WO2013187150A1 - 医用画像システム及び医用画像処理装置 - Google Patents
医用画像システム及び医用画像処理装置 Download PDFInfo
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Definitions
- the present invention relates to a medical image system and a medical image processing apparatus.
- contrast is formed by a difference in attenuation of X-ray intensity when X-rays pass through a subject.
- phase contrast method has been proposed in which contrast is obtained not by X-ray absorption but by X-ray phase change.
- Patent Document 1 proposes an X-ray imaging system that obtains an X-ray image with high visibility by edge enhancement using refraction of X-rays at the time of magnified imaging.
- Japanese Patent Application Laid-Open No. H10-228561 describes superimposing a phase contrast image and an absorption contrast image.
- Patent Document 2 describes that in the field of computed tomography (CT), a phase contrast image by tomography is created, and further, this phase contrast image by tomography is superimposed on an absorption image by tomography. Yes.
- CT computed tomography
- phase contrast image described in Patent Document 1
- the subject edge portion is enhanced in contrast and the visibility is improved, the image signal near the subject edge is distorted. Therefore, a realistic shape is not reproduced near the edge.
- the phase contrast image (enlarged shooting) and the absorption contrast image (close contact shooting) need to be taken twice, and are taken at different shooting magnifications. Therefore, enlargement interpolation processing and reduction processing are performed to adjust the magnification and alignment. There is a need to do.
- Patent Document 2 describes that a composite image obtained by superimposing a phase contrast image and an absorption contrast image is effective for diagnosing a structure at a transition portion between a bone portion and a cartilage. However, there is no description about what kind of composite image is displayed and how effective it is depending on the site to be diagnosed and the disease to be diagnosed at that site.
- An object of the present invention is to realize early diagnosis and improve diagnostic accuracy by performing image display effective for diagnosis according to a diagnosis target site and a disease.
- X-ray imaging of the diagnostic target part of the subject is performed using any of the Talbot type imaging apparatus, the Talbot low type imaging apparatus, or the Fourier transform type imaging apparatus, and the absorption image and the differential phase relating to the diagnostic target part of the subject
- a medical image system that generates three types of reconstructed images, an image and a small-angle scattered image,
- An input means for inputting diagnostic target information for specifying the diagnostic target part or the diagnostic target part and a disease to be diagnosed in the part;
- Control that combines two types of reconstructed images of the three types of reconstructed images to generate a composite image based on the diagnosis target information input by the input unit, and causes the display unit to display the generated composite image Means, Is provided.
- one of the two types of reconstructed images is an absorption image.
- control means generates a composite image after processing at least one of the two types of reconstructed images.
- the control means processes the absorption image to generate a differential absorption image, and the signal intensity of the structure depicted in common to the differential phase image and the differential absorption image with respect to the generated differential absorption image. Multiply by a coefficient to match the differential phase image and subtract from the differential phase image, or process the differential phase image to generate a phase image, and the phase image and the absorption with respect to the absorption image By multiplying the signal intensity of the structure depicted in common with the image by a coefficient for matching with the phase image and subtracting from the phase image, the differential phase image and the absorption image are depicted in common. It is preferable to generate a composite image in which the signal of the existing structure is removed or attenuated.
- control unit generates a plurality of types of synthesized images and causes the display unit to display the generated plurality of types of synthesized images simultaneously or in a switched manner.
- control unit causes the display unit to display the generated composite image and at least one of the three types of reconstructed images simultaneously or in a switching manner.
- the control unit further synthesizes the three types of reconstructed images, and displays the synthesized image of the two types of generated reconstructed images and the synthesized image of the three types of reconstructed images on the display unit. It is preferable to display at the same time or switching.
- the site to be diagnosed is a breast.
- a medical image processing apparatus comprises: Based on the image signal of the subject obtained by an X-ray imaging apparatus using a Talbot interferometer or a Talbot-Lau interferometer, at least a differential phase among three reconstructed images of a differential phase image, an absorption image, and a small angle scattered image Reconstructed image generating means for generating images and absorption images;
- the absorption image is processed to generate a differential absorption image, and the signal intensity of the structure depicted in common to the differential phase image and the differential absorption image is generated in the differential phase image.
- the signal of the structure depicted in common to the differential phase image and the absorption image is obtained by multiplying the signal intensity of the depicted structure by a coefficient for matching the phase image and subtracting from the phase image.
- the synthesizing unit calculates a ratio of the signal of the commonly depicted structure in the two images used for the subtraction, and uses the calculated ratio as the coefficient.
- Storage means for storing a threshold value corresponding to at least one of an absorption image, a differential absorption image, a phase image, a differential phase image, and a small angle scattering image;
- the synthesizing unit compares each pixel value of the image corresponding to the threshold value generated by the reconstructed image generating unit or the absolute value thereof with the threshold value, and for the pixel value region not exceeding the threshold value, It is preferable to generate the composite image with a small coefficient.
- Correction means for correcting artifacts caused by imaging conditions in the X-ray imaging apparatus for the differential phase image Preferably, the synthesizing unit generates the synthesized image using the differential phase image corrected by the correcting unit.
- the present invention it is possible to realize early diagnosis and improve diagnostic accuracy by performing image display effective for diagnosis according to a diagnosis target site and a disease. .
- FIG. 1 is a diagram illustrating an overall configuration of a medical image system according to an embodiment. It is a figure for demonstrating the principle of a Talbot interferometer. It is a block diagram which shows the functional structure of the controller of FIG. 1A. It is a flowchart which shows the image generation display process performed by the control part of FIG. It is a figure which shows an example of the absorption image which made the cherry a subject. It is a figure which shows an example of the differential phase image which used the cherry as a to-be-photographed object. It is a figure which shows an example of the small angle scattering image which used the cherry as a to-be-photographed object.
- FIG. 6A It is a figure which shows an example of the small angle scattering image which used the wrist joint as the to-be-photographed object. It is a figure which shows the synthesized image (absorption image + differential phase image) which synthesize
- FIG. 7B is a view showing a composite image (small angle scattered image ⁇ absorbed image) obtained by combining the absorption image of the wrist joint shown in FIG. 7A and the small angle scattered image of the wrist joint shown in FIG. 7C.
- FIG. 6 is a diagram showing a small angle scattered image with the breast as a subject. It is a figure which shows the synthesized image (differential phase image + absorption image) which synthesize
- FIG. 3 is a flowchart showing an image display process executed by the control unit of FIG. 2 when the diagnosis target site is a breast.
- 3 is a flowchart showing an image display process executed by the control unit in FIG. 2 when the diagnosis target site is a bone / joint system and the disease is rheumatism.
- 3 is a flowchart showing an image display process executed by the control unit in FIG.
- FIG. 1A shows an overall configuration of a medical image system 100 according to the present embodiment.
- the medical image system 100 includes an X-ray imaging apparatus 1, a controller 2, and an order input apparatus 3.
- the X-ray imaging apparatus 1 and the controller 2 are connected so as to be able to transmit and receive data via a communication network N such as a LAN (Local Area Network).
- a communication network N such as a LAN (Local Area Network).
- the controller 2 and the order input device 3 are connected via a communication network N so that data can be transmitted and received.
- the X-ray imaging apparatus 1 is an apparatus that includes a known Talbot interferometer or a Talbot-Lau interferometer and generates a moire image for obtaining a reconstructed image of a subject.
- the Talbot interferometer and the Talbot-Lau interferometer are, for example, International Publication No. 2004/058070 (Publication 1), International Publication No. 2011/033798 (Publication 2), International Publication No. 2011-114845 (Publication 3). ), A moiré image for generating a reconstructed image of a subject using the Talbot effect.
- the Talbot effect is the direction in which light travels when coherent light (X-rays emitted from the X-ray source 11) passes through the first grating 14 provided with slits at a constant period.
- a phenomenon in which the lattice images are connected in the (z direction) at a constant period.
- This lattice image is called a self-image
- the Talbot interferometer arranges the second grating 15 in parallel at the position connecting the self-images, and the second grating 15 is placed on the optical axis (X-ray focal point and X-ray focal point) with respect to the first grating 14.
- An interference fringe (moire) M generated by tilting around the center of the grating is measured.
- photographing can be performed even when the relative angle between the first grating 14 and the second grating 15 is 0 degree. If an object is placed in front of the second grating 15, the moire M is disturbed. Therefore, the subject H is placed before and after the first grating 14 and irradiated with coherent X-rays, and an image of the obtained moire M is calculated. Thus, a reconstructed image of the subject H can be obtained.
- the Talbot interferometer includes an X-ray source 11, a first grating 14, a second grating 15, and a radiation detector (not shown) provided substantially perpendicular to the X-ray irradiation direction. .
- the first grating 14 and the second grating 15 are diffraction gratings, and a plurality of slits are arranged in a direction (x direction) orthogonal to the X-ray irradiation direction (z direction).
- the subject H is disposed between the X-ray source 11 and the first grating 14 or the first grating 14 and the second grating 15, and the first grating 14 and the second grating 15 are relative to each other at regular intervals.
- a plurality of moiré images for the fringe scanning method are generated by repeating the process in which the radiation detector reads the image signal in accordance with the X-rays irradiated by the X-ray source 11 every movement at regular intervals. It is.
- a multi-slit (not shown) is further arranged at a position close to the X-ray source 11 between the X-ray source 11 and the first grating 14 in the configuration of the Talbot interferometer described above. It is a configuration.
- the multi-slit is a diffraction grating, and a plurality of slits are arranged in a direction orthogonal to the X-ray irradiation direction, like the first grating 14 and the second grating 15.
- the subject H is disposed between the multi-slit and the first grating 14, and the multi-slit is moved relative to the first and second gratings 14 and 15 at regular intervals.
- the radiation detector repeats the process of reading the image signal in accordance with the X-rays emitted from the X-ray source 11, thereby generating a plurality of moire images for the fringe scanning method.
- a method for generating a plurality of moire images for the fringe scanning method is referred to as a fringe scanning method.
- the relative angle between the first grating 14 and the second grating 15 is set to a predetermined angle.
- X-rays are irradiated once without moving each of the gratings 14 and 15 and the multi-slit, and the radiation detector reads an image signal according to the irradiated X-rays to generate a moire image. It is good.
- Such a moire image generation method is called a Fourier transform method.
- the controller 2 generates three types of reconstructed images (absorption image, differential phase image, and small angle scattered image) of the subject using the moire image obtained by the X-ray imaging apparatus 1, and based on the region to be diagnosed and the disease
- the controller 2 includes a control unit 21, an operation unit 22, a display unit 23, a communication unit 24, and a storage unit 25.
- the control unit 21 includes a CPU (Central Processing Unit), a RAM (Random Access Memory), and the like, and in cooperation with a program stored in the storage unit 25, various processes including an image generation display process described later. Execute.
- the operation unit 22 includes a keyboard having cursor keys, numeric input keys, various function keys, and the like, and a pointing device such as a mouse, and includes a key pressing signal pressed by the keyboard and an operation signal by the mouse. Is output to the control unit 21 as an input signal. It is good also as a structure provided with the touchscreen comprised integrally with the display of the display part 23, and producing
- the display unit 23 includes a monitor such as a CRT (Cathode Ray Tube) or an LCD (Liquid Crystal Display), and the operation screen and the operation status of the X-ray imaging apparatus 1 according to the display control of the control unit 21.
- the generated reconstructed image and composite image are displayed.
- the communication unit 24 includes a communication interface and communicates with the X-ray imaging apparatus 1 and the order input apparatus 3 on the communication network N by wire or wirelessly. For example, the communication unit 24 receives imaging order information from the order input device 3, transmits imaging conditions and control signals to the X-ray imaging device 1, and receives a moire image from the X-ray imaging device 1.
- the storage unit 25 stores a program executed by the control unit 21 and data necessary for executing the program.
- the storage unit 25 stores imaging order information transmitted from the order input device 3.
- the imaging order information includes an imaging date, a patient name, diagnosis target information (diagnosis target part (imaging part), or information on a diagnosis target part and a disease name to be diagnosed in the part), and the like.
- the storage unit 25 stores an imaging condition table in which diagnosis target information is associated with imaging conditions suitable for imaging the diagnosis target.
- the storage unit 25 stores a composite image table in which diagnosis target information is associated with information on the type of image (including a composite image) suitable for the diagnosis target and display mode information thereof.
- the storage unit 25 includes three types of reconstructed images generated based on the moire image transmitted from the X-ray imaging apparatus 1, a composite image, and types of processing used to generate the composite image (addition, subtraction, multiplication, Information), image processing parameters, display parameters such as gradation correction and enlargement / reduction positions, and the like are stored in association with shooting order information. Furthermore, the storage unit 25 stores gain correction data, a defective pixel map, and the like corresponding to the radiation detector of the X-ray imaging apparatus 1 in advance. These data may be stored on the X-ray imaging apparatus 1 side, and a moire image that has been subjected to various correction processes based on these data may be input to the controller 2.
- the order input device 3 is a device that generates shooting order information in response to operator input.
- HIS Hospital Information System
- RIS Radiology Information System
- FIG. 3 shows a flowchart of image generation / display processing executed by the controller 21 of the controller 2.
- the image generation / display processing is executed in cooperation with the program stored in the control unit 21 and the storage unit 25 according to the operation of the operation unit 22.
- a list of shooting order information is displayed on the display unit 23 of the controller 2, and shooting order information to be shot is designated by the operation unit 22 (step S1).
- the imaging conditions corresponding to the diagnosis target information included in the specified imaging order information are read from the imaging condition table in the storage unit 25, transmitted to the X-ray imaging apparatus 1 by the communication unit 24, and set (step). S2).
- the X-ray imaging apparatus when an imaging condition is received from the controller 2, X-ray imaging with a subject and X-ray imaging without a subject are performed based on the received imaging condition. A moiré image with a subject and a moiré image without a subject are generated. The generated moire image with a subject and the moire image without a subject are transmitted to the controller 2.
- step S3 When the moire image from the X-ray imaging apparatus 1 is received by the communication unit 24 (step S3), reconstruction of three types of subjects, that is, an absorption image, a differential phase image, and a small angle scattered image, is performed based on the received moire image. An image is generated (step S4).
- FIGS. 4A to 4C show examples of an absorption image, a differential phase image, and a small angle scattered image with a cherry as a subject.
- the absorption image (X-ray absorption image) is an image of an average component of interference fringes, and has a contrast according to the amount of X-ray attenuation by the subject.
- the image has been used for diagnosis conventionally and is familiar to medical personnel such as doctors. It is excellent in the depiction of bones where X-ray absorption contrast tends to occur (see FIG. 4A).
- the differential phase image is obtained by imaging the phase information of the interference fringes, and has a contrast according to the amount of inclination of the X-ray wavefront by the subject.
- the soft tissue is more excellent than the absorption image (see FIG. 4B).
- the small-angle scattered image is an image of the visibility of the interference fringes, and the contrast is added according to the X-ray scattering by the subject (Publication 5: Distribution of unresolvable anisotropic microstructures revealed in visibility-contrast images using x-ray Talbot interferometry. Wataru Yashiro et.al. PHYSICAL REVIEW B 84, 094106 (2011)). It is superior to the description of the fine structure than the absorption image (see FIG. 4C). Since the absorption image, differential phase image, and small-angle scattered image generated in step S4 are generated based on the same moire image (group) transmitted from the X-ray imaging apparatus 1, the three images are the same for the same subject. The portion is depicted, and it is not necessary to align the subject between the three images.
- the three types of reconstructed images can be generated by a known method, for example, as described in publicly known document 4 described above.
- an offset correction process, a gain correction process, a defective pixel correction process, an X-ray intensity fluctuation correction, and the like are performed on a moiré image with a subject and a moiré image without a subject.
- three types of reconstructed images (absorption image, differential phase image, and small angle scattered image) with a subject are generated based on the corrected moire image with the subject.
- three types of reconstructed images (absorption image, differential phase image, and small angle scattered image) without a subject are generated based on the corrected moire image without the subject.
- a moire image is created by the Fourier transform method in the X-ray imaging apparatus 1, first, each of the corrected moire image with a subject and the moire image without a subject is subjected to Fourier transform (two-dimensional Fourier transform).
- each of the extracted 0th-order component and 1st-order component is subjected to inverse Fourier transform.
- an absorption image is generated from the amplitude of the zeroth-order component
- a differential phase image is generated from the phase of the first-order component
- the interference fringes Phase correction and correction processing for removing image unevenness are performed, and three types of reconstructed images for final diagnosis are generated.
- a composite image is generated by combining at least two types of reconstructed images among the three types of reconstructed images (step S5).
- a plurality of types of composite images may be generated.
- the composite image table stored in the storage unit 25 is read, and a composite image of a type associated with the diagnosis target information included in the imaging order information is generated in the composite image table.
- the composite image can be generated by adding, subtracting, dividing, or multiplying the corresponding pixel values of at least two types of reconstructed images among the three types of reconstructed images.
- FIG. 5A shows an example of a composite image obtained by adding and combining the absorption image shown in FIG. 4A and the differential phase image shown in FIG. 4B.
- FIG. 5B shows an example of a composite image obtained by adding and combining the absorption image shown in FIG. 4A and the small-angle scattered image shown in FIG. 4C.
- FIG. 5C shows an example of a synthesized image obtained by subtracting the small-angle scattered image shown in FIG. 4C from the absorption image shown in FIG. 4A.
- FIG. 5D shows an example of a composite image synthesized by dividing the small angle scattered image shown in FIG. 4C by the absorption image shown in FIG. 4A.
- FIGS. 5A to 5D it is possible to obtain images having different characteristics depending on the composite image calculation method (addition, subtraction, division, and multiplication). Which calculation method is used is stored in advance in the composite image table in association with the diagnosis target information.
- the diagnostic ability deteriorates when the noise increase due to the synthesis is stronger than the contrast increase of the object of interest, or when a signal unnecessary for the diagnosis is synthesized.
- it is equivalent to a single reconstructed image by changing the contribution according to the density of the individual reconstructed image in the process at the time of synthesis, or by reducing the contribution of a flat area with small signal change in the individual reconstructed image.
- the diagnostic ability of “ ⁇ ” indicates that the inspection target is shown but is inferior to “ ⁇ ” (it is difficult to diagnose or may be overlooked by itself), and “X” indicates that the part to be inspected is not shown.
- the evaluation of “ ⁇ ”, “ ⁇ - ”, “ ⁇ ”, and “ ⁇ ” is the vertical relative comparison of [Table 1], not the horizontal relative comparison.
- the composite image of the absorption image and the differential phase image, and the composite image of the absorption image and the small-angle scattering image show the results of evaluating those generated by addition.
- the degree of contribution represents the degree to which each reconstructed image (or a partial area or pixel thereof) contributes to the composite image. For example, each reconstructed image when a composite image is generated by addition or subtraction.
- the weighting coefficient is included.
- FIG. 6A shows an absorption image with bird wing cartilage as a subject.
- FIG. 6B shows a differential phase image with bird wing cartilage as a subject.
- FIG. 6C shows a small-angle scattered image with bird wing cartilage as a subject.
- FIG. 7A shows an absorption image with the wrist joint as the subject.
- FIG. 7B shows a differential phase image with the wrist joint as the subject.
- FIG. 7C shows a small-angle scattered image with the wrist joint as the subject.
- the composite image of the absorption image and the small-angle scatter image depicts the bone, micro-fracture, and fine structure of the trabecula in a diagnosable manner, so that the bone is more visible than when only one small-angle scatter image is observed.
- the composition of the absorption image and the differential phase image or the small angle scattering image is effective in an imaging apparatus using a one-dimensional grating in which slits are provided at a constant period.
- the differential phase image and the small-angle scattered image can detect a subject change in a direction perpendicular to the grating structure, but there is a problem of image directivity that the subject change in the vertical direction is insensitive and cannot be detected.
- synthesizing an absorption image without image directivity and a differential phase image or a small-angle scattered image it is possible to compensate for missing information in the differential phase image or the small-angle scattered image, and to facilitate diagnosis such as specifying the location of a lesion. be able to.
- FIG. 8A shows a composite image (absorption image + differential phase image) obtained by combining the absorption image of the bird wing cartilage shown in FIG. 6A and the differential phase image of the bird wing cartilage shown in FIG. 6B.
- FIG. 8B shows a composite image (small angle scattered image ⁇ absorbed image) obtained by synthesizing the absorption image of bird wing cartilage shown in FIG. 6A and the small angle scattered image of bird wing cartilage shown in FIG. 6C.
- FIG. 9A shows a composite image (differential phase image + absorption image) obtained by combining the absorption image of the wrist joint shown in FIG. 7A and the differential phase image of the wrist joint shown in FIG. 7B.
- FIG. 9B shows a composite image (small angle scattered image + absorbed image) obtained by combining the absorption image of the wrist joint shown in FIG. 7A and the small angle scattered image of the wrist joint shown in FIG. 7C.
- FIG. 9C shows a composite image (small angle scattered image-absorbed image) obtained by combining the absorption image of the wrist joint shown in FIG. 7A and the small angle scattered image of the wrist joint shown in FIG. 7C.
- the meaning of “small-angle scattered image ⁇ absorption image” is the standardized X-ray scattering amount of a substance in terms of absorption amount. If this value is high, it is composed of fine trabeculae even with the same absorption amount.
- the absorption image shows all of the tumor, spicula, and microcalcification, but the tumor Cannot be diagnosed by absorption images alone. There is also the possibility of overlooking spicula and microcalcifications.
- differential phase images the spicule structure is depicted diagnosable, while others are not diagnosable or may be missed.
- microcalcifications are diagnosable, while others are not diagnosable or may be missed.
- FIG. 10A shows an absorption image with the breast as the subject.
- FIG. 10B shows a differential phase image with the breast as the subject.
- FIG. 10C shows a small angle scattered image with the breast as the subject.
- the edge of the tumor and the spicule structure can be clearly depicted.
- the composite image of the absorption image and the small-angle scatter image is excellent in depiction of the structure inside the tumor and the light microcalcification that may be missed in the absorption image, and the small-angle scatter image is used for the absorption image familiar to doctors.
- FIG. 11A shows a composite image (differential phase image + absorption image) obtained by combining the absorption image shown in FIG. 10A and the differential phase image shown in FIG. 10B.
- FIG. 11B shows a combined image (small angle scattered image + absorbed image) obtained by combining the absorption image shown in FIG. 10A and the small angle scattered image shown in FIG. 10C.
- the synthesized image may be synthesized by providing contributions for each image, for each region, or for each pixel, instead of synthesizing the reconstructed images at a ratio of 1: 1.
- the diagnosis target information is stored in association with the contribution of each reconstructed image to be combined with the type of the composite image, and the composite image is based on the contribution. It is good also as producing
- an area for example, bone, cartilage, etc.
- an area for example, bone, cartilage, etc.
- each area extracted area and not extracted.
- (Region) contribution degree may be stored in association with each other, and a composite image may be generated based on the contribution degree.
- the differential phase image shown in FIG. 12A total contribution 1
- the absorption image shown in FIG. 12B bone contribution 1, 1 otherwise
- the contribution of the absorption image is 1 for the bone, otherwise
- the bone portion is an absorption image that is easy for doctors to examine
- the other is a composite image composed of differential phase images that can depict cartilage. Can be generated.
- the contribution for each pixel density is stored in association with the diagnosis target information.
- a composite image may be generated based on this contribution. Since the noise of the X-ray image is related to the image density (related to the number of photons detected by the detector), it is possible to reduce the noise of the composite image by changing the contribution according to the density of the pixel.
- each reconstructed image to be combined with the diagnosis target information with respect to the diagnosis target information is contributed by the difference from the surrounding pixels of each pixel (the flatness of the subject signal). May be stored in association with each other, and a composite image may be generated based on the contribution. Since the flat portion does not improve the contrast of the composite image and only noise is added, it is possible to reduce the noise of the composite image by reducing the contribution.
- step S6 an image display process is executed based on the diagnosis target information included in the imaging order information.
- step S6 when one image is sequentially switched and displayed on the display screen of the display unit 23, each image has the same size in the same area on the display screen of the display unit 23. Is displayed. This is because the same portion of the subject in each image is displayed in the same area on the screen.
- FIG. 13 shows a flowchart of the image display process executed in step S6 when the diagnosis target region is the breast.
- the combined image of the absorption image and the differential phase image and the combined image of the absorption image and the small-angle scattered image are simultaneously displayed (side-by-side) on the display unit 23 or are switched and displayed (alternately repeatedly and flipped) (step T1). ).
- the site to be diagnosed is the breast
- the presence / absence of abnormal shadow candidates such as a mass, spicule, and microcalcification in the entire image region is comprehensively diagnosed.
- the interpretation and diagnosis are performed in detail, paying attention to the area of each abnormal shadow candidate.
- the composite image of the two types of reconstructed images covers all of the mass, spicule, and microcalcification, but there is an item of “ ⁇ ” in the evaluation of [Table 1], and only one sheet Doctors who are not skilled just by observing may miss it.
- the diagnosis target site is the breast
- the combined image of the absorption image and the differential phase image, and the combined image of the absorption image and the small angle scattered image are simultaneously displayed on the display unit 23.
- the confirmation of the presence or absence of an abnormal shadow candidate in the initial stage of diagnosis can be made more efficient by switching display. This is because the doctor can compare the two composite images at the same time or by switching and displaying the two composite images, so that there is an abnormal shadow candidate rather than observing only one of the composite images. This is because it is easy to notice.
- any one of the above two synthesized images and a synthesized image of three types of reconstructed images may be displayed on the display unit 23 simultaneously or in a switched manner. If the composite image of the three types of reconstructed images is not displayed alone but is displayed in a manner comparable to the other composite images, the composite image of the three types of reconstructed images and the other composite image This is because doctors are more likely to notice the lesion due to the difference (change).
- the affinity with the diagnostic ability based on the conventional absorption image is low, out of the three types of reconstructed images, either one of the differential phase image or the small angle scattered image, the other reconstructed image and the absorption
- the composite image with the image may be displayed on the display unit 23 simultaneously or in a switching manner. This is because all items of the breast cancer test shown in [Table 1] can be drawn so as to be diagnosed.
- an operation button for instructing “detailed examination of the tumor margin and spicule”, “detailed examination of mass homogeneity and microcalcification” And an operation button for instructing “END” are displayed.
- the display in step T1 can recognize general findings such as whether there is an abnormal shadow candidate in the breast, what kind of abnormal shadow candidate exists, and where the region is. The doctor can determine the position of the region of interest (interest of interest) and the items to be confirmed in detail. Then, according to the result of observing the display in step T1, any one of the operation buttons is operated, and if necessary, an individual reconstructed image corresponding to the purpose can be displayed.
- step T2 When any one of the operation buttons is operated by the operation unit 22, it is determined whether or not the operated operation button is “detailed examination of a tumor edge or a spicule” (step T2). When it is determined that the operated operation button is “examine the tumor margin or spicule in detail” (step T2; YES), a combined image of the differential phase image and the absorption image is displayed on the display unit 23, and the differential is performed.
- a GUI Graphic User Interface
- the GUI may change the contribution degree discretely like a button, or may change the contribution degree continuously like a slider bar.
- a composite image is generated by changing the contribution degree of each of the differential phase image and the absorption image according to the operation of the operation unit 22 (step S4). T5). Then, the process returns to step T3, and the composite image whose contribution is changed is displayed on the display unit 23.
- the doctor can easily make a diagnosis by adjusting the composite image.
- the doctor can confirm the intensity of the phase change with respect to the X-ray absorption of the object of interest, and the judgment when specifying the substance of interest Can be a material. If the contribution of one reconstructed image is 0, the other reconstructed image can be displayed individually. That is, the differential phase image or the absorption image can be displayed individually.
- step T2 When it is determined that the operation button operated by the operation unit 22 is “examine the homogeneity and microcalcification of the tumor in detail” (step T2; NO, step T6; YES), the display unit 23 displays the small-angle scattered image and A composite image of the absorption image is displayed, and a button or a slide bar for changing the contribution of the small-angle scattered image and the absorption image (contribution for each image, each region, and each pixel) according to the operation of the operation unit 22 Etc. is displayed. (Step T7).
- the composite image is generated by changing the contribution degree of each of the small angle scattered image and the absorption image according to the operation of the operation unit 22 (step T9).
- the process returns to step T7, and the composite image whose contribution is changed is displayed on the display unit 23.
- the doctor can easily make a diagnosis by adjusting the composite image.
- the doctor can confirm the intensity of scattering with respect to the X-ray absorption in the object of interest, and a determination material for specifying the substance of interest It can be. If the contribution degree of any one of the reconstructed images is set to 0, the other reconstructed image can be displayed individually. That is, a small angle scattered image or an absorption image can be displayed individually.
- step T2 The processes from step T2 to step T9 are repeatedly executed until “end” is operated by the operation unit 22.
- step T10 When “end” is operated by the operation unit 22 (step T10; YES), the process proceeds to step S7 in FIG.
- FIG. 14 shows a flowchart of the image display process executed in step S6 when the diagnosis target site is a bone / joint system site and the disease name is rheumatism.
- a composite image of the absorption image and the differential phase image is displayed on the display unit 23 (step T11). By observing the composite image of the absorption image and the differential phase image, it is possible to confirm the presence or absence of cartilage abnormality and determine the region of interest.
- an operation button for instructing “confirm erosion to the bone”, and an operation for instructing “examine cartilage contour in detail” A button, an operation button for instructing “detailed examination of trabecular bone and bone structural change”, and an operation button for instructing “end” are displayed.
- the presence or absence of cartilage abnormality can be confirmed by the display in step T11, so that the doctor operates one of the operation buttons according to the result, and if necessary, a composite image of the absorption image and the small angle scattering image Or, an individual reconstructed image according to the purpose can be displayed.
- the operation button for instructing “confirm erosion to the bone” is disabled when another operation button is pressed.
- step T12 it is determined whether or not the operation button “confirm erosion to the bone” has been operated by the operation unit 22 (step T12). If it is determined by the operation unit 22 that “confirm erosion to bone” is not operated (step T12; NO), the process proceeds to step T14. If it is determined that “confirm erosion to the bone” has been operated by the operation unit 22 (step T12; YES), a combined image of the absorption image and the small-angle scattered image is displayed (step T13), and the process is performed in step T14.
- Migrate to As rheumatic symptoms progress it affects the bones under the cartilage. For example, the bone under the cartilage is eroded by granulation tissue in the bone marrow.
- a small-angle scattered image is suitable for observing minute changes in bone, erosion to the bone part can be confirmed by observing a composite image of an absorption image and a small-angle scattered image.
- the image displayed in step T13 may be obtained by further combining a small-angle scattered image with the combined image displayed in step T11.
- step T14 when any one of the operation buttons is operated by the operation unit 22, it is determined whether or not the operated operation button is “examine the outline of the cartilage in detail” (step T14).
- step T14 When it is determined that the operated operation button is “examine the outline of cartilage in detail” (step T14; YES), a combined image of the differential phase image and the absorption image is displayed on the display unit 23, and the differential phase image is displayed. Then, a GUI such as a button or a slide bar for changing the contribution degree of the absorption image (contribution degree for each image, for each region, for each pixel) according to the operation of the operation unit 22 is displayed (step T15).
- a composite image is generated by changing the contribution degree of each of the differential phase image and the absorption image according to the operation of the operation unit 22 (step T17).
- the process returns to step T15, and the composite image whose contribution is changed is displayed on the display unit 23.
- the doctor can easily make a diagnosis by adjusting the composite image.
- the doctor can be used as a judgment material when specifying what kind of substance is the signal component in the region of interest. For example, cartilage is depicted in the differential phase image but not in the absorption image.
- the signal component that disappears when the contribution of the differential phase image is changed toward 0 is cartilage. If the contribution degree of any one of the reconstructed images is set to 0, the other reconstructed image can be displayed individually. That is, the differential phase image or the absorption image can be displayed individually.
- step T14 when it is determined that the operation button operated by the operation unit 22 is “diagnose a detailed change in trabecular bone or bone structure” (step T14; NO, step T18; YES), a small-angle scattered image is displayed on the display unit 23.
- a button or slide for changing the contribution of the small-angle scattered image and the absorption image (contribution for each image, each region, and each pixel) according to the operation of the operation unit 22 A GUI such as a bar is displayed. (Step T19).
- the composite image is generated by changing the contribution degree of each of the small angle scattered image and the absorption image according to the operation of the operation unit 22 (step T21). ), The process returns to step T19, and the composite image whose contribution is changed is displayed on the display unit 23.
- the composite image can be easily adjusted and diagnosed.
- the doctor can confirm the intensity of the scattering with respect to the X-ray absorption in the object of interest, and thereby the size and orientation of the trabecular structure.
- the other reconstructed image can be displayed individually. That is, a small angle scattered image or an absorption image can be displayed individually.
- step T14 The processes from step T14 to step T21 are repeatedly executed until “end” is operated by the operation unit 22.
- step T22 step T22; YES
- the process proceeds to step S7 in FIG.
- FIG. 15 shows a flowchart of the image display process executed in step S6 when the diagnosis target site is a bone / joint system site and the disease name is a micro fracture.
- a composite image of the absorption image and the small angle scattered image is displayed on the display unit 23 (step T31).
- the display screen displayed in step T31 together with the image, an operation button for instructing “detailed diagnosis of micro fracture” and an operation button for instructing “end” are displayed.
- step T32 When the operation button of “diagnose minute fracture in detail” is operated by the operation unit 22 (step T32; YES), a combined image of the absorption image and the small angle scattered image is displayed on the display unit 23, and the small angle scattered image and the absorption are displayed.
- a GUI such as a button or a slide bar for changing the contribution degree of the image (contribution degree for each image, each region, and each pixel) according to the operation of the operation unit 22 is displayed. (Step T33).
- step T34 When the change of the contribution degree is instructed by the operation unit 22 (step T34; YES), a composite image is generated by changing the contribution degree of each of the small angle scattered image and the absorption image according to the operation of the operation unit 22 (step T35). ), The process returns to step T ⁇ b> 33, and the composite image whose contribution is changed is displayed on the display unit 23.
- the doctor can confirm the intensity of the scattering with respect to the X-ray absorption in the region of interest, and thereby the size, orientation, It can be used as a judgment material for estimating the shape and the like. If the contribution degree of any one of the reconstructed images is 0, the other reconstructed image is individually displayed. That is, a small angle scattered image or an absorption image can be displayed individually.
- step T32 The processes from step T32 to step T35 are repeatedly executed until “end” is operated by the operation unit 22.
- step T36 When “end” is operated by the operation unit 22 (step T36; YES), the process proceeds to step S7 in FIG.
- the composite image has advantages and disadvantages.
- Advantages of the composite image include, for example, (1) many elements can be examined with a single image, which is more efficient than comparison of single reconstructed images. (2) When either the absorption image and the differential phase image or the small angle scattering image are synthesized, the affinity with the conventional diagnostic method is high. (3) Increase in noise due to synthesis ⁇ In the case of an increase in signal for drawing an object of interest, the visibility of the object is improved.
- a disadvantage of the composite image is that when the increase in noise is larger than the increase in the signal of interest, the diagnostic ability is lower than that of the individual reconstructed image.
- This demerit can be reduced by means such as changing the degree of contribution according to the density of each reconstructed image and the flatness of the signal as described above.
- individual reconstructed images can be displayed by adjusting the contribution of each reconstructed image in the composite image. Can be displayed.
- an individual reconstructed image corresponding to the purpose obtained from the observation of the composite image may be displayed. Thereby, it is possible to display an individual reconstructed image without the disadvantage of the composite image without performing an operation of adjusting the contribution degree.
- step S6 of FIG. 3 an example in which an individual reconstructed image is displayed by switching the image after the composite image is displayed will be described.
- FIG. 16 shows a flowchart of another example of the image display process executed in step S6 of FIG. 3 when the diagnosis target region is the breast.
- the combined image of the absorption image and the differential phase image and the combined image of the absorption image and the small angle scattered image are simultaneously displayed (side-by-side) on the display unit 23 or are switched and displayed (alternately repeatedly and flipped) (step T41). ).
- an operation button for instructing “detailed examination of spicula”, an operation button for instructing “detailed examination of microcalcification”, “ An operation button for instructing “confirm familiar absorption image” and an operation button for instructing “end” are displayed.
- the display in step T41 can recognize general findings such as whether there is an abnormal shadow candidate in the breast, what kind of abnormal shadow candidate exists, and where the region is. The doctor can determine the position of the region to be noted and the items to be confirmed in detail. Then, according to the result of observing the display in step T41, any one of the operation buttons is operated, and if necessary, an individual reconstructed image according to the purpose can be displayed.
- step T42 it is determined whether or not the operated operation button is “check the spicula in detail” (step T42). If it is determined that the operated operation button is “check the spicula in detail” (step T42; YES), a differential phase image is displayed on the display unit 23 (step T43).
- step T42 When it is determined that the operation button operated by the operation unit 22 is “examine microcalcification in detail” (step T42; NO, step T44; YES), a small-angle scattered image is displayed on the display unit 23 (step S42). T45).
- step T44 When it is determined that the operation button operated by the operation unit 22 is “confirm familiar absorption image” (step T44; NO, step T46; YES), the absorption image is displayed on the display unit 23 (step S44). T47).
- step T42 The processes from step T42 to step T47 are repeatedly executed until “end” is operated by the operation unit 22.
- step T48 When “end” is operated by the operation unit 22 (step T48; YES), the process proceeds to step S7 in FIG.
- FIG. 17 shows a flowchart of another example of the image display process executed in step S6 when the diagnosis target site is a bone / joint system site and the disease name is rheumatism.
- a composite image of the absorption image and the differential phase image is displayed on the display unit 23 (step T51).
- the composite image of the absorption image and the differential phase image it is possible to confirm the presence or absence of cartilage abnormality and determine the region of interest.
- an operation button for instructing “confirm erosion to the bone”, and an operation for instructing “examine cartilage contour in detail” A button, an operation button for instructing “detailed examination of trabecular bone and bone structural change”, an operation button for instructing “detailed examination of bone part”, and an operation button for instructing “end” Is displayed.
- the presence or absence of cartilage abnormality can be confirmed by the display in step T51, so that the doctor operates any operation button according to the result, and if necessary, a composite image of the absorption image and the small angle scattering image Or, an individual reconstructed image according to the purpose can be displayed.
- the operation button for instructing “confirm erosion to the bone” is disabled when another operation button is pressed.
- step T52 it is determined whether or not the operation button “confirm erosion to bone” has been operated by the operation unit 22 (step T52). If it is determined by the operation unit 22 that “confirm erosion to bone” has not been operated (step T52; NO), the process proceeds to step T54. If it is determined that “confirm erosion to bone” has been operated by the operation unit 22 (step T52; YES), a combined image of the absorption image and the small-angle scattered image is displayed (step T53), and the process is performed in step T54. Migrate to The image displayed in step T53 may be obtained by further combining a small-angle scattered image with the combined image displayed in step T51.
- step T54 when any one of the operation buttons is operated by the operation unit 22, it is determined whether or not the operated operation button is “examine the outline of the cartilage in detail” (step T54). When it is determined that the operated operation button is “examine cartilage contour in detail” (step T54; YES), a differential phase image is displayed on the display unit 23 (step T55).
- step T54 when it is determined that the operation button operated by the operation unit 22 is “examine in detail the structural changes of trabecular bone and bone” (step T54; NO, step T56; YES), the small-angle scattered image is displayed on the display unit 23. Is displayed. (Step T57).
- step T56 if it is determined that the operation button operated by the operation unit 22 is “examine the bone part in detail” (step T56; NO, step T58; YES), an absorption image is displayed on the display unit 23 (step S56). T59).
- the processes in steps T54 to T59 are repeatedly executed until “end” is operated by the operation unit 22.
- step T60 When “end” is operated by the operation unit 22 (step T60; YES), the process proceeds to step S7 in FIG.
- FIG. 18 shows a flowchart of another example of the image display process executed in step S6 when the diagnosis target site is a bone / joint system site and the disease name is a micro fracture.
- a composite image of the absorption image and the small angle scattered image is displayed on the display unit 23 (step T71).
- an operation button for instructing “detailed examination of micro fracture” an operation button for instructing “detailed examination of bone part”, “end” "Is displayed.
- step T72 When the operation button of “diagnose minute fracture in detail” is operated by the operation unit 22 (step T72; YES), a small-angle scattered image is displayed on the display unit 23. (Step T73). On the other hand, when it is determined that the operation button operated by the operation unit 22 is “examine the bone part in detail” (step T72; NO, step T74; YES), an absorption image is displayed on the display unit 23 (step S72). T75).
- step T72 The processes from step T72 to step T75 are repeatedly executed until “end” is operated by the operation unit 22.
- step T76 When “end” is operated by the operation unit 22 (step T76; YES), the process proceeds to step S7 in FIG.
- step S7 of FIG. 3 the imaging order information specified in step S1, the reconstructed image generated this time, the composite image, information on the type of image processing used to generate the composite image, image processing parameters, and display The parameters are associated with each other and stored in the storage unit 25 (step S7). Thereby, when it is desired to display the composite image generated this time again, it can be easily read out from the storage unit 25 and easily displayed under the processing conditions displayed this time, so that convenience is improved.
- an operation button for displaying a composite image, an individual reconstructed image, or the like for each purpose for example, “examine the tumor margin and spicule in detail” displayed in step T1 in FIG. 13.
- Operation buttons for instructing and "operation buttons for instructing detailed examination of mass homogeneity and microcalcification” are displayed based on these operations. This is merely an example, and the motivation (purpose) and operation for displaying each composite image and individual reconstructed image are not limited to these.
- the sign of the differential value depends on the subject, and the appearance changes depending on the background density due to human visual characteristics. Therefore, an interface for switching the differential value to a value obtained by reversing the positive or negative value or an absolute value may be displayed on the display unit 23, and the operation unit 22 may be operated so that each doctor can make the diagnosis easier.
- the control unit 21 of the controller 2 performs diagnosis in the diagnosis target part or the diagnosis target part and the part included in the imaging order information specified by the operation unit 22. Based on the diagnosis target information for identifying the disease to be generated, a composite image is generated by combining two types of reconstructed images among the three types of reconstructed images of the absorption image, the differential phase image, and the small-angle scattered image, The generated composite image is displayed on the display unit 23.
- one of two types of reconstructed images be an absorption image. This is because the absorption image is an image that has been conventionally used by a doctor for diagnosis, and thus has a high affinity with the conventional diagnostic ability.
- a display mode for example, it is preferable to generate a plurality of types of synthesized images and to display the generated plurality of types of synthesized images simultaneously or on the display unit 23.
- the diagnosis target region is a breast
- two synthesized images can be compared, and by paying attention to the difference, it is easier to notice the presence of an abnormal shadow candidate than observing only one of the synthesized images.
- the doctor can immediately notice the change, so it is possible to recognize abnormal shadow candidates quickly and accurately. It is preferable.
- the generated composite image and at least one of the three types of reconstructed images may be displayed on the display unit 23 simultaneously or in a switched manner.
- the display unit displays a single image of either a differential phase image or a small-angle scattered image among the three types of reconstructed images, and a composite image of the other reconstructed image and absorption image 23 may be displayed simultaneously or switched.
- the composite image of the two types of reconstructed images generated and the composite image of the three types of reconstructed images may be displayed on the display unit 23 simultaneously or in a switched manner.
- the small angle scattered image may be a differential small angle scattered image obtained by differentiating the small angle scattered image or an image obtained by taking the absolute value of the differential small angle scattered image.
- the absorption image depicts a structure such as a bone with high sensitivity.
- the differential phase image can depict soft tissues such as cartilage, which are difficult to depict with an absorption image, as well as bone.
- soft tissue such as cartilage and a bone are drawn to overlap each other, it is difficult to visually recognize the signal of the soft tissue because the bone has a larger signal than the soft tissue. It was.
- the inventors of the present application have made extensive studies, and as a result, by removing or attenuating the bone signal of the differential phase image using the absorption image obtained together with the differential phase image, the soft tissue such as cartilage
- the soft tissue such as cartilage
- the present inventors have found that an image capable of visually recognizing soft tissue can be generated even when bones are depicted overlapping. The outline will be described below.
- the absorption image I Abs can be represented by the integral of the physical quantity in the X-ray irradiation direction (z direction in FIG. 1B), and the differential phase image dI DP is the lattice structure of the integral of the physical quantity in the X-ray irradiation direction. Can be expressed in a form proportional to the differentiation in the vertical direction (x direction in FIG. 1B).
- I Abs_RAW represents the X-ray intensity (without logarithm) of an absorption image reconstructed using a Talbot interferometer or a Talbot-Lau interferometer.
- ⁇ represents the X-ray absorption coefficient by the subject
- 1 ⁇ represents the X-ray refractive index by the subject. Since the relationship between ⁇ and ⁇ varies depending on the subject, even if the absorption image I Abs is differentiated, it does not become the differential phase image dI DP, and even if the differential phase image dI DP is integrated, it does not become the absorption image I Abs .
- Absorption image I Abs or its differential image shows bone but not soft tissue such as cartilage
- differential phase image dI DP or its integral image shows both bone and soft tissue
- the structure other than the common structure can be obtained by subtracting the signal intensity of the common structure part together. Only an image can be generated. That is, even when the bone and soft tissue overlap in differential phase image dI DP, it is possible to obtain a visible easily image the soft tissues using absorption image I Abs and differential phase image dI DP.
- the absorption image and the differential phase image as a method of obtaining an image obtained by removing (or attenuating) a signal having a structure common to both images, (A) processing (differentiating) the absorption image to generate a differential absorption image A method of subtracting from the differential phase image by multiplying the differential absorption image by a coefficient for matching the signal intensity of the structure common to the differential phase image and the differential absorption image to the differential phase image, (B) processing the differential phase image There is a method of generating a phase image by (integrating), multiplying the absorption image by a coefficient for matching the signal intensity of the structure common to the phase image and the absorption image, and subtracting from the phase image.
- a soft tissue differential image An image in which the bone signal is removed or attenuated by (A) to improve the visualization of the soft tissue is referred to as a soft tissue differential image.
- the above-mentioned soft tissue differential image is generated and displayed as a composite image of an absorption image and a differential phase image when the diagnosis target site is a bone / joint system (rheumatic).
- the composite image table stored in the storage unit 25 illustrated in FIG. 2 includes a composite image generated when the diagnosis target part is a bone / joint part and the disease name is rheumatism. Further, the above-mentioned soft tissue differential image is stored as the type.
- the storage unit 25 stores a program for the control unit 21 to execute the operation of the second embodiment (for example, a program for executing the soft tissue differential image generation process shown in FIG. 19).
- the other medical image system and the configuration of each device constituting the medical image system are the same as the medical image system 100 described in the first embodiment and each device constituting the medical image system. The operation of the medical image system 100 in the embodiment will be described below.
- control unit 21 of the controller 2 executes the image generation / display process shown in FIG. 3 according to the operation of the operation unit 22.
- the soft tissue differential image generation processing shown below is executed, and the differential absorption image and the differential image obtained by processing the absorption image are processed.
- a soft tissue differential image obtained by combining the phase image is generated.
- FIG. 19 shows a soft tissue differential image generation process executed by the control unit 21 of the controller 2.
- the soft tissue differential image generation process first, the absorption image and differential phase image generated in step S4 are acquired (step S501).
- a differential absorption image is generated from the absorption image (step S502).
- the differential absorption image can be generated by differentiating the absorption image.
- the pixel value of each pixel of the differential absorption image is multiplied by a coefficient for matching the signal intensity of the bone signal to the differential phase image.
- the coefficient to be multiplied may be a preset value in consideration of the apparatus configuration, shooting conditions, or the like, or may be calculated each time.
- a coefficient at which the above-described common structure signal (bone signal) disappears most is obtained by calculation.
- a ratio of a signal having a common structure (here, a bone signal) to be subtracted from the differential phase image is obtained by calculation, and the ratio (the bone signal in the differential phase image) is calculated.
- Bone signal of differential absorption image) can be calculated as a coefficient.
- an entire image or a bone region can be set as a region of interest, and a ratio of pixel values of the region of interest in both images (for example, a ratio of representative values of pixel values in the region of interest) can be used as a coefficient.
- a differential phase image (soft tissue differential image) from which the common structure (bone signal) is removed or attenuated is generated (step) S504). That is, the differential in which the common structure (bone signal) is removed or attenuated by subtracting the pixel value of the corresponding pixel of the differential absorption image after multiplication by the coefficient from the pixel value of each pixel of the differential phase image A phase image (soft tissue differential image) is generated.
- a soft tissue differential image that allows the soft tissue to be visually recognized can be obtained even when the soft tissue is photographed while overlapping the bone.
- the signal of the artifact can be corrected by estimating and subtracting the coefficient of the function that best reproduces the artifact component from the differential phase image. . Therefore, after acquiring the differential phase image in step S501, it is preferable that the control unit 21 performs the above-described artifact correction and generates a soft tissue differential image using the differential phase image after the artifact correction and the absorption image. . Alternatively, the soft tissue differential image may be generated after removing signal non-uniformity from the signal distribution of the differential phase image and the differential absorption image.
- an image obtained by multiplying the differential absorption image by a certain coefficient is subtracted from the differential phase image.
- a differential phase image using a joint as a subject Sufficient soft tissue signals are obtained in areas that do not overlap bone. If the differential absorption image is subtracted from such a region, there is a possibility that the noise component increases and the image quality deteriorates. Therefore, it is preferable to specify the bone region in the differential absorption image and reduce the coefficient by which the differential absorption image is multiplied for other regions. In this way, it is possible to prevent the above-described deterioration in image quality.
- a threshold corresponding to the absorption image is stored in advance in the storage unit 25, each pixel value of the absorption image is compared with the above threshold, Pixel value of absorption image> threshold value (1)
- a region that satisfies the condition can be identified as a bone region.
- the absorption image is defined by [Equation 1] (the pixel value is defined to be larger as the absorption by the subject is larger)
- a threshold value is provided which is the upper limit of the pixel value of the region other than the bone.
- the lower threshold value is stored in the storage unit 25 and the lower limit threshold value is exceeded (lower limit).
- a region whose pixel value is smaller than the threshold value) is specified as a bone region.
- the threshold value corresponding to the differential absorption image is stored in the storage unit 25 in advance, and the absolute value of each pixel value of the differential absorption image is compared with the threshold value of the differential absorption image stored in the storage unit 25, Absolute value of differential absorption image pixel value> threshold (2) A region that satisfies the condition can be identified as a bone region.
- a threshold corresponding to the small angle scattered image is stored in the storage unit 25, each pixel value of the small angle scattered image is compared with the threshold, and a region satisfying “pixel value of the small angle scattered image> threshold” is a bone region. It may be specified as In addition, a threshold value corresponding to a phase image (details will be described later) is stored in the storage unit 25, and each pixel value of the phase image is compared with the threshold value. It may be specified as a region.
- the threshold corresponding to the differential phase image is stored in the storage unit 25, the absolute value of each pixel value of the differential phase image is compared with the threshold of the differential phase image stored in the storage unit 25, and the differential An area that satisfies the absolute value of the pixel value of the phase image> the threshold value may be specified as a bone area.
- the control unit 21 executes the image display process in step S6 of FIG.
- the image display process (FIG. 14) executed when the diagnosis target site is a bone / joint system site and the disease name is rheumatism is different from the first and second embodiments.
- the generated soft tissue differential image is displayed on the display unit 23 as a composite image of the differential phase image and the absorption image.
- the soft tissue differential image is an image in which the bone signal is attenuated or removed from the differential phase image in which the signals of both the soft tissue such as bone and cartilage are depicted.
- step T15 a GUI such as a button or a slide bar for changing the contribution of the differential phase image and the differential absorption image in accordance with the operation of the operation unit 22 is displayed. It is good also as displaying GUI which can change separately the contribution of both the images in a bone area, and the contribution of both the images in areas other than a bone area.
- the control unit 21 calculates a coefficient corresponding to the contribution degree instructed by the operation unit 22 and multiplies the differential absorption image, and this is calculated as the differential phase image.
- a composite image soft tissue differential image in which the degree of contribution is changed by subtracting from is displayed.
- step T15 a “slide show” button or the like for instructing to stepwise change the contribution of the differential absorption image from minimum to maximum (or vice versa) is displayed.
- the control unit 21 automatically generates a composite image in which the coefficient to be multiplied with the differential absorption image is changed stepwise from minimum to maximum (or vice versa) and is displayed on the display unit 23. It is also possible to display sequentially by switching.
- the soft tissue differential image is an image unfamiliar to many doctors. Therefore, in order to facilitate comparison with the absorption image conventionally used for image diagnosis, in step T15, a soft tissue differential image and a composite image of the absorption image, and a GUI for changing the contribution are displayed.
- the composite image may be displayed in which the relative weighting of the soft tissue differential image and the absorption image is changed according to the change operation of the contribution degree from the operation unit 22. In this way, by operating the operation unit 22, for example, it is possible to change the ratio of both images stepwise from an absorption image to a soft tissue differential image. The doctor can easily recognize where in the absorption image the soft tissue) corresponds.
- step T15 a button for instructing switching display is also displayed, and when the switching display is instructed, the absorption image and the soft tissue differential image may be alternately switched and displayed on the display unit 23.
- step T15 the GUI for changing the contribution of the differential phase image and the differential absorption image is displayed as the GUI for changing the coefficient to be multiplied to the differential absorption image. It is also possible to display a GUI for directly changing the coefficient to be multiplied with the image. Further, the GUI for changing the threshold value for specifying the bone region described above is configured to be displayed on the display unit 23 together with the GUI for changing the contribution degree (coefficient) or alone, and the control unit 21 includes:
- the soft threshold differential image may be generated by changing the threshold value according to an operation from the operation unit 22, and the generated soft tissue differential image may be displayed on the display unit 23.
- the third embodiment according to the present invention will be described below.
- the above-mentioned soft tissue image is generated and displayed as a composite image of an absorption image and a differential phase image when the diagnosis target site is a bone / joint system (rheumatic).
- the composite image table stored in the storage unit 25 illustrated in FIG. 2 includes a composite image generated when the diagnosis target region is a bone / joint region and the disease name is rheumatism.
- the storage unit 25 stores a program for the control unit 21 to execute the operation of the third embodiment (for example, a program for executing the soft tissue image generation process shown in FIG. 20).
- the other medical image system and the configuration of each device constituting the medical image system are the same as the medical image system 100 described in the first embodiment and each device constituting the medical image system. The operation of the medical image system 100 in the embodiment will be described below.
- the control unit 21 of the controller 2 executes the image generation / display process shown in FIG. 3 in accordance with the operation of the operation unit 22.
- a soft tissue image generation process shown below is executed to process the absorption image and the differential phase image. To generate a soft tissue image.
- FIG. 20 shows a soft tissue image generation process executed by the control unit 21 of the controller 2.
- the absorption image and the differential phase image generated in step S4 are acquired (step S601).
- a phase image is generated from the differential phase image (step S602).
- the phase image can be generated by integrating the differential phase image. However, if the pixels are simply added from the end pixels in the differential direction, noise is accumulated and linear artifacts are generated.
- the absorption image is multiplied by a coefficient for matching the signal intensity of the structure (here, the bone signal) to be erased from the phase image among the structures drawn in common to the phase image and the absorption image.
- the pixel value of each pixel of the absorption image is multiplied by a coefficient for matching the signal intensity of the bone signal to the phase image.
- the coefficient to be multiplied may be a preset value in consideration of the apparatus configuration, shooting conditions, or the like, or may be calculated each time. When calculating each time, when the absorption image is subtracted from the phase image, a coefficient at which the above-mentioned common structure signal (bone signal) disappears most is obtained by calculation.
- a ratio of signals having a common structure (here, a bone signal) to be subtracted from the phase image to be deleted is obtained by calculation, and the ratio (the bone signal / absorption image of the phase image) Bone signal) can be calculated as a coefficient.
- a ratio of pixel values of the region of interest for example, a representative value of pixel values in the region of interest
- a bone signal is attenuated or removed, and a phase image (soft tissue image) with improved soft tissue rendering is generated (step S604).
- a phase image soft tissue image
- Soft tissue differential image the differential phase image in which the common structure (bone signal) is removed or attenuated by subtracting the pixel value of the corresponding pixel of the absorption image after multiplication by the coefficient from the pixel value of each pixel of the phase image.
- the control unit 21 applies the acquired differential phase image to the acquired differential phase image. It is preferable to perform artifact correction and generate a soft tissue image using the phase image created using the differential phase image after artifact correction and the absorption image. Alternatively, the soft tissue image may be generated after removing non-uniformity of signals other than the subject from the signal distribution of the phase image and the absorption image.
- the absorption image is subtracted from a region where a signal is sufficiently obtained with only the phase image, the noise component increases and the image may be deteriorated.
- the control unit 21 executes an image display process in step S6 of FIG.
- the image display process (FIG. 14) executed when the diagnosis target site is a bone / joint system site and the disease name is rheumatism is different from the first and second embodiments.
- the generated soft tissue image is displayed on the display unit 23 as a composite image of the differential phase image and the absorption image.
- the soft tissue image is an image in which the bone signal is attenuated or removed from the phase image in which the signals of both the soft tissue such as bone and cartilage are depicted, the soft tissue image is displayed.
- the doctor can visually recognize the signal of the soft tissue.
- step T15 a GUI such as a button or a slide bar for changing the contribution degree of the phase image and the absorption image according to the operation of the operation unit 22 is displayed. It is good also as displaying GUI which can change separately the contribution of both the images in a bone area, and the contribution of both the images in areas other than a bone area.
- the control unit 21 calculates a coefficient corresponding to the changed contribution degree, multiplies the absorption image, and subtracts this from the phase image to change the contribution degree.
- the synthesized image is displayed. In this way, by allowing the doctor to freely change the contribution degree of the phase image and the absorption image manually, for example, it is possible to draw both the bone and the soft tissue by reducing the coefficient multiplied to the absorption image. Thus, the position of the soft tissue can be confirmed, or conversely, the coefficient can be increased and adjusted so as to improve the depiction of the soft part, and the diagnosis of the soft tissue is facilitated. .
- step T15 a “slide show” button or the like for instructing to gradually change the contribution degree of the absorption image from minimum to maximum (or vice versa) is displayed.
- the control unit 21 automatically generates a composite image in which the coefficient to be multiplied with the absorption image is changed stepwise from minimum to maximum (or vice versa) and sequentially switches to the display unit 23. It may be displayed.
- the soft tissue image is an image unfamiliar to many doctors. Therefore, in order to facilitate comparison with the absorption image conventionally used for diagnostic imaging, in step T15, a soft tissue image and a combined image of the absorption image, and a GUI for changing the contribution are displayed.
- a composite image in which the relative weighting of the soft tissue image and the absorption image is changed may be displayed in accordance with the contribution change operation from the operation unit 22.
- the ratio of both images can be changed stepwise from an absorption image to a soft tissue image, for example, by the operation of the operation unit 22, so that the structure (soft tissue) seen in the soft tissue image can be changed. ) Can easily recognize where in the absorption image corresponds.
- a button for switching display may be displayed together, and when the switching display is instructed, the absorption image and the soft tissue image may be alternately switched and displayed on the display unit 23.
- step T15 the GUI for changing the contribution between the phase image and the absorption image is displayed as the GUI for changing the coefficient to be multiplied by the absorption image.
- the absorption image is multiplied. It is good also as displaying GUI which changes a coefficient directly.
- the GUI for changing the threshold value for specifying the bone region described above is configured to be displayed on the display unit 23 together with the GUI for changing the contribution degree (coefficient) or alone, and the control unit 21 includes: A soft tissue image may be generated by changing the threshold value according to an operation from the operation unit 22, and the generated soft tissue image may be displayed on the display unit 23.
- the control unit 21 is based on the image signal of the subject obtained by the X-ray imaging apparatus 1, the differential phase image, the absorption image, Of the three reconstructed images of the small angle scattered image, at least a differential phase image and an absorption image are generated. Then, the control unit 21 processes the absorption image to generate a differential absorption image, and the signal intensity of the structure depicted in common to the differential phase image and the differential absorption image with respect to the generated differential absorption image is changed to the differential phase.
- the ratio of the signal of the structure drawn in common is calculated, and the calculated ratio is used so that the structure drawn in common is used. It is possible to obtain an image from which the above signal is substantially removed.
- a threshold corresponding to at least one of an absorption image, a differential absorption image, a phase image, a differential phase image, and a small angle scattered image is stored in the storage unit 25, and each pixel of the image corresponding to the stored threshold is stored.
- the composite image and the GUI for changing the coefficient or the threshold are displayed together on the display unit 23, and the composite image is generated and displayed by changing the coefficient or the threshold according to the operation by the operation unit 22. This makes it possible for the doctor to make a diagnosis by adjusting the coefficient and the threshold value so that they can be easily diagnosed.
- artifacts due to imaging conditions in the X-ray imaging apparatus 1 are corrected for the differential phase image, and a synthesized image is generated using the corrected differential phase image, thereby suppressing the artifact. It is possible to stably provide a good image for diagnosis.
- the said embodiment is a suitable example of this invention, and is not limited to this.
- the diagnosis target is the breast, bone / joint system (rheumatic, micro fracture)
- the present invention is not limited to this, and is applicable to other regions and cases. can do.
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Abstract
Description
また、特許文献2においては、位相コントラスト画像と吸収コントラスト画像を重ね合わせた合成画像が骨部と軟骨の移行部における構造を診断するのに有効であることが記載されている。しかしながら、診断対象の部位やその部位において診断すべき疾患によってどのような合成画像をどのように表示したら効果的であるかについては記載がない。
タルボ方式撮影装置、タルボ・ロー方式撮影装置、又はフーリエ変換方式撮影装置のうち何れかを用いて被写体の診断対象部位のX線撮影を行い、前記被写体の診断対象部位に係る吸収画像、微分位相画像及び小角散乱画像の3種類の再構成画像を生成する医用画像システムであって、
前記診断対象部位、又は、前記診断対象部位及びその部位において診断すべき疾患を特定するための診断対象情報を入力する入力手段と、
前記入力手段により入力された診断対象情報に基づいて、前記3種類の再構成画像のうち2種類の再構成画像を合成して合成画像を生成し、生成した合成画像を表示手段に表示させる制御手段と、
を備える。
タルボ干渉計又はタルボ・ロー干渉計を用いたX線撮影装置により得られた被写体の画像信号に基づいて、微分位相画像、吸収画像、小角散乱画像の3つの再構成画像のうち、少なくとも微分位相画像及び吸収画像を生成する再構成画像生成手段と、
前記吸収画像を加工して微分吸収画像を生成し、生成した前記微分吸収画像に対して前記微分位相画像と前記微分吸収画像に共通して描出されている構造の信号強度を前記微分位相画像に合わせるための係数を乗算して前記微分位相画像から減算するか、又は、前記微分位相画像を加工して位相画像を生成し、前記吸収画像に対して前記位相画像と前記吸収画像に共通して描出されている構造の信号強度を前記位相画像に合わせるための係数を乗算して前記位相画像から減算することにより、前記微分位相画像と前記吸収画像に共通して描出されている構造の信号を除去又は減弱した合成画像を生成する合成手段と、
を備える。
前記合成手段は、前記再構成画像生成手段により生成された前記閾値に対応する画像の各画素値又はその絶対値を前記閾値と比較し、前記閾値を越えない画素値の領域に対しては前記係数を小さくして前記合成画像を生成することが好ましい。
前記係数及び/又は前記閾値を変更するための操作手段と、
を備え、
前記合成手段は、前記操作手段の操作に応じて前記係数及び/又は前記閾値を変更して合成画像を生成し、
前記表示手段は、前記係数及び/又は前記閾値を変更して生成された合成画像を表示することが好ましい。
前記合成手段は、前記補正手段により補正された微分位相画像を用いて前記合成画像を生成することが好ましい。
以下、図面を参照して本発明の第1の実施形態について説明する。
図1Aに、本実施形態に係る医用画像システム100の全体構成を示す。
医用画像システム100は、X線撮影装置1と、コントローラー2と、オーダー入力装置3とを備えて構成されている。
X線撮影装置1とコントローラー2は、LAN(Local Area Network)等の通信ネットワークNを介してデータ送受信可能に接続されている。また、コントローラー2とオーダー入力装置3は、通信ネットワークNを介してデータ送受信可能に接続されている。
X線撮影装置1であるタルボ干渉計又はタルボ・ロー干渉計において、縞走査法用の複数のモアレ画像を生成する方式を縞走査方式と呼ぶ。
制御部21は、CPU(Central Processing Unit)やRAM(Random Access Memory)等から構成され、記憶部25に記憶されているプログラムとの協働により、後述する画像生成表示処理をはじめとする各種処理を実行する。
例えば、記憶部25は、オーダー入力装置3から送信された撮影オーダー情報を記憶している。撮影オーダー情報は、撮影日付、患者名、診断対象情報(診断対象部位(撮影部位)、又は、診断対象部位及びその部位において診断すべき疾患名の情報)等が含まれる。
また、記憶部25は、診断対象情報と、その診断対象の撮影に適した撮影条件とを対応付けた撮影条件テーブルを記憶している。
また、記憶部25は、診断対象情報と、その診断対象に適した画像(合成画像を含む)の種類及びその表示態様の情報とを対応付けた合成画像テーブルを記憶している。
また、記憶部25は、X線撮影装置1から送信されたモアレ画像に基づき生成された3種類の再構成画像、合成画像、合成画像の生成に用いた処理の種類(加算、減算、乗算、除算等)の情報や画像処理パラメーター、階調補正や拡大縮小の位置等の表示パラメーター等を撮影オーダー情報に対応付けて記憶する。
更に、記憶部25は、X線撮影装置1の放射線検出器に対応するゲイン補正データ、欠陥画素マップ等を予め記憶する。なお、これらデータは、X線撮影装置1側で記憶され、これらのデータに基づき各種補正処理済のモアレ画像をコントローラー2に入力するようにしても良い。
図3に、コントローラー2の制御部21により実行される画像生成表示処理のフローチャートを示す。画像生成表示処理は、操作部22の操作に応じて制御部21と記憶部25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。
次いで、指定された撮影オーダー情報に含まれる診断対象情報に応じた撮影条件が記憶部25の撮影条件テーブルから読み出され、通信部24によりX線撮影装置1に送信され、設定される(ステップS2)。
吸収画像(X線吸収画像)は、干渉縞の平均成分を画像化したものであり、被写体によるX線減衰量に応じてコントラストが付く。従来から診断に用いられており、医師等の医療従事者にとってなじみのある画像である。X線の吸収コントラストがつきやすい骨部の描写に優れている(図4A参照)。
微分位相画像は、干渉縞の位相情報を画像化したものであり、被写体によるX線波面の傾き量に応じてコントラストが付く。吸収画像よりも軟部組織の描写に優れている(図4B参照)。
小角散乱画像は、干渉縞のVisibilityを画像化したものであり、被写体によるX線散乱に応じてコントラストが付く(公知文献5:Distribution of unresolvable anisotropic microstructures revealed in visibility-contrast images using x-ray Talbot interferometry Wataru Yashiro et.al. PHYSICAL REVIEW B 84, 094106 (2011)参照。)。吸収画像よりも微細構造の描写に優れている(図4C参照)。
ステップS4で生成される吸収画像、微分位相画像、小角散乱画像は、X線撮影装置1から送信された同一のモアレ画像(群)に基づいて生成されるので、3つの画像は同一被写体の同一部分を描写しており、3つの画像間における被写体の位置合わせは不要である。
まず、被写体有りのモアレ画像と被写体無しのモアレ画像に、オフセット補正処理、ゲイン補正処理、欠陥画素補正処理、X線強度変動補正等が施される。次いで、補正後の被写体有りのモアレ画像に基づいて、被写体有りの3種類の再構成画像(吸収画像、微分位相画像、小角散乱画像)が生成される。また、補正後の被写体無しのモアレ画像に基づいて、被写体無しの3種類の再構成画像(吸収画像、微分位相画像、小角散乱画像)が生成される。
具体的には、X線撮影装置1において、縞走査方式により、縞走査法用のモアレ画像が作成された場合、複数のモアレ画像の干渉縞を加算することにより吸収画像が生成される。また、縞走査法の原理を用いて干渉縞の位相が計算され、微分位相画像が生成される。また、縞走査法の原理を用いて干渉縞のVisibilityが計算され(Visibility=振幅÷平均値)、小角散乱画像が生成される。
X線撮影装置1において、フーリエ変換方式によりモアレ画像が作成された場合、まず、補正後の被写体有りのモアレ画像と被写体無しのモアレ画像のそれぞれがフーリエ変換(二次元フーリエ変換)され、それぞれ0次成分、キャリア周波数(=モアレ周波数)分シフトされた1次成分がHanning窓等により切り出される。次いで、切り出された0次成分、1次成分のそれぞれが逆フーリエ変換される。次いで、0次成分の振幅から吸収画像が生成され、1次成分の位相から微分位相画像が生成され、0次成分と1次成分の振幅の比(=Visibility)から小角散乱画像が生成される。
そして、生成された被写体有りの再構成画像に対し、同種の被写体無しの再構成画像を用いて(例えば、被写体有りの小角散乱画像に対し、被写体無しの小角散乱画像を用いて)、干渉縞の位相の除去と、画像ムラを除去するための補正処理が行われ、最終的な診断用の3種類の再構成画像が生成される。
ここでは、記憶部25に記憶されている合成画像テーブルが読み出され、合成画像テーブルにおいて、撮影オーダー情報に含まれる診断対象情報に対応付けられている種類の合成画像が生成される。
図5Aに、図4Aに示す吸収画像と図4Bに示す微分位相画像とを加算して合成した合成画像の一例を示す。図5Bに、図4Aに示す吸収画像と図4Cに示す小角散乱画像とを加算して合成した合成画像の一例を示す。図5Cに、図4Aに示す吸収画像から図4Cに示す小角散乱画像を減算して合成した合成画像の一例を示す。図5Dに、図4Cに示す小角散乱画像を図4Aに示す吸収画像で除算して合成した合成画像の一例を示す。
図5A~図5Dに示すように、合成画像の算出方法(加算、減算、除算、乗算)によって、異なる特性の画像を得ることができる。何れの算出方法を用いるかは、予め診断対象情報に対応付けて合成画像テーブルに記憶されている。
なお、寄与度とは、各再構成画像(あるいはその一部領域や画素)が合成画像に寄与する度合いを表すものであり、例えば、加算、減算により合成画像を生成する場合の各再構成画像の重み付け係数等が含まれる。
図6Aに、鳥手羽軟骨を被写体とした吸収画像を示す。図6Bに、鳥手羽軟骨を被写体とした微分位相画像を示す。図6Cに、鳥手羽軟骨を被写体とした小角散乱画像を示す。図7Aに、手関節を被写体とした吸収画像を示す。図7Bに、手関節を被写体とした微分位相画像を示す。図7Cに、手関節を被写体とした小角散乱画像を示す。
また、吸収画像と小角散乱画像の合成画像では、骨、微小骨折、及び骨梁の微細構造が診断可能に描写されるので、1枚の小角散乱画像のみを観察したときに比べて骨の視認性が向上する。また、医師に馴染みのある吸収画像に、骨梁の微小構造の分布や微小骨折の有無の描写に優れる小角散乱画像を合成することで、小角散乱画像の診断に不慣れな医師にとっても骨粗鬆症や微小骨折の診断をし易くすることができる。
さらに、吸収画像と微分位相画像または小角散乱画像の合成は、一定の周期でスリットが設けられたような1次元格子を用いた撮影装置において有効である。一次元格子を用いた場合、微分位相画像および小角散乱画像は格子構造と直角方向の被写体変化を検出できるが、垂直方向の被写体変化には感度がなく検出できないという画像指向性の問題がある。しかし画像指向性のない吸収画像と、微分位相画像または小角散乱画像を合成することで、微分位相画像または小角散乱画像で欠落した情報を補うことができ、病変位置の特定など診断をし易くすることができる。
図8Bに、図6Aに示す鳥手羽軟骨の吸収画像と図6Cに示す鳥手羽軟骨の小角散乱画像を合成した合成画像(小角散乱画像÷吸収画像)を示す。
図9Aに、図7Aに示す手関節の吸収画像と図7Bに示す手関節の微分位相画像を合成した合成画像(微分位相画像+吸収画像)を示す。
図9Bに、図7Aに示す手関節の吸収画像と図7Cに示す手関節の小角散乱画像を合成した合成画像(小角散乱画像+吸収画像)を示す。
図9Cに、図7Aに示す手関節の吸収画像と図7Cに示す手関節の小角散乱画像を合成した合成画像(小角散乱画像-吸収画像)を示す。
なお、「小角散乱画像÷吸収画像」が示す意味は、物質でのX線散乱量を吸収量で規格したものであり、この値が高いと同じ吸収量でも細かい骨梁で構成され、低いとより大きな骨梁で構成されていることを示すので、同一患者で同じ箇所を定期的に撮影し、値の推移を確認することで、骨粗鬆症の進行度合いが診断可能である。さらに「小角散乱画像÷吸収画像」の値に基づく指標を定義し、検査結果を画像ではなく数値として記録することでデータ量の大幅な削減が可能となる。
図10Aに、乳房を被写体とした吸収画像を示す。図10Bに、乳房を被写体とした微分位相画像を示す。図10Cに、乳房を被写体とした小角散乱画像を示す。
また、吸収画像と小角散乱画像の合成画像では、腫瘤内部の構造や、吸収画像では見逃す可能性のある淡い微小石灰化の描写に優れており、医師に馴染みのある吸収画像に小角散乱画像を合成することで、小角散乱画像の診断に不慣れな医師にとっても違和感のない画像で腫瘤の内部構造の推定や微小石灰化の診断を行うことが可能となる。
図11Aに、図10Aに示す吸収画像と図10Bに示す微分位相画像を合成した合成画像(微分位相画像+吸収画像)を示す。図11Bに、図10Aに示す吸収画像と図10Cに示す小角散乱画像を合成した合成画像(小角散乱画像+吸収画像)を示す。
例えば、合成画像テーブルにおいて、診断対象情報に対し、合成画像の種類と併せて、合成される各再構成画像の寄与度を対応付けて記憶しておくこととし、この寄与度に基づいて合成画像を生成することとしてもよい。
まず、吸収画像と微分位相画像の合成画像と、吸収画像と小角散乱画像の合成画像と、が表示部23に同時に(並べて)、又は切替表示(交互に繰り返しパラパラ捲り表示)される(ステップT1)。
しかし、[表1]に示すように、1枚で腫瘤、スピキュラ、微小石灰化の全てを診断可能に描画できる再構成画像はない。また、2種類の再構成画像の合成画像においても、腫瘤、スピキュラ、微小石灰化の全てが網羅されてはいるが、[表1]の評価で「△」の項目があり、ただ1枚を観察しているだけでは熟練していない医師は見逃す可能性もある。また、3種類の再構成画像を合成することも考えられるが、3種類の再構成画像の合成は、複雑で高度な合成処理が無い限り、複数の情報が重なり、それ1枚の画像を表示しただけではかえってわかりにくくなる可能性がある。
これは、上記2つの合成画像を同時に、又は切替表示することで、医師は2つの合成画像を比較することができるので、何れか1つの合成画像のみを観察しているより異常陰影候補の存在に気づき易いためである。特に、2つの合成画像を切替表示した場合、前後に表示した画像に変化(例えば、一方に表示されているが、他方に表示されていない領域がある等)があれば、医師はすぐにその変化に気付くことができるので、異常陰影候補を迅速に、精度良く認識することが可能となる。即ち、早期診断を実現するとともに、診断精度の向上を図ることが可能となる。
また、微分位相画像、小角散乱画像を単独で表示するよりも、吸収画像と合成した方が、従来から確立された診断能との親和性が高く、医師が観察し易い。よって、本実施の形態のように、吸収画像をベースとした2つの合成画像を同時に又は切替表示する方が診断精度が高く、優れているといえる。
GUIは、ボタンのように離散的に寄与度を変化させるものであってもよいし、スライダーバーのようにより連続的に寄与度を変化させるものであってもよい。
なお、一方の再構成画像の寄与度を0とすれば、他方の再構成画像を個別に表示することができる。即ち、微分位相画像又は吸収画像を個別に表示することもできる。
なお、何れかの再構成画像の寄与度を0とすれば、他方の再構成画像を個別に表示することができる。即ち、小角散乱画像又は吸収画像を個別に表示することもできる。
まず、吸収画像と微分位相画像の合成画像が表示部23に表示される(ステップT11)。吸収画像と微分位相画像の合成画像を観察することによって、軟骨の異常の有無を確認し、注目領域を決定することができる。
なお、何れかの再構成画像の寄与度を0とすれば、他方の再構成画像を個別に表示することができる。即ち、微分位相画像又は吸収画像を個別に表示することもできる。
まず、吸収画像と小角散乱画像の合成画像が表示部23に表示される(ステップT31)。吸収画像と小角散乱画像の合成画像を観察することによって、微小骨折や骨折の有無を確認し、注目領域を決定することができる。
ステップT31で表示される表示画面上には、画像と併せて「微小骨折を詳しく診る」ことを指示するための操作ボタン、「終了」を指示するための操作ボタンが表示される。
スライドバーやボタンの操作により各画像の寄与度を変えることで、合成画像を診易く調整して診断を行うことができる。また、寄与度の変更に応じた合成画像の変化を観察することにより、医師は関心領域におけるX線吸収に対する散乱の強さを確認することができ、これにより、微小骨折の大きさ、向き、形等を推測するための判断材料とすることができる。なお、何れかの再構成画像の寄与度を0とすれば、他方の再構成画像の個別表示となる。即ち、小角散乱画像又は吸収画像を個別に表示することもできる。
合成画像のメリットとしては、例えば、(1)一枚の画像で多くの要素を診ることができ、単独の再構成画像の比較よりも効率が良い。(2)吸収画像と、微分位相画像又は小角散乱画像の何れかを合成した場合、従来の診断法との親和性が高い。(3)合成によるノイズ増加<関心対象を描画する信号増加の場合、対象の視認性が良くなる、という点が挙げられる。
合成画像のデメリットとしては、関心対象の信号の増加よりノイズの増加のほうが大きい場合、個別の再構成画像よりも診断能が低下することが挙げられる。このデメリットは、上述のように各再構成画像の濃度や信号の平坦度によって寄与度を変える等の工夫で軽減は可能である。また、上記図13~図15の処理においては、合成画像における各再構成画像の寄与度を調整することにより個別の再構成画像を表示可能としているので、合成のデメリットのない個別の再構成画像を表示することが可能である。その他の例として、合成画像を表示した後、合成画像の観察から得られた目的に応じた個別の再構成画像を表示するようにしてもよい。これにより、寄与度を調整する操作をすることなく、合成画像のデメリットのない個別の再構成画像を表示することができる。
まず、吸収画像と微分位相画像の合成画像と、吸収画像と小角散乱画像の合成画像と、が表示部23に同時に(並べて)、又は切替表示(交互に繰り返しパラパラ捲り表示)される(ステップT41)。
まず、吸収画像と微分位相画像の合成画像が表示部23に表示される(ステップT51)。吸収画像と微分位相画像の合成画像を観察することによって、軟骨の異常の有無を確認し、注目領域を決定することができる。
操作部22により「終了」が操作されるまでステップT54~ステップT59の処理が繰り返し実行される。操作部22により「終了」が操作されると(ステップT60;YES)、処理は図3のステップS7に移行する。
まず、吸収画像と小角散乱画像の合成画像が表示部23に表示される(ステップT71)。吸収画像と小角散乱画像の合成画像を観察することによって、微小骨折や骨折の有無を確認し、注目領域を決定することができる。
ステップT71で表示される表示画面上には、画像と併せて「微小骨折を詳しく診る」ことを指示するための操作ボタン、「骨部を詳しく診る」ことを指示するための操作ボタン、「終了」を指示するための操作ボタンが表示される。
一方、操作部22により操作された操作ボタンが「骨部を詳しく診る」であると判断されると(ステップT72;NO、ステップT74;YES)、表示部23に吸収画像が表示される(ステップT75)。
具体的に、診断対象部位が乳房である場合、吸収画像と微分位相画像の合成画像、吸収画像と小角散乱画像の合成画像を生成し、表示部23に同時に又は切替表示させることが好ましい。これにより、2つの合成画像を比較することができるので、その違いに注目することで、何れか1つの合成画像のみを観察しているより異常陰影候補の存在に気づき易くなる。特に、2つの合成画像を切替表示した場合、前後に表示した画像に変化があれば、医師はすぐにその変化に気付くことができるので、異常陰影候補を迅速に、精度良く認識することが可能となり、好ましい。
また、生成された2種類の再構成画像の合成画像と、3種類の再構成画像の合成画像と、を表示部23に同時に、又は切替表示させることとしてもよい。
以下、本発明に係る第2の実施形態について説明する。
上述のように、吸収画像は、骨などの構造を感度良く描出する。また、微分位相画像は、骨はもちろんのこと、吸収画像では描出が困難な軟骨などの軟部組織を描出することができる。しかし、微分位相画像において、軟骨などの軟部組織と骨が重なって描出されている場合には、骨のほうが軟部組織より信号が大きいため、従来、軟部組織の信号を視認することは困難であった。
のように、吸収画像IAbsは、X線照射方向(図1Bのz方向)の物理量の積分で表すことができ、微分位相画像dIDPは、X線照射方向の物理量の積分の、格子構造に垂直方向(図1Bのx方向)への微分に比例する形で表すことができる。ここで、IAbs_RAWは、タルボ干渉計又はタルボ・ロー干渉計を用いて再構成される吸収画像のX線強度(対数をとっていないもの)を表す。また、μは被写体によるX線吸収係数、1-δは被写体によるX線屈折率を表す。μとδの関係は被写体により異なるため、吸収画像IAbsを微分したとしても微分位相画像dIDPにはならないし、微分位相画像dIDPを積分したとしても吸収画像IAbsにはならない。吸収画像IAbsあるいはその微分画像には骨は描出されているが軟骨などの軟部組織は描出されていないのに対して、微分位相画像dIDPあるいはその積分画像では骨も軟部組織も描出することが出来るのがその例である。ただし、吸収画像IAbsと微分位相画像dIDPの両画像中に同じ構造が描出されているのであれば、その共通する構造部分の信号強度を合わせて減算することにより、共通する構造以外の構造のみの画像を生成することができる。即ち、微分位相画像dIDPにおいて骨と軟部組織が重なっている場合であっても、吸収画像IAbsと微分位相画像dIDPを用いて軟部組織を視認しやすい画像を得ることが可能である。
第2の実施形態においては、診断対象部位が骨・関節系(リウマチ)の場合に、吸収画像と微分位相画像の合成画像として、上述の軟部組織微分画像を生成して表示する場合について説明する。
その他の医用画像システム及び医用画像システムを構成する各装置の構成は、第1の実施形態で説明した医用画像システム100及びこれを構成する各装置と同様であるので説明を援用し、第2の実施形態における医用画像システム100の動作について以下に説明する。
軟部組織微分画像生成処理においては、まず、ステップS4で生成された吸収画像と微分位相画像が取得される(ステップS501)。
微分吸収画像は、吸収画像を微分することにより生成することができる。本実施形態においては、例えば、吸収画像において、[数3]に示すように、格子構造と垂直方向(図1Bのx方向)の両隣の画素の差分をとって微分吸収画像を生成する手法を用いることが好ましい。
または、吸収画像で単純に隣の画素との間で差分をとる、または、吸収画像に画像処理のエッジ検出に用いられるSobelフィルターのような微分フィルターをかけることとしてもよい。または、あらかじめ、円柱、球のような単純な被写体で微分吸収画像の信号形状が微分位相画像の信号形状と最も相関をもつ微分フィルターを設計し、そのフィルターを保持しておいて、吸収画像に適用するとしてもよい。なお、ここでは吸収画像を用いることとしたが、[数1]のIAbs_RAWに対応する対数をとらない吸収画像を用いることとしてもよい。
このように、軟部組織微分画像生成処理を実行することにより、軟部組織が骨に重なって撮影された場合であっても、軟部組織を視認可能な軟部組織微分画像が得られる。
吸収画像の画素値>閾値 (1)
を満たす領域を骨領域として特定することができる。
ただし、吸収画像は[数1]で定義している(被写体による吸収が大きいところほど画素値が大きいと定義している)ため、骨以外の領域の画素値の上限となる閾値を設けているが、被写体による吸収が小さいほど画素値が大きいという定義とした場合には、骨以外の領域の画素値の下限となる閾値を記憶部25に記憶しておき、下限の閾値を越えた(下限の閾値より画素値が小さい)領域を骨領域として特定する。
微分吸収画像の画素値の絶対値>閾値 (2)
を満たす領域を骨領域として特定することができる。
上述のように、軟部組織微分画像は、骨と軟骨等の軟部組織の双方の信号が描出されている微分位相画像から骨の信号が減弱又は除去された画像であるので、軟部組織微分画像を表示することで、骨と軟部組織が重なって撮影された場合であっても、医師が軟部組織の信号を視認することが可能となる。
このようにすれば、操作部22の操作によって、例えば、吸収画像から軟部組織微分画像へと段階的に両画像の割合を変化させることが可能となるので、軟部組織微分画像に見られる構造(軟部組織)が吸収画像のどこに対応しているかを医師が容易に認識することが可能となる。或いは、ステップT15において、切り替え表示を指示するボタンを併せて表示し、切り替え表示が指示された場合、吸収画像と軟部組織微分画像を交互に切り替えて表示部23に表示することとしてもよい。これにより、見慣れた吸収画像と軟部組織微分画像で描出された信号との対比が可能となり、軟部組織微分画像に見られる構造(軟部組織)が吸収画像のどこに対応しているかを医師が容易に認識することが可能となるので、軟部組織の診断が容易となる。
以下、本発明に係る第3の実施形態について説明する。
第3の実施形態においては、診断対象部位が骨・関節系(リウマチ)の場合に、吸収画像と微分位相画像の合成画像として、上述の軟部組織画像を生成して表示する場合について説明する。
その他の医用画像システム及び医用画像システムを構成する各装置の構成は、第1の実施形態で説明した医用画像システム100及びこれを構成する各装置と同様であるので説明を援用し、第3の実施形態における医用画像システム100の動作について以下に説明する。
次いで、微分位相画像から位相画像が生成される(ステップS602)。
位相画像は、微分位相画像を積分することにより生成することができる。しかし、単純に微分方向に端の画素から加算していったのではノイズが蓄積され、線状のアーチファクトが発生してしまう。そこで、例えば、以下の公知文献7に記載されているように、微分位相画像の微分方向をx方向とおいた場合、位相画像のx方向の隣り合う画素で差分をとった画像と微分位相画像との差(対応する画素値同士の差)の2乗の画像面内の和がノイズで規定される値よりも小さい、との条件のもと、位相画像のy方向に隣り合う画素で差分をとった画素値の絶対値の画像面内の和(位相画像のy方向微分のノルムの画像面内の和)を最小化する最適化手法を用いることにより、上記の線状アーチファクトを抑制した位相画像を得ることもできる(公知文献7:”Non-linear regularized phase retrieval for unidirectional X-ray differential phase contrast radiography”, Thuring et al .OPTICS EXPRESS,Vol.19, No.25, 25545-25558, 2011 )。
このように、軟部組織画像生成処理を実行することにより、骨と軟部組織が重なって撮影された場合であっても、軟部組織を視認可能な軟部組織画像が得られる。
上述のように、軟部組織画像は、骨と軟骨等の軟部組織の双方の信号が描出されている位相画像から骨の信号が減弱又は除去された画像であるので、軟部組織画像を表示することで、骨と軟部組織が重なって撮影された場合であっても、医師が軟部組織の信号を視認することが可能となる。
このようにすれば、操作部22の操作によって、例えば、吸収画像から軟部組織画像へと段階的に両画像の割合を変化させることが可能となるので、軟部組織画像に見られる構造(軟部組織)が吸収画像のどこに対応しているかを医師が容易に認識することが可能となる。或いは、ステップT15において、切り替え表示を指示するボタンを併せて表示し、切り替え表示が指示された場合、吸収画像と軟部組織画像を交互に切り替えて表示部23に表示することとしてもよい。これにより、見慣れた吸収画像と軟部組織画像で描出された信号との対比が可能となるので、軟部組織画像に見られる構造(軟部組織)が吸収画像のどこに対応しているかを医師が容易に認識することが可能となり、軟部組織の診断が容易となる。
例えば、上記実施の形態においては、具体例として、診断対象を乳房、骨・関節系(リウマチ、微小骨折)とした場合について説明したが、これに限定されず、他の部位や症例にも適用することができる。
2 コントローラー
21 制御部
22 操作部
23 表示部
24 通信部
25 記憶部
3 オーダー入力装置
Claims (13)
- タルボ方式撮影装置、タルボ・ロー方式撮影装置のうち何れかを用いて被写体の診断対象部位のX線撮影を行い、前記被写体の診断対象部位に係る吸収画像、微分位相画像及び小角散乱画像の3種類の再構成画像を生成する医用画像システムであって、
前記診断対象部位、又は、前記診断対象部位及びその部位において診断すべき疾患を特定するための診断対象情報を入力する入力手段と、
前記入力手段により入力された診断対象情報に基づいて、前記3種類の再構成画像のうち2種類の再構成画像を合成して合成画像を生成し、生成した合成画像を表示手段に表示させる制御手段と、
を備える医用画像システム。 - 前記2種類の再構成画像のうちの1つが吸収画像である請求項1に記載の医用画像システム。
- 前記制御手段は、前記2種類の再構成画像のうちの少なくとも1つを加工した後に合成画像を生成する請求項1又は2に記載の医用画像システム。
- 前記制御手段は、前記吸収画像を加工して微分吸収画像を生成し、生成した前記微分吸収画像に対して前記微分位相画像と前記微分吸収画像に共通して描出されている構造の信号強度を前記微分位相画像に合わせるための係数を乗算して前記微分位相画像から減算するか、又は、前記微分位相画像を加工して位相画像を生成し、前記吸収画像に対して前記位相画像と前記吸収画像に共通して描出されている構造の信号強度を前記位相画像に合わせるための係数を乗算して前記位相画像から減算することにより、前記微分位相画像と前記吸収画像に共通して描出されている構造の信号を除去又は減弱した合成画像を生成する請求項3に記載の医用画像システム。
- 前記制御手段は、複数種類の合成画像を生成し、生成した複数種類の合成画像を前記表示手段に同時に、又は切替表示させる請求項1又は2に記載の医用画像システム。
- 前記制御手段は、前記生成された合成画像と、前記3種類の再構成画像のうちの少なくとも一つと、を前記表示手段に同時に、又は切替表示させる請求項1又は2に記載の医用画像システム。
- 前記制御手段は、更に、前記3種類の再構成画像を合成し、前記生成された2種類の再構成画像の合成画像と、前記3種類の再構成画像の合成画像と、を前記表示手段に同時に、又は切替表示させる請求項1又は2に記載の医用画像システム。
- 前記診断対象部位が乳房である請求項5~7の何れか1項に記載の医用画像システム。
- タルボ干渉計又はタルボ・ロー干渉計を用いたX線撮影装置により得られた被写体の画像信号に基づいて、微分位相画像、吸収画像、小角散乱画像の3つの再構成画像のうち、少なくとも微分位相画像及び吸収画像を生成する再構成画像生成手段と、
前記吸収画像を加工して微分吸収画像を生成し、生成した前記微分吸収画像に対して前記微分位相画像と前記微分吸収画像に共通して描出されている構造の信号強度を前記微分位相画像に合わせるための係数を乗算して前記微分位相画像から減算するか、又は、前記微分位相画像を加工して位相画像を生成し、前記吸収画像に対して前記位相画像と前記吸収画像に共通して描出されている構造の信号強度を前記位相画像に合わせるための係数を乗算して前記位相画像から減算することにより、前記微分位相画像と前記吸収画像に共通して描出されている構造の信号を除去又は減弱した合成画像を生成する合成手段と、
を備える医用画像処理装置。 - 前記合成手段は、前記減算に用いる2つの画像における前記共通して描出されている構造の信号の比を算出し、この算出した比を前記係数として用いる請求項9に記載の医用画像処理装置。
- 吸収画像、微分吸収画像、位相画像、微分位相画像、小角散乱画像の少なくとも一つの画像に対応する閾値を記憶する記憶手段を備え、
前記合成手段は、前記再構成画像生成手段により生成された前記閾値に対応する画像の各画素値又はその絶対値を前記閾値と比較し、前記閾値を越えない画素値の領域に対しては前記係数を小さくして前記合成画像を生成する請求項9又は10に記載の医用画像処理装置。 - 前記合成画像を表示する表示手段と、
前記係数及び/又は前記閾値を変更するための操作手段と、
を備え、
前記合成手段は、前記操作手段の操作に応じて前記係数及び/又は前記閾値を変更して合成画像を生成し、
前記表示手段は、前記係数及び/又は前記閾値を変更して生成された合成画像を表示する請求項11に記載の医用画像処理装置。 - 前記微分位相画像に対して前記X線撮影装置における撮影条件に起因するアーチファクトの補正を行う補正手段を備え、
前記合成手段は、前記補正手段により補正された微分位相画像を用いて前記合成画像を生成する請求項9~12の何れか一項に記載の医用画像処理装置。
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