JPH06259486A - Medical diagnosis support system - Google Patents

Abstract

PURPOSE:To attain the successive reading of entire inspection pictures, and to minimize a workload by comparing and classifying plural inputted diagnostic results for each medical inspection data, and outputting the identified informa tion. CONSTITUTION:Information related with medical interview or history is inputted from a medical interview information inputting device H1, and picture data being one kind of the medical inspection data are inputted from a picture collector 1A. In a data base DB to which the picture data are inputted, each picture data are CAD-processed, abnormality detection is operated, and an abnormality data chart being the result is prepared. On the other hand, the picture data or the medical interview information or the like are transmitted from the data base DB to a word station WS, the picture data are displayed, and read by a doctor. Then, the doctor prepares and inputs a view data chart being the read result of each picture data. When the reading by the doctor is ended, the view data chart and the abnormality data chart are compared and classified, an abnormality detection result list being the result is prepared, and outputted for each classification.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention improves the diagnostic efficiency of medical examination data of a doctor by comparing and comparing a plurality of pieces of diagnostic information such as a doctor's finding with respect to medical examination data such as medical images and analysis results by a computer. Medical diagnosis support system for.

[0002]

2. Description of the Related Art At present, various group medical examinations are conducted in Japan, among which medical examinations (one of medical examination data) such as chest X-ray examination and gastric X-ray contrast examination are performed. It is included. Taking lung cancer screening as an example, the work flow from examination to result reporting is performed in the following procedure. Step 1) Determine the examination date and notify the examinee. Step 2) Conduct an interview. The information obtained by the interview includes the medical history of the examinee, recent symptoms, smoking status and extent. Step 3) An X-ray of the chest is taken. Filming is often done in the examination car. Step 4) Interpretation of the chest X-ray image. Interpretation is supposed to be performed by two or more doctors. If suspicious abnormal findings are found as a result of interpretation, it is judged that detailed examination is necessary. Step 5) Notify the examinee of the result. In addition, sputum examination is also performed in lung cancer screening, but the explanation is omitted here. There are a plurality of types of methods in step 4 above. For example, when two doctors perform image interpretation, they are represented by the following two. (a) Two doctors interpret independently at different places. (Fig. 2
4 (a)) (b) Two doctors simultaneously read the same image. (Fig. 2
(See 4 (b)) (a) and (b) In either case, if one of the two doctors points out a suspicious abnormality, the examinee of the image is judged to need detailed examination. .

There are two methods for carrying out such a group medical examination, and the local government and public health centers carry out steps 1 to 5.
Up to step 5, and the business establishment steps 1 and 5
In some cases, a specific hospital or a specialized medical examination company performs steps 2 to 4. The place where steps 2 to 4 are performed will be called the center. The center has a film storage for storing annual inspection films and a data storage for storing data such as doctor's image interpretation results and interview information at the time of inspection. Regarding the chest X-ray photography, the center prepares a chest X-ray photography vehicle and a technologist at the date and time when the center is requested, and the center requests doctors of other hospitals to interpret the inspection image. Deliver the paper with the image and interpretation findings to the doctor, and go to the paper with the image and interpretation findings written after the interpretation. According to the interpretation result, it is classified into those requiring a detailed examination and those requiring normal examination, and the classification result and the doctor's interpretation result, examination image and inquiry information regarding the person requiring close examination are established (perform step 5 above). Send to.

For a doctor who is requested to interpret images, image interpretation for lung cancer screening is an overtime work performed in addition to normal work, and the time devoted to image interpretation is limited. Furthermore, since the number of images requested to be read reaches hundreds at a time, the image reading time required for each image is 2 to 3 minutes per image in the normal work.
Remarkably short at 10 seconds. In addition, chest X-ray images that are interpreted in normal work are taken by the direct imaging method and are images of good quality with a size of 14 inches x 14 inches (about 35 cm) or more, whereas images obtained in lung cancer screening are 10cm x 10cm of roll film taken by mirror indirect photography
It is a small image with poor image quality. Therefore, it has been pointed out that many of the early lung cancers are overlooked despite the task of early detection of lung cancer. Currently, it takes one week from the medical examination to deliver the image interpretation material to the first doctor, and it takes one week for each doctor to deliver the image interpretation results and two weeks for two doctors. It takes a week from the results of two doctors to report the results to the examinees, so it takes a month from receiving the results of the examination to receiving the results. Furthermore, after a detailed examination, a tumor is diagnosed, and it is judged as malignant or benign, and undergoes surgery or treatment. Therefore, it is customary that a considerable amount of time elapses after the examination. On the other hand, the growth of cancer (malignant tumor) is considerably fast, and the earlier cancer is detected, the better the prognosis is. Therefore, it is desired to shorten the period from the examination to the operation or treatment. At present, the digital image system for mass examination has not been constructed yet.

By the way, a digital image has a feature that an image can be easily processed by a computer as compared with an analog image on a photographic film. Therefore, an attempt has been made to analyze the digital image by a computer and detect an abnormality. And is producing results. This technology
It is called Computer Aided Diagnosis (hereinafter referred to as "CAD"), and is expected to improve the accuracy of image diagnosis and reduce the burden on doctors. An abnormality detection algorithm when using this CAD is introduced, for example, in the following document. (1) Katsuragawa S. et al: Image feature analysis a
nd computer-aided Diagnosis in digital radiography
: Classification of normal and abnormal lungs wit
h interstitial disease in chest images.Medical Physics 16, pp.38-44 (1989) (2) Giger ML et al: Image feature analysis and
computer-aided Diagnosis in digital radiography:
3.Automated detection of nodules in peripheral lun
g fields. Medical Physics 15, pp.158-166 (1988) (3) Chan HP et al: Image feature analysis and
computer-aided Diagnosis in digital radiography:
1.Automated detection of microcalcifications in ma
mmography. Medical Physics 14, pp.538-548 (1987) (4) Kunio Doi et al .: "Possibilities of Computer-Aided Diagnosis in Digital Radiography", Journal of Japanese Society of Radiation Technology, pp.653-663 (1989) The following documents also include a description of a system that operates. (5) JP-A-02-185240 (Japanese Patent Application No. 63-3307)
24) (6) JP-A-02-152443 (Japanese Patent Application No. 63-3051)
33) (7) JP-A-01-125675 (Japanese Patent Application No. 63-1921)
71).

With the digitization of images, recently, a medical image archiving and communication system (Picture Archiving and
Communication System; hereinafter referred to as "PACS". ) Is being used to perform image diagnosis. PACS is a medical image created in a hospital (digital image such as X-ray image, X-ray CT image, MR image)
It is a system that supports the work of doctors viewing medical images by storing, communicating, and displaying. According to this PACS, image data of medical images sent from image acquisition devices such as X-ray imaging, X-ray CT imaging, and MRI are stored in a database, and when the images are needed, the database is transferred to a workstation. Image data can be transmitted. The workstation displays the sent image on a CRT or the like. Then, the doctor looks at the image displayed on the workstation and interprets the image to create an image interpretation report. Interpretation report is also PACS
Can be created and stored above. Many techniques have been disclosed regarding the PACS system configuration and functions, and are described in detail in the following documents, for example. (1) Japanese Patent Application Laid-Open No. 62-121576 (Japanese Patent Application No. 60-2612)
86) (2) Japanese Patent Application Laid-Open No. 63-10269 (Japanese Patent Application No. 61-1540)
86) (3) JP-A-64-13837 (Japanese Patent Application No. 62-1703)
08) (4) JP-A-64-17154 (Japanese Patent Application No. 62-1725)
85) (5) JP-A-02-103668 (Japanese Patent Application No. 63-2567)
26) (6) JP-A-02-119840 (Japanese Patent Application No. 63-2724)
39) This PACS eliminates the need to search for a medical image film (analog image), carry the film, and hang or remove the film from the Schaukasten.

[0007] The present inventors have already filed an application regarding the case of applying CAD when performing image interpretation using PACS. For example, Japanese Patent Application No. 03-105852. In the technique described in the example of this application, CAD is applied to analyze an image, the CAD processing result is compared with the interpretation result of a doctor, and if there is a mismatch between the two, It is displayed to call attention. However, this application does not continuously process a large number of images at one time as in mass screening.

[0008]

As described in the section of the prior art, it is pointed out that there are many oversights in the interpretation of the inspection image of the group medical examination. Therefore, it is conceivable to use CAD to perform image interpretation. However, in the conventional system, when the image interpreting doctor uses CAD, the diagnostic result of the image interpreting doctor and the result of the CAD process are displayed side by side every time one image is read,
It is necessary for the radiologist to compare the two results one after another, and if there are discrepancies in the results, such as oversight or overreading, reinterpret the image and correct the diagnostic results. As the number increases, the time required for image interpretation also increases. Further, the image interpretation method of the image interpretation doctor in the group medical examination is a method of continuously interpreting all the image inspection images at once. The CAD usage method for realizing this image interpretation method is not yet known. There is a demand that it will be convenient if such a CAD utilization method is realized. further,
Even in such a method of using CAD, when the image interpretation doctor compares the CAD processing result with the image interpretation result and then interprets again, the image to be reinterpreted is different.
For example, the interpreting doctor A wants to re-interpret all the overlooked images, the interpreting doctor B wants to re-interpret all the diagnostic results that differ from the CAD processing results, and the interpreting doctor C points out the type and position. I want to check up to the disagreement, etc. In realizing the CAD usage method, it is necessary to be able to flexibly respond to the idea of each radiogram interpreter.

[0009] Further, the interpretation doctor has different requirements depending on his or her personal preference when, at the time of interpretation of the inspection image, and at what timing the CAD processing result should be referred to. For example, you basically want to read images collectively, but sometimes you want to refer to the CAD processing results during image reading. At this time, C
There is a request that it should be possible to refer to the AD processing result when it is desired.

Further, the center requests a plurality of doctors to read the inspection image. Then, the obtained results of the doctors are compared to list the subjects who need detailed examination, and the images of the subjects are taken from the film storage and the data such as the doctor's interpretation results and interview information at the time of the examination. Is searched from the data storage and sent. Also, for those who do not require a detailed examination, the examination results must be sent. Since all the huge amount of work is done manually, the work is difficult. In other words, from the examination of the entire group examination to the output of the result, the large amount of work, such as the interpretation of the two doctors and the aggregation of the interpretation results, lengthens the period from the examination to the output of the examination result. Therefore, even in this part, CA
There is a request to use D.

The present invention has been made in view of the above circumstances, and an object thereof is to enable continuous interpretation of all examination images using CAD, minimize the workload of a doctor, and reduce the time required for the interpretation. It is to provide a medical diagnosis support system whose number is as small as possible. Another object of the present invention is to provide a medical diagnosis support system that enables a flexible image interpretation method according to the thinking of a doctor. Still another object of the present invention is to provide a medical diagnosis support system capable of eliminating comparison work of image interpretation results of a plurality of doctors and search work for classification and data. Still another object of the present invention is to allow an image reading doctor to refer to a CAD processing result when he / she wants to refer to the image while continuously reading images, and an image read while referring to the CAD processing result It is to provide a medical diagnosis support system that prevents re-interpretation.

[0012]

In order to achieve the above object, the medical diagnosis support system of the present invention has the following configuration. That is, a means for inputting a plurality of diagnostic results having one or more pieces of diagnostic information obtained from medical examination data, a means for comparing and classifying a plurality of inputted diagnostic results for each medical examination data, and a classification result. Means for storing the medical examination data or identification information of the medical examination data according to
Means for outputting medical examination data or identification information of the medical examination data. In this medical diagnosis support system, there is provided means for computer processing medical test data to obtain a large amount of diagnostic information, and one of a plurality of diagnostic results to be compared is a diagnostic result obtained by computer processing medical test data. Is characterized in that.
Further, means for inputting a plurality of diagnostic results having one or more pieces of diagnostic information obtained from the medical examination data, and when making a diagnosis from the medical examination data, it becomes possible to refer to the previously inputted diagnostic results. In the case of reference, a means for detecting and storing it, a means for comparing and classifying this diagnosis result with the previously input diagnosis result for each medical examination data, and writing in the storage means at the time of this comparison Means for excluding the existing diagnostic information, means for collectively storing the medical examination data or the identification information of the medical examination data according to the classification result, and means for outputting the medical examination data or the identification information of the medical examination data And having. In this medical diagnosis support system, the previously input diagnosis result is a diagnosis result obtained by computer processing the medical examination data.

[0013]

According to the above construction, the results of image interpretation by a plurality of doctors are automatically compared and classified, and the results of lung cancer screening are output. That is, when the interpretation result of the doctor A and the interpretation result of the doctor B are input from the outside, a large number of input diagnostic information are compared and classified, and those included in the classification requiring the detailed examination are compared with the medical examination data. Outputs information related to diagnostic information and medical examination data. On the other hand, for those included in the classification that does not require detailed examination, the diagnostic information of the doctor is output. Further, when a doctor's interpretation result is input from the outside, it is compared with the CAD processing result. A large number of diagnostic information included in the image interpretation result and a large number of detection (diagnosis) information included in the CAD processing result are compared and classified, and for the items included in a certain classification, the inspection image, the interpretation result of the doctor, and the CA.
D Process result is output. A certain classification is, for example, a doctor's oversight, a doctor's overread, a doctor's and a CAD processing result match, or when both indicate an abnormality, the type of abnormality. And the positions of abnormalities are the same or not. Furthermore, when the doctor interprets the inspection image, the result of the CAD processing is prepared and can be referred to. Also, CA
It is detected and stored whether or not the result of the D processing is referred to. The presence or absence of a reference is judged before comparing and classifying the interpretation result of a doctor and the result of CAD processing, and when there is a reference, it is excluded from the comparison target. That is, the output result of the CAD processing result is stored in the storage area of the display device, and when the doctor requests the display for reference, it is displayed and the reference / non-reference information is set to “with reference”. When comparing and classifying the interpretation results of the doctor and the results of CAD processing, when the reference presence / absence information is “referenced”, no comparison is performed, and when the reference presence / absence information is “no reference”, the doctor's interpretation result and CAD Compare the processing results.

[0014]

Embodiments of the present invention will be described below with reference to the drawings. In this embodiment, an example of performing CAD using PACS will be described. First, the main points of the present invention will be described, and then the system configuration of PACS will be described.
Lastly, the procedure for image interpretation using the system of the present invention will be described in detail. Hereinafter, the system configuration of PACS will be described by taking an example of interpretation of a chest X-ray image for lung cancer screening. 1 and 2 are flowcharts for explaining the main points of the present invention. FIG. 1 shows the essential points of the first invention and FIG. 2 shows the essential points of the second invention. In FIG.
(A) shows the broadest point of the first aspect of the invention, in which there are a plurality of diagnostic results having one or more diagnostic information obtained by a mass examination or the like in the medical diagnostic support system, and the diagnostic results In the case of comparing and classifying, the diagnostic results are assumed to be a diagnostic result A and a diagnostic result B, these are first compared and classified for each diagnostic information. Then,
A large number of items of diagnostic information are divided into lists and selected, and selected and output to be reported. The diagnosis result A and the diagnosis result B may be the diagnosis results of a plurality of doctors.
It may be a D processing (diagnosis) result and a doctor's image interpretation (diagnosis) result. The latter case will be described with reference to FIG. 1B, and the former case will be described here. That is, when the interpretation result of the doctor A and the interpretation result of the doctor B, which are interpreted by the workstation WS, are input to the database DB, a large number of input diagnostic information are compared and classified, and those requiring a detailed examination are unnecessary. Divide into things. For the items included in the classifications that require the detailed examination, the identification information of the medical examination data or the medical examination data, the diagnostic information, and the information related to the medical examination data are output. On the other hand, for those that are included in the classification that does not require the detailed examination, the identification information of the medical examination data and the diagnosis information of the doctor are output.

FIG. 1B shows a case of comparing the CAD processing result with the doctor's image interpretation result. Information regarding the medical inquiry and medical history is input from the medical inquiry information input device HI, and image data, which is one type of medical examination data, is input from the image acquisition device IA. In the database DB to which these are input, CAD processing is performed on each image data, abnormality detection is performed, and an abnormality data table as a result is created. On the other hand, image data and inquiry information are stored in the database DB from the workstation W.
The image data is sent to S, where the image data is displayed and the image is read by a doctor. The image interpretation doctor creates and inputs a finding data table which is an image interpretation result for each image data. When the interpretation by the doctor is completed, this finding data table is compared with the abnormal data table that is the CAD processing result, and the results are classified and an abnormal detection result list that is the result is created, which can be output for each classification. . At the time of re-interpretation, the doctor outputs his / her favorite classification (including display) and completes the finding data, and the result is sent from the workstation WS to the database DB.
Send to and register there. Interpretation in the group medical examination is performed by two or more doctors, and at least two pieces of the completed finding data are sent to the database DB.
After a plurality of interpretations are input to the database DB, the operation is performed as described with reference to FIG.

FIG. 2 is for showing the main points of the second aspect of the invention, in which the information regarding the medical inquiry and the medical history is the medical inquiry information input device H.
Image data that is input from I and is a type of medical examination data is input from the image acquisition apparatus IA. In the database DB to which these are input, CAD processing is performed on each image data before interpretation by a doctor, and abnormality detection is performed. Then, an abnormal data table as a result is created. On the other hand, the doctor interprets the image based on the image data and the inquiry information sent from the database DB to the workstation WS.
In this case, the CAD processing result created previously can be referred to. The ones referred to at the time of this interpretation are registered in the CAD processing result reference list, and they are referred to when comparing and classifying the finding data table and the abnormal data table performed after the doctor completes the interpretation. I try to remove things and compare them. After comparison and classification, an abnormality detection result list that is the result is created, and thereafter, the same operation as in FIG. 1B is performed.

The broken line portion in the drawing indicates that it is not the point of the present invention. Further, although the CAD processing has been described in the example of being performed by the database DB, image data or the like may be sent to the workstation WS to be performed there.

FIG. 3 shows an example of the basic system configuration of PACS. This system consists of each device (subsystem) of 1) Interview information input device (HI) 2) Image collection device (IA) 3) Database (DB) 4) Workstation (WS). The medical inquiry information input device (HI) is a device for inputting medical inquiry information and medical history information obtained by a medical inquiry to an examinee. The image acquisition device (IA) includes an X-ray imaging device, an X-ray CT device,
It is a medical image acquisition device for PACS, such as an MRI device and a film digitizer. Here, it is assumed that the X-ray imaging apparatus is mounted on the examination car. The database (DB) is for storing various data generated during the medical examination work. Workstation (WS)
Is a database (DB) or image acquisition device (I
A digital image or the like sent from A) is appropriately processed to obtain a desired result, which is displayed or output. In this embodiment, it is used for interpretation of a captured image. Data transfer between these four types of devices is performed using a transportable and rewritable data storage medium such as a magneto-optical disk.

Next, the function of each device (subsystem) and its constituent elements will be described. The main functions and actions of the inquiry information input device (HI) will be described. ○ An inquiry sheet (contents of questions to the examinee) can be displayed. Fig. 4 shows the items on the questionnaire. ○ You can enter the identification information (examinee ID number) of the examinee. ○ You can enter and display the answer of the examinee to the items on the questionnaire. ○ The entered answer (interview information) and the identification information of the examinee can be written on the magneto-optical disk. The inquiry information input device (HI) can be easily realized by applying a commercially available personal computer. The structure is not related to the gist of the present invention, and thus the description thereof is omitted. Image acquisition device (IA)
First, the main functions will be described. ○ Digital image data can be collected. ○ It is possible to enter the identification information (examinee ID number) of the examinee. ○ You can enter and display information associated with inspections and images. ○ It is possible to write the identification information of the examinee, the image data, the information associated with the examination and the image on the magneto-optical disk. The components and functions of the image acquisition device (IA) will be described. The configuration of the image acquisition device (IA) is shown in FIG. Control device (IA-CTRL) Controls the operation of the entire image acquisition device, including the central processing unit (CPU) and system memory (which is a semiconductor memory). ● System disk (IA-SD) This is a magnetic disk, and (a) a program for operating the image acquisition device (b) identification information of the examinee (C) program and data such as information accompanying the examination and image I remember. This program is read when the power of the image acquisition device is turned on and written in the system memory in the control device (IA-CTRL). Further, the identification information of the examinee and the information associated with the examination and the image are stored each time the examination is performed, and the type of data is shown in FIG. 6 together with the data structure. ● X-ray generator (IA-XGEN) This is a device that generates X-rays to illuminate the subject. X-ray imaging device (IA-IMG) This is a device that detects X-rays that have passed through a subject, converts them into electrical signals, and digitizes them to obtain digital images. It includes image intensifiers, TV cameras, analog / digital converters, etc. Input device (IA-INPUT) A means for an operator to input information such as a command, and a keyboard, a mouse, a touch screen or the like is used. Display device (IA-DISP) A device for displaying information input by an operator and a collected digital image, such as a CRT display or a liquid crystal panel display. Image storage device (IA-IM) A device (for example, semiconductor memory or magnetic disk) that temporarily stores digital image data collected by an X-ray imaging device. ● Magneto-optical disk drive (IA-MODD) This is a device that reads and writes data from a portable magneto-optical disk. Control Bus (IA-CBUS) This is a transmission path for various control information in the image acquisition device. Image bus (IA-IBUS) This is a transmission path for image data in the image acquisition device. Although not shown in FIG. 6, the image acquisition device (I
A) has a built-in clock.

Regarding the database (DB), the main functions and actions will be described first. A database (DB) stores the identification information of the examinee, the inquiry information, the image data, the examination information, and the information associated with the image. ○ Keep the findings that are the result of the doctor's interpretation. ○ Detect a suspected abnormality from image data. ○ It is possible to write / read various data to / from a portable magneto-optical disk. About the database (DB)
The components and their functions are explained. Database (DB)
The configuration of is shown in FIG. Control unit (DB-CTRL) Controls the operation of the entire database including the central processing unit (CPU) and system memory (which is a semiconductor memory). ● System disk (DB-SD) This is a magnetic disk, which stores programs for operating the database. This program and the like are read when the database is powered on and written in the system memory in the control device (DB-CTRL). Search device (DB-SRCH) A device that has a function of searching for information that matches a given keyword according to an instruction from the control device (DB-CTRL) and returning the search result to the control device (DB-CTRL). is there. The search device includes a directory of information stored in the database and a search means. A magnetic disk is used as the storage means of the directory. Data storage device (DB-STRG) A device for storing identification information of a examinee, inquiry information, image data, examination information and information associated with an image, and a doctor's finding for a long time, and an optical disc is used. Image processing device (DB-IP) is a means for detecting an abnormality from an image, and when image data and data representing the type (disease) of the abnormality to be detected are input, the type of abnormality is detected and the abnormality is detected. The position and degree of are output. This includes a plurality of types of abnormality detecting means. That is, (a) means for detecting the shadow of a nodule of the lung in the front view of the plain X-ray image of the lung (b) means for detecting the shadow of the interstitial disease of the lung in the front view of the plain X-ray image of the chest. is there. These detecting means are disclosed in the following documents. (1) JP-A-02-185240 (Japanese Patent Application No. 63-3307)
24) (2) JP-A-02-152443 (Japanese Patent Application No. 63-3051)
33) (3) JP-A-01-125675 (Japanese Patent Application No. 63-1921)
71) ● Input device (DB-INPUT) A means for an operator to input information such as a command, and a keyboard, a mouse, a touch screen or the like is used. ● Magneto-optical disk drive (DB-MODD) This is a device that reads / writes data from / to a portable magneto-optical disk. Control Bus (DB-CBUS) This is a transmission path for various control information in the database. Image bus (DB-IBUS) This is a transmission path for image data in the database.

Regarding the workstation (WS), its main functions and actions will be described first. ○ Display the identification information of the examinee, interview information, image data, examination information and information accompanying the image, and the findings of the doctor. ○ For information about suspected detected abnormalities, display various information about the abnormality such as the type of abnormality (disease), its position, and the degree of abnormality. ○ You can enter the findings that are the results of the doctor's interpretation. ○ It is possible to write / read various data to / from a portable magneto-optical disk. Next, the workstation (W
The components of S) and their functions will be described. FIG. 8 is a configuration diagram of the workstation (WS). Control unit (WS-CTRL) Controls the operation of the entire workstation, including the central processing unit (CPU) and system memory (which is a semiconductor memory). ● System disk (WS-SD) This is a magnetic disk for storing programs. This program is read when the power of the workstation (WS) is turned on and is read by the controller (W
S-CTRL) in the system memory. Input device (WS-INPUT) A means for the operator to input information such as commands and interpretation reports (findings), and a keyboard, mouse, touch screen, etc. are used. The touch screen is mounted on the screen of the display device (WS-DISP). ● Data storage device (WS-MEM) This is a device that temporarily stores various data such as image data, and is a magnetic disk. Image frame memory (WS-IFM) A device for temporarily storing a large number of image data, which is a semiconductor memory.

Image Display Manager (WS-IDM) Controls operations for displaying images and overlays.
FIG. 9 is a configuration diagram of the image display manager (WS-IDM), and the inside of the broken line is the image display manager (WS-IDM).
Part of. This includes: a) Control unit This controls the entire components of the image display manager (WS-IDM). b) Overlay data creation unit that creates overlay data (that is in color) from the overlay display information. This includes a means for causing the specified data in the overlay display information to blink and display. c) Image memory for storing image data This is for one image (matrix size is 2,048 ×
It has a memory capacity of 2,048 pixels). d) Overlay memory for storing overlay data Since the overlay data is displayed in color, the overlay memory for one screen has 3 areas for red, green and blue.
It consists of one overlay memory. The matrix size of the overlay memory for each color is 2,048 × 2,048 pixels, and the bit length of one pixel is 1 bit. FIG. 10 shows the relationship between the display color and the bit value of each pixel. In FIG. 10, for example, as shown in the second row, the pixel value (pixel bit value) of the pixel coordinates (X, Y) of the overlay memory for red is 1, and the overlay memory for green and blue is not. If the pixel values at the same coordinate are both 0, then 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 the display color is superimposed on the image, only the image is displayed.

E) Overlay portion for superimposing image data and overlay data f) Display memory for storing display data This image display manager (WS-IDM) is for one image (matrix size is 2,048 × 2, It has two display memories (048 pixels). This is the same as the number of display devices (WS-DISP). The display memory and each display device (WS-DISP) are associated with each other. g) D / A converter for converting display data from digital data to analog data This is provided in the same number in association with each display device (WS-DISP). Then, the image display manager (WS-IDM) can receive the following information. (a) Type of data to be displayed Image only, overlay only, image and overlay 3
Which one? (b) Designation information of the display device (WS-DISP) that displays the data (c) Overlay display information For each figure, type of figure, size of figure, coordinates, display color, presence / absence of display (including blinking) control Information etc. (d) Image data When displaying an image with an overlay, it operates as follows. (1) The control unit of the image display manager (WS-IDM)
Workstation (WS) controller (WS-CTR
Receive the following three pieces of information from L). (a) "Image and overlay" as the type of data to be displayed (b) Display device number of the display device (WS-DISP) that displays data (c) Overlay display information (2) Image display manager (WS-IDM) , Receives image data, and writes it in the image memory. (3) The overlay data creation unit creates the overlay data based on the overlay display information according to an instruction from the control unit. Then, when the display presence / absence control information is “display”, the specified figure is created at the specified coordinates with the specified color data. (4) Image data and overlay data are read out according to an instruction from the control unit, input to the overlay unit, and data are combined. (5) The combined data is written in the display memory of the specified display device number. (6) The combined data is converted into analog data by the D / A converter. The above operations (4) to (6) are always repeated during display. Display of a figure with a certain coordinate (including blinking)
Only when the control information indicates “display”, the overlay data creation unit writes the graphic in the overlay memory to display the graphic. On the other hand, when only displaying images, in (1) above, (a) “image only” as the type of data to be displayed (b) the display device number of the display device that displays the data is received, and the overlay display information is received. Is not sent.
Then, in the above operation (4), the overlay data is not read, and therefore, the image data and the overlay data are not superposed.

Display device (WS-DISP) is a device for displaying characters, figures and images, and is a CRT.
A display or a liquid crystal panel display is used. Color display is possible. In this embodiment, the number is two. ● Magneto-optical disk drive (WS-MODD) A device that reads and writes data from a portable magneto-optical disk. ● Control Bus (WS-CBUS) This is a transmission line for various control information in the workstation. ● Image bus (WS-IBUS) This is a transmission path for image data and overlay data in the workstation. In addition, a clock (not shown) is incorporated in the workstation (WS) for referring to the date and time.

Using the PACS configured as above,
As an example, a flow of a series of system operations when a chest X-ray image is read in lung cancer screening will be described. The operations are performed in the following order. 1. Input of interview information 2. Collection of chest X-ray images 3. Registration of collected data 4. Preparation of interpretation data 5. Interpretation of image data 6. Output of interpretation results.

The above series of system operations will be described in detail below. 1. Input of inquiry information (1) Display of inquiry sheet Display the inquiry sheet on the display screen of the inquiry information input device (HI). (2) Input of inquiry information The operator inputs the patient identification information using the inquiry information input device (HI). The examinee identification information is assigned to the examinees so as not to be duplicated within the examination area, and here, the examinee ID number described in the ledger is entered. The input data is
It is displayed at a predetermined position on the screen. The operator inputs the answer obtained from the examinee by using the inquiry information input device (HI). The input data is displayed at a predetermined position on the screen. The above (1) and (2) are repeated for the number of people to be examined. (3) Writing inquiry information to magneto-optical disk The control device of the inquiry information input device (HI) stores the inquiry information (examinee identification information and answer from the examinee) stored in the system disk according to the operator's instruction. Read and write on a magneto-optical disk inserted in a magneto-optical disk drive (HI-MODD). The magneto-optical disk thus obtained is then transported to a place where a database (DB) is located.

2. Collection of chest X-ray images (1) Input of patient identification information The operator is the input device (IA) of the image acquisition device (IA).
-INPUT) to input the patient identification information. The input data is displayed at a predetermined position on the screen of the display device (IA-DISP). (2) Digital image acquisition controller (IA-CTRL) is an X-ray generator (IA-CTRL).
-XGEN) and the X-ray imaging device (IA-IMG) are instructed to perform X-ray irradiation and imaging. X-ray generator (IA-XGE
N) generates X-rays and irradiates the subject (examinee). The X-ray transmitted through the subject is detected by an X-ray imaging device (IA-IMG) to obtain a digital image. X-ray imaging device (IA
-IMG is for transferring image data to the image bus (IA-IBU).
S). As a result, an image storage device (IA-I
M) receives the image data and writes it to itself. The control device (IA-CTRL) writes information associated with imaging conditions and images in the system disk (IA-SD) together with the examinee identification information. The above (1) and (2) are repeated for the number of people to be examined. (3) Writing of data to magneto-optical disk The control device (IA-CTRL) reads out the information associated with the inspection and the image stored in the system disk (IA-SD) according to the operator's instruction, and drives the magneto-optical disk drive. Write on the magneto-optical disk inserted in (IA-MODD). The control device (IA-CTRL) subsequently reads the image data from the image storage device (IA-IM) and writes it on the magneto-optical disk inserted in the magneto-optical disk drive (IA-MODD). The magneto-optical disk thus obtained is then transported to a place where a database (DB) is located.

3. Registration of collected data The operator inserts the magneto-optical disk in which the inquiry information is recorded into the magneto-optical disk drive (DB-MODD) of the database (DB), and inputs the input device (DB-INP).
UT) to input the inquiry information reading command of the magneto-optical disk. Then, the magneto-optical disk drive (DB-MODD) is instructed by the controller (DB-CTRL).
Reads the inquiry information recorded on the magneto-optical disk and writes it in the data storage device (DB-STRG). The control device (DB-CTRL) extracts information to be registered in the data directory (hereinafter referred to as directory information; see FIG. 11) from the inquiry information, and the search device (DB-SRC).
H). The search device (DB-SRCH) stores the received directory information. In addition, the control device (DB
-CTRL) extracts image data of a patient who has been imaged in the past (hereinafter, referred to as past image data) from the data storage device (DB-STRG) from the patient identification information of the interview information, and the search device (DB). -SRCH). The search device (DB-SRCH) adds the received past image data to the directory information. An operator uses a magneto-optical disk drive (DB-MO) of a database (DB) to store a magneto-optical disk on which information associated with inspection and images and image data is recorded.
DD), and the image information read command of the magneto-optical disk is input from the input device (DB-INPUT).
Then, according to an instruction from the control device (DB-CTRL), the magneto-optical disk drive (DB-MODD) reads out information and image data associated with the inspection and the image recorded on the magneto-optical disk, and the data storage device (DB-MOD).
STRG). The control device (DB-CTRL) extracts the directory information from the information associated with the examination and the image and sends it to the search device (DB-SRCH). The search device (DB-SRCH) stores the received directory information.

4. Preparation of data for image interpretation (1) Anomaly detection from image After the registration of data, the control device (DB-CTRL) of the database (DB) becomes the search device (DB-SRC).
H) is instructed to search for images (images to be interpreted and past images), and an answer is obtained. Then, the following abnormality detection operation is performed for each image. The abnormalities detected are nodule shadows in the lungs. One piece of image data is read from the data storage device (DB-STRG) and sent to the image processing device (DB-IP). Upon receiving the image data, the image processing device (DB-IP) operates the lung nodule shadow detection means included therein to detect the position on the image of the suspected abnormality. The detected position of the abnormality is recognized in an absolute coordinate system as shown in FIG. 12, in which the image upper end and the image left end are coordinate axes.
It is written in the abnormal data table as shown in FIG. In the image of the inspection ID number 920001, N1 (700,1200), N2 (1
Anomalous shadows have been detected at two locations (500, 1000). In the abnormality determination of the entire image, if no abnormality is detected at all, it is “normal”, and if at least one abnormality is detected, it is “suspicious of abnormality”. Since an abnormality is detected in the image of the inspection ID number 920001, the abnormality determination of the entire image is “suspicion of abnormality”. The abnormal data table which is the detection result is stored in the data storage device (DB-STRG). Inspection ID number
Abnormal data tables for images 920002 to 920005 are shown in FIGS. 14 to 17. (2) Preparation of interpretation data When the abnormality detection process from the image is completed, the database (D
The control device (DB-CTRL) of B) reads the image data to be interpreted, the past image data, the inquiry information, the examination and the information associated with the image (including the abnormal data table) to the data storage device (DB-STRG). , Write to the magneto-optical disk drive (DB-MODD). The data storage device (DB-STRG) reads out these data and sends them to the image bus (DB-IBUS). The magneto-optical disk drive (DB-MODD) receives these data and writes them on the magneto-optical disk. Interpretation is performed by two doctors in the group medical examination. Therefore, two pieces of this magneto-optical disk are prepared, and one piece is carried to each of the two workstations (WS).

5. Interpretation of Image Data (1) Input of Interpretation Data to Workstation (WS)
Insert the magneto-optical disk on which the inquiry information, inspection and information associated with the image are recorded into the magneto-optical disk drive (WS-MODD) of the workstation (WS), and from the input device (WS-INPUT) to the magneto-optical disk. Input the data read command. Then, in accordance with an instruction from the control device (WS-CTRL), the magneto-optical disk drive (WS-MODD) reads the data recorded on the magneto-optical disk, and the data storage device (WS-ME).
Write in M). The image data to be interpreted, the past image data, the inquiry information, the information associated with the examination and the image are stored in association with each examinee. (2) Image display The workstation (WS) displays the image to be interpreted. Now, since there are two display devices (WS-DISP), one image of the interpretation target (inspection ID number 920001) is displayed on the left display device (WS-DISP) as a past image (inspection ID).
No. 910041) is automatically displayed on the right display device (WS-DISP). When an image is displayed on the display device (WS-DISP), the examination ID number (in the image accompanying information) is displayed.

(3) Input of Interpretation Findings From the interpretation of images to the input of the findings, the following steps are performed. (a) Interpretation doctor reads the displayed image. When displaying an image or an image interpretation report other than the displayed image, a command for that is input from the input device (WS-INPUT) and operated. (b) After completing the image interpretation, the doctor points out the position of the lung nodular shadow on the image to be interpreted with the mouse. Controller (W
S-CTRL) reads and stores the coordinates of the input abnormal position, and creates a finding data table as shown in FIG. Then, the image display manager (WS-IDM)
With reference to the finding data table, overlay display information "arrow, coordinates of abnormal position, white, display" is created for the abnormality of each finding number. The created overlay display information is shown in FIG. Image display manager (WS-ID
M) creates and displays an overlay according to the overlay display information. As a result, an arrow is displayed at the position pointed out by the doctor on the image. Controller (WS-CTRL)
Writes the created overlay display information in the data storage device (WS-MEM) in association with the inspection ID number. (c) Interpretation doctor, when abnormality except lung nodule is recognized,
Input device for abnormal type selection command (WS-INPUT)
Select from the displayed abnormality types and select the corresponding abnormality type. Next, the abnormal position is input, but the abnormal position input method differs depending on the type of abnormality. For example,
In the case of pulmonary interstitial disease, the abnormal range is entered by enclosing it with a closed curve using a mouse. In this case, the control device (WS-
CTRL) stores an area instead of a position. Do the same operation to add information about anomalies to the overlay,
Store and display on image. (d) The radiogram interpreter inputs an image interpretation end command after inputting all the detected abnormalities. Controller (WS-CTRL)
When an abnormality is input to the finding data table, the diagnosis result of the entire image is set as “abnormal”, and when no abnormality is input, the diagnosis result of the entire image is set as “normal” and written in the finding data table, and the data is stored. Stored in the device (WS-MEM).

(4) Comparison and Classification of Diagnostic Information The control device (WS-CTRL) uses the data storage device (WS-MEM) to output the finding data table which is the image interpretation result and the corresponding abnormal data table which is the CAD processing result. read out. 5.
In the same way as the overlay display information was created from the finding data table in (3) of section 3, the overlay display information was created from the abnormal data table with the display color set to "red" and was associated with the inspection ID number to the data storage device (WS). -MEM). FIG. 20 shows overlay display information created from the abnormal data table of the CAD processing result regarding the inspection ID number 920001.
The control device (WS-CTRL) extracts the diagnosis result of the entire image from the finding data table and the determination result of the entire image of the CAD processing from the abnormal data table, compares both, and classifies them into the following four. Case a: The doctor says “abnormal” but CAD is “normal”
And Case b: The doctor judged "abnormal" and CAD also "suspicious of abnormal". Case c: Doctor is “normal”, CAD is also “normal”
And Case d: The doctor judged “normal”, but the CAD judged “abnormal”. For example, with respect to the inspection ID number 920001, the doctor has determined “abnormal” and the CAD also has “suspected of abnormality”, and thus is classified into case b. Subsequent operations differ depending on the classification result. The possible operations are described below. (a) When classified into case a, the following operations are possible. (a-1) Register the inspection ID number in the abnormality detection result list. (a-2) Do nothing. (b) When classified into case b, the following operations are possible. (b-1) Refer to the findings data table and the anomaly data table and compare and classify the anomaly type and its location. The type of abnormality and the inspection ID number of an image whose position does not match are registered in the abnormality detection result list. (b-2) Do nothing. (c) If classified into case c, do nothing. (d) When classified into case d, the following operations are possible. (d-1) Register the inspection ID number in the abnormality detection result list. (d-2) Do nothing. Here, each operation of (a-1), (b-1), and (d-1) will be described. Regarding the operations of (a-1) and (d-1): The control device (WS-CTRL) reads the abnormality detection result list (creates it if it does not exist), writes the inspection ID number, and writes it in the data storage device ( WS-MEM). The operation of (b-1) will be described with an example of the inspection ID number 920001. Looking at finding numbers 1 and 2 with reference to FIG. 18, the type of abnormality is a lung nodule. In the lung nodule, the CAD processing target range is the entire image. The method of pointing out the abnormal position is the same for the doctor and CAD, and is indicated by an arrow on the overlay. Therefore, the abnormal position is assumed to be indicated by the tip of the arrow, and its coordinates are obtained. From FIG. 13 and FIG. 18, respective coordinates are A1 (1520,1040), A2 (1430,659), N1 (700,120).
0) and N2 (1500,1000). Abnormality A pointed out by the doctor
If the distance between 1, A2 and the abnormalities N1 and N2 detected by CAD is equal to or smaller than a predetermined value A0 (= 100), the same abnormal position is indicated. Comparison of A1 and N1: √ {(1520- 700) ² + (1040-120
0) ² } = 835> 100 Comparison of A1 and N2: √ {(1520-1500) ² + (1040-100
0) ² } = 45 <100 Comparison of A2 and N1: √ {(1430- 700) ² + (659-120
0) ² } = 909> 100 Comparison of A2 and N2: √ {(1430-1500) ² + (659-100
0) ² } = 348> 100 Therefore, it is assumed that A1 and N2 indicate the same abnormality, and the display presence / absence control information of N2 of the overlay display information of the CAD processing result is rewritten from “display” to “non-display”. . It is assumed that N1 is detected only by CAD and not specified by the doctor, and the display presence / absence control information remains "display".
Further, it is assumed that A2 is discovered only by the doctor and no CAD is detected. In this way, there is an abnormality that the doctor overlooked, or the doctor has overdiagnosed.
When the abnormalities pointed out by the
-CTRL) writes the inspection ID number of this image in the abnormality detection result list.

(5) Display of comparison result and creation of abnormality detection result list 5. Repeat steps (1) to (4) for all images to be interpreted.
FIG. 21 shows a part of the results obtained by extracting and comparing diagnostic results and determination results for the entire image from the doctor's findings data table and CAD abnormal data table. Interpreted image is inspection I
There are 50 sheets of D numbers 920001 to 920050. The classification results were as follows: Case a: 5 sheets, Case b: 15 sheets, Case c: 26 sheets, Case d: 4 sheets. After that, the control device (WS-CTRL)
5. Display the classification results in (4) of (WS-DIS
P) is displayed as shown in FIG. The doctor of
Select the operation after classification described in (4). Input device (WS
-INPUT) to input a motion selection command to select a motion suitable for one's thoughts. In this embodiment, (a-2),
(b-2) and (d-1) will be selected. When the command is input, the control unit (WS-CTRL) performs the operation (d-1) to create the abnormality detection result list.

(6) Reinterpretation and reference of abnormality detection result The doctor inputs a reinterpretation command. Then, the control device (WS-CTRL) displays the inspection I in the abnormality detection result list.
The data storage device stores the image data to be interpreted for which the D number is registered and the information regarding the examinee (interview information, information associated with examinations and images (abnormality data table, finding data table, overlay display information), past image data) (WS-M
EM), the image to be interpreted and the overlay which is one's own observation are overlaid, and two display devices (WS-DIS)
P) is displayed on the display device on the left side (WS-DISP), and the image on the right side is overlapped with the overlay which is the result of the CAD processing for that image (WS-DISP).
To display. The doctor reads the image, finds his findings and CAD
Compare the processing results. When displaying an image or an image interpretation report other than the displayed image, a command for that is input from the input device (WS-INPUT) and operated. When the doctor finishes reading the image and finds an abnormal shadow, the doctor points the position on the image to be read with a mouse. It is also possible to correct the abnormal position pointed out previously with the mouse. After that, 5. Perform the same operations as in (3) and (c) of to input all the detected anomalies. Controller (WS-CTRL)
Displays the corrected finding data table in the data storage device (WS-M
EM) and overlay and CAD of the next image and doctor's findings stored in the abnormality detection result list
Display processing result overlay (WS-DISP)
To display. Above, the procedure described in (6) is performed for all images registered in the abnormality detection result list.

(7) Writing of Finding Data to the Magneto-Optical Disk The control device (WS-CTRL) reads the finding data table for all the images to be read from the data storage device (WS-MEM), and drives the magneto-optical disk drive (WS). -MODD)
Write on the magneto-optical disk inserted in. These 5. of
The operations from (1) to (7) are performed in two places.

6. Output of interpretation results (1) Registration of finding data in the database The operator inserts the magneto-optical disk in which the finding data is additionally recorded into the magneto-optical disk drive (DB-MODD) of the database (DB), and inputs the device ( DB-I
NPUT) to input a finding data read command of the magneto-optical disk. Then, the control device (DB-CTR
L), the magneto-optical disk drive (DB-M
ODD) reads the finding data recorded on the magneto-optical disk and writes it in the data storage device (DB-STRG). The control device (DB-CTRL) extracts the directory information from the finding data, and the search device (DB-SRCH)
Send to. The search device (DB-SRCH) stores the received directory information. The other magneto-optical disk is also registered in the database by the same operation. As a result, the finding data of two doctors regarding the same examination image was input to the database.

(2) Extraction of required detailed inspection personnel The operator uses the input device (D) of the database (DB).
B-INPUT), enter the detailed inspection person extraction command and the operation selection command. Then, the control device (DB-CT
In accordance with the instruction of RL), the search device (DB-SRCH) searches the finding data table of the chest X-ray examination for which the comprehensive determination of the image interpretation result (determination of necessity of detailed examination) has not been made, and the examinee identification information and The diagnostic result information of the two doctors is read into the system memory of the control device (DB-CTRL). The control device (DB-CTRL) extracts the diagnostic results of the two doctors of each examinee from the finding data table and makes the following comparison. Case α: When the two diagnostic results are both “normal” Case β: One of the diagnostic results is “abnormal” and the other is “normal”
Case γ: When the two diagnostic results are both “abnormal” The determination method for the comprehensive judgment can be selected. In case α, which is selected from the following, the comprehensive determination is “normal”.
In case β, the following two choices are possible. (Β-1): The comprehensive judgment is “abnormal”. (Β-2): The comprehensive judgment is “normal”. In case γ, the following two choices are possible. (Γ-1); Nothing is done and the comprehensive judgment is “abnormal”. (Γ-2); Regarding the abnormal positions of the two finding data tables,
5. (4) The diagnostic information is compared and classified, and the abnormal position is classified and classified according to the type of abnormality. In this case as well, the comprehensive judgment is “abnormal”. From the input device (DB-INPUT), the operator
In the present embodiment, the command for selecting the above (β-1) and (γ-1) was input at the same time as the detailed inspector extraction command. Then, the comprehensive judgment is associated with the examinee identification information, transferred to the data storage device (DB-STRG) and the search device (DB-SRCH), and stored.

(3) Output of Interpretation Result The control device (DB-CTRL) reads the comprehensive judgment from the data storage device (DB-STRG), and if the comprehensive judgment result is "normal", The judgment result is written in the magneto-optical disk in association with the recipient identification information and the recipient name. If the comprehensive judgment result is "abnormal",
The control device (DB-CTRL) is a search device (DB-SRC).
H) is instructed to retrieve and read the image to be interpreted from the data storage device (DB-STRG). The finding data tables of the two doctors and the images for comprehensive judgment and interpretation are written in the magneto-optical disk in association with the recipient identification information and the recipient name. The magneto-optical disk is taken to the person to be reported. This completes the flow of a series of system operations for interpretation of chest X-ray images in lung cancer screening.

Next, an embodiment of the second invention of the present application will be described. As described in FIGS. 1 and 2, in the second invention of the present application, as in the first invention, a series of system operation flows are performed in the following order. 1. Input of interview information 2. Collection of chest X-ray images 3. Registration of collected data 4. Preparation of interpretation data 5. Interpretation of image data 6. Output of interpretation result And the above 1. To 3. Up to this point, the description is omitted because it is exactly the same as the first invention. An example of interpretation of a chest X-ray image in lung cancer screening similar to that of the first invention will be described below.

4. Preparation of data for image interpretation (1) Anomaly detection from image After the registration of data, the control device (DB-CTRL) of the database (DB) becomes the search device (DB-SRC).
H) is instructed to search for images (images to be interpreted and past images), and an answer is obtained. Then, the following abnormality detection operation is performed for each image. The abnormalities detected are nodule shadows in the lungs. One piece of image data is read from the data storage device (DB-STRG) and sent to the image processing device (DB-IP). Upon receiving the image data, the image processing device (DB-IP) operates the lung nodule shadow detection means included therein to detect the position on the image of the suspected abnormality. The detected position of the abnormality is recognized in an absolute coordinate system as shown in FIG. 12, in which the image upper end and the image left end are coordinate axes.
It is written in the abnormal data table as shown in FIG. In the image of the inspection ID number 920001, N1 (700,1200), N2 (1
Anomalous shadows have been detected at two locations (500, 1000). In the abnormality determination of the entire image, if no abnormality is detected at all, it is “normal”, and if at least one abnormality is detected, it is “suspicious of abnormality”. Since an abnormality is detected in the image of the inspection ID number 920001, the abnormality determination of the entire image is “suspicion of abnormality”. The abnormal data table which is the detection result is stored in the data storage device (DB-STRG). Inspection ID number
Abnormal data tables for images 920002 to 920005 are shown in FIGS. 14 to 17. (2) Preparation of interpretation data When the abnormality detection process from the image is completed, the database (D
The control device (DB-CTRL) of B) reads the image data to be interpreted, the past image data, the inquiry information, the examination and the information associated with the image (including the abnormal data table) to the data storage device (DB-STRG). , Write to the magneto-optical disk drive (DB-MODD). The data storage device (DB-STRG) reads out these data and sends them to the image bus (DB-IBUS). The magneto-optical disk drive (DB-MODD) receives these data and writes them on the magneto-optical disk. Interpretation is performed by two doctors in the group medical examination. Therefore, two pieces of this magneto-optical disk are prepared, and one piece is carried to each of the two workstations (WS).

5. Interpretation of Image Data (1) Input of Interpretation Data to Workstation (WS)
Insert the magneto-optical disk on which the inquiry information, inspection and information associated with the image are recorded into the magneto-optical disk drive (WS-MODD) of the workstation (WS), and from the input device (WS-INPUT) to the magneto-optical disk. Input the data read command. Then, in accordance with an instruction from the control device (WS-CTRL), the magneto-optical disk drive (WS-MODD) reads the data recorded on the magneto-optical disk, and the data storage device (WS-ME).
Write in M). The image data to be interpreted, the past image data, the inquiry information, the information associated with the examination and the image are stored in association with each examinee. Controller (W
S-CTRL) creates overlay display information from the abnormal data table and stores it in the data storage device (WS-MEM) in association with the inspection ID number. Inspection ID number 920001
20 shows the overlay display information created from the abnormal data table. Similarly, overlay display information is created for each examination ID number.

(2) Image Display The workstation (WS) displays an image to be interpreted. Now, since there are two display devices (WS-DISP), one image to be interpreted (examination ID number 920001) is automatically displayed on the left display device (WS-DISP). When an image is displayed on the display device (WS-DISP), the examination ID number (in the image accompanying information) is displayed.

(3) Input of Interpretation Findings From the interpretation of images to the input of the findings, the following steps are performed. (a) Interpretation doctor reads the displayed image. When displaying an image or an image interpretation report other than the displayed image, a command for that is input from the input device (WS-INPUT) and operated. When referring to the CAD processing result, CA
D When displaying the processing result, input device (WS-INP
UT) to input a CAD processing result display command. Then, the control device (WS-CTRL) instructs the image display manager (WS-IDM) to create the overlay in accordance with the overlay display information, and then the left display device (WS-D).
It is displayed while being superimposed on the image to be read by ISP).
The inspection ID number is registered in the D processing result reference list and stored in the data storage device (WS-MEM). To delete the CAD processing result, input device (WS-INPU)
Input the CAD processing result deletion command from T). Then, the control device (WS-CTRL) instructs the image display manager (WS-IDM) to erase the overlay. (b) After completing the image interpretation, the doctor points out the position of the lung nodular shadow on the image to be interpreted with the mouse. Controller (W
S-CTRL) reads and stores the coordinates of the input abnormal position, and creates a finding data table as shown in FIG. Then, the image display manager (WS-IDM)
With reference to the finding data table, overlay display information "arrow, coordinates of abnormal position, white, display" is created for the abnormality of each finding number. The created overlay display information is shown in FIG. Image display manager (WS-ID
M) creates and displays an overlay according to the overlay display information. As a result, an arrow is displayed at the position pointed out by the doctor on the image. Controller (WS-CTRL)
Writes the created overlay display information in the data storage device (WS-MEM) in association with the inspection ID number. (c) Interpretation doctor, when abnormality except lung nodule is recognized,
Input device for abnormal type selection command (WS-INPUT)
Select from the displayed abnormality types and select the corresponding abnormality type. Next, the abnormal position is input, but the abnormal position input method differs depending on the type of abnormality. For example,
In the case of pulmonary interstitial disease, the abnormal range is entered by enclosing it with a closed curve using a mouse. In this case, the control device (WS-
CTRL) stores an area instead of a position. Do the same operation to add information about anomalies to the overlay,
Store and display on image. (d) The radiogram interpreter inputs an image interpretation end command after inputting all the detected abnormalities. Controller (WS-CTRL)
When an abnormality is input to the finding data table, the diagnosis result of the entire image is set as “abnormal”, and when no abnormality is input, the diagnosis result of the entire image is set as “normal” and written in the finding data table, and the data is stored. Stored in the device (WS-MEM).

(4) Comparison and Classification of Diagnostic Information The control device (WS-CTRL) stores the finding data table which is the image interpretation result, the abnormal data table which is the corresponding CAD processing result and the CAD processing result reference list in the data storage device. (W
S-MEM). When the examination ID number is registered in the CAD processing result reference list, the diagnostic information is not compared. In this case, classify into case e below.
Complete (4). Case e: The doctor has already referred to the CAD processing result at the time of image interpretation. When the inspection ID number is not registered in the CAD processing result reference list, the control device (WS-CTRL) displays the diagnosis result of the entire image from the finding data table and the determination result of the entire image of the CAD processing from the abnormal data table. It is extracted, and both are compared and classified into the following four. Case a: The doctor says “abnormal” but CAD is “normal”
And Case b: The doctor judged "abnormal" and CAD also "suspicious of abnormal". Case c: Doctor is “normal”, CAD is also “normal”
And Case d: The doctor judged “normal”, but the CAD judged “abnormal”. For example, with respect to the inspection ID number 920001, the doctor has determined “abnormal” and the CAD also has “suspected of abnormality”, and thus is classified into case b. Subsequent operations differ depending on the classification result. The possible operations are described below. (a) When classified into case a, the following operations are possible. (a-1) Register the inspection ID number in the abnormality detection result list. (a-2) Do nothing. (b) When classified into case b, the following operations are possible. (b-1) Refer to the findings data table and the anomaly data table and compare and classify the anomaly type and its location. The type of abnormality and the inspection ID number of an image whose position does not match are registered in the abnormality detection result list. (b-2) Do nothing. (c) If classified into case c, do nothing. (d) When classified into case d, the following operations are possible. (d-1) Register the inspection ID number in the abnormality detection result list. (d-2) Do nothing. Here, each operation of (a-1), (b-1), and (d-1) will be described. Regarding the operations of (a-1) and (d-1): The control device (WS-CTRL) reads the abnormality detection result list (creates it if it does not exist), writes the inspection ID number, and writes it in the data storage device ( WS-MEM). The operation of (b-1) will be described with an example of the inspection ID number 920001. Looking at finding numbers 1 and 2 with reference to FIG. 18, the type of abnormality is a lung nodule. In the lung nodule, the CAD processing target range is the entire image. The method of pointing out the abnormal position is the same for the doctor and CAD, and is indicated by an arrow on the overlay. Therefore, the abnormal position is assumed to be indicated by the tip of the arrow, and its coordinates are obtained. From FIG. 13 and FIG. 18, respective coordinates are A1 (1520,1040), A2 (1430,659), N1 (700,120).
0) and N2 (1500,1000). Abnormality A pointed out by the doctor
If the distance between 1, A2 and the abnormalities N1 and N2 detected by CAD is equal to or smaller than a predetermined value A0 (= 100), the same abnormal position is indicated. Comparison of A1 and N1: √ {(1520- 700) ² + (1040-120
0) ² } = 835> 100 Comparison of A1 and N2: √ {(1520-1500) ² + (1040-100
0) ² } = 45 <100 Comparison of A2 and N1: √ {(1430- 700) ² + (659-120
0) ² } = 909> 100 Comparison of A2 and N2: √ {(1430-1500) ² + (659-100
0) ² } = 348> 100 Therefore, it is assumed that A1 and N2 indicate the same abnormality, and the display presence / absence control information of N2 of the overlay display information of the CAD processing result is rewritten from “display” to “non-display”. . It is assumed that N1 is detected only by CAD and not specified by the doctor, and the display presence / absence control information remains "display".
Further, it is assumed that A2 is discovered only by the doctor and no CAD is detected. In this way, there is an abnormality that the doctor overlooked, or the doctor has overdiagnosed.
When the abnormalities pointed out by the
-CTRL) writes the inspection ID number of this image in the abnormality detection result list.

(5) Display of comparison result and creation of abnormality detection result list 5. Repeat steps (1) to (4) for all images to be interpreted.
FIG. 21 shows a part of the results obtained by extracting and comparing diagnostic results and determination results for the entire image from the doctor's findings data table and CAD abnormal data table. Interpreted image is inspection I
There are 60 sheets of D numbers 920001 to 920060. The classification results were: case a: 5 sheets, case b: 15 sheets, case c: 26 sheets, case d: 4 sheets, case e: 10 sheets. After that, the control device (WS-CTRL)
5. Display the classification results in (4) of (WS-DIS
P) is displayed as shown in FIG. The doctor of
Select the operation after classification described in (4). Input device (WS
-INPUT) to input a motion selection command to select a motion suitable for one's thoughts. In this embodiment, (a-2),
(b-2) and (d-1) will be selected. When the command is input, the control unit (WS-CTRL) performs the operation (d-1) to create the abnormality detection result list.

(6) Reinterpretation and reference of abnormality detection result The doctor inputs a reinterpretation command. Then, the control device (WS-CTRL) displays the inspection I in the abnormality detection result list.
The data storage device stores the image data to be interpreted for which the D number is registered and the information regarding the examinee (interview information, information associated with examinations and images (abnormality data table, finding data table, overlay display information), past image data) (WS-M
EM), the image to be interpreted and the overlay which is one's own observation are overlaid, and two display devices (WS-DIS)
P) is displayed on the display device on the left side (WS-DISP), and the image on the right side is overlapped with the overlay which is the result of the CAD processing for that image (WS-DISP).
To display. The doctor reads the image, finds his findings and CAD
Compare the processing results. When displaying an image or an image interpretation report other than the displayed image, a command for that is input from the input device (WS-INPUT) and operated. When the doctor finishes reading the image and finds an abnormal shadow, the doctor points the position on the image to be read with a mouse. It is also possible to correct the abnormal position pointed out previously with the mouse. After that, 5. Perform the same operations as in (3) and (c) of to input all the detected anomalies. Controller (WS-CTRL)
Displays the corrected finding data table in the data storage device (WS-M
EM) and overlay and CAD of the next image and doctor's findings stored in the abnormality detection result list
Display processing result overlay (WS-DISP)
To display. Above, the procedure described in (6) is performed for all images registered in the abnormality detection result list.

(7) Writing of Finding Data to the Magneto-Optical Disk The control device (WS-CTRL) reads the finding data table for all the images to be read from the data storage device (WS-MEM), and drives the magneto-optical disk drive (WS). -MODD)
Write on the magneto-optical disk inserted in. These 5. of
The operations from (1) to (7) are performed in two places.

6. Output of interpretation results (1) Registration of finding data in the database The operator inserts the magneto-optical disk in which the finding data is additionally recorded into the magneto-optical disk drive (DB-MODD) of the database (DB), and inputs the device ( DB-I
NPUT) to input a finding data read command of the magneto-optical disk. Then, the control device (DB-CTR
L), the magneto-optical disk drive (DB-M
ODD) reads the finding data recorded on the magneto-optical disk and writes it in the data storage device (DB-STRG). The control device (DB-CTRL) extracts the directory information from the finding data, and the search device (DB-SRCH)
Send to. The search device (DB-SRCH) stores the received directory information. The other magneto-optical disk is also registered in the database by the same operation. As a result, the finding data of two doctors regarding the same examination image was input to the database.

(2) Extraction of required detailed inspection personnel The operator is the input device (D) of the database (DB).
B-INPUT), enter the detailed inspection person extraction command and the operation selection command. Then, the control device (DB-CT
In accordance with the instruction of RL), the search device (DB-SRCH) searches the finding data table of the chest X-ray examination for which the comprehensive determination of the image interpretation result (determination of necessity of detailed examination) has not been made, and the examinee identification information and The diagnostic result information of the two doctors is read into the system memory of the control device (DB-CTRL). The control device (DB-CTRL) extracts the diagnostic results of the two doctors of each examinee from the finding data table and makes the following comparison. Case α: When the two diagnostic results are both “normal” Case β: One of the diagnostic results is “abnormal” and the other is “normal”
Case γ: When the two diagnostic results are both “abnormal” The determination method for the comprehensive judgment can be selected. In case α, which is selected from the following, the comprehensive determination is “normal”.
In case β, the following two choices are possible. (Β-1): The comprehensive judgment is “abnormal”. (Β-2): The comprehensive judgment is “normal”. In case γ, the following two choices are possible. (Γ-1); Nothing is done and the comprehensive judgment is “abnormal”. (Γ-2); Regarding the abnormal positions of the two finding data tables,
5. (4) The diagnostic information is compared and classified, and the abnormal position is classified and classified according to the type of abnormality. In this case as well, the comprehensive judgment is “abnormal”. From the input device (DB-INPUT), the operator
In the present embodiment, the command for selecting the above (β-1) and (γ-1) was input at the same time as the detailed inspector extraction command. Then, the comprehensive judgment is associated with the examinee identification information, transferred to the data storage device (DB-STRG) and the search device (DB-SRCH), and stored.

(3) Output of interpretation result The control device (DB-CTRL) reads the comprehensive judgment from the data storage device (DB-STRG), and if the comprehensive judgment result is "normal", The judgment result is written in the magneto-optical disk in association with the recipient identification information and the recipient name. If the comprehensive judgment result is "abnormal",
The control device (DB-CTRL) is a search device (DB-SRC).
H) is instructed to retrieve and read the image to be interpreted from the data storage device (DB-STRG). The finding data tables of the two doctors and the images for comprehensive judgment and interpretation are written in the magneto-optical disk in association with the recipient identification information and the recipient name. The magneto-optical disk is taken to the person to be reported. This completes the flow of a series of system operations for interpretation of chest X-ray images in lung cancer screening.

The findings and CAD which are the results of the doctor's image interpretation
The processing results are compared and classified, and the classified ones can be selected after the comparison, but the selection time may be specified in advance before the image interpretation, or a plurality of images may be obtained after the image interpretation, or not selected. It may be fixed to the recommended shape. You can select the operation after comparing the findings of multiple doctors when extracting the detailed examination required in the database, but the selection can be done before the data input to the database, at the time of input, or at the time of comparison. However, it may be fixed to the recommended shape without selecting it. In the present embodiment, the display method of the comparison result uses the form of an ellipse set, but is not limited to this, various sets such as rectangles, various graphs such as bars and circles, itemization, any of Good. Further, in the embodiment of the second aspect of the invention, the reference time of the CAD processing result is before the doctor's input of the findings, but the present invention is not limited to this and may be after the input of the doctor.

Further, in this embodiment, the offline PAC is used.
Although the implementation on the S has been described, the present invention is not limited to this and may be performed on the online PACS. Although medical images have been described in the present embodiment, medical examination data other than images, that is, data in the form of graphs such as electrocardiograms and electroencephalograms, or data in which numerical values obtained by an automatic chemical analyzer are arranged Good. In the present embodiment, the examination of lung cancer was described using an example of a chest X-ray image, but it may be an examination or examination of an organ of the digestive system other than the chest, such as the stomach.

[0053]

As described above, according to the present invention, it is not necessary for the doctor to specify the images to be reinterpreted one by one, but only the displayed set need be specified, which reduces the workload of the doctor. it can. In addition, the doctor can use the CAD at the time of image interpretation to prevent oversight in a medical examination or the like. Furthermore, even if CAD is used, the working time hardly increases. Since an image that has been diagnosed by referring to the CAD processing result and an image that has been diagnosed by a doctor alone can be distinguished, the image that has been diagnosed by referring to the CAD processing result is removed when reinterpreting. This eliminates the need for wasting time during image interpretation.

It is possible to eliminate the work of a person who is involved in the mass examination at the center, or at least to greatly reduce the work amount. In addition, the period from the inspection to the output of the inspection result can be shortened.

[Brief description of drawings]

FIG. 1 is a flowchart for explaining the main points of the present invention.

FIG. 2 is a flowchart for explaining the main points of the present invention.

FIG. 3 is a basic system configuration diagram of PACS.

FIG. 4 is a diagram showing items described in a medical inquiry table.

FIG. 5 is a configuration diagram of an image collection device.

FIG. 6 is a diagram showing a data type and a data structure of information about an examinee's identification, information associated with an examination and an image.

FIG. 7 is a configuration diagram of a database.

FIG. 8 is a configuration diagram of a workstation.

FIG. 9 is a configuration diagram of an image display manager.

FIG. 10 is a diagram showing a relationship between a display color and a bit value of a pixel in an overlay memory.

FIG. 11 is a diagram showing an example of data types of directory information.

FIG. 12 is a diagram showing a coordinate system of an image.

FIG. 13 is a diagram showing an abnormal data table.

FIG. 14 is a diagram showing an abnormal data table.

FIG. 15 is a diagram showing an abnormal data table.

FIG. 16 is a diagram showing an abnormal data table.

FIG. 17 is a diagram showing an abnormal data table.

FIG. 18 is a diagram showing a finding data table.

FIG. 19 is a diagram showing overlay display information (a doctor's finding).

FIG. 20 is a diagram showing overlay display information (CAD processing result).

FIG. 21 is a diagram showing classified results of comparison.

FIG. 22 is a diagram showing a set of classifications of comparison results.

FIG. 23 is a view showing a set of classifications of comparison results.

FIG. 24 is a diagram showing an image interpretation method when a doctor is involved in image interpretation.

[Explanation of symbols]

 HI Interview information input device IA image acquisition device DB database WS workstation

 ─────────────────────────────────────────────────── ─── Continuation of the front page (72) Inventor Takehiro Ema 1385-1 Shimoishigami, Otawara-shi, Tochigi Prefecture Toshiba Medical Engineering Co., Ltd.

Claims (16)

[Claims] 1. Means for inputting a plurality of diagnostic results having one or more pieces of diagnostic information obtained from medical examination data, and means for comparing and classifying a plurality of inputted diagnostic results for each medical examination data. A medical diagnosis support system comprising: means for storing the medical examination data or identification information of the medical examination data according to the classification result; and means for outputting the medical examination data or the identification information of the medical examination data. 2. The medical diagnosis support system according to claim 1, wherein the diagnosis result is diagnosis information indicating abnormality or normality of each medical examination data. 3. The medical diagnosis support system according to claim 1, wherein the diagnosis result is diagnostic information indicating the type of abnormality (disease) and the position of the abnormality in the medical examination data. 4. The medical diagnosis support system according to claim 3, wherein, when comparing the diagnostic results, it is determined for each type of abnormality (disease) whether the positions of the abnormality match. 5. The medical diagnosis support system according to each of the claims, wherein in addition to the medical examination data or the identification information of the medical examination data, information related to the medical examination data is output. 6. The medical diagnosis support system according to each of the claims, wherein the presence or absence of output and the content to be output can be selected according to the result of comparison and classification. 7. In each of the above claims, there is provided means for computer processing medical examination data to obtain a large amount of diagnostic information, and one of a plurality of diagnostic results to be compared is obtained by computer processing medical examination data. A medical diagnosis support system, which is a diagnostic result obtained. 8. The medical diagnosis support system according to each of the claims, wherein the medical examination data is a medical image. 9. A means for inputting a plurality of diagnostic results having one or more pieces of diagnostic information obtained from medical examination data, and it is possible to refer to previously inputted diagnostic results when making a diagnosis from the medical examination data. In the case of reference, means for detecting and storing it, means for comparing and classifying this diagnosis result and the previously input diagnosis result for each medical examination data, and a means for storing at the time of this comparison The diagnostic information written in the means is excluded, the means for collectively storing the medical examination data or the identification information of the medical examination data according to the classification result, and the medical examination data or the identification information of the medical examination data are stored. And a means for outputting the medical diagnosis support system. 10. The medical diagnosis support system according to claim 9, wherein the previously input diagnosis result is a diagnosis result obtained by computer processing medical examination data. 11. The medical diagnosis support system according to claim 9, wherein the diagnosis result is diagnostic information indicating abnormality or normality of each medical examination data. 12. The medical diagnosis support system according to claim 9, wherein the diagnostic result is diagnostic information indicating the type of abnormality (disease) and the position of the abnormality in the medical examination data. 13. The medical diagnosis support system according to claim 12, wherein, when comparing the diagnosis results, it is determined for each type of abnormality (disease) whether or not the positions of the abnormality match. 14. The medical diagnosis support system according to each of the claims, wherein in addition to the medical examination data or the identification information of the medical examination data, information related to the medical examination data is output. 15. The medical diagnosis support system according to each of the claims, wherein the presence or absence of output and the content to be output can be selected according to the result of comparison and classification. 16. The medical diagnosis support system according to each of the claims, wherein the medical examination data is a medical image.