KR101573863B1 - System and Method for output of Dose information - Google Patents

Abstract

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a dose information extraction system apparatus and an extraction method thereof. The present invention provides a dose information analysis program that automatically extracts dose information for each test in the CT examination, so that there is an advantage that the accumulation of the individual patients and the CT dose for each patient can be inquired. According to the present invention, the dose of the patient can be continuously monitored, and the dose can be expected to be reduced.

Description

TECHNICAL FIELD The present invention relates to a system and method for extracting a dose information,

The present invention relates to radiation dose extraction in CT examination, and more particularly, to a radiation dose information extraction system and a radiation dose information extraction method for automatically extracting dose factors and dose values for evaluating patient dose in CT examination.

In recent years, with the development of state-of-the-art medical devices and the active introduction to the medical field, the patient's exposure dose to medical radiation has also increased exponentially, and the public interest in health promotion has increased due to the improvement of living standard, Usage is also increasing rapidly.

Especially, various tests through computed tomography (CT) are an important part of modern medicine for diagnosis of various diseases and wounds, but the number of CT examinations is also increasing year by year because of various applications.

Therefore, with the increase of radiation dose in medical field by diagnostic radiation generator such as CT, public interest and concern about risk and side effect of radiation exposure are increasing together. The reason for this is that according to a paper published by Brenner in the New England Journal of Medicine in 2007, 1.5 to 2.0% of cancer in the United States has been claimed to be caused by CT radiation exposure. In other words, it is known that cancer caused by radiation is caused by electrons having a high energy directly destroying the linkage of DNA or by generating cancer inducing factors, and thus, it can be caused by a small amount of radiation.

Ultimately, low doses of radiation by CT can also cause serious problems. This is because CT scans are widely used clinically, but they can receive 50-150 mSv of radiation with only a few CT scans in the treatment process.

Therefore, there is a growing awareness of minimizing the exposure dose of patients, which is not only domestically but also nationally. For example, the International Radiation Protection Institute (ICRP) states that the radiation dose used in the medical field should be minimized for the benefit of the patient. In addition, with increasing interest in patient dose in the diagnostic field, the IAEA and the National Institutes of Health (NIH) in the United States have recognized the importance of dose tracking and are studying dose records, Efforts are being made to reduce usage.

At present, various attempts have been made both in domestic and abroad as an effort to reduce the patient dose. For example, the IAEA is working on a "Smart card / SmartRad Track" project to track the radiation dose of an individual and thereby reduce unnecessary radiation dose. And the United States is using a patient card that records the dose of radiation the patient receives led by the NIH. In addition, Canada is carrying out a project to share image information using diagnostic radiation using the iPhone. And some European countries are implementing a program to track medical radiation exposure, which allows individuals to carry medical radiation exposure information. In addition, Japan has initiated efforts to reduce patient dose by tracking the dose of patient radiation by establishing 'J-RIME' (Japanese Network for Research and Information on Medical Exposure).

However, in order to reduce the patient dose, it is necessary to accurately measure the patient dose and calculate the dose to be received by the actual patient.

There are various methods of calculating radiation dose, such as direct measurement method using dose evaluation simulator, computer simulation calculation method using radiation transport program, and CT dose calculation program use method.

However, there is a problem in each method of calculating the radiation dose by CT examination at present.

First, a direct measurement method using a dose evaluation simulator can perform a radiation dose measurement test for a specific shooting condition of a specific CT scanner, but it is possible to use various CT scanners, various inspection conditions (for example, Mode, inspection area, inspection length, pitch, kVp, mAs, etc.). In addition, it takes a lot of time and expense to conduct actual experiments, and if a part of the organ in the body is exposed to the radiation source (eg, only about half of the lungs are included in the examination area) It is impossible to calculate average dose for.

Secondly, the computer simulation calculation method using the radiation transport program is mainly performed using the radiation transport computer program using the Monte Carlo methodology, which requires a lot of computation time and expert knowledge on the use code. Therefore, it is limited that CT users who perform CT examination directly use it to calculate the dose of the patient during CT examination.

Third, there is a method of using a CT dose calculation program. A small number of CT dose calculation programs have been developed and are in use. CTDosimetry and CT-Expo are most commonly used among the developed programs. The advantage of the program is that even a general practitioner who does not have expertise in dosimetry can easily calculate the radiation dose from CT examinations (Stamm and Nagel 2002, 2007, ImPACT 2008). However, since there are some important limitations in existing dose calculation programs, development of new dose calculation programs is required. In other words, conventional dose calculation programs include CT-Expo and CT Dosimetry, which use mathematical phantoms different from those of the actual human body, making it difficult to evaluate the dose accurately.

On the other hand, among the CT equipment, CT equipment which can not display the dose report or which is not actually used accounts for a small percentage of all CT equipment. Therefore, the clinical CT protocol does not recognize the actual patient dose.

Japanese Laid-Open Patent Publication No. 2004-195121 (July, 2004)

It is therefore an object of the present invention to accurately measure the patient dose in the medical field and the diagnostic field and to monitor the dose of each patient to reduce the patient dose.

It is another object of the present invention to automatically extract dose factors and dose figures for patient doses in the medical and diagnostic fields.

It is still another object of the present invention to provide actual measurement data and predictive dose data for CT apparatuses which can not automatically extract dose related factors.

According to an aspect of the present invention, A DICOM server receiving DICOM image information from the CT; A dose information analyzing program for analyzing the DICOM image information in an analytical string form; A database for storing the analyzed dose information based on a RADIANCE; And a terminal device for displaying the dose information on a screen.

Wherein the dose analyzing program includes first through third analysis units according to the type of the DICOM image information, the first analyzing unit analyzes the DICOM image information in the form of data, and the second analyzing unit analyzes the DICOM image And the third analyzing unit predicts and analyzes the dose information using the manually input information when the CT does not provide the DICOM image information.

At this time, the third analyzing unit uses a CT dose calculation program.

The dose information analysis program includes an initial screen for setting a dose calculation, and the initial screen includes a dose factor setting screen, a dose factor list screen, and an unprocessed test name screen.

The unprocessed test name screen extracts a test name included in the header of the DICOM image information and displays a list.

According to another aspect of the present invention, there is provided a method comprising: transmitting a DICOM image information to a DICOM server; Analyzing the DICOM image information in a character string form by a dose information analyzing program provided in the DICOM server; Setting a dose factor by connecting the terminal device to the dose information analysis program in a state where the analyzed DICOM image information is stored; And when the dose factor is set, the DICOM server displays the dose information for each patient on the screen of the terminal.

The step of setting the dose factor comprises: recognizing a CT region by searching a character string by extracting a test name included in a header of the DICOM image information; and setting a dose change factor corresponding to the CT region by setting the dose factor.

In the case of CT in which a plurality of regions are photographed at one time in the step of setting the dose factor, a test name is generated as a name combined with the corresponding sites.

When the CT does not provide the DICOM image information, the DICOM server displays the predicted dose to the terminal device when the patient number, the CTDI, and the test name are manually input.

The patient-specific dose information includes the individual CT dose and the total dose value of the patient, the date and time of the examination, the prescription name, the site, the DLP, and the predicted effective dose.

The apparatus and method for extracting a dose information of the present invention have the following effects.

The present invention proposes a dose information analysis program for extracting dose information. This dose information analysis program is developed on a Windows basis and can be easily used even if it does not have expert knowledge. The CT site can be easily recognized by string search even if it is not linked with hospital prescription system (EMR).

Since the DICOM server automatically and manually analyzes the dose information from the CT, the user can check the individual dose and cumulative dose of each individual patient with a minimum of operation, thereby reducing the patient dose. can do.

The present invention can calculate the dose information through manual input and provide the result even when the CT does not provide the DICOM image information in any form. Therefore, it can be applied to conventional CT, which is advantageous in utilization value.

1 shows an example of dose reporting information provided by a general CT apparatus
2 is a schematic diagram of an apparatus for extracting a dose information according to a preferred embodiment of the present invention
FIG. 3 is an exemplary initial screen of the dose information analysis program shown in FIG. 2
FIG. 4 is an exemplary screen for setting dose calculation in the dose information analyzing program of FIG. 3
FIGS. 5 and 6 are diagrams of a screen for setting a dose factor in the dose information analyzing program of FIG. 3. FIG.
FIG. 7 is a schematic diagram of a result screen of the dose information analysis program of FIG. 2
FIGS. 8 and 9 are screen examples for extracting dose information in CT for not providing DICOM image information

The present invention is characterized in that the dose factor and the dose value for the patient dose are automatically extracted to obtain relevant data for reducing the patient dose. In other words, by automatically extracting dose factors and dose figures for patient doses in CT examinations and CT examinations, and by developing a system for inputting patient doses in CT, establish a basis for establishing a database for medical radiation exposure management will be.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, embodiments of a dose information extraction system and a dose information extraction method for evaluating a patient dose of CT according to the present invention will be described in detail with reference to the accompanying drawings.

First, in order to extract patient dose information according to the present embodiment, it is necessary to acquire unique information of the CT apparatus basically. The CT information includes basic information such as equipment model, format, manufacturer, country of manufacture, equipment unique number, type of data capable of reporting dose together with the type, and the like. This is shown in the following Tables 1 and 2.

general Hospital hospital Nursing hospital lawmaker gun Conventional 5 143 4 210 362 Single spiral 76 286 3 173 538 2CH 16 109 One 72 198 4 ~ 10CH 99 147 One 55 302 16 ~ 40CH 148 63 27 238 64CH or more 285 40 42 367 gun 629 788 9 579 2,005

manufacturer Conventional Single Spiral Other GE CT-MAX, MAX II, SYTEC1800I HISPEED
SYTEC SRI 4ch
LightSpeed plus Siemens Somatom Plus 4 Philips Tomoscan CX / S Toshiba TCT-300, TSX-001A (X-PEED) TSX-002A (X-Vision)
TSX-003A (Auklet) Hitachi Carino, CT-W400, W450 Pronto, Presto, Practico Shimadzu SCT-4800 SCT-7800TC Other Picker PQ-5000
Elscint SELE-CT

Here, Table 1 and Table 2 are the CT apparatuses that have undergone the quality control inspection by the Korean Medical Image Quality Management Service in 2011. [

On the other hand, the type of CT reporting is divided into the case of being stored as a medical digital image and communication standard (DICOM) image and the case of not storing it. At this time, the DICOM image can be stored in data form or image form. In this case, the dose information can be easily analyzed if it is stored in the form of data, whereas it is troublesome to change the image information into numerical information if it is stored in the image form. If the DICOM image can not be stored, the method of quantifying the predicted dose will be used.

The dose reporting form of the CT is shown in FIG. FIG. 1A is an example of outputting in the form of data, and FIG. 1B is an example of outputting in the form of an image. If the DICOM image can not be provided, no information is output.

Meanwhile, in the present embodiment, the dose information to be automatically extracted for analyzing the patient dose information is determined as the dose length product (DLP) information.

As described above, when information on various kinds of CTs is secured, the dose reporting information should be extracted and analyzed from the CTs. In other words, it is to confirm the accumulated dose of each patient.

To this end, the present embodiment provides a dose information analysis program for analyzing dose report information. That is, even if the DICOM image can be obtained in the CT as described above, the DICOM image itself does not have information on any part of the body. Therefore, the dose information analysis program automatically analyzes the dose information.

Hereinafter, the dose information analysis program will be referred to as " KDose (Korean dose) ", and its configuration will be described in detail.

'KDose' is built on the Windows environment. In the web development environment, 'Apache' is used for the web server, 'Mysql' is used for the database, 'PHP' is used for the web language, and 'phpMyadmin' is used for the database management.

DICOM header analysis uses DICOM library 'DCMTK' and DICOM character recognition uses 'GOCR'.

In addition, RADIANCE is provided for a comprehensive analysis of CT DICOM.

The web interface environment is 'Xpressengine'.

Meanwhile, a database for storing patient data analyzed by KDose is provided. The database is based on the RADIANCE and has tables and items as shown in Tables 3 to 5 for web environment and analysis.

masterflatfile table (CT information / patient dose information storage) AccessionNumber CT number Studydate inspection date PatientID patient StudyDescription The name of the probe in the CT DICOM header CalculatedTotalDLP Total DLP Conversion factor The k factor set in the dose factor bodysite2 Connected to the part set in the dose factor bodysite3 Connected to the part set in the dose factor estimateddose2 Predicted dose (mSv) isdupe Identification of duplicate sites no Unique number

masterflatfile 2 table (save dose information for manual addition) Studydate inspection date PatientID patient StudyDescription CT test name no Unique number (auto-generated)

xe_radiance_dose (dose factor setting table) no Unique number rank String search priority order text String to be searched for bodypart part conversionfactor k-factor subspecialty Division

KDose constructed in this way can easily provide dose information and cumulative dose at the time of individual CT examination by analyzing the patient dose information.

Next, the configuration of a system device provided for a method of extracting dose information for evaluating a patient dose of CT will be described with reference to FIG.

2, the CT 110 is provided in the dose information extraction system 100 of the present embodiment. As is well known, CT (110) is an image diagnostic device widely used for diagnosing various diseases and wounds in recent years. The X-ray or ultrasonic wave is projected on a human body at various angles and reconstructed by a computer, As shown in FIG. The CT 110 provides diagnosis results in a DICOM format or can not provide them at all.

The DICOM server 120 receiving the DICOM image information from the CT 110 is connected. At this time, the DICOM server 120 periodically receives the DICOM image information from the CT 110. That is, the transmission setting of the CT 110 can be set and automatically provided.

The DICOM server 120 is provided with a dose information analysis program KDose 122 for receiving DICOM image information and automatically analyzing the dose information. The KDose 122 periodically analyzes the DICOM image information.

Here, the KDose 122 provides an analysis tool 124 for analyzing the dose information corresponding to the type of the DICOM image information and the DICOM image information if not provided. That is, one of the analysis tools 124 is a first analysis unit 124a that directly analyzes the DICOM image information when the DICOM image information is provided in the form of data. And the second analyzing unit 124b converts the text (i.e., text) provided in the image into numerical information when the DICOM image information is provided in the form of an image. In the case of the second analyzing unit 124b, many techniques of character recognition software will be used. And a third analysis unit 124c for predicting the dose using the CT dose calculation program when no DICOM image information is provided at all. In the case of the third analysis unit 124c, the dose information is manually input through a web browser or the like. In this case, the dose information uses the CT dose calculation program.

Here, the first to third analyzing units 124a, 124b and 124c may be included in the KDose 122, or only the first and second analyzing units 124a and 124b may be included in the KDose And the third analysis unit 124c may be provided as a separate program.

The CT dose calculation program uses a UF phantom to compensate the major limitations of the conventional CT calculation programs 'CT-Expo' and 'CTDosimtery' using mathematical phantoms, and the ICRP 103 new recommendation of the International Radiation Protection Committee To allow accurate dose evaluation. It is based on Windows, so it runs on most computers and also supports graphical user interface. It is a program that users can easily use even without expert knowledge of computed tomography or radiation transport theory.

An electronic prescription device (EMR) (not shown) connected to the DICOM server 120 may be configured. This is to confirm easily which part of the body the photographed CT image is. However, the present embodiment may allow the DICOM server 120 not to associate with the electronic prescription device, but instead to identify a part of the body by using only the taken CT image. That is, the CT region is recognized through the string search of the test name included in the header information of the DICOM image information transmitted from the CT 110.

Next, a database 130 for storing patient data is constructed. The database 130 has the tables and the items of Tables 3 to 5 described above.

The terminal device 140 is configured to access the DICOM server 120 in the form of a web browser to set a dose factor and inquire dose information for each patient. KDose 122 must also be installed in the terminal device 140.

A method of extracting patient dose information through the thus configured dose information extraction system will be described with reference to the related drawings.

First, the CT 110 provides DICOM image information.

In this case, if the CT 110 and the DICOM server 120 are set, the CT 110 transmits DICOM image information, that is, a CT dose information image, to the DICOM server 120. At this time, DICOM image information is transmitted automatically and can be executed at a predetermined time set by the user.

Then, the first and second analysis units 124a and 124b of the KDose 122 process the data in the form of a character string that can be analyzed for database-based RADIANCE according to the type of the DICOM image information. The information in an analytical string format processed in a radian is stored in the database 130.

When the character string information is stored in the database 130, a process of confirming individual patient dose information is performed.

To this end, the user first accesses the DICOM server 120 through the terminal device 140. 3 is displayed on the terminal device 140, and the user performs a series of login processes.

When the login is normally performed, a menu screen for dose calculation setting is displayed as shown in FIG. On the menu screen, a dose factor setting screen A and a dose factor list screen B are displayed. And an unprocessed study description screen (C) is displayed. The untreated test name includes the information of the DICOM header basic test name (ex, Abdomen & Pelvis), the related test date and time (ex, 20100831), and the patient number (ex, 22793102). At this time, the untreated test name indicates the CT region. That is, the inspection name included in the DICOM header information is extracted and recognized through a string search, for example, Abdomen, Pelvis, Chest, Neck, or the like.

When the menu screen is displayed, information for calculating a dose is input. An example of information input is shown in Fig. As shown in FIG. 5, when a name, a site, a dose change factor, and a dose are input from the dose factor setting screen A displayed on the menu screen and an 'add' button is operated, the dose factor is displayed on the dose factor list screen B. On the other hand, in the untreated test name screen C, the corresponding item is deleted. Refer to the dose reference table in the menu for dose change factors.

For example, if CT Abdomen & Pelvis has a prescription, the prescription containing 'Abdomen' in the examination name setting screen (A) and abdomen and dose change factor (K-factor) All are assigned to the abdomen and are input in conjunction with the entered dose change factor 0.015. At this time, the prescription name 'Abdomen' is deleted from the untreated test name screen (C).

The above process is repeatedly input for each site.

Of course, in the case of a CT in which a plurality of regions are photographed at once, a virtual test name such as 'abdomen thorax' is generated and displayed as a combined name of the relevant regions in a predetermined order. An example of this is shown in Fig.

Then, from the menu, select Patient Dose Lookup and enter the patient number you want to search.

Then, the DICOM server 120 inquires the patient dose and displays it on the terminal device 140 in the form of a result screen shown in FIG. In the result screen, the dose information and the accumulated total dose information of the individual examined by the patient are shown in graph form. Also information on the date and time of the examination, the name of the prescription, the DLP, and the predicted effective dose are displayed.

On the other hand, the CT does not provide DICOM image information.

At this time, the dose information can be inputted manually by using the database management tool provided on the menu screen.

In other words, if '' [tool] manual CT database management 'displayed on the menu is selected, the screen of FIG. 8 is displayed. In this state,' insertion 'is operated to input relevant values in the screen of FIG. That is, enter the test date, patient number, CT test name, and total DLP of the CT.

Thereafter, if the process after the above-described login is repeated on the menu screen, the result screen as shown in FIG. 7 is provided even when the DICOM image information is not provided.

On the other hand, in order to evaluate the accuracy of the dosimetric values according to the present embodiment, the results were compared with those obtained by the dose measurement phantom.

The results are compared with the CTDIvol measured at the center, top, bottom, left, and right of the dose measurement phantom in the five CT instruments of Table 6 below. The dosimetry phantom used in this study was measured using a 16cm head phantom and a 10cm ionization chamber among dedicated acrylic phantoms for CT dose measurement. The measurement equipment was 'Unors Xi platnum edition'. The measurement points were measured at the center, top, bottom, left, and right of the phantom using the above measuring instrument.

equipment SOMATOM
Definition Flash SOMATOM
Definition SOMATOM
Definition AS SOMATOM
sensation16 LightSpeed VCT kVp
mAs
TI
BC 120kVp
200mA
1 sec
34.5 mm 120kVp
200mA
1 sec
30mm 120kVp
200mA
1 sec
14mm 120kVp
200mA
1 sec
18mm 120kVp
200mA
1 sec
40mm Dose report Measures Dose report Measures Dose report Measures Dose report Measures Dose report Measures Center 117.3 117 70.5 68.3 47 44.1 69 65.18 143.38 141 Superior 117.3 119.8 70.5 68.5 47 47.36 69 67.41 143.38 155 Inferior 117.3 109 70.5 66.5 47 46.26 69 66.77 143.38 138.6 RT 117.3 115.7 70.5 69 47 43.91 69 65.21 143.38 150.5 LT 117.3 116 70.5 65.85 47 44.07 69 64.89 143.38 146.2 Average 117.3 113.5 70.5 67.63 47 45.14 69 65.89 143.38 146.2

As a result, the dose value of the present example was 1.9% to 4.2% higher than the average of the five measured values of the measured values. However, this is not only within the general error range, but also by other studies (Shope TB, Gagne RM, Johnson GC, A method for describing the doses delivered by transmission x-ray computed tomography. Med Phys. 1981 Jul- : 488-95) (i.e., 10%).

As described above, in the present embodiment, the DICOM server periodically receives and analyzes the image information captured by the CT apparatus, and the individual dose information and the cumulative dose information of each patient are simply provided according to the user's request. It is understood that it is a basic technical point.

While the present invention has been particularly shown and described with reference to exemplary embodiments thereof, it is to be understood that the invention is not limited to the disclosed exemplary embodiments. It will be apparent that modifications, variations and equivalents of other embodiments are possible. Therefore, the true scope of the present invention should be determined by the technical idea of the appended claims.

100: CT 120: DICOM server
122: dose information analysis program 124: analysis tool
124a to 124c: First to third analysis units
130: Database 140: Terminal device

Claims (10)

CT imaging the patient;
A DICOM server receiving DICOM image information from the CT;
A dose information analysis program provided to the DICOM server for analyzing dose information according to characteristics of the DICOM image information;
A database for storing the analyzed dose information based on a RADIANCE; And
And a terminal device for displaying an initial screen composed of a dose factor setting screen, a dose factor list screen and an unprocessed test name screen of the dose information analyzing program according to the driving of the DICOM server,
Wherein the dose information analysis program comprises:
A second analyzing unit for analyzing the DICOM image information in the form of data, analyzing the text provided to the image in the DICOM image information of the image type into numerical information and analyzing it, and a second analyzing unit for analyzing the DICOM image information, And a third analyzer for predicting and analyzing the dose information using input information. delete The method according to claim 1,
And the third analysis unit uses a CT dose calculation program. delete The method according to claim 1,
Wherein the unprocessed test name screen extracts a test name included in a header of the DICOM image information and displays a list of the test names. The CT transmitting the DICOM image information to the DICOM server;
Analyzing a dose information analysis program included in the DICOM server according to characteristics of the DICOM image information transmitted from the CT;
Setting a dose factor using the dose information analysis program in a state where the analyzed DICOM image information is stored; And
When the dose factor is set, the DICOM server displays an initial screen of the dose information analysis program, which includes the dose factor setting screen, the dose factor list screen, and the unprocessed test name screen, on the screen of the terminal device so as to calculate the individual dose amount information ≪ / RTI >
Wherein the dose information analysis program comprises:
And first to third analysis units according to the type of the DICOM image information,
Wherein the first analyzing unit analyzes the DICOM image information in the form of data and the second analyzing unit converts the text provided to the image in the DICOM image information of the image form into numerical information and analyzes the analyzed information, A method of extracting dose information for predicting and analyzing dose information using manually input information when image information is not provided. The method according to claim 6,
Wherein the setting of the dose factor comprises: recognizing a CT region by searching a character string by extracting a test name included in a header of the DICOM image information, and setting a dose change factor corresponding to the CT region Information extraction method. The method according to claim 6,
Wherein in the step of setting the dose factor, in the case of a CT in which a plurality of regions are photographed at one time, a test name is generated as a name combined with the corresponding portions. The method according to claim 6,
Wherein the DICOM server displays the predicted dose to the terminal device when the CT number is not provided, the CTDI, and the test name are manually input. The method according to claim 6,
Wherein the dose information per patient is an individual CT dose and total dose value of a patient, a date and time of examination, a prescription name, a site, DLP, and a predicted effective dose.

Images