WO2011132468A1 - Medical-image displaying device and program - Google Patents

Medical-image displaying device and program Download PDF

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Publication number
WO2011132468A1
WO2011132468A1 PCT/JP2011/055223 JP2011055223W WO2011132468A1 WO 2011132468 A1 WO2011132468 A1 WO 2011132468A1 JP 2011055223 W JP2011055223 W JP 2011055223W WO 2011132468 A1 WO2011132468 A1 WO 2011132468A1
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WIPO (PCT)
Prior art keywords
medical image
area
abnormal shadow
displayed
image
Prior art date
Application number
PCT/JP2011/055223
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French (fr)
Japanese (ja)
Inventor
仁 二村
昭教 角森
Original Assignee
コニカミノルタエムジー株式会社
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Priority to JP2012511587A priority Critical patent/JPWO2011132468A1/en
Publication of WO2011132468A1 publication Critical patent/WO2011132468A1/en

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/46Arrangements for interfacing with the operator or the patient
    • A61B6/461Displaying means of special interest
    • A61B6/463Displaying means of special interest characterised by displaying multiple images or images and diagnostic data on one display
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/46Arrangements for interfacing with the operator or the patient
    • A61B6/461Displaying means of special interest
    • A61B6/465Displaying means of special interest adapted to display user selection data, e.g. graphical user interface, icons or menus
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/56Details of data transmission or power supply, e.g. use of slip rings
    • A61B6/563Details of data transmission or power supply, e.g. use of slip rings involving image data transmission via a network
    • GPHYSICS
    • G16INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16HHEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H30/00ICT specially adapted for the handling or processing of medical images
    • G16H30/20ICT specially adapted for the handling or processing of medical images for handling medical images, e.g. DICOM, HL7 or PACS
    • GPHYSICS
    • G16INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16HHEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H30/00ICT specially adapted for the handling or processing of medical images
    • G16H30/40ICT specially adapted for the handling or processing of medical images for processing medical images, e.g. editing

Definitions

  • the present invention relates to a medical image display device and a program.
  • breast cancer screening In recent years, interest in breast cancer screening has increased with the increasing incidence of breast cancer among women.
  • a doctor interprets a medical image obtained by photographing a breast to diagnose the presence or absence of an abnormality.
  • the number of interpretation doctors who perform diagnosis is insufficient, and there is a problem that diagnosis is delayed.
  • 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.
  • CAD Computer-Aided Detection
  • 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.
  • 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.
  • 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.
  • 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.
  • control means displays a different mark in each of the extracted abnormal shadow candidate area and the attention area designated by the operation means.
  • 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.
  • 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.
  • the interpretation doctor is influenced by the detection result by CAD. This makes it possible to perform image interpretation diagnosis without using it.
  • FIG. 3 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
  • C is displayed in step S10 in FIG.
  • 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.
  • 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
  • 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.
  • a 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 via a communication network N built in a medical institution such as a LAN (Local Area Network) so as to be able to transmit and receive data to and from each other.
  • a communication network N built in a medical institution such as a LAN (Local Area Network) so as to be able to transmit and receive data to and from each other.
  • the DICOM Digital Imaging and Communication in Medicine
  • the number of each device is not particularly limited.
  • the image generation apparatus 1 captures a human body and generates digital data of the captured image (medical image).
  • digital data 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.
  • CR Computer Radiography
  • FPD Fluorescence Deformation
  • CT Magnetic Tomography
  • MRI Magnetic Resonance Imaging
  • cassette reader film digitizer
  • film digitizer etc.
  • 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 generation apparatus 1 adds the above patient information, examination information, UID (Unique ID) etc.
  • the image generation device 1 For identifying the image as header information to the generated medical image.
  • 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), 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.
  • 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.
  • a known algorithm can be applied as an abnormal shadow candidate detection algorithm.
  • a method using an iris filter disclosed in Japanese Patent Laid-Open No. 10-91758 a method using a Laplacian filter (the 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.
  • 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.
  • 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.
  • the abnormal shadow candidate detection device 2 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, RAM, and 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.
  • the image DB 351 has an image management table that stores management information regarding each medical image stored in the image DB 351.
  • 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.).
  • 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.
  • 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.
  • 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.
  • the image display device 4 is a medical image display device that acquires and displays a medical image designated by an interpreting doctor's operation and CAD information corresponding to the medical image.
  • FIG. 2 shows a functional configuration example of the image display device 4.
  • 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 to be 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 in accordance with display signal instructions input from the control unit 41.
  • a monitor such as a CRT (Cathode Ray Tube) or an LCD (Liquid Crystal Display)
  • LCD Liquid Crystal Display
  • 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.
  • 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. is doing.
  • 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.
  • 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.
  • a search condition patient ID, examination site, laterality, etc.
  • the input search condition and search request are transmitted to the image server 3 by the communication unit 44.
  • 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.
  • an image selection screen based on the list data is displayed on the display unit 43.
  • 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.
  • Step S2 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).
  • 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.
  • a viewer screen 431 on which the acquired medical image is displayed is displayed on the display unit 43 (step S3).
  • 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.
  • the attention area is designated by clicking with the mouse of the operation unit 42 or the like.
  • step S4 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.
  • 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.
  • 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).
  • 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.
  • step S6 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • the interpretation doctor 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.
  • 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.
  • step S9 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.
  • 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.
  • step S11 When the operation unit 42 instructs the end of interpretation (step S11; YES), the medical image display process ends.
  • 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.
  • 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 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), that 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.
  • 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.
  • 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.
  • 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.
  • a search condition patient ID, examination site, laterality, etc.
  • the input search condition and search request are transmitted to the image server 3 by the communication unit 44.
  • 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.
  • an image selection screen based on the list data is displayed on the display unit 43.
  • 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.
  • 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).
  • 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.
  • the position information of the attention area of the other interpreting doctor is not acquired.
  • the interpretation doctor ID currently logged in to the image display device 4 and the interpretation of the previously interpreting doctor.
  • 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.
  • the viewer screen 432 on which the acquired medical image is displayed is displayed on the display unit 43 (step S23).
  • 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).
  • the attention area is designated by clicking with the mouse of the operation unit 42 or the like.
  • step S24 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.
  • 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.
  • step S26 it is determined whether display of diagnosis support information is instructed by the operation unit 42 (step S26).
  • 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.
  • diagnosis support information 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.
  • step S26 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).
  • 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 specified by another interpreting 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • step S30 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.
  • 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.
  • step S31 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.
  • 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.
  • 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.
  • the control unit 41 positions the designated region of interest and the abnormal shadow candidate region detected from the displayed medical image.
  • 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.
  • 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.
  • 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.
  • the interpretation doctor 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.
  • the control unit 41 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.
  • 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.
  • 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.
  • the attention area designated by the other interpreting doctor is used as diagnosis support information. It can be used.
  • 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.
  • the abnormal shadow candidate detection device 2 that detects abnormal shadow candidates
  • the image server 3 as a storage device that stores medical images
  • the image display device 4 that displays medical images.
  • the present invention is not limited to this.
  • 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.
  • part is not limited to a breast.
  • 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.
  • 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, but the present invention is not limited to this example.
  • 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.

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Abstract

Provided is an image displaying device that can shorten the time required for reading an image by inhibiting the displaying of unnecessary marks, and with which image reading and diagnosis can be carried out without the radiologist being influenced by the detection results of CAD (computer-aided detection) in cases where the CAD has failed to detect abnormal shadow candidates. When a medical image to be read is selected with an operating section (42), the controlling section (41) of the image displaying device (4) acquires, from an image server (3), the medical image and positional information on abnormal-shadow-candidate areas that have been detected from the medical image, and displays the medical image on a displaying section (43). When an area of interest is designated with the operating section (42) in the medical image displayed on the displaying section (43), the controlling section (41) compares the designated area of interest with the positional information on the abnormal-shadow-candidate areas detected from the medical image being displayed, extracts the abnormal-shadow-candidate area(s) existing outside the designated area of interest, and displays a mark (M2) that indicates each extracted abnormal-shadow-candidate area on the medical image displayed on the displaying section (43).

Description

医用画像表示装置及びプログラムMedical image display apparatus and program
 本発明は、医用画像表示装置及びプログラムに関する。 The present invention relates to a medical image display device and a program.
 近年、女性の乳癌の罹患率の上昇に伴い、乳癌検診への関心が高まっている。乳癌検診では、乳房を撮影した医用画像を医師が読影し、異常の有無を診断している。しかしながら、診断を行う読影医の数は不足しており、診断が滞る問題が発生している。 In recent years, interest in breast cancer screening has increased with the increasing incidence of breast cancer among women. 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.
 このような問題を改善すべく、診断作業の支援を目的として、医用画像から乳癌等の病変の特徴を示す異常陰影候補を自動的に検出する異常陰影候補検出装置(CAD(Computer-Aided Detection))が開発されている。 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.
 CADにより検出された異常陰影候補の領域を医用画像表示装置に表示する技術として、例えば、特許文献1には、異常陰影候補検出手段で検出された異常陰影候補位置にマークを表示するもの、及び異常陰影候補群を与えられた順位に従って順次切り替え表示するものが記載されている。 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.
特開2000-287955号公報JP 2000-287955 A
 ところで、CADにより検出された異常陰影候補の領域にマークを表示した場合、読影医が読影する時間は、マーク数に応じて増加する傾向がある。特許文献1においては、異常陰影候補の表示順序を指定することはできるが、読影医が確認する必要のない無用なマークも含めて、CADにより検出された全ての異常陰影候補領域を示すマークが表示されてしまうという問題がある。 By the way, when a mark is displayed in the area of the abnormal shadow candidate detected by CAD, the time taken for the interpretation by the interpreting doctor 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.
 また、読影医が異常陰影の疑いありと判断した注目領域をCADが万が一検出できなかった場合、読影医がCADの検出結果に影響されてしまい、読影医自身の判断への確信度が低下し、本来異常陰影である領域を注目領域から落としてしまうおそれがある。 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.
 本発明の課題は、無用なマーク表示を低減することにより読影時間の低減を図るとともに、CADによる異常陰影候補の検出が失敗した場合に読影医がCADによる検出結果に左右されずに読影診断を行うことができるようにすることである。 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.
 上記課題を解決するため、本発明の第1の側面によると、
 医用画像と当該医用画像から検出された異常陰影候補領域の位置情報とを対応付けて記憶する記憶装置から前記医用画像及び前記異常陰影候補領域の位置情報を取得し、この取得した医用画像を表示する医用画像表示装置であって、
 前記記憶装置から取得された医用画像を表示する表示手段と、
 前記表示手段に表示された医用画像において、操作者が異常陰影の疑いがあると判断した注目領域を指定するための操作手段と、
 前記操作手段により注目領域が指定されると、前記指定された注目領域と前記医用画像から検出された異常陰影候補領域の位置情報とを比較して前記指定された注目領域以外に存在する異常陰影候補領域を抽出し、当該抽出された異常陰影候補領域を示す情報を前記表示手段に表示された医用画像上に表示させる制御手段と、
 を備える。
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.
 前記制御手段は、前記抽出された異常陰影候補領域を示す情報と、前記操作手段により指定された注目領域を示す情報とを前記表示手段に表示された医用画像上に同時に表示させることが好ましい。 Preferably, 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.
 前記制御手段は、前記抽出された異常陰影候補領域と前記操作手段により指定された注目領域のそれぞれに異なる態様のマークを表示させることが好ましい。 It is preferable that the control means displays a different mark in each of the extracted abnormal shadow candidate area and the attention area designated by the operation means.
 他の読影医により以前に指定された注目領域の位置情報が前記医用画像に対応付けて前記記憶装置に記憶されている場合、前記制御手段は、前記他の読影医により以前に指定された注目領域の位置情報を前記記憶装置から取得し、前記操作手段により指定された注目領域と、前記医用画像から検出された異常陰影候補領域及び前記他の読影医により指定された注目領域の位置情報とを比較して、前記操作手段により指定された注目領域以外に存在する、前記検出された異常陰影候補領域及び前記他の読影医により指定された注目領域を抽出し、当該抽出された異常陰影候補領域及び他の読影医により指定された注目領域を示す情報を前記表示手段に表示された医用画像上に表示させることが好ましい。 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.
 本発明の第2の側面によると、
 プログラムは、
 医用画像と当該医用画像から検出された異常陰影候補領域の位置情報とを対応付けて記憶する記憶装置から前記医用画像及び前記異常陰影候補領域の位置情報を取得し、この取得した医用画像を表示する医用画像表示装置に用いられるコンピュータを、
 前記記憶装置から取得された医用画像を表示する表示手段、
 前記表示手段に表示された医用画像において、操作者が異常陰影の疑いがあると判断した注目領域を指定するための操作手段、
 前記操作手段により注目領域が指定されると、前記指定された注目領域と前記医用画像から検出された異常陰影候補領域の位置情報とを比較して前記指定された注目領域以外に存在する異常陰影候補領域を抽出し、当該抽出された異常陰影候補領域を示す情報を前記表示手段に表示された医用画像上に表示させる制御手段、
 として機能させる。
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.
 本発明によれば、無用なマーク表示を低減することにより読影時間の低減を図ることが可能となるとともに、CADによる異常陰影候補の検出が失敗した場合に読影医がCADによる検出結果に影響されずに読影診断を行うことが可能となる。 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.
本実施の形態における医用画像表示システムの全体構成例を示す図である。It is a figure which shows the example of whole structure of the medical image display system in this Embodiment. 図1の画像表示装置の機能的構成を示すブロック図である。It is a block diagram which shows the functional structure of the image display apparatus of FIG. 第1の実施の形態において図2の制御部により実行される医用画像表示処理を示すフローチャートである。3 is a flowchart illustrating medical image display processing executed by the control unit in FIG. 2 in the first embodiment. Aは、図3のステップS5で表示されるビューア画面の一例を示す図、Bは、図3のステップS8で表示されるビューア画面の一例を示す図、Cは、図3のステップS10で表示されるビューア画面の一例を示す図である。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. 図1の異常陰影候補検出装置により検出された異常陰影候補領域の一例を示す図である。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. 第2の実施の形態において、図2の制御部により実行される医用画像表示処理Bを示すフローチャートである。6 is a flowchart showing a medical image display process B executed by the control unit of FIG. 2 in the second embodiment. Aは、図6のステップS25で表示されるビューア画面の一例を示す図、Bは、図6のステップS28で表示されるビューア画面の一例を示す図、Cは、図6のステップS30で表示されるビューア画面の一例を示す図である。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. 図1の異常陰影候補検出装置により検出された異常陰影候補領域の一例を示す図である。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.
[第1の実施の形態]
(医用画像表示システム100の構成)
 まず、第1の実施の形態の構成を説明する。
 図1に、第1の実施の形態における医用画像表示システム100のシステム構成を示す。
 医用画像表示システム100は、医用画像を撮影し、当該医用画像から異常陰影候補を検出し、医用画像とともにその検出結果情報を読影医に提供するシステムである。
[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.
 図1に示すように、医用画像表示システム100は、画像生成装置1、異常陰影候補検出装置2、画像サーバ3、画像表示装置4を備えて構成されている。これら各装置1~4は、LAN(Local Area Network)等の医療機関内で構築された通信ネットワークNを介して相互にデータを送受信可能に接続されている。通信ネットワークNは、DICOM(Digital Imaging and Communication in Medicine)規格が適用されている。なお、各装置の台数は特に限定されない。 As shown in FIG. 1, a 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 via a communication network N built in a medical institution such as a LAN (Local Area Network) so as to be able to transmit and receive data to and from each other. 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.
 以下、各構成装置1~4について説明する。
 画像生成装置1は、人体を撮影し、その撮影画像(医用画像)のデジタルデータを生成するものであり、例えばCR(Computed Radiography)、FPD(Flat Panel Detector)、CT(Computed Tomography)、MRI(Magnetic Resonance Imaging)、カセッテ専用の読取装置、フィルムディジタイザ等のモダリティを適用可能である。本実施形態では、画像生成装置1として、左右乳房のX線撮影を行う乳房専用のCRを適用し、乳房画像のデータが生成されるものとする。
Hereinafter, each of the constituent devices 1 to 4 will be described.
The image generation apparatus 1 captures 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.
 なお、画像生成装置1は、上述したDICOM規格に準拠した装置であり、生成した医用画像に付帯させる各種情報、例えば、患者情報や検査情報を外部から入力可能であるとともに、自動生成することもできる。患者情報には、患者を識別するための患者識別情報(例えば、患者ID)、患者の名前、性別、生年月日等の情報が含まれる。検査情報は、検査を識別するための検査識別情報(例えば、検査ID)、検査日、検査条件(検査部位、側性(左、右)、方向(例えば、上下方向(CC)、斜位方向(MLO))、モダリティ種等の情報が含まれる。画像生成装置1は、生成された医用画像に上記患者情報や検査情報、画像を識別するためのUID(Unique ID)等をヘッダ情報として付加して通信ネットワークNを介して異常陰影候補検出装置2及び画像サーバ3へ送信する。なお、DICOM規格に準拠していない場合には、図示しないDICOM変換装置を用いて付帯情報を画像生成装置1に入力させることも可能である。 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 generation apparatus 1 adds the above patient information, examination information, UID (Unique ID) etc. 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.
 異常陰影候補検出装置(CAD)2は、画像生成装置1から供給される医用画像の画像解析を行って異常陰影候補の検出処理を行うコンピュータである。異常陰影候補検出装置2は、CPU(Central Processing Unit)、RAM(Random Access Memory)、HDD(Hard Disk Drive)等の記憶部、LANカード等の通信部を備える。異常陰影候補検出装置2の記憶部には、異常陰影の種類に応じた検出アルゴリズムの検出プログラムが記憶されており、異常陰影候補検出装置2のCPUは、記憶部に記憶された検出プログラムとの協働により、通信部を介して入力された各医用画像から異常陰影候補を検出する。例えば、乳房画像における腫瘤、微小石灰化クラスタの異常陰影候補を検出する。 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), 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.
 異常陰影候補の検出アルゴリズムとしては、公知のものを適用可能である。例えば、乳房画像における腫瘤陰影候補のアルゴリズムとしては、特開平10-91758号公報に開示されているアイリスフィルタを用いた手法や、ラプラシアンフィルタを用いた手法(電気情報通信学会論文誌(D-II),Vol.J76-D-II,no.2,pp.241-249,1993)等が適用可能である。また、微小石灰化クラスタ陰影候補の検出アルゴリズムとしては、例えばモルフォルジーフィルタ(電気情報通信学会論文誌(D-II),Vol.J71-D-II,no.7,pp.1170-1176,1992)、ラプラシアンフィルタ(電気情報通信学会論文誌(D-II),Vol.J71-D-II,no.10,pp.1994-2001,1998)、3重リングフィルタ等を用いた方法等を適用可能である。 A known algorithm can be applied as an abnormal shadow candidate detection algorithm. 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 (the 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.
 異常陰影候補検出装置2は、上記検出アルゴリズムによる異常陰影候補の検出処理が終了すると、異常陰影候補の検出結果情報(以下、CAD情報と呼ぶ)を生成する。CAD情報は、例えば、検出された各異常陰影候補の領域(輪郭)の位置情報及び異常陰影候補の種類(例えば、腫瘤、微小石灰化クラスタ等)の情報が含まれる。そして、異常陰影候補検出装置2は、生成されたCAD情報に検出元の医用画像のヘッダ情報を付加して通信部により画像サーバ3に送信する。 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.
 画像サーバ3は、CPU、RAM、HDD等の記憶部、LANカード等の通信部を備えたコンピュータである。画像サーバ3の記憶部には、画像DB(Data Base)351が備えられている。画像サーバ3は、画像生成装置1から受信された医用画像と異常陰影候補検出装置2から受信された当該医用画像についてのCAD情報とを対応付けて記憶し、その入出力を管理する。 The image server 3 is a computer including a storage unit such as a CPU, RAM, and 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.
 例えば、画像DB351は、画像DB351に記憶されている各医用画像に関する管理情報を格納する画像管理テーブルを有している。画像管理テーブルには、各医用画像についての管理情報が1レコードとして格納される。管理情報には、UID、患者情報、検査情報、ファイル情報(医用画像のファイル名及びこれに対応するCAD情報のファイル名、ファイル格納場所、更新日付、ファイルサイズ等)が含まれる。
 画像サーバ3において、画像生成装置1からの医用画像が受信されると、受信された医用画像が画像DB351に格納されるとともに、受信された医用画像のヘッダ情報に基づいて管理情報が作成され、画像管理テーブルに格納される。また、異常陰影候補検出装置2からのCAD情報が受信されると、受信されたCAD情報が画像DB351に格納されるとともに、画像管理テーブルからCAD情報とUIDが一致するレコードが検索され、検索されたレコードにCAD情報のファイル名、格納場所等が追加書き込みされる。このようにして、画像DB351には、医用画像と当該医用画像から検出された異常陰影候補の検出結果情報が対応付けて検索可能に記憶される。
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.
 図1に戻り、画像表示装置4は、読影医の操作により指定された医用画像及びこれに対応するCAD情報を画像サーバ3から取得して表示する医用画像表示装置である。 Referring back to FIG. 1, the image display device 4 is a medical image display device that acquires and displays a medical image designated by an interpreting doctor's operation and CAD information corresponding to the medical image.
 図2に、画像表示装置4の機能構成例を示す。
 図2に示すように、画像表示装置4は、制御部41、操作部42、表示部43、通信部44、記憶部45を備えて構成され、各部はバス46により接続されている。
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.
 制御部41は、CPU、RAM等により構成される。制御部41のCPUは、記憶部45に記憶されているシステムプログラムや処理プログラム等の各種プログラムを読み出してRAMに展開し、展開されたプログラムに従って各種処理を実行する。 例えば、制御部41は、後述する医用画像表示処理を実行する。 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 to be described later.
 操作部42は、文字入力キー、数字入力キー、及び各種機能キー等を備えたキーボードと、マウス等のポインティングデバイスを備えて構成され、キーボードで押下操作されたキーの押下信号とマウスによる操作信号とを、入力信号として制御部41に出力する。 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.
 表示部43は、例えば、CRT(Cathode Ray Tube)やLCD(Liquid Crystal Display)等のモニタを備えて構成されており、制御部41から入力される表示信号の指示に従って、各種画面を表示する。 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 in accordance with display signal instructions input from the control unit 41.
 通信部44は、LANカード等により構成され、スイッチングハブを介して通信ネットワークNに接続された外部機器との間でデータの送受信を行う。 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.
 記憶部45は、例えばHDD(Hard Disk Drive)や半導体の不揮発性メモリ等で構成されている。記憶部45には、前述のように各種プログラムが記憶されている。また、記憶部45には、医用画像を診断に適した画質に調整するための画像処理パラメータ(階調処理に用いる階調曲線を定義したルックアップテーブル、周波数処理の強調度等)等を記憶している。 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. is doing.
(医用画像表示システム100の動作)
 次に、医用画像表示システム100の動作について説明する。
 図3に、第1の実施の形態において画像表示装置4により実行される医用画像表示処理のフローチャートを示す。医用画像表示処理は、制御部41と記憶部45に記憶されているプログラムとの協働により実行される。
(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.
 まず、操作部42の操作により読影対象の医用画像の選択が行われる(ステップS1)。具体的には、操作部42による操作に応じて、表示部43に、医用画像の検索画面が表示される。検索画面において操作部42により検索条件(患者ID、検査部位、側性等)が入力されると、入力された検索条件及び検索要求が通信部44により画像サーバ3に送信される。画像サーバ3においては、画像DB351の画像管理テーブルから検索条件に合致した医用画像の管理情報が検索され、検索条件に合致した医用画像のリストデータが作成されて画像表示装置4に送信される。画像表示装置4においては、通信部44によりリストデータが受信されると、当該リストデータに基づく画像選択画面が表示部43に表示される。画像選択画面は、例えば、検査ID、患者ID、患者氏名、検査日、モダリティ種、検査部位、側性、方向等の項目を有するリストが検査単位で表示され、表示部43への表示対象とする医用画像を操作部42を介して選択可能な構成となっている。読影医は、操作部42の操作により読影対象の医用画像を選択する。 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.
 読影対象の医用画像が選択されると、選択された読影対象の医用画像の取得要求が通信部44により画像サーバ3に送信され、読影対象の医用画像及び当該医用画像のCAD情報が画像サーバ3から取得される(ステップS2)。画像サーバ3においては、読影対象の医用画像の取得要求が受信されると、要求された読影対象の医用画像及び当該医用画像に対応するCAD情報が医用画像DB351から検索されて読み出され、画像表示装置4に送信される。 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.
 読影対象の医用画像及びCAD情報が取得されると、取得された医用画像が表示されたビューア画面431が表示部43に表示される(ステップS3)。
 表示部43のビューア画面431に医用画像が表示されると、読影医は表示された医用画像を観察し、注目領域(異常陰影の疑いのある領域をいう)が存在するか否かの診断を行う。注目領域が存在した場合には、操作部42のマウスでクリックする等により注目領域を指定する。
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.
 操作部42により、表示部43に表示された医用画像上から注目領域が指定されると(ステップS4;YES)、指定された注目領域の位置情報がRAMに記憶され、表示された医用画像上の指定された注目領域にマークM1が表示され(ステップS5)、処理はステップS6に移行する。操作部42により注目領域が指定されない場合は、処理はステップS6に移行する。 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.
 図4のAに、ステップS5で表示されるビューア画面431の一例を示す。図4のAに示すように、ビューア画面431に表示された医用画像上には、操作部42により指定された注目領域にマークM1が重畳表示される。マークM1は、読影医が指定した注目領域を示す情報であり、注目領域の代表点(例えば、重心等)を示す○や矢印等の記号や、指定された注目領域を線で表した描画情報等が含まれる。 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.
 ステップS6においては、操作部42によりCADの検出結果(即ち、異常陰影候補検出装置2により検出された異常陰影候補領域)の表示が指示されたか否かが判断される(ステップS6)。例えば、表示部43のビューア画面431上に表示されているCAD結果表示ボタンB1が押下されることによりCAD結果の表示を指示することが可能となる。 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.
 操作部42によりCAD結果の表示が指示されると(ステップS6;YES)、ステップS4において操作部42により指定された注目領域と、ステップS2で受信された当該医用画像に対するCAD情報により指摘されている異常陰影候補領域の位置情報とが比較され、表示されている医用画像の注目領域以外の領域に存在する異常陰影候補領域が抽出される(ステップS7)。そして、表示部43に表示されている医用画像上の、抽出された異常陰影候補領域にマークM2が表示される(ステップS8)。
 マークM2は、CADにより検出された異常陰影候補領域を示す情報であり、異常陰影候補領域の代表点(例えば、重心等)を示す○や矢印等の記号や、異常陰影候補領域を線で表した描画情報等が含まれる。マークM2は、マークM1と同じ態様の表示であってもよいが、異なる表示とした方が注目領域とそれ以外の異常陰影候補領域を読影医が容易に認識できるので好ましい。なお、ビューア画面431上には、読影医により指定された注目領域及びCAD結果を同時に医用画像上に表示させる指示を入力するための「全て表示」ボタンB2が表示される。
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.
 図4のBに、ステップS8で表示されるビューア画面431の一例を示す。図4のBに示すように、ステップS8においては、ステップS7で抽出された領域のみ、即ち、読影医により指定された注目領域以外の領域に存在する異常陰影候補領域のみにマークM2が重畳表示される。例えば、ステップS4において読影医により指定された注目領域が図4のAにM1で示す領域であり、CAD情報が示す異常陰影候補領域が図5にM0で示す領域であった場合、ステップS8においては、図4のBに示す表示となる。即ち、読影医が確認する必要のある領域、具体的には、読影医が注目しなかった領域であってCADで検出された異常陰影候補領域のみにマークM2が表示される。既に読影医が確認済みである領域、具体的には、読影医が注目領域として指定したがCADにより検出されなかった領域、及び、読影医が指定した注目領域とCADで検出された異常陰影候補領域の双方が重複した領域には、マークが表示されない。このように、マークM2の表示は、読影医が真に確認をすべき領域に限定されるため、読影にかかる時間を低減することができる。また、読影医の指定した注目領域がCADの結果と一致したか否かを読影医が知り得ない表示態様であるため、読影医が注目領域と判断したがCADにより検出されなかった領域について、CAD結果に影響されて読影医自身の判断の確信度を低下させてしまうといったことを防止することができる。  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. *
 なお、ビューア画面431に表示されているマークM2の領域等を読影医が観察し、異常陰影の疑いがあると判断した場合は、操作部42によりその領域を指定することにより、その領域を注目領域として指定することもできる。 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.
 次いで、操作部42により「全て表示」ボタンB2が押下されたか否かが判断され、「全て表示」ボタンB2が押下されたと判断されると(ステップS9;YES)、ステップS4で指定された注目領域を示すマークM1及びステップS7で抽出された異常陰影候補領域を示すマークM2の双方が同時に医用画像上に表示される(ステップS10)。 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).
 図4のCに、ステップS10で表示されるビューア画面431の一例を示す。図4のCに示すように、ステップS10においては、読影医により指定された注目領域及びCADにより検出された異常陰影候補領域の双方がマーク表示されるため、読影医が最終的に診断すべき領域に見落としがないかを確認することができる。 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.
 操作部42により読影の終了が指示されると(ステップS11;YES)、医用画像表示処理は終了する。例えば、操作部42により終了ボタンB3が押下されると、医用画像表示処理は終了する。 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.
[第2の実施の形態] 
 次に、本発明の第2の実施の形態について説明する。
 第2の実施の形態において、画像DB351は、医用画像に対し、その医用画像について異常陰影候補検出装置2で生成されたCAD情報を対応付けて記憶するとともに、更に、その医用画像について以前に読影医により指定された注目領域の位置情報及び読影医ID(読影医識別情報)を対応付けて記憶する。即ち、他の読影医(一次読影医)により既に読影済みの医用画像を或る読影医(例えば、二次読影医)が読影しようとした場合に、その読影医は、他の読影医が指定した注目領域を利用することができるようになっている。
 その他の構成は、第1の実施の形態と同様であるので説明を援用する。
[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), that 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.
 次に、第2の実施の形態の動作について説明する。
 図6に、第2の実施の形態において画像表示装置4により実行される医用画像表示処理(医用画像表示処理Bとする)のフローチャートを示す。医用画像表示処理Bは、制御部41と記憶部45に記憶されているプログラムとの協働により実行される。なお、医用画像表示処理Bの実行の前提として、画像表示装置4の操作者である読影医は、操作部42により読影医ID及びパスワード等の認証情報を入力し、画像サーバ3によりログイン認証されている。
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.
 まず、操作部42の操作により読影対象の医用画像の選択が行われる(ステップS21)。具体的には、まず、操作部42による操作に応じて、表示部43に、医用画像の検索画面が表示される。検索画面において操作部42により検索条件(患者ID、検査部位、側性等)が入力されると、入力された検索条件及び検索要求が通信部44により画像サーバ3に送信される。画像サーバ3においては、画像DB351の画像管理テーブルから検索条件に合致した医用画像の管理情報が検索され、検索条件に合致した医用画像のリストデータが作成されて画像表示装置4に送信される。画像表示装置4においては、通信部44によりリストデータが受信されると、当該リストデータに基づく画像選択画面が表示部43に表示される。画像選択画面は、例えば、検査ID、患者ID、患者氏名、検査日、モダリティ種、検査部位、側性、方向等の項目を有するリストが検査単位で表示され、表示部43への表示対象とする医用画像を操作部42を介して選択可能な構成となっている。読影医は、操作部42の操作により読影対象の医用画像を選択する。  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. *
 読影対象の医用画像が選択されると、選択された読影対象の医用画像の取得要求が通信部44により画像サーバ3に対して送信され、読影対象の医用画像、当該医用画像のCAD情報、及び他の読影医により指定された注目領域(他の読影医の注目領域)の位置情報が画像サーバ3から取得される(ステップS22)。
 画像サーバ3においては、読影対象の医用画像の取得要求が受信されると、要求された読影対象の医用画像、当該医用画像に対応するCAD情報、及び他の読影医の注目領域の位置情報が医用画像DB351から検索されて読み出され、画像表示装置4に送信される。なお、例えば、一次読影医が読影する場合等、まだその医用画像の読影がされていない場合は、他の読影医の注目領域の位置情報は取得されない。また、本実施の形態においては、現在読影中の読影医の確認すべき領域のみを表示するという観点から、画像表示装置4に現在ログイン中の読影医IDと、以前に読影した読影医の読影医IDが一致する場合は(即ち、同じ読影医が2回以上読影を行うような場合)、注目領域の位置情報は画像表示装置4に送信されないこととするが、同一読影医であっても送信する態様としてもよい。
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.
 読影対象の医用画像及びCAD情報が取得されると、取得された医用画像が表示されたビューア画面432が表示部43に表示される(ステップS23)。
 表示部43に医用画像が表示されると、読影医は表示された医用画像を観察し、注目領域(異常陰影の疑いのある領域をいう)が存在するか否かの診断を行う。注目領域が存在した場合には、操作部42のマウスでクリックする等により注目領域を指定する。
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.
 操作部42により、表示部43に表示された医用画像上から注目領域が指定されると(ステップS24;YES)、指定された注目領域の位置情報がRAMに記憶され、表示された医用画像上の指定された注目領域にマークM11が表示され(ステップS25)、処理はステップS26に移行する。操作部42により注目領域が指定されない場合は、処理はステップS26に移行する。 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.
 図7のAに、ステップS25で表示されるビューア画面432の一例を示す。図7のAに示すように、ビューア画面432には、操作部42により指定された注目領域にマークM11が重畳表示される。マークM11は、現在読影中の読影医が指定した注目領域を示す情報であり、注目領域の代表点(例えば、重心等)を示す○や矢印等の記号や、指定された注目領域を線で表した描画情報等が含まれる。 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.
 ステップS26においては、操作部42により診断支援情報の表示が指示されたか否かが判断される(ステップS26)。例えば、表示部43のビューア画面432上に表示されている診断支援情報ボタンB11が操作部42により押下されることにより診断支援情報の表示を指示することが可能となる。ここで、CADの検出結果及び他の読影医(一次読影医等)が以前に指定した注目領域等の、読影診断を支援する情報を診断支援情報と呼ぶ。 In step S26, it is determined whether display of diagnosis support information is 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.
 操作部42により診断支援情報の表示が指示されると(ステップS26;YES)、ステップS24において操作部42により指定された注目領域と、CAD情報により指摘されている異常陰影候補領域及び他の読影医の注目領域の位置情報とが比較され、指定された注目領域以外の領域に存在する異常陰影候補領域及び他の読影医の注目領域が抽出される(ステップS27)。そして、表示部43のビューア画面432に表示されている医用画像上の、抽出された領域(CADにより検出された異常陰影候補領域及び他の読影医が指定した注目領域)にマークM12が表示される(ステップS28)。
 マークM12は、CADにより検出された異常陰影候補領域又は他の読影医の注目領域を示す情報であり、異常陰影候補領域又は他の読影医の注目領域の代表点(例えば、重心等)を示す○や矢印等の記号や、異常陰影候補領域又は他の読影医の注目領域を線で表した描画情報等が含まれる。マークM12は、マークM11と同じ態様の表示であってもよいが、異なる表示とした方が、読影中の読影医が指定した注目領域とそれ以外の領域とを読影医が容易に認識できるので好ましい。また、CADにより検出された異常陰影候補領域と他の読影医により指定された注目領域とを異なる態様のマークで表示することとしてもよい。
 なお、ビューア画面上432には、読影医により指定された注目領域及びCAD結果を同時に医用画像上に表示させる指示を入力するための「全て表示」ボタンB12が表示される。
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 specified by another interpreting 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.
 図7のBに、ステップS28で表示されるビューア画面432の一例を示す。図7のBに示すように、ステップS28においては、ステップS27で抽出された領域のみ、即ち、現在読影中の読影医により指定された注目領域以外の領域に存在する、CADにより検出された異常陰影候補領域及び他の読影医の注目領域のみにマークM12が重畳表示される。例えば、ステップS24において読影医により指定された注目領域が図7のAにM11で示す領域であり、CAD情報が示す異常陰影候補領域が図8にM01で示す領域であり、他の読影医が指定した注目領域が図8にM02で示す領域であった場合、ステップS28においては、図7のBに示す表示となる。即ち、現在読影中の読影医が確認する必要のある領域、具体的には、現在読影中の読影医が注目しなかった領域であって、CADで検出された領域又は他の読影医が指定した注目領域のみにマークM12が表示される。既に現在読影中の読影医が確認済みである領域、具体的には、現在読影中の読影医が注目領域として指定したがCADや他の読影医により指摘されなかった領域、及び、現在読影中の読影医が注目した注目領域とCAD又は他の読影医により指摘された領域とが重複した領域には、マークが表示されない。このように、マークM12の表示は、現在読影中の読影医が真に確認をすべき領域に限定されるため、読影にかかる時間を低減することができる。また、読影医の指定した注目領域がCADの結果や他の読影医の注目領域と一致したか否かを読影医が知り得ない表示態様であるため、読影医が注目領域と判断したがCADや他の読影医により指摘されなかった領域について、診断支援情報に影響されて読影医自身の判断の確信度を低下させてしまうといったことを防止することができる。 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.
 次いで、操作部42により「全て表示」ボタンB12が押下されたか否かが判断され、「全て表示」ボタンB12が押下されたと判断されると(ステップS29;YES)、ステップS24で指定された注目領域を示すマークM11及びステップS27で抽出された領域を示すマークM12の双方が同時に医用画像上に表示される(ステップS30)。 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).
 図7のCに、ステップS30で表示されるビューア画面432の一例を示す。図7のCに示すように、ステップS30においては、読影医により指定された注目領域及びCADにより検出された異常陰影候補領域の双方がマーク表示されるため、読影医が最終的に診断すべき領域に見落としがないかを確認することができる。 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.
 操作部42により読影終了が指示されると(ステップS31;YES)、読影対象の医用画像のUID、及びステップS24において指定された注目領域の位置情報が通信部44により画像サーバ3に送信され(ステップS32)、医用画像表示処理Bは終了する。
 画像サーバ3においては、画像表示装置4からUID、及び注目領域の位置情報が受信されると、受信された注目領域の位置情報が画像DB351に格納される。また、受信されたUIDを有するレコードが画像管理テーブルからが検索され、検索されたレコードに、受信した位置情報の格納場所及びログイン中の読影医ID等が対応付けて記憶される。
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.
 以上説明したように、第1の実施の形態における医用画像表示システム100によれば、画像表示装置4の制御部41は、画像サーバ3から読影対象の医用画像及び当該医用画像から検出された異常陰影候補領域の位置情報を取得して表示部43に医用画像を表示する。表示部43に表示された医用画像において、操作部42により注目領域が指定されると、制御部41は、指定された注目領域と、表示された医用画像から検出された異常陰影候補領域の位置情報とを比較して、指定された注目領域以外に存在する異常陰影候補領域を抽出し、当該抽出された異常陰影候補領域を示すマークM2を表示部43に表示された医用画像上に表示させる。 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. .
 従って、読影医が確認する必要のある領域、具体的には、読影医が注目しなかった領域であってCADで検出された異常陰影候補領域のみに、異常陰影候補領域であることを示すマークM2が表示され、既に読影医が確認済みである領域、具体的には、読影医が注目領域として指定したがCADにより検出されなかった異常陰影候補領域、及び、読影医が指定した注目領域とCADで検出された異常陰影候補領域の双方が重複した領域には、マークが表示されない。このように、マークM2の表示は、読影医が真に確認をすべき領域に限定されるため、読影にかかる時間を低減することができる。また、読影医の指定した注目領域がCADの結果と一致したか否かを読影医が知り得ない表示態様であるため、読影医が注目領域と判断したがCADにより検出されなかった領域について、CAD結果に影響されて読影医自身の判断の確信度を低下させてしまうといったことを防止することができる。 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.
 また、制御部41は、操作部42から「全て表示」ボタンB2が押下されると、抽出された異常陰影候補領域を示すマークM2と、操作部42により指定された注目領域を示すマークM1とを表示部43に表示された医用画像上に同時に表示させる。従って、読影医が診断すべき領域に見落としがないかを最終確認することが可能となる。また、抽出された異常陰影候補領域と操作部42により指定された注目領域のそれぞれに異なる態様のマークを表示させることで、自身が初見で異常ありと判断した領域とCADにより検出された領域とを一瞥して識別することが可能となる。 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.
 また、第2の実施の形態における画像表示装置4によれば、他の読影医により以前に指定された注目領域の位置情報が医用画像に対応付けて画像サーバ3に記憶されている場合、制御部41は、他の読影医により以前に指定された注目領域の位置情報を画像サーバ3から取得する。そして、操作部42により指定された注目領域と、CADにより検出された異常陰影候補領域及び他の読影医により指定された注目領域の位置情報とを比較して、操作部42により指定された注目領域以外に存在する、検出された異常陰影候補領域及び他の読影医により指定された注目領域を抽出し、当該抽出された異常陰影候補領域及び他の読影医により指定された注目領域を示す情報を表示部43に表示された医用画像上に表示させる。 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.
 従って、例えば一次読影医が以前に同じ医用画像について読影を行っている場合等、他の読影医が読影済みの医用画像を読影する場合、他の読影医が指定した注目領域を診断支援情報として利用することが可能となる。 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.
 なお、上記第1及び第2の実施の形態における記述内容は、本発明の好適な一例であり、これに限定されるものではない。
 例えば、上記第1及び第2の実施の形態においては、異常陰影候補を検出する異常陰影候補検出装置2、医用画像を記憶する記憶装置としての画像サーバ3、医用画像を表示する画像表示装置4をそれぞれ別体の装置として説明したが、これに限定されない。例えば、全ての装置の機能を一つの装置に備える構成としてもよいし、何れか2つの装置の機能を組み合わせた装置と、残りの装置の機能を備えた装置とにより構成することとしてもよい。
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.
また、上記実施の形態においては、乳房画像を例として説明したが、部位は乳房に限定されない。 Moreover, in the said embodiment, although demonstrated using the breast image as an example, a site | part is not limited to a breast.
 また、例えば、異常陰影候補検出装置2が接続されていない医用画像表示システムの場合は、画像サーバ3に読影医の指定した注目領域の位置情報を医用画像と対応付けて記憶しておき、現在読影中の読影医が指定した注目領域以外の領域に存在する、他の読影医が指定した注目領域を示す情報を診断支援情報として表示することとしてもよい。 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.
 また、上記の説明では、本発明に係るプログラムのコンピュータ読み取り可能な媒体としてハードディスクや半導体の不揮発性メモリ等を使用した例を開示したが、この例に限定されない。その他のコンピュータ読み取り可能な媒体として、CD-ROM等の可搬型記録媒体を適用することが可能である。また、本発明に係るプログラムのデータを通信回線を介して提供する媒体として、キャリアウエーブ(搬送波)も適用される。 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 other computer-readable media, 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.
 その他、医用画像表示システムを構成する各装置の細部構成及び細部動作に関しても、本発明の趣旨を逸脱することのない範囲で適宜変更可能である。 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.
 なお、明細書、請求の範囲、図面及び要約を含む2010年4月21日に出願された日本特許出願No.2010-097659号の全ての開示は、そのまま本出願の一部に組み込まれる。 It should be noted that the Japanese Patent Application No. 10 filed on April 21, 2010, including the description, claims, drawings and abstract. The entire disclosure of 2010-097659 is incorporated in its entirety into this application.
 医療の分野における医用画像の読影診断に利用可能性がある。 There is a possibility of use for interpretation of medical images in the medical field.
100 医用画像表示システム
1 画像生成装置
2 異常陰影候補検出装置
3 画像サーバ
351 画像DB
4 画像表示装置
41 制御部
42 操作部
43 表示部
44 通信部
45 記憶部
46 バス
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)

  1.  医用画像と当該医用画像から検出された異常陰影候補領域の位置情報とを対応付けて記憶する記憶装置から前記医用画像及び前記異常陰影候補領域の位置情報を取得し、この取得した医用画像を表示する医用画像表示装置であって、
     前記記憶装置から取得された医用画像を表示する表示手段と、
     前記表示手段に表示された医用画像において、操作者が異常陰影の疑いがあると判断した注目領域を指定するための操作手段と、
     前記操作手段により注目領域が指定されると、前記指定された注目領域と前記医用画像から検出された異常陰影候補領域の位置情報とを比較して前記指定された注目領域以外に存在する異常陰影候補領域を抽出し、当該抽出された異常陰影候補領域を示す情報を前記表示手段に表示された医用画像上に表示させる制御手段と、
     を備える医用画像表示装置。
    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:
  2.  前記制御手段は、前記抽出された異常陰影候補領域を示す情報と、前記操作手段により指定された注目領域を示す情報とを前記表示手段に表示された医用画像上に同時に表示させる請求項1に記載の医用画像表示装置。 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.
  3.  前記制御手段は、前記抽出された異常陰影候補領域と前記操作手段により指定された注目領域のそれぞれに異なる態様のマークを表示させる請求項2に記載の医用画像表示装置。 3. The medical image display apparatus according to claim 2, wherein the control means displays different marks in each of the extracted abnormal shadow candidate area and the attention area designated by the operation means.
  4.  他の読影医により以前に指定された注目領域の位置情報が前記医用画像に対応付けて前記記憶装置に記憶されている場合、前記制御手段は、前記他の読影医により以前に指定された注目領域の位置情報を前記記憶装置から取得し、前記操作手段により指定された注目領域と、前記医用画像から検出された異常陰影候補領域及び前記他の読影医により指定された注目領域の位置情報とを比較して、前記操作手段により指定された注目領域以外に存在する、前記検出された異常陰影候補領域及び前記他の読影医により指定された注目領域を抽出し、当該抽出された異常陰影候補領域及び他の読影医により指定された注目領域を示す情報を前記表示手段に表示された医用画像上に表示させる請求項1~3の何れか一項に記載の医用画像表示装置。 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 device 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 means.
  5.  医用画像と当該医用画像から検出された異常陰影候補領域の位置情報とを対応付けて記憶する記憶装置から前記医用画像及び前記異常陰影候補領域の位置情報を取得し、この取得した医用画像を表示する医用画像表示装置に用いられるコンピュータを、
     前記記憶装置から取得された医用画像を表示する表示手段、
     前記表示手段に表示された医用画像において、操作者が異常陰影の疑いがあると判断した注目領域を指定するための操作手段、
     前記操作手段により注目領域が指定されると、前記指定された注目領域と前記医用画像から検出された異常陰影候補領域の位置情報とを比較して前記指定された注目領域以外に存在する異常陰影候補領域を抽出し、当該抽出された異常陰影候補領域を示す情報を前記表示手段に表示された医用画像上に表示させる制御手段、
     として機能させるためのプログラム。
    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.
PCT/JP2011/055223 2010-04-21 2011-03-07 Medical-image displaying device and program WO2011132468A1 (en)

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