WO2022113587A1 - 画像表示装置、方法およびプログラム - Google Patents

画像表示装置、方法およびプログラム Download PDF

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Publication number
WO2022113587A1
WO2022113587A1 PCT/JP2021/039013 JP2021039013W WO2022113587A1 WO 2022113587 A1 WO2022113587 A1 WO 2022113587A1 JP 2021039013 W JP2021039013 W JP 2021039013W WO 2022113587 A1 WO2022113587 A1 WO 2022113587A1
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WIPO (PCT)
Prior art keywords
interest
image
region
information
display
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Ceased
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PCT/JP2021/039013
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English (en)
French (fr)
Japanese (ja)
Inventor
晶路 一ノ瀬
佳児 中村
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Fujifilm Corp
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Fujifilm Corp
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Priority to JP2022565121A priority Critical patent/JP7756107B2/ja
Priority to EP21897565.4A priority patent/EP4252663B1/en
Publication of WO2022113587A1 publication Critical patent/WO2022113587A1/ja
Priority to US18/314,796 priority patent/US20230281810A1/en
Anticipated expiration legal-status Critical
Priority to JP2025168683A priority patent/JP2026001194A/ja
Ceased legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/46—Arrangements for interfacing with the operator or the patient
    • A61B6/461—Displaying means of special interest
    • A61B6/463—Displaying means of special interest characterised by displaying multiple images or images and diagnostic data on one display
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/02—Arrangements for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis
    • A61B6/03—Computed tomography [CT]
    • A61B6/032—Transmission computed tomography [CT]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/46—Arrangements for interfacing with the operator or the patient
    • A61B6/467—Arrangements for interfacing with the operator or the patient characterised by special input means
    • A61B6/468—Arrangements for interfacing with the operator or the patient characterised by special input means allowing annotation or message recording
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    • G16H30/00—ICT specially adapted for the handling or processing of medical images
    • G16H30/40—ICT specially adapted for the handling or processing of medical images for processing medical images, e.g. editing

Definitions

  • This disclosure relates to image display devices, methods and programs.
  • CT Computer Tomography
  • MRI Magnetic Resonance Imaging
  • CAD Computer-Aided Diagnosis
  • CAD Computer-Aided Diagnosis
  • the analysis result generated by the CAD analysis process is associated with the test information such as the patient name, gender, age, and the modality obtained from the medical image, stored in the database, and used for diagnosis.
  • the doctor interprets the medical image by referring to the delivered medical image and the analysis result on his / her own image interpretation terminal. At this time, on the image interpretation terminal, the annotation is superimposed and displayed on the region of interest including the disease included in the medical image based on the analysis result.
  • Annotation is a general term for figures, characters, and symbols attached to medical images. For example, a rectangle surrounding the region of interest, a figure such as an arrow indicating the region of interest, and text such as the type and size of the disease are superimposed and displayed as annotations.
  • the interpretation doctor creates an interpretation report by referring to the annotations given to the region of interest.
  • the present disclosure has been made in view of the above circumstances, and an object of the present disclosure is to allow an image interpreter to refer only to annotations about an area of interest without performing troublesome operations.
  • the image display device comprises at least one processor.
  • the processor superimposes and displays the relevant information related to each of the multiple regions of interest contained in the medical image on the medical image so that it can be displayed or hidden. Identify at least one region of interest based on specific information that includes other information than dedicated information for identifying the region of interest of the user. Switch to view related information about the identified area of interest.
  • the processor may switch the related information related to the region of interest other than the region of interest to non-display or weak display.
  • other information may be observation conditions for medical images.
  • the other information may be the detection result of other operations related to the display or interpretation of the medical image.
  • the processor displays a medical image in which all related information is hidden.
  • related information about the region of interest may be displayed.
  • the medical image is a three-dimensional image including a plurality of tomographic images.
  • the other operation is a tomographic image paging operation.
  • the processor may identify the region of interest contained in the paging-manipulated tomographic image as the region of interest.
  • another operation is an operation of inputting a finding regarding a medical image.
  • the processor may specify the region of interest related to the term contained in the finding as the region of interest.
  • another operation is an operation of further adding related information to the region of interest included in the medical image.
  • the processor may specify the region of interest to which the relevant information is attached as the region of interest.
  • another operation is an operation of changing the size of the medical image based on the designated region of interest.
  • the processor may specify the designated region of interest as the region of interest.
  • the processor may switch to hide the related information superimposed on the region of interest by another operation.
  • the specific information may include only other information.
  • the related information may include annotations related to the region of interest.
  • the annotation may include at least one of the recognition result of the region of interest and the character information regarding the region of interest.
  • the region of interest may be a lesion or an organ included in a medical image.
  • the information processing method superimposes and displays related information related to each of a plurality of regions of interest contained in a medical image on the medical image so as to be switchable between display and non-display. Identify at least one region of interest based on specific information that includes other information than dedicated information for identifying the region of interest of the user. Switch to view related information about the identified area of interest.
  • image display method according to the present disclosure may be provided as a program for executing the computer.
  • the image interpreter can refer only to the annotation of the area of interest without performing troublesome operations.
  • FIG. 1 The figure which shows the schematic structure of the medical information system to which the image display device by embodiment of this disclosure is applied.
  • Functional configuration diagram of the image display device according to this embodiment A diagram schematically showing the relationship between the target image and the annotation
  • Diagram to explain the identification of the area of interest Diagram showing an enlarged target image A diagram showing a tomographic image with annotations displayed
  • a diagram showing a tomographic image with annotations displayed A diagram showing a tomographic image with annotations displayed
  • Flow chart showing processing performed in this embodiment A diagram showing a tomographic image in which a part of the annotation is weakly displayed.
  • a diagram showing a tomographic image in which part of the annotation is hidden A diagram showing a tomographic image in which part of the annotation is hidden A diagram showing a tomographic image in which part of the annotation is hidden A diagram showing a state in which a mask showing the area extraction result is superimposed and displayed on the image as related information. Diagram showing adjacent regions of interest A diagram showing a tomographic image in which part of the annotation is hidden
  • FIG. 1 is a diagram showing a schematic configuration of a medical information system 1.
  • the medical information system 1 shown in FIG. 1 is based on an inspection order from a doctor in a clinical department using a known ordering system, photographs of a part to be inspected of a subject, storage of a medical image acquired by the imaging, and an image interpreter. It is a system for interpreting medical images and creating interpretation reports, and for viewing the interpretation reports by the doctor of the requesting clinical department and observing the details of the medical images to be interpreted.
  • the medical information system 1 includes a plurality of imaging devices 2, a plurality of image interpretation WS (WorkStation) 3, a medical treatment WS4, an image server 5, and an image database (hereinafter, image DB (DataBase)) which are image interpretation terminals.
  • image DB DataBase
  • the report server 7 and the report database (hereinafter referred to as report DB) 8 are connected and configured so as to be able to communicate with each other via a wired or wireless network 10.
  • Each device is a computer on which an application program for functioning as a component of the medical information system 1 is installed.
  • the application program is stored in the storage device of the server computer connected to the network 10 or in the network storage in a state of being accessible from the outside, and is downloaded and installed in the computer as requested. Alternatively, it is recorded and distributed on a recording medium such as a DVD (Digital Versatile Disc) and a CD-ROM (Compact Disc Read Only Memory), and is installed in a computer from the recording medium.
  • the imaging device 2 is a device (modality) that generates a medical image representing the diagnosis target portion by photographing the diagnosis target portion of the subject. Specifically, it is a simple X-ray imaging apparatus, a CT apparatus, an MRI apparatus, a PET (Positron Emission Tomography) apparatus, and the like.
  • the medical image generated by the photographing apparatus 2 is transmitted to the image server 5 and stored in the image DB 6.
  • the image interpretation WS3 is a computer used by, for example, a radiology interpreter to interpret a medical image and create an image interpretation report, and includes an image display device according to the present embodiment.
  • a request for viewing a medical image to the image server 5 various image processing for the medical image received from the image server 5, display of the medical image, input acceptance of a finding sentence related to the medical image, and the like are performed.
  • the image interpretation WS3 creates an image interpretation report, requests registration and viewing of the image interpretation report to the report server 7, displays the image interpretation report received from the report server 7, and the like. These processes are performed by the interpretation WS3 executing a software program for each process.
  • the medical care WS4 is a computer used by doctors in the clinical department for detailed observation of images, viewing of interpretation reports, creation of electronic medical records, etc., and is a processing device, a display device such as a display, and an input device such as a keyboard and a mouse. It is composed of.
  • an image viewing request is made to the image server 5
  • an image received from the image server 5 is displayed
  • an image interpretation report viewing request is made to the report server 7
  • an image interpretation report received from the report server 7 is displayed.
  • the image server 5 is a general-purpose computer in which a software program that provides a database management system (DataBase Management System: DBMS) function is installed. Further, the image server 5 includes a storage in which the image DB 6 is configured. This storage may be a hard disk device connected by the image server 5 and the data bus, or a disk device connected to NAS (Network Attached Storage) and SAN (Storage Area Network) connected to the network 10. It may be. Further, when the image server 5 receives the request for registration of the medical image from the photographing apparatus 2, the image server 5 arranges the medical image in a format for a database and registers the medical image in the image DB 6.
  • DBMS Database Management System
  • the image data and incidental information of the medical image acquired by the imaging device 2 are registered in the image DB 6.
  • the incidental information includes, for example, an image ID (identification) for identifying an individual medical image, a patient ID for identifying a subject, an examination ID for identifying an examination, and a unique ID assigned to each medical image ( UID: unique identification), examination date when the medical image was generated, examination time, type of imaging device used in the examination to acquire the medical image, patient information such as patient name, age, gender, examination site (imaging) Information such as site), imaging information (imaging protocol, imaging sequence, imaging method, imaging conditions, use of contrast medium, etc.), series number or collection number when multiple medical images are acquired in one examination. ..
  • the image server 5 when the image server 5 receives the browsing request from the image interpretation WS3 and the medical examination WS4 via the network 10, the image server 5 searches for the medical image registered in the image DB 6, and uses the searched medical image as the requesting image interpretation WS3 and the medical examination. Send to WS4.
  • the report server 7 incorporates a software program that provides the functions of a database management system to a general-purpose computer.
  • the report server 7 receives the image interpretation report registration request from the image interpretation WS3, the report server 7 prepares the image interpretation report in a database format and registers the image interpretation report in the report DB 8.
  • the image interpretation report created by the image interpretation doctor using the image interpretation WS3 is registered in the report DB8.
  • the interpretation report is for accessing, for example, a medical image to be interpreted, an image ID for identifying the medical image, an image interpretation doctor ID for identifying the image interpretation doctor who performed the image interpretation, a disease name, a disease location information, and a medical image. Information and the like may be included.
  • the report server 7 when the report server 7 receives the image interpretation report viewing request from the image interpretation WS3 and the medical treatment WS4 via the network 10, the report server 7 searches for the image interpretation report registered in the report DB 8 and uses the searched image interpretation report as the requester's image interpretation. It is transmitted to WS3 and medical treatment WS4.
  • the diagnosis target is the chest and abdomen of the human body
  • the medical image is a three-dimensional CT image consisting of a plurality of tomographic images including the chest and abdomen.
  • the interpretation doctor interprets the CT image to create an interpretation report including findings on diseases such as lungs and liver contained in the thoracoabdomen.
  • the medical image is not limited to the CT image, and any medical image such as an MRI image and a simple X-ray image acquired by a simple X-ray imaging apparatus can be used.
  • the medical image when creating the interpretation report, the medical image is analyzed and the region of interest contained in the medical image is detected.
  • the image interpreter interprets the image while referring to the detection result. The detection of the region of interest will be described later.
  • Network 10 is a wired or wireless local area network that connects various devices in the hospital.
  • the network 10 may be configured such that the local area networks of each hospital are connected to each other by the Internet or a dedicated line.
  • FIG. 2 describes the hardware configuration of the image display device according to the present embodiment.
  • the image display device 20 includes a CPU (Central Processing Unit) 11, a non-volatile storage 13, and a memory 16 as a temporary storage area.
  • the image display device 20 includes a display 14 such as a liquid crystal display, an input device 15 including a pointing device such as a keyboard and a mouse, and a network I / F (InterFace) 17 connected to the network 10.
  • the CPU 11, the storage 13, the display 14, the input device 15, the memory 16, and the network I / F 17 are connected to the bus 18.
  • the CPU 11 is an example of the processor in the present disclosure.
  • the storage 13 is realized by an HDD (Hard Disk Drive), an SSD (Solid State Drive), a flash memory, or the like.
  • the image display program 12 is stored in the storage 13 as a storage medium.
  • the CPU 11 reads the image display program 12 from the storage 13, expands it into the memory 16, and executes the expanded image display program 12.
  • FIG. 3 is a diagram showing a functional configuration of an image display device according to the present embodiment.
  • the image display device 20 includes an image acquisition unit 21, an analysis unit 22, a display control unit 23, and a specific unit 24. Then, when the CPU 11 executes the image display program 12, the CPU 11 functions as an image acquisition unit 21, an analysis unit 22, a display control unit 23, and a specific unit 24.
  • the image acquisition unit 21 acquires a medical image to be read for creating an image interpretation report from the image server 5 in response to an instruction from the input device 15 by the image interpretation doctor who is the operator.
  • the medical image to be read is referred to as a target image G0 in the following description.
  • a plurality of images may be acquired in one inspection. Since all the images acquired in one inspection are interpreted, there may be a plurality of target images G0. Further, with respect to the patient to be inspected for interpreting the target image G0, a plurality of images may have been acquired and stored in the image server 5 in the past.
  • the target image G0 of the patient to be inspected when the target image G0 of the patient to be inspected is to be read, all the images acquired by photographing the patient to be inspected including the target image G0 are acquired from the image server 5.
  • the images other than the target image G0 are acquired before the target image G0 in a timely manner, and thus are referred to as past images GP0.
  • the target image G0 is a three-dimensional CT image composed of a plurality of tomographic images acquired by photographing the chest and abdomen of the patient to be inspected. Further, when a plurality of target images G0 are acquired in one inspection, each target image G0 may include an X-ray image acquired by simple X-ray photography in addition to a CT image. Further, the past image GP0 may include an X-ray image or the like acquired by simple X-ray photography in addition to the CT image.
  • the analysis unit 22 detects the region of the abnormal shadow included in the target image G0 as the region of interest, and derives the annotation for the detected region of interest.
  • the analysis unit 22 detects a region of shadow of a plurality of types of diseases as a region of interest from the target image G0 by using a known computer-aided image diagnosis (that is, CAD) algorithm, and derives the properties of the region of interest. , Derivation of annotations.
  • the analysis unit 22 detects abnormal shadows of a plurality of types of diseases as regions of interest from the target image G0, and machine learning is performed to derive the properties of the abnormal shadows. It has a learning model 22A.
  • deep learning is performed using teacher data so as to determine whether or not each pixel (voxel) in the target image G0 represents a shadow or an abnormal shadow of various diseases. It consists of a convolutional neural network (CNN (Convolutional Neural Network)).
  • CNN Convolutional Neural Network
  • the learning model 22A uses, for example, a teacher image including an abnormal shadow, a teacher data consisting of correct answer data representing a region of the abnormal shadow in the teacher image and the nature of the abnormal shadow, and a teacher data consisting of a teacher image not including the abnormal shadow. Is constructed by learning.
  • the learning model 22A derives a certainty (likelihood) indicating that each pixel in the medical image is an abnormal shadow, and uses a region consisting of pixels whose certainty is equal to or higher than a predetermined threshold value as a region of interest. To detect.
  • the certainty is a value of 0 or more and 1 or less.
  • the learning model 22A derives the properties of the detected region of interest.
  • the properties include the position, size, type of disease, etc. of the region of interest.
  • the learning model 22A may detect the region of interest from the three-dimensional target image G0, but may also detect the region of interest from each of the plurality of tomographic images constituting the target image G0. good. Further, as the learning model 22A, in addition to the convolutional neural network, any learning model such as a support vector machine (SVM (Support Vector Machine)) can be used.
  • SVM Support Vector Machine
  • the analysis unit 22 derives a figure surrounding the region of interest detected by the learning model, a text representing the property, a line connecting the figure and the text, and the like as annotations.
  • the annotation is derived as an image of a channel different from the target image G0 and is attached to the target image G0. Therefore, if the image of the channel of the annotation is superimposed and displayed on the target image G0, the annotation is superimposed and displayed on the target image G0.
  • FIG. 4 is a diagram schematically showing the relationship between the target image G0 and the annotation.
  • the target image G0 includes a plurality of tomographic images Dj. Further, it is assumed that an abnormal shadow is detected as a region of interest in each of the tomographic image groups GA1, GA2, and GA3 among the plurality of tomographic images Dj, and annotations are added to the detected region of interest.
  • the tomographic image Dj represents an axial cross section of a human body, but is not limited thereto.
  • FIG. 5 is a diagram showing annotations given to the tomographic image groups GA1 to GA3 shown in FIG.
  • the region of interest R1 is detected in the tomographic image DA1 included in the tomographic image group GA1, and the annotation 31 is added to the region of interest R1.
  • the annotation 31 is character information relating to the region of interest R1, and the content thereof is "recognize a SOL of 10 mm in S1.” SOL is an abbreviation for Space Occupying Lesion.
  • the annotation 31 is attached to all tomographic images in which the region of interest R1 is detected, which is included in the tomographic image group GA1.
  • the region of interest R2 is detected in the left lung, and the region of interest R3 is detected in the right lung.
  • the annotation 32 for the region of interest R2 of the left lung and the annotation 33 for the region of interest R3 of the right lung are added, respectively.
  • the annotation 32 includes a graphic 32A surrounding the region of interest of the left lung included in the tomographic image DA2, a text 32B representing the properties of the region of interest surrounded by the graphic 32A, and a leader line 32C connecting the graphic 32A and the text 32B.
  • the annotation 33 includes a figure 33A surrounding the area of interest of the right lung included in the tomographic image DA2, a text 33B representing the properties of the area of interest surrounded by the figure 33A, and a leader line 33C connecting the figure 33A and the text 33B.
  • the texts 32B and 33B relating to the region of interest are, for example, the position, size and properties of the region of interest.
  • the annotations 32 and 33 are added to all the tomographic images in which the regions of interest R2 and R3 are detected, which are included in the tomographic image group GA2.
  • the region of interest R4 contained in the liver is detected, and the annotation 34 for the region of interest R4 in the liver is added.
  • the annotation 34 includes a figure 34A surrounding the area of interest of the liver included in the tomographic image DA3, a text 34B representing the properties of the area of interest surrounded by the figure 34A, and a leader line 34C connecting the figure 34A and the text 34B.
  • the annotation 34 is attached to all tomographic images in which the region of interest R4 is detected, which is included in the tomographic image group GA3.
  • the display control unit 23 displays the image of the patient to be inspected including the target image G0 and the past image GP0 on the display 14.
  • FIG. 6 is a diagram showing an image display screen. As shown in FIG. 6, the display screen 40 has a test list area 41 for displaying a test list, a target image G0 included in the selected test, and a thumbnail image area 42 for displaying thumbnail images of past images of the patient to be tested. , Includes an image display area 43 for displaying images.
  • the patient name, patient ID, and examination date and time are displayed for each examination.
  • the operator can select the patient to be examined by clicking the desired examination list.
  • diagonal lines are added to the rows of patients to be examined selected in the examination list area 41.
  • thumbnail images of the target image G0 of the selected patient to be examined and the representative image of the past image GP0 are displayed.
  • the thumbnail image area 42 has six thumbnail images C1 to C6 as shown in FIG. Is displayed.
  • the image is a three-dimensional image
  • a reduced image of a tomographic image of a predetermined tomographic surface included in the three-dimensional image can be used as a representative image.
  • the reduced image can be used as a representative image.
  • the thumbnail images C1 and C2 are the thumbnail images of the target images G1 and G2
  • the thumbnail images C3 to C6 are the thumbnail images of the past images GP1 to GP4.
  • the target image G1 corresponds to the target image G0 shown in FIG. 4, and abnormal shadows are detected as a region of interest in the tomographic image groups GA1, GA2, and GA3 among the plurality of tomographic images Dj included in the target image G1. , It is assumed that the detected region of interest is annotated.
  • the image selected in the thumbnail image area 42 is displayed in the image display area 43.
  • the image display area 43 includes four display areas 43A to 43D.
  • representative images of the four images selected from the six thumbnail images C1 to C6 are displayed in the display areas 43A to 43D of the image display area 43, respectively.
  • the thumbnail images other than the images displayed in the image display area 43 are provided with diagonal lines in order to clearly indicate that they are not displayed in the image display area 43.
  • the thumbnail images C1 and C2 correspond to the target images G1 and G2
  • the target images G1 and G2 are displayed in the display areas 43A and 43B, respectively.
  • the past images GP1 and GP2 are displayed in the display areas 43C and 43D.
  • the target image G1 is annotated as shown in FIG. 4, the annotation is added to the representative image of the target image G1 displayed on the initial display screen 40 immediately after being displayed on the display 14. Not superimposed.
  • the image interpreter interprets the target image G1 displayed on the display screen 40 to confirm the region of interest detected by the analysis unit 22, and newly creates an abnormal shadow that the analysis unit 22 could not detect. Do the work to identify to.
  • the image interpreter can perform a paging operation for switching the tomographic plane of the target image G1 displayed in the display area 43A by moving the mouse cursor 45 to the display area 43A and rotating the mouse wheel. Further, the image interpreting doctor can perform an operation of changing the size of the displayed target image G1 by performing a predetermined size change operation using the input device 15.
  • Examples of the size change operation include moving the mouse cursor 45 to a reference position where the size of the target image G1 is desired to be changed, and rotating the mouse wheel while pressing the CTRL key. In this case, the size of the target image G1 being displayed is changed around the cursor position.
  • the paging operation and the resizing operation are examples of other operations related to the display of medical images.
  • the image interpreter may perform an operation of adding tag information indicating the nature of the newly found abnormal shadow to the target image, or an operation of inputting a finding sentence about the target image G1. Can be done.
  • the operation of adding tag information and the operation of inputting a finding sentence are examples of other operations related to the interpretation of medical images.
  • the operation of assigning the tag information indicating the property to the target image is, for example, by specifying the newly found abnormal shadow with the mouse cursor 45 and right-clicking the specified abnormal shadow, the property input window 50 shown in FIG. 7 is used. Is an operation that pops up.
  • the properties of abnormal shadows of the lung include border, shape, serration, spicula, lobation, straight line, absorption value, bronchial translucency image, cavity, calcification, fat, pleural invagination and pleural contact. Item is shown.
  • Negative (-) and positive (+) can be selected for the items of boundary, serrated, spicula, lobation, straight line, bronchial translucency, cavity, calcification, fat, pleural invagination and pleural contact. ..
  • shape item irregular and shaped items can be selected.
  • absorption value a solid type or a ground glass type can be selected.
  • the operation of inputting the finding text is an operation of popping up the finding text input window 51 shown in FIG. 8 by right-clicking the mouse on the displayed target image.
  • the specifying unit 24 identifies the region of interest that the image interpreting doctor pays attention to among the plurality of regions of interest included in the target image.
  • the specifying unit 24 identifies at least one region of interest based on specific information including information other than the dedicated information for identifying the region of interest.
  • the detection result of other operations related to the display or interpretation of the medical image shall be used as other information.
  • the identification unit 24 identifies the region of interest based on the specific information including the detection result of another operation as other information.
  • the dedicated information for specifying the region of interest includes, for example, the detection result of an operation of clicking the region of interest using a mouse.
  • a paging operation is performed to repeatedly read the tomographic images before and after the tomographic image including the abnormal shadow.
  • the paging operation for repeatedly reading an image is an operation in which the tomographic surface is reciprocated in the direction of the body axis of the human body by rotating the mouse wheel back and forth to repeatedly switch.
  • the specific unit 24 detects such a paging operation, if the tomographic image repeatedly displayed during the paging operation contains annotations, the identification unit 24 identifies the annotated region of interest as the region of interest that the image interpreter pays attention to. do.
  • the specifying unit 24 specifies the region of interest R1 included in the tomographic image DA1 shown in FIG. 5 as the region of interest.
  • the specific unit 24 pays attention to the region of interest R2 and the region R3 included in the tomographic image DA2 shown in FIG. Specific to the area.
  • the specifying unit 24 specifies the region of interest R4 included in the tomographic image DA3 shown in FIG. 5 as the region of interest. ..
  • the display control unit 23 displays the annotation attached to the region of interest specified by the specific unit 24 on the display screen 40. That is, in the target image G1 displayed in the display area 43A, when the paging operation is performed in the vicinity of the tomographic image group GA1, the annotation 31 is superimposed and displayed on the target image G1 (tomographic image DA1) as shown in FIG. do. Further, when the paging operation is performed in the vicinity of the tomographic image group GA2 in the target image G1, the annotations 32 and 33 are superimposed and displayed on the target image G1 (tomographic image DA2) as shown in FIG. When the paging operation is performed in the vicinity of the tomographic image group GA3 in the target image G1, the annotation 34 is superimposed and displayed on the target image G1 (tomographic image DA3) as shown in FIG.
  • the display control unit 23 may continue to display the annotation or hide the annotation when the paging operation is stopped. Further, the annotation may be displayed for a predetermined time and then hidden.
  • the image interpreter finds an abnormal shadow in the target image G1, the abnormal shadow may be enlarged and displayed.
  • the image interpreting doctor performs an operation to enlarge the displayed target image G1.
  • the target image G1 tomographic image DA2 on which the annotations 32 and 33 are superimposed and displayed as shown in FIG. 10
  • the image interpreter wants to enlarge the target image G1 with reference to the region of interest R3 to which the annotation 33 is attached
  • the image interpreter As shown in FIG. 12, the mouse cursor 45 is moved to the region of interest R3, and the mouse wheel is rotated while pressing a specific key such as the CTRL key.
  • the specifying unit 24 identifies the region of interest R3 where the mouse cursor 45 is located as the region of interest based on the detection result of such an operation of changing the size.
  • the display control unit 23 displays the annotation attached to the region of interest specified by the specific unit 24 on the display screen 40.
  • the region of interest R3 is the region of interest.
  • the display control unit 23 displays only the annotation 33 for the region of interest R3 and hides the annotation 32 for the region of interest R2.
  • the target image G1 tomographic image DA2
  • the annotation 32 is hidden and assigned to the area of interest R3. Only the annotation 33 that has been added will be displayed.
  • the display control unit 23 may continue to display the annotation or hide the annotation when the operation of changing the size is stopped. Further, the annotation may be displayed for a predetermined time and then hidden.
  • the reading input window 51 shown in FIG. 8 may be displayed in a pop-up and the finding about the abnormal shadow may be input.
  • the specifying unit 24 may specify the region of interest based on the detection result of the operation of inputting the finding by the image interpreting doctor. Specifically, the specifying unit 24 may analyze the input finding sentence and specify the region of interest corresponding to the term included in the finding sentence as the region of interest.
  • FIG. 8 shows that the region of interest corresponding to the term included in the finding sentence as the region of interest.
  • the input findings are "There is a nodule in the left lung.”
  • the specific part 24 analyzes the findings and identifies a part called "left lung”.
  • the identification unit 24 identifies the region of interest R2 of the left lung included in the tomographic image DA2 as the region of interest based on the specified term “left lung”.
  • the specific unit 24 identifies the term "nodule” included in the finding, refers to the description of the texts 32B and 33B of the annotations 32 and 33 given to the regions of interest R2 and R3, and describes the nodule.
  • the region of interest to which the inclusion annotation is attached may be specified as the region of interest.
  • the display control unit 23 displays only the annotation 32 for the region of interest R2 and hides the annotation 33 for the region of interest R3.
  • the finding text input window 51 is displayed in the display area 43A, and is based on the finding text of "a nodule is seen in the left lung" input in the finding text input window 51. Therefore, the annotation 33 assigned to the region of interest R3 is hidden, and only the annotation 32 assigned to the region of interest R2 is displayed.
  • the specifying unit 24 analyzes the newly input finding sentence and identifies the term "cavity".
  • the text 33B of the annotation 33 assigned to the region of interest R3 contains a description regarding the cavity
  • the annotation 33 assigned to the region of interest R3 may be further displayed.
  • the display control unit 23 displays "a cavity is also seen” as shown in FIG.
  • the annotation 33 given to the region of interest R3 corresponding to the finding sentence of ".” May be displayed, and the annotation 32 given to the region of interest R2 may be hidden.
  • the display control unit 23 corresponds to the finding sentence of "Nodule is seen in the left lung.”
  • the annotation 32 given to the area of interest R2 may be displayed, and the annotation 33 given to the area of interest R3 may be hidden.
  • the display control unit 23 may continue to display the annotation or hide the annotation when the operation for inputting the finding sentence is stopped. Further, the annotation may be hidden after being displayed for a predetermined time.
  • the image interpreter may perform an operation of inputting the properties when an abnormal shadow is found in the target image G1.
  • the interpreting doctor identifies the found abnormal shadow with the mouse cursor 45, and right-clicks the identified abnormal shadow to pop up the property input window 50 shown in FIG. 7.
  • the specifying unit 24 identifies the region of interest in which the mouse cursor 45 is located as the region of interest based on the detection result of this operation. For example, when an operation of inputting a property to the region of interest R2 is performed in the target image G1 (tomographic image DA2) on which the annotations 32 and 33 are superimposed and displayed as shown in FIG. Move the mouse cursor 45 to R2 and right-click.
  • the specifying unit 24 detects this operation, it identifies the region of interest R2 where the mouse cursor 45 is located as the region of interest.
  • the display control unit 23 hides the annotation 33 given to the region of interest R3 in the target image G0 (tomographic image DA2), and only the annotation 32 given to the region of interest R2. Will be displayed.
  • the interpreter can see the annotation 32 displayed for the region of interest R2 to add missing properties or correct incorrect properties.
  • the display control unit 23 may continue to display the annotation or hide the annotation when the operation for inputting the property is stopped. Further, the annotation may be hidden after being displayed for a predetermined time.
  • FIG. 18 is a flowchart showing the processing performed in the present embodiment. It is assumed that a plurality of images including the target image G0 and the past image GP0 of the patient to be inspected are acquired from the image server 5 and stored in the storage 13. Further, it is assumed that the display control unit 23 displays the display screen 40 on the display 14, the inspection list is selected on the display screen 40, and is displayed in the thumbnail image area 42 of the image related to the selected inspection. When the image to be displayed in the image display area 43 is selected in the thumbnail image area 42 (step ST1; affirmative), the display control unit 23 displays the selected image in the image display area 43 (step ST2). At this time, even if the image has an area of interest detected, the display control unit 23 first hides the annotation (step ST3).
  • the image interpreter can perform operations such as paging operations, inputting findings, and adding property tags to newly found abnormal shadows.
  • step ST4 determines whether or not another operation related to the display of the target image or another operation related to image interpretation is detected.
  • step ST4 other operation detection
  • step ST5 the specific unit 24 identifies a region of interest among a plurality of regions of interest based on specific information including other information that is a detection result of another operation.
  • the display control unit 23 switches the annotation for the specified region of interest to display (step ST6).
  • the image interpreter can interpret the area of interest by referring to the displayed annotation.
  • the entered finding is stored in the storage 13 as an interpretation report.
  • the property tag is attached to the target image G0 as tag information.
  • step ST7 determines whether or not another operation has been completed (step ST7), and if step ST7 is denied, the process returns to step ST6.
  • step ST7 affirmed, the annotation is hidden (step ST8).
  • step ST4 is denied and after step ST8, it is determined whether or not an instruction to end image interpretation has been given (step ST9), and when step ST9 is denied, the process returns to step ST4.
  • step ST9 is affirmed, the process ends.
  • the image interpretation report generated by the image interpretation of the target image G0 and the target image G0 to which the property tag is attached are transferred to the report server 7. In the report server 7, the transferred image interpretation report is saved together with the target image G0.
  • step ST7 the annotation may be hidden after a predetermined time has elapsed. Further, the display of the annotation may be continued. When the display of the annotation is continued, another operation is detected, the region of interest is specified according to the detected operation, and the annotation related to the identified region of interest is displayed.
  • At least one attention area is specified and the specified attention is specified based on the specific information including other information other than the dedicated information for specifying the attention area to be noticed by the user. Changed to switch the annotation about the area to display. Therefore, the image interpreter can refer only to the annotation about the region of interest without performing a troublesome operation.
  • the interpreting doctor can perform the region of interest without performing a dedicated operation for identifying the region of interest. It can be specified to display annotations related to the area of interest.
  • all annotations are hidden when the target image G0 is displayed, but the present invention is not limited to this.
  • all annotations may be displayed.
  • the display control unit 23 switches the annotation related to the region of interest other than the region of interest to non-display to hide the region of interest. It is only necessary to display the annotations related to.
  • the annotation related to the region of interest is displayed and the annotation related to the region of interest other than the region of interest is hidden, but the present invention is not limited to this.
  • Annotations related to areas of interest other than the area of interest may be weakly displayed.
  • the weak display is displayed more than the displayed annotation by increasing the transparency of the annotation, displaying it with a broken line, lowering the density than the displayed annotation, making it a lighter color, and so on. It means to weaken the degree of.
  • the annotation 32 related to the region of interest R2 is displayed and the annotation 33 related to the region of interest R3 is displayed as shown in FIG. May be displayed as a broken line.
  • the detection result of another operation is used as other information included in the specific information, but the present invention is not limited to this.
  • the region of interest may be specified.
  • the target image G0 is a CT image
  • the window level (WL) and the window width (WW) are used as the observation conditions when displaying the CT image.
  • the WL is a CT value that is the center of the portion to be observed in the gradation that can be displayed by the display 14 when the CT image is displayed on the display 14.
  • WW is the width between the lower limit value and the upper limit value of the CT value of the part to be observed.
  • observation conditions according to the site such as mediastinal conditions in which bones and abdominal organs can be easily observed and lung field conditions in which lung fields can be easily observed are known. Further, not only the CT image but also other medical images such as an MRI image or a radiographic image acquired by simple radiography are displayed under observation conditions that make it easy to observe a specific part. Therefore, in the specific unit 24, the organ to be observed may be specified according to the observation conditions, and the region of interest included in the specified organ may be specified as the region of interest.
  • the region of interest R5 is detected in the left lung and the region of interest R6 is detected in the liver in the tomographic image DA4 including a part of the liver and the left lung as shown in FIG.
  • the annotation 35 is attached to the region of interest R5 of the left lung and the annotation 36 is attached to the region of interest R6 of the liver.
  • the specific unit 24 specifies the region of interest R6 of the liver as the region of interest. Therefore, as shown in FIG. 21, the display control unit 23 displays the annotation 36 assigned to the region of interest R6 and hides the annotation 35 assigned to the region of interest R5.
  • the annotation related to the region of interest is displayed, but in the annotation related to the region of interest, the annotation superimposed on the region of interest may be switched to non-display.
  • the region of interest R4 included in the tomographic image DA3 is specified as the region of interest
  • the figure 34A and the leader line 34C surrounding the region of interest R4 are hidden from the annotation 34, and the human body is displayed. Only the text 34B outside the area of may be displayed.
  • annotations are used as related information, but the present invention is not limited to this.
  • the related information related to the region of interest include, in addition to the annotation, the region extraction result of the structure included in the target image G0.
  • the mask 60 for the liver region included in the target image G0 may be superimposed and displayed on the tomographic image DA5 of the target image as the region extraction result.
  • the mask 60 is displayed on the liver based on the detection results of other operations related to image display or other operations related to image interpretation. You may try to do it.
  • the display and non-display of the annotation only for the target image G0 (G1) displayed in the display area 43A is described, but the annotations are displayed in the other display areas 43B to 43D. If the annotation is also attached to the image, the display / non-display of the annotation may be switched in the same manner as in the display area 43A.
  • the area of interest is specified based on information other than the dedicated information for specifying the area of interest that the user pays attention to, but the specific information is not limited to this. do not have.
  • the detection result of a dedicated operation for specifying a region of interest such as a mouse click by an image interpreter may also be used as specific information.
  • a dedicated operation for specifying a region of interest such as a mouse click by an image interpreter may also be used as specific information.
  • the pleura of the lung field included in the tomographic image DA6 contains the region of interest R7
  • the mediastinum contains the region of interest R8 adjacent to the region of interest R7.
  • the interpreter selects the region of interest R7 in the lung field by clicking the mouse
  • the region of interest R8 adjacent to the region of interest R7 may be erroneously selected.
  • the specific unit 24 annotates using the detection result of the operation of the image interpreter to select the region of interest by clicking the mouse and the observation condition of the target image G0 including the tomographic image DA6 as specific information. May be displayed.
  • the region of interest 24 selected is the region of interest R7 included in the lung field based on the detection result of the observation condition and the operation of selecting the region of interest. Is determined, and the region of interest R7 is specified as the region of interest. In this case, as shown in FIG. 25, the annotation 37 attached to the region of interest R7 is displayed.
  • the observation condition is the mediastinum condition
  • the specific unit 24 determines that the selected region of interest is the region of interest R8 included in the mediastinum based on the detection result of the observation condition and the operation of selecting the region of interest. Judgment is made and the region of interest R8 is specified as the region of interest. In this case, only the annotation attached to the region of interest R8 may be displayed.
  • a plurality of images are displayed on the display screen 40 at the same time, but the present invention is not limited to this.
  • the technique of the present disclosure can also be applied when displaying only one image on the display screen 40.
  • the image display device included in the image interpretation WS3 according to the present embodiment is provided with an analysis unit 22 so that the image interpretation WS3 analyzes the target image, but the present invention is not limited to this.
  • the target image may be analyzed by an external analysis device different from the image interpretation WS3, and the analysis result may be acquired by the image interpretation WS3.
  • the annotation may already be superimposed on the image stored in the image server 5. Even in such a case, as in the above embodiment, the image on which the annotation is superimposed is displayed in the image interpretation WS3, and based on the detection result of another operation related to image display or another operation related to image interpretation. , Annotations can be hidden.
  • the hardware structure of the processing unit (Processing Unit) that executes various processes such as the image acquisition unit 21, the analysis unit 22, the display control unit 23, and the specific unit 24 is as follows.
  • Various processors (Processors) shown in the above can be used.
  • various processors as described above, in addition to the CPU, which is a general-purpose processor that executes software (program) and functions as various processing units, circuits after manufacturing FPGA (Field Programmable Gate Array) and the like are used.
  • Dedicated electricity which is a processor with a circuit configuration specially designed to execute specific processing such as programmable logic device (PLD), ASIC (Application Specific Integrated Circuit), which is a processor whose configuration can be changed. Circuits etc. are included.
  • One processing unit may be composed of one of these various processors, or a combination of two or more processors of the same type or different types (for example, a combination of a plurality of FPGAs or a combination of a CPU and an FPGA). ) May be configured. Further, a plurality of processing units may be configured by one processor.
  • one processor is configured by a combination of one or more CPUs and software. There is a form in which this processor functions as a plurality of processing units.
  • SoC System On Chip
  • the various processing units are configured by using one or more of the above-mentioned various processors as a hardware-like structure.
  • circuitry in which circuit elements such as semiconductor elements are combined can be used.

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