JPH08186762A - Mammography device - Google Patents

Abstract

PURPOSE: To easily discriminate between a very small calcified shadow and a mass shadow by providing a means for inputting a mammogram image and a means for emphasizing the contrast of the mammary gland area of the inputted mammogram image. CONSTITUTION: A memory 14 temporarily stores image data and the data and programs of a system disk 12 and the writing/reading of data in the memory 14 is controlled by a central controller 16. The image obtained by an X-ray detector 4 is stored in the memory 14 and is outputted from an output device 10, and an image reader performs the diagnosis based on the output. When the adjustment of a contrast is performed as an image processing, the range of the picture element value of an image to be displayed when a magnified display is performed becomes smaller as compared with the range of a standard image and the difference of maximum and minimum signals becomes smaller. Therefore, the contrast is adjusted by combining this signal difference. An abnormal shadow is shown on a mammogram image due to various kinds of factors such as a calcification and the shape of a tumor and the abnormal shadow is displayed on the device 10.

Description

Detailed Description of the Invention

[0001]

FIELD OF THE INVENTION The present invention relates to a mammography apparatus for examining the breast of a subject.

[0002]

2. Description of the Related Art Currently used screens
Mammography by film combination (X
In the examination of a linear mammography apparatus, image diagnosis of images (hereinafter referred to as mammogram images) taken by mammography in many hospitals is performed, for example, by the following procedure.

First, a doctor in an examination request department (for example, mammary surgery) requests the radiology department to examine a patient (for example, examination by mammography). This request is made by issuing an inspection request form. The test request form includes the patient's ID number,
Name, date of birth, sex, examination request department name, examination requesting doctor name, examination modality (here, mammography), site, method, examination purpose, clinical information, etc. are described.

Next, an examination engineer in the radiology department examines the patient (takes a mammogram image by mammography) in accordance with the instructions in the examination request form and develops the film.

Then, the doctor who interprets the image interprets the developed film. Interpretation refers to the period until the doctor sees the uninterpreted image, confirms the diagnosis, and completes the diagnostic report. At this time, an image (film) of a past examination of the patient under examination is often referred to. It is important to use the images of past examinations for image interpretation in order to improve the quality of image interpretation. The doctor who interprets the image confirms the diagnosis and creates an image interpretation report. At this time, the information described by the doctor who interprets the image in the image interpretation report is the finding after reading the image, the conclusion, the name of the image interpreting doctor, the date of image interpretation, and the like. Then, the image interpretation report is sent from the doctor who performed the image interpretation to the doctor in the examination requesting department.

[0006] As the photographing conditions of the mammography by the screen / film combination, Mo (R
h) The target and the characteristic X-rays from the Mo (Rh) filter are effectively used for the purpose of improving the image quality. Further, the X-ray tube voltage is a low tube voltage of 30 kvp or less.

Next, the inspection of mammography without using the screen / film combination will be described. Here, a mammography detection system using a computed radiography, a slot scan method, a two-dimensional CCD method, or the like will be described.

Computed radiography (Compu
Ted-Radiography) is an X-ray imaging method using a plate (imaging plate, IP) coated with a photostimulable luminescent material instead of using a conventional film as an X-ray detector. The imaging plate has a very wide dynamic range as compared with film, and can capture images in a wide dose range. When the imaging plate is irradiated with X-rays, the energy level of the electrons is increased by the energy of the X-rays, and the X-ray intensity distribution is stored as a latent image. When the laser is irradiated later to excite higher-order electrons, the energy at that time is detected as light. This light is proportional to the energy of the X-rays absorbed in the imaging plate, so that an X-ray image can be obtained electrically (for example, as a digital image).

The use of such an imaging plate in a detection system for mammography is described in US Pat. No. 4,721,856.

Current imaging plates have various problems. That is, the resolution is poor (the pixel size of the pixel is 100 μm × 100 μm), there is a lot of noise, the IP is scratched when used, and the performance deteriorates (the IP needs to be used 100,000 times and replaced), There is a problem that the device is expensive.

Next, the case where the slot scan system is used in the mammography detection system will be described. In the slot scan method, a fan beam-like X-ray is irradiated to scan the breast. Line CCD for X-ray detection
The detector using is used. At this time, the influence of scattering (scatter) is reduced by moving the detector in accordance with the scanning of the irradiation X-ray. Although it is a detector using a CCD, it is not a complete line detector but a semi-area detector having pixels in the width direction. In the semi-area detector, when scanning is performed in accordance with the transfer speed of CCD charges in the width direction, the charges of pixels are added by the width size, so that the load on the X-ray tube can be reduced.

The detected X-rays are converted into light by an intensifying screen and guided to a CCD by a tapered fiber. For details, the following documents can be referred to. Yaffe MJ et al: Imaging performance of a prototy
pe scanned-slot digital mammography system, SPIE. P
hysics of Medical Imaging, 93-103 (1993) The optimum shooting conditions for such a mammography detection system using the slot scan method are different from those for the screen / film combination in that the W target is used. , It is reported that it is appropriate to set the X-ray tube voltage to 40 kvp. For details, the following documents can be referred to. Yaffe MJ et al: Dynamic range requirements in di
gital mammography, Medical Physics 20,1621-1633 (199
3) At present, the slot scan method has an advantage that a high quality image can be obtained. However, the device is mechanically unreliable, the device is relatively expensive,
There is also the opposite side.

Next, the case where the two-dimensional CCD system is used for the mammography detection system will be described. 2D CC
The digital detector using D includes the following. That is, there are digital detectors of II-TV system, intensifying screen-lens-CCD system, intensifying screen-tapered fiber-CCD system, and the like.

The II-TV digital detector is II
CC the light multiplied by (Image Intensifier)
It is digitalized by a D TV camera.

At present, there are problems that (1) the resolution is low in a large field of view, (2) II is a bulky shape, and (3) the device is relatively expensive.

The intensifying screen-lens-CCD type digital detector receives light emitted from the intensifying screen by a lens and collects it on a CCD television camera to digitize it.

At present, there are problems that (1) the resolution is low in a large field of view, and (2) the amount of light is small.

The intensifying screen-tapered fiber-CCD type digital detector guides the light emitted from the intensifying screen to the CCD by means of the tapered fiber to digitize it.

At present, there are problems that (1) the amount of light is small and (2) the device is relatively expensive.

Intensifying Screen-Lens-CCD System and Intensifying Screen-
Regarding the digital detector of the tapered fiber-CCD system, the following paper can be referred to. Roehrig H et al: Digital X-ray Cameras for Real-
time Stereo tactic Breast Needle Biopsy, SPIE.Phys
ics of Medical Imaging, 213-224 (1993) As a detector that overcomes the problems of the various detectors described above, a TFT flat panel detector (TFT: Thin Film Tr
ansister).

Next, a TFT is used in the mammography detection system.
The case of using a flat panel detector will be described.

The TFT flat panel detector detects light emitted from the intensifying screen with a photodiode array. For details, you can refer to the following papers. Antonuk LE et al: Large area, Flat-Panel a-Si: HA
rrays for X-ray Imaging, SPIE.Physics of Medical Im
aging, 18-29 (1993) Next, computer aided diagnosis (CAD) will be described.

Attempts have been made to analyze an image by a computer and detect an abnormality by taking advantage of the characteristic of digital image that the image processing by the computer is easy.
It has been successful. This technique is called Computer-Aided Diagnosis (CAD), and is expected to be used for the purpose of improving the accuracy of image diagnosis and reducing the burden on doctors.

The abnormality detection algorithm is introduced, for example, in the following documents. (1) Katsuragawa, S. et al: Image feature analysis
and computer-aided diagnosis in digital radiograph
y: Classification of normal and abnormal lungs wit
h interstitial disease in chest images.Medical Phy
sics 16,38-44 (1989) (2) Giger, ML et al: Image feature analysis and
computer-aided diagnosis in digital radiography:
3. Automated detection of nodules in peripheral lu
ng fields.Medical Physics 15,158-166 (1988) (3) Chan, HP et al: Image feature analysis and co
mputer-aided diagnosisin digital radiography: 1. A
utomated detection of microcalcifications in mammo
graphy.Medical Physics 14,538-548 (1987) (4) Kunio Doi et al .: "Possibilities of computer-aided diagnosis in digital radiography" Journal of Japanese Society of Radiological Technology, p653-663, 1989 System for detecting abnormalities such as tumor shadows The technology is also disclosed below. (1) Japanese Patent Application Laid-Open No. 02-185240 (2) Japanese Patent Application Laid-Open No. 02-152443 (3) Japanese Patent Application Laid-Open No. 01-125675 In particular, regarding CAD of breast cancer, US Pat.
No. 20 describes a method for discriminating whether a cancer shadow pointed out by a doctor on a digital mammogram is benign or malignant. Further, US Pat. No. 4,907,156 describes a method of detecting a candidate position for microcalcification from a digital mammogram.

The method for detecting the candidate position of the tumor shadow is described in the following paper. Yin FF et al: Computerized detection of masses
in digital mammograms: Analysis of bilateral subtra
ction images, Medical Physics 18,955-963 (1991) Next, a medical image archiving and communication system (PACS) will be described.

With the progress of digitization of images, recently, a medical image archiving and communication system (PACS: Picture Ar) has been developed.
It is becoming possible to perform this diagnostic imaging business using the chiving and Communication System).
PACS is a medical image generated in a hospital (X-ray image, C
It is a system for supporting the work of doctors viewing medical images by storing, communicating, and displaying (T images, MR images, etc.). The PACS stores the image data sent from the image acquisition device in a database, transfers the image data from the database to the image workstation when the image is needed, and the image workstation transfers the image to a cathode ray tube (CRT: CRT). Cathode Ray Tube) has a function to display. The doctor makes a diagnosis by looking at the displayed image. In addition, PACS is also available for interpretation reports that record diagnostic results.
Can be created and stored above. According to PACS
There is no need to search for the film, carry the film, hang the film on the Schaukasten, or remove it.

Many technologies have been disclosed regarding the system configuration and functions of PACS, and (1) JP-A-62-1
21576, (2) JP-A-63-010269, (3) JP-A- 64-013837, (4) JP-A- 64-017154, (5) JP-A-02-1036
68, (6) Japanese Patent Application Laid-Open No. 02-119840, and the like.

FIG. 81 is a block diagram showing a schematic structure of a conventional PACS system.

PACS consists of network, IA, WS,
It has the components of DB.

The network carries out data communication between the respective constituent elements. The IA collects images from various diagnostic imaging instruments. WS displays an image. The DB stores the image.

Next, the outline of the image interpretation operation in WS will be described.

First, it is assumed that the patient image is read on the WS in the order of the examination numbers. Here, the order of the inspection numbers is the newest order of the inspection date. First, the WS sends a transfer request for an unread image to the DB via the network. DB searches for the requested unread image and WS via the network
Send to The WS creates an image list in the order of inspection numbers from the inspection history. Next, the WS sends a transfer request for past images to the DB via the network. The DB retrieves the requested past image and sends it to the WS via the network.
Then, the WS first displays the transmitted uninterpreted image and further displays the transmitted reference (past) image.

Such a medical image archiving communication system (P
Mammogram images captured by mammography using (ACS) are managed to efficiently perform image diagnosis such as image interpretation.

By the way, when mammography is used as a modality and a mammogram image is diagnosed, there are the following problems at the time of diagnosis. (1) The mammogram image of a woman with a full mammary gland is
There were many areas with low optical density in the mammary gland area, and it was difficult to distinguish microcalcification shadows and tumor shadows from them. (2) When comparing and reading mammograms, the densities of the individual images were different. An accurate comparative diagnosis could not be made if the image densities were different when the corresponding parts were compared. (3) The user (doctor) manually inputs the enlargement instruction and the emphasized portion on the image using a mouse or the like, which is troublesome. (4) When diagnosing multiple images at the same time, it is troublesome to arrange the images. (5) When the abnormal position is detected by the computer, if the result of the abnormal position is superimposed on the original image and output on the screen, the original image cannot be seen and the diagnostic accuracy deteriorates. (6) The abnormality detecting means may not be applicable to the target image by the detecting means, and if the abnormal result is forcibly given to the image which cannot be applied, the result becomes unreliable. (7) Just by looking at the newest image (current image), the change can be understood by comparing with the past image even when it seems that there is no abnormality. It was troublesome to prepare images for comparison, and therefore the performance of diagnosis was degraded.

[0035]

As described above, in the conventional example of mammogram image diagnosis, the burden on a doctor who interprets images during diagnosis is large, or the doctor cannot obtain information suitable for diagnosis from images. However, there was a problem that the diagnostic ability was lowered.

Therefore, an object of the present invention is to provide the following mammography device. (1) Even in a mammogram image in which the mammary gland is dense, it is possible to easily distinguish the microcalcification shadow and the tumor shadow. (2) When the mammogram images are comparatively read, it is possible to observe the images to be compared with the same density range. (3) It is possible to automatically specify an enlargement instruction and a highlighted portion on a mammogram image. (4) Automatically arrange mammogram images on the screen. (5) When detecting an abnormal position by the computer, instruct that the result of the abnormal position does not overlap the original screen. (6) If the abnormal shadow detecting means cannot be applied to the target image, the fact that it cannot be applied is output. (7) Automatically compare with past images and call attention if there is a change.

[0037]

A mammography apparatus according to claim 1 of the present invention comprises input means for inputting a mammogram image, and means for emphasizing the contrast of the mammary gland region of the mammogram image input by the input means. .

A mammography apparatus according to a fifth aspect of the present invention comprises an input means for inputting at least two or more mammogram images, and an output means for equalizing and outputting the density ranges of the mammogram images input by the input means. To do.

According to a seventh aspect of the present invention, there is provided a mammography apparatus which sets a plurality of minute areas based on an input means for inputting a mammogram image and a contour of the breast on the mammogram image inputted by the input means. And means for performing predetermined image processing for each set micro area.

According to an eleventh aspect of the present invention, there is provided a mammography apparatus, wherein input means for inputting a mammogram image, detecting means for detecting an abnormal shadow from the mammogram image input by the input means, and abnormal shadows detected by the detecting means are detected. And an image processing means for performing a predetermined image processing on the image of the minute area including the image.

According to a fourteenth aspect of the present invention, in a mammography apparatus, at least two or more mammogram images are inputted, a means for outputting the mammogram images inputted by the input means, and an output means for outputting the mammogram images. An image arranging unit that manages the arrangement position and the arrangement direction at that time is provided.

A mammography apparatus according to claim 18 of the present invention is an input means for inputting a mammogram image, a detecting means for detecting an abnormal shadow from the mammogram image input by the input means, and a position of the abnormal shadow detected by the detecting means. And a marker image indicating that the marker image is combined with the mammogram image without overlapping, and an output unit that outputs the combined result is provided.

A mammography apparatus according to a twenty-first aspect of the present invention is an input means for inputting a mammogram image, a determining means for determining whether or not an abnormal shadow can be detected in the mammogram image input by the input means, and a determining means. The mammography apparatus according to claim 23, further comprising: a detection unit that detects an abnormal shadow from the mammogram image, and a result output unit that outputs a result of the detection performed by the detection unit when the unit determines that the detection can be performed. The apparatus includes an input unit for inputting the first mammogram image and a second mammogram image of the same site captured from the same direction at a time different from that of the first mammogram image, and first, first input by the input unit. The detection means for detecting each abnormal shadow from the mammogram image of No. 2 and each abnormal shadow detected by the detection means. To and a result output unit for outputting only the detection results to vary.

[0044]

As a result of taking the above means, the following effects are exhibited. (1) The mammary glands are full and dense, and therefore there are many regions with low optical density. For example, even in a mammogram image of a woman, microcalcification shadows and tumor shadows can be easily distinguished. (2) When comparing and reading mammograms, if the densities of the individual images are different, the densities are made the same. (3) The enlargement instruction and the emphasized portion designation on the image are automatically performed. (4) When a plurality of images are simultaneously viewed and diagnosed, they are automatically arranged according to a predetermined rule. (5) When the abnormal position is detected by the computer, the result of the abnormal position is clearly indicated on the outer frame of the mammogram image. (6) If the detection means cannot be applied to the target image, the abnormality detection means outputs a message indicating that it cannot be applied. (7) The arrangement of images can be determined according to the doctor's preference, and the captured image and the past image can be easily compared.

[0045]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Embodiments of a mammography apparatus according to the present invention will be described below with reference to the drawings by referring to first to fourth embodiments. In the first embodiment, a system in which digital mammography is used as a single modality and a batch process from photographing to image output (referred to as a basic system in this embodiment) will be described. In the second embodiment, a system in which a network function is applied to a basic system (called a modality system) will be described. In the third embodiment, a system in which PACS is applied to the basic system (referred to as PACS system) will be described. Fourth
In the embodiment, other system variations will be described. (First Embodiment) FIG. 2 is a perspective view showing the external appearance of the basic system 1. In the basic system 1, digital mammography is used as a single modality, and shooting to image output are collectively performed.

The C-arm 5 is constructed by integrating the X-ray generator 2, the compression plate 3 and the X-ray detector 4 and is rotatable in the direction of the arrow 1a, that is, right and left. The compression plate 3 is movable in the direction of the arrow 1b, that is, in the vertical direction.

FIG. 1 is a block diagram showing a schematic configuration of the basic system 1. The basic system 1 includes an X-ray generator 2, an X-ray detector 4, an input device 6, a RISI / F (interface) unit 8, an output device 10, a system disk 12, a memory 14, a central controller 16, a bar code reader. The system is composed of only one image capturing device like the existing mammography system. Further, since the process from image capturing to output is all performed in the system at once, the basic system itself can be regarded as one modality.

First, the X-ray generator 2 will be described.
The X-ray generator 2 is controlled by the central controller 16. FIG. 3 is a block diagram schematically showing the internal configuration of the X-ray generator 2. The X-ray generation device 2 has an X-ray tube 20, a high-pressure generation unit 22, an X-ray controller 24, an AEC 30, a filter switching unit 26, a compression pressure control unit 28, a photo sensor 32, and a control panel 34, and has a main function. ,
a. A function that sets the most suitable imaging conditions for each inspection; b. It has a function of controlling breast compression in relation to X-ray exposure. Each of these two functions a and b will be described.

Regarding the function a for setting the most suitable photographing condition for each inspection, the setting of the photographing condition here means X.
This is to properly set the type of filter that defines the quality of the wire, kVp (X-ray tube voltage), and mA (X-ray tube current). The imaging conditions are, first of all, unique information that varies from patient to patient,
That is, the type is divided according to the age of the patient, the hardness of the breast, the thickness of the breast, and the size of the breast, and it is determined based on the imaging condition determination table that gives the imaging conditions for each type. Table 1 shows an example of the shooting condition determination table. In Table 1, shooting conditions for type A and type B are described, and other types are omitted.

[0050]

[Table 1] The patient's age is obtained from the examination request information input by the input device 6 described later. Regarding the hardness of the breast, first, the compression plate 3 is moved with reference to the position of the detector 42 of the X-ray detection device 4 and the position x at which the compression plate 3 touches the breast.
And the moving distance d of the compression plate 3 after a predetermined amount of compression. The detector 42 will be described later. x is equal to the breast thickness without compression. Here, the ratio of the compression distance d and the thickness x of the breast when not compressed is defined as A value (A
Value = d / x). Then, the hardness of the breast is determined by the characteristics shown in FIG. That is, the hardness is obtained by giving an A value to a known characteristic curve that gives the hardness of the breast. At this time, the hardness of the breast is roughly divided into three levels of "soft", "medium", and "hard". The size of the breast is optically determined by the mechanism shown in FIGS. 5 (a) and 5 (b). FIG. 5A is a side view showing how the size of the breast is measured by the optical detector 38 and the reflector 40, and FIG. 5B is a top view showing this state. is there.

Light beam 39 emitted from optical detector 38
Of these, the detector 38 detects the light beam reflected by the reflection plate 40, whereby the amount of reflected light is measured. Then, the size of the breast is obtained from the characteristic shown in FIG.
That is, the size of the breast is obtained by giving the measured light amount to the known characteristic curve. For breast size,
The method may be determined as follows instead of using only the optical method. That is, the size of the irradiation field may be input from the operation panel 34 and the size of the irradiation field may be used as the size of the breast. Then, the size of the breast can be simply obtained. FIG. 6 is a view showing the operation panel 34. As the irradiation field size, “12 ″ × 10 ″”,
"10" x 8 "" can be selected. The irradiation field size is not limited to these values.

Regarding the thickness of the breast, the compression plate 3 during compression is used.
And the position of the detector 42 to calculate the compression thickness, which is taken as the breast thickness.

By the way, a predetermined rule obtained theoretically and empirically has been obtained for the determination of each parameter of the photographing condition. That is, regarding the type of filter that defines the quality of X-rays, the Mo (molybdenum) filter is used for normal breasts and Rh is used for breasts with many mammary gland regions.
Preference is given to using (Risme) filters. In addition,
Filters are switched by the filter switching unit 26 under the control of the AEC 30 described later.
kVp (X-ray tube voltage) is 30 for normal breasts
By giving a low tube voltage of kVp or less, an image with good contrast can be captured by X-rays in a low dose energy region. For a breast with many mammary gland areas, 30 kVp
Imaging with X-rays in a high dose energy region, which gives a higher tube voltage, is suitable for diagnosis. For mA (X-ray tube current), mAs for 3 large breasts
In order to obtain the above, it is preferable to set the tube current to a large current as well as the energization time. Table 1 is formed based on such a rule. Then, the shooting conditions set according to the shooting condition determination table are input to the AEC 30 as thickness / size / hardness data 36.

Here, the AEC 30 will be described. A
An EC (Automatic Exposure Control) 30 is for obtaining a control amount for exposing X-rays at an appropriate dose, and the obtained control amount is an X-ray controller 24, a filter switching unit 26, a compression pressure control unit 28. To control exposure. At this time, there are two methods for obtaining a desired control amount. One is that the data of a specific pixel is destructively read from the detector 42 at regular intervals during exposure, and is suitable for the pixel having the lowest optical density among those data (AEC data). This is a method of obtaining the amount of X-ray exposure for giving a dose. The exposure time is controlled by the obtained exposure amount. This approach applies when the detector is a planar detector. FIG. 7 shows a data collection point 44 for reading out a specific pixel in the detector 42. Second, as shown in FIG. 8, an AEC detector 46 consisting of an intensifying screen and a photodiode is provided below the data collection point 44 of the detector 42, which enables destructive readout of the detector data. It is a prescription that collects AEC data without doing it. X for giving an appropriate dose to the pixel having the lowest optical density in the output of the AEC detector 46
Get the dose of a line. The exposure time is controlled by this exposure amount.

Next, the function b for controlling breast compression in relation to X-ray exposure will be described. If the breast is pressed with uniform pressure from setting to the end of imaging, the patient may be burdened. For this reason, the compression is appropriately controlled in order to alleviate the compression of the breast as much as possible. That is, the pressure is slightly relaxed before the image is taken, the positive pressure is given just before the image is taken, the image is taken with an appropriate pressure value and the image is released immediately after the end. In this way, the patient's pain can be relieved.

First, the mechanism for compressing the breast will be described. FIG. 9 is a cross-sectional view of a mechanism portion for compressing the breast by the compression plate 3 as seen from the side. The compression unit 48 is configured by integrating the compression plate 3, the compression plate support unit 49, and the pressure sensor 50. The compression unit 48 is movable in the vertical direction, and is driven by applying pressure to the upper surface of the pressure sensor 50. As a method of driving the compression unit 48, it is conceivable that the compression unit 48 is driven by pressurizing the oil 51, and when the compression plate 3 presses the breast, the lower hydraulic pressure is released while the breast is sandwiched and the upper part is released. The hydraulic pressure is increased, and the pressure sensor 50 presses the pressure while controlling the pressure. When releasing the breast from compression, the upper hydraulic pressure is released and the lower hydraulic pressure is applied to raise the pressing plate. FIG. 11 is a block diagram showing a schematic configuration of such a breast compression mechanism. The control unit 52 controls the movable unit 54 based on the signal from the pressure sensor 50 and the preset value 56 to drive the compression plate 3. Here, the breast compression mechanism is not limited to the mechanism shown in FIG. For example, the compression plate 3 itself may have a function of controlling pressure.

Next, two methods for appropriately controlling the timing of compression so as not to burden the patient will be described. With these techniques, the compression pressure control unit 28
The breast compression mechanism described above is controlled by the instruction of the EC 30. FIG. 12 is a diagram for explaining the first method,
It is a figure which shows the process of pressing a breast in relation to X-ray exposure. Here, FIG. 12A is a timing chart of the X-ray generation signal, FIG. 12B is an exposure timing chart of the x-ray (X-ray), and FIG. 12C is a timing of pressure compressing the compression plate 3. It is a figure. The pressure shown in FIG. 12C is expressed as a percentage (%) when the pressure required for X-ray irradiation is 100%.

First, an X-ray technician in charge of radiography gives a pressure instruction to the control unit 50 using an operation console (not shown) or the like, and presses the breast with a pressure actually required during X-ray exposure. The pressure value at that time is read by the pressure sensor 50 and stored as an appropriate pressure value in a memory (not shown) of the control unit 52 (setting period). Next, the pressure value stored under the control of the control unit 52 is lowered to 80% and the unit stands by (standby period).
Then, the pressure is set to 10 by using the X-ray generation signal (a) as a trigger.
0%, that is, x-ray after pressurizing to an appropriate pressure value
(B) is generated and imaging is performed (X-ray is being generated). The pressure shall be completely released immediately after the shooting. The compression rate (80% here) during the waiting period can be changed as appropriate.

FIG. 13 is a diagram for explaining the second method. FIG. 13A is a timing chart of an X-ray generation signal, FIG. 13B is an exposure timing chart of x-ray (X-ray), and FIG. 12C is a timing chart of pressure that presses the compression plate 3. is there. The pressure shown in FIG. 13C is represented by a pressure value. First, at the time of setting, an X-ray technician gives a compression instruction to the control unit 50 using an operator console (not shown) or the like, and appropriately (slightly loosely) compresses the breast and waits (setting and waiting period). Then, the X-ray generation signal (a) is used as a trigger to pressurize to a preset set pressure value, and then x-ray (b) is generated to perform imaging (during X-ray generation). The pressure shall be completely released immediately after the shooting. The set pressure value can be changed as appropriate. Next, the X-ray detection device 4 will be described.
The X-ray detector 4 is controlled by the central controller 16. FIG. 14 is a block diagram schematically showing the internal configuration of the X-ray detection device 4. The X-ray detection device 4 includes a read time setting device 60, a timing generation device 62, a drive device 64,
It has a detector 42, a reading device 68, an A / D converter 70, and a reading range setting device 72, and has a device control function for X-ray detection and a data reading function. In this embodiment, the X-ray detection device (detector 42) is a TFT flat panel detector. FIG. 15 shows a TFT flat panel detector (hereinafter simply referred to as the detector 42
Is a circuit diagram showing a configuration). Array 73 is 2
It is composed of a plurality of cells arranged in a three-dimensional lattice. One cell is the gate line 7 from the driver 64.
6 and a data line 78 from the reading device 68, and a FET (a-Si: H) 80, a sensor (a-Si: H) 82 connected to the FET 80, and a capacitor (not shown). . The sensor 82 is a photodiode that detects photon photons. Further, an intensifying screen (not shown) is placed on the array 73 to convert the X-rays radiated on the array 73 into light. Instead of the intensifying screen, a material coated with a substance having a scintillation function for converting X-rays into light may be used.

The drive device 64 is the read range setting device 7
Based on the read range set in 2 and the timing pulse according to the read time set in the read time setting device 60, a control pulse for detecting a signal is created to drive the detector 42.

Here, the device control and data reading for X-ray detection in the X-ray detection device 4 will be described. First, the detector 42 is initialized to discharge the charge accumulated in the capacitor of each cell of the array 73. next,
The X-ray generator 2 irradiates the subject with X-rays. The X-rays that have passed through the subject reach the intensifying screen placed on the detector 42. The X-rays that reach the intensifying screen are converted into light here. Photodiodes (sensors 82), one for each cell on the array 73, detect the light (photon photons) converted by the intensifying screen and convert it into an electrical signal. The obtained electric signal is once stored in the capacitor as an electric charge.

When the X-ray exposure is completed, that is, when the high voltage generation signal of the X-ray controller 24 changes from ON to OFF, the control pulse generated in the driving device 64 is supplied to the array 73 as a trigger. Then, the TFT element (FET 80) of the array 73 is turned on.
Then, the reading device 68 reads the electric charge accumulated in the capacitor as an analog signal through the data line 78. Here, it is assumed that the reading device 68 controls integration by an operational amplifier, parallel reading, and the like. The analog signal read in this way is A / D converted by the A / D converter 70 and converted into a 14-bit (or 16-bit or the like) digital signal for each pixel. In this embodiment, the digital signal having the predetermined bit width is defined as a pixel value. Image data composed of a matrix of a plurality of pixel values is transferred to the memory 14.

The reading device 68 can change the image reading time according to the drive timing generated by the timing generating device 62. The drive timing is changed by the read time setting device 60. Further, when the image is read in the size of the breast and the small irradiation field at the time of biopsy, the reading range can be limited with the intention of efficient image reading. The biopsy will be described later.

The read range is limited by limiting the control line for sending the control pulse, that is, the gate line 76, and the read signal line, that is, the data line 78 by the read range setting device 72.

As a post-processing of photographing, after the above-mentioned image acquisition is completed, when the X-rays are not exposed (when the high voltage generation signal of the X-ray controller 24 is OFF), the capacitors of the array 73 are again for the same time. Accumulate the dark signal at. A control pulse for turning on the FET 80 is sent to the detector 24, image data is collected, and the result at dark is stored in the memory 14. Dark image data is subtracted from the last acquired X-ray image data, and this is stored in the memory 14 as a collected image.

In this embodiment, the case where the TFT flat panel detector is used as the X-ray detection device has been described, but the present invention is not limited to this. For example, if a screen-film system is applied and a film thus photographed is digitized by a digitizer, detection data can be obtained in the same manner as in the TFT flat panel detector. In addition,
In this case, real-time imaging control based on the detection data becomes impossible. Further, an imaging plate may be used as a device for X-ray detection. In this case as well, shooting control is similarly impossible. A slot scan method may be applied as a device for X-ray detection. In this case, the shooting time cannot be set during shooting, so pre-exposure is performed first and shooting conditions including the shooting time are set. Preferably. A two-dimensional CCD may be used as a device for X-ray detection. In this case, real-time imaging control based on detector data is possible, and TF is used as image data (detection data).
The same type of data as the T-plane detector can be obtained and stored in memory.

Next, the input device 6 will be described. The input device 6 has five functions. That is, a. Function of inputting patient information and examination information, b. A function for inputting control of the output screen, c. A function of inputting an image interpretation doctor ID, d. Function of selecting image interpretation and inspection mode, e. It has a function of selecting the output means. Regarding these functions a to e, the input device 6 will be described. FIG. 16 is a diagram showing screen transitions of the operation panel 90. The operation panel is composed of a touch screen.

First, the function a will be described. The function a is for inputting patient information and examination information. In inputting these information, a case where the system is connected to the RIS and a case where the system is not connected to the RIS will be described. The RIS is a system for obtaining information from an external system and will be described later in detail.

First, when there is no information input from the RIS, patient information and examination information are inputted from examination request information.
In this case, since the inspection request information is on paper, the operator inputs it through a keyboard or the like (not shown). The patient information is a patient name, a patient ID, etc., and the examination information is an examination ID, a site, a direction, etc. Table 2 shows an example of the inspection request information. In Table 2, the examination request information for the patient ID-880841 and the patient name-Yama Yamako is described.

[0070]

[Table 2] Next, a case where information is input from the RIS will be described. When information can be input from the RIS, the computerized inspection request information is sent from the RIS via the RIS I / F unit 8 and stored in the memory 14. Then, the individual examinations are registered in the order in which they arrive in the memory 14.

The individual examinations registered as described above are displayed on the operation panel. When the operation panel 90 is composed of a touch panel, the examination of interest can be selected via the touch sensor. . FIG. 17 is a diagram showing the examination (patient) list panel displayed on the operation panel, and shows a state in which the display line of the selected examination, that is, the selected patient name is highlighted.

Next, the function b for inputting control of the output screen will be described. First, a case where the operation panel 90 is configured by a touch panel will be described. FIG. 18 is a diagram showing an operation panel for inputting for controlling the output screen. Here, (a) of the figure is a diagram showing the image selection panel, and (b) of the figure is a diagram showing the selection panel of the detailed display ROI. In the image selection panel of FIG. 18A, two types of schemas 92, which are abstracted (deformed) images, are displayed on the operation panel 90, and characters (for example, “CC image”) indicating a part or direction of the image are displayed. , "ML image") is displayed. When one of the schemas 92 is touched with a finger or the like, the schema 92 of the one touched with the finger is displayed in reverse, though not shown, and an image can be selected. In addition, FIG.
In the detailed display ROI selection panel in (b), the schema 9
2 is displayed as a grid. When it is desired to observe the details of the image, the detail of the image is displayed on the CRT by touching the portion of the displayed grid where the detail is to be observed.

Here, the schema 92 uses the sobel edge of the skin of the subject (breast) in the actual image.
) An operator may be used to detect and draw only the edge (breast contour).

Next, a case where the operation panel 90 is constituted by means other than the touch panel will be described. FIG.
FIG. 4 is a perspective view of an image selection panel. The image selection panel 94 is composed of a mechanical switch 95,
An image is selected by pressing this. 20
It is a perspective view of the selection panel of detailed display ROI. The detailed display ROI selection panel 96 is an image selection panel 94.
Is composed of mechanical switch 95,
By pressing this, the part whose details you want to observe is selected. The position of each mechanical switch 95 corresponds to the position of the irradiation field of the displayed image.

Next, the function c for inputting the image interpretation doctor ID will be described. When the operation panel 90 is composed of a touch panel, an image interpretation doctor ID input panel is displayed as shown in FIG. A doctor who interprets images inputs an ID using the ID input panel 98. Next, the function d for selecting the inspection / interpretation mode will be described. 16 (a)-
As shown in (c), the mode is selected on the display of each panel. After selecting the mode, the function in each scene can be executed.

Next, the function e for selecting the output means will be described. As shown in FIG. 16 (d), the image is output to film ("4.1 CRT output"), the image is output to film ("4.2 film output"), and the image is output to film and CRT ("4.3 CRT output"). It is possible to select an output form such as “film & CRT output”).

According to the functions a to e described above, it is possible to deal with the screen and the interpretation style according to the interpretation doctor's preference.

Next, the case where this system (basic system) obtains data from another system by using the external system / connection interface will be described in detail. Here, especially RIS (Radiology Information)
A case where data is obtained from the (System) via the RIS I / F unit 8 will be described.

First, regarding the data transfer function and routine from another system, as described above, the computerized inspection request information is sent from the external RIS, and the data format that this system can process as information is as follows. And is stored in the memory 14. Further, the individual examinations are registered in the examination list in the order of arrival in the memory 14. When it is displayed on the touch panel, as shown in FIG.
The examination (patient) of interest can be selected via the touch sensor.

Next, as an example of the data structure of the RIS data, the structure of the inspection request information is the same as in Table 2 above. Further, Table 3 shows the structure of the image interpretation report which is the result of the inspection.

[0081]

[Table 3] Next, the output device 10 will be described. FIG. 22 is a block diagram showing the internal configuration of the output device 10. Output device 1
0 is for inputting processed image data and character / symbol data (hereinafter referred to as information) consisting of character data and screen (symbol) data from the memory 14 and outputting it to the screen of the CRT 100 or the film 102. Yes, image reduction / enlargement processing unit 104, screen creation unit 1
06, frame memory 108, overlay memory 11
0, a display management unit 112, a D / A conversion unit 114, a barcode generation unit 116, and a laser writing device 118.

The frame memory 108, the overlay memory 110, the display management unit 112, and the D / A conversion unit 114 are C
It is a dedicated device for outputting an image and information on the screen of the RT100, and the barcode generation unit 11
6. The laser writing device 118 is a dedicated device for outputting an image and information on the film 102.

When outputting an image and information on the screen of the CRT 100, that is, when selecting "CRT output" by the operation panel 90 of the input device 6 described above and giving an instruction to the display management unit 112 to output the image, The image enlargement / reduction processing unit 104 performs image processing such as reduction or enlargement of the image data sent from the memory 14 to a predetermined size, and sends the image data to the screen creation unit 106. The screen creation unit 106 creates a screen by arranging the processed image data at a predetermined position and writes the screen in the frame memory 108. Also, the character / symbol data is stored in the overlay memory
Written to zero. Then, the display management unit 112 superimposes the overlay of the predetermined number designated by the central controller 16 on the frame memory 108 and sends it to the D / A conversion unit 114. The D / A converter 114 converts the content of the frame memory 108, which is a digital signal, into an analog signal (D / A conversion) and outputs it to the screen of the CRT 100.

When outputting an image and information to the film 102, that is, the input device 6 described above.
Select "Film output" on the operation panel 90 of
When the laser writing device 118 is instructed to output, the image reduction / enlargement processing unit 104 performs image processing such as reduction or enlargement of the image data sent from the memory 14 to a predetermined size and creates a screen. Send to section 106.
Also, the barcode generation unit 116 generates a barcode based on the predetermined information sent from the memory 14 and sends it to the screen creation unit 106. The predetermined information for generating the barcode is information unique to the inspection such as the inspection ID and the image number recorded in the inspection request information. The screen creation unit 106 arranges the sent image data at a predetermined position, creates output data by superimposing the image data, the character / symbol data (binarized) and the bar code, and creates the laser writing device 118. Send to. The laser writing device 118 outputs the output data to the film according to an instruction from the central processing unit 16. FIG. 23
FIG. 4 is a diagram showing an example of the output film 102.
A bar code 120 is written at a predetermined position on the film 102.

Next, the system disk 12 will be described. The system disk 12 stores a control program for realizing the following functions. However, the following functions may be implemented as hardware for the purpose of speeding up. a. Means for recognizing the mammary gland region and enhancing contrast b. Density range adjusting means c. ROI position determining means, shuttle corresponding means d. Image processing means e. Abnormal shadow detection means applicable discrimination means f. Abnormal shadow detection means, detection result storage means g. Output screen creating means h. Abnormality detection result output means i. Means for recognizing the shooting direction from the tilt of the arm j. Pressure timing adjusting means k. Biopsy puncture status confirmation means 1. Biopsy visual field recognition and partial data storage means m. Shooting scene, automatic setting of shooting conditions by detector (mode) n. Means for reading out an image triggered by the end of exposure o. Input / output means for patient information from RIS, identifier output means p. Means for scaling the image to an arbitrary size q. CRT, film output selection means r. Means for discriminating malignancy and benignity of abnormality and outputting the result s. ROI manual input means t. Overall Control Program First, when the system starts up, the central control unit (CPU) 16 first activates the overall control program (described later), and according to each scene of use (described later),
Each function is triggered by an event from an input device.

The functions a to t will be described below.

A. Means for Recognizing Mammary Gland Region and Emphasizing Contrast Taking a histogram of pixels of an image, a normal breast (breast) histogram has a shape as shown in FIG. 24, and a breast (dense breast) dense breast region is formed. The histogram is as shown in FIG. Here, in FIG. 25, the anatomical structure to be diagnosed cannot be seen unless the contrast of the region A having a high pixel value is high. Therefore, in order to recognize the anatomical position of the region A, first, a small region (hereinafter referred to as ROI) 122 of n pixels × n pixels as shown in FIG. Among them, a bright ROI (ROI having a high pixel value) is selected. Next, a representative value (for example, median value, median value) of the pixels of the selected ROI 122 is displayed, and a look-up table for converting the pixel value into the brightness is set so that the output has the highest brightness (brightness). Change to enhance contrast. FIG. 27 is a diagram showing the relationship between pixel values and gray scale (luminance). The slope of the straight line 128 representing the correspondence between the pixel value after contrast enhancement and the gray scale (brightness) is compared with the straight line before the look-up table is changed, that is, the straight line 126 representing the correspondence at the time of output from the detector. The look-up table is changed so that it becomes larger and the contrast is enhanced. Here, the contrast enhancement may be performed not only when the look-up table is changed, but also by changing the pixel value of the image data so that the inclination of the straight line 128 is larger than the inclination of the straight line 126.

In contrast enhancement, straight line 12
If the inclination of 8 becomes too large, noise may be emphasized. Therefore, it is preferable to limit the degree of noise emphasis. b. 28. Means for Adjusting Density Range (Aligning Image Density) FIG. 28 is a diagram schematically showing a flow until displaying or outputting images of the left and right breasts. The captured image is
Initially, it exists in the image memory bank 129 composed of an IC memory and a magnetic disk. When an instruction to display an image of a specific patient taken from a specific direction is issued, the images of the left and right breasts are first analyzed by the density identification processing unit 13.
0 and the composite image 132 is created. Composite image 13
Reference numeral 2 denotes an image in which two images of the left and right breasts are arranged in order to display or output the left and right breasts as one image, and indicates an image in which the average image density of the left and right images is uniform. The created composite image 132 is the frame memory 1
08, the overlay memory 110, and the laser writing device 118, and then displayed on the CRT 100 or output to the film 102. Note that the composite image 132
Since the operation of the output device 10 at the time of outputting is the same as the case described above, the description thereof will be omitted.

Here, the density equalization processing unit will be described in detail. FIG. 29 shows the density identification processing unit 13
It is a figure which shows the specific example of the process of 0, and has shown the example of the process which makes the average density in ROI133 of the image of right and left breasts the same. In the present embodiment, the case where the processing is performed so that the average density of the right image is aligned with the average density of the left image will be described. However, this may be aligned with the average density of either the left or right image, or either The third average density different from the average density of the image may be used.

First, the average value calculating unit 134 calculates the average values m ₁ and m ₂ of the pixel values of the left image and the right image, respectively, and then the dividing unit 135 calculates the ratio of m ₁ and m ₂ . Then, the image calculation unit 136, based on the value of the obtained ratio,
The average density of the right image is calculated so that the average density in the ROI 133 is the same as the average density of the left image, and the composite image 132 having the same left and right image densities is created.

Although the ROI 133 is usually set in advance, a fixed ROI such as the ROI 133 is set.
In addition, it is desirable that the special ROI (free ROI) given by the operator can be accepted and processed. Further, the ROI 133 can be set in a region centered on the portion pointed out by CAD as a lesion candidate.

As another example of the density equalization processing, in addition to the example in which the average values of the pixels are aligned as described above, an example in which the median value, the mode value, and the histogram in the ROI are aligned is also known.

Further, the process of aligning the average values of the pixels and the standard deviation of the pixels may be performed. c. ROI position determining means, shuttle corresponding means For example, the position of the ROI for performing enlarged display as image processing can be automatically set and moved.

FIG. 30 shows an ROI for enlarged display and RO
It is a figure which shows the locus | trajectory of the position movement of I center. ROI133
Is composed of 4 A pixels × 5 A pixels of the image (A is a natural number).
Here, the XY coordinates are set, and the extracted subject (breast)
3 toward the inside of the breast in the X direction.
A contour line 137 moved A and straight line X = 4000-2
A first closed curve 139 surrounded by A, straight line Y = 3A, and straight line Y = 5000-3A is created.

Next, the center of the ROI 133 is set to the first closed curve 1
The image data inside the ROI 133 is enlarged while being moved above 39, and is displayed on the CRT 100 of the output device 10. When the ROI 133 completes one round of the first closed curve 139, the position movement is temporarily stopped.

Next, a contour line obtained by further moving the breast contour 138 by 3A × 2 in the X direction and a straight line X = 400.
0-2A × 2, straight line Y = 3A × 2, straight line Y = 5000−
A second closed curve 140 surrounded by 3A × 2 is created. First
As in the case of the closed curve 139 of FIG. 1, while moving the center of the ROI 133 on the second closed curve 140 once,
The image data in 133 is enlarged and output device 1
0 output to CRT100. Note that in FIG. 30, the second
The closed curve 140 of is not shown.

The above processing is repeated until the X coordinate value of the leftmost point of the contour line becomes smaller than 4000-2A × N (N is a natural number). Further, the movement from the closed curve N to N + 1 is performed linearly. FIG. 31 shows a locus when the position movement of the ROI center is continuously performed.

The contour line 137 to be extracted first may be obtained by approximating the breast contour 138 with a polygon as shown in FIGS. 32 (a) and 32 (b). The size of the ROI 133 to be displayed (determination of the value of A) is determined by the enlargement ratio. This enlargement ratio is set in advance by the inspector before the inspection. ROI1 set in this way
FIG. 33 shows an example of the case of enlarging display by 33.

The ROI position determination for the image processing has been described above in the case of performing the enlarged display as the image processing. However, in the case of performing other image processing such as contrast enhancement, the same as in the case of the enlarged display. Is.
FIG. 34 shows an example in which the contrast enhancement is performed. Means for performing various image processing will be described later. A known method such as automatic extraction may be used for the method of extracting the breast contour 138 and the method of setting the contour line 137. It can also be set by the inspector using the shuttle.

Observation can be performed by automatically moving the ROI according to the shape of the breast shown in the mammogram image. FIG. 35 shows ROIs corresponding to various mammogram images.
The locus of position movement is shown. d. Image Processing Unit The image processing unit can perform the following three types of image processing. 1. Image processing such as unsharp masking is performed by emphasizing an appropriate frequency range to make it easier to see shadows. Regarding unsharp masking, the following paper can be referred to.

Leh-Nien D.loo, "Investigation of basic
imagingpropertiesindigital radiography 4.Effect o
f unsharp masking on detectability of sample patte
rns ", Med.Phys.12 (2), pp.209-214. 2. Perform image processing for enhancing contrast by changing the lookup table as described in Contrast enhancing means. Related processing, which is image processing for converting the density range into a constant range, is performed in the process before performing all image processing.
If it is "posure" or B (under exposure), it is converted to the pixel range of C (appropriate exposure). e. Means for Determining Whether Abnormal Shadow Detecting Means is Applicable In the tumor shadow detecting method, the abnormal shadow is detected by obtaining the difference between the pixel values of the left and right breasts. However, this method cannot be applied when the sizes and shapes of the left and right breasts are extremely different. Therefore, in this embodiment, the following 2
Two processes are performed to determine whether or not the tumor shadow detection method is applicable. If it is determined that the application is not applicable, the output device 10 outputs a comment to that effect without applying the abnormal shadow detection means. 1. Check the left and right areas of the breast.

As shown in FIG. 37, the image is divided into two areas, area A and area B, and the area of area B is taken as the breast area. Regarding the division of the region, the p point (pixel value p) in the histogram of the breast image shown in FIG. 24 may be used as a threshold (a threshold value) for the division.

The areas obtained for the left and right breasts are compared, and if the difference is, for example, 10% or less of the total area, it is determined that the tumor shadow detecting means can be applied. 2. Check the angle of the breast contour.

As shown in FIG. 38, a circle is overlaid on the breast contour (fitting), and the midpoint 14 of the arc included in the image.
The angle formed by the straight line connecting 2 and the center of the circle and the horizontal line of the image is defined as the contour angle 144. The contour angles obtained for the left and right breasts are compared, and the angle difference is, for example, 1
If it is 0% or less, the tumor shadow detecting means is applied.

For contour detection and the like, a method is known in which a Sobel operator or the like is used and then binarized and extracted. f. Abnormal shadow detection means, detection result storage means As the means for detecting abnormal shadows, the CAD described above is used.
(Computer-aided diagnosis) detects microcalcification shadows and tumor shadows. The means for detecting these abnormal shadows are sequentially applied to the mammogram image, the detection results are described in the abnormality detection result table, and stored in the system disk 12 as, for example, a data file. When the detection results are sequentially output, they are stored in the memory 14 and output. Table 4 shows the abnormality detection result table.

[0106]

[Table 4] g. Output screen creating means <Mammogram image placement method managing means> As the function 1, the output screen creating means can determine the placement method of the image on the screen according to the doctor's preference. Further, as the function 2, the arrangement method can be determined according to the result of the abnormality detection from the image.

FIG. 39 is a diagram showing types of photographing directions. For example, FIG. 1A shows a case where X-rays of the right breast are exposed in the up-down direction, particularly from “top to bottom” (from the head to the legs of the subject). There is. In addition,
At the time of photographing, the breast is pressed and pinched perpendicularly to the direction of X-ray exposure.

FIG. 39 shows six kinds of patterns (a) to (f) for the right breast as the photographing directions. In this embodiment, there are two kinds of photographing directions, that is, the vertical direction and the horizontal direction. There are two types of mammogram images for each shooting direction. That is, in the vertical direction, the "top to bottom" direction and the "bottom to top" direction are not distinguished, and in the left and right direction, the "inside to outside" direction and the "outside to inside" direction are not distinguished. In addition, this is not taken into consideration for the oblique direction (no shooting is performed).

The layout method on the screen is set according to the type of the mammogram image for each shooting direction. In this embodiment, two CRTs are provided and different images can be displayed on each CRT. Further, each CRT simultaneously displays two images on one screen.

FIG. 40 is a diagram showing types of arrangement methods of images on a screen, FIG. 40A is a diagram showing types of arrangement positions, and FIG. 40B is a diagram showing types of arrangement directions. Is.

As shown in FIG. 10A, the layout positions on the screen include a layout position L on the left side and a layout position R on the right side when the screen is divided vertically, and when the screen is divided horizontally. There is an upper arrangement position U and a lower arrangement position D.

As shown in FIG. 11B, there are four types of arrangement directions on the screen, (1) to (4). The doctor holds, in the memory 14 or the system disk 12, as a table, a preferred arrangement method according to the abnormality detection result for each image type (represented by cases 1, 2, and 3). Table 5 shows the contents of the table held by the three doctors A, B, and C.

[0113]

[Table 5] FIG. 41 shows images on the left side and the right side of the image for each image type (each case) based on the table of Table 5 held by the doctor A.
It is the figure which showed a mode that it arranges on the screen of the CRT of a stand.

FIG. 42 is a diagram showing how images are arranged on the screens of two left and right CRTs for each type of image (for each case) based on the table of Table 5 held by doctor B. is there.

FIG. 43 is a diagram showing how images are arranged on the screens of two left and right CRTs for each image type (for each case) based on the table of Table 5 held by doctor C. is there. For the doctor C, regardless of the abnormality detection result, the doctor C always outputs the information in a fixed arrangement method.

Next, the operation up to outputting on the screen according to the determined arrangement method will be described. 1) A doctor inputs doctor identification information (doctor ID number) before image interpretation. 2) If the inputted doctor ID number is registered in the table, the central control unit 16 instructs the arrangement method of the image to be displayed according to the registered content. Here, if doctor ID
If the number is not registered in the table, the default placement method (preset placement method, for example, the placement method similar to that of the doctor A) is followed. 3) If the image matrix size to be displayed and the display area matrix size of the display device match, the image is displayed in the specified arrangement position and arrangement direction as it is. If the image matrix size and the display area matrix size do not match, the image data is processed and both ends are cut and displayed in order to match the image matrix size with the display area matrix size.

Regarding the processing of image data, for example, it is assumed that the image data size is (4000 × 5000) and the display area matrix size is (4000 × 5000).

Here, when displaying at the arrangement positions "L" and "R", the matrix size of the area required for display is (2000 × 5000), so that FIG.
As shown in, the hatched area is deleted.

Further, when displaying at the arrangement positions "U" and "D", the matrix size of the area required for display is (4000 × 2500), so that FIG.
As shown in, the hatched area is deleted.

As described above, according to the output screen creating means, the method of arranging the image on the screen can be changed according to the doctor's preference.
Alternatively, various determinations can be made according to the abnormality detection result, and the output screen can be created by processing the image data if necessary according to the determined arrangement direction.

The photographing direction and the number of images are not limited to the contents of Table 5 described above, and the images in the oblique direction are “left oblique top to right oblique bottom” and “right oblique top to left oblique bottom”. For example, a plurality of images may be taken. Further, the number of display devices is not limited to two. For example, one unit may be used, or three or more units may be used and displayed in various arrangement directions. h. Abnormality detection result output means As the first function, the abnormality detection result output means can show the position of the abnormality detected by the abnormal shadow detection means from the outside of the image. Further, as the function 2, the number of detected abnormalities can be shown. Further, as the function 3, a plurality of abnormalities can be given identifiers and can be clearly distinguished from each other.

The abnormality detection result output means satisfies both conflicting requests from the observer (interpretation doctor) who wants to refer to the abnormal shadow detection result but does not want to disturb the image interpretation.

FIG. 45 is a schematic view of a screen in which the abnormal shadow detection result is shown from the outside of the image. According to FIG. 45A, the detected abnormality (shadow) 148 is displayed on the screen 145.
Is displayed, the two markers 147 located outside the mammogram image 146, and the number of detected abnormalities (shadows) 149 are displayed. In FIGS. 45 (a) to (c), the marker 147 is displayed as an arrow. The marker is not limited to the arrow. The markers 147 are positioned outside the mammogram image 146 so that the intersections on the extension lines of the arrows of the respective markers are equal to the position of the detected abnormality 148.

When the number of detected anomalies is plural and the number is relatively large, the display becomes troublesome if the abnormalities are indicated by a plurality of markers as described above.

Therefore, as shown in FIG. 45 (b), the number of abnormalities (shadows) 149 in which one abnormal position is detected from the outside of the image and other abnormalities are detected is displayed in the corner of the screen. . As a result, in addition to the abnormality indicated by the marker,
It can be seen that the detected anomaly exists.

Further, as shown in FIG. 45 (c), an identifier 152 such as a number may be displayed near the detected abnormal position.

Further, as shown in FIG. 45 (d), when it is desired to indicate a plurality of abnormal positions at the same time from the outside of the mammogram image using a plurality of markers, the shapes or colors of the markers are changed and displayed. Good.

As shown in FIG. 45 (e), the respective positions of the markers indicating the position of the abnormality (shadow) from the outside of the image are the X-axis from the coordinates (x, y) in the image of the detected abnormality. It can be obtained by the intersections (x, 0) and (y, 0) of the perpendicular lines extending on the Y axis. <Comparison of CAD results> The main function is the above-mentioned CA.
The diagnosis result of the past image by D (computer assisted diagnosis) and the diagnosis result of the current image are compared, and displayed when there is a difference between the past image and the current image. 1) The central controller 16 performs CAD processing (abnormality detection) on the current image to obtain the CAD processing result. 2) The central controller 16 searches for past images from the patient identification information (patient ID). 3) The central control unit 16 compares the CAD processing result of the past image (when the CAD processing result does not exist, the CAD processing is executed to obtain the result) with the CAD processing result of the current image. 4) If there is a difference between the two results, the central controller 16 outputs that effect. 5) The doctor inputs a comparative image reading command. 6) The central controller 16 outputs the present image and the past image to the display device 10 according to the table of Table 6 shown below.
In Table 6, only the table for the case 1 of the doctor A is shown, and the tables of the other cases of the doctor A and the tables of the other doctors are omitted.

[0129]

[Table 6] FIG. 46 is a diagram showing a state in which the present image and the previous image (past image) are arranged on the screens of two CRTs based on the table of Table 6.

If there is a difference between the two results, the current image and the past image may be displayed without waiting for the doctor to input the comparative image interpretation command.

The image obtained by the X-ray detection device 4 is stored in the temporary memory 14 and output from the output device 10. The image reader makes a diagnosis based on the output.

At this time, as an auxiliary role of image interpretation, in this system, an abnormal shadow is detected, and image processing is automatically performed based on this result, and the abnormal shadow is displayed more clearly. To do so. For image processing, enlargement,
Performs contrast adjustment, frequency processing, etc. The image interpreter presets which image processing is to be performed. When an abnormal shadow is performed, the image processing automatically set is performed and the image is displayed.

As a display method, first, a display screen after image processing and a standard display screen are set. At this time,
Depending on the number of screens, use multiple (for example, two) CRTs,
The display screen after image processing is set on one CRT, and the standard display screen is set on the other one. Further, a single CRT may be configured and a plurality of screens may be realized by dividing the screen.

When the amount of image information is equal to the amount of information that can be displayed on the screen, the standard screen is displayed as it is.
When the image information amount is larger than the screen displayable information amount, the image information is compressed and displayed. Means for compression include averaging and thinning.

Next, the image subjected to the image processing is displayed on the image processing screen. At this time, the image is displayed so that the position of the detected abnormality is the center of the screen.

When enlargement is performed as image processing, the image information may be displayed as it is (when the image information amount is larger than the image display information amount) or may be displayed by interpolating the information between pixels. .

When the contrast is adjusted as the image processing, the range of the pixel value of the image displayed when enlarged is displayed is smaller than that of the standard image, and the difference between the maximum and minimum signals is small. Adjust the contrast accordingly. 47A and 47B are views for explaining the contrast adjustment, in which FIG. 47A shows the input / output characteristics of the standard image, and FIG. 47B shows the input / output characteristics of the image after the contrast adjustment. FIG. 6C is a diagram showing a display example of a standard image, and FIG. 7D is a diagram showing a display example of an image after contrast adjustment.

The abnormal shadow appears on the mammogram image due to various factors such as calcification and tumor shape. The abnormal shadow detected by the abnormal shadow detecting means is subjected to image processing according to such various factors, and then displayed.

Regarding the frequency processing in the above-mentioned image processing means, the frequency characteristic of the image is changed according to various factors. For example, when calcification appears on the image as an abnormal shadow, such a shadow has a relatively high contrast, but since it is a small shadow, the contour is further enhanced by emphasizing the high frequency range. Make it clear. Further, when the tumor appears as an abnormal shadow on the image, such a shadow is judged (interpreted) by a slight difference in light and shade on the image. Therefore, it is easier to view the image by emphasizing the low frequency band.
Thus, by changing the frequency characteristic of the image, the abnormal shadow can be more clearly displayed.

The range of the image (for example, ROI) displayed on the image processing screen is displayed on the standard image as to where on the standard screen it is.

As shown in FIG. 48A, when there are several abnormal shadows, the screen is divided and displayed according to the number. Since image processing is performed on each of the divided screens, the degree of image processing varies depending on each screen. At this time, in order to make it easy to understand where on the standard screen is displayed, numbers may be added as shown in FIG. 48 (b). If the number of abnormal shadows is too large to be displayed, inform the image reader by sound or message so that it can be seen that not all are displayed. Regarding the image processing that is automatically performed, the contents of the image processing can be set in advance by the radiogram interpreter, and thus it is also possible to perform image processing other than the image processing described above.

With the above-mentioned structure, it is possible to read images by a quick operation and to realize excellent lesion detection ability. i. Means for Recognizing Shooting Direction from Inclination of Arm <Automatic Recognition of Shooting Direction> FIG. 49 is a side view of the C arm and the C arm support. In the figure, the X-ray generator 2, the compression plate 3, the X-ray detector 4 and the like provided on the C-arm 5 are omitted. The C arm 5 has a C arm support 154.
Is rotatably attached to.

According to the automatic recognition of the photographing direction, it is possible to automatically obtain a part of the accompanying information such as “examination information” in Table 3 described above and simplify the input. Here, the photographing method is automatically recognized from the inclination of the C arm 5. That is, as shown in FIG. 49, the tilt angle θ of the C arm 5 is defined, and the tilt angle θ of the C arm 5 is obtained,
The contents to be entered in the item of the shooting method of the incidental information are determined, and the contents are written and stored in the memory 14.

FIG. 50 is a diagram schematically showing the processing for automatically recognizing the photographing direction in this way. First, in S1, the rotation angle of the C arm 5 is recognized using a mechanism that automatically recognizes the rotation angle.

FIG. 51 is a perspective view showing the outline of a mechanism for automatically recognizing the rotation angle. As a method of automatically recognizing the rotation angle, first, the first gear 158 is attached to the rotation shaft 156 of the C arm 5, and the first gear 158 is engaged with the second gear 160. A variable resistor (not shown) is attached to the rotation shaft of the second gear 160 so as to be rotatable in the same manner as the rotation shaft, and the angle recognition unit 162 electrically converts the rotation angle into a resistance value. The angle can be recognized. In this case, the rotation angle can be continuously recognized. In addition, a device that converts a rotation angle into an electric signal can be treated in the same manner.

Next, in S2, the photographing direction is determined from the rotation angle of the C arm 5 obtained in S1.

Here, in S3, the boundary angle can be set by the input of the technician as the condition for determining the photographing direction. For example, when the boundary angle is θ,
As shown in 2, when the angle θ is “θ = 0 °”, the photographing direction is determined to be “CC”, and the angle θ is “−70 ° <θ <0.
When “°” or “0 ° <θ <70 °” is satisfied, the shooting direction is determined to be “MLO”, and the angle θ is “−90 ° <θ <
When “−70 °” or “70 ° <θ <90 °” is satisfied, the shooting direction is determined as “MO.” The range of the angle θ and the types of direction notation characters such as “CC” and “MLO” are examples. However, the present invention is not limited to this.

Next, the result determined in S4 is written in the item "imaging method" of the accompanying information. Here, at the time of performing special photographing, it is possible to manually input the accompanying information in S5 and also to make corrections.

As another example of automatic recognition of the rotation angle, as shown in FIG. 53, the first electrode 164 is placed on the rotation shaft 156.
And a second electrode (divided electrode) 166 obtained by dividing the upper surface of the disk into several parts is arranged on the C-arm support portion 154 side, and a switching action is caused by the positional relationship between the first electrode 164 and the second electrode 166. , Mechanically perform angle recognition and shooting direction determination. The judgment condition of the photographing direction is given by the division angle of the second electrode, and the information of the photographing direction is written in the accompanying information according to the switching.

In addition, various mechanisms for switching according to the rotation angle are also included.

When performing a special photographing, it is possible to manually input / correct the incidental information in S5.

Discrimination between left breast and right breast, that is,
The item “imaging region” of the accompanying information is automatically written by pressing the “right button” or “left button” (neither is shown) of the C-arm 5. j. Compression Timing Adjusting Means The means for adjusting the timing of compression in association with X-ray exposure has been described in the description of the X-ray generator 2.
Here, it is omitted. k. Biopsy inspection status confirmation means <Confirm biopsy puncture status by X-ray imaging at ultra-low dose> FIG. 54 is a diagram showing a pressure pad used for a biopsy inspection. Biopsy inspection, pressure pad 1
The breast is sandwiched by 68, and a thin needle is pierced through the window 170 provided on the pressing surface of the pressing pad 168 to the diseased part 172 of the breast to collect a sample.

The details of the biopsy test up to sample collection will be described.

First, the breast is sandwiched between the pressure pads 168. At this time, the diseased part 172 is sandwiched so as to be located in the window 170.

Next, photographing is performed with the photographing angle set to "0 °", and it is confirmed that the diseased part 172 is inside the window 170.

Next, as shown in FIGS. 55 and 56, the posture (shooting angle) of the C arm is "+ 15 °" and "-15 °".
The three-dimensional information is obtained by shooting as.

Next, from the obtained three-dimensional information, the 3
The dimensional position is calculated, and the double-structured needle 174 is located at the calculated position.
Is inserted through the window 170.

FIG. 57 is a diagram showing how a needle is inserted into a diseased part of the breast.

Next, the photographing angle is set to "+ 15 °" and "-15".
The specimen is collected by making a photograph as “°” and making sure that the needle is in the center of the diseased part.

An image is taken again after collecting the sample to confirm that the sample of the diseased part was collected.

When inserting the needle into the diseased part, the needle may be bent. If it is possible to confirm whether or not the needle is inserted straight, it is possible to prevent radiographing at the time of sample collection while the bent needle is inserted, so that unnecessary exposure to the patient is avoided.

Therefore, before taking an image at the time of collecting a sample, an image is taken by low-dose X-ray in the process of inserting the needle to confirm whether or not the needle is inserted in a correct posture. In this case, shooting is performed at shooting angles “+ 15 °” and “−15 °”.

The X-ray dose at the time of radiography may be such that the shape of the needle can be confirmed. Therefore, the X-ray dose is set to be smaller than that normally used for fluoroscopy. After confirming the straight movement of the needle in this low-dose image, the image is taken during sample collection. According to the biopsy puncture status confirmation means, it is possible to know whether or not the needle has been punctured straight into the diseased part by low-dose X-ray imaging, and thus a biopsy test can be appropriately performed without causing unnecessary invasion to the patient. l. Biopsy visual field recognition and partial data storage means FIG. 58 is a diagram showing a profile acquisition line set on the detector. On the surface of the detector 42, 176 is a biopsy irradiation field and 178 is a profile acquisition line (a to d).

In the detector, the profile data in each profile acquisition line 178 of a to d is collected before all the data, and as shown in FIG. 59, the profile acquisition line "a" and the profile acquisition line "c" Get the data. Then, the position where the image data exists is detected as, for example, the point A by the primary differentiation of the profile data or the like, and the read range is determined so that only the data in the shaded area (biopsy irradiation field 176) in FIG. 58 is read.

The details of the data read based on the read range have been described in the description of the X-ray detection apparatus 2, and will not be repeated here. m. Automatic setting means for photographing conditions by photographing scene and detector (mode) As a general rule, automatic setting of photographing conditions is carried out using the above-mentioned Table 1 based on the measurement results of various conditions as described above.

As shown in the operation panel 90 of FIG. 16C, this system can select various system use scenes (photographing scenes) for each examination.

In this case, the normal inspection and (1) group inspection,
(2) Biopsy, (3) Excision specimen examination, (4) Different imaging conditions for fluoroscopy, and the setting of imaging conditions is supported by having the imaging condition determination table in Table 1 for each case. n. Means for reading out an image triggered by the end of exposure Since it has been described in the explanation of the X-ray detection apparatus 2, it will be omitted here. o. Means for outputting patient information including RIS, means for outputting an identifier (including barcode) RIS information (for example, examination request information) can be displayed and viewed. When the inspection request information is selected by the operation panel 90 of FIG. 16 (the item for outputting the inspection request information is not shown), the requested items regarding the currently selected inspection (such as the patient information and the inspection information shown in Table 2) ) Is displayed on the screen of the CRT 100 of the output device 10. p. A means for enlarging / reducing an image to an arbitrary size Enlarging / reducing is performed by filtering pixel data of an image. Assuming n × n, the 1 / n filter has n
It is applied when the average value or the maximum value of the pixel values of the xn matrix is taken, or when the predetermined specific matrix element of the nxn matrix is acquired. q. CRT / Film Output Selection Means In the initial operation of the system, an output method such as “CRT” or “film” can be selected by the operation panel 90 of FIG. r. Means for discriminating whether the abnormality is malignant or benign and outputting the result As means for determining whether the abnormality is benign or malignant, US Pat.
It was mentioned above that reference can be made to No. 20.

Here, when the doctor gives an instruction to analyze the shadow (analysis of abnormalities) on the screen as shown in FIG. 60 when the doctor interprets the image, if there is a previously detected tumor shadow, the analysis result of the computer for the shadow. Is output as being guided as malignant or benign. On the other hand, the doctor directly outputs on the image whether or not the shadow pointed out by the pointing means such as a mouse has been analyzed.

The present system has a mouse as one of input means (instruction means). The mouse is displayed using one surface of the overlay memory 110 of the output device 10, and the clicked position of the mouse button is associated with the image as the coordinate position of the screen. s. The ROI manual input device is a means using a touch panel that outputs a schema, and is omitted here because it is shown in FIG. 18B. t. Overall Control Program When the present system is activated, a screen as shown in FIG. 16 (a) is displayed on the operation panel 90.

The operator touches the operation panel to read "interpretation", "inspection", "interpretation after inspection", "others".
Such processing can be selected.

The system disk 12 stores the following data in addition to the control program having the functions a to t as described above. Specific items of each data will be described. (1) Image and accompanying information Image has maximum matrix size “6000 × 4800”
This is (2 bytes) data. FIG. 61 is a diagram showing a coordinate system of image data. In normal shooting, “4” of these
An area of 800 × 3600 ″ matrix size is used.

The screen coordinate system is CR as shown in FIG.
T screen (for example, the matrix size is “2500 × 20
00 ") and film (for example, the matrix size is" 8500 x 7000 ") are considered separately. (2) Inspection history As shown in Table 7, as information for searching and reading out past images Keep the inspection history.

[0173]

[Table 7] (3) Inspection request information As shown in Table 2, the inspection request information obtained from the RIS and the like is held, and the inspection request information created by manually inputting the request information on the paper is also held. (4) Table for arranging images As shown in Table 5, a table is held for the doctor to decide how to arrange images. (5) Abnormality detection result table As shown in Table 4, the result detected by the abnormal pattern detecting means is held as a table. (6) Reference image data At the time of shipment, the detector 42 is irradiated with X-rays for a specified time, and the reference image data is collected and held.

At the time of maintenance, the deterioration of the detector 42 is detected by taking the difference between the reference data and the image data of the test shot. Next, the memory will be described. The memory 14 is a semiconductor memory, and is a memory for performing operations such as temporarily storing image data and programs and data of the system disk 12. The writing and reading of data to and from the memory 14 are controlled by the central controller 16.

The central controller 16 controls all operating functions of the system. The operation of the basic system configured as described above is performed by "normal examination", "group examination", "needle biopsy examination", "excision / biopsy examination with a scalpel", "follow-up examination", "detector deterioration," Maintenance correspondence work ”will be described in this order.

First, the operation of the outpatient examination and the normal examination based on image interpretation will be described. The most common use of mammography in a normal hospital is
This is an examination and diagnosis for an outpatient who visited an hospital because of an abnormality.

The operation of the system during inspection and image interpretation work will be described below.

As described above, when the system is started, the first operation panel 90 is displayed as shown in FIG.
Display the panel.

On the first panel, any one of "interpretation", "inspection", and "others" is selected.

When "interpretation" is selected, the interpreting doctor ID is input, and after the interpreting doctor inputs the ID, FIG.
As shown in (b), the second panel is output to the operation panel 90. The ID of the image interpretation doctor is stored in the memory 14, and thereafter,
Output according to the interpretation doctor's preference is made until the device (system) is brought down.

Here, for example, the image interpreting doctor is assumed to be Y and the ID is 987.
Suppose 6 is entered.

When "inspection" is selected, a third panel is displayed on the operation panel 90 as shown in FIG. 16 (c).

When "other" is selected, a fourth panel is displayed on the operation panel 90 as shown in FIG. 16 (d).
Set the output conditions on this panel.

Here, a case will be described in which "examination" is selected from the first panel and "normal interpretation" (follow-up interpretation and group examination are similar examinations) from the second panel. (1) Input of patient examination information For example, when an examination request for a certain patient X is transferred from the RIS to the memory 14 of the system as examination request information, the list of patients including the patient X is operated as shown in FIG. Since the examination list is output to the panel 90, the examination engineer selects the patient X by touching (touching) the portion of the patient X. (2) Positioning The patient X is positioned (positioned). With regard to the set of imaging devices, it is only necessary to instruct which of the left and right breasts to be imaged with the button of the arm (designation of imaging site). The photographing means (photographing method) is also determined by the tilt of the arm. Information related to the RIS inspection and information such as an imaged site and an imaging method are stored in the image accompanying information. (3) Breast compression The compression of the breast is applied by a foot switch (not shown). When the specified pressure (10N) is reached, compression is stopped. (4) Imaging condition setting The imaging condition is determined based on the imaging condition determination table while the breast is pressed by the foot switch. In the shooting condition table, for example, "age: 50 years old, hardness: soft, size:
"Small, thickness: 3 cm" is given as the information of the patient X. According to the imaging condition determination table, for example, "filter: Mo, kvp:
The imaging condition of 28 kvp, mA: 10 mA "is obtained. (5) X-ray exposure The X-ray is controlled under the above-mentioned imaging conditions and the technician determines the X-ray exposure. The exposure time is managed by the AEC30. Is
Imaging is performed with an appropriate mAs value. It should be noted that an appropriate pressure is applied to the patient's breast only during the exposure by the setting of the technician. For example, when the technician determines that a load of 1N is to be applied and inputs the value, a total pressure of 11N is applied to the breast only during the exposure time, and the pressure is released at the same time as the end of the exposure. The pressure is set in advance above the ACR standard, and it is a safety mechanism that does not give an excessive pressure. (6) Storage of image and associated information associated with each other The image data obtained from the detector 42 is temporarily stored in the memory 14. The image accompanying information is created based on this data and stored in the memory 14 in association with the image data. Table 8 shows an example of the image accompanying information.

[0185]

[Table 8] Here, a case of interpretation using a film will be described.

Interpretation by a film may be performed by using the CRT 100 as an auxiliary or by using only the film. When the CRT 100 is used as an auxiliary, the output of the film is simply density-corrected. These outputs are performed sequentially after one set of inspection is performed. The operation inside the system is as follows. (1) Image reading The image data in the memory 14 is read one by one. (2) Density correction The density correction processing function is activated for the image to correct the exposure appropriately. The exposure-corrected image data is stored in the memory 14. (3) CAD processing CAD processing is not performed when the CRT 100 is used supplementarily.

First, the abnormal shadow detecting means is applied to the image data after the image density correction. As shown in FIG. 63, the microcalcification shadow 180 is detected at the position of coordinates (1000, 1500), and the tumor shadow 182 is detected at the coordinates (2000, 30).
00) is detected. The detection result is described in the abnormality detection result table (Table 4) described above and stored in the memory 14. (4) Image processing Image processing is not performed when the CRT 100 is used supplementarily.

According to the abnormality detection result table created in the above-mentioned CAD processing, "1000 ×" centered on the image coordinates (1000, 1500) and coordinates (2000, 2000).
Take out 1000 "ROI data. The abnormal position is R
If it is included in the OI, the data extracted first is used as ROI data. Further, these ROI data are processed by the image processing function and stored again in the memory 14. Unsharp masking processing is performed on the microcalcification shadow 180, and image processing is performed on the tumor shadow according to the shadow such as changing the look-up table. (5) Screen Creation A position obtained by converting the image coordinates (1000, 1500) into screen coordinates by the abnormality detection result table created in the CAD process described above, that is, a mark indicating the position of the microcalcification shadow, is applied to the outer frame of the image. Set in the inside and set the image coordinates (200
(0, 3000) is converted to the coordinates of the screen, that is, a mark indicating the position of the tumor shadow is set in the outer frame of the image. Also, as shown in FIG. 64, the ROI is displayed beside the image.
An image in which the size of one pixel of the data is doubled is arranged. These screen data are sent to the laser writing device 118.

When using the CRT 100 as an auxiliary,
For the radiogram interpreter Y, for example, how to arrange the images is determined according to Table 6 already shown, a screen in which only the images are arranged is created, and the data is sent to the laser writing device 118. (6) Film printing The screen data obtained by the image processing described above is sent to the laser writing device 118, and an instruction is given to print the film. Next, the operation when performing (support) diagnosis using a CRT will be described. (1) Examination Information Input A list of patients who have undergone examination is displayed on the operation panel 90. Here, the examination of the patient X is selected. (2) Image reading The image data in the memory 14 is read one by one. (3) Density correction The density correction processing function is activated for the image to correct it for proper exposure. The exposure-corrected image data is stored in the memory 14. (4) CAD processing The abnormal shadow detection means is applied to the image data after the image density correction. As shown in FIG. 63, microcalcification shadow 180
Is detected at the position of coordinates (1000, 1500), and the tumor shadow 182 is detected at the position of coordinates (2000, 3000). The detection result is described in the abnormality detection result table (Table 4) described above and stored in the memory 14. (5) Image processing Image processing is not performed when the CRT 100 is used supplementarily.

From the abnormality detection result table (Table 4) created in the CAD processing described above, the image coordinates (1000, 15
00) and coordinates (2000, 2000)
The ROI data of 000 × 1000 ″ is taken out. When the abnormal position is included in the ROI, the previously taken out data is taken as the ROI data. Further, these ROI data are processed by the image processing function and stored in the memory 14. Unsharp masking processing is performed on the microcalcification shadow 180, and image processing is performed on the tumor shadow according to the shadow table change, etc. (6) Screen creation and display Interpretation doctor Y The initial screen is displayed on the operation panel according to the instruction of 1. The target image is selected on the initial screen, and the display abnormal shadow detection result and the abnormal shadow gaze are displayed.

FIG. 65 is a diagram showing an initial screen displayed on the operation panel.

The images of the examination are all taken by the interpreting doctor Y until the examination is completed.
It is displayed in the layout method of your choice. Further, an image that needs to be reduced in display is reduced and displayed.

The initial screen abstracts the image (deformation)
The selected image is selected by the switch. Further, it has a switch used to display the abnormal shadow detection result and a switch used to gaze (enlarge, emphasize) the abnormal shadow.

As the image of interest, only the image selected on the operation panel of the initial screen is displayed.

As shown in FIG. 66, the abnormal shadow detection result is displayed overlaid on the displayed image. The abnormal shadow indication mark is created on the overlay memory at the position of coordinates (1000, 1500) for the microcalcification shadow and at the coordinates (2000, 3000) for the mass shadow, and is displayed on the image by the display management unit 112. Overlap and display.

In the gaze of the abnormal shadow, the ROI data created by the image processing of (5) based on the priority of the displayed image is displayed without reduction or the like.

Table 9 is a table showing the priority levels of gaze of abnormal shadows.

[0198]

[Table 9] 67A and 67B are views showing ROI display and CRT display on the operation panel. FIG. 67A shows the CRT display and FIG.
Shows the display of the operation panel 90.

On the operation panel 90, which position on the image the ROI displayed on the CRT represents is abstracted (deformed) and displayed.

Next, the operation in the group medical examination will be described.

The contents of the examination at the time of the mass examination are the same as the examination flow of the above-mentioned ordinary examination. Further, if only the film is diagnosed, it is the same as the image interpretation by the film in the normal inspection. In the group medical examination, the examination and the film output are performed together, and the image interpretation is also performed later.

It is assumed that all inspection results (image data etc.) are stored in the hard disk. The operation flow of the system in the image interpretation work in such a case will be described below. (1) A list of patients who have completed the examination is displayed on the examination information input panel. Here, the examination of the patient X is selected. (2) Image reading The image data of the patient X on the memory 14 is read one by one. The density correction processing function is activated for the image to correct the exposure appropriately. The exposure-corrected image data is stored in the memory 14. An abnormal shadow detection means is applied to the corrected image data. As shown in FIG. 63, the microcalcification shadow 18
It is assumed that 0 is detected at the position of coordinates (1000, 1500) and the tumor shadow 182 is detected at the position of coordinates (2000, 3000). The detection result is described in the abnormality detection result table (Table 4) described above and stored in the memory 14. (3) Image processing ROI setting The ROI position determining means set by the shuttle sets the ROI of “1000 × 1000” to obtain the ROI data in real time. (4) Image Processing The ROI data is processed by the image processing function and stored again in the memory 14. Unsharp masking processing is performed on the microcalcification shadow 180, and image processing according to the shadow is performed on the tumor shadow 182, such as changing the look-up table. (5) Screen Creation The initial screen is displayed on the operation panel 90 according to an instruction from the image interpreting doctor Y. The target image is selected on the initial screen, and the display abnormal shadow detection result, the abnormal shadow gaze, and the gaze position by the shuttle are displayed.

As shown in FIG. 65, the initial screen is displayed on the operation panel 90. The image of the inspection, until the end of the inspection,
All the images are displayed according to the layout method of the image interpreting doctor Y. Further, an image that needs to be reduced in display is reduced and displayed.

The initial screen abstracts the image (deformation)
The selected image is selected by the switch. Further, it has a switch used to display the abnormal shadow detection result and a switch used to gaze (enlarge, emphasize) the abnormal shadow.

As the image of interest, only the image selected on the operation panel of the initial screen is displayed.

As shown in FIG. 66, the abnormal shadow detection result is displayed overlaid on the displayed image. The abnormal shadow indication mark is created on the overlay memory at the position of coordinates (1000, 1500) for the microcalcification shadow and at the coordinates (2000, 3000) for the mass shadow, and is overlaid on the image by the image display manager. To display. The gaze of the abnormal shadow displays the ROI data created on the basis of the priorities of the above-mentioned Table 9 with respect to the displayed image without reducing or the like.

When the gaze position is displayed by the shuttle, the ROI data created by the shuttle is displayed without being reduced.

FIG. 67 shows the ROI display and C on the operation panel.
It is a figure which shows the display of RT, the figure (a) shows the display of CRT, and the figure (b) shows the display of the operation panel 90.

On the operation panel 90, which position on the image the ROI displayed on the CRT represents is abstracted (deformed) and displayed.

Next, the operation in the needle biopsy test will be described.

When an abnormal shadow is found as a result of mammogram interpretation, a biopsy for determining whether the shadow is malignant or benign is performed if necessary by the doctor. The purpose of this test is to insert a needle into the lesion and remove abnormal cells.

The operation in the inspection / interpretation work in such a case will be described below.

In this case, as shown in FIG. 16 (c), "Biopsy" is selected on the third panel of the operation panel 90. In addition, in FIG. 16C, “biopsy (fluoroscopy)” can also be selected, but in this case, X-ray fluoroscopy is performed without performing X-ray imaging.
Other operations are the same as in this inspection. (1) X-ray irradiation X-ray irradiation is performed under biopsy conditions.

The small field of view for biopsy is judged and the image is written in the memory 14.

The X-ray is irradiated while changing the angle and stored in the memory 14 in the same manner. (2) Image reading Two images are taken out from the memory 14. (3) Creation of biopsy inspection screen As shown in FIG. 68, a screen in which two images are arranged is created and displayed on the CRT 100. (4) Shading instruction The shading of two images is designated by the mouse, and the designated position is stored in the memory 14. (5) Calculation of puncture distance from shadow position The distance is calculated by the biopsy puncture position calculation means. (6) Output of puncture distance The puncture distance is displayed on the CRT screen or panel.
In order to confirm the biopsy puncture status, confirmation radiography is performed with ultra-low dose X-rays. As in the calculation of the puncture distance, the image is exposed and stored in the memory 14. Further, the shade designated position at the time of calculating the puncture distance is shown in the overlay memory 110 and is displayed so as to be superimposed on the image. Next, the operation in the excision / biopsy inspection by the scalpel will be described.

In the above-mentioned biopsy (biopsy test), if the lesion is excised with a scalpel, the condition of the lesion can be observed most reliably. However, there is a drawback that the invasion of the patient is very large.

When carrying out such an inspection, mammography is mainly used for confirmation work. The operation of the system in image interpretation work will be described below.

Select "Biopsy" on the third panel of the operation panel 90. (1) Setting of excision specimen Set the excision specimen. (2) X-ray exposure X-ray is emitted under the imaging conditions of the excised specimen. (3) Image storage The image is stored in the memory 14. (4) Image reading and density correction An image is read from the memory 14 and the image density is corrected as described above. (5) CRT display As shown in FIG. 69, an image of the excised specimen 300 is displayed on the CRT1.
Displayed at 00. Next, the operation in image interpretation for follow-up will be described.

When the inspection is being carried out regularly, the past inspection data is used for comparison. The operation of the system in such image interpretation work will be described below.

"Follow-up interpretation" is selected on the second panel of the operation panel 90. (1) A list of patients who have completed the examination is displayed on the examination information input panel. Select patient X. (2) Obtain data of past examinations from the database or PACS. The past examination of the patient X is selected from the examination history, searched in the database, and the image is transferred to the memory 14. Further, it is assumed that the uninterpreted image is already stored in the memory 14. (3) Screen Creation When the CRT 100 is used supplementarily, the image arranging method for the image interpreting doctor Y is determined according to Table 5, and a screen in which uninterpreted images and past images are arranged is created as shown in FIG. To the laser writing device 110. Further, the abnormal shadow detection means may detect the uninterpreted image as in the case of normal interpretation. As shown in FIG. 71, the result may be output only when the abnormality is not detected in the past image and when the abnormality is detected in the unread image. (5) CRT output or film output (3) The screen created by screen creation is output to the CRT 100 or film 102.

Next, the operation for carrying out maintenance work for detector deterioration will be described.

In order to keep the mammogram quality constant at a high level, it is necessary to frequently perform maintenance of the device. The operation of the system for work in which highly accurate maintenance can be easily performed on the detector 42 that influences the imaging performance will be described in the following two cases. The maintenance of the detector 42 includes automatic maintenance performed every time the system is started up and maintenance performed by the user (imaging technician) at appropriate intervals.

In the automatic maintenance performed every time the system is started,
First, the image data on the detector 42 is reset to collect dark image data. The dark image data is data obtained by leaving the X-rays unexposed for a certain period of time. After resetting again, X-ray exposure is performed for a certain period of time to collect X-ray exposure data. The difference between the pixel values of the collected X-ray exposure data and the dark data is calculated, and for pixels with a difference of a certain value or more, this is determined to be a flaw. When a flaw is detected, if the flaw is a single flaw, the data of the adjacent pixels is corrected as it is as the value of the pixel. When the scratch becomes a certain value or more, it is determined that the deterioration is large, and a warning mark or the like is displayed on the CRT 100 or the operation panel 90. For maintenance performed by the user (photographer) at appropriate intervals, first, "maintenance" is selected on the fourth panel as shown in FIG. next,
Under the test conditions, the X-ray is subjected to test exposure, and the obtained data is stored in the memory 14. System disk 1
The reference image is stored in advance in 2 and the difference between the data obtained by the X-ray test exposure and the reference image is obtained. In the case of a pixel having a difference equal to or greater than a certain value, this is determined as a flaw. The correction is performed in the case of a single flaw or the like, and the data of the adjacent pixels is directly used as the pixel value. When the scratch becomes a certain value or more, it is determined that the deterioration is large, and a warning mark or the like is displayed on the CRT 100 or the operation panel 90. Next, PAC
The case where S is used will be described.

When information such as patient information or examination information is obtained from an external system, for example, R from RIS is used.
The IS data is transferred to the PACS system via the gateway.

When a mammogram image is read using a general-purpose workstation, the general-purpose workstation has a mammogram interpretation function as one application. (Second Embodiment) Next, a second embodiment will be described. In the second embodiment, a system in which a network function is applied to a basic system (called a modality system) will be described.

FIG. 72 is a block diagram showing a device configuration of a modality system. The modality system is configured such that a mammography imaging device 210, a digitizer 220, an imager 230, a database 240, and a mammogram interpretation workstation 250 are connected to each other via a local area network (hereinafter abbreviated as LAN) 200. Has become. The LAN 200 has a function of transferring data and commands input / output between the respective devices at high speed.

The modality system is different from the basic system of the first embodiment in that the image capturing system and the image output system are distributed via a network. Therefore, the output device 10 in the basic system is not provided in this system. The CRT 260 is merely for confirming the captured image, and the mammogram interpretation workstation 250 interprets the captured image. Further, the film output of the photographed image is performed by the imager 230.

FIG. 73 shows a mammography camera 210.
3 is a block diagram showing the internal configuration of FIG. The mammography imaging device 210 includes an X-ray generation device 211 and an X-ray detection device 2.
12, input device 213, RIS (I / F) unit 214, memory 215, ROM 216, optical disk 217, LAN
An I / F unit 218 and a control device 219 are provided, and an image confirmation CRT 260 is connected thereto.

X-ray generator 211, X-ray detector 212
Is the same as that of the first embodiment. The mammography imaging device 210 also includes an optical disk 213 that holds image data and the like obtained by the X-ray detection device 211. This allows the image data to be transferred offline without going through the LAN 200.

The data from the RIS is stored in the RIS I / F section 8
Is input to this system.

The photographing confirmation CRT 211 is for confirming an image immediately after photographing and corrects the image density.

FIG. 74 is a block diagram showing the internal structure of the digitizer 220. The digitizer 220 includes a film feed / laser irradiation control unit 221, a data reading unit 222, an input device 223, a memory 224, and a ROM 22.
5, a LAN I / F unit 226, and a control device 227.

Film feeding / laser irradiation control section 221
The data reading section 222 digitizes the data of the analog film that has not been digitized, such as past images. The digitized data is transferred from the data reading unit 222 to the LAN 200 via the memory 224 and the LAN I / F unit 226.

The input device 223 has a function of inputting identification information for inputting film identification.

FIG. 75 is a block diagram showing the internal structure of the imager 230. The imager 230 includes a film feed / laser irradiation / film development control unit 231, a data writing unit 232, an input device 233, a memory 234, and an RO.
It is composed of an M235, a LAN I / F unit 236, and a control device 237.

The imager 230 inputs image data from the LAN 200 and outputs it to film. The image data is sent from the LAN 200 to the LAN I / F unit 236 and the memory 234.
To the data writing unit 232 via. The data writing unit 232 sends image data to the film feed / laser irradiation / film development control unit 231 and controls writing on the film.

The film feeding / laser irradiation / film development control unit 231 writes image data on a film by a laser, develops the film, and discharges the film.
Very high-definition can be depicted on the film. The beam diameter of the laser writing on the film is arbitrarily changed,
The screen data is written according to the size of the film.

FIG. 76 is a block diagram showing the internal structure of the database 240. The database 240 includes an optical disk 242, a hard disk 243, a memory 241,
ROM 244, LAN I / F unit 245, control device 246
It is composed by.

The database 240 stores past images and images of other inspections on the hard disk 243 or the optical disk 242 of the optical disk changer. The stored image can be retrieved from the hard disk 243 or the optical disk 242 of the optical disk changer using the patient name (patient ID) as a key by the ROM 244. The searched image is transferred to the LAN 200 via the memory 241 and the LAN I / F unit 245, and the LAN 200 further transfers the image to an external device.

[0240] Fig. 77 is a block diagram showing the internal structure of the mammogram interpretation workstation 250. Mammogram interpretation workstation 250 is LANI /
F part 251, system disk 252, input device 25
3, a memory 254, a CRT 255, and a control device 256.

Mammogram interpretation workstation 25
0 has a function equivalent to that of the operation panel 90 described in the first embodiment, and has a function of inputting an instruction from an operator through a touch screen and a function of outputting a mammogram image for image interpretation.

The system disk 252 is the same as the system disk 12 described in the first embodiment,
Various control programs are provided, and various functions such as image processing are executed by the control programs.

As described above, according to the second embodiment,
Since the network function is added to the basic system, the image capturing system and the image output system can be configured separately, and the load in the system can be distributed. It is also easy to add another device or replace a certain device with a device having higher performance. (Third Embodiment) Next, a third embodiment will be described.

In the third embodiment, the basic system is PACS.
A system (referred to as a PACS system) to which is applied will be described.

FIG. 78 is a block diagram showing a device configuration of the PACS system. The PACS system includes a mammography apparatus 280, a gateway 281, a gateway 282, a digitizer 283, an imager 284, a database 285, and a workstation 286.

The mammography camera 280, digitizer 283, imager 284, database 285.
Is a device equivalent to the modality system described above.
On the other hand, the workstation 286 is not a dedicated apparatus for handling a mammogram image, unlike the workstation for image interpretation 250 of the modality system described above.

The CRT 287 is a device for image confirmation, and the mammogram image is read by the workstation 2
86.

Unlike the modality system described above, the PACS system can be connected to another modality 288 via the gateway 281. Information from the RIS 289 such as inspection request information is once input to the PACS system via the gateway 282. (Fourth Embodiment) Next, a fourth embodiment will be described. In the fourth embodiment, other system variations will be described.

FIG. 79 is a block diagram showing a schematic configuration of an abnormality detection (diagnosis support) system. The anomaly detection system digitizes the analog film by the digitizer 260 and the workstation 262 detects the anomalous shadow.

The detected abnormal shadow is output to the CRT 268 or the imager 264. With the above configuration, the system becomes simple.

The simplest system that does not indicate the detected abnormal position but simply emits a warning sound is also conceivable.

FIG. 80 is a block diagram showing a schematic structure of a photographing system. The imaging system includes a mammography imaging device 270, an imager 272, and a CRT 274. The photographic system has only the function of correcting the density of a photographed image and outputting the same, and is handled in the same manner as the conventional screen film system.

The present invention is not limited to the above-mentioned embodiments, but can be carried out in various modified forms. For example, as a method of arranging images, when an abnormality is detected in one of the images taken in the “CC” or “ML” direction, for example, when the abnormality is detected in the “CC” image, it is the same. Part of "M
The L "images may be displayed side by side, or, for example, when detected in the" ML "image, the" CC "images of the same part may be displayed side by side.

Further, in displaying the abnormal shadow detection result by CAD, even when the "CC" image or the "ML" image is displayed, that fact may be output if an abnormality is detected. Further, an image for indicating an abnormal shadow may be created next to the original image (mammogram image), and the image may be displayed so as to be superimposed on the original image. In that case, the size of the superimposed image is the same as or smaller than the original image. Further, character information indicating that an abnormal shadow is pointed out may be output next to the original image or the processed image.

[0255]

According to the present invention, the following mammography device can be provided. (1) Even in a mammogram image in which the mammary gland is dense, it is possible to easily distinguish the microcalcification shadow and the tumor shadow. (2) When the mammogram images are comparatively read, it is possible to observe the images to be compared with the same density range. (3) It is possible to automatically specify an enlargement instruction and a highlighted portion on a mammogram image. (4) Automatically arrange mammogram images on the screen. (5) When detecting an abnormal position by the computer, instruct that the result of the abnormal position does not overlap the original screen. (6) If the abnormal shadow detecting means cannot be applied to the target image, the fact that it cannot be applied is output. (7) Automatically compare with past images and call attention if there is a change.

[Brief description of drawings]

FIG. 1 is a block diagram showing a schematic configuration of a basic system according to a first embodiment of a mammography apparatus according to the present invention.

FIG. 2 is a perspective view showing the external appearance of the basic system 1.

FIG. 3 is a block diagram schematically showing an internal configuration of an X-ray generator 2.

FIG. 4 is a diagram showing characteristics for determining breast hardness.

FIG. 5 is a diagram for explaining breast size detection.

FIG. 6 is a diagram showing an example of an operation panel for selecting a film size.

FIG. 7 shows data collection points for AEC in a flat panel detector.

FIG. 8 AE without destructive readout of detector data
The figure which shows the detector 46 for AEC for collecting C data.

FIG. 9 is a cross-sectional view of a mechanism portion for compressing the breast by the compression plate 3 as seen from the side.

FIG. 10 is a diagram showing an example of a driving method of the compression unit 48.

FIG. 11 is a block diagram showing a schematic configuration of a breast compression mechanism.

FIG. 12 is a diagram showing a process of compressing a breast in relation to X-ray exposure.

FIG. 13 is a diagram showing a process of compressing the breast in relation to X-ray exposure.

FIG. 14 is a block diagram schematically showing an internal configuration of an X-ray detection device 4.

FIG. 15 is a circuit diagram showing a configuration of a TFT flat panel detector.

FIG. 16 is a diagram showing a screen transition of an operation panel 90.

FIG. 17 is a view showing an examination (patient) list panel displayed on the operation panel.

FIG. 18 is a diagram showing an operation panel for performing input for controlling an output screen.

FIG. 19 is a perspective view of an image selection panel.

FIG. 20 is a perspective view of a panel for selecting a detailed display ROI.

FIG. 21 is a diagram showing an image interpretation doctor ID input panel.

FIG. 22 is a block diagram showing the internal configuration of the output device 10.

FIG. 23 is a diagram showing an example of an output film 102.

FIG. 24 is a diagram showing a normal breast histogram.

FIG. 25: Breasts with dense mammary gland area (dense breast)
FIG.

FIG. 26 is a diagram showing a minute region of n pixels × n pixels.

FIG. 27 is a diagram showing the relationship between pixel values and gray scale (luminance).

FIG. 28 is a diagram schematically showing the flow of displaying or outputting left and right breast images.

FIG. 29 is a diagram showing a specific example of processing of the density equalization processing unit 130.

FIG. 30 is a diagram showing an ROI for enlarged display and a locus of position movement of the ROI center.

FIG. 31 is a diagram showing a trajectory when the position movement of the ROI center is continuously performed.

FIG. 32 is a diagram showing how a breast contour 138 is approximated by a polygon.

FIG. 33 is a view showing an example of enlarged display by the set ROI 133.

FIG. 34 is a diagram showing an example of contrast enhancement by the set ROI 133.

FIG. 35 is a diagram showing a trajectory of ROI position movement according to various mammogram images.

FIG. 36 is a diagram showing a relationship between a pixel value and a gray scale.

FIG. 37 is a diagram showing a breast area.

FIG. 38 is a diagram for obtaining a contour angle 144.

FIG. 39 is a diagram showing types of shooting directions.

FIG. 40 is a diagram showing types of arrangement methods of images on a screen.

FIG. 41 is a diagram showing how an image of doctor A is arranged.

FIG. 42 is a diagram showing how the images of doctor B are arranged.

FIG. 43 is a view showing the arrangement of images of doctor C.

FIG. 44 is a diagram showing size processing of image data.

FIG. 45 is a schematic diagram of a screen on which the abnormal shadow detection result is shown from the outside of the image.

[Fig. 46] Two images of the current image and the previous image (past image)
The figure which shows a mode that each is arrange | positioned on the screen of RT.

FIG. 47 is a diagram for explaining contrast adjustment.

FIG. 48 is a diagram showing a screen displaying an abnormal shadow.

FIG. 49 is a side view of the C arm and the C arm support.

FIG. 50 is a block diagram schematically showing processing for automatically recognizing a shooting method.

FIG. 51 is a perspective view showing the outline of a mechanism for automatically recognizing a rotation angle.

FIG. 52 is a diagram showing a method of determining shooting conditions.

FIG. 53 is a diagram showing another example of automatic recognition of a rotation angle.

FIG. 54 is a view showing a pressure pad used for a biopsy test.

FIG. 55 is a diagram schematically showing the posture of a C arm.

FIG. 56 is an external view showing the posture of the C arm.

FIG. 57 is a view showing how a needle is inserted into a diseased part of the breast.

FIG. 58 is a view showing a profile acquisition line set on the detector.

FIG. 59 is a diagram showing a profile acquisition line “a” and a profile acquisition line “c”.

FIG. 60 is a diagram showing a screen for a doctor to instruct shadow analysis (abnormality analysis).

FIG. 61 is a diagram showing a coordinate system of image data.

FIG. 62 is a diagram showing a coordinate system of a CRT and a film.

FIG. 63 is a diagram showing coordinates of detected microcalcification shadows and tumor shadows.

FIG. 64 is a diagram showing a screen on which a CAD result and an enlarged ROI are displayed.

FIG. 65 is a diagram showing an initial screen displayed on the operation panel.

FIG. 66 is a diagram showing a screen in which an abnormal shadow detection result is displayed in an overlapping manner on an image.

FIG. 67 is a diagram showing ROI display and CRT display on the operation panel.

FIG. 68 is a diagram showing a screen in which two images are displayed side by side.

FIG. 69 is a diagram showing an image of a resected specimen.

FIG. 70 is a diagram showing a screen in which unread images and past images are arranged.

FIG. 71 is a diagram showing a screen in which an unread image in which an abnormal shadow is output and a past image are arranged.

FIG. 72 is a block diagram showing a schematic configuration of a modality system according to a second embodiment of the mammography apparatus according to the present invention.

FIG. 73 is a block diagram showing the internal configuration of the mammography imaging apparatus 210.

FIG. 74 is a block diagram showing the internal configuration of the digitizer 220.

75 is a block diagram showing the internal configuration of the imager 230. FIG.

FIG. 76 is a block diagram showing the internal structure of the database 240.

FIG. 77: Mammogram interpretation workstation 250
Block diagram showing the internal configuration of FIG.

FIG. 78 is a block diagram showing a schematic configuration of a PACS system according to a third embodiment of the mammography apparatus according to the present invention.

FIG. 79 is a block diagram showing a schematic configuration of an abnormality detection (diagnosis support) system according to a fourth example of the mammography apparatus according to the present invention.

FIG. 80 is a fourth mammography apparatus according to the present invention.
FIG. 1 is a block diagram showing a schematic configuration of an image capturing system according to an example.

FIG. 81 is a block diagram showing a schematic configuration of a conventional PACS system.

[Explanation of symbols]

1 ... Basic system, 2 ... X-ray generator, 3 ... Compression plate, 4
... X-ray detection device, 5 ... C arm, 6 ... Input device, 8 ... R
ISI / F section, 10 ... Output device, 12 ... System disk, 14 ... Memory, 16 ... Central processing unit, 18 ... Bar code reader, 20 ... X-ray tube, 22 ... High voltage generating section, 24
... X-ray controller, 26 ... Filter switching unit, 28
... compression pressure control unit, 30 ... AEC, 32 ... photo sensor, 34 ... control panel, 36 ... thickness data, 38 ... optical detector, 39 ... light beam, 40 ... reflector, 42 ... plane detector, 44 ... Data collection points, 48 ... Compression section, 49 ...
Compression plate support section, 50 ... Pressure sensor, 52 ... Control section, 54
... Movable part, 56 ... Set value, 60 ... Readout time setting device, 62 ... Timing generating device, 64 ... Driving device, 68
... reading device, 70 ... A / D converter, 72 ... reading range setting device, 73 ... array, 76 ... gate line, 78 ...
Data line, 80 ... FET, 82 ... Sensor, 90 ... Operation panel, 92 ... Schema, 94 ... Image selection panel, 95
... mechanical switch, 96 ... detailed display ROI selection panel, 98 ... ID input device, 100 ... CRT, 102
... film, 104 ... image reduction / enlargement processing section, 106 ...
Screen creation unit, 108 ... Frame memory, 110 ... Overlay memory, 112 ... Display management unit, 114 ... D / A conversion unit, 116 ... Bar code generation unit, 118 ... Laser writing device, 120 ... Bar code, 122 ... ROI, 1
24 ... Image data, 126 ... Straight line before conversion, 128 ... Straight line after change, 129 ... Image memory bank, 130 ... Density equalization unit, 132 ... Composite image, 133 ... ROI,
134 ... Average value calculation section, 135 ... Division section, 136 ... Image calculation section, 137 ... Contour section, 138 ... Breast contour, 139 ...
First closed curve, 140 ... Second closed curve, 145 ... Screen,
146 ... Mammogram image, 147 ... Marker, 148
... abnormalities (shadows), 149 ... number of detected abnormalities, 150
... Other markers, 152 ... Identifier, 154 ... C-arm support portion, S1 ... C-arm angle recognition processing, S2 ... Shooting direction determination processing, S3 ... Judgment condition input processing, S4 ... Accompanying information writing processing, S5 ... Manual input / correction process, 156 ... Rotation axis, 158 ... First gear, 160 ... Second gear, 16
4 ... 1st electrode, 166 ... 2nd electrode, 168 ... Pressure pad, 170 ... Window, 172 ... Disease part, 174 ... Needle, 17
6 ... Biopsy field, 178 ... Profile acquisition line, 180 ... Microcalcification shadow, 300 ... Excised specimen.

Continuation of the front page (51) Int.Cl. ⁶ Identification number Office reference number FI Technical display location G06T 1/00 5/00 5/20 G06F 15/62 390 A 15/68 310 J 400 A (72) Inventor Masayuki Nishiki 1385-1 Shimoishigami, Otawara-shi, Tochigi, Toshiba Corporation Nasu factory (72) Inventor Koichiro Nabuchi 1385-1 Shimoishigami, Otawara-shi, Tochigi Toshiba Corporation, Nasu factory (72) Inventor Katsuyuki Taguchi 1385-1 Shimoishigami, Otawara-shi, Tochigi, Toshiba Corporation Nasu factory (72) Inventor Toru Saisu 1385-1 Shimoishi, Otawara, Tochigi corporation, Toshiba Nasu factory (72) Inventor Tomisaki Takayuki 1385-1 Shimoishigami, Otawara-shi, Tochigi Stock company Toshiba Nasu factory (72) Inventor Akira Tsukamoto 1385-1 Shimoishigami, Otawara city, Tochigi prefecture Toshiba Nasu factory

Claims (23)

[Claims] 1. A mammography apparatus comprising: input means for inputting a mammogram image; and means for emphasizing the contrast of a mammary gland region of the mammogram image input by the input means. 2. The mammography apparatus according to claim 1, wherein the means for enhancing the contrast associates a representative pixel value of the mammary gland region with the highest brightness. 3. The mammography apparatus according to claim 2, wherein the means for enhancing the contrast converts only pixel values in a predetermined range into luminance. 4. The means for emphasizing the contrast uses the highest median value of each minute region when the mammogram image is divided into minute regions, as a representative pixel value of the mammary gland region. The mammography device according to claim 2. 5. A mammography apparatus comprising: an input unit for inputting at least two or more mammogram images, and an output unit for outputting the mammogram images input by the input unit in the same density range. 6. The mammogram image input by the input means is an image of the same region photographed from the same direction in the past examination and the present examination.
The mammography apparatus according to claim 1. 7. An input means for inputting a mammogram image, a micro area setting means for setting a plurality of micro areas based on a contour of a breast on the mammogram image input by the input means, and the set micro area. A mammography apparatus, comprising: an image processing unit that performs predetermined image processing for each image. 8. The image processing means includes at least one of enlargement processing, contrast enhancement processing, and frequency enhancement processing.
The mammography device according to claim 7, wherein 9. The mammography apparatus according to claim 7, wherein the minute area setting means sets a plurality of minute areas so as to cover the entire subject area on the mammogram image. 10. The mammography apparatus according to claim 9, further comprising a manual operation member for changing the position of the minute area set by the minute area setting means. 11. An input unit for inputting a mammogram image, a detecting unit for detecting an abnormal shadow from the mammogram image input by the input unit, and a predetermined area on an image of a minute area including the abnormal shadow detected by the detecting unit. A mammography apparatus comprising: an image processing unit that performs image processing. 12. The position of the center of the minute area is the position where the abnormal shadow is detected.
The mammography device according to 1. 13. The image processing means performs at least one of an enlarging process, a contrast enhancing process, and a frequency enhancing process, and determines the content of the image process according to the detected abnormality type. The mammography device according to claim 11. 14. An input unit for inputting at least two or more mammogram images, a unit for outputting the mammogram image input by the input unit, and an arrangement position and an arrangement direction when the output unit outputs the mammogram image. An image arranging means for managing the image data. 15. The apparatus according to claim 1, further comprising means for storing the arrangement position and the arrangement direction for each doctor.
The mammography device according to item 4. 16. The apparatus further comprises detection means for detecting an abnormal shadow from a mammogram image inputted by the input means, wherein the image arrangement means has an arrangement position and an arrangement direction according to a type of the abnormal shadow detected by the detection means. 15. The mammography device according to claim 14, wherein 17. The mammography apparatus according to claim 14, wherein the mammogram images input by the input unit are images obtained by a past examination and a current examination of the same subject. 18. An input means for inputting a mammogram image, a detecting means for detecting an abnormal shadow from the mammogram image input by the input means, and a marker image showing a position of the abnormal shadow detected by the detecting means as a mammogram image. A mammography apparatus comprising: an output unit configured to perform composition without overlapping and output a composition result. 19. The output means arranges a marker image indicating the position of the abnormal shadow detected by the detection means, outside the mammogram image.
The mammography device according to item 8. 20. The apparatus further comprises means for outputting the number of abnormal shadows detected by the detecting means, and the output means indicates an abnormal position by attaching an identifier to the abnormal shadows. Item 18. The mammography apparatus according to Item 18. 21. An input unit for inputting a mammogram image, a judging unit for judging whether or not an abnormal shadow can be detected in the mammogram image input by the input unit, and a judgment unit for judging the abnormal shadow. In this case, the mammography apparatus is provided with a detection unit that detects an abnormal shadow from the mammogram image, and a result output unit that outputs a result of the detection performed by the detection unit. 22. The mammography apparatus according to claim 21, wherein the determination unit makes a determination based on a breast area of the mammogram image input by the input unit and a tilt of the breast. 23. A first mammogram image and the first mammogram image.
Inputting means for inputting a second mammogram image of the same site taken from the same direction at a different time from the mammogram image of No. 1, and abnormal shadows are respectively detected from the first and second mammogram images input by the inputting means. A mammography apparatus comprising: a detection unit; and a result output unit that outputs a detection result only when the abnormal shadows detected by the detection unit are different.