JP4731127B2 - Image diagnosis support apparatus and method - Google Patents

Description

  The present invention relates to an image diagnosis support apparatus and method for extracting and displaying abnormal shadow candidates from a medical image by a computer.

  In an image diagnosis support apparatus that performs CAD (Computer Aided Detection) to detect abnormal shadow candidates from a subject image acquired by a medical imaging apparatus, a shadow region cut out from the subject image by multi-value processing is used. An abnormal shadow candidate is extracted by comparing the feature amount with a reference value, and the subject image is displayed with a marker indicating the abnormal shadow candidate (see Patent Document 1). The abnormal shadow candidates extracted by the computer include shadows that are not actually abnormal, called false positive shadows, and false positive shadows are excluded from the abnormal shadow candidates according to the judgment of the operator who performs the image diagnosis. Furthermore, the operator can add a marker at a desired location in the subject image.

In addition, when there is a subject image acquired in the past (for example, one year ago) from the same part of the same subject as the subject image that is the subject of the image diagnosis, the subject image that is the subject of the image diagnosis and the past The subject images are displayed in parallel to enable comparative interpretation.
JP 2002-325761 A

  However, in the conventional comparative interpretation, the marker attached to the past image is not displayed. For example, even if there is an area determined to require follow-up in the past image diagnosis, the image diagnosis is performed without paying attention to the area. May end.

  The present invention has been made in view of such circumstances, and an object thereof is to provide an image diagnosis support apparatus and method that can effectively use past markers in comparative interpretation.

In order to achieve the object, an image diagnosis support apparatus according to claim 1, an image data reading unit that reads image data representing a subject image acquired by a medical image capturing device, and the acquired subject image. An abnormal shadow candidate extracting means for extracting an abnormal shadow candidate from the display, a display control means for displaying the marker indicating the abnormal shadow candidate and the acquired subject image superimposed on the display means, and the marker on the display means. An operation unit that accepts an operation to be selected; information on the selected marker ; or a storage unit that stores information in which the selected marker is associated with the subject image to which the selected marker is attached; attached to the display target has been that from the same region of the subject image and the same object in the past is a subject image obtained in the past the object image by said display control means And a search unit that searches in the past of the storage means the information of the marker, prior Symbol display control means, based on the retrieved said information of past marker by the searching means, the said display target The displayed subject image or the past subject image and the past marker are superimposed on the display means.

  Preferably, the display control unit causes the display unit to display the marker indicating the abnormal shadow candidate extracted from the subject image to be displayed and the past marker in different display forms. .

Preferably, the operation means accepts an operation for attaching a new marker to a desired location in the subject image displayed on the display means, and the storage means stores information on the new marker. Preferably, the operation means accepts an operation for attaching a new marker to a desired location in the subject image displayed on the display means, and the storage means accepts the new marker and the subject image. Are stored in association with each other.

According to a second aspect of the present invention, in the diagnostic imaging support apparatus according to the first aspect, the display control unit superimposes and displays the past subject image and the past marker. Is displayed on the display means in parallel with the subject image to be displayed. The image diagnosis support apparatus according to claim 3 is the image diagnosis support apparatus according to claim 1 or 2, wherein the search means includes the object image to be displayed and the past object image. The storage means is searched for information on past markers attached to the past subject image having a correlation value with a predetermined value or more.

An image diagnosis support method according to the present invention includes an image data reading step of reading image data representing a subject image acquired by a medical imaging apparatus, and an abnormal shadow for extracting an abnormal shadow candidate from the acquired subject image. A candidate extraction step, a display control step for displaying the marker indicating the abnormal shadow candidate and the acquired subject image superimposed on a display means, an operation step for accepting an operation for selecting the marker on the display step , A storage step for storing information on the selected marker or information on association of the selected marker and the subject image to which the selected marker is attached in a storage means, and display by the display control step past marker attached to the past of the subject image from the same region of the subject image and the same subject has been the subject is a subject image obtained in the past Anda search step of searching in said storage unit information, pre-Symbol display control step, based on the retrieved said information of past marker, the acquired subject image or the subject in the past has been The image and the past marker are superimposed on a display means and displayed.

  Preferably, the display control step causes the display unit to display the marker indicating the abnormal shadow candidate extracted from the subject image to be displayed and the past marker in different display forms. .

  Preferably, the operation step accepts an operation of attaching a new marker to a desired location in the subject image displayed on the display means, and the storage step stores information on the new marker.

In a preferred embodiment, the operating step accepts an operation of subjecting the new marker to the desired location in the subject image displayed on the display step, said storing step, said new marker and the subject image Are stored in association with each other.

  According to the present invention, it is possible to effectively use past markers in comparative interpretation.

  Hereinafter, preferred embodiments of an image diagnosis support apparatus according to the present invention will be described in detail with reference to the accompanying drawings.

  FIG. 1 is a schematic configuration diagram of an image diagnosis support apparatus according to an embodiment of the present invention. The diagnostic imaging support apparatus 10 mainly includes a central processing unit (CPU) 12 that controls the operation of each component, a main memory 14 that stores a control program for the diagnostic imaging support apparatus 10, and image data and operations of a subject. A data recording device 16 in which a program or the like is stored, a display memory 18 that temporarily stores image data for display, a display 20 that displays an image based on the image data from the display memory 18, and a screen on the display 20 A pointing device 22 and a pointing device controller 24 such as a mouse, a trackball, and a touch panel for operating the soft switch, a keyboard 26 having keys and switches for setting various parameters, and the image diagnosis support apparatus 10 are connected to a local area network. , Telephone lines, internet A network adapter 28 for connecting to the workpiece N, and a data bus 30 which connects the above components. The data recording device 16 includes a storage device such as a memory and a magnetic disk built in or externally attached to the diagnostic imaging support device 10, a device that writes and reads data to and from a removable external medium, A device that transmits and receives data via a network may be used. The image diagnosis support apparatus 10 is connected to an external medical image capturing apparatus 50 or an image database 60 via the network adapter 28 and the network N, and transmits / receives image data to / from them. This image data is an image obtained by various medical imaging apparatuses such as an X-ray imaging apparatus, an X-ray CT apparatus, and an MRI apparatus from various imaging target parts such as a lung field, a bronchus, a breast, and a large intestine of a subject. Although it may be data and is not particularly limited, an example in which the image data is CT image data obtained from the lung field of the subject by an X-ray CT apparatus will be described below. In the data recording device 16 and / or the image database 60, an examination history database 62 (see FIGS. 3, 4, 6, and 7) in which the results of past image diagnosis are recorded for each subject is constructed.

  FIG. 2 is a flowchart showing processing for detecting and displaying an abnormal shadow candidate and searching for and displaying a past marker by the diagnostic imaging support apparatus 10 configured as described above. The CPU 12 controls the image diagnosis support apparatus 10 according to this flowchart.

  First, the subject ID input screen is displayed on the display 20, and the operator inputs the ID number of the subject to be diagnosed (S201). Based on the input ID number of the subject, the image data to be subjected to the abnormal shadow candidate detection process is read from the data recording device 16, the medical imaging device 50, or the image database 60 (S202). An abnormal shadow candidate detection process (S203) is performed on the image data. Based on the result of S203, the target image and the marker indicating the detected abnormal shadow candidate are superimposed and displayed on the display 20 (S204).

  Next, in order to refer to the image diagnosis of the subject image displayed on the display 20, whether or not to display the past marker of the same subject is selected (S205). If display of a past marker is selected, records about the same part of the same subject are searched in the examination history database 62 (S206), and if past marker information is obtained, the past marker is also found. It is displayed on the display 20 (S207).

  When the marker attached by the image diagnosis support apparatus 10 indicates a false positive shadow, or the region of interest that the image reader suspects of an abnormal shadow or determines that follow-up is necessary is not attached. In some cases, the marker is deleted and / or added via the pointing device 22 or the keyboard 26 (S208). Then, the information of the selected marker is stored in the examination history database 62 (S209).

  Hereinafter, some steps of FIG. 2 will be described in detail. FIG. 3 is a conceptual diagram illustrating an example of the display screen of the display 20 and an example in which information on the selected marker is stored in the examination history database 62. The operator determines that a marker indicating a false positive shadow or follow-up observation is unnecessary via the pointing device 22 or the keyboard 26 while referring to the subject images n1, n2,... Displayed on the display 20 in S204. An operation of deleting a marker to be added or adding a new marker to a region of interest that has not yet been marked is performed (S208). As a result, there are markers that are automatically assigned by the image diagnosis support apparatus 10 and not deleted by the operator, and markers that are newly added by the operator. All of these existing markers (301, 302) are considered to be markers selected by the operator as a target for recording information to be used as a reference for future image diagnosis of the subject. Information on the selected marker (the number of the image to which the marker is attached, the position on the subject, the coordinates of the marker on the image, the radius of the marker, etc.) is stored in the examination history database 62 (S209). Moreover, it is good also as storing information in the test | inspection log | history database 62 about only the marker especially designated by the operator as an object which records information among the existing markers.

  FIG. 4 is a conceptual diagram illustrating an example in which past markers are displayed on the display 20. As described with reference to FIG. 3, when image diagnosis is performed on the same subject after information on the markers 301 and 302 is stored (for example, several months to several years later), the past markers 301 and 302 are displayed. , The reader can focus on that area. The subject images n1 and n4 and the markers 401 and 402 are displayed in the steps up to S204, and when the operator selects the reference button 403 (S205), they are attached to the subject images acquired in the past from the same part of the same subject. Information on the past marker thus searched is searched in the examination history database 62 (S206). In this search, it is an essential requirement that the subject is the same. However, since there is a case where exactly the same past image does not exist for a part, for example, an image acquired from a part different by several mm to several centimeters at a slice position is regarded as an image acquired from the same part. It is preferable to provide a predetermined allowable range.

  When the information of the past markers 301 and 302 is obtained by this search, the subject images n1 and n4 displayed on the display 20 as the target of image diagnosis and markers indicating abnormal shadow candidates extracted from the subject images Past markers 301 and 302 are displayed together with 401 and 402 (S207). At this time, it is preferable to display the markers 401 and 402 and the past markers 301 and 302 in different display forms. In the example of FIG. 4, the markers 401 and 402 are circular and the past markers 301 and 302 are square. However, the display is not limited to the shape of the marker, but other display forms (line type (solid line, broken line, etc.), thickness, color, Brightness, blinking cycle, etc.) may be different.

  Image diagnosis for the subject image is performed with reference to the marker displayed as described above. Then, in preparation for future image diagnosis, the marker is deleted, added, and stored (S208 and S209).

  FIG. 5 is a flowchart showing processing for detecting and displaying abnormal shadow candidates and searching for and displaying past subject images and markers. The processes similar to those in FIG. FIG. 6 is a conceptual diagram illustrating an example in which the selected marker and the subject image to which the marker is attached are stored in the examination history database 62. After the deletion and / or addition of the marker (S208), the selected marker (601, 602) and the subject image (n1, n2) to which the marker is attached are associated and stored in the examination history database 62. (S509). At this time, the information may be stored in the examination history database 62 only for the subject image and the marker specifically designated by the operator as the information recording target. In the example of FIG. 6, the subject image n1 ′ with marker is created and stored by synthesizing the image of the marker 601 with the subject image n1, but the present invention is not limited to this, and the subject image n1 is stored as it is. In addition, the association and storage may be performed by storing information such as the coordinates and radius of the marker 601 on the subject image n1 in association with the subject image n1.

  FIG. 7 is a conceptual diagram illustrating an example in which past subject images and markers are displayed on the display 20. As described with reference to FIG. 6, when image diagnosis is performed on the same subject after the subject image and the marker are stored (for example, several months to several years later), a past subject image with a marker is displayed. Thus, it is possible to make the image interpreter pay attention to the area where the marker has been attached in the past. When the operator selects the reference button 703 (S505), subject images acquired in the past from the same part of the same subject are searched in the examination history database 62 (S506). In this search, a correlation value between a subject image displayed on the display 20 as a target of image diagnosis and a past subject image is calculated, and a past subject image whose correlation value is equal to or greater than a predetermined value is selected. Is issued. Then, the selected past subject image and the marker associated therewith are superimposed on the display 20 (S507). At this time, when a marker-attached subject image in which marker images are already combined is stored in the examination history database 62, the selected past subject-marked subject image may be displayed on the display 20 as it is. Further, when the past subject image and the information of the marker associated therewith are stored in the examination history database 62, the past subject image and the marker associated therewith may be superimposed on the display 20. .

  With the above processing, in the example of FIG. 7, when the image diagnosis is performed on the subject image acquired on August 7, 2003, the subject image acquired on August 8, 1998, and the image attached thereto. The marker is superimposed on the display 20. Thereby, the subject image with marker on August 7, 2003 obtained in the steps up to S204 and the subject image with marker on August 8, 1998 acquired from the same part of the same subject, They are displayed in parallel on the display 20. Then, an image diagnosis is performed on the subject image on August 7, 2003, and a marker is deleted and / or added on the subject image on August 7, 2003 (S208) in preparation for a future image diagnosis, and The subject image and the marker are stored (S509).

FIG. 1 is a schematic configuration diagram showing an embodiment of an image diagnosis support apparatus according to the present invention. FIG. 2 is a flowchart showing processing for detecting and displaying abnormal shadow candidates and searching for and displaying past markers. FIG. 3 is a conceptual diagram illustrating an example of a display screen and an example in which information of a selected marker is stored. FIG. 4 is a conceptual diagram showing an example in which past markers are displayed. FIG. 5 is a flowchart showing processing for detecting and displaying abnormal shadow candidates and searching for and displaying past subject images and markers. FIG. 6 is a conceptual diagram illustrating an example in which a selected marker and a subject image with the marker are stored. FIG. 7 is a conceptual diagram showing an example in which past subject images and markers are displayed.

Explanation of symbols

  DESCRIPTION OF SYMBOLS 10 ... Image diagnosis assistance apparatus, 12 ... CPU, 14 ... Main memory, 16 ... Data recording device, 18 ... Display memory, 20 ... Display, 22 ... Pointing device, 24 ... Pointing device controller, 26 ... Keyboard, 28 ... Network adapter , 30 ... Data bus, 50 ... Medical imaging device, 60 ... Image database, 62 ... Examination history database, N ... Network

Claims (4)

A marker indicating an abnormal shadow candidate included in a subject image made up of tomographic images obtained by reconstructing image data acquired at each slice position by a medical imaging apparatus, and selected by an operator for recording the marker was, display control means for superimposed display the and the object image, on the display means,
Storage means for storing information associated with the marker information or the marker and a subject image to which the marker is attached or an image number of the subject image;
A past subject image that is a subject image acquired in the past from the same part of the same subject as the subject image to be displayed by the display control means is searched in the storage means, and is set as the display target. A correlation value between the subject image and the past subject image is calculated, a past subject image whose correlation value is equal to or greater than a predetermined value is selected, and past past images attached to the past subject image are selected. Search means for searching marker information or past markers in the storage means, the past being acquired at a slice position within a predetermined allowable range with reference to the slice position of the subject image to be displayed The subject image is provided with search means for performing a search by regarding the subject image as a past subject image acquired from the same site as the subject image to be displayed ,
The display control unit superimposes the subject image to be displayed and the past marker on the display unit based on the past marker information or past marker searched by the search unit. An image diagnosis support apparatus characterized by displaying.   The display control means causes the display means to display the past subject image and the past marker superimposed on the display subject in parallel with the subject image to be displayed. The image diagnosis support apparatus according to claim 1. An operation means for accepting an operation of selecting the marker on the display means;
The storage means stores information on the selected marker, or information in which the selected marker is associated with an object image to which the selected marker is attached or an image number of the object image.
The diagnostic imaging support apparatus according to claim 1 or 2, wherein A marker indicating an abnormal shadow candidate included in a subject image acquired by a medical image capturing apparatus, the marker selected for recording by an operator, and the subject image are superimposed on the display means. A display control process;
  A storage step of storing in the storage means information associated with the marker information or the marker and a subject image to which the marker is attached or an image number of the subject image;
  A past subject image that is a subject image acquired in the past from the same part of the same subject as the subject image to be displayed by the display control step is searched in the storage means, and is set as the display subject. A correlation value between the subject image and the past subject image is calculated, a past subject image whose correlation value is equal to or greater than a predetermined value is selected, and past past images attached to the past subject image are selected. A search step for searching marker information or a past marker in the storage means, the past being acquired at a slice position within a predetermined allowable range based on a slice position of the subject image to be displayed The subject image is a search step in which the subject image is regarded as a past subject image acquired from the same site as the subject image to be displayed,
  A step of superimposing and displaying on the display means the subject image to be displayed and the past marker based on the retrieved past marker information or past marker;
  A diagnostic imaging support method comprising:

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