WO2019215905A1 - Dispositif et système d'assistance therapeutique - Google Patents

Dispositif et système d'assistance therapeutique Download PDF

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Publication number
WO2019215905A1
WO2019215905A1 PCT/JP2018/018285 JP2018018285W WO2019215905A1 WO 2019215905 A1 WO2019215905 A1 WO 2019215905A1 JP 2018018285 W JP2018018285 W JP 2018018285W WO 2019215905 A1 WO2019215905 A1 WO 2019215905A1
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image
treatment
fluorescence
fluorescent
unit
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PCT/JP2018/018285
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English (en)
Japanese (ja)
Inventor
紘之 妻鳥
石川　亮宏
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株式会社島津製作所
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Priority to PCT/JP2018/018285 priority Critical patent/WO2019215905A1/fr
Publication of WO2019215905A1 publication Critical patent/WO2019215905A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons

Definitions

  • the present invention relates to a treatment support apparatus and a treatment support system, and more particularly to a treatment support apparatus and a treatment support system that capture an image of a treatment target site in a subject at the time of treatment and perform treatment support.
  • JP 2012-023492 A irradiates a subject containing a fluorescent agent with visible light and excitation light, and obtains a fluorescent image based on the fluorescence generated from the fluorescent agent by the visible light image and the excitation light of the subject.
  • a treatment support apparatus that performs treatment support is disclosed.
  • Japanese Patent Application Laid-Open No. 2012-023492 discloses a configuration in which a visible light image and a fluorescence image are acquired by irradiating an operation site to which a fluorescent agent has been administered with switching between visible light and excitation light. Yes.
  • the fluorescent agent is an agent that emits fluorescence of a predetermined wavelength when irradiated with excitation light of a predetermined wavelength.
  • ICG indocyanine green
  • a fluorescent agent for purposes other than simply visualizing the part to be excised.
  • a method of using such a fluorescent agent is disclosed in, for example, Japanese Patent Application Laid-Open No. 2017-071654.
  • a drug in which a substance that emits fluorescence by absorbing excitation light and an antibody that selectively binds to cancer cells is bound is administered to a subject, and the fluorescence image is displayed on the fluorescence image.
  • a method for killing cancer cells by irradiating with excitation light after specifying the position of the cancer cells by the fluorescence to be displayed is disclosed.
  • IRDye (registered trademark) 700Dx hereinafter referred to as IR700
  • IR700 IRDye (registered trademark) 700Dx
  • the present invention is not limited to the method disclosed in Japanese Patent Application Laid-Open No. 2017-071654, and there is a case where it is desired to easily confirm the therapeutic effect by comparing the fluorescence images before and after treatment when performing treatment using a fluorescent agent. It is believed that there is. In addition, there are cases where it is desired to simply confirm whether there is a therapeutic effect or whether the treatment has already been completed during treatment.
  • the present invention has been made to solve the above-described problems, and one object of the present invention is to easily confirm the therapeutic effect when performing treatment using a fluorescent agent.
  • a treatment support apparatus is a treatment support apparatus that captures an image of a treatment target site in a subject at the time of treatment, and performs treatment support.
  • Fluorescence detection unit that detects fluorescence emitted from the fluorescent agent accumulated in the region
  • fluorescence image generation unit that generates a fluorescence image based on the signal output from the fluorescence detection unit, and fluorescence generated by the fluorescence image generation unit
  • An image output unit that outputs at least a first fluorescent image and a second fluorescent image at different treatment points of time to the display unit.
  • the fluorescence detection unit and the fluorescence image generation unit image the fluorescence image based on the fluorescence emitted from the fluorescent agent, and the image output unit.
  • the first fluorescent image and the second fluorescent image that are different in the treatment time point out of the fluorescent images generated by the fluorescent image generating unit can be output to the display unit.
  • the first fluorescence is extracted based on the extraction unit that extracts at least one feature point in the fluorescence image and the position information of the feature point extracted by the extraction unit.
  • An alignment unit that aligns the image with the second fluorescent image, and the image output unit includes the first fluorescent image and the second fluorescent image that are aligned by the alignment unit, It is comprised so that it may output to a display part. If comprised in this way, the 1st fluorescence image and 2nd fluorescence image from which a treatment time differs will be displayed on a display part in the state aligned based on the positional information on the feature point in a fluorescence image Therefore, it is possible to accurately compare fluorescent images at different treatment points.
  • the image output unit outputs an output image that displays the first fluorescent image and the second fluorescent image in a comparable manner, or an output image that is displayed in a superimposed manner. Is output to the display unit. If comprised in this way, since the 1st fluorescence image and 2nd fluorescence image from which a treatment time differs can be displayed on a display part so that contrast is possible, or it can be made to superimpose and display, Compared with the case where the images cannot be displayed in a comparable manner and the case where they cannot be displayed in a superimposed manner, fluorescence images at different treatment points can be compared more easily.
  • the image output unit includes a region in which fluorescence is reflected in common among the fluorescence regions reflected in the first fluorescence image and the second fluorescence image, It is configured so that it is colored in a different color in the region where the fluorescence is reflected only on one side and is output to the display unit. If configured in this manner, the first fluorescent image can be displayed on the display unit by coloring the common fluorescent region and the fluorescent region only on one side in different colors. And the second fluorescent image can be easily compared. As a result, it is possible to easily compare differences between fluorescent images at different treatment points.
  • a visible light detection unit that detects visible light
  • a visible image generation unit that generates a visible image based on a signal output by the visible light detection unit
  • An extraction unit that extracts at least one feature point in the image, and alignment of the first fluorescence image and the second fluorescence image based on the positional information of the feature point in the visible image extracted by the extraction unit
  • an image output unit configured to output the first fluorescent image and the second fluorescent image aligned by the alignment unit to the display unit.
  • the 1st fluorescence image and 2nd fluorescence image from which a treatment time differs will be displayed on a display part in the state aligned based on the positional information on the feature point in a visible image Therefore, it is possible to accurately compare fluorescent images at different treatment points.
  • the image output unit is configured to output at least one or more visible images generated by the visible image generating unit together with the first fluorescent image and the second fluorescent image to the display unit. Yes. If configured in this way, the area around the part where the fluorescence is reflected in the fluorescence image can be observed by the visible image, so that it is reflected in the fluorescence image as compared with the case where only the fluorescence image is displayed. The part to which the fluorescent agent is administered can be easily confirmed.
  • the image output unit preferably superimposes one visible image, the first fluorescent image, and the second fluorescent image among the visible images generated by the visible image generation unit. And output to the display unit. If configured in this way, the area around the portion where the fluorescence is reflected in the fluorescence image can be observed with the visible image superimposed on the fluorescence image, so the imaging direction, imaging position, imaging angle, etc. of the subject Even when the imaging conditions are different between fluorescent images at different treatment points, the difference between the portions to which the fluorescent agent is administered can be easily confirmed.
  • the image output unit superimposes the first visible image on the first fluorescent image among the visible images generated by the visible image generation unit, and generates the second visible image.
  • the image is superimposed on the second fluorescent image and output to the display unit. If comprised in this way, the area
  • the alignment unit performs alignment between the first visible image and the second visible image based on the position information of the feature points in the visible image extracted by the extraction unit, and outputs the image.
  • the unit superimposes the first visible image aligned by the alignment unit on the first fluorescence image, superimposes the second visible image aligned by the alignment unit on the second fluorescence image, It is comprised so that it may output to a display part. If comprised in this way, the 1st fluorescence image and the 2nd fluorescence image which were mutually aligned on the 1st visible image and 2nd visible image which were mutually aligned, respectively, may be superimposed and displayed. Therefore, even if the imaging conditions such as the imaging direction, imaging position, and imaging angle of the subject are different between fluorescent images at different treatment points, the difference between the portions where the fluorescent drug is administered can be confirmed easily and more accurately. Can do.
  • a treatment support system is a treatment support system that captures an image of a treatment target site in a subject at the time of treatment, and performs treatment support.
  • a fluorescence detection unit that detects fluorescence emitted from the fluorescent agent accumulated in the treatment target site
  • a fluorescence image generation unit that generates a fluorescence image based on a signal output by the fluorescence detection unit
  • a display device that displays at least a first fluorescent image and a second fluorescent image that are different in time of treatment among the fluorescent images generated by the fluorescent image generating unit is provided.
  • the fluorescence detection unit and the fluorescence image generation unit image the fluorescence image based on the fluorescence emitted from the fluorescent agent, and the display device Of the fluorescence images generated by the fluorescence image generation unit, at least a first fluorescence image and a second fluorescence image at different treatment points can be displayed.
  • the fluorescence images from which a treatment time differs can be compared easily.
  • the therapeutic effect can be easily confirmed.
  • the therapeutic effect when a treatment using a fluorescent agent is performed, the therapeutic effect can be easily confirmed.
  • FIG. 1 is a perspective view of a treatment support apparatus and a treatment support system according to a first embodiment of the present invention. It is the block diagram which showed the outline of the treatment assistance apparatus and treatment assistance system by 1st Embodiment of this invention. It is the schematic of the imaging part of the treatment assistance apparatus by 1st Embodiment of this invention. It is the block diagram which showed the outline inside the imaging part of the treatment assistance apparatus by 1st Embodiment of this invention. It is the figure which showed a mode that the pre-treatment visible image, the pre-treatment fluorescence image, and the pre-treatment synthetic image were displayed on the display apparatus of the treatment assistance system by 1st Embodiment of this invention.
  • the treatment support apparatus 100 is an apparatus (system) for capturing an image of a treatment target site in the subject P during treatment and performing treatment support.
  • the display device 900 is an example of the “display unit” in the claims.
  • the treatment support apparatus 100 includes an imaging unit 10 for imaging a subject P, a main body unit 20 including a control unit 21 (see FIG. 2), and the like.
  • the arm part 30 which connects the part 10 and the main-body part 20 and the operation part 40 for operating the treatment assistance apparatus 100 are provided.
  • the treatment support apparatus 100 is configured to irradiate the fluorescent agent administered to the subject P with the excitation light Ex and detect and image the fluorescence Lx emitted when the fluorescent agent is excited by the excitation light Ex. Device.
  • the treatment support apparatus 100 is configured to be able to display an image captured by the imaging unit 10 on the display device 900.
  • the imaging unit 10 is configured to correspond to the IR700 wavelength band as a fluorescent agent to be administered to the subject P.
  • IR700 is a drug obtained by binding a substance that emits fluorescence Lx (Lx1) by absorbing excitation light Ex (Ex1) and an antibody that selectively binds to cancer cells M. That is, the IR 700 is a fluorescent agent that is accumulated at the treatment target site of the subject P.
  • the fluorescence Lx1 is light having a peak in the wavelength band of near-infrared light (invisible light).
  • IR700 is an example of the “fluorescent agent” in the claims.
  • IR700 is a drug used for near-infrared photoimmunotherapy (NIR-PIT) in which cancer cells M (see FIG. 5) are killed by irradiation with therapeutic light in a state administered to the subject P. .
  • the therapeutic light is near infrared light having an absorption wavelength of IR700 of about 600 nm to about 700 nm.
  • the treatment light has a higher irradiation intensity than the excitation light Ex1 for imaging the cancer cell M (see FIG. 5) that is the treatment target site in the subject P, and the IR 700 irradiated with the treatment light Heat is generated.
  • produced from IR700 is destroyed.
  • the fluorescence Lx1 is not generated even when the excitation light Ex1 is irradiated. That is, by comparing the intensity of the fluorescence Lx1 before and after the treatment light irradiation, it is possible to confirm how much the cancer cells M (see FIG. 5) have been destroyed (therapeutic effect). Further, whether or not the treatment light is correctly applied to the treatment target site of the subject P can be grasped depending on whether the intensity of the fluorescence Lx1 has changed (becomes small) before or after the treatment light irradiation. . Even when the cancer cell M (see FIG. 5) is present at a position different from the assumed position, the position of the cancer cell M (see FIG.
  • IR700 is accurately grasped based on the fluorescence Lx1 emitted from the IR700. be able to.
  • IR700 is administered before treatment (for example, 1 to 2 days before) so as to be bound to the cancer cell M of the subject P at the time of treatment (at the time of irradiation with the excitation light Ex1). .
  • the imaging unit 10 includes a light source unit 50 for irradiating visible light Vis and excitation light Ex1, an optical system 60 for separating visible light Vis and fluorescence Lx1, and visible light Vis and And a detector 70 for detecting the fluorescence Lx1.
  • the light source unit 50 includes an excitation light source 51 that generates excitation light Ex1 for exciting the IR 700, and a visible light source 53 that generates visible light Vis.
  • the excitation light source 51 and the visible light source 53 include, for example, a light emitting diode (LED) as a light source.
  • the excitation light source 51 is configured to generate excitation light Ex1 in a wavelength band corresponding to IR700.
  • the excitation light Ex1 has near-infrared light having a peak wavelength of 700 mm.
  • the excitation light Ex1 is excitation light Ex (confirmation light) for confirming a portion to which IR700 is administered, and has a lower irradiation intensity than excitation light Ex (treatment light) for treating cancer. It is comprised so that it may become.
  • the visible light source 53 is configured to generate, for example, white light including a plurality of (all) wavelengths in the visible region as the visible light Vis.
  • the visible light Vis is not limited to white light, and may be configured to include only a specific wavelength in the visible region.
  • a plurality (six) of excitation light sources 51 and visible light sources 53 are provided in the treatment support apparatus 100.
  • the plurality (six) of excitation light sources 51 and the plurality (six) of visible light sources 53 are arranged in a circular shape at approximately equal intervals in the light source unit 50.
  • the six excitation light sources 51 and the six visible light sources 53 are arranged in a ring so as to surround the periphery of the optical system 60.
  • the excitation light sources 51 and the visible light sources 53 are alternately arranged at substantially equal intervals. Thereby, the excitation light source 51 and the visible light source 53 are in a state of being arranged at substantially equal intervals in the light source unit 50, respectively.
  • the light source unit 50 is configured to irradiate the subject P with excitation light Ex1 and visible light Vis irradiated from the excitation light source 51 and the visible light source 53, respectively. Yes.
  • the IR 700 is administered to the subject P
  • the excitation light Ex1 is irradiated to the surgical site Pa where the IR 700 exists
  • the IR 700 is excited, and thereby the fluorescence Lx1 is emitted from the IR 700.
  • the visible light Vis irradiated to the subject P is reflected by the subject P.
  • the optical system 60 includes a zoom lens 61 for focusing, and a prism 62 for separating visible light Vis and fluorescence Lx1 reflected from the subject P. As shown in FIG. 4, the zoom lens 61 and the prism 62 are arranged in this order along the optical axis L direction.
  • the zoom lens 61 is configured to be able to reciprocate in the direction of the optical axis L by a lens moving mechanism (not shown) for focusing.
  • the prism 62 separates the visible light Vis and the fluorescence Lx1 reflected from the subject P and passed through the zoom lens 61, and guides the visible light Vis and the fluorescence Lx1 to the visible light detection unit 73 and the fluorescence detection unit 71, respectively. It is configured as follows.
  • the detection unit 70 includes a fluorescence detection unit 71 for detecting the fluorescence Lx1 and a visible light detection unit 73 for detecting the visible light Vis.
  • the visible light detection unit 73 is configured to detect the visible light Vis guided to the prism 62.
  • the fluorescence detection unit 71 is configured to detect the fluorescence Lx1 guided to the prism 62.
  • the fluorescence detection unit 71 and the visible light detection unit 73 are each configured by an image sensor (imaging device) using, for example, a CMOS (complementary metal oxide semiconductor) or a CCD (charge coupled device).
  • an imaging device capable of detecting light in a range including the wavelength band of the fluorescence Lx1 is used.
  • the visible light detection unit 73 uses an image sensor that can detect light in a range including the wavelength band of the visible light Vis.
  • the visible light detection unit 73 uses an image sensor that can capture a visible image 830 (see FIGS. 5 and 6) as a color image.
  • the main body unit 20 includes a control unit 21 for controlling various configurations of the treatment support apparatus 100, an image generation unit 22 that generates an image based on a signal detected by the detection unit 70, A storage unit 23 that stores an image generated by the image generation unit 22 and an image output unit 24 that outputs the image generated by the image generation unit 22 to the display device 900 are provided.
  • the main unit 20 includes a personal computer (PC) including a control unit 21, an image generation unit 22, a storage unit 23, an image output unit 24, and the like, and is provided with wheels so that the treatment support apparatus 100 can be moved. It is configured as a trolley.
  • the image generation unit 22 is an example of the “fluorescence image generation unit” and the “visible image generation unit” in the claims.
  • the control unit 21 is a computer including a CPU (Central Processing Unit), a ROM (Read Only Memory), a RAM (Random Access Memory), and the like.
  • CPU Central Processing Unit
  • ROM Read Only Memory
  • RAM Random Access Memory
  • the image generation unit 22 is a computer including a processor such as a GPU (Graphics Processing Unit) or an FPGA (Field-Programmable Gate Array) configured for image processing.
  • the image generation unit 22 is based on the detection signals output by the fluorescence detection unit 71 and the visible light detection unit 73, respectively, and the fluorescence image 810 (see FIGS. 5 and 6) and the visible image 830 (see FIGS. 5 and 6), respectively. ) Can be generated.
  • the storage unit 23 includes, for example, a nonvolatile memory or a hard disk drive (HDD).
  • the storage unit 23 stores a program used for the processing of the control unit 21 and is configured to store images (fluorescent image 810 and visible image 830) generated by the image generation unit 22 and the like.
  • the storage unit 23 stores the image generated by the image generation unit 22 together with a time stamp such as an imaging date and time.
  • the fluorescence image 810 includes a pre-treatment fluorescence image 811 (see FIG. 5) and a post-treatment fluorescence image 812 (see FIG. 6) generated before and after the treatment, respectively.
  • the visible image 830 includes a pre-treatment visible image 831 (see FIG.
  • the pre-treatment fluorescence image 811 (see FIG. 5) and the post-treatment fluorescence image 812 (see FIG. 6) are examples of the “first fluorescence image” and the “second fluorescence image” in the claims, respectively. is there.
  • the pre-treatment visible image 831 (see FIG. 5) and the post-treatment visible image 832 (see FIG. 6) are examples of the “first visible image” and the “second visible image” in the claims, respectively. is there.
  • the image output unit 24 is an interface for connecting the treatment support apparatus 100 to the display apparatus 900.
  • the image output unit 24 is connected to the display device 900 by a video interface such as HDMI (registered trademark), for example.
  • the image output unit 24 is configured to output an output image 800 (see FIGS. 5 and 6) including the images (fluorescence image 810 and visible image 830) generated by the image generation unit 22 to the display device 900.
  • the image output unit 24 includes the pre-treatment fluorescence image 811 (see FIG. 5) and the post-treatment fluorescence image 812 (see FIG. 5) of the fluorescence images 810 generated by the image generation unit 22 at different treatment points. 6) is output to the display device 900.
  • the image output unit 24 is configured to output the visible image 830 generated by the image generation unit 22 together with the pre-treatment fluorescent image 811 and the post-treatment fluorescent image 812 to the display device 900.
  • the display device 900 is configured to display the output image 800 output by the image output unit 24 on the screen.
  • “before treatment” and “after treatment” mean not only before and after the start of treatment, but also before and after a certain treatment time point.
  • the arm unit 30 connects the main body unit 20 and the imaging unit 10 via a plurality of arms and a plurality of hinges.
  • the arm unit 30 is configured to be able to change the relative position of the imaging unit 10 with respect to the main body unit 20.
  • the operation unit 40 is configured to receive an input for operating the treatment support apparatus 100 via the control unit 21.
  • the operation unit 40 is, for example, a remote controller that can communicate with the treatment support apparatus 100.
  • the operation unit 40 is configured to be able to accept an input for selecting a pre-treatment fluorescence image 811 and a post-treatment fluorescence image 812 from the fluorescence image 810 stored in the storage unit 23.
  • the operation unit 40 is configured to receive an input for selecting the pre-treatment visible image 831 and the post-treatment visible image 832 from the visible image 830 stored in the storage unit 23. Yes.
  • the treatment support apparatus 100 causes the display device 900 to display a plurality of pre-treatment fluorescent images 811 and a plurality of post-treatment fluorescent images 812. Then, a user such as a doctor can use the pretreatment fluorescent image 811 and the pretreatment fluorescent image 811 to be used for treatment support from the plurality of pretreatment fluorescent images 811 and the plurality of posttreatment fluorescent images 812 displayed on the display device 900. A post-treatment fluorescent image 812 is selected.
  • the image output unit 24 outputs the selected pre-treatment fluorescent image 811 and post-treatment fluorescent image 812 to the display device 900.
  • the display device 900 is configured to be able to display images (fluorescent image 810 and visible image 830) generated by the image generation unit 22 and output by the image output unit 24. ing.
  • the display device 900 is configured by, for example, a liquid crystal display, an organic EL display, an inorganic EL display, or the like. 5 and 6 show an example in which the surgical site Pa affected by cancer is imaged and displayed on the display device 900. FIG.
  • the fluorescence image 810 includes cancer cells M administered with IR700.
  • the visible image 830 includes the surgical site Pa around the cancer cell M to which IR700 has been administered.
  • the cancer cells M are indicated by thick solid lines with white inside.
  • the cancer cell M before treatment and the cancer cell M after treatment are shown to be similar and different in size (smaller after treatment than before treatment). The change in the shape of the cancer cell M caused by the treatment is not limited to this.
  • the image output unit 24 can output the fluorescent image 810 and the visible image 830 so that the fluorescent image 810 and the visible image 830 are superimposed and displayed on the display device 900. It is configured. More specifically, the treatment support system 1100 is configured to be able to display the composite image 840 obtained by superimposing the fluorescent image 810 and the visible image 830 on the display device 900. Specifically, as illustrated in FIG. 5, the treatment support system 1100 can cause the display device 900 to display a pre-treatment composite image 841 in which a pre-treatment fluorescence image 811 and a pre-treatment visible image 831 are superimposed. It is configured. As shown in FIG.
  • the treatment support system 1100 is configured to display a post-treatment composite image 842 in which the post-treatment fluorescence image 812 and the post-treatment visible image 832 are superimposed on the display device 900.
  • the image output unit 24 includes the pre-treatment visible image 831 and the post-treatment visible image 832 of the visible image 830 generated by the image generation unit 22, and the pre-treatment fluorescent image 811 and the treatment, respectively. It is configured to be able to be superimposed on the post-fluorescence image 812 and output to the display device 900.
  • the image output unit 24 displays the pre-treatment fluorescent image 811 and the post-treatment fluorescent image 812 in the fluorescent image 810 stored by the storage unit 23 in a comparable manner.
  • an output image 800 to be displayed in a superimposed manner is output to the display device 900.
  • the image output unit 24 includes the pre-treatment composite image 841 in which the pre-treatment fluorescence image 811 is superimposed on the pre-treatment visible image 831 among the visible images 830 stored in the storage unit 23.
  • displaying in a comparable manner means displaying in a manner in which a plurality of images can be compared with each other, and includes displaying the images side by side. For example, FIGS.
  • FIG. 7 and 8 show an example in which the pre-treatment composite image 841 and the post-treatment composite image 842 are displayed side by side on the display device 900.
  • 9 and 10 show an example in which a pre-treatment composite image 841 and a post-treatment composite image 842 are displayed superimposed on the display device 900.
  • FIG. In the treatment support device 100 the cancer cells M reflected in the pre-treatment composite image 841 and the cancer cells M reflected in the post-treatment composite image 842 can be displayed in different colors, and treatment can be performed.
  • An area common to the pre-combination image 841 and the post-treatment composite image 842 and a non-common area an area where the cancer cells M have been reduced after treatment) can be displayed in different colors.
  • the image output unit 24 fluoresces only in one of the fluorescent regions reflected in the pre-treatment fluorescent image 811 and the post-treatment fluorescent image 812 and the region in which the fluorescent Lx is reflected. It is configured such that it can be colored in a color different from the area where Lx is reflected and output to the display unit. In particular, when images before and after treatment are displayed in a superimposed manner, it is effective to color the image before treatment and the image after treatment in different colors.
  • the image output unit 24 can output to the display apparatus 900 an output image 800 in which a plurality of pre-treatment composite images 841 and post-treatment composite images 842 are displayed side by side. It is configured.
  • the treatment support system 1100 includes a plurality (three) of pre-treatment composite images 841 (841a, 841b, and 841c) and a plurality (three) of post-treatment composite images 842 ( 842a, 842b, and 842c) can be displayed side by side on the display device 900.
  • the pre-treatment composite image 841a, the pre-treatment composite image 841b, and the pre-treatment composite image 841c have different imaging directions.
  • the post-treatment composite image 842a, the post-treatment composite image 842b, and the post-treatment composite image 842c have different imaging directions.
  • the image output unit 24 is configured to be able to output to the display apparatus 900 an output image 800 that displays the pre-treatment composite image 841 and the post-treatment composite image 842 superimposed on each other.
  • the treatment support system is configured to be able to display on the display device 900 a pre-treatment composite image 843 in which a pre-treatment composite image 841 and a post-treatment composite image 842 are superimposed.
  • the cancer cells M before and after treatment are indicated by a white chain line inside and a thick solid line inside.
  • the treatment support system 1100 is configured to be able to display a plurality (three) of pre- and post-treatment composite images 843 (843a, 843b, and 843c) side by side.
  • the image output unit 24 includes the pre-treatment fluorescent image 811 and the post-treatment aligned by the alignment unit 26 (see FIG. 2).
  • the fluorescent image 812 is configured to be output to the display device 900.
  • the treatment support apparatus 100 includes an extraction unit 25 that extracts a marker member 80 (see FIGS. 5 and 6) in the fluorescence image 810 (see FIGS. 5 and 6), and an extraction unit. Based on the positional information of the marker member 80 (see FIGS. 5 and 6) in the fluorescence image 810 (see FIGS. 5 and 6) extracted by the unit 25, the pre-treatment fluorescence image 811 (see FIG. 5) and the post-treatment An alignment unit 26 that performs alignment with the fluorescent image 812 (see FIG. 6) is provided.
  • the treatment support apparatus 100 As shown in FIGS. 5 and 6, a plurality of surgical parts Pa in the vicinity of the surgical part Pa or near the surgical part Pa so that the marker member 80 is reflected in the images before and after the treatment.
  • the marker member 80 is placed.
  • the marker member 80 is, for example, a surgical marker that appears in the fluorescent image 810.
  • 5 and 6 show an example in which three marker members 80 are arranged.
  • the marker members 80 before and after treatment are referred to as marker members 81 and 82, respectively.
  • the extraction unit 25 extracts the marker member 81 reflected in the pre-treatment fluorescent image 811 and the marker member 81 reflected in the post-treatment fluorescent image 812. Then, the alignment unit 26 matches the position of the marker member 81 reflected in the pre-treatment fluorescent image 811 with the position of the marker member 81 reflected in the post-treatment fluorescent image 812 or the pre-treatment fluorescent image 811 or the treatment. The post fluorescence image 812 is corrected.
  • the alignment unit 26 reflects the distance between the plurality of marker members 81 reflected in the pre-treatment fluorescent image 811 and the post-treatment fluorescent image 812. Based on the distances between the plurality of marker members 81, the magnification of the pre-treatment fluorescent image 811 and the post-treatment fluorescent image 812 is corrected.
  • the image output unit 24 substantially matches the position and size of the subject P reflected in the pre-treatment fluorescent image 811 with the position and size of the subject P reflected in the post-treatment fluorescent image 812. In this state, it is possible to output to the display device 900 an output image 800 that can be compared and an output image 800 that is displayed in a superimposed manner. That is, as shown in FIG.
  • the image output unit 24 is in a state in which the position and size of the subject P reflected in the pre-treatment fluorescent image 811 and the post-treatment fluorescent image 812 are substantially matched (the marker member 81 and the marker
  • An output image 800 that displays the pre-treatment composite image 841 and the post-treatment composite image 842 side by side can be output to the display device 900 in a state where the position and size of the member 82 are substantially the same. Further, as shown in FIG.
  • the image output unit 24 is in a state in which the position and size of the subject P reflected in the pre-treatment fluorescent image 811 and the post-treatment fluorescent image 812 are substantially matched (the marker member 81 and the marker In a state in which the position and the size of the member 82 are substantially matched), an output image 800 that displays the pre-treatment composite image 841 and the post-treatment composite image 842 superimposed on each other can be output to the display device 900.
  • the treatment support system 1100 uses the operation unit 40 to determine which of the display forms shown in FIGS. 5, 7, 8, 9, and 10 is to be displayed on the display device 900.
  • the controller 21 can be set.
  • the treatment support apparatus 100 images the fluorescence image 810 based on the fluorescence Lx (Lx1) emitted from the IR 700 by the fluorescence detection unit 71 and the image generation unit 22.
  • the image output unit 24 can output, to the display device 900, the pre-treatment fluorescent image 811 and the post-treatment fluorescent image 812 at different treatment points in the fluorescent image 810 generated by the image generation unit 22.
  • the pre-treatment fluorescence image 811 and the post-treatment fluorescence image 812 at different treatment points can be displayed on the display device 900, so that the fluorescence images 810 at different treatment points can be easily compared.
  • the therapeutic effect can be easily confirmed when performing treatment using IR700.
  • the treatment support apparatus 100 includes the extraction unit 25 that extracts the plurality of marker members 80 in the fluorescence image 810 and the plurality of marker members 80 extracted by the extraction unit 25.
  • An alignment unit 26 that aligns the pre-treatment fluorescence image 811 and the post-treatment fluorescence image 812 based on the position information, and the image output unit 24 is aligned by the alignment unit 26 before treatment.
  • the fluorescent image 811 and the post-treatment fluorescent image 812 are configured to be output to the display device 900.
  • the pre-treatment fluorescent image 811 and the post-treatment fluorescent image 812 at different treatment points are displayed on the display device 900 in a state of being aligned based on the positional information of the plurality of marker members 80 in the fluorescent image 810. Therefore, it is possible to accurately compare the fluorescence images 810 at different treatment points. Further, when the treatment support apparatus 100 performs alignment based on the plurality of marker members 80, the distance between the plurality of marker members 81 in the pre-treatment fluorescent image 811 and the plurality of markers in the post-treatment fluorescent image 812 are used. Based on the distance between the members 81, the magnification of the pre-treatment fluorescent image 811 and the post-treatment fluorescent image 812 is corrected.
  • the pre-treatment fluorescent image 811 or the post-treatment fluorescent image 812 can be corrected so that the enlargement ratio is matched with the positions of the pre-treatment fluorescent image 811 and the post-treatment fluorescent image 812.
  • the size of cancer cells M before and after treatment can be compared. As a result, it is possible to more accurately grasp how much therapeutic effect has been obtained.
  • the image output unit 24 causes the output image 800 to display the pre-treatment fluorescent image 811 and the post-treatment fluorescent image 812 so as to be comparable to each other, or an output to be displayed in a superimposed manner.
  • the image 800 is configured to be output to the display device 900.
  • the pre-treatment fluorescence image 811 and the post-treatment fluorescence image 812 at different treatment points can be displayed on the display device 900 in a comparable manner or can be displayed in a superimposed manner.
  • the fluorescence images 810 at different treatment points can be compared more easily.
  • the image output unit 24 includes, in the fluorescent regions reflected in the pre-treatment fluorescent image 811 and the post-treatment fluorescent image 812, a region in which fluorescence is reflected in common, It is configured such that only one side is colored in a different color in the region where the fluorescence is reflected and output to the display device 900.
  • the region where the fluorescence Lx (Lx1) is reflected in common and the region where the fluorescence Lx (Lx1) is reflected only in one color can be colored in different colors and displayed on the display device 900,
  • the difference between the pre-treatment fluorescence image 811 and the post-treatment fluorescence image 812 can be easily compared.
  • the difference between the fluorescence images 810 at different treatment points can be easily compared.
  • the visible light detection unit 73 that detects the visible light Vis and the image generation unit 22 that generates the visible image 830 based on the signal output by the visible light detection unit 73.
  • the pre-treatment fluorescent image 811 and the post-treatment An alignment unit 26 that performs alignment with the fluorescence image 812.
  • the image output unit 24 displays the pre-treatment fluorescence image 811 and the post-treatment fluorescence image 812, which are aligned by the alignment unit 26, with a display device. It is comprised so that it may output to 900.
  • the pre-treatment fluorescent image 811 and the post-treatment fluorescent image 812 at different treatment points can be displayed on the display device 900 in a state of being aligned based on the position information of the marker member 80 in the visible image 830. Therefore, the fluorescence images 810 at different treatment points can be accurately compared with each other.
  • the image output unit 24 displays the pre-treatment fluorescent image 811 and the post-treatment fluorescent image 812 together with at least one or more visible images 830 generated by the image generation unit 22. It is configured to output to the device 900. Thereby, since the area
  • the image output unit 24 aligns the pre-treatment visible image 831 and the post-treatment visible image 832 of the visible image 830 generated by the image generation unit 22, respectively.
  • the pre-treatment fluorescence image 811 and the post-treatment fluorescence image 812 aligned by the unit 26 are superimposed on each other and output to the display device 900.
  • the visible image 830 captured at the time corresponding to the fluorescent image 810 captured at different time points is superimposed on the fluorescent image 810 in the area around the portion where the fluorescence Lx (Lx1) is reflected in the fluorescent image 810. Since the visible image 830 can be observed, even when the imaging conditions such as the imaging direction, imaging position, and imaging angle of the subject P are different between the fluorescent images 810 at different treatment points, the difference in the portion to which IR700 is administered Can be confirmed easily and accurately.
  • the image output unit 24 causes the display device 900 to display the output image 800 that displays a plurality of pre-treatment composite images 841 and post-treatment composite images 842, respectively. Configure to output. Thereby, a plurality of pretreatment composite images 841 and a plurality of posttreatment composite images 842 captured from various directions can be displayed side by side. As a result, compared with the case where the composite images 840 before and after treatment imaged from one direction are displayed side by side, the change before and after the treatment of the portion to which IR700 is administered (the treated portion) can be accurately confirmed. .
  • the image output unit 24 outputs, to the display device 900, the output image 800 in which the pre-treatment composite image 841 and the post-treatment composite image 842 are superimposed and displayed.
  • the image output unit 24 outputs, to the display device 900, the output image 800 in which the pre-treatment composite image 841 and the post-treatment composite image 842 are superimposed and displayed.
  • the treatment support apparatus 100 receives an input for selecting the pre-treatment fluorescent image 811 and the post-treatment fluorescent image 812 from the fluorescent image 810 stored in the storage unit 23.
  • the operation unit 40 receives an input for selecting a pre-treatment visible image 831 and a post-treatment visible image 832 from the visible image 830 stored in the storage unit 23.
  • the treatment support apparatus 100 includes the light source unit 50 that emits the excitation light Ex1 for exciting the IR 700.
  • the IR 700 can be easily excited by the excitation light Ex1 emitted from the light source unit 50, the fluorescence Lx1 can be easily generated from the IR 700 administered to the subject P.
  • the intensity of the excitation light Ex1 applied to the subject P can be adjusted. For example, the intensity of the excitation light Ex is too strong and halation occurs. Can be suppressed.
  • the treatment support apparatus 200 included in the treatment support system 1200 of the second embodiment includes an imaging unit 210 and a main body unit 220 including an image generation unit 222 and the like.
  • the imaging unit 210 is configured to correspond to the IR700 and ICG wavelength bands as a fluorescent agent to be administered to the subject P.
  • IR700 and ICG differ in absorption spectrum and emission spectrum.
  • the ICG is a drug containing a substance that emits fluorescence Lx2 having a wavelength band different from the fluorescence Lx1 of IR700 by absorbing excitation light Ex2 having a wavelength band different from the excitation light Ex1 of IR700. Both the fluorescence Lx1 and the fluorescence Lx2 are light having a peak in the wavelength band of near infrared light (invisible light).
  • ICG is a drug that is administered to the subject P and used for visualization of the surgical site Pa during surgery by irradiating the excitation light Ex2.
  • ICG is administered to the subject P at the same time as the IR 700 or after the IR 700 in order to improve the visibility of the subject P around the cancer cells M in the follow-up after treatment with the IR 700.
  • ICG is an example of the “fluorescent agent” in the claims.
  • the imaging unit 210 includes a light source unit 250 for irradiating visible light Vis and excitation light Ex (Ex1, Ex2), an optical system 260 for separating visible light Vis, fluorescence Lx1, and fluorescence Lx2, and visible light Vis. And a detection unit 270 for detecting the fluorescence Lx (Lx1, Lx2).
  • the light source unit 250 includes an excitation light source 52 that generates excitation light Ex2 for exciting the ICG, in addition to the excitation light source 51 and the visible light source 53.
  • the excitation light source 52 is configured to generate excitation light Ex2 in a wavelength band corresponding to ICG.
  • the excitation light Ex2 has near-infrared light having a peak wavelength of 760 mm.
  • the excitation light Ex2 is excitation light Ex (confirmation light) for confirming a portion to which ICG is administered, and the irradiation intensity is higher than that of excitation light Ex (treatment light) for treating cancer. It is configured to be low.
  • a plurality (four each) of excitation light sources 51, excitation light sources 52, and visible light sources 53 are provided in the treatment support apparatus 200. Further, the plurality (four) of the excitation light sources 51, the plurality of (four) of the excitation light sources 52, and the plurality of (four) of the visible light sources 53 are respectively arranged in a ring shape and at substantially equal intervals in the light source unit 250. ing. Specifically, in the light source unit 250, the four excitation light sources 51, the four excitation light sources 52, and the four visible light sources 53 are arranged in a ring shape so as to surround the periphery of the optical system 260.
  • the excitation light source 51, the excitation light source 52, and the visible light source 53 are arrange
  • the excitation light source 51, the excitation light source 52, and the visible light source 53 are in the state arrange
  • the light source unit 250 is configured to irradiate the subject P with the excitation light Ex1, the excitation light Ex2, and the visible light Vis emitted from the excitation light source 51, the excitation light source 52, and the visible light source 53, respectively. ing.
  • the surgical light Pa where IR700 and ICG are present is irradiated with the excitation light Ex1 and the excitation light Ex2, IR700 and ICG are excited. Then, fluorescence Lx1 and fluorescence Lx2 are emitted from IR700 and ICG, respectively.
  • the optical system 260 includes a prism 62 for separating visible light Vis and fluorescence Lx (fluorescence Lx1, fluorescence Lx2) reflected from the subject P, and fluorescence Lx (fluorescence Lx1, fluorescence Lx2) separated by the prism 62.
  • a prism 63 for separating the light into fluorescence Lx1 and fluorescence Lx2. As shown in FIG. 13, the zoom lens 61, the prism 62, and the prism 63 are arranged in this order along the optical axis L direction.
  • the prism 62 separates the visible light Vis and fluorescence Lx (Lx1, Lx2) reflected from the subject P and passed through the zoom lens 61, and converts the visible light Vis and fluorescence Lx (Lx1, Lx2) into visible light, respectively. It is configured to be guided to the detection unit 73 and the prism 63.
  • the prism 63 is configured to separate the fluorescence Lx (fluorescence Lx1, fluorescence Lx2) that has passed through the prism 62 and guide the fluorescence Lx1 and fluorescence Lx2 to the fluorescence detection unit 71 and the fluorescence detection unit 72, respectively.
  • the detection unit 270 includes a fluorescence detection unit 72 for detecting the fluorescence Lx2.
  • the fluorescence detection unit 72 is configured to detect the fluorescence Lx2 guided to the prism 63.
  • an image sensor capable of detecting light in a range including the wavelength band of the fluorescence Lx2 is used.
  • the main body unit 220 generates an image based on a signal detected by the detection unit 270, and outputs an image generated by the image generation unit 222 to the display device 900.
  • the image generation unit 222 is an example of the “fluorescence image generation unit” and the “visible image generation unit” in the claims.
  • the image generation unit 222 generates a fluorescence image 810, a fluorescence image 820 (see FIG. 14), and a visible image 830 based on the detection signals output from the fluorescence detection unit 71, the fluorescence detection unit 72, and the visible light detection unit 73, respectively. It is configured to be able to generate.
  • the image output unit 224 is an interface for connecting the treatment support apparatus 200 to the display apparatus 900.
  • the image output unit 224 is configured to output the images (fluorescence image 810, fluorescence image 820, and visible image 830) generated by the image generation unit 222 to the display device 900. That is, in the second embodiment, the image output unit 224 displays the fluorescence images 810 and 820 (see FIG. 14) before and after the treatment at different treatment points among the fluorescence images 810 generated by the image generation unit 222, as the display device 900. It is configured to output to. In FIG. 14, only the fluorescence images 810 and 820 before treatment among the fluorescence images 810 and 820 are shown.
  • the display device 900 is configured to be able to display the images (fluorescence image 810, fluorescence image 820, and visible image 830) generated by the image generation unit 222 and output by the image output unit 224.
  • a pre-treatment fluorescent image 811, a pre-treatment fluorescent image 821, and a pre-treatment visible image 831 generated before treatment are shown as a fluorescence image 810, a fluorescence image 820, and a visible image 830, respectively.
  • the pre-treatment fluorescent image 821 is an example of the “first fluorescent image” in the claims.
  • cancer cells M administered with ICG are reflected.
  • ICG and IR700 have different distributions at the surgical site Pa due to differences in biochemical characteristics. Therefore, in the fluorescence image 810 and the fluorescence image 820, the cancer cells M are reflected in different display modes.
  • the cancer cell M is indicated by a solid line in which the inside is filled with diagonal lines.
  • the image output unit 224 causes the display device 900 to display the fluorescent image 810, the fluorescent image 820, and the visible image so that the fluorescent image 810, the fluorescent image 820, and the visible image 830 are superimposed.
  • 830 can be output.
  • the treatment support system 1200 is configured to display on the display device 900 a composite image 860 in which a fluorescent image 810, a fluorescent image 820, and a visible image 830 are superimposed.
  • FIG. 14 shows an example in which a pre-treatment composite image 861 in which a pre-treatment fluorescent image 811, a pre-treatment fluorescent image 821, and a pre-treatment visible image 831 are superimposed is displayed on the display device 900.
  • the image output unit 224 causes the display device 900 to display the fluorescent image 810 and the visible image 830 in a superimposed manner, and to display the fluorescent image 820 and the visible image 830 in a superimposed manner.
  • a fluorescence image 810, a fluorescence image 820, and a visible image 830 can be output.
  • the treatment support system 1200 includes a composite image 840 in which a fluorescent image 810 and a visible image 830 are superimposed, and a composite image 850 in which a fluorescent image 820 and a visible image 830 are superimposed. Can be displayed side by side on the display device 900.
  • An example of display is shown.
  • the image output unit 224 like the image output unit 24 of the first embodiment, among the fluorescence images 810 stored in the storage unit 23, the pre-treatment fluorescence image 811 and the post-treatment fluorescence.
  • An output image 800 that displays the image 812 in a comparable manner or an output image 800 that displays the image 812 in a superimposed manner can be output to the display device 900.
  • the image output unit 224 outputs, to the display device 900, an output image 800 that displays the pre-treatment fluorescent image 821 and the post-treatment fluorescent image 822 in a comparable manner among the fluorescent images 820 stored in the storage unit 23. It is configured to be able to.
  • the image output unit 224 outputs to the display apparatus 900 an output image 800 that displays a plurality of pre-treatment composite images 861 and post-treatment composite images 862 side by side. It is configured as follows. Specifically, as illustrated in FIG. 15, the treatment support system 1200 includes a plurality (three) of pre-treatment composite images 861 (861a, 861b, and 861c) and a plurality (three) of post-treatment composite images 862 ( 862a, 862b, and 862c) can be displayed side by side on the display device 900.
  • the image output unit 224 displays the fluorescent image 810 and the visible image 830 generated after the treatment while superimposing and displaying the fluorescent image 810 and the visible image 830 generated before the treatment.
  • An output image 800 to be displayed in a superimposed manner is output to the display device 900.
  • the treatment support system 1200 includes a pre-treatment composite image 841 in which a pre-treatment visible image 831 is superimposed on a pre-treatment visible image 811 and a post-treatment fluorescent image on the post-treatment visible image 832.
  • the post-treatment composite image 852 superimposed with 822 can be displayed side by side on the display device 900. Therefore, in FIG.
  • IR700 is used to identify the position of cancer cell M, and after treatment, not IR700 whose visibility has decreased due to the death of cancer cell M, but by ICG The progress of cancer cells M can be accurately observed.
  • the treatment support apparatus 200 uses the image output unit 24 to select the pre-treatment fluorescent image and the post-treatment among the fluorescent images 810 and 820 generated by the image generation unit 22.
  • a fluorescent image can be output to the display device 900.
  • the fluorescence images 810 and 820 before and after treatment fluorescence images
  • the therapeutic effect can be easily confirmed.
  • the detection unit 70 detects two types of fluorescence Lx (Lx1 and Lx2) respectively emitted from two types of fluorescent agents (IR700 and ICG), and the image generation unit 222.
  • IR700 and ICG fluorescent agents
  • the image generation unit 222 are configured to generate two types of fluorescence images 810 and 820 based on the two types of fluorescence Lx (Lx1 and Lx2).
  • two types of fluorescent agents (IR700 and ICG) having different properties two types of fluorescent images 810 and 820 having different display modes before and after treatment can be displayed in a comparable manner. It can be displayed on the device 900.
  • two types of fluorescent images 810 and 820 having different display modes can be observed in combination, when a treatment using a fluorescent agent is performed, compared to the case of using one type of fluorescent agent. The therapeutic effect can be confirmed more easily.
  • the light source unit 250 uses the two types of excitation light Ex (Ex1 and Ex1) for exciting the two types of fluorescent agents (IR700 and ICG) administered to the subject P, respectively. It is configured to irradiate Ex2).
  • Ex1 and Ex2 two types of fluorescent agents
  • Ex2 and Ex2 Two types of fluorescent Lx (Lx1 and Lx2) can be easily generated from two types of fluorescent agents (IR700 and ICG).
  • the treatment support system 1100 (1200) is configured so that the pre-treatment composite image 841 and the post-treatment composite image 842 have the same orientation, position, and size of the surgical site Pa.
  • the present invention is not limited to this.
  • the treatment support apparatus system may be configured to match any of the orientation, position, or size of the surgical site in the image between the pre-treatment image and the post-treatment image. , They need not be configured to match.
  • the pre-treatment fluorescence image 811 and the post-treatment fluorescence image 812 are aligned based on the marker member 80 reflected in the pre-treatment fluorescence image 811 and the post-treatment fluorescence image 812.
  • the present invention is not limited to this.
  • the pre-treatment fluorescent image 811 and the post-treatment fluorescent image 812 may be aligned based on the marker member 80 reflected in the pre-treatment visible image 831 and the post-treatment visible image 832. Further, based on both the marker member 80 reflected in the fluorescent image 810 and the marker member 80 reflected in the visible image 830, the pre-treatment fluorescent image 811 and the post-treatment fluorescent image 812 may be aligned. .
  • the treatment support system 1100 (1200) is based on the position and size deviation of the marker member 80 reflected in the pre-treatment visible image 831 and the post-treatment visible image 832.
  • the present invention shows this Not limited to.
  • the treatment support system substantially matches the imaging direction with respect to the surgical site Pa at the time of imaging before treatment and at the time of imaging after treatment, whereby the pre-treatment composite image 841 (861) and the post-treatment composite image. You may comprise so that the position and magnitude
  • the treatment support system is configured so that the position of the subject P reflected in the pre-treatment composite image 841 (861) based on the specific position of the subject P reflected in the visible image 830 instead of the marker member 80, and The position of the subject P reflected in the post-treatment composite image 842 (852, 862) may be substantially matched.
  • the position of the subject P reflected in the post-treatment composite image 842 (852, 862) may be substantially matched.
  • throat cancer based on the difference in the position of the nose, ear, mouth, etc. of the subject P reflected in the pre-treatment composite image 841 (861) and the post-treatment composite image 842 (852, 862), respectively.
  • the pre-treatment composite image 841 is obtained.
  • the post-treatment composite image 842 (852, 862) may be substantially coincident with the position and size of the subject P.
  • the treatment support system 1100 (1200) is used to determine the position of the surgical site Pa in the pre-treatment composite image 841 (861) and the post-treatment composite image 842 (852, 862).
  • the pre-treatment composite image 841 (861) and the post-treatment composite image 842 (852, 862) are superposed with the sizes substantially matched, the present invention is not limited to this. I can't.
  • the pre-treatment composite image 841 (861) and the post-treatment composite image 842 are used in the treatment support system in addition to the case where the pre-treatment composite image 841 (861) and the post-treatment composite image 842 (852, 862) are superimposed.
  • the position and size of the surgical site Pa in the (852, 862) image may be substantially matched.
  • a plurality of 841 (861) and post-treatment composite images 842 (852, 862) may be displayed side by side.
  • the operation unit 40 is configured to receive an input for selecting the pre-treatment fluorescent image 811 and the post-treatment fluorescent image 812 from the fluorescent image 810 stored in the storage unit 23.
  • the operation unit may be configured not to accept an input for selecting a pre-treatment fluorescent image and a post-treatment fluorescent image. In that case, for example, a pre-treatment fluorescence image and a post-treatment fluorescence image may be determined based on the time stamp of the fluorescence image stored in the storage unit 23. Moreover, you may make it receive the input of the implementation date of treatment.
  • the image output unit 224 causes the fluorescent image 810 and the visible image 830 generated before the treatment to be superimposed and displayed, and the fluorescent image 820 and the visible image 830 generated after the treatment are displayed.
  • the fluorescence image superimposed on the visible image may be reversed before and after treatment. That is, the image output unit 224 causes the fluorescent image 820 generated before the treatment and the visible image 830 to be superimposed and displayed, and the fluorescent image 810 generated after the treatment and the visible image 830 are superimposed and displayed.
  • the image 800 may be configured to be output to the display device 900.
  • the treatment support system 1100 (1200) is configured to superimpose and display the pre-treatment composite image 841 (861) and the post-treatment composite image 842 (852, 862).
  • the present invention is not limited to this.
  • the treatment support system 1100 (1200) is displayed by superimposing only the portion of the surgical site Pa reflected in the pre-treatment composite image 841 (861) and the post-treatment composite image 842 (852, 862). You may make it comprise.
  • the treatment support system 1100 (1200) includes a plurality of pre-treatment composite images 841 (861) having different imaging directions and a plurality of post-treatment composite images 842 having different imaging directions. Although (852, 862) is displayed side by side on the display device 900, the present invention is not limited to this.
  • the treatment support system 1100 (1200) displays a plurality of pretreatment composite images 841 having different imaging timings and a plurality of posttreatment composite images 842 (852, 862) having different imaging timings on the display device 900. May be displayed side by side. In this case, for example, a plurality of pre-treatment composite images 841 (861) and a plurality of post-treatment composite images 842 (852, 862) may be displayed in chronological order, respectively.
  • the treatment support system 1100 (1200) is configured to display the pre-treatment visible image 831 on the pre-treatment fluorescent image 811 (821) and the post-treatment visible image 832 after the treatment.
  • the treatment support system 1100 (1200) superimposes the pre-treatment fluorescent image 811 (821) on the post-treatment visible image 832 and the post-treatment fluorescent image 812 (822) on the post-treatment visible image 832. You may comprise so that the made image may be displayed so that contrast is possible.
  • the post-treatment visible image 832 may be the current (latest) visible image 830.
  • the image output unit 24 (224) causes the visible image 830 generated by the image generation unit 22 (222) to include one visible image 830, a pre-treatment fluorescent image 811 (821), and a post-treatment fluorescent image 812 ( 822) may be superimposed and output to the display device 900.
  • the excitation light source 51 and the visible light source 53 were each arrange
  • the excitation light source 51 and the visible light source 53 may be arranged non-annularly, at non-uniform intervals, or may be provided one by one in the light source unit 50. Further, the numbers of the excitation light source 51 and the visible light source 53 may be different from each other. The same applies to the light source unit 250 shown in the second embodiment.
  • the treatment support apparatus 100 irradiates the fluorescent agent administered to the subject P with the excitation light Ex (Ex1, Ex2), which is confirmation light, and the excitation light.
  • Ex excitation light
  • the fluorescence Lx (Lx1, Lx2) emitted when the fluorescent agent is excited by Ex (Ex1, Ex2) is detected and imaged the present invention is not limited to this.
  • the treatment support apparatus irradiates the fluorescent drug administered to the subject P with excitation light Ex (treatment light) irradiated from a light source other than the treatment support apparatus for treating cancer, You may comprise so that the fluorescence emitted when a fluorescent chemical
  • the “treatment light” is excitation light Ex that has a wavelength band substantially equal to the excitation light Ex1 for exciting the IR 700 and has a higher irradiation intensity than the excitation light Ex1.
  • the treatment support apparatus may not include the light source unit 50 for irradiating the excitation light Ex.
  • the light source other than the treatment support apparatus disposed in the vicinity of the treatment support apparatus may be configured to emit the excitation light Ex for exciting the fluorescent drug administered to the subject P.
  • the fluorescence detection unit 71 and the fluorescence detection unit 72 for detecting the fluorescence Lx1 and the fluorescence Lx2 are provided.
  • the present invention is not limited to this.
  • the fluorescence Lx1 and the fluorescence Lx2 can be detected by one fluorescence detection unit, and a member for separating the fluorescence Lx1 and the fluorescence Lx2 is not required, so that the apparatus configuration can be simplified.
  • the treatment support system 1100 (1200) displays the image captured by the imaging unit 10 (210) on the display device 900.
  • the present invention is not limited to this. Not limited to. In this invention, you may comprise so that a treatment assistance apparatus may be equipped with the display part which displays the image imaged by the imaging part.
  • the fluorescent image 810 and 820 and the visible image 830 are displayed on the display device 900.
  • the present invention is not limited to this. In the present invention, only the fluorescent image may be displayed on the display device 900.
  • fluorescence may be emitted from different sites for each fluorescent agent.
  • one fluorescent agent may emit fluorescence from cancer cells, and another fluorescent agent may emit fluorescence from around the cancer cells.
  • a treatment support apparatus that can easily confirm a treatment effect when performing treatment using a fluorescent agent may be applied to a treatment support apparatus for treatment other than cancer.
  • the fluorescent agent is used to visualize other objects than cancer by fluorescence.
  • ICG is used as a medicine containing a substance that emits fluorescence Lx2 in a wavelength band different from the fluorescence Lx1 of IR700
  • a fluorescent agent other than ICG may be used as the agent containing a substance that emits fluorescence Lx2 in a wavelength band different from that of IR700 fluorescence Lx1.
  • a drug in which a substance that emits fluorescence Lx (Lx1) by absorbing excitation light Ex (Ex1) and an antibody that selectively binds to cancer cells M are combined.
  • a fluorescent agent other than IR700 may be used as an agent in which a substance that emits fluorescence Lx by absorbing excitation light Ex and an antibody that selectively binds to cancer cells M are combined.
  • the example using the fluorescent agent that emits the fluorescence Lx1 and the fluorescence Lx2 having peaks in the wavelength band of near-infrared light (invisible light) is shown.
  • a fluorescent agent that emits fluorescence having a peak in the wavelength band of visible light or ultraviolet light may be used as long as it is an agent that emits fluorescence when irradiated with excitation light.
  • the treatment support system 1100 (1200) displays the images side by side or displays the images in a superimposed manner so that the images can be compared with each other.
  • the present invention is not limited to this.
  • the treatment support system 1100 (1200) may be displayed by other display methods so that the images can be compared with each other.
  • the images may be switched and displayed at a predetermined time.
  • the treatment support system 1100 (1200) is configured to display the output image 800 on one display device 900 has been described. Not limited to.
  • the present invention may be configured to display on a plurality of display devices.

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Abstract

Selon l'invention, un dispositif (100) d'assistance thérapeutique comporte: une unité (22) de génération d'image fluorescente, laquelle génère une image fluorescente (810) sur la base d'un signal émis en sortie par une unité (71) de détection de rayonnement fluorescent; et une unité (24) de sortie d'image, laquelle émet en sortie parmi les images fluorescentes générées par l'unité de génération d'image fluorescente, en direction d'une unité (900) d'affichage, au moins une première image fluorescente (811) et une deuxième image fluorescente (812) correspondant à un moment thérapeutique différent.
PCT/JP2018/018285 2018-05-11 2018-05-11 Dispositif et système d'assistance therapeutique WO2019215905A1 (fr)

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Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2021038913A1 (fr) 2019-08-27 2021-03-04 株式会社島津製作所 Dispositif d'aide au traitement et procédé de génération d'image
DE102020117579A1 (de) 2020-07-03 2022-01-05 Hoya Corporation Endoskopisches Beleuchtungssystem für ein Fluoreszenzmittel
WO2022219783A1 (fr) * 2021-04-15 2022-10-20 オリンパス株式会社 Dispositif de luminothérapie, procédé de luminothérapie et programme de luminothérapie
US11931008B2 (en) 2020-06-03 2024-03-19 Shimadzu Corporation Treatment support device and method of setting region of interest
JP7472988B2 (ja) 2020-08-19 2024-04-23 株式会社島津製作所 治療支援システムおよび治療支援装置

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2011509768A (ja) * 2008-01-25 2011-03-31 ノバダック テクノロジーズ インコーポレイテッド 心筋組織におけるブラッシュを評価する方法
US20140073885A1 (en) * 2002-03-12 2014-03-13 Beth Israel Deaconess Medical Center Multi-channel medical imaging system
JP2015066129A (ja) * 2013-09-27 2015-04-13 富士フイルム株式会社 蛍光観察装置、内視鏡システム及びプロセッサ装置並びに作動方法
US20150182106A1 (en) * 2013-12-31 2015-07-02 Timothy King Switching Between White Light Imaging And Excitation Light Imaging Leaving Last Video Frame Displayed
JP2016214507A (ja) * 2015-05-19 2016-12-22 株式会社島津製作所 イメージング装置

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20140073885A1 (en) * 2002-03-12 2014-03-13 Beth Israel Deaconess Medical Center Multi-channel medical imaging system
JP2011509768A (ja) * 2008-01-25 2011-03-31 ノバダック テクノロジーズ インコーポレイテッド 心筋組織におけるブラッシュを評価する方法
JP2015066129A (ja) * 2013-09-27 2015-04-13 富士フイルム株式会社 蛍光観察装置、内視鏡システム及びプロセッサ装置並びに作動方法
US20150182106A1 (en) * 2013-12-31 2015-07-02 Timothy King Switching Between White Light Imaging And Excitation Light Imaging Leaving Last Video Frame Displayed
JP2016214507A (ja) * 2015-05-19 2016-12-22 株式会社島津製作所 イメージング装置

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2021038913A1 (fr) 2019-08-27 2021-03-04 株式会社島津製作所 Dispositif d'aide au traitement et procédé de génération d'image
US11931008B2 (en) 2020-06-03 2024-03-19 Shimadzu Corporation Treatment support device and method of setting region of interest
DE102020117579A1 (de) 2020-07-03 2022-01-05 Hoya Corporation Endoskopisches Beleuchtungssystem für ein Fluoreszenzmittel
JP7472988B2 (ja) 2020-08-19 2024-04-23 株式会社島津製作所 治療支援システムおよび治療支援装置
WO2022219783A1 (fr) * 2021-04-15 2022-10-20 オリンパス株式会社 Dispositif de luminothérapie, procédé de luminothérapie et programme de luminothérapie
JP7430845B2 (ja) 2021-04-15 2024-02-13 オリンパス株式会社 光治療装置、光治療方法および光治療プログラム

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