sends it to the film digitizer 2 through the network interface (SM-NWIF) 1h. instructs data transfer. The network interface (SM-NWIF) 1h sends inspection request information to the film digitizer (FDG) 2.

2-2-9) Film digitizer 2 network interface (FDG-NWIF)
When the 2i receives the inspection request information from the system manager (SM) 1, it transmits the control device (FDG) of the film digitizer 2.
-CTRL) 2a transfers the transferred test request information to the network interface (FDG-NWIF) 2.
i, and write it to the system memory in the control device (FDG-CTRL) 2a.

2-2-10) The control device (FDG-CTRL) 2a of the film digitizer 2 selects the items to be displayed from among the test request information that has just been written into the system memory, that is, the patient's name, patient ID number, and patient's name. Data regarding the patient's date of birth, patient's gender, test modality name, test site name, test method, test requesting department name, and test requesting doctor name are displayed at a predetermined position on the display device (FDG-DISP) 2e.

2-2-11) The operator looks at the displayed patient and test information and confirms that it is correct. If there is a mistake, enter the correct data using the input device (FDG-
INPUT) Input from 2d. Control device (FDG-C
TRL) 2a is the examination information/image accompanying information storage device (FD
G-EIIM) 2f is rewritten, and the corrected data is displayed on the display device (FDG-D
ISP) 2e at a predetermined location.

2-2-12) The operator inputs image accompanying information. In this case, the input device (FDG-I
NPUT) 2d, input the "shooting direction" for each of the two images. Control device (FDG-CTRL) 2
a writes the input imaging direction data into the examination information/image accompanying information storage device (FDG-EIIM) 2f, and further displays it at a predetermined position on the display device (FDG-DISP) 2e.

2-2-13) When the operator has finished inputting the necessary data, he inputs an input end command from the input device (FDG-INPUT) 2d of the film digitizer 2.

[0239] The display device (FDG-DISP) at this point
) The information displayed on the screen of 2e is shown in FIG. Reference numeral 58 is a display screen of the display device (FDG-DISP) 2e. Furthermore, the meanings of P→A and R→L in the figure are as explained above in Table 13, and according to these photographing directions, a front image and a left side image are obtained, respectively.

Table 18 and Table 19 below respectively show the examination information and image accompanying information data written in the examination information/image accompanying information storage device (FDG-EIIM) 2f at this point.

[0241]

[Table 18]

[0242]

[Table 19]

(3) Data transfer to database 2-
3-1) When the input end command is input, the control device (FDG-CTRL) 2a reads the examination information (patient's information and examination ID number), the image accompanying information of each image, and the image data stored in the image data storage device (FDG-IM) 2g,
NWIF) 2i. That is, the image data, the examination information data and the image accompanying information data shown in Tables 18 and 19 are combined and sent to the network interface (FDG-NWIF) 2i. The control device (FDG-CTRL) 2a instructs the network interface (FDG-NWIF) 2i to send the data to the database 3.

2-3-2) The network interface (FDG-NWIF) 2i transfers the given data to the database 3.

(4) Registration and storage of examination information, image accompanying information, and image data 2-4-1) When the data from the film digitizer 2 arrives at the network interface (DB-NWIF) 3h of the database 3, the database 3 The control device (DB-CTRL) 3a transfers the transferred data to the network interface (DB-NWIF).
)3h, block memory (DB-BLKM
) Write in 3g.

2-4-2) Control device (DB-CTR
L) 3a writes the image data and image accompanying information written in the block memory (DB-BLKM) 3g to the image storage magnetic disk device (DB-IHD) 3f.

2-4-3) Control device (DB-CTR
L) 3a writes the image data and image accompanying information written in the block memory (DB-BLKM) 3g to the image storage optical disk device (DB-IOD) 3f. Then, for each image (two images in this case), the storage address of the image accompanying information and the storage address of the image data are obtained. Furthermore, for each image, the data amount of image accompanying information is determined.

2-4-4) Control device (DB-CTR
L) 3a further includes a test directory storage device (DB).
-DIR) Write the directory information of the test to the test directory in 3c. The types of information included in the inspection directory are already shown in Table 10. The storage address of the image accompanying information, the image data, and the data amount of the image accompanying information for each image are written from the data obtained in this operation. Other data is included in the examination information and image accompanying information, so you can copy the necessary data from among them.

2-4-5) Control device (DB-CTR
L) 3a reads the test information of the test from the block memory (DB-BLKM) 3g and transfers it to the system manager (SM) 1 via the network interface (DB-NWIF) 3h.

(5) Addition of inspection history 2-5-1) When inspection information arrives from the database 3 to the network interface (SM-NWIF) 1h of the system manager (SM) 1, the control of the system manager (SM) 1 Device (SM-CTRL) 1a
is a network interface (SM-NWIF)
The inspection information is read from 1h, and the control device (SM-CTR
L) Write to system memory in 1a.

2-5-2) Control device (SM-CTR
L) 1a retrieves the patient ID number from the test information read into the system memory and uses the information retrieval device (SM-S
RCH) 1g and instructs to search the test history of the patient with that patient ID number.

2-5-3) Information retrieval device (SM-S
RCH) 1g is the inspection history storage device (SM-EHM) 1e
, perform the directed search, and search for the control device (SM).
-CTRL) Read the test history of the patient with the patient ID number given from 1a, and control the control device (SM-CTRL)
Write to system memory in 1a.

2-5-4) Control device (SM-CTR
L) 1a extracts only necessary test history data from the test information transferred from the database 3 and adds it to the test history data read into the system memory. The control device (SM-CTRL) 1a stores the inspection history to which new data has been added to the inspection history storage device (SM-E).
HM) Write to 1e. The latest test is now added to the patient's test history.

[0254] The test history data (with new data added) of this patient in this example is shown in Table 20 below.

0255]

[Table 20]

0256]3. Preparing images for interpretation (1) Instructions for preparing past images to the database 3-1-1)
System manager 1 control device (SM-CTRL) 1
a examines the test site name, modality name, and test date data for each test in the patient's test history data in the system memory of the control device (SM-CTRL) 1a, and gives priority to each test for interpretation reference. Give rank. Then, it is stored as image interpretation reference priority information in association with the examination ID number of each examination. The interpretation reference priority order information data is shown in Table 2 below.
Shown in 1. In the table, a test whose image interpretation reference priority is 0 means a test to be interpreted.

0257]

[Table 21]

3-1-2) The control device (SM-CTRL) 1a of the system manager 1 reads the interpretation reference priority information data from the system memory, transfers it to the network interface (SM-NWIF) 1h, and transmits it to the network interface (SM-NWIF) 1h. Interface (SM-NWIF)
1h to send data to database (DB) 3. Network Interface (SM-NWI)
F) 1h sends the image interpretation reference priority order information data to the database (DB) 3.

(2) Reading past images from a low-speed medium to a high-speed medium within the database 3-2-1) When the interpretation reference priority information data arrives at the network interface (DB-NWIF) 3h of the database 3. , the control device (DB-CTRL) 3a of the database 3 transmits the interpretation reference priority information data to the network interface (DB-NWIF).
) 3h, control device (DB-CTRL) 3a
write to system memory within.

3-2-2) The control device (DB-CTRL) 3a of the database 3 sends the examination ID number included in the interpretation reference priority order information data to the information search device (DB-CTRL).
-SRCH) 3d to instruct searching and reading of test directory information for the corresponding test.

3-2-3) Information retrieval device (DB-S
RCH) 3d accesses the test directory storage device 3c to search the test directory and finds that the test ID number is 1.
03541, 100902, 102287 and 605
The test directory data of test No. 63 is read out and written to the system memory in the control device (DB-CTRL) 3a.

3-2-4) The control device (DB-CTRL) 3a of the database 3 has the inspection ID number 1035.
The image data and image accompanying information data of 41 examinations (unread images) are stored in an image storage magnetic disk device (DB-IHD).
) Check that it is written to 3f. If it is not stored, the image storage optical disk device (DB
- All image data and image accompanying information data of the examination are read from the IOD) 3e and written to the image storage magnetic disk device (DB-IHD) 3f.

3-2-5) Next, the control device (DB-CTRL) 3a of the database 3 has the test ID number 1.
All image data and image accompanying information data for each of the examinations 00902, 102287, and 60563 are read from the image storage optical disk device (DB-IOD) 3e and written to the image storage magnetic disk layer (DB-IHD) 3f. Image storage magnetic disk device (DB-IHD) 3f
Reading of images from past examinations is performed in the priority order included in the image interpretation reference priority information data. Therefore, in the middle of the process, the image storage magnetic disk device (DB-
When the IHD (IHD) 3f is full and no more can be written, it means that images of examinations with lower priority have been written to the image storage magnetic disk device (DB-IHD) 3f. That is, images of past examinations that are likely to be referred to during image interpretation are written to the image storage magnetic disk device (DB-IHD) 3f.

(3) Instruct the workstation to prepare images At the point when the system manager (SM) 1 instructs the database 3 to prepare past images, the system memory of the system manager 1 stores the patient ( Examination history data (with new data added) and image interpretation reference priority order information data exist for ○Yama○o).

3-3-1) The control device (SM-CTRL) 1a of the system manager 1 is the control device (SM-CTRL) 1a.
CTRL) 1a, among the patient's interpretation reference priority order information data written in the system memory, the examination to be interpreted (the examination with priority 0, in this case, examination I
The test ID number of the test whose D number is 103541 is sent to the information retrieval device (SM-SRCH) 1g, and the test I
Instructs to search and read test request information for the test with the D number.

3-3-2) Information retrieval device (SM-S
RCH) 1g is the test request information storage device (SM-EOI)
M) Access 1d, perform the specified search, read the test request information data for the test with the test ID number given from the control device (SM-CTRL) 1a, and write to system memory.

3-3-3) The control device (SM-CTRL) 1a of the system manager 1 is the control device (SM-CTRL) 1a.
Among the patient's interpretation reference priority order information data written in the system memory in CTRL) 1a, send the examination ID numbers of all examinations (for 4 examinations in this case) to the information retrieval device (SM-SRCH) 1g. , instructs to search and read out the interpretation reports of the examinations having those examination ID numbers.

3-3-4) Information retrieval device (SM-S
RCH) 1g is an interpretation report storage device (SM-IDR)
M) Access 1f, perform the specified search, read the interpretation report of the examination with the examination ID number given from the control device (SM-CTRL) 1a, and
M-CTRL) Write to system memory in 1a.

3-3-5) The control device (SM-CTRL) 1a of the system manager 1 refers to the WS-Interpretation target examination type information and interprets the image of the plain chest X-ray examination with the examination ID number 103541. Select the ID of the workstation 4 to be used.

[0270] The data included in the WX-image interpretation target examination type information is already shown in Table 4.

[0271] According to the WS-interpretation target examination type information, the image of the plain chest X-ray examination (examination ID number is 103541), which is the examination to be interpreted for the patient (○yama○hu), is WS-1 or WS-2. It can be seen that the image is interpreted by a workstation with an ID of . In this case, it is assumed that WS-1 is selected.

[0272] In order to make the load on the workstations 4 as similar as possible, the interpretation of the next X-ray examination image is set to WS-2, and the readings are alternately assigned.

3-3-6) The control device (SM-CTRL) 1a of the system manager 1 is the control device (SM-CTRL) 1a.
CTRL) Test request information written in the system memory in 1a (in this case, the test ID number is 103541)
Transfer the examination history data, interpretation reference priority information data, and interpretation reports of the patient's past examinations (in this case, for 3 examinations) to the network interface (SM-NWIF) 1h. and instructs to send those data to WS-1. The network interface (SM-NWIF) 1h sends the given data towards the WS-1.

(4) Preparation of images to workstation 3-4-1) Data sent by system manager 1 to network interface (WS-NWIF) 4j of workstation WS-1 (inspection request information, inspection history, When the interpretation reference priority information, interpretation report) arrives, the control device of workstation WS-1 (
The WS-CTRL) 4a reads the arrived data from the network interface (WS-NWIF) 4j and writes it to the system memory within the control device (WS-CTRL) 4a.

3-4-2) Workstation WS
-1 control device (WS-CTRL) 4a writes examination request information, examination history, image interpretation reference priority order information, and image interpretation report to image storage device (WS-IM) 4f.

3-4-3) Workstation WS
-1 control device (WS-CTRL) 4a looks at the image interpretation reference priority information and transfers the examination ID number (103541) of the examination with the lowest reference priority to the network interface (WS-NWIF) 4j, Instructs an image transfer request to the database. The network interface (WS-NWIF) sends the given examination ID number and image request command to the database (DB) 3.

3-4-4) When the examination ID number and image request command arrive at the network interface (DB-NWIF) 3h of the database 3, the control device (DB-CTRL) 3a of the database 3 receives the received Transfer data to network interface (DB-
NWIF) 3h, control device (DB-CTR)
L) Write to system memory in 3a.

3-4-5) The control device (DB-CTRL) 3a of the database 3 stores the image data of the sent examination ID number and the image accompanying information data in a magnetic disk storage device for image storage (DB-IHD). Check if it is on 3F,
If so, read out all the image data and image accompanying information data included in the test with that test ID number, and connect it to the network.
Via interface (DB-NWIF) 3h,
Send to workstation WS-1. Inspection ID number 10
3541 examination includes two plain chest X-ray images, but the probability that the image data and image accompanying information data of these two images are in the image storage magnetic disk storage device (DB-IHD) is extremely high. expensive.

[0279] If those data are deleted from the image storage magnetic disk storage device (DB-IHD) 3f for some reason, the information retrieval device 3d is instructed to retrieve the examination ID from the examination directory storage device 3c. The inspection directory number is read out, and the image storage optical disk storage device (
Obtain the storage address in the DB-IOD) 3e, read the image data and image accompanying information from the image storage optical disk storage device (DB-IOD) 3e, and read out the image data and image accompanying information via the network interface (DB-NWIF) 3h. Send to station WS-1.

3-4-6) Workstation WS
-1 network interface (WS-NWI
F) When the image data and image accompanying information data sent from the database (DB) 3 arrive at 4j, the control device (WS-CTRL) 4a of the workstation WS-1:
The arrived data is transferred to the network interface (W
S-NWIF) 4j, image etc. storage device (W
S-IM) Write to 4f.

3-4-7) The control device (DB-CTRL) 3a of the database 3 uses the same procedure as above to collect image data and image accompanying information for other examinations included in the interpretation reference priority information. The data is requested from the database (DB) 3 to be transferred and written to the image storage device (WS-IM) 4f. Database (DB
) 3 are made in descending order of reference priority, so for images of past examinations, 100902, 1
Image data and image accompanying information data are obtained in the order of the examination ID numbers 02287 and 60563.

0282]4. CAD processing and creation of diagnostic information (1)
The CAD processing workstation performs CAD on all images obtained for the four examinations to which CAD processing can be applied.
Perform D processing. There is a high probability that this CAD processing will be performed before image interpretation. This is because, with current technology, images are ready on a workstation within minutes of an exam being performed and the images being collected, but images from that exam are typically not interpreted until much later. It is.

4-1-1) Workstation WS
-1 control device (WS-CTRL) 4a applies CAD processing to each of the two images of the examination to be interpreted (examination ID number is 103541) by referring to the abnormality detection means selection information (Table 11). determine whether it is possible. That is, it is checked whether the combination of the test site name, modality name, and test method included in the test information data is included in the abnormality detection means selection information. Regarding this test,
As is clear from Tables 18, 19, and 11, for the exam with exam ID number 103541, the image number is 1.
Only the image shown in FIG. There are two types of abnormalities that can be detected: pulmonary interstitial disease and pulmonary nodules.

4-1-2) Workstation WS
-1 control device (WS-CTRL) 4a reads the image with image number 1 of the test with test ID number 103541 from the image storage device (WS-IM) 4f, and instructs to detect "pulmonary interstitial disease". It is input to the CAD processing device (WS-CADP) 4e together with data meaning . It also instructs to output the positions of normal anatomical structures.

The CAD processing device (WS-CADP) 4e causes the pulmonary interstitial disease detection means to act on the input image data to analyze the image data. The data on the abnormal position and degree of abnormality obtained as a result of the analysis, and the position data on the normal anatomical structure or the region on the image diagnosis are stored in the internal memory of the CAD processing device (WS-CADP) 4e.

4-1-3) Workstation WS
-1 control device (WS-CTRL) 4a reads the image with image number 1 of the test with test ID number 103541 from the image storage device (WS-IM) 4f, and reads out the image of "pulmonary nodule".
The CAD processing device (W
S-CADP) 4e.

The CAD processing device (WS-CADP) 4e causes the pulmonary nodule detection means to act on the input image data and analyzes the image data. The data on the abnormal position and degree of abnormality obtained as a result of the analysis is processed by a CAD processing device (WS-
CADP) 4e is stored in the internal memory.

4-1-4) Workstation WS
-1 control device (WS-CTRL) 4a is 3 whose inspection ID number is 100902, 102287, 60563.
For each image of the two examinations, check whether there is an applicable abnormality detection method in the same way as described above, and if there is, check the CAD for all applicable abnormality detection methods.
The processing device 4e is used to detect an abnormality. Also, CA
The positions of normal anatomical structures or image diagnostic regions are also determined once for each image subjected to D processing.

[0289] Assume that the two images of a plain chest X-ray examination whose examination ID number is 100902 are a front view (image number 1) and a left side image (image number 2). For frontal images, detection of pulmonary interstitial disease and pulmonary nodules is performed.

[0290] Since the examination part of the examination with examination ID number 102287 is the right foot, all images of this examination are not applicable to CAD.

[0291] Since the examination part of the examination with examination ID number 60563 is the head and the modality is CT, all images of this examination are not subject to CAD.

[0292] The CAD processing is performed in the order of examinations with the lowest reference priority included in the image interpretation reference priority information.

[0293] At this point, the CAD processing device (WS-CA
Table 22 below shows data representing the abnormal position and degree of abnormality stored in the internal memory of DP) 4e.

0294

[Table 22]

[0295] The degree of abnormality in this table can be expressed as a number from 1 to 10 in the case of pulmonary interstitial disease. Note that when the type of abnormality is a pulmonary nodule, the degree of abnormality represents the size (cm) of the nodule. Further, data indicating the area where the abnormality exists has not been created at this stage and is left blank. The data shown in Table 22 will be hereinafter referred to as the "abnormal data table" for simplicity.

FIGS. 16 and 17 show images corresponding to the center positions of the abnormalities in Table 22 above. FIG. 16 shows an image with the test ID number 103541 (image number 1), and FIG. 17 shows an image with the test ID number 100902 (image number 1). In both figures, numerals 31a and 31b are the left lung field and right lung field, respectively, as previously described in FIG. 9, and numeral 24 is the clavicle.

Table 23 below shows positional data of normal anatomical structures or regions on image diagnosis. It may be helpful to refer to FIGS. 16 and 17 for understanding.

0298

[Table 23]

[0299] In this table, the position data corresponds to the "boundary position" (the position of the boundary between regions in image diagnosis), and by using this data, it is possible to determine in which region a certain abnormality exists. Therefore, both are equivalent data. In this embodiment, abnormalities are detected only in the lung field on the image. The data shown in Table 23 will be hereinafter referred to as the "area data table" for simplicity.

(2) Determination of lung field region where abnormality exists 4
-2-1) The control device (WS-CTRL) 4a of the workstation WS-1 analyzes the normal anatomical structure or image contained in the regional data table for each abnormality contained in the abnormal data table. Referring to the position data of the diagnostic area, it is determined which area on the image diagnosis includes the abnormal position. Data indicating the area is written to the abnormal data table. The abnormal data table is created using the CAD processing device (WS-
CADP) 4e internal memory to the control device (WS-C)
After being read into the system memory of TRL) 4a, it is processed in the following procedure and the updated abnormal data table is written to image storage device (WS-IM) 4f.

(a) For a certain abnormality, extract data from the area data table where the inspection number and image number match.

(b) Compare the abscissa of the abnormal position with the abscissa of the center line of the left and right lungs, and if the abscissa of the abnormal position is smaller than the abscissa of the center line of the left and right lungs, it is the right lung field, and if it is larger, it is the left lung field. Lung field. This is because, in this example, only images taken by applying X-rays from the patient's back are used as frontal images, and in that case, the left side of the image is the right lung field, and the right side of the image is the left lung field. for it will become a field.

[0303] An image taken by applying X-rays from the entire surface of the patient is also a frontal image and can be handled. In this case, the data "A→P" is used as the imaging direction, and the positions of the left lung field and the right lung field are opposite. Which one it is can be determined by referring to the photographing direction data in the image accompanying information.

(c) Compare the ordinate of the abnormal position with the ordinate of the boundary line between the upper and middle lung fields, and if the ordinate of the abnormal position is smaller, it is determined that the abnormal position is in the upper lung field. and (e
). If the ordinate of the abnormal position is greater or equal, proceed to the next step.

(d) Compare the ordinate of the abnormal position with the ordinate of the boundary between the middle and lower lung fields, and if the ordinate of the abnormal position is smaller, it is determined that the abnormal position is in the middle lung field. and if the ordinates of the abnormal location are greater or equal, the abnormal location is determined to be in the lower lung field.

(e) The data indicating the determined left and right or upper middle and lower lung field regions is written in the abnormal data table in association with the abnormal position.

[0307] The above procedure is performed for all abnormalities in the abnormal data table. The abnormal data table after the procedure is completed is shown in Table 24 below. In the table, data indicating the lung field area (
Lung field, right, lower) means "lower right lung field," and the same applies to the others.

0308

[Table 24]

(3) Creation of abnormality temporal change data table 4
-3-1) The control device (WS-CTRL) 4a of the workstation WS-1 creates an "abnormality temporal change data table" using the data included in the abnormality data table. The abnormality temporal change data table is in the format shown in Table 25 below.

0310]

[Table 25]

[0311] The data included in this table is created using the following procedure.

(a) For certain abnormal data detected in the image of the examination to be interpreted, the examination ID number, image number, type of abnormality, position of the abnormality on the image, and area where the abnormality exists are determined based on changes over time of the abnormality. Write to data table.

(b) Regarding the abnormal data detected in the image of the examination to be interpreted, search for other abnormal data (data for comparison) whose type and position of the abnormality match.

[0314] If there is comparison data, proceed to step (c).

[0315] If there is no comparison data, data "occurrence" is given to the data item "abnormal change". The degree of change in abnormality is the value obtained by subtracting the degree of abnormality in the abnormal data of the image to be interpreted (denoted as Ab1) by the degree of abnormality in the comparison data (denoted as Ab2), that is, [Ab1-Ab2] as the degree of change in abnormality. However, since Ab2 is defined as 0, [Ab1
].

[0316] "Examination ID number of past examination" and "image number of past image" are given the examination ID number and image number of examinations other than the examination to be interpreted in the abnormal data table.

(c) Compare the "degree of abnormality" of the abnormal data of the image to be interpreted with the "degree of abnormality" of the comparison data.

■If the degree of abnormality of the abnormal data of the image to be interpreted is greater than the degree of abnormality of the comparison data, the "change in abnormality" is determined to be "progress".

■If the degree of abnormality of the abnormal data of the image to be interpreted is equal to the degree of abnormality of the comparison data, the "change in abnormality" is set to "no change".

■If the degree of abnormality of the abnormal data of the image to be interpreted is smaller than the degree of abnormality of the comparison data, the "change in abnormality" is determined as "recovery".

[0321] In any case, the examination ID number and image number in the comparison data are given to the "examination ID number of past examination" and "image number of past image".

[0322] Similarly, in any case, the value obtained by subtracting the abnormality degree of the abnormal data of the image to be interpreted (denoted as Ab1) from the abnormality degree of the comparison data (denoted as Ab2), that is, [Ab1-Ab2], is determined as abnormal. (d)
Steps (a), (b), and (c) are performed for all other abnormal data detected in the image of the examination to be interpreted.

(e) If there is any abnormal data that has never been used as comparison data, do the following with respect to it.

■Write the type of abnormality in the comparison data, the position of the abnormality on the image, and the area where the abnormality exists in the temporal change data table.

■Write the examination ID number and image number in the comparison data into the temporal change data table as the examination ID number of the past examination and the image number of the past image, respectively.

[0326] Regarding the change in abnormality, "disappearance" is written. The degree of change in abnormality is calculated from the degree of abnormality of abnormal data of the image to be interpreted (assumed Ab1) to the degree of abnormality of comparison data (Ab2).
), that is, [Ab1-Ab2], is the degree of change in abnormality. Since Ab1 is defined as 0, [-
Ab2] is the degree of change in abnormality.

[0327] For "Examination ID number", the examination ID number of the examination to be interpreted is written, and for "Image number", the image number of the image in the examination to be interpreted that has the same shooting direction is written. written.

[0328] Created abnormality change data table over time (Table 2
5) is written to the image storage device (WS-IM) 4f.

(4) Creation of overlay display information for displaying abnormalities 4-4-1) Creation of overlay display information for displaying changes in abnormalities over time Control device of workstation WS-1 (WS-CTRL) Step 4a creates an abnormality change over time data table, creates "overlay display information" to indicate the position of the abnormality and change over time, and stores the created overlay display information in an image storage device (WS-IM). )
Store in 4f.

[0330] The created overlay display information is shown in Table 26 below.

0331]

[Table 26]

[0332] Overlay display information regarding changes in abnormalities over time is associated with images. The overlay display information in this table is for displaying the change in abnormality over time in the image with image number 1 in the exam with exam ID number 103541. The data numbers in the table are added for explanation.

[0333] The position of the abnormality is indicated by an arrow, and the change in the abnormality over time is expressed by changing the color of the arrow. The data included in this table is created using the following steps.

(a) The control device (WS-CTRL) 4a of the workstation WS-1 calculates the abnormality position on the image and the change over time of the abnormality for the abnormality with the serial number 1 in the abnormality change over time data table. Read the data. Regarding data number 1 of the overlay display information, the type of figure is "
"Arrow" is written, and the size of the figure is written as "10 mm." The type of figure and the size of the figure are common to all abnormality change data. For the coordinates, write the same data as in the anomaly temporal change data table.

(b) The control device (WS-CTRL) 4a of the workstation WS-1 determines the display color by referring to the relationship information (Table 12) between the change in abnormality over time and the display color. In this case, the time course of the abnormality is "progressing", so the display color is yellow. Data number 1 of overlay display information
"Yellow" is written in the display color.

(c) Regarding the blinking control information, "no blinking" is always written at this stage.

(d) For other serial number abnormalities, perform the same operations as in (a) to (c). However, since the overlay is displayed over the image, only abnormalities for which the inspection number and image number match are written in the same overlay display information. In this example, all aging data is written in the same overlay display information.

(e) The control device (WS-CTRL) 4a of the workstation WS-1 associates the created overlay display information with the examination number and image number,
It is stored in the image storage device (WS-IM) 4f.

4-4-2) Creation of overlay display information showing abnormality detection results for each image Workstation WS-1 control device (WS-CTR
L) 4a refers to the abnormality data table, creates overlay display information for indicating the position and degree of abnormality, and stores the created overlay data in the image storage device (WS-I).
M) Store in 4f.

[0340] Examples of the created overlay display information are shown in Tables 27 and 28 below. Table 27 is inspection ID number 103
It is related to the image number 1 in 541,
Table 28 shows image number 1 in examination ID number 100902.
This is something that hangs over the image. The data in these tables
The data numbers are provided for explanation.

0341]

[Table 27]

0342]

[Table 28]

[0343] The position of the abnormality is expressed by an arrow, and the size of the abnormality is expressed by the length of the arrow. The longer the arrow, the greater the abnormality. Also, the color of the arrow is white.

[0344] The data included in this table is created using the following procedure.

(a) The control device (WS-CTRL) 4a of the workstation WS-1 records the abnormal data table (Table 2).
2) For the abnormality with serial number 1, read the abnormality position and degree of abnormality data on the image. Regarding data number 1 of the overlay display information, the type of figure is written as "arrow". For the coordinates, write the same data as in the anomaly temporal change data table. The type of figure is common to all abnormality change data.

(b) The control device (WS-CTRL) 4a of the workstation WS-1 determines the length of the arrow depending on the degree of abnormality. For an abnormality with an abnormality level of N, the length of the arrow on the screen is set to be Nmm. The size of the shape is
"Nmm" is written.

(c) Since the display color is determined to be white, "white" is written in the display color.

(d) Regarding the blinking control information, "no blinking" is always written at this stage.

(e) For other serial number abnormalities, perform the same operations as in (a) to (d). However, since the overlay display information is displayed over the image, the same overlay display information data is written only for abnormalities for which the inspection number and image number match. In this example, four sets of data regarding abnormalities with serial numbers 1 to 4 in Table 24 are created as one overlay display information (Table 27), and also with serial numbers 5 to 7.
Three sets of data regarding the abnormalities up to are created as separate overlay display information (Table 28).

(f) The control device (WS-CTRL) 4a of the workstation WS-1 associates the created overlay display information with the examination number and image number and stores it in the image storage device (WS-IM) 4f. to remember.

0351]5. Interpretation Doctors Interpret Images and Enter Interpretation Reports A workstation generally has images of multiple patients prepared, but when interpreting images, the interpretation doctor does not know which patient's image to interpret first. It is normal to be indifferent. Therefore, in the workstation, the order is automatically determined so that the images of the examinations to be interpreted are interpreted in descending order of the examination date.

[0352] Using the workstation WS-1, the image interpretation doctor interprets the image of a plain chest X-ray examination (examination ID number 103541) of patient ○yama○o (patient ID number 870802) and creates an interpretation report. The operation in this case will be explained below.

(1) Data display 5 for image interpretation
-1-1) Data preparation First, prepare the necessary data using the following steps.

(a) Reading of examination history The control device (WS-CTRL) 4a of the workstation WS-1 reads the examination history data whose patient ID number is 870802 from the image storage device (WS-IM) 4f, Control device(
WS-CTRL) 4a.

(b) Reading of image accompanying information and image data Control device (WS-C) of workstation WS-1
TRL) 4a looks at the image interpretation reference priority information and stores the image accompanying information of all images (in this case, two images) for the examination ID number (103541) whose priority is 0 in the image storage device. (WS-IM) 4f and writes it to the system memory of the control device (WS-CTRL) 4a.

[0356] In addition, the inspection ID number whose priority is 1 (
100902), all image data (
In this case, 2 images) are stored in the image storage device (WS-IM).
Read from 4f, image frame memory (WS-IF
M) Write in 4g.

[0357] Next, each test ID number whose priority is 1, 2, or 3 (100902, 102287, 60, respectively)
563), the image accompanying information of all images is read from the image storage device (WS-IM) 4f and written to the system memory of the control device (WS-CTRL) 4a, and all the image data is stored in the image storage device (WS-IM) 4f. Equipment (WS-
IM) 4f and transfer it to the image frame memory (W
S-IFM) Write to 4g.

[0358] What is important here is that image data is read out in the order of descending interpretation reference priorities. As a result, even if the number of images of a patient is large and it is not possible to write all the image data to the image frame memory (WS-IFM) 4g, the data of images that are likely to be referenced can be stored in the image frame memory. can be placed in

(c) Reading of interpretation report Control device (WS-CTRL) 4a of workstation WS-1
looks at the image interpretation reference priority order information and selects (examination ID numbers 103541, 100902) in descending order of priority number.
, 102287, 60563),
The interpretation report is read from the image storage device (WS-IM) 4f and written into the system memory of the control device (WS-CTRL) 4a.

(d) Reading of abnormality change data table over time Workstation WS-1 control device (WS-CT
RL) 4a reads the abnormality temporal change data table (Table 25) created earlier from the image storage device (WS-IM) 4f, and writes it into the system memory of the control device (WS-CTRL) 4a.

(e) Reading of abnormality data table Control device (WS-CTRL) 4 of workstation WS-1
a reads out the abnormal data table (Table 24) just created from the image storage device (WS-IM) 4f and writes it into the system memory of the control device (WS-CTRL) 4a.

(f) Reading of overlay display information for displaying changes in abnormality over time Control device of workstation WS-1 (WS-CTR
L) 4a looks at the abnormality change over time data table in the system memory and identifies the abnormalities stored in association with the combination of examination ID number (the data item next to the serial number in Table 25) and image number. Overlay display information for showing changes over time is read from the image storage device (WS-IM) 4f and written into the system memory of the control device (WS-CTRL) 4a. In this case, only the overlay display information associated with examination number 103541 and image number 1 is read out.

(g) Reading of overlay display information for displaying abnormality detection results for each image Control device (WS-CTR) of workstation WS-1
L) 4a is the abnormal data table (Table 2) in the system memory.
4), the image storage device (WS-IM) 4 displays overlay display information for indicating abnormality detection results stored in association with the combination of the examination ID number and image number.
Read from f and write to the system memory of the control device (WS-CTRL) 4a. In this case, inspection number 103
541, the overlay display information associated with image number 1, and the overlay display information associated with inspection number 100902, image number 1, are read out.

5-1-2) Image Display The workstation WS-1 displays images of the examination to be interpreted. Currently, there are four image display devices (WS-IDISP) 4i, so two images of the examination to be interpreted (examination ID number 103541) and the examination that is most likely to be referenced (examination ID number 10) are displayed.
0902) can be displayed at once, and this display is performed automatically. The display is performed using the following steps.

(a) The control device (WS-CTRL) 4a of the workstation WS-1 first checks the inspection ID number 1.
The shooting direction is known from the image accompanying information of the two images 03541. P → A (front view) and R → L (left side view) (
See Table 19). Next, the imaging direction is determined by comparing the relationship information table (Table 13) between the imaging direction of the plain chest X-ray image and the relative display position. As a result, four image display devices (WS-IDISP) 4 arranged horizontally in a row
On the leftmost image display device of i, the shooting direction is P →
An image of A (frontal image) is displayed, and an image of the shooting direction R→L (left side image) is displayed on the image display device on the right side.

(b) The control device (WS-CTRL) 4a of the workstation WS-1 next checks the inspection ID number 1.
The shooting direction is known from the image accompanying information of the two images 00902. Assume that P→A (front view) and R→L (left side view). The imaging direction is determined by checking the relationship information table (Table 13) between the imaging direction of the plain chest X-ray image and the relative display position. As a result, an image (front view) whose shooting direction is P→A is displayed on the third image display device from the left among the four image display devices (WS-IDISP) 4i arranged horizontally in a row. , displays an image (left side image) in the shooting direction R→L on the image display device on the right side.

FIG. 18 shows the relationship between the image display device 4i and the types of images displayed at this point. In the figure, code 6
0a, 60b, 60c and 60d are four image display devices (WS-IDISP) 4 arranged in one row, respectively.
The images displayed on each display screen of i are shown in order from the left.

According to the relationship between the image display device 4i and the image type described above, the images 60a and 60b are images of the examination to be interpreted (plain chest X-ray image, examination ID number 103541).
The image 60a is a front view, and the image 60b is a left side view. On the other hand, image 60c and image 60d are images of past examinations (plain chest X-ray image, examination ID number l0090).
2), the image 60c is a front view, and the image 60d is a left side view.

[0369] Furthermore, the image display device (WS-IDISP)
When displaying an image on 4i, the examination ID number of the examination and the image number within the examination (both of which are included in the image accompanying information) are also displayed.

5-1-3) Display of inspection request information Control device of workstation WS-1 (WS-CTRL)
4a selects predetermined data such as the test purpose, clinical information, and disease name already given to the patient from the test request information read out into the system memory earlier, and displays it on the character display device (WS-CDISP) 4d. to be displayed.

5-1-4) Inspection history display The control device (WS-CTRL) 4a of the workstation WS-1 selects predetermined data from the inspection history data read out to the system memory earlier, and displays the text. Display device (WS-
CDISP) 4d.

[0372] Workstation WS-1 control device (
WS-CTRL) 4a displays test numbers in order of newest test date in the test history. Also, look at the image interpretation reference priority information and mark ★ in front of the examination number in the displayed examination history for examinations whose priority is 0 (examinations that are subject to interpretation, images are unread). Tests that are displayed and have a priority of 1 (these are the tests that are most likely to be referenced)
, a star mark will be displayed in front of the test number in the displayed test history. This makes it possible to determine at a glance which test is the most likely to be referred to as the target test for image interpretation.

FIG. 19 shows the inspection history displayed on the character display device (WS-CDISP) 4d. In the figure, the code 61 is
This is a CRT screen of a character display device (WS-CDISP) 4d.

5-1-5) Display of past interpretation reports Workstation WS-1 control device (WS-CT
RL) 4a selects the interpretation report with the examination number having the lowest interpretation reference priority from among the patient's past interpretation reports read out to the system memory earlier, and displays it on the character display device (WS-CDIP) 4d. . Then, the interpretation doctor reads the image. If the interpretation doctor wishes to display images other than those currently displayed or an interpretation report, he/she inputs a command therefrom from the input device (WS-INPUT) 4c.

(2) After the interpretation doctor finishes interpreting the input image of the interpretation report, the doctor uses the workstation (W
Enter the interpretation report in S). For input, use an input device (W
S-INPUT) 4c, but the character display device (WS
-CDISP)4d is used. The interpretation report is input by selecting words, phrases, and sentences. The words, phrases, and sentences to be selected are
) is registered in advance on the system disk of the control device (WS-CTRL) 4a, and this dictionary is commonly used throughout the system.

5-2-1) Display of interpretation report creation screen The interpretation doctor uses the input device (
When an image interpretation report creation command is input from the WS-INPUT) 4c, the control device (WS-CTRL) 4a of the workstation WS-1 causes the character display device (WS-CDISP) 4d to display the format of the image interpretation report.

[0377] Figure 20 shows the format of the interpretation report displayed on the screen of the character display device (WS-CDISP) 4d.
Shown below. In the figure, the area surrounded by dotted lines is an area where words, phrases, and sentences to be selected by the interpreting doctor are displayed. Reference numeral 61 indicates the CRT screen of the character display device (WS-CDISP) 4d.

[0378] 5-2-2) Inputting the interpretation report The interpreting doctor follows the displayed format and enters the following information for each finding: ■ Type of abnormality ■ Area where abnormality exists ■ Comparison results with past images ■ Comparison of past images Input 5 items: Image inspection ID number ■Image number of the past image to be compared. For the test ID number of the compared past test and the image number of the compared past test, enter the numbers displayed together with the images. If the finding is obtained by interpretation without comparison with past images, enter 0 for the past examination that was compared. Control device (WS-CTR
L) 4a displays the input data at a predetermined position on the screen and stores it in the system memory in association with the finding number.

[0379] At this point, the findings displayed on the screen are shown in FIG. The code 61 is a character display device (WS-CD
ISP) 4d CRT screen.

[0380] Furthermore, the finding data written to the system memory is shown in Table 29 below.

0381]

[Table 29]

Comparing FIG. 21 and Table 29, there are differences. That is, in finding 1, the interpreting doctor selected the word "lower right lung field" as the region where the abnormality exists, but the finding in the system memory is written as "lung field, right, lower." This means that although the term to be selected is displayed as "lower right lung field," the internal dictionary stores the data "lung field, right, lower" in association with that word. means.

[0383] Also, in the input findings, the word "discovery" has been replaced with "occurrence".

[0384] When the input of the findings is completed, the conclusion is input.

[0385] The interpretation doctor uses the input device (WS-INPUT) 4
Input the interpretation report input end command from c.

0386]6. Comparison of diagnostic information and calling attention to the interpreting doctor (1) Extraction of findings to be compared from the interpretation report Extracting findings from the interpretation report that are to be compared with the diagnostic information created from the CAD processing results do.

[0387] Workstation WS-1 control device (
WS-CTRL) 4a checks whether the following combination of data exists in the abnormality detection means selection information for each finding in the image interpretation report, and extracts matching findings.

○ Type of abnormality (found in the findings in the interpretation report) ○ Examination site of the examination to be interpreted (found in the examination history) ○ Modality (found in the examination history) ○ Examination method (found in the examination history) ○ Image capture Direction (This is the imaging direction for the image with the image number in the examination to be interpreted in the findings of the interpretation report,
(in the image accompanying information) In the case of this embodiment, the finding with finding number 1 in Table 29 above is extracted.

(2) Comparison of interpretation report and abnormal data table and call for attention Workstation WS-1 control device (WS-CTR)
L) 4a compares each of the findings of the image interpretation report extracted in the above-mentioned operation (1) with the abnormal data table in the following procedure.

(a) Read the "examination ID number of the past examination compared" in the findings of the image interpretation report, and determine whether the finding was obtained by interpreting only the image to be interpreted. That is, it is checked whether the test ID number of the past test compared is 0. If it is 0, proceed to step (b), and if it is not 0, proceed to step (c).

(b) The control device (WS-CTRL) 4a of the workstation WS-1 compares the following four sets of data for each abnormality in the abnormality data table (Table 22) with the finding in the image interpretation report, Each anomaly in the anomaly data table that matches all four sets is extracted.

○ Type of abnormality ○ Area where abnormality exists ○ Examination ID number of the examination to be interpreted (not entered in the findings in the interpretation report, but easily known from the examination history) ○ Image number in the examination to be interpreted Regarding the abnormalities in the abnormal data table extracted here, it is determined that the results match the findings of the image interpreting doctor.

(c) Steps (a) and (b) are also executed for other findings in the image interpretation report extracted in operation (1).

(d) At this stage, if there is a match for all the findings and all abnormalities in the abnormal data table extracted in operation (1), the interpretation doctor's findings and the results of the CAD processing are It is determined that there is a match. Then, the steps after this are not executed.

[0395] If there is a finding in a report that has no matching partner or an abnormality in the abnormal data table, it is determined that the findings of the interpretation doctor and the results of the CAD processing are different for those findings. There are two cases for this:

Case 1: The interpretation doctor judged it to be normal (no findings), and the CAD detected an abnormality.

Case 2: The interpreting doctor determines that there is an abnormality, and the CAD
could not detect any abnormality.

[0398] Workstation WS-1 control device (
WS-CTRL) 4a reads out findings from the interpretation report and abnormalities from the abnormality data table that have no matching partner from the interpretation report and the abnormality data table, and stores them separately.

(e) If there is abnormal data belonging to Case 1 above, the control device (WS-CTRL) 4a:
Do the following:

[0400] ○ Outputs a "beep" sound.

0401] ○Character display device (WS-CDISP) 4d
The message "CAD has pointed out an abnormality not found in the findings" is displayed in the terminology display area of the part where the created image interpretation report is displayed.

[0402] An image in which abnormal data corresponding to case 1 is detected is displayed on the image display device (WS-IDISP) 4d.

[0403] Overlay data indicating the abnormality detection results for the image is displayed over the image.

[0404] Of the arrows displayed as overlay data, only the abnormal arrow corresponding to case 1 is displayed in a blinking manner. That is, only at this time, data in which the blinking control information in the overlay display information is changed to "blinking" is sent to the image display manager 4h.

[0405] By the way, the reason why the interpreting doctor is not alerted to case 2 is that there are areas in the image that cannot be detected as an abnormality using current CAD technology, and the interpreting doctor may have recognized an abnormality in that area. This is because they cannot. If advances in technology eliminate areas where abnormalities cannot be detected, interpretation doctors will be alerted to case 2 as well. In that case, in the terminology display area of the text display device (WS-CDISP) 4d where the interpretation report is displayed, “Finding 1:
Displays the finding number and warning message such as "CAD indicates normal".

The following methods can be considered.

Now, in this embodiment, there are no findings obtained by interpretation of only the image to be interpreted among the findings in the interpretation report, so (d) and (e) are not executed.

(3) Comparison of interpretation report and abnormality change data table over time and alert workstation WS-
The control device (WS-CTRL) 4a of No. 1 compares each finding of the image interpretation report extracted in operation (1) with the temporal change data table in the following procedure.

(a) Read the "examination ID number of the compared past examination" in the findings of the image interpretation report, and determine whether the finding was obtained by comparison with the image of the past examination. That is, it is checked whether the test ID number of the past test compared is 0. If it is not 0, proceed to step (b); if it is 0, proceed to step (c).

(b) The control device (WS-CTRL) 4a of the workstation WS-1 compares the following six pieces of data for each abnormality in the abnormality temporal change data table with the finding in the image interpretation report, and Extract each anomaly from the temporal change data table of anomalies that match each other. ○ Type of abnormality ○ Area where abnormality exists ○ Exam ID number of the examination to be interpreted (not entered in the findings in the interpretation report, but easily known from the examination history) ○ Image number in the examination to be interpreted ○ Comparison Examination ID number of past examination ○ Image number of past image compared In this embodiment, the time-dependent change data with serial numbers 1, 2, and 3 in Table 25 are extracted. If no abnormality is extracted from the abnormality change data table over time, proceed to (d). If extracted, proceed to (c).

(c) Next, perform a comprehensive judgment on the degree of abnormality change for all the abnormalities extracted in (b), and compare the results with the findings in the interpretation report with past images.
to determine whether they match the findings. That is, first, the sum of the degree of change in abnormality in each piece of extracted temporal change data is calculated, and the change in abnormality is comprehensively determined based on the value of the sum (referred to as x). Then, ■ If 2≦x, proceed ■-1≦x≦
If 1, there is no change■ x≦−2
If so, it is determined that it has recovered. In this example, the sum of the degrees of change in abnormalities of the temporal change data with reference numbers 1, 2, and 3 in Table 25 is 1.
1, and is determined to be "progressing". Next, when comparing the ``results of comparison with past images'' of the findings in the interpretation report and the overall judgment of abnormal changes, both are ``progression'' and match, so the findings in the interpretation report and the CAD processing It is determined that the results match.

(d) Steps (a) to (c) are also executed for other findings in the image interpretation report extracted in operation (1).

(e) At this stage, if there is a match for all the findings and all abnormalities in the abnormality change data table over time extracted in operation (1), the interpretation doctor's findings and CAD processing are performed. It is determined that the results match. Then, the steps after this are not executed.

[0414] (f) If there is an abnormality in the temporal change data table of findings or abnormalities in a report that has no matching partner, it is determined that the interpretation doctor's findings and the CAD processing results are different for those findings. . There are three cases:

Case 1: The interpreting doctor did not find any abnormal changes and judged the image to be normal (no findings), and CAD detected abnormal changes.

Case 2: The interpreting doctor finds an abnormal change,
CAD also detected an abnormal change, but the judgment regarding the abnormal change was different [obtained from the result of step (c)].

Case 3: The interpretation doctor found an abnormal change, but the CAD could not detect the abnormal change and judged it to be normal.

[0418] Workstation WS-1 control device (
WS-CTRL) 4a reads out the abnormality in the finding and abnormality temporal change data table of the image interpretation report that has no matching partner from the image interpretation report and abnormality temporal change data table, and stores it separately.

[0419] As can be seen from Tables 29 and 25, in the case of this example, serial numbers 4 and 5 of the abnormality temporal change data table
is selected as data for which there is no matching partner.

(g) If data belonging to Case 1 or Case 2 above is selected, the control device (WS-C
TRL) 4a does the following:

[0421] ○ Outputs a "beep" sound.

[0422] If there is data belonging to case 1, "CA
D indicates an abnormal change not found in the findings.'' is displayed.

[0423] If there is data belonging to Case 2, the term display area of the text display device (WS-CDISP) 4d where the created interpretation report is displayed will display "Finding N: CAD indicates different abnormal changes." Displays the finding number and warning message, such as "This has been pointed out." Here, N is the finding number of the image interpretation report.

[0424] ○ Among the images of the examination with the "examination ID number" included in the abnormal temporal change data of the serial number corresponding to Case 1 or Case 2 in the table of abnormal temporal change data, the abnormal temporal change data The image with the included image number (referred to as image A) is displayed on the image display device (WS-IDISP) 4d.

[0425] Overlay data indicating changes in abnormality over time for image A is displayed over image A. (The arrows are in a color other than white.) Of the arrows superimposed on image A, only the arrows of abnormal changes that correspond to case 1 or case 2 are displayed in a blinking manner. That is, only at this time, data in which the blinking control information in the overlay display information is changed to "blinking" is sent to the image display manager 4h.

0426] Case 1 in the abnormality temporal change data table
Or, among the images of the examination with the "examination ID number of the past examination" included in the abnormal temporal change data of the serial number that corresponds to Case 2, the image of the "image number" included in the abnormal temporal change data (Image B and image display device (WS-ID)
ISP) Display on 4d. Image B is displayed side by side with image A.

[0427] Overlay data indicating the abnormality detection results for image B is displayed superimposed on image B. (The arrow is white) In this embodiment, the character display device (WS-
Figure 2 shows the interpretation report creation screen in CDISP) 4d.
Shown in 2. The code 61 is a character display device (WS-CDISP
) refers to the 4d CRT screen.

[0428] Also, image display device (WS-IDISP)
Figure 2 shows how the image and overlay are displayed on the 4i.
Shown in 3. In the figure, reference numerals 60a and 60b denote four image display devices (W) arranged in a row, as shown in FIG.
The first and second CRT screens from the left of S-IDISP) 4i are shown, but in FIG.
Inspection ID number 103541 and image number 1 are displayed on the screen 60a.
, and the inspection ID number 10 is also displayed on the CRT screen 60b.
0902・The image with image number 1 is displayed. Code 30a
, 30b and 24 represent the left lung field, right lung field and clavicle, respectively.

[0429] Also, the symbols ■ to ■ attached to each arrow in the figure (■ to ■ are for the CRT screen 60a, and ■ to ■ are for the CRT screen 6
0b) are attached to make it easier to refer to the abnormal position when illustrated, and the reference numbers in Table 24 are circled. ■Arrow is coordinates (350, 1350)
The ■ arrow indicates the coordinates (400, 1500) and it is yellow, the ■ arrow indicates the coordinate (350, 1600) and it is red, the ■ arrow indicates the coordinate (1600, 1300) and it is red. Flashing, ■ arrow is coordinates (1500,800)
indicates the coordinates (350, 135
0) and the white arrow indicates the coordinates (400, 1500
) is white, and the ■ arrow indicates the coordinates (1500,800)
It is white. Therefore, the image of the CRT screen 60a overlaid with the arrows ``■'' to ``■'' indicates information on changes over time of the abnormality.

[0430] By the way, the reason why the interpretation doctor is not alerted in case 3 is that there are areas in the image where no abnormality can be detected using the current CAD technology, and the interpretation doctor can detect abnormal changes in that area. This is because he may have recognized that. If advances in technology eliminate areas where abnormalities cannot be detected, interpretation doctors will be alerted to Case 3 as well. In that case, the character display device (WS-CDISP)
In the terminology display area of the part where the created interpretation report in 4d is displayed, the finding number and warning message are displayed, such as "Finding 1: CAD indicates that there is no abnormal change and it is normal." Possible methods include:

0431]7. Referring to the CAD processing results by the interpreting doctor The interpreting doctor now looks at the displayed image and arrows for reference. Then, if necessary, the CAD processing results, that is, the abnormality data and the abnormality change data table over time, can be further displayed on the character display device (WS-CDISP) 4d. To do this, the interpretation doctor must use an input device (WS-INPU).
T) Enter the command, inspection ID number, and image number from 4c.

[0432] Furthermore, overlay data can be displayed superimposed on a specified image. To do so, the interpretation doctor inputs a command, examination ID number, and image number from the input device (WS-INPUT) 4c.

(1) The corresponding operation of the workstation will be explained in the case where the interpretation doctor wants to display an image and overlay data in a superimposed manner.

(a) The interpretation doctor uses the input device (WS-INP)
UT) Input the command, examination ID number, and image number from 4c.

(b) Workstation control device (W
S-CRTL) 4a determines whether the specified image is an image to which CAD processing is applied. The method of judgment is
First 4. (1)C in CAD processing and creation of diagnostic information
This is exactly the same as described in 4-1-1) of AD processing.

[0436] If there is no applicable abnormality detection means, proceed to (c). If there is, proceed to (d).

(c) Since there was no applicable abnormal shadow detection means, the control device (WS-CRTL) 4a displays on the character display device (WS-CDISP) 4d, ``There are no abnormalities that can be applied to the specified image.'' ” is displayed. This allows the interpretation doctor to know that the specified image is not subject to CAD processing. After displaying, (g)
Proceed to.

(d) If there is an applicable abnormality detection means, check whether there is an abnormality detected from the image in the abnormality data table.

[0439] If an abnormality is detected, proceed to (e). If not, proceed to (f).

(e) Since there was an abnormality detected, the image display manager displays the information necessary to display the image and overlay data in an overlapping manner, such as overlay display information associated with the specified image. 4h, overlay the image and overlay data, and display it on the image display device (WS-I).
DISP) Display on 4i. After displaying, proceed to (g).

(f) If no abnormality is detected, there is no overlay display information associated with the image. In this case, the control device (WS-CTRL) 4a displays the designated image on the image display device (WS-IDISP) 4i, and also displays the specified image on the character display device (WS-CDISP).
4d displays the message "No abnormality was detected from the specified image."

[0442] This allows the interpreting doctor to add C to the specified image.
As a result of applying the AD processing, it can be known that no abnormality was detected. However, currently this does not mean that the image is a normal image. This is because, with the current technology, the area in which abnormalities can be detected is limited, and the types of abnormalities that can be detected are also limited. Therefore, it is necessary for the interpretation doctor to understand the meaning of this word in advance. After displaying, proceed to (g).

(g) Finish this series of procedures.

(2) The same concept as above is used when the interpretation doctor displays diagnostic information obtained through CAD processing such as an abnormality data table and an abnormality change data table over time. That is,
(a) If the designated image is not a CAD processing target image, this fact is displayed on the character display device (WS-CDISP) 4d.

(b) If an abnormality cannot be detected from the specified image, this fact will be displayed on the character display device (WS-CDI).
SP) Display on 4d.

[0446] These pieces of information are provided in 6. above. The display may be automatically displayed in the system operation of comparing diagnostic information and alerting the interpreting doctor.

0447]8. Completion and storage of the interpretation report (1) Completion of the interpretation report (a) If the interpretation physician deems it necessary, the interpretation physician shall use the input device (WS).
-INPUT) Correct the image interpretation report input earlier using the input from 4d. Workstation WS-1
The control device (WS-CTRL) 4a changes the interpretation report stored in the system memory and displays the changed data in the interpretation report creation area of the character display device (WS-CDISP) 4d.

(b) When the correction is completed, the interpretation doctor inputs an interpretation end command from the input device (WS-INPUT) 4d.

(c) The control device (WS-CTRL) 4a displays on the character display device a prompt to input the interpreting doctor ID number, and the interpreting doctor inputs the interpreting doctor ID number assigned to him/her. The control device (WS-CTRL) 4a checks whether the input interpretation doctor ID number exists in the interpretation doctor information table (Table 14). If the image interpretation doctor name exists, the image interpretation doctor name corresponding to the image interpretation doctor ID number is selected as the image interpretation doctor name to be added to the image interpretation report.

(d) The control device (WS-CTRL) 4a uses the patient ID number from among the types of data included in the interpretation report shown in Table 7 above for the findings and conclusions of the created interpretation report. Add data up to the date of interpretation. Of these data, the data other than the name of the doctor who interpreted the image and the date of image interpretation are included in the patient's examination history.

[0451] The name of the image interpreting doctor determined in (c) is used.

[0452] The date of image reading can be determined from the workstation's built-in clock.

(2) Transfer and storage of image interpretation reports (a) Workstation WS-1 control device (WS-CTRL
) 4a sends the completed interpretation report to the network interface (WS-NWIF) 4j and instructs the system manager (SM) 1 to forward the interpretation report. Network interface (WS-NW
IF) 4j sends the interpretation report to the system manager (S
M) Send to 1.

(b) Network interface (WS-NWIF) 4j of system manager (SM) 1
When the interpretation report arrives from the workstation, the system manager (SM) 1 control unit (SM-C
TRL) 4a is a network interface (S
The interpretation report is read from the M-NWIF) 1h and written to the system memory of the control device (SM-CTRL) 4a. Further, the image interpretation report is transferred from the system memory to the image interpretation report storage device (SM-IDRM) 1f and stored there.

[0455] With this, the series of operations described above from receiving the examination request information to completing and storing the image interpretation report has been completed. The series of operations are as follows: 1. Receiving test request information 2. Image collection and storage 3. Preparing images for interpretation 4. CAD processing and creation of diagnostic information5. Interpretation of images by interpretation doctor and input of interpretation report 6.
Comparison of diagnostic information and alerting the interpreting doctor 7. Reference of CAD processing results by interpretation doctor 8. The interpretation report was completed and stored.

Note that the system of the present invention is not limited to the above embodiments. Modifications will be described below.

[0457] ● In "(3) Creating an abnormality change data table over time" in the system operation "4. Creating CAD processing and diagnostic information", in step (b) of 4-3-1), We decided to compare items that match the type of anomaly and the location of the anomaly. However, the positions of detected abnormalities do not always match completely. Therefore, if the position of the abnormality is less than a certain distance, it is considered to be the same position, so that a proper comparison can be performed.

That is, in the example, when determining the lung field region where an abnormality exists in "(2) Determining the lung field region where an abnormality exists" in "4. CAD processing and creation of diagnostic information", The regions on the images matched between the images being compared. In addition, there were cases in which the positions of abnormalities were completely the same among the compared images.

[0459] However, since the images are from different inspection dates, it is unlikely that the positions will be perfectly aligned. Therefore, it is desirable to either (1) align the images in advance, or (2) detect the amount of positional deviation and correct the position data in the abnormal data table.

● In the above embodiment, the CAD processing device (
In WS-CADP) 4e, when determining areas on the image (left upper lung field, left middle lung field, etc.), the position coordinates of the left and right lower clavicle edges and the left and right upper diaphragm edges were flattened. The values were used to determine the boundaries of the upper, middle, and lower lung fields. However, the boundaries of the upper lung field, middle lung field, and lower lung field may be determined separately for the left lung field and the right lung field.

[0461] In the above embodiment, the abnormality change data table over time was created for two images, the image to be interpreted and the past image, but it is of course possible to compare more than two images.

[0462] In the above example, the change in abnormality over time is displayed on the overlay by distinguishing it by the color of the arrow, but the position of the abnormality is surrounded by various figures, and the shapes of the figures (○, ◇, □, Changes over time may be distinguished by changing Δ).

[0463]● In the above embodiment, three abnormality detection means are used.
Although there are several types (pulmonary interstitial disease, pulmonary nodules, microcalcifications), any number of types may be used, and any type of image (CT, MRI, etc. other than X-rays) may be used.

[0464] ● The results of comparison with the abnormality data table, the abnormality change over time data table, and the findings in the interpretation report were displayed on the character display device 4d, but it was also possible to output them in voice using voice synthesis technology. It's okay. The operator or doctor also needs to use the input device (F) of the film digitizer 2.
It is also possible to input by voice using the DG-INPUT) 2d or the workstation input device (WS-INPUT) 4c.

[0465] In the example, a case was explained in which medical images were used for diagnosis, but medical test data other than images, that is, graphical data such as electrocardiograms and electroencephalograms, or numerical values obtained with an automatic chemical analyzer, etc. It may be arranged data.

● In the above embodiment, the CAD processing device (
We compared multiple plain X-ray images taken at different times of the same region (chest) of the same patient using WS-CADP), but if a corresponding knowledge database was obtained, it would be possible to compare different regions or different types of medical images ( CAD can also be performed by comparing different types of test data (for example, X-rays and MRI) or different types of test data (medical images and electrocardiogram data).

[0467] In the example, the image interpretation report of one doctor and the CAD processing result were compared, but for example, in a group medical examination, it is possible to compare the image interpretation reports of multiple doctors, or to perform CAD processing on the changes over time of the same type of medical images. Comparing processing results with CAD processing results of different types of medical images, etc.
It is also possible to compare AD processing results.

● In the example, the doctor's image interpretation report and CAD processing results are sent to the workstation control device (WS
- CTRL) 4a and created the results, but this was done by connecting a device that specializes in comparing multiple pieces of diagnostic information and creating the results to the network 5, and using the CPU of this device.
You can go there. Also, if you want to compare the data stored in the database 3 (CAD processing results and doctor's diagnosis results) and create the results, you can also use the control device (DB-CTRL) 3a of the database 3. good.

0469]

[Effects of the Invention] As explained above, according to the medical support diagnosis system of the present invention, the interpretation report can be automatically checked by comparing the CAD processing results and the findings of the input interpretation report. Can be done. Then, by outputting the comparison results and notifying the interpretation doctor,
It can support the diagnosis of the image interpreting doctor and improve the accuracy of diagnosis.

[0470] Furthermore, if the comparison results are output for only the diagnostic items for which the CAD processing results and the findings in the input image interpretation report are different, the efficiency of image interpretation will be improved compared to when comparing the entire image. improves.

[0471] Furthermore, it has one or more types of abnormality detection means,
A means for associating types of medical test data and anomaly detection means is provided, and an appropriate anomaly detection means is selected and applied to input medical test data using the means for associating types of medical test data and anomaly detection means. Therefore, CAD processing can be performed efficiently and in a short time. If there is no abnormality detection means applicable to the specified medical test data, or if no abnormality is detected after processing the specified medical test data, the doctor will be able to It is possible to measure the convenience of diagnosis.

[0472] In addition, it is possible to create temporal change information for a certain diagnostic item from the results of CAD processing of two or more images, and if that information is displayed over the image,
The interpreting doctor can also easily know the temporal change information, which can be used for convenience in diagnosis. CAD processing can be performed in the order of images of examinations that are likely to be referred to during image interpretation, so if a doctor starts interpreting an image while CAD processing is in progress and requests the CAD processing results. Results can also be displayed for images of interest to the doctor.

[Brief explanation of drawings]

FIG. 1 is a system configuration diagram of PACS.

FIG. 2 is a configuration diagram of a system manager.

FIG. 3 is a configuration diagram of a film digitizer.

FIG. 4 is a diagram showing the relationship between film size and film density reading area.

FIG. 5 is a diagram showing the relationship between images and pixels.

FIG. 6 is a diagram showing the relationship between pixels and pixel size.

FIG. 7 is a configuration diagram of a database.

FIG. 8 is a configuration diagram of a workstation.

FIG. 9 is a diagram showing the lung field area in a plain chest X-ray image.

FIG. 10 is a configuration diagram of the image display manager of the workstation.

FIG. 11 is a configuration diagram of an overlay memory.

[Fig. 12] (A), (B), and (C) are front images, respectively;
The figure which shows the positional relationship of the X-ray source, a patient, and X-ray film when photographing a right side view and a left side view.

FIG. 13 is a diagram showing how to arrange X-ray photographs when viewing X-ray photographs taken in different photographing directions.

FIG. 14 is a diagram showing an example of information displayed on the screen of a display device of a film digitizer after digitizing film density.

FIG. 15 is a diagram showing an example of information displayed on the screen of the display device of the film digitizer after the operator finishes inputting necessary data following digitizing film density.

[Figure 16] Part of the abnormal data table in Table 22 (reference number 1 to
Image diagram corresponding to 4).

[Figure 17] Part of the abnormal data table in Table 22 (reference number 5 to
Image diagram corresponding to 7).

FIG. 18 is a diagram showing the relationship between the workstation image display device and the types of images displayed thereon at the start of image interpretation.

FIG. 19 is a diagram showing an example of an examination history displayed on a workstation character display device during image interpretation.

FIG. 20 is a diagram showing an example format of an interpretation report displayed on a workstation character display device.

FIG. 21 is a diagram showing an example of findings inputted and displayed on a workstation character display device when creating an interpretation report.

FIG. 22 is a diagram showing an example of a message to an interpretation doctor displayed on an interpretation report creation screen of a workstation character display device.

FIG. 23 is a diagram showing a screen of a workstation image display device on which an image and overlay data are displayed in an overlapping manner.

[Explanation of symbols]

1. System manager 2a, 2b Image collection device 3 Database 4a, 4b Workstation 5　Network

Claims (16)

[Claims] 1. A medical diagnosis support system comprising means for comparing a plurality of pieces of diagnostic information regarding the same kind of diagnostic items obtained from medical test data, and means for creating a comparison result of the plurality of pieces of diagnostic information. 2. The medical diagnosis support system according to claim 1, wherein the plurality of pieces of diagnostic information include diagnostic information obtained by computer processing medical test data and diagnostic information by a doctor of the medical test data. 3. The system comprises means for inputting doctor's diagnosis information, means for inputting medical test data, and computer means for processing the medical test data to create diagnostic information. The medical diagnosis support system according to item 2. 4. The medical diagnosis support system according to claim 1, wherein the system includes means for outputting a comparison result of the plurality of pieces of diagnostic information. 5. The medical diagnosis support system according to claim 1, wherein the medical examination data includes medical image data. 6. The medical diagnosis support system according to claim 5, wherein the medical image data has mutually distinguishable types such as examination site, modality, examination method, and photographing direction. 7. The computer means has abnormality detection means for obtaining a specific type of diagnostic information from a specific type of medical image data, and means for associating each type of medical image data with applicable abnormality detection means. The medical diagnosis support system according to claim 6. 8. The system includes means for specifying a specific type of medical image data, and a means for specifying a specified type of medical image data.
Claim 7 further comprising means for outputting a notification to that effect if the data does not have abnormality detection means for obtaining specific types of diagnostic information about the data.
The medical diagnosis support system described. 9. The medical diagnosis support system according to claim 7, further comprising means for outputting a notification when no abnormality is detected by the abnormality detection means. 10. The system includes means for identifying a normal anatomical structure or an image diagnostic region from medical image data, a means for detecting a position of an abnormality from the medical image data, and a means for detecting a position of an abnormality from the medical image data. 8. The medical diagnosis support system according to claim 7, further comprising means for associating the normal anatomical structure or the region on image diagnosis. 11. The medical diagnosis support system according to claim 10, wherein the system includes means for outputting the position of the abnormality in association with the normal anatomical structure or the region on image diagnosis. 12. The medical diagnosis support system according to claim 2, wherein the plurality of diagnostic information includes a plurality of diagnostic information obtained by computer processing a plurality of medical test data. 13. The plurality of pieces of medical test data include medical test data with different test dates and times, and the plurality of diagnostic information includes information on changes over time between the medical test data with different test dates and times. 13. The medical diagnosis support system according to item 12. 14. The plurality of medical test data includes a medical image, and the system includes means for inputting the medical image, and means for superimposing and outputting the medical image and the temporal change information. 13. The medical diagnosis support system according to 13. 15. The system classifies the temporal change information into types such as occurrence, progression, recovery, and disappearance, and visually displays the classified temporal change information to means for superimposing and outputting the medical image and the temporal change information. 15. The medical diagnosis support system according to claim 14, further comprising means for displaying a visually distinguishable display. 16. The system further comprises means for causing the computer means to create diagnostic information in order of likelihood of reference when a doctor creates an examination report regarding the plurality of medical examination data. The medical diagnosis support system according to item 3.