WO2018212231A1

WO2018212231A1 - Image processing device, image processing system, and image processing method

Info

Publication number: WO2018212231A1
Application number: PCT/JP2018/018902
Authority: WO
Inventors: 康之本間
Original assignee: テルモ株式会社
Priority date: 2017-05-16
Filing date: 2018-05-16
Publication date: 2018-11-22
Also published as: JPWO2018212231A1

Abstract

This image processing device comprises: a storage unit that stores a three-dimensional image of the heart, the image including a heart abnormality site; and a control unit that estimates a permeation region to which an administered substance will permeate when the administered substance is injected into a given injection point in the abnormality site.

Description

Image processing apparatus, image processing system, and image processing method

The present disclosure relates to an image processing apparatus, an image processing system, and an image processing method.

Currently, in the treatment of heart failure and the like, treatments that are expected to have a therapeutic effect by injecting biological materials such as cells or administration materials such as biomaterials into tissues are being studied. In such procedures, instruments such as catheters are used for tissue injection. In cell therapy using such a catheter or the like, the position of the infarct is specified by performing 3D mapping or the like on a living tissue such as a heart ventricle before the injection procedure. Thereafter, injecting cells or the like as the administration target toward a desired location according to the treatment such as the boundary between the infarct and the normal myocardial tissue is performed. For example, Patent Document 1 describes that a diagnosis is made by estimating a portion of the heart wall motion decreased from an ultrasonic image or the like as an abnormal portion.

JP 2009-106530 A

However, with the conventional technology, it was not possible to simulate treatment before treatment.

In view of the above problems, an object of the present disclosure is to provide an image processing apparatus, an image processing system, and an image processing method capable of performing treatment simulation before performing treatment.

The image processing apparatus according to the first aspect of the present invention includes a storage unit that stores a three-dimensional image of the heart including an abnormal part of the heart, and a subject to be injected at an arbitrary injection point of the abnormal part. And a control unit that estimates a permeation region through which the administration target permeates.

In the image processing apparatus as one embodiment of the present invention, the storage unit stores physical property information of the administration target, and the control unit estimates the penetration region based on the physical property information of the administration target. .

In the image processing apparatus as one embodiment of the present invention, the storage unit stores a dose of the administration target, and the control unit estimates the penetration region based on the administration dose of the administration target. .

In the image processing apparatus as one embodiment of the present invention, the control unit estimates the wall thickness of the heart based on the three-dimensional image, and estimates the penetration region based on the wall thickness.

In the image processing apparatus as an embodiment of the present invention, the control unit estimates the position of a blood vessel in the heart based on the three-dimensional image, and based on the position of the injection point with respect to the position of the blood vessel, Estimate the penetration area.

In the image processing apparatus as an embodiment of the present invention, the storage unit stores a plurality of the three-dimensional images captured at predetermined time intervals, and the control unit is configured to change the plurality of three-dimensional images over time. Based on this, the penetration area is estimated.

In the image processing apparatus according to an embodiment of the present invention, the storage unit stores shape information of an injection member that injects the administration target, and the control unit performs the penetration based on the shape information of the injection member. Estimate the region.

An image processing system according to a second aspect of the present invention includes a first imaging device that captures a first tomographic image of the heart from outside the body, a second imaging device that captures a second tomographic image of the heart from outside the body, and image processing. An image input device that receives input of the first tomographic image and the second tomographic image, and an abnormality of the heart based on the first tomographic image and the second tomographic image. A control unit that generates a three-dimensional image of the heart including a site and estimates a permeation region through which the administration material penetrates when the administration material is injected at an arbitrary injection point of the abnormal site.

An image processing method according to a third aspect of the present invention is an image processing method executed using an image processing apparatus, and stores a three-dimensional image of the heart including an abnormal part of the heart. And an infiltration region estimation step of estimating an infiltration region into which the administration object penetrates when the administration object is injected into an arbitrary injection point of the abnormal site.

An image processing apparatus according to a fourth aspect of the present invention includes a storage unit that stores a three-dimensional image of the heart including an abnormal part of the heart, a display unit that can display the three-dimensional image, and a three-dimensional image. A control unit that determines positions of a plurality of target injection points for injecting the administration target into the abnormal site based on the three-dimensional image and displays the target injection points on the display unit. .

In the image processing apparatus as an embodiment of the present invention, the control unit determines the order of the plurality of target injection points, and causes the display unit to display the plurality of target injection points in a manner based on the order.

In the image processing apparatus as one embodiment of the present invention, the control unit estimates a moving path along which the distal end portion of the injection member for injecting the administration object moves via the plurality of target injection points, The order is determined based on the movement route.

In the image processing apparatus as an embodiment of the present invention, the control unit estimates an infiltration region into which the administration object penetrates when the administration object is injected into a predetermined injection point of the abnormal site, Based on the permeation region, the positions of the plurality of target injection points are determined.

An image processing system according to a fifth aspect of the present invention includes a first imaging device that captures a first tomographic image of the heart from outside the body, a second imaging device that captures a second tomographic image of the heart from outside the body, and image processing. The image processing device based on the image input unit that receives input of the first tomographic image and the second tomographic image, a display unit, the first tomographic image, and the second tomographic image. Generating a three-dimensional image of the heart including an abnormal part of the heart, determining positions of a plurality of target injection points for injecting a substance to be administered into the abnormal part based on the three-dimensional image, and the plurality of target injections A control unit that causes the display unit to display a point superimposed on the three-dimensional image.

An image processing method according to a sixth aspect of the present invention is an image processing method executed using an image processing apparatus, and stores a three-dimensional image of the heart including an abnormal part of the heart. A three-dimensional image display step for displaying the three-dimensional image; a target injection point determination step for determining the positions of a plurality of target injection points for injecting the administration target into the abnormal site based on the three-dimensional image; And a target injection point display step of displaying the plurality of target injection points in a superimposed manner on the three-dimensional image.

According to the image processing device, the image processing system, and the image processing method of the present disclosure, it is possible to perform treatment simulation before performing treatment.

1 is a block diagram illustrating a schematic configuration of an image processing system including an image processing apparatus as an embodiment of the present invention. 3 is a flowchart illustrating an overview of image processing performed by the image processing apparatus illustrated in FIG. 1. It is a flowchart which shows the detail of the target part specific process which the image processing apparatus shown in FIG. 1 performs. It is a figure explaining the image process accompanying the target part specific process which the image processing apparatus shown in FIG. 1 performs. It is a schematic diagram which shows an example of the osmosis | permeation area | region estimated by the osmosis | permeation area estimation process which the image processing apparatus shown in FIG. 1 performs. It is a flowchart which shows the detail of the target injection | pouring point determination process which the image processing apparatus shown in FIG. 1 performs. It is a schematic diagram which shows an example of the target injection | pouring point determined by the target injection | pouring point determination process which the image processing apparatus shown in FIG. 1 performs. It is a figure which shows the mode of the treatment by an injection | pouring member.

Hereinafter, an embodiment of the present invention will be described with reference to the drawings. In each figure, the same code | symbol is attached | subjected to the common structure part.

[Image processing system 1]
FIG. 1 is a block diagram showing a schematic configuration of an image processing system 1 including an image processing apparatus 10 as an embodiment of the present invention. As illustrated in FIG. 1, the image processing system 1 includes an image processing device 10, an ultrasonic image generation device 20 as a first imaging device, a radiation image generation device 30 as a second imaging device, and a heartbeat acquisition device 40. With.

The ultrasound image generation device 20 as the first imaging device is located outside the body of the subject and captures an ultrasound image as a first tomographic image of the heart from outside the subject. The ultrasonic image generation device 20 generates an ultrasonic transmission unit 21 that transmits ultrasonic waves, an ultrasonic reception unit 22 that receives ultrasonic waves, and a first tomographic image based on the ultrasonic waves received by the ultrasonic reception unit 22. And an image forming unit 23 to be formed. The ultrasonic image generation apparatus 20 transmits ultrasonic waves from the ultrasonic transmission unit 21 toward the subject's heart in a state where the ultrasonic transmission unit 21 and the ultrasonic reception unit 22 are in contact with the body surface of the subject. The ultrasonic wave reception unit 22 receives the ultrasonic wave reflected from the heart of the subject. The ultrasonic image generating apparatus 20 obtains a tomographic image along the ultrasonic traveling surface as a first tomographic image by processing the ultrasonic wave received by the ultrasonic wave receiving unit 22 by the image forming unit 23. The ultrasonic image generation apparatus 20 outputs the captured first tomographic image to the image input unit 11 of the image processing apparatus 10.

The ultrasonic image generation apparatus 20 changes the position or orientation of the ultrasonic transmission unit 21 and the ultrasonic reception unit 22 and changes the position or orientation of the ultrasonic image generation unit 21 and the ultrasonic reception unit 22 into a first tomographic image based on a plurality of tomographic images captured along different planes. May be generated as That is, the first tomographic image may be a tomographic image captured along one plane, or may be a three-dimensional image generated based on a plurality of tomographic images captured along a plurality of planes.

The radiation image generating device 30 as a second imaging device is located outside the body of the subject and captures a radiation image as a second tomographic image of the heart from outside the subject. The radiation image generation apparatus 30 is, for example, a computed tomography (CT) apparatus. The radiation image generating apparatus 30 includes a radiation emitting unit 31 that emits radiation, a radiation detecting unit 32 that detects radiation, and an image forming unit 33 that forms a second tomographic image based on the radiation detected by the radiation detecting unit 32. . The radiation image generating apparatus 30 includes a radiation emitting unit 31 and a radiation detecting unit 32 at positions facing each other around the subject, and while rotating the radiation emitting unit 31 and the radiation detecting unit 32 around the subject, Radiation such as X-rays is emitted from the radiation emitting unit 31 toward the subject's heart, and the radiation that has passed through the subject's heart is detected by the radiation detection unit 32. The radiological image generation apparatus 30 obtains a radiological image that is a three-dimensional image of the heart as a second tomographic image by processing the radiation detected by the radiation detection unit 32 using the image forming unit 33. The radiation image generation apparatus 30 outputs the captured second tomographic image to the image input unit 11 of the image processing apparatus 10.

The second imaging device may be a magnetic resonance image generation (MRI) device instead of the radiation image generation device 30. The magnetic resonance image generation apparatus is located outside the subject's body and captures a magnetic resonance image as a second tomographic image of the heart from outside the subject's body. The magnetic resonance image generating apparatus includes a magnetic field generating unit that generates a magnetic field, a signal receiving unit that receives a nuclear magnetic resonance signal, and a magnetic resonance image that is a three-dimensional image based on the nuclear magnetic resonance signal received by the signal receiving unit. An image forming unit formed as a second tomographic image.

A contrast agent is administered to the subject's heart a predetermined time before the second tomographic image is captured by the radiation image generation device 30 or the magnetic resonance image generation device as the second imaging device. Accordingly, the second tomographic image captured by the second imaging device includes a delayed contrast image.

The second imaging apparatus is a nuclear medicine inspection apparatus that performs scintigraphy inspection, SPECT (Single Photon Emission Computed Tomography) inspection, PET (Positoron Emission Tomography) inspection, and the like, instead of the radiation image generation apparatus 30 or the magnetic resonance image generation apparatus. There may be. The nuclear medicine inspection apparatus is located outside the body of the subject, and acquires a radioisotope (RI: radioisotope) distribution image as a second tomographic image of the heart from outside the subject. The nuclear medicine examination apparatus obtains the second tomographic image by imaging the distribution of the drug labeled with the radioisotope previously administered to the subject.

The heartbeat acquisition device 40 acquires heart beat information of the subject. The heart beat information includes time change information of the heart beat. The heartbeat acquisition device 40 may acquire the first tomographic image or the second tomographic image at the same time as the image and associate it with the image. The heartbeat acquisition device 40 is, for example, an electrocardiogram monitor that measures temporal changes in cardiac action potential via electrodes attached to the subject's chest or limbs and continuously displays an electrocardiogram waveform.

The image processing apparatus 10 is located outside the body of the subject and is configured by an information processing apparatus such as a computer. The image processing apparatus 10 includes an image input unit 11, a heartbeat input unit 12, an operation input unit 13, a display unit 14, a storage unit 15, and a control unit 16.

The image input unit 11 receives an input of the first image from the ultrasonic image generation device 20 as the first imaging device. The image input unit 11 receives an input of the second image from the radiation image generation device 30 as the second imaging device. The image input unit 11 includes an interface that receives information from the ultrasonic image generation device 20 and the radiation image generation device 30 by, for example, wired communication or wireless communication. The image input unit 11 outputs information on the input image to the control unit 16.

The heartbeat input unit 12 receives input of heart beat information from the heartbeat acquisition device 40. The heartbeat input unit 12 includes an interface that receives information from the heartbeat acquisition device 40 by, for example, wired communication or wireless communication. The heartbeat input unit 12 outputs the input heart beat information to the control unit 16.

The operation input unit 13 includes, for example, a keyboard, a mouse, or a touch panel. When the operation input unit 13 includes a touch panel, the touch panel may be provided integrally with the display unit 14. The operation input unit 13 outputs the input information to the control unit 16.

The display unit 14 displays a first tomographic image, a second tomographic image, and an image generated by the control unit 16 based on these based on a signal from the control unit 16. The display unit 14 includes a display device such as a liquid crystal display or an organic EL display.

The storage unit 15 stores various information and programs for causing the control unit 16 to execute a specific function. The storage unit 15 stores, for example, a three-dimensional image of the heart. The three-dimensional image of the heart is the first tomographic image, the second tomographic image, or display information generated by the control unit 16 based on these in a target part specifying process described later. The three-dimensional image of the heart includes an abnormal portion R ′ (see FIGS. 5 and 7) of the heart. The abnormal part R ′ of the heart is, for example, a target part R (see FIG. 4C) specified by the control unit 16 in a target part specifying process described later. For example, the storage unit 15 stores a plurality of three-dimensional images based on a plurality of tomographic images captured at different times. The storage unit 15 stores, for example, the dose and physical property information of the administration target to be injected into the abnormal site R ′ by treatment using an injection member described later. The storage unit 15 stores, for example, shape information of the injection member. The storage unit 15 includes a storage device such as a RAM or a ROM.

The control unit 16 controls the operation of each component that constitutes the image processing apparatus 10. The control unit 16 executes a specific function by reading a specific program. Specifically, the control unit 16 generates display information based on the first tomographic image and the second tomographic image. The control unit 16 causes the display unit 14 to display the generated display information. The control unit 16 may output the generated display information to an external display device. The control unit 16 includes a processor, for example.

When the second tomographic image is captured by the radiation image generating device 30 or the magnetic resonance image generating device, the control unit 16 may generate display information by correcting the first tomographic image based on the second tomographic image. Good. For example, the control unit 16 detects a feature point in the first tomographic image and a feature point in the second tomographic image by pattern recognition or the like, and selects a feature point corresponding to a region including the feature point in the first tomographic image. By replacing the region in the second tomographic image including the display information, the display information obtained by correcting the first tomographic image based on the second tomographic image can be generated. As a result, the first tomographic image can be corrected with a higher-definition second tomographic image, so that the structure and shape information of the heart can be shown more accurately.

[Image processing overview]
FIG. 2 is a flowchart showing an outline of image processing performed by the image processing apparatus 10. As shown in FIG. 2, the image processing apparatus 10 first performs a target part specifying process (step S10). Next, the image processing apparatus 10 performs penetration region estimation processing (step S20). Finally, the image processing apparatus 10 performs target injection point determination processing (step S30).

[Target site identification process]
FIG. 3 is a flowchart showing details of the target part specifying process performed by the image processing apparatus 10. FIG. 4 is a diagram for explaining image processing accompanying the target region specifying process performed by the image processing apparatus 10, and is a diagram showing a cross section of the left ventricle LV of the heart. As shown in FIG. 4A, the control unit 16 of the image processing apparatus 10 reads the first tomographic image input via the image input unit 11, and based on the first tomographic image, the low-motion site P of the heart. Is estimated (step S11: low motion site estimation step). Specifically, the image input unit 11 receives an input of a plurality of first tomographic images captured every predetermined time. And the control part 16 estimates the low exercise | movement site | part P based on the time change of several 1st tomographic image. More specifically, the control unit 16 first extracts a plurality of points whose luminance is a predetermined value or more in the first tomographic image as feature points. The control unit 16 extracts a plurality of feature points from a plurality of first tomographic images captured at different times including the diastole in which the myocardium is most dilated and the systole in which the myocardium is most deflated. The control unit 16 calculates a change rate obtained by measuring the distance between an arbitrary feature point and another adjacent feature point in the first tomographic image in the diastole and the first tomographic image in the systole. The change rate is reflected in the three-dimensional image of the heart. For example, the control unit 16 reflects in the three-dimensional image of the heart so that the region where the change rate is equal to or less than a predetermined threshold and the region where the change rate exceeds the predetermined threshold have different modes (for example, different colors). . The control unit 16 estimates that the part of the heart corresponding to the region where the rate of change is equal to or less than a predetermined threshold is the low motion part P. The predetermined threshold value of the change rate is, for example, 12%, but may be changed as appropriate depending on the setting.

As shown in FIG. 4B, the control unit 16 reads out the second tomographic image input via the image input unit 11, and estimates the infarct region Q of the heart based on the second tomographic image (step S12). : Infarct site estimation step). The infarct site Q is a site where the myocardium is ischemic and necrotic. The infarct region Q is included in the low-motion region P because the change rate described above is equal to or less than a predetermined threshold value. Specifically, when the second tomographic image includes a delayed contrast image, the control unit 16 estimates the infarct region Q based on the delayed contrast image of the second tomographic image. Specifically, the control unit 16 estimates that the part where the delayed contrast image is reflected is the infarcted part Q. When the second tomographic image is a radioisotope distribution image, the control unit 16 estimates the infarct site Q based on the radioisotope distribution. Specifically, the control unit 16 estimates that an accumulation defect site where radioisotopes are not accumulated is the infarct site Q. The control unit 16 may execute the infarct site estimation step (step S12) before the above-described low motion site estimation step (step S11).

As shown in FIG.4 (c), the control part 16 is other than the infarct site Q estimated by the infarct site estimation process (step S12) among the low exercise sites P estimated by the low exercise site estimation process (step S11). The part is specified as the target part R (step S13: target part specifying step). The target site R is a site where the above change rate is equal to or less than a predetermined threshold but is not necrotic, and is a hibernating myocardium or a stunned myocardium. The control unit 16 generates display information in which the identified target region R is superimposed on the first tomographic image or the second tomographic image. The target region R includes the hibernating myocardium and the stunned myocardium, but exists independently of each other. The hibernating myocardium is a chronic ischemic state and the stunned myocardium is an acute ischemic state. Stunned myocardium is caused by overload due to resumption of blood flow. Therefore, the region of stunned myocardium can be specified by causing an overload condition and eliminating it. Thereby, stunned myocardium and hibernating myocardium can be selected.

Since the heart repeatedly contracts and dilates as the heart beats, the heart stretches and contracts in the first tomographic image used in the low motion region estimation step (step S11) and the infarct region estimation step (step S12). The stretched state of the heart in the two tomographic images is preferably the same or close. Therefore, the control unit 16 selects a first tomographic image corresponding to the expansion / contraction state of the heart in the second tomographic image from the plurality of first tomographic images, and specifies the target region R using the selected first tomographic image. To do. The expansion / contraction state of the heart in the first tomographic image may be estimated based on position information of the feature point by detecting a feature point from the first tomographic image by pattern recognition or the like. Similarly, the expansion / contraction state of the heart in the second tomographic image may be estimated based on position information of the feature point by detecting a feature point from the second tomographic image by pattern recognition or the like. The feature points include, for example, the apex AP or the aortic valve AV. The expansion / contraction state of the heart in the first tomographic image and the second tomographic image may be determined based on heart beat information input via the heartbeat input unit 12. Specifically, the first tomographic image and the second tomographic image are associated with pulsation information of the heart at the time of imaging, and the stretched state of the heart in the first tomographic image and the second tomographic image is Each is determined by the associated beat information.

As described above, since the image processing apparatus 10 can specify the hibernating myocardium or stunned myocardium having a relatively high therapeutic effect as the target region R, it can contribute to the improvement of the therapeutic effect.

[Penetration area estimation processing]
FIG. 5 is a schematic diagram showing an example of the penetration region S estimated by the penetration region estimation process performed by the image processing apparatus 10. FIG. 5 is a view showing a cross section of the heart wall of the left ventricle LV of the heart, and shows the range of the permeation region S located in the abnormal region R ′. When it is assumed that the administration target is injected at an arbitrary injection point T of the abnormal site R ′ included in the three-dimensional image of the heart stored in the storage unit 15, the control unit 16 penetrates the administration target. The permeation region S to be estimated is estimated (permeation region estimation step). The control unit 16 generates display information in which the estimated penetration region S is superimposed on the three-dimensional image. The abnormal part R ′ of the heart is, for example, the target part R specified by the above-described target part specifying process. The administration target is a biological substance such as a cell or a substance such as a biomaterial. The permeation region S is a region after a predetermined time has elapsed within a time when the effect of the administered product is obtained after the administered product is injected.

For example, the control unit 16 estimates the position of the blood vessel BV in the heart based on the three-dimensional image, and estimates the penetration region S based on the position of the injection point T with respect to the position of the blood vessel BV. It is considered that the administration substance injected into the abnormal site R ′ is likely to penetrate in the direction of the blood vessel BV near the blood vessel BV due to the influence of blood flow. Therefore, as illustrated in FIG. 5, the control unit 16 estimates that the infiltration region S extends in the direction of the blood vessel BV as the injection point T is closer to the blood vessel BV. For example, the control unit 16 estimates the position of the infarct site Q based on the three-dimensional image, and estimates the penetration region S based on the position of the injection point T with respect to the position of the infarct site Q. It is considered that the administration substance injected into the abnormal site R ′ is less likely to penetrate in the direction of the infarct site Q because the heart activity such as blood flow or pulsation is reduced near the infarct site Q. Therefore, as shown in FIG. 5, the control unit 16 estimates that the infiltration region S is prevented from extending in the direction of the infarct site Q as the injection point T is closer to the infarct site Q.

The control unit 16 may estimate the permeation region S based on the administration dose and physical property information stored in the storage unit 15. Specifically, the control unit 16 estimates that the permeation region S increases as the dose of the administration target increases. The control unit 16 may estimate the wall thickness for each part of the heart based on the three-dimensional image, and may estimate the penetration region S based on the wall thickness. Specifically, the control unit 16 estimates that the penetration region S becomes wider along the heart wall as the wall thickness near the injection point T is thinner. The control unit 16 may estimate the permeation region S based on temporal changes of a plurality of three-dimensional images stored in the storage unit 15. Specifically, the control unit 16 detects temporal changes in the positions of feature points in a plurality of three-dimensional images, and based on the temporal changes in the positions of the feature points, motions due to pulsations and the like for each part of the heart wall are detected. presume. And it estimates that the penetration | infiltration area | region S becomes large, so that a site | part with large motion. The control unit 16 may estimate the infiltration region S based on the shape information of the injection member stored in the storage unit 15. The injection member is composed of, for example, a needle-like member, and a side hole for discharging the administration target is formed around the injection member. The shape information of the injection member includes, for example, the outer shape (linear shape, curved shape, spiral shape, etc.), diameter size, side hole position, side hole size, etc. of the injection member.

As described above, the image processing apparatus 10 can estimate in advance the permeation region S into which the administration target injected at an arbitrary injection point T of the abnormal region R ′ permeates. Can be simulated.

[Target injection point determination process]
FIG. 6 is a flowchart showing details of target injection point determination processing performed by the image processing apparatus 10. FIG. 7 is a schematic diagram illustrating an example of the target injection point U determined by the target injection point determination process performed by the image processing apparatus 10. FIG. 7 is a cross-sectional view of the left ventricle LV of the heart as viewed from the aortic valve AV (see FIG. 4) to the apex AP (see FIG. 4). The control unit 16 reads out the three-dimensional image stored in the storage unit 15 and displays it on the display unit 14 (step S31: three-dimensional image display step). Based on the three-dimensional image, the control unit 16 determines the positions of a plurality of target injection points U where the administration target should be injected into the abnormal site R ′ (step S32: target injection point determination step). The control unit 16 causes the display unit 14 to display the determined plurality of target injection points U superimposed on the three-dimensional image (step S33: target injection point display step). The position of the target injection point U includes information on the depth along the wall thickness direction from the inner surface of the heart wall. In other words, the target injection point U indicates at what position from the inner surface of the heart wall and how deep the administration target should be injected. The position of the target injection point U is determined based on, for example, the penetration region S estimated by the above-described penetration region estimation process. Specifically, the control unit 16 estimates the permeation areas S for a plurality of injection points T, and based on the estimated plurality of permeation areas S, determines the injection point T where the administration target should be injected as the target injection point. U is determined. For example, the control unit 16 specifies the injection point T corresponding to the permeation region S included in the other plurality of permeation regions S. Then, the injection point T other than the specified injection point T is determined as the target injection point U. Accordingly, by injecting the administration target into the target injection point U, the permeation region S due to the administration injected into the target injection point U fills the abnormal site R ′ more efficiently.

The control unit 16 determines the order of the plurality of target injection points U. The control unit 16 causes the display unit 14 to display a plurality of target injection points U in a manner based on the determined order. For example, as illustrated in FIG. 7, the control unit 16 causes the determined order to be written together with the target injection point U. For example, the control unit 16 displays only the target injection point U in the next order. The control unit 16 estimates the movement path V along which the tip of the injection member that injects the administration object moves via the plurality of target injection points U, and determines the order of the target injection points U based on the movement path V. To do. For example, the control unit 16 determines the order of the target injection points U so that the movement route V is the shortest. Specifically, the control unit 16 determines the target injection points U that are closest to each other in order. The control unit 16 may cause the estimated movement route V to be superimposed on the three-dimensional image and displayed on the display unit 14. Thereby, operators, such as a medical worker, can grasp | ascertain the optimal how to move the injection | pouring member according to the order of the target injection | pouring point U. FIG.

As shown in FIG. 7 (a), the control unit 16 surrounds the long axis O in which the movement path V is directed from the aortic valve AV (see FIG. 4) to the apex AP (see FIG. 4) in the left ventricle LV of the heart. The order of the target injection points U may be determined so as to draw a spiral. As a result, the movement path V is a path that advances in the left ventricle LV from the front aortic valve side toward the back apex side along the circumferential direction M, so that the operation of the injection member can be performed. It can be made easier.

As shown in FIG. 7 (b), the control unit 16 causes the target injection point U to reciprocate along the long axis O from the aortic valve AV to the apex AP in the left ventricle LV of the heart. The order may be determined. Thereby, since the movement path V is along the long axis O, the possibility that the movement of the injection member is hindered by the papillary muscle located along the long axis O in the left ventricle LV can be reduced. It is possible to reduce the trapping on the accompanying chords.

FIG. 8 is a diagram showing a state of treatment by the injection member. FIG. 8 shows a state where the catheter 50 extends from the femoral artery FA through the aorta AO to the aortic valve AV which is the entrance of the left ventricle LV of the heart lumen. The infusion member is delivered through the catheter 50 to the left ventricle LV. The catheter 50 is not limited to the femoral artery FA, and may extend from the radial artery of the wrist to the aortic valve AV, for example.

As shown in FIG. 8, the ultrasonic image generating device 20 is located on the body surface of the subject, takes a first tomographic image at any time, and transmits it to the image processing device 10. The ultrasonic image generation device 20 acquires the position information of the distal end portion of the injection member as needed and transmits it to the image processing device 10. Thereby, the control part 16 of the image processing apparatus 10 can display the three-dimensional image which followed the position of the front-end | tip part of an injection | pouring member on the display part 14 as display information, for example. The ultrasonic image generation device 20 may be photographed not only from the body surface but also from the esophagus, blood vessel, and heart lumen (atrium, ventricle). However, it is preferable that the ultrasound image generation apparatus 20 captures images from the body surface in that non-invasive treatment can be performed.

The control unit 16 causes the display unit 14 to display the target injection point U that has been subjected to the injection treatment of the administration target by the injection member among the plurality of target injection points U in a manner different from the untreated target injection point U. May be. The control unit 16 determines that the target injection point U has been treated based on, for example, the input of a signal indicating that the target injection point U has been treated via the operation input unit 13. The control unit 16 may determine the treated target injection point U based on the newly input first tomographic image.

As described above, the image processing apparatus 10 can determine the positions of the plurality of target injection points U where the administration target should be injected into the abnormal site R ′, so that more specific simulation of the treatment is performed before the treatment is performed. It can be performed. Since the image processing apparatus 10 displays the target injection point U in a manner based on the order in which treatment should be performed, the treatment in a predetermined order can be guided to the operator.

The present disclosure is not limited to the configuration specified in each of the above-described embodiments, and various modifications can be made without departing from the contents described in the claims. For example, the functions included in each component, each step, etc. can be rearranged so that there is no logical contradiction, and a plurality of components, steps, etc. can be combined or divided into one It is.

1: Image processing system 10: Image processing device 11: Image input unit 12: Heartbeat input unit 13: Operation input unit 14: Display unit 15: Storage unit 16: Control unit 20: Ultrasonic image generation device (first imaging device)
21: Ultrasonic transmitter 22: Ultrasonic receiver 23: Image forming unit 30: Radiation image generating device (second imaging device)
31: Radiation emitting unit 32: Radiation detecting unit 33: Image forming unit 40: Heart rate acquisition device 50: Catheter AO: Aortic AP: Apex AV: Aortic valve BV: Blood vessel FA: Femoral artery LV: Left ventricle M: Circumferential direction O : Long axis P: Low motion site Q: Infarct site R: Target site R ': Abnormal site S: Penetration region T: Injection point U: Target injection point V: Movement path

Claims

A storage unit for storing a three-dimensional image of the heart including an abnormal portion of the heart;
An image processing apparatus comprising: a control unit that estimates a permeation region through which the administration target penetrates when the administration product is injected at an arbitrary injection point of the abnormal site.
The storage unit stores physical property information of the administration target,
The image processing apparatus according to claim 1, wherein the control unit estimates the penetration region based on physical property information of the administration target.
The storage unit stores a dose of the administration target,
The image processing apparatus according to claim 1, wherein the control unit estimates the penetration region based on a dose of the administration target.
The image processing apparatus according to claim 1, wherein the control unit estimates a wall thickness of the heart based on the three-dimensional image, and estimates the penetration region based on the wall thickness. .
5. The control unit according to claim 1, wherein the control unit estimates a position of a blood vessel in the heart based on the three-dimensional image, and estimates the penetration region based on a position of the injection point with respect to the position of the blood vessel. An image processing apparatus according to claim 1.
The storage unit stores a plurality of the three-dimensional images captured every predetermined time,
The image processing apparatus according to claim 1, wherein the control unit estimates the penetration region based on a time change of the plurality of three-dimensional images.
The storage unit stores shape information of an injection member that injects the administration target,
The image processing apparatus according to claim 1, wherein the control unit estimates the penetration region based on shape information of the injection member.
A first imaging device for imaging a first tomographic image of the heart from outside the body;
A second imaging device for imaging a second tomographic image of the heart from outside the body;
An image processing apparatus,
The image processing apparatus includes:
An image input unit for receiving input of the first tomographic image and the second tomographic image;
Based on the first tomographic image and the second tomographic image, a three-dimensional image of the heart including an abnormal part of the heart is generated, and the administration target is injected at an arbitrary injection point of the abnormal part An image processing system comprising: a control unit that estimates a permeation region through which an administration target permeates.
An image processing method executed using an image processing apparatus,
A three-dimensional image storage step of storing a three-dimensional image of the heart including an abnormal portion of the heart;
And an infiltration region estimation step of estimating an infiltration region into which the administration object penetrates when the administration object is injected at an arbitrary injection point of the abnormal site.
A storage unit for storing a three-dimensional image of the heart including an abnormal portion of the heart;
A display unit capable of displaying the three-dimensional image;
Control for determining positions of a plurality of target injection points for injecting the administration target into the abnormal site based on the three-dimensional image, and displaying the plurality of target injection points on the display unit in a superimposed manner on the three-dimensional image. An image processing apparatus.
The image processing apparatus according to claim 10, wherein the control unit determines an order of the plurality of target injection points and displays the plurality of target injection points on the display unit in a manner based on the order.
The control unit estimates a movement path along which a distal end portion of an injection member that injects the administration object moves via the plurality of target injection points, and determines the order based on the movement path. The image processing apparatus according to 11.
The control unit estimates an infiltration region into which the administration object penetrates when the administration object is injected into a predetermined injection point of the abnormal site, and the plurality of target injection points are determined based on the infiltration region. The image processing apparatus according to claim 10, wherein the position is determined.
A first imaging device for imaging a first tomographic image of the heart from outside the body;
A second imaging device for imaging a second tomographic image of the heart from outside the body;
An image processing apparatus,
The image processing apparatus includes:
An image input unit for receiving input of the first tomographic image and the second tomographic image;
A display unit;
Generating a three-dimensional image of the heart including an abnormal portion of the heart based on the first tomographic image and the second tomographic image, and injecting a substance to be administered into the abnormal portion based on the three-dimensional image; An image processing system comprising: a control unit that determines a position of a target injection point, and causes the display unit to display the plurality of target injection points superimposed on the three-dimensional image.
An image processing method executed using an image processing apparatus,
A three-dimensional image storage step of storing a three-dimensional image of the heart including an abnormal portion of the heart;
A three-dimensional image display step for displaying the three-dimensional image;
A target injection point determination step for determining positions of a plurality of target injection points for injecting the administration target into the abnormal site based on the three-dimensional image;
A target injection point display step of displaying the plurality of target injection points in a superimposed manner on the three-dimensional image.