WO2021199962A1 - プログラム、情報処理方法および情報処理装置 - Google Patents

プログラム、情報処理方法および情報処理装置 Download PDF

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Publication number
WO2021199962A1
WO2021199962A1 PCT/JP2021/009305 JP2021009305W WO2021199962A1 WO 2021199962 A1 WO2021199962 A1 WO 2021199962A1 JP 2021009305 W JP2021009305 W JP 2021009305W WO 2021199962 A1 WO2021199962 A1 WO 2021199962A1
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Prior art keywords
image
merkmal
control unit
diagnostic imaging
catheter
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PCT/JP2021/009305
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English (en)
French (fr)
Japanese (ja)
Inventor
雄紀 坂口
悠介 関
陽 井口
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Terumo Corp
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Terumo Corp
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Priority to JP2022511730A priority Critical patent/JP7577734B2/ja
Publication of WO2021199962A1 publication Critical patent/WO2021199962A1/ja
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/04—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
    • A61B1/045—Control thereof
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/12—Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters

Definitions

  • the present invention relates to a program, an information processing method, and an information processing device.
  • a catheter system is used in which a catheter for diagnostic imaging is inserted into a luminal organ such as a blood vessel to display an image for diagnostic imaging (Patent Document 1).
  • the orientation of the image obtained by the diagnostic imaging catheter changes depending on the bending state of the diagnostic imaging catheter.
  • An operation may be performed to manually rotate the image in a predetermined orientation so that the doctor and the comedic staff can quickly grasp the condition of the luminal organ.
  • it is necessary to have the ability to correctly interpret the image being drawn, so that long-term training is required.
  • One aspect is to provide a program or the like that makes the catheter system easy to use.
  • the program acquires an image generated using a diagnostic imaging catheter inserted into a luminal organ, and displays the image in a rotated state so that the merkmal contained in the acquired image is oriented in a predetermined direction. do.
  • FIG. 1 is an explanatory diagram illustrating an outline of the catheter system 10.
  • the catheter system 10 includes a catheter 40 for diagnostic imaging, an MDU (Motor Driving Unit) 33, and an information processing device 20.
  • the diagnostic imaging catheter 40 is connected to the information processing device 20 via the MDU 33.
  • a display device 31 and an input device 32 are connected to the information processing device 20.
  • the input device 32 is an input device such as a keyboard, mouse, trackball or microphone.
  • the display device 31 and the input device 32 may be integrally laminated to form a touch panel.
  • the input device 32 and the information processing device 20 may be integrally configured.
  • FIG. 2 is an explanatory diagram illustrating an outline of the diagnostic imaging catheter 40.
  • FIG. 2 shows an example of a diagnostic imaging catheter 40 for IVUS (Intravascular Ultrasound), that is, for ultrasonic tomographic image generation, which is used when generating an ultrasonic tomographic image from the inside of a blood vessel.
  • IVUS Intravascular Ultrasound
  • the diagnostic imaging catheter 40 has a probe portion 41 and a connector portion 45 arranged at the end of the probe portion 41.
  • the probe portion 41 is connected to the MDU 33 via the connector portion 45.
  • the side of the diagnostic imaging catheter 40 far from the connector portion 45 will be referred to as the distal end side.
  • the shaft 43 is inserted inside the probe portion 41.
  • a sensor 42 is connected to the tip end side of the shaft 43. The shaft 43 and the sensor 42 can rotate and move forward and backward inside the probe portion 41.
  • the sensor 42 is an ultrasonic transducer that transmits and receives ultrasonic waves.
  • An annular tip marker 44 is fixed in the vicinity of the tip of the probe portion 41.
  • the material of the tip marker 44 is a material such as metal that does not allow X-rays to pass through.
  • the diagnostic imaging catheter 40 may be a catheter for optical tomography (Optical Coherence Tomography) or OFDI (Optical Frequency Domain Imaging) that generates an optical tomography using near-infrared light. good.
  • the sensor 42 of these diagnostic imaging catheters 40 is a transmission / reception unit that irradiates near-infrared light and receives reflected light.
  • the diagnostic imaging catheter 40 may have sensors 42 for both an ultrasonic transducer and a transmitter / receiver for OCT or OFDI.
  • the diagnostic imaging catheter 40 may have a total of three sensors 42, including an ultrasonic transducer, a transmission / reception unit for OCT, and a transmission / reception unit for OFDI.
  • the diagnostic imaging catheter 40 is not limited to the mechanical scanning method that mechanically rotates and moves forward and backward. It may be an electronic radial scanning type diagnostic imaging catheter 40 using a sensor 42 in which a plurality of ultrasonic transducers are arranged in an annular shape.
  • the diagnostic imaging catheter 40 may have a so-called linear scanning type sensor 42 in which a plurality of ultrasonic transducers are arranged in a row along the longitudinal direction.
  • the diagnostic imaging catheter 40 may have a so-called two-dimensional array type sensor 42 in which a plurality of ultrasonic transducers are arranged in a matrix.
  • the diagnostic imaging catheter 40 in addition to the luminal wall such as the blood vessel wall, the reflexes existing inside the luminal organ such as erythrocytes and the outside of the luminal organ such as the epicardium and the heart A tomographic image containing existing organs can be generated.
  • the diagnostic imaging catheter 40 may be a vascular endoscope used when optically observing the inner wall of a luminal organ.
  • the luminal organ into which the diagnostic imaging catheter 40 is inserted and used is, for example, a blood vessel, pancreatic duct, bile duct or bronchus.
  • the diagnostic imaging catheter 40 is the machine scanning type IVUS catheter shown in FIG. 2 as an example.
  • FIG. 3 is an explanatory diagram illustrating the configuration of the catheter system 10.
  • the catheter system 10 includes an information processing device 20, an MDU 33, and a diagnostic imaging catheter 40.
  • the information processing device 20 includes a control unit 21, a main storage device 22, an auxiliary storage device 23, a communication unit 24, a display unit 25, an input unit 26, a catheter control unit 271, and a bus.
  • the control unit 21 is an arithmetic control device that executes the program of the present embodiment.
  • One or more CPUs Central Processing Units
  • GPUs Graphics Processing Units
  • TPUs Torsor Processing Units
  • multi-core CPUs and the like are used for the control unit 21.
  • the control unit 21 is connected to each hardware unit constituting the information processing device 20 via a bus.
  • the main storage device 22 is a storage device such as SRAM (Static Random Access Memory), DRAM (Dynamic Random Access Memory), and flash memory.
  • SRAM Static Random Access Memory
  • DRAM Dynamic Random Access Memory
  • flash memory temporary stores information necessary in the middle of processing performed by the control unit 21 and a program being executed by the control unit 21.
  • the auxiliary storage device 23 is a storage device such as a SRAM, a flash memory, a hard disk, or a magnetic tape.
  • the auxiliary storage device 23 stores a program to be executed by the control unit 21, a standard image DB (Database) 65, and various data necessary for executing the program.
  • the standard image DB 65 may be stored in an external large-capacity storage device or the like connected to the information processing device 20.
  • the communication unit 24 is an interface for communicating between the information processing device 20 and the network.
  • the display unit 25 is an interface that connects the display device 31 and the bus.
  • the input unit 26 is an interface that connects the input device 32 and the bus.
  • the catheter control unit 271 controls the MDU 33, controls the sensor 42, generates an image based on the signal received from the sensor 42, and the like.
  • the MDU 33 rotates the sensor 42 and the shaft 43 inside the probe unit 41.
  • the catheter control unit 271 generates one image for each rotation of the sensor 42.
  • the generated image is a cross-layer image centered on the probe portion 41 and substantially perpendicular to the probe portion 41.
  • the MDU 33 can move forward and backward while rotating the sensor 42 and the shaft 43 inside the probe unit 41.
  • the catheter control unit 271 continuously generates a plurality of transverse layer images substantially perpendicular to the probe unit 41 at predetermined intervals.
  • the control unit 21 may realize the function of the catheter control unit 271.
  • the information processing device 20 is an X-ray angiography device, an X-ray CT (Computed Tomography) device, an MRI (Magnetic Resonance Imaging) device, a PET (Positron Emission Tomography) device, or a supermarket via HIS (Hospital Information System) or the like. It is connected to various diagnostic imaging devices 37 such as a sound wave diagnostic device.
  • X-ray CT Computed Tomography
  • MRI Magnetic Resonance Imaging
  • PET Positron Emission Tomography
  • HIS Hospital Information System
  • the information processing device 20 of the present embodiment is a dedicated ultrasonic diagnostic device, a personal computer, a tablet, a smartphone, or the like having the function of the ultrasonic diagnostic device.
  • FIG. 4 is an explanatory diagram illustrating the record layout of the standard image DB65.
  • the standard image DB 65 is a database in which the observation target site and the standard image are recorded in association with each other.
  • the standard image DB 65 has a site field and a standard image field.
  • the part to be observed is recorded in the part field.
  • "LAD” in the first line indicates the left anterior descending artery (Left Anterior Descending Coronary Artery).
  • "LCX” and “RCA” also indicate the site of the coronary artery.
  • the site shown in FIG. 4 is an example and is not limited thereto.
  • the standard image DB 65 may record records corresponding to any site where the diagnostic imaging catheter 40 may be inserted, such as blood vessels in the lower extremities, bile ducts, or bronchial bifurcations.
  • the standard image field a standard image generated at the observation target site is recorded.
  • the standard image is a typical image used by a doctor for diagnosis using the diagnostic imaging catheter 40, and is rotated in a direction familiar to the doctor.
  • standard images contain merkmal, which doctors use to mark their decisions.
  • the merkmal is, for example, a side branch structure of a luminal organ into which a diagnostic imaging catheter 40 is inserted, an organ such as the heart adjacent to the luminal organ, or a luminal organ running parallel to the luminal organ.
  • a diagnostic imaging catheter 40 is inserted into a coronary artery
  • doctors and technicians as merkmal, use a blood vessel in the side branch that branches off the coronary artery to rotate the displayed image so that it is on the lower side.
  • the epicardium is used to rotate the image displayed so that it is on top.
  • the standard image may be an image artificially generated using a technique such as computer graphics.
  • the standard image may be an image generated by synthesizing a plurality of case images.
  • the standard image DB 65 has one record for one observation target site.
  • the standard image DB 65 may have a field for recording the subject's attributes such as the subject's age, gender or underlying disease.
  • the standard image DB 65 may have a field for recording lesions included in the observation target site, such as the presence or absence of dissociation or the presence or absence of calcification. In the standard image field, a standard image corresponding to each attribute or lesion is recorded.
  • FIG. 5 to 7 are examples of screens displayed by the catheter system 10.
  • FIG. 5 shows an example of a screen displayed on the display device 31 by the control unit 21 in a state where the association with the standard image is not detected.
  • the screen shown in FIG. 5 includes a first image field 51, a part selection button 591, a status notification field 571, and an automatic rotation button 581.
  • the part selection button 591 is a pull-down menu type button, and the part to be observed that the user is observing is selected.
  • control unit 21 acquires the observation target part from the electronic medical record system.
  • the control unit 21 may detect the position of the tip marker 44 from the image of the diagnostic imaging apparatus 37 and determine the observation target portion.
  • the control unit 21 may acquire the observation target portion determined by the diagnostic imaging apparatus 37.
  • the control unit 21 automatically sets the site selection button 591 in a state where the observation target site is selected.
  • the control unit 21 may wait for the user to operate the part selection button 591 without automatically setting the part selection button 591. Even when the control unit 21 automatically sets the part selection button 591, the user can operate the part selection button 591 to change the observation target part.
  • the control unit 21 may accept the operation of the part selection button 591 by the user by voice input.
  • the control unit 21 searches the standard image DB 65 using the observation target part set on the part selection button 591 as a key, and extracts the standard image.
  • the control unit 21 rotates the real-time image and detects an angle at which the image becomes similar to the standard image.
  • control unit 21 repeats the process of determining the similarity with the standard image after rotating the real-time image by an arbitrary angle such as 3 degrees or 5 degrees.
  • the control unit 21 may repeat the process of generating an image obtained by rotating one or a plurality of sound line data acquired from the sensor 42 and determining the similarity with the standard image.
  • the degree of similarity is, for example, the sum of the difference squares (SSD: Sum of Squared Difference), the sum of the absolute values of the differences (SAD: Sum of Absolute Difference), or the normalized cross-correlation (SSD) of the pixel values of the pixels at the same position in the two images. It can be evaluated by NCC: Normalized Cross-Correlation). All of the above methods are examples. The similarity evaluation method is not limited to these.
  • control unit 21 After repeating the process until the real-time image makes one rotation, the control unit 21 extracts the angle having the highest degree of similarity. The control unit 21 determines whether or not the similarity at the angle exceeds a predetermined threshold value.
  • the control unit 21 displays "not detected” in the status notification column 571 as shown in FIG. 5, and sets the automatic rotation button 581 to a non-selectable state.
  • the control unit 21 sets the automatic rotation button 581 in a selectable state as shown in FIG. In FIG. 6, the automatic rotation button 581 is set to the “OFF” state.
  • the control unit 21 displays a real-time image in a non-rotated state in the first image field 51.
  • FIG. 7 shows an example of an image displayed on the display device 31 by the control unit 21 when the user sets the automatic rotation button 581 to the “ON” state.
  • the control unit 21 displays a real-time image rotated in the direction most similar to the standard image in the first image field 51. The user can easily grasp the state of the luminal organ and its surroundings from the displayed real-time image.
  • control unit 21 may rotate the real-time image and set the automatic rotation button 581 to the "ON" state at the same time when the orientation similar to the standard image is detected.
  • the control unit 21 may accept the operation of the automatic rotation button 581 by voice input.
  • FIG. 8 is a modified example of the screen displayed by the catheter system 10.
  • the second image field 52 is displayed between the part selection button 591 and the automatic rotation button 581.
  • the control unit 21 displays the rotated real-time image in the first image field 51 and the non-rotated real-time image in the second image field 52.
  • the image described with reference to FIG. 8 is displayed on the display device 31 arranged in a place where it is easy for a doctor who mainly operates the diagnostic imaging catheter 40 to observe, and it is easy for other medical staff to observe.
  • the image described with reference to FIG. 7 may be displayed on the display device 31 arranged at the location.
  • FIG. 9 is a flowchart illustrating the flow of program processing.
  • the control unit 21 acquires the observation target portion (step S501).
  • the control unit 21 searches the standard image DB 65 using the observation target portion acquired in step S501 as a key, and acquires the extracted standard image (step S502).
  • the control unit 21 acquires a real-time image from the catheter control unit 271 (step S503).
  • the control unit 21 displays the image described with reference to FIG. 5 (step S504).
  • the control unit 21 activates a subroutine for calculating the rotation angle (step S505).
  • the rotation angle calculation subroutine is a subroutine that calculates the rotation angle at which the degree of similarity between the standard image and the real-time image becomes high. The processing flow of the rotation angle calculation subroutine will be described later.
  • the control unit 21 determines whether or not the similarity between the real-time image and the standard image at the rotation angle calculated by the rotation angle calculation subroutine exceeds a predetermined threshold value (step S506). When it is determined that the predetermined threshold value is not exceeded, that is, it is not sufficiently similar (NO in step S506), the control unit 21 returns to step S503.
  • control unit 21 sets the rotation angle for rotating the real-time image when the automatic rotation button 581 is selected to the angle calculated in step S505 (step). S507).
  • the control unit 21 displays the image described with reference to FIGS. 6 to 8 on the display device 31 (step S508).
  • control unit 21 updates the image displayed in the first image field 51 in real time.
  • the control unit 21 switches whether or not to rotate the real-time image displayed in the first image field 51 based on the operation of the automatic rotation button 581 by the user.
  • the control unit 21 ends the process when the diagnostic imaging catheter 40 is removed from the MDU 33.
  • step S503 the control unit 21 displays a real-time image at the same rotation angle as immediately before the user operates the part selection button 591.
  • the image displayed in the first image field 51 is rotated, and it is possible to prevent the user who is observing the real-time image from being confused.
  • FIG. 10 is a flowchart illustrating the processing flow of the rotation angle calculation subroutine.
  • the rotation angle calculation subroutine is a subroutine that calculates the rotation angle at which the degree of similarity between the standard image and the real-time image becomes high.
  • the control unit 21 calculates the degree of similarity between the standard image and the real-time image (step S511). As described above, the similarity can be evaluated by using an arbitrary method such as the sum of the difference squares of the pixel values of the pixels at the same position in the two images, the sum of the absolute values of the differences, or the normalized cross-correlation.
  • the control unit 21 may accept the selection of the method to be used by the user.
  • the control unit 21 stores the rotation angle and the degree of similarity in the auxiliary storage device 23 or the main storage device 22 (step S512).
  • the initial value of the rotation angle is zero.
  • the control unit 21 determines whether or not the real-time image has rotated once (step S513). When it is determined that the image has not rotated once (NO in step S513), the control unit 21 rotates the image being processed by a predetermined angle (step S514). The control unit 21 returns to step S511.
  • control unit 21 calculates a rotation angle having a high degree of similarity based on the relationship between the rotation angle recorded in step S512 and the degree of similarity (step S515). After that, the control unit 21 ends the process.
  • the control unit 21 may perform image processing for clearly extracting the merkmal, such as edge enhancement or contrast correction, on the standard image and the real-time image before calculating the similarity in step S511.
  • the control unit 21 may calculate the similarity by using an image obtained by averaging images of a plurality of adjacent frames instead of a real-time image. Since the reflectors such as red blood cells flowing inside the luminal organ are not depicted, the merkmal becomes clear. By using an image in which the merkmal is clearly extracted, it is possible to accurately calculate the rotation angle at which the degree of similarity between the two becomes high.
  • the control unit 21 may perform a process of reducing the standard image and the real-time image before calculating the similarity in step S511.
  • the standard image DB 65 may record a standard image for reduction processing. By using the reduced image, it is possible to speed up the arithmetic processing when calculating the similarity.
  • control unit 21 may activate step S505 once every two frames or three frames, for example.
  • the control unit 21 may determine that the frame to be processed in step S505 is synchronized with the electrocardiogram.
  • Part or all of the program may be executed on a large computer connected via a network, a virtual machine running on the large computer, or a cloud computing system.
  • a part or all of the program may be executed by a plurality of personal computers or the like that perform distributed processing.
  • a catheter system 10 that automatically rotates a real-time image in a direction similar to a standard image. For example, when multiple medical staff such as doctors and nurses work together to make a diagnosis and treatment, such as in a catheter room, the real-time images are displayed in the appropriate orientation so that each medical staff can quickly perform the diagnosis and treatment of the luminal organ. You can grasp the state. Therefore, catheter treatment can be performed promptly and appropriately.
  • a moving image or a still image stored in the auxiliary storage device 23 or the like may be used. It is possible to provide a catheter system 10 that can be used for recording medical records after the end of a case.
  • the information processing device 20 may be a personal computer, tablet, smartphone, or the like that does not have a function of connecting the MDU 33 and the diagnostic imaging catheter 40.
  • the present embodiment relates to a catheter system 10 that continuously calculates a rotation angle.
  • the description of the parts common to the first embodiment will be omitted.
  • FIG. 11 is a flowchart illustrating a processing flow of the program of the second embodiment. Since the processes from step S501 to step S508 are common to the processes of the program of the first embodiment described with reference to FIG. 9, the description thereof will be omitted.
  • the control unit 21 acquires a real-time image from the catheter control unit 271 (step S521).
  • the control unit 21 activates a subroutine for calculating the rotation angle (step S522).
  • the subroutine for calculating the rotation angle is the same subroutine as the subroutine described with reference to FIG.
  • the control unit 21 determines whether or not the real-time image has rotated (step S523). Specifically, the control unit 21 determines that the real-time image has rotated when the difference between the rotation angle set in step S507 and the rotation angle calculated in step S522 is larger than a predetermined threshold value.
  • the predetermined threshold value may be an angle for one sound line data, or may be an angle such as 30 degrees or 60 degrees that can be easily identified by the user.
  • the control unit 21 may accept the setting of the threshold value by the user.
  • step S523 When it is determined that the rotation has been performed (YES in step S523), the control unit 21 updates the rotation angle set in step S507 to the rotation angle newly calculated in step S522 (step S524). When it is determined that the rotation is not occurring (NO in step S523), or after the end of step S524, the control unit 21 determines whether or not to end the process (step S525).
  • control is performed when a termination instruction is received from the user, when the diagnostic imaging catheter 40 is removed from the MDU 33, or when the user operates the site selection button 591 to select another observation target site.
  • the unit 21 determines that the process is completed. When it is determined that the process is not completed (NO in step S525), the control unit 21 returns to step S508. If it is determined that the process is to be completed (YES in step S525), the control unit 21 ends the process.
  • the catheter system 10 that automatically follows the rotation of the real-time image due to the influence of the bending state of the luminal organ and continues to correct the orientation of the real-time image.
  • the present embodiment relates to a catheter system 10 that uses a schema that schematically represents the structure of a luminal organ and its surrounding organs as a standard image.
  • the real-time image is rotated in a direction in which the similarity with the schema becomes high.
  • the description of the parts common to the first embodiment will be omitted.
  • FIG. 12 is an explanatory diagram illustrating the configuration of the learning model 61.
  • the learning model 61 is a model that accepts a real-time image and outputs an object arrangement image 482 that maps the types of a plurality of objects included in the real-time image and the range of each object in association with each other.
  • the learning model 61 is generated by machine learning.
  • the hatch of the thin horizontal line is the "cross section of the diagnostic imaging catheter 40"
  • the hatch of the lower right is “inside the luminal organ”
  • the hatch of the thick left lower is “outside the heart”. "Membrane” is shown respectively.
  • FIG. 12 schematically shows that each object is painted in a different color.
  • Coloring objects is an example of how to display each object separately. It may be displayed so as to be distinguishable from other objects by any aspect such as surrounding the outer edge of each object.
  • a cross-layer image is displayed in a portion of the object arrangement image 482 other than the objects listed above.
  • the control unit 21 may classify the entire surface of the object arrangement image 482 into some object such as "luminal organ wall”, “plaque”, “calcification”, “guide wire”, etc., and display them separately. ..
  • the learning model 61 is, for example, a semantic segmentation model, and includes an input layer, a neural network, and an output layer.
  • the neural network has a U-Net structure that realizes semantic segmentation.
  • the U-Net structure is composed of a multi-layered encoder layer and a multi-layered decoder layer connected behind the multi-layered encoder layer. Semantic segmentation assigns a label to each pixel that makes up the input image, indicating the type of object.
  • the control unit 21 can generate an output image in which objects are mapped with different colors for each type, as shown in the object arrangement image 482 of FIG. 4, by determining the display method of each pixel according to the label.
  • a schema of the standard image which is painted in the same color as the object arrangement image, is recorded.
  • the learning model 61 shown in FIG. 12 is an example of a model that outputs information about the merkmal included in the image when the image is input.
  • the learning model 61 may be a model that detects merkmal or the like from an image using Mask R-CNN (Regions with Convolutional Neural Networks).
  • FIG. 13 is a flowchart illustrating a processing flow of the subroutine for calculating the rotation angle according to the third embodiment.
  • the subroutine of FIG. 13 is a subroutine used in place of the rotation angle calculation subroutine described with reference to FIG.
  • the control unit 21 inputs the real-time image acquired from the catheter control unit 271 into the learning model 61, and acquires an object arrangement image 482 in which the types of a plurality of objects included in the real-time image and the range of each object are associated with each other. (Step S531).
  • the control unit 21 calculates the degree of similarity between the standard image and the object arrangement image 482 (step S532).
  • the control unit 21 stores the rotation angle and the degree of similarity in the auxiliary storage device 23 or the main storage device 22 (step S533).
  • the initial value of the rotation angle is zero.
  • the control unit 21 determines whether or not the real-time image has rotated once (step S534). When it is determined that the object has not rotated once (NO in step S534), the control unit 21 rotates the object arrangement image acquired in step S531 by a predetermined angle (step S535). The control unit 21 returns to step S532.
  • control unit 21 calculates a rotation angle having a high degree of similarity based on the relationship between the rotation angle recorded in step S533 and the degree of similarity (step S536). After that, the control unit 21 ends the process.
  • a catheter system 10 that can use a schema for a standard image. For example, when using a new type of diagnostic imaging catheter 40, or when using a diagnostic imaging catheter 40 for a new application, a catheter that can be used even when an actual case image suitable for a standard image cannot be prepared. System 10 can be provided.
  • the present embodiment relates to a catheter system 10 that calculates a rotation angle based on a user-designated merkmal from a real-time image.
  • the description of the parts common to the third embodiment will be omitted.
  • FIG. 14 is an explanatory diagram illustrating the record layout of the Mercumal DB.
  • the merkmal DB is a DB that records an observation target site, a name of the merkmal, and a merkmal image indicating a position where the merkmal is displayed in association with each other.
  • the Mercumal DB has a site field, a Mercumal name field, and a Mercumal image field.
  • the part to be observed is recorded in the part field.
  • the name of the merkmal is recorded in the merkmal name field.
  • An image showing the range of the merkmal is recorded in the merkmal image field.
  • a plurality of merkmal names may be recorded for one observation target site.
  • One merkmal name may be associated with a plurality of observation target sites.
  • the Mercumal DB has one record for a combination of a set of observation sites and a Mercumal name.
  • a record is recorded when the observation target site is "LAD" and the merkmal name is "epicardium".
  • the standard range for displaying the merkmal "epicardium” that is, the standard position for displaying the "epicardium” while the diagnostic imaging catheter 40 is being inserted into the "LAD”.
  • a merkmal image showing a standard shape is recorded.
  • the hatched portion is a standard range for displaying the merkmal.
  • a record is recorded when the observation target site is "LAD” and the merkmal name is "D1 (First Diagonal Branch)".
  • D1 First Diagonal Branch
  • FIG. 15 is an example of a screen displayed by the catheter system 10 of the fourth embodiment.
  • FIG. 15 is an example of an image displayed on the display device 31 by the control unit 21 when the user manually specifies the merkmal.
  • the screen shown in FIG. 15 includes a first image field 51, a part selection button 591, a merkmal selection button 592, and an automatic rotation button 581.
  • a designated reception image for accepting the designation of the merkmal by the user is displayed.
  • the designated reception image is a real-time image obtained by using the diagnostic imaging catheter 40, or a pause image in which the update of the real-time image is paused based on an operation by the user.
  • the part selection button 591 is a pull-down menu type button, and the part to be observed that the user is observing is selected.
  • the merkmal selection button 592 is a pull-down menu type button, and the name of the merkmal specified by the user is selected.
  • control unit 21 acquires the observation target part from the electronic medical record system.
  • the control unit 21 may detect the position of the sensor 42 from the image being captured by the diagnostic imaging apparatus 37 and determine the observation target portion.
  • the control unit 21 may acquire the observation target portion determined by the diagnostic imaging apparatus 37.
  • the control unit 21 automatically sets the site selection button 591 in a state where the observation target site is selected.
  • the control unit 21 may wait for the user to operate the part selection button 591 without automatically setting the part selection button 591. Even when the control unit 21 automatically sets the part selection button 591, the user can operate the part selection button 591 to change the observation target part.
  • the control unit 21 may accept the operation of the part selection button 591 by the user by voice input.
  • the control unit 21 searches the merkmal DB using the observation target site as a key, and extracts the merkmal name associated with the site.
  • the control unit 21 sets the extracted merkmal name as an option when the pull-down menu of the merkmal selection button 592 is opened.
  • the control unit 21 accepts the operation of the merkmal selection button 592 by the user.
  • the control unit 21 displays the cursor 68 in the first image field 51.
  • the user operates the cursor 68 using an input device such as a mouse to input a designated frame 69 indicating the range of the merkmal.
  • the control unit 21 acquires the range of the merkmal specified by the user.
  • control unit 21 accepts the designation of the range of the merkmal through a user interface similar to that of so-called paint software.
  • the control unit 21 specifies the range of the merkmal in the first image field 51 based on the observation target part selected via the part selection button 591 and the part selection button 591 selected via the merkmal selection button 592.
  • a designated frame 69 having a shape suitable for the above may be displayed, and movement and deformation operations by the user may be accepted.
  • the user selects the automatic rotation button 581.
  • the control unit 21 searches the merkmal DB using the observation target part set on the part selection button 591 and the merkmal name set on the merkmal selection button 592 as keys, and extracts the merkmal image.
  • the control unit 21 detects an angle at which the range of the designated frame 69 designated by the user and the range of the merkmal included in the merkmal image are in a similar state.
  • a designated frame image is generated in which the range designated by the designated frame 69 is filled in the same manner as the merkmal image on a white background having the same dimensions as the control unit 21 designated reception image.
  • the control unit 21 repeatedly performs a process of determining the degree of similarity with the Mercumal image after rotating the designated frame image by an arbitrary angle. After repeating the process until the designated frame image makes one rotation, the control unit 21 extracts the angle having the highest degree of similarity. The control unit 21 rotates the designated reception image together with the designated frame 69.
  • FIG. 16 is a flowchart illustrating a processing flow of the program of the fourth embodiment.
  • the control unit 21 acquires the observation target portion (step S541).
  • the control unit 21 searches the merkmal DB using the observation target portion acquired in step S541 as a key, and extracts the merkmal name (step S542).
  • the control unit 21 sets the merkmal name extracted in step S542 as the option of the merkmal selection button 592.
  • the control unit 21 acquires the merkmal name selected by the user (step S543).
  • the control unit 21 searches the merkmal DB using the observation target portion acquired in step S541 and the merkmal name acquired in step S543 as keys, and extracts the merkmal image (step S544).
  • the control unit 21 prompts the user to input the merkmal.
  • the user operates the cursor 68 to input the designated frame 69 indicating the range of the merkmal drawn on the designated reception image.
  • the control unit 21 acquires the designated frame 69 input by the user (step S545).
  • the control unit 21 generates a designated frame image (step S546).
  • the control unit 21 activates a subroutine for calculating the rotation angle (step S547).
  • the subroutine for calculating the rotation angle is the same subroutine as the subroutine described with reference to FIG. 10, and is a subroutine for calculating the rotation angle at which the degree of similarity between the standard image and the real-time image becomes high.
  • the control unit 21 inputs the merkmal acquired in step S544 into the standard image instead of the standard image, and inputs the designated frame image generated in step S546 instead of the real-time image into the subroutine for calculating the rotation angle. do.
  • the control unit 21 sets the rotation angle for rotating the real-time image when the automatic rotation button 581 is selected to the angle calculated in step S547 (step S548).
  • the control unit 21 rotates the designated reception image displayed in the first image field 51 (step S549).
  • the control unit 21 updates the image displayed in the first image field 51 in real time.
  • the control unit 21 switches whether or not to rotate the real-time image displayed in the first image field 51 based on the operation of the automatic rotation button 581 by the user.
  • the control unit 21 ends the process.
  • the control unit 21 may deform the position and shape of the designated frame 69 so as to follow the real-time image. Since the method of following a designated area or point on a moving image has been conventionally used, the description thereof will be omitted.
  • the control unit 21 ends the process and re-executes the program.
  • the control unit 21 receives an instruction to display a real-time image during re-execution, the control unit 21 displays it at the same rotation angle as immediately before the user operates the part selection button 591.
  • the image displayed in the first image field 51 is rotated, and it is possible to prevent the user who is observing the real-time image from being confused.
  • a catheter system 10 that automatically rotates a real-time image in a direction similar to a standard image based on a merkmal that is read and specified by a user.
  • the user can specify the appropriate merkmal according to the planned treatment procedure.
  • control unit 21 supports the input of the designated frame 69 by using the learning model 61 described with reference to FIG.
  • the control unit 21 replaces step S545 of the program described with reference to FIG. 16 with the following processing and executes the program.
  • the control unit 21 inputs the designated reception image into the learning model 61 and acquires the object arrangement image.
  • the control unit 21 extracts the outline of the object corresponding to the merkmal name received via the merkmal selection button 592.
  • the control unit 21 uses the extracted contour line for the default designated frame 69 and displays it in the first image field 51.
  • the control unit 21 accepts the user to modify the designated frame 69.
  • Modification 2 In the modification-2, the rotation angle is automatically calculated without accepting the modification of the designated frame 69 by the user.
  • the control unit 21 replaces step S545 and step S546 of the program described with reference to FIG. 16 with the following processing and executes the program.
  • the control unit 21 inputs the designated reception image into the learning model 61 described with reference to FIG. 12 and acquires the object arrangement image.
  • the control unit 21 extracts the pixels corresponding to the object corresponding to the merkmal name received via the merkmal selection button 592.
  • the control unit 21 generates a designated frame image by setting a background color other than the extracted pixels to, for example, white.
  • the present embodiment relates to a catheter system 10 that extracts a merkmal and rotates an image during a pullback operation.
  • the description of the parts common to the first embodiment will be omitted.
  • the screen shown in FIG. 17 includes a first image field 51, a second image field 52, a part selection button 591, a merkmal selection button 592, and an automatic rotation button 581.
  • a real-time image is displayed in the first image column 51.
  • a vertical tomographic image is displayed in the second image column 52.
  • the right end of the vertical tomographic image corresponds to the real-time image, and as the sensor 42 moves to the MDU33 side by the pullback operation, the vertical tomographic image displayed in the second image field 52 extends to the right.
  • SFA Superficial Femoral Artery
  • DFA Deep Femoral Artery
  • FIG. 17 shows the state after the detection of merkmal.
  • the detection mark 572 displayed on the edge of the second image field 52 indicates the position where the merkmal is detected.
  • the control unit 21 sets the automatic rotation button 581 in a selectable state.
  • the automatic rotation button 581 is selected, and the rotated image is displayed in the first image field 51 and the second image field 52.
  • FIG. 19 is a flowchart illustrating a processing flow of the program of the fifth embodiment.
  • the control unit 21 acquires the observation target portion (step S551).
  • the control unit 21 searches the standard image DB 65 using the observation target portion acquired in step S551 as a key, and acquires the extracted standard image (step S552).
  • the control unit 21 receives an instruction from the user to start the pullback operation (step S553).
  • the control unit 21 acquires a real-time image from the catheter control unit 271 (step S554).
  • the control unit 21 displays the image described with reference to FIG. 17 (step S555).
  • the control unit 21 activates a subroutine for calculating the rotation angle (step S556).
  • the subroutine for calculating the rotation angle is the same subroutine as the subroutine described with reference to FIG.
  • the control unit 21 determines whether or not the similarity between the real-time image and the standard image at the rotation angle calculated by the rotation angle calculation subroutine exceeds a predetermined threshold value (step S557). When it is determined that the predetermined threshold value is not exceeded, that is, it is not sufficiently similar (NO in step S557), the control unit 21 determines whether or not the pullback operation is completed (step S558).
  • step S558 If it is determined that the process has not been completed (NO in step S558), the control unit 21 returns to step S554. When it is determined that the process is completed (YES in step S558), the control unit 21 ends the process.
  • control unit 21 determines the rotation angle for rotating the real-time image when the automatic rotation button 581 is selected.
  • the angle is set to the angle calculated in step S557 (step S559).
  • the control unit 21 displays the image described with reference to FIG. 18 on the display device 31 (step S560).
  • control unit 21 updates the images displayed in the first image field 51 and the second image field 52 in real time.
  • the control unit 21 switches whether or not to rotate the images displayed in the first image field 51 and the second image field 52 based on the operation of the automatic rotation button 581 by the user.
  • the control unit 21 ends the process.
  • control unit 21 may rotate the images to be displayed in the first image field 51 and the second image field 52 when the rotation angle is set in step S560.
  • a catheter system 10 that detects a merkmal during a pullback operation and rotates an image. It is possible to provide a catheter system 10 that automatically rotates an image in a predetermined direction even when the place where the merkmal is drawn is small.
  • the present embodiment relates to a program that generates a learning model 61.
  • the description of the parts common to the third embodiment will be omitted.
  • FIG. 20 is an explanatory diagram for explaining the record layout of the training DB.
  • the training DB is a database that records the input and the correct label in association with each other, and is used for training the model by machine learning.
  • the training DB has an input data feel and a color-coded data field.
  • an input image acquired by using the diagnostic imaging catheter 40 is recorded.
  • an image in which an input image is painted in a different color for each object by a specialist such as a doctor is recorded. That is, an object corresponding to each pixel constituting the input image is recorded in the coloring data field.
  • the training DB a large amount of combinations of an input image generated by using the diagnostic imaging catheter 40 and an image painted by an expert or the like are recorded.
  • FIG. 21 is a flowchart illustrating a processing flow of the program of the sixth embodiment. A case where machine learning of the learning model 61 is performed using the information processing device 20 will be described as an example.
  • the program of FIG. 21 may be executed by hardware different from the information processing device 20, and the learning model 61 for which machine learning has been completed may be copied to the auxiliary storage device 23 via the network.
  • the learning model 61 trained by one hardware can be used by a plurality of information processing devices 20.
  • an unlearned model such as a U-Net structure that realizes semantic segmentation is prepared.
  • the U-Net structure is composed of a multi-layered encoder layer and a multi-layered decoder layer connected behind the multilayer encoder layer.
  • the program of FIG. 19 adjusts each parameter of the prepared model to perform machine learning.
  • the control unit 21 acquires a training record used for training one epoch from the training DB (step S571).
  • the control unit 21 adjusts the model parameters so that the correct image label is output from the output layer when the input image is input to the input layer of the model (step S572).
  • the program may appropriately have a function of causing the control unit 21 to accept corrections by the user, present the basis for judgment, relearn, and the like.
  • the control unit 21 determines whether or not to end the process (step S573). For example, when the control unit 21 finishes learning a predetermined number of epochs, it determines that the process is finished.
  • the control unit 21 may acquire test data from the training DB, input it to the model being machine-learned, and determine that the process ends when an output with a predetermined accuracy is obtained.
  • step S573 If it is determined that the process is not completed (NO in step S573), the control unit 21 returns to step S571.
  • the control unit 21 records the parameters of the trained model in the auxiliary storage device 23 (step S574). After that, the control unit 21 ends the process.
  • a trained model is generated.
  • the learning model 61 can be generated by machine learning.
  • FIG. 22 is a functional block diagram of the information processing device 20 according to the seventh embodiment.
  • the information processing device 20 includes an acquisition unit 81 and a display unit 82.
  • the acquisition unit 81 acquires an image generated by using a diagnostic imaging catheter inserted into a luminal organ.
  • the display unit 82 displays the image in a rotated state so that the merkmal included in the image acquired by the acquisition unit 81 has a predetermined orientation.
  • FIG. 23 is an explanatory diagram illustrating the configuration of the catheter system 10 of the eighth embodiment.
  • the catheter system 10 of the present embodiment is realized by operating the catheter control device 27, the MDU 33, the diagnostic imaging catheter 40, the general-purpose computer 90, and the program 97 in combination.
  • the catheter control device 27 the MDU 33, the diagnostic imaging catheter 40, the general-purpose computer 90, and the program 97 in combination.
  • the program 97 the program 97 in combination.
  • morphology The description of the parts common to the first embodiment will be omitted.
  • the catheter control device 27 is an ultrasonic diagnostic device for IVUS that controls the MDU 33, controls the sensor 42, and generates a transverse layer image and a longitudinal tomographic image based on the signal received from the sensor 42. Since the function and configuration of the catheter control device 27 are the same as those of the conventionally used ultrasonic diagnostic device, the description thereof will be omitted.
  • the catheter system 10 of this embodiment includes a computer 90.
  • the computer 90 includes a control unit 21, a main storage device 22, an auxiliary storage device 23, a communication unit 24, a display unit 25, an input unit 26, a reading unit 29, and a bus.
  • the computer 90 is an information device such as a general-purpose personal computer, a tablet, a smartphone, or a server computer.
  • Program 97 is recorded on the portable recording medium 96.
  • the control unit 21 reads the program 97 via the reading unit 29 and stores it in the auxiliary storage device 23. Further, the control unit 21 may read the program 97 stored in the semiconductor memory 98 such as the flash memory mounted in the computer 90. Further, the control unit 21 may download the program 97 from the communication unit 24 and another server computer (not shown) connected via a network (not shown) and store the program 97 in the auxiliary storage device 23.
  • the program 97 is installed as a control program of the computer 90, loaded into the main storage device 22, and executed. As a result, the computer 90 functions as the information processing device 20 described above.
  • the computer 90 is a general-purpose personal computer, tablet, smartphone, large computer, virtual machine running on the large computer, cloud computing system, or quantum computer.
  • the computer 90 may be a plurality of personal computers or the like that perform distributed processing.
  • Catheter system 20 Information processing device 21 Control unit 22 Main storage device 23 Auxiliary storage device 24 Communication unit 25 Display unit 26 Input unit 27 Catheter control device 271 Catheter control unit 29 Reading unit 31 Display device 32 Input device 33 MDU 37 Diagnostic imaging device 40 Diagnostic imaging catheter 41 Probe part 42 Sensor 43 Shaft 44 Tip marker 45 Connector part 482 Object placement image 51 1st image field 52 2nd image field 571 Status notification field 571 Detection mark 581 Automatic rotation button 591 Site selection Button 592 Mercumal selection button 61 Learning model 65 Standard image DB 68 Cursor 69 Designated frame 81 Acquisition unit 82 Display unit 90 Computer 96 Portable recording medium 97 Program 98 Semiconductor memory

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