JPWO2011132468A1 - Medical image display apparatus and program - Google Patents

Abstract

By reducing unnecessary mark display, it is possible to reduce the interpretation time, and when the detection of abnormal shadow candidates by CAD fails, the interpretation doctor can perform interpretation diagnosis without being influenced by the detection result by CAD. To do. When a medical image to be interpreted is selected by the operation unit 42, the control unit 41 of the image display device 4 acquires the position information of the medical image and the abnormal shadow candidate area detected from the medical image from the image server 3. A medical image is displayed on the display unit 43. In the medical image displayed on the display unit 43, when a region of interest is designated by the operation unit 42, the control unit 41 positions the designated region of interest and the abnormal shadow candidate region detected from the displayed medical image. The abnormal shadow candidate area existing outside the designated attention area is extracted by comparing with the information, and the mark M2 indicating the extracted abnormal shadow candidate area is displayed on the medical image displayed on the display unit 43. .

Description

  The present invention relates to a medical image display device and a program.

  In recent years, with an increase in the incidence of breast cancer in women, interest in breast cancer screening has increased. In breast cancer screening, a doctor interprets a medical image obtained by photographing a breast to diagnose the presence or absence of an abnormality. However, the number of interpretation doctors who perform diagnosis is insufficient, and there is a problem that diagnosis is delayed.

  In order to improve such problems, an abnormal shadow candidate detection device (CAD (Computer-Aided Detection) that automatically detects abnormal shadow candidates indicating the characteristics of a lesion such as breast cancer from a medical image for the purpose of assisting diagnosis work. ) Has been developed.

  As a technique for displaying an abnormal shadow candidate area detected by CAD on a medical image display device, for example, Patent Document 1 displays a mark at an abnormal shadow candidate position detected by an abnormal shadow candidate detection unit, and An abnormal shadow candidate group that is sequentially switched and displayed according to a given order is described.

JP 2000-287955 A

  By the way, when a mark is displayed in the region of an abnormal shadow candidate detected by CAD, the time for the interpretation doctor to interpret tends to increase according to the number of marks. In Patent Document 1, the display order of abnormal shadow candidates can be specified, but marks indicating all abnormal shadow candidate areas detected by CAD, including useless marks that need not be confirmed by an interpreting physician, are displayed. There is a problem of being displayed.

  In addition, if the CAD cannot detect the attention area that the interpreting doctor has determined to be suspected of an abnormal shadow, the interpreting doctor is affected by the CAD detection result, and the confidence of the interpreting doctor's own judgment decreases. There is a risk that an area that is originally an abnormal shadow is dropped from the attention area.

  An object of the present invention is to reduce interpretation time by reducing unnecessary mark display, and when an abnormal shadow candidate detection by CAD fails, an interpretation doctor can perform interpretation diagnosis without being influenced by the detection result by CAD. Is to be able to do it.

In order to solve the above problems, according to a first aspect of the present invention,
The medical image and the position information of the abnormal shadow candidate region are acquired from a storage device that associates and stores the medical image and the position information of the abnormal shadow candidate region detected from the medical image, and the acquired medical image is displayed. A medical image display device,
Display means for displaying a medical image acquired from the storage device;
In the medical image displayed on the display means, an operation means for designating a region of interest that the operator has determined to be suspected of an abnormal shadow;
When the attention area is designated by the operation means, the specified shadow area is compared with the position information of the abnormal shadow candidate area detected from the medical image, and the abnormal shadow existing outside the designated attention area is compared. Control means for extracting a candidate area and displaying information indicating the extracted abnormal shadow candidate area on the medical image displayed on the display means;
Is provided.

  It is preferable that the control means simultaneously displays information indicating the extracted abnormal shadow candidate area and information indicating the attention area specified by the operation means on the medical image displayed on the display means.

  It is preferable that the control means display different marks in the extracted abnormal shadow candidate area and the attention area designated by the operation means.

  When the position information of the attention area previously designated by another image interpreting doctor is stored in the storage device in association with the medical image, the control unit is configured to pay attention to the attention area previously designated by the other image interpreting doctor. The position information of the area is acquired from the storage device, the attention area specified by the operation means, the abnormal shadow candidate area detected from the medical image, and the position information of the attention area specified by the other interpretation doctor, And extracting the detected abnormal shadow candidate area and the attention area specified by the other image interpretation doctor that exist outside the attention area specified by the operation means, and extract the extracted abnormal shadow candidate. It is preferable to display information indicating a region and a region of interest designated by another image interpretation doctor on the medical image displayed on the display means.

According to a second aspect of the present invention,
The program
The medical image and the position information of the abnormal shadow candidate region are acquired from a storage device that associates and stores the medical image and the position information of the abnormal shadow candidate region detected from the medical image, and the acquired medical image is displayed. A computer used in a medical image display device
Display means for displaying a medical image acquired from the storage device;
In the medical image displayed on the display means, an operating means for designating a region of interest that the operator has determined is suspected of an abnormal shadow,
When the attention area is designated by the operation means, the specified shadow area is compared with the position information of the abnormal shadow candidate area detected from the medical image, and the abnormal shadow existing outside the designated attention area is compared. Control means for extracting a candidate area and displaying information indicating the extracted abnormal shadow candidate area on the medical image displayed on the display means;
To function as.

  According to the present invention, it is possible to reduce the interpretation time by reducing unnecessary mark display, and when the detection of an abnormal shadow candidate by CAD fails, the interpretation doctor is influenced by the detection result by CAD. This makes it possible to perform image interpretation diagnosis without using it.

It is a figure which shows the example of whole structure of the medical image display system in this Embodiment. It is a block diagram which shows the functional structure of the image display apparatus of FIG. 3 is a flowchart illustrating medical image display processing executed by the control unit in FIG. 2 in the first embodiment. A is a diagram showing an example of the viewer screen displayed in step S5 in FIG. 3, B is a diagram showing an example of the viewer screen displayed in step S8 in FIG. 3, and C is displayed in step S10 in FIG. It is a figure which shows an example of the viewer screen displayed. It is a figure which shows an example of the abnormal shadow candidate area | region detected by the abnormal shadow candidate detection apparatus of FIG. 6 is a flowchart showing a medical image display process B executed by the control unit of FIG. 2 in the second embodiment. A is a diagram showing an example of the viewer screen displayed in step S25 in FIG. 6, B is a diagram showing an example of the viewer screen displayed in step S28 in FIG. 6, and C is displayed in step S30 in FIG. It is a figure which shows an example of the viewer screen displayed. It is a figure which shows an example of the abnormal shadow candidate area | region detected by the abnormal shadow candidate detection apparatus of FIG.

[First embodiment]
(Configuration of Medical Image Display System 100)
First, the configuration of the first embodiment will be described.
FIG. 1 shows a system configuration of a medical image display system 100 according to the first embodiment.
The medical image display system 100 is a system that captures a medical image, detects an abnormal shadow candidate from the medical image, and provides detection result information to the interpretation doctor together with the medical image.

  As shown in FIG. 1, the medical image display system 100 includes an image generation device 1, an abnormal shadow candidate detection device 2, an image server 3, and an image display device 4. These devices 1 to 4 are connected to each other through a communication network N constructed in a medical institution such as a LAN (Local Area Network) so that data can be transmitted and received between them. The DICOM (Digital Imaging and Communication in Medicine) standard is applied to the communication network N. The number of each device is not particularly limited.

Hereinafter, each component apparatus 1-4 is demonstrated.
The image generation apparatus 1 images a human body and generates digital data of the captured image (medical image). For example, CR (Computed Radiography), FPD (Flat Panel Detector), CT (Computed Tomography), MRI (MRI) Modality such as Magnetic Resonance Imaging), cassette reader, film digitizer, etc. can be applied. In the present embodiment, it is assumed that breast image data is generated by applying a breast-specific CR that performs X-ray imaging of the left and right breasts as the image generation apparatus 1.

  The image generation apparatus 1 is an apparatus that complies with the above-mentioned DICOM standard, and can input various information attached to the generated medical image, for example, patient information and examination information from the outside, and can also automatically generate the information. it can. The patient information includes information such as patient identification information (for example, patient ID) for identifying the patient, patient name, sex, date of birth, and the like. The inspection information includes inspection identification information (for example, inspection ID), inspection date, inspection conditions (inspection site, laterality (left, right), direction (for example, vertical direction (CC), oblique direction) (MLO)), modality type, etc. The image generating apparatus 1 adds the above patient information, examination information, UID (Unique ID) for identifying the image as header information to the generated medical image. To the abnormal shadow candidate detection device 2 and the image server 3 via the communication network N. If the DICOM standard is not complied with, the accompanying information is transmitted to the image generation device 1 using a DICOM conversion device (not shown). It is also possible to make it input.

  The abnormal shadow candidate detection device (CAD) 2 is a computer that performs image analysis of a medical image supplied from the image generation device 1 and performs detection processing of an abnormal shadow candidate. The abnormal shadow candidate detection device 2 includes a storage unit such as a CPU (Central Processing Unit), a RAM (Random Access Memory), and an HDD (Hard Disk Drive), and a communication unit such as a LAN card. The storage unit of the abnormal shadow candidate detection device 2 stores a detection algorithm detection algorithm corresponding to the type of abnormal shadow, and the CPU of the abnormal shadow candidate detection device 2 stores the detection program stored in the storage unit. By cooperation, an abnormal shadow candidate is detected from each medical image input via the communication unit. For example, an abnormal shadow candidate of a tumor or a microcalcification cluster in a breast image is detected.

  As an abnormal shadow candidate detection algorithm, a known algorithm can be applied. For example, as an algorithm for a tumor shadow candidate in a breast image, a method using an iris filter disclosed in Japanese Patent Laid-Open No. 10-91758, a method using a Laplacian filter (Journal of the Institute of Electronics, Information and Communication Engineers (D-II) , Vol. J76-D-II, no. 2, pp. 241-249, 1993), etc. are applicable. In addition, as a detection algorithm for micro-calcification cluster shadow candidates, for example, Morphology filter (The Institute of Electronics, Information and Communication Engineers (D-II), Vol.J71-D-II, no.7, pp.1170-1176, 1992), Laplacian filter (The Institute of Electrical, Information and Communication Engineers Journal (D-II), Vol. J71-D-II, no. 10, pp. 1994-2001, 1998) Applicable.

  When the abnormal shadow candidate detection process by the detection algorithm is completed, the abnormal shadow candidate detection device 2 generates detection result information (hereinafter referred to as CAD information) of the abnormal shadow candidate. The CAD information includes, for example, position information of each detected area (contour) of abnormal shadow candidates and information on the types of abnormal shadow candidates (for example, tumors, microcalcification clusters, etc.). Then, the abnormal shadow candidate detection device 2 adds the header information of the detection source medical image to the generated CAD information, and transmits it to the image server 3 by the communication unit.

  The image server 3 is a computer including a storage unit such as a CPU, a RAM, and an HDD, and a communication unit such as a LAN card. The storage unit of the image server 3 includes an image DB (Data Base) 351. The image server 3 stores the medical image received from the image generation device 1 and the CAD information about the medical image received from the abnormal shadow candidate detection device 2 in association with each other, and manages input / output thereof.

For example, the image DB 351 has an image management table that stores management information regarding each medical image stored in the image DB 351. In the image management table, management information for each medical image is stored as one record. The management information includes UID, patient information, examination information, file information (file name of medical image and file name of CAD information corresponding thereto, file storage location, update date, file size, etc.).
In the image server 3, when a medical image is received from the image generation device 1, the received medical image is stored in the image DB 351, and management information is created based on the received medical image header information. Stored in the image management table. When the CAD information from the abnormal shadow candidate detection device 2 is received, the received CAD information is stored in the image DB 351, and a record in which the CAD information and the UID match is searched from the image management table. The file name, storage location, etc. of the CAD information are additionally written in each record. In this way, in the image DB 351, the medical image and the detection result information of the abnormal shadow candidate detected from the medical image are stored in association with each other so as to be searchable.

  Returning to FIG. 1, the image display device 4 is a medical image display device that acquires and displays a medical image designated by an operation of an interpreting doctor and CAD information corresponding thereto from the image server 3.

FIG. 2 shows a functional configuration example of the image display device 4.
As shown in FIG. 2, the image display device 4 includes a control unit 41, an operation unit 42, a display unit 43, a communication unit 44, and a storage unit 45, and each unit is connected by a bus 46.

  The control unit 41 includes a CPU, a RAM, and the like. The CPU of the control unit 41 reads out various programs such as system programs and processing programs stored in the storage unit 45, expands them in the RAM, and executes various processes according to the expanded programs. For example, the control unit 41 executes a medical image display process described later.

  The operation unit 42 includes a keyboard having character input keys, numeric input keys, various function keys, and the like, and a pointing device such as a mouse, and a key pressing signal pressed by the keyboard and an operation signal by the mouse. Are output to the control unit 41 as an input signal.

  The display unit 43 includes, for example, a monitor such as a CRT (Cathode Ray Tube) or an LCD (Liquid Crystal Display), and displays various screens according to instructions of a display signal input from the control unit 41.

  The communication unit 44 is configured by a LAN card or the like, and transmits / receives data to / from an external device connected to the communication network N via a switching hub.

  The storage unit 45 includes, for example, an HDD (Hard Disk Drive), a semiconductor nonvolatile memory, or the like. The storage unit 45 stores various programs as described above. In addition, the storage unit 45 stores image processing parameters (a lookup table defining a gradation curve used for gradation processing, an enhancement degree of frequency processing, and the like) for adjusting a medical image to an image quality suitable for diagnosis. doing.

(Operation of Medical Image Display System 100)
Next, the operation of the medical image display system 100 will be described.
FIG. 3 shows a flowchart of a medical image display process executed by the image display device 4 in the first embodiment. The medical image display process is executed in cooperation with the control unit 41 and a program stored in the storage unit 45.

  First, a medical image to be interpreted is selected by operating the operation unit 42 (step S1). Specifically, a medical image search screen is displayed on the display unit 43 in response to an operation by the operation unit 42. When a search condition (patient ID, examination site, laterality, etc.) is input by the operation unit 42 on the search screen, the input search condition and search request are transmitted to the image server 3 by the communication unit 44. In the image server 3, medical image management information that matches the search condition is searched from the image management table of the image DB 351, and list data of medical images that match the search condition is created and transmitted to the image display device 4. In the image display device 4, when list data is received by the communication unit 44, an image selection screen based on the list data is displayed on the display unit 43. In the image selection screen, for example, a list having items such as an examination ID, a patient ID, a patient name, an examination date, a modality type, an examination site, a laterality, and a direction is displayed in examination units, The medical image to be selected can be selected via the operation unit 42. The interpretation doctor selects a medical image to be interpreted by the operation of the operation unit 42.

  When the medical image to be interpreted is selected, an acquisition request for the selected medical image to be interpreted is transmitted to the image server 3 by the communication unit 44, and the medical image to be interpreted and the CAD information of the medical image are stored in the image server 3. (Step S2). In the image server 3, when a request for acquiring a medical image to be interpreted is received, the requested medical image to be interpreted and CAD information corresponding to the medical image are retrieved from the medical image DB 351 and read out. It is transmitted to the display device 4.

When the medical image to be interpreted and CAD information are acquired, a viewer screen 431 on which the acquired medical image is displayed is displayed on the display unit 43 (step S3).
When a medical image is displayed on the viewer screen 431 of the display unit 43, the interpretation doctor observes the displayed medical image and diagnoses whether or not there is a region of interest (which is a region suspected of having an abnormal shadow). Do. When the attention area exists, the attention area is designated by clicking with the mouse of the operation unit 42 or the like.

  When a region of interest is designated from the medical image displayed on the display unit 43 by the operation unit 42 (step S4; YES), the position information of the designated region of interest is stored in the RAM and displayed on the displayed medical image. The mark M1 is displayed in the designated attention area (step S5), and the process proceeds to step S6. If the attention area is not designated by the operation unit 42, the process proceeds to step S6.

  FIG. 4A shows an example of the viewer screen 431 displayed in step S5. As shown in A of FIG. 4, the mark M <b> 1 is superimposed on the attention area designated by the operation unit 42 on the medical image displayed on the viewer screen 431. The mark M1 is information indicating the attention area designated by the image interpretation doctor. Symbols such as ○ and arrows indicating the representative points (for example, the center of gravity) of the attention area, and drawing information representing the designated attention area with lines. Etc. are included.

  In step S6, it is determined whether or not display of the CAD detection result (that is, the abnormal shadow candidate area detected by the abnormal shadow candidate detection device 2) is instructed by the operation unit 42 (step S6). For example, the CAD result display button B1 displayed on the viewer screen 431 of the display unit 43 can be pressed to instruct display of the CAD result.

When the display of the CAD result is instructed by the operation unit 42 (step S6; YES), it is pointed out by the attention area designated by the operation unit 42 in step S4 and the CAD information for the medical image received in step S2. Are compared with the position information of the abnormal shadow candidate area, and the abnormal shadow candidate area existing in the area other than the attention area of the displayed medical image is extracted (step S7). Then, the mark M2 is displayed in the extracted abnormal shadow candidate region on the medical image displayed on the display unit 43 (step S8).
The mark M2 is information indicating an abnormal shadow candidate area detected by CAD, and a symbol such as a circle or an arrow indicating a representative point (for example, the center of gravity) of the abnormal shadow candidate area, or an abnormal shadow candidate area is represented by a line. Drawing information and the like. The mark M2 may be displayed in the same manner as the mark M1, but a different display is preferable because the interpretation doctor can easily recognize the attention area and the other abnormal shadow candidate areas. On the viewer screen 431, an “all display” button B2 for inputting an instruction to simultaneously display the attention area designated by the interpretation doctor and the CAD result on the medical image is displayed.

  FIG. 4B shows an example of the viewer screen 431 displayed in step S8. As shown in FIG. 4B, in step S8, the mark M2 is superimposed and displayed only in the region extracted in step S7, that is, only in the abnormal shadow candidate region existing in the region other than the region of interest designated by the interpretation doctor. Is done. For example, in the case where the attention area designated by the interpretation doctor in step S4 is the area indicated by M1 in FIG. 4A and the abnormal shadow candidate area indicated by the CAD information is the area indicated by M0 in FIG. 5, in step S8 Is displayed as shown in FIG. In other words, the mark M2 is displayed only in an area that the interpreting doctor needs to check, specifically, an area that the interpreting doctor has not paid attention to and an abnormal shadow candidate area detected by CAD. An area that has already been confirmed by the interpreting physician, specifically, an area that has been designated as the attention area by the interpreting doctor but has not been detected by CAD, and an abnormal shadow candidate that has been detected by the attention area designated by the interpreting doctor and CAD No mark is displayed in an area where both areas overlap. In this way, the display of the mark M2 is limited to the area that the image interpretation doctor should truly check, so that the time required for image interpretation can be reduced. In addition, since the interpretation doctor cannot know whether or not the attention area designated by the interpretation doctor matches the CAD result, the interpretation doctor determines that the attention area is the attention area but is not detected by CAD. It can be prevented that the confidence of the interpretation doctor's own judgment is lowered due to the influence of the CAD result.

  If the image interpretation doctor observes the area of the mark M2 displayed on the viewer screen 431 and determines that there is a suspicion of an abnormal shadow, the area is designated by the operation unit 42, and attention is paid to the area. It can also be specified as an area.

  Next, it is determined whether or not the “display all” button B2 is pressed by the operation unit 42, and if it is determined that the “display all” button B2 is pressed (step S9; YES), the attention specified in step S4 Both the mark M1 indicating the region and the mark M2 indicating the abnormal shadow candidate region extracted in step S7 are simultaneously displayed on the medical image (step S10).

  FIG. 4C shows an example of the viewer screen 431 displayed in step S10. As shown in FIG. 4C, in step S10, since both the attention area designated by the interpretation doctor and the abnormal shadow candidate area detected by CAD are displayed as marks, the interpretation doctor should finally make a diagnosis. You can check if there are any oversights in the area.

  When the operation unit 42 instructs the end of interpretation (step S11; YES), the medical image display process ends. For example, when the end button B3 is pressed by the operation unit 42, the medical image display process ends.

[Second Embodiment]
Next, a second embodiment of the present invention will be described.
In the second embodiment, the image DB 351 stores the medical image in association with the CAD information generated by the abnormal shadow candidate detection device 2 for the medical image, and further interprets the medical image previously. The position information of the attention area designated by the doctor and the interpretation doctor ID (interpretation doctor identification information) are stored in association with each other. That is, when a certain interpreting doctor (for example, a secondary interpreting doctor) interprets a medical image that has already been interpreted by another interpreting doctor (primary interpreting doctor), the interpreting doctor is designated by another interpreting doctor. The attention area thus made can be used.
Since the other configuration is the same as that of the first embodiment, the description is incorporated.

Next, the operation of the second embodiment will be described.
FIG. 6 shows a flowchart of medical image display processing (referred to as medical image display processing B) executed by the image display device 4 in the second embodiment. The medical image display process B is executed in cooperation with the control unit 41 and a program stored in the storage unit 45. As a premise for executing the medical image display process B, an interpreting doctor who is an operator of the image display apparatus 4 inputs authentication information such as an interpreting doctor ID and a password by the operation unit 42 and is authenticated by the image server 3 for login. ing.

  First, a medical image to be interpreted is selected by operating the operation unit 42 (step S21). Specifically, first, a medical image search screen is displayed on the display unit 43 in response to an operation by the operation unit 42. When a search condition (patient ID, examination site, laterality, etc.) is input by the operation unit 42 on the search screen, the input search condition and search request are transmitted to the image server 3 by the communication unit 44. In the image server 3, medical image management information that matches the search condition is searched from the image management table of the image DB 351, and list data of medical images that match the search condition is created and transmitted to the image display device 4. In the image display device 4, when list data is received by the communication unit 44, an image selection screen based on the list data is displayed on the display unit 43. In the image selection screen, for example, a list having items such as an examination ID, a patient ID, a patient name, an examination date, a modality type, an examination site, a laterality, and a direction is displayed in examination units, The medical image to be selected can be selected via the operation unit 42. The interpretation doctor selects a medical image to be interpreted by the operation of the operation unit 42.

When a medical image to be interpreted is selected, an acquisition request for the selected medical image to be interpreted is transmitted to the image server 3 by the communication unit 44, and the medical image to be interpreted, CAD information of the medical image, and The position information of the attention area (the attention area of another interpretation doctor) designated by another interpretation doctor is acquired from the image server 3 (step S22).
In the image server 3, when a request for acquiring a medical image to be interpreted is received, the requested medical image to be interpreted, the CAD information corresponding to the medical image, and the position information of the attention area of another interpreting doctor are obtained. It is retrieved from the medical image DB 351 and read out, and transmitted to the image display device 4. Note that, for example, when the medical image is not yet interpreted, for example, when the primary interpreting doctor interprets, the position information of the attention area of the other interpreting doctor is not acquired. Further, in the present embodiment, from the viewpoint of displaying only the area to be confirmed by the currently interpreting doctor, the interpretation doctor ID currently logged in to the image display device 4 and the interpretation of the previously interpreting doctor. When the medical IDs match (that is, when the same interpreting doctor performs interpretation more than once), the position information of the region of interest is not transmitted to the image display device 4, but even the same interpreting doctor It is good also as a mode which transmits.

When the medical image and CAD information to be interpreted are acquired, the viewer screen 432 on which the acquired medical image is displayed is displayed on the display unit 43 (step S23).
When the medical image is displayed on the display unit 43, the image interpretation doctor observes the displayed medical image and diagnoses whether or not there is a region of interest (referred to as a region suspected of having an abnormal shadow). When the attention area exists, the attention area is designated by clicking with the mouse of the operation unit 42 or the like.

  When a region of interest is designated from the medical image displayed on the display unit 43 by the operation unit 42 (step S24; YES), the position information of the designated region of interest is stored in the RAM and displayed on the displayed medical image. The mark M11 is displayed in the designated attention area (step S25), and the process proceeds to step S26. If the attention area is not designated by the operation unit 42, the process proceeds to step S26.

  FIG. 7A shows an example of the viewer screen 432 displayed in step S25. As shown in A of FIG. 7, the mark M <b> 11 is superimposed and displayed on the viewer screen 432 in the attention area specified by the operation unit 42. The mark M11 is information indicating the attention area designated by the interpreting doctor who is currently interpreting the image. The mark M11 is a symbol such as a circle or arrow indicating the representative point (for example, the center of gravity) of the attention area, or the designated attention area with a line. The drawn drawing information and the like are included.

  In step S26, it is determined whether or not display of diagnosis support information has been instructed by the operation unit 42 (step S26). For example, the diagnosis support information button B11 displayed on the viewer screen 432 of the display unit 43 can be instructed to be displayed by pressing the operation unit 42. Here, information that supports interpretation diagnosis, such as a CAD detection result and a region of interest previously specified by another interpretation doctor (primary interpretation doctor or the like), is referred to as diagnosis support information.

When display of diagnostic support information is instructed by the operation unit 42 (step S26; YES), the attention area specified by the operation unit 42 in step S24, the abnormal shadow candidate area pointed out by the CAD information, and other interpretations The position information of the attention area of the doctor is compared, and an abnormal shadow candidate area and an attention area of another interpretation doctor existing in an area other than the designated attention area are extracted (step S27). Then, the mark M12 is displayed in the extracted area (the abnormal shadow candidate area detected by CAD and the attention area specified by another interpreting doctor) on the medical image displayed on the viewer screen 432 of the display unit 43. (Step S28).
The mark M12 is information indicating an abnormal shadow candidate area detected by CAD or an attention area of another interpreting doctor, and indicates a representative point (for example, the center of gravity, etc.) of the abnormal shadow candidate area or the attention area of another interpreting doctor. Symbols such as ○ and arrows, abnormal shadow candidate areas, or drawing information representing the attention areas of other image interpretation doctors as lines are included. The mark M12 may be displayed in the same manner as the mark M11. However, if the display is different, the interpreting doctor can easily recognize the attention area designated by the interpreting doctor who is interpreting and the other areas. preferable. Further, the abnormal shadow candidate area detected by CAD and the attention area designated by another image interpretation doctor may be displayed with different marks.
On the viewer screen 432, an “all display” button B12 for inputting an instruction to simultaneously display the attention area designated by the interpretation doctor and the CAD result on the medical image is displayed.

  FIG. 7B shows an example of the viewer screen 432 displayed in step S28. As shown in FIG. 7B, in step S28, an abnormality detected by CAD that exists only in the region extracted in step S27, that is, in a region other than the region of interest designated by the currently interpreting doctor. The mark M12 is superimposed and displayed only on the shadow candidate area and the attention area of another interpreting doctor. For example, the attention area designated by the interpreting doctor in step S24 is the area indicated by M11 in FIG. 7A, the abnormal shadow candidate area indicated by the CAD information is the area indicated by M01 in FIG. If the designated attention area is the area indicated by M02 in FIG. 8, the display shown in FIG. 7B is made in step S28. That is, an area that needs to be confirmed by an interpreting doctor who is currently interpreting an image, specifically, an area that is not noticed by an interpreting doctor who is currently interpreting an image that is detected by CAD or specified by another interpreting doctor. The mark M12 is displayed only in the attention area. An area that has already been confirmed by the interpreting doctor who is currently interpreting, specifically, an area that has been designated as the attention area by the interpreting doctor who is currently interpreting, but has not been pointed out by CAD or another interpreting doctor, and is currently being interpreted No mark is displayed in an area where the attention area noted by the image interpretation doctor overlaps with the area pointed out by CAD or another image interpretation doctor. In this way, the display of the mark M12 is limited to the area that the interpreting doctor who is currently interpreting should really confirm, so that the time required for interpretation can be reduced. Further, since the interpretation doctor cannot know whether the attention area designated by the interpreting doctor matches the CAD result or the attention area of another interpreting doctor, the interpretation doctor determines that the attention area is the attention area. In addition, it is possible to prevent an area not pointed out by other interpreting doctors from being affected by the diagnosis support information and reducing the certainty of the interpretation doctor's own judgment.

  Next, it is determined whether or not the “display all” button B12 is pressed by the operation unit 42. If it is determined that the “display all” button B12 is pressed (step S29; YES), the attention specified in step S24 is performed. Both the mark M11 indicating the area and the mark M12 indicating the area extracted in step S27 are simultaneously displayed on the medical image (step S30).

  FIG. 7C shows an example of the viewer screen 432 displayed in step S30. As shown in FIG. 7C, in step S30, since both the attention area designated by the interpreting doctor and the abnormal shadow candidate area detected by CAD are displayed as marks, the interpreting doctor should finally make a diagnosis. You can check if there are any oversights in the area.

When the operation unit 42 instructs the end of interpretation (step S31; YES), the UID of the medical image to be interpreted and the position information of the attention area specified in step S24 are transmitted to the image server 3 by the communication unit 44 ( In step S32), the medical image display process B ends.
In the image server 3, when the UID and the position information of the attention area are received from the image display device 4, the received position information of the attention area is stored in the image DB 351. Also, a record having the received UID is searched from the image management table, and the storage location of the received position information, the interpretation doctor ID being logged in, and the like are stored in association with the searched record.

  As described above, according to the medical image display system 100 in the first embodiment, the control unit 41 of the image display device 4 detects the medical image to be interpreted from the image server 3 and the abnormality detected from the medical image. The position information of the shadow candidate area is acquired and a medical image is displayed on the display unit 43. In the medical image displayed on the display unit 43, when a region of interest is designated by the operation unit 42, the control unit 41 positions the designated region of interest and the abnormal shadow candidate region detected from the displayed medical image. Compared with the information, an abnormal shadow candidate area that exists outside the designated attention area is extracted, and a mark M2 indicating the extracted abnormal shadow candidate area is displayed on the medical image displayed on the display unit 43. .

  Therefore, a mark indicating an abnormal shadow candidate area only in an area that the interpretation doctor needs to check, specifically, an abnormal shadow candidate area that is not noticed by the interpretation doctor and detected by CAD M2 is displayed and has already been confirmed by the interpreting physician, specifically, an abnormal shadow candidate region designated by the interpreting physician but not detected by CAD, and an attention region designated by the interpreting physician No mark is displayed in an area where both of the abnormal shadow candidate areas detected by CAD overlap. In this way, the display of the mark M2 is limited to the area that the image interpretation doctor should truly check, so that the time required for image interpretation can be reduced. In addition, since the interpretation doctor cannot know whether or not the attention area designated by the interpretation doctor matches the CAD result, the interpretation doctor determines that the attention area is the attention area but is not detected by CAD. It can be prevented that the confidence of the interpretation doctor's own judgment is lowered due to the influence of the CAD result.

  In addition, when the “display all” button B2 is pressed from the operation unit 42, the control unit 41 includes a mark M2 indicating the extracted abnormal shadow candidate region, and a mark M1 indicating the attention region designated by the operation unit 42. Are simultaneously displayed on the medical image displayed on the display unit 43. Therefore, it is possible to finally confirm whether or not there is an oversight in the area to be diagnosed by the interpretation doctor. In addition, by displaying a mark of a different aspect in each of the extracted abnormal shadow candidate area and the attention area specified by the operation unit 42, an area that is determined to be abnormal at first glance and an area that is detected by CAD Can be identified at a glance.

  Further, according to the image display device 4 in the second embodiment, when the position information of the attention area previously specified by another image interpretation doctor is stored in the image server 3 in association with the medical image, the control is performed. The unit 41 acquires from the image server 3 the position information of the attention area previously specified by another image interpretation doctor. Then, the attention area designated by the operation section 42 is compared with the positional information of the abnormal shadow candidate area detected by the CAD and the attention area designated by another interpreting doctor. Information indicating the detected abnormal shadow candidate area and the attention area specified by another interpretation doctor that exist outside the area, and the extracted abnormal shadow candidate area and the attention area specified by the other interpretation doctor Is displayed on the medical image displayed on the display unit 43.

  Therefore, for example, when another interpreting doctor interprets a medical image that has already been interpreted, such as when the primary interpreting doctor has previously interpreted the same medical image, the attention area designated by the other interpreting doctor is used as diagnosis support information. It can be used.

Note that the descriptions in the first and second embodiments are a preferred example of the present invention, and the present invention is not limited to this.
For example, in the first and second embodiments, the abnormal shadow candidate detection device 2 that detects abnormal shadow candidates, the image server 3 as a storage device that stores medical images, and the image display device 4 that displays medical images. However, the present invention is not limited to this. For example, it is good also as a structure provided with the function of all the apparatuses in one apparatus, and it is good also as comprising by the apparatus which combined the function of any two apparatuses, and the apparatus provided with the function of the remaining apparatuses.

Moreover, in the said embodiment, although demonstrated using the breast image as an example, a site | part is not limited to a breast.

  Further, for example, in the case of a medical image display system to which the abnormal shadow candidate detection device 2 is not connected, the position information of the attention area designated by the interpretation doctor is stored in the image server 3 in association with the medical image. Information indicating a region of interest specified by another image interpreting doctor, which is present in a region other than the region of interest specified by the interpreting physician during interpretation, may be displayed as diagnosis support information.

  In the above description, an example in which a hard disk, a semiconductor nonvolatile memory, or the like is used as a computer-readable medium of the program according to the present invention is disclosed, but the present invention is not limited to this example. As another computer-readable medium, a portable recording medium such as a CD-ROM can be applied. A carrier wave is also applied as a medium for providing program data according to the present invention via a communication line.

  In addition, the detailed configuration and detailed operation of each device constituting the medical image display system can be changed as appropriate without departing from the spirit of the present invention.

  It should be noted that the Japanese Patent Application No. 1 filed on April 21, 2010, including the description, claims, drawings and abstract, was applied. The entire disclosure of 2010-097659 is incorporated in its entirety into this application.

  It may be used for interpretation of medical images in the medical field.

DESCRIPTION OF SYMBOLS 100 Medical image display system 1 Image generation apparatus 2 Abnormal shadow candidate detection apparatus 3 Image server 351 Image DB
4 image display device 41 control unit 42 operation unit 43 display unit 44 communication unit 45 storage unit 46 bus

Claims (5)

The medical image and the position information of the abnormal shadow candidate region are acquired from a storage device that associates and stores the medical image and the position information of the abnormal shadow candidate region detected from the medical image, and the acquired medical image is displayed. A medical image display device,
Display means for displaying a medical image acquired from the storage device;
In the medical image displayed on the display means, an operation means for designating a region of interest that the operator has determined to be suspected of an abnormal shadow;
When the attention area is designated by the operation means, the specified shadow area is compared with the position information of the abnormal shadow candidate area detected from the medical image, and the abnormal shadow existing outside the designated attention area is compared. Control means for extracting a candidate area and displaying information indicating the extracted abnormal shadow candidate area on the medical image displayed on the display means;
A medical image display device comprising:   The control means causes the information indicating the extracted abnormal shadow candidate area and the information indicating the attention area specified by the operation means to be simultaneously displayed on the medical image displayed on the display means. The medical image display device described.   The medical image display apparatus according to claim 2, wherein the control unit displays a different mark in each of the extracted abnormal shadow candidate region and the attention region designated by the operation unit.   When the position information of the attention area previously designated by another image interpreting doctor is stored in the storage device in association with the medical image, the control unit is configured to pay attention to the attention area previously designated by the other image interpreting doctor. The position information of the area is acquired from the storage device, the attention area specified by the operation means, the abnormal shadow candidate area detected from the medical image, and the position information of the attention area specified by the other interpretation doctor, And extracting the detected abnormal shadow candidate area and the attention area specified by the other image interpretation doctor that exist outside the attention area specified by the operation means, and extract the extracted abnormal shadow candidate. The medical image display apparatus according to any one of claims 1 to 3, wherein information indicating a region and a region of interest designated by another image interpretation doctor is displayed on a medical image displayed on the display unit. The medical image and the position information of the abnormal shadow candidate region are acquired from a storage device that associates and stores the medical image and the position information of the abnormal shadow candidate region detected from the medical image, and the acquired medical image is displayed. A computer used in a medical image display device
Display means for displaying a medical image acquired from the storage device;
In the medical image displayed on the display means, an operating means for designating a region of interest that the operator has determined is suspected of an abnormal shadow,
When the attention area is designated by the operation means, the specified shadow area is compared with the position information of the abnormal shadow candidate area detected from the medical image, and the abnormal shadow existing outside the designated attention area is compared. Control means for extracting a candidate area and displaying information indicating the extracted abnormal shadow candidate area on the medical image displayed on the display means;
Program to function as.

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