JP6366966B2 - Dose management system and diagnostic imaging apparatus - Google Patents

Description

  Embodiments described herein relate generally to an exposure dose management system and an image diagnostic apparatus that manage the exposure dose of a subject by X-ray irradiation.

  Image diagnostic apparatuses such as an X-ray CT apparatus, an X-ray diagnostic apparatus, and a mammography apparatus generate image data used for diagnosis by irradiating a subject with X-rays based on examination conditions set at the time of examination. . In the examination by this diagnostic imaging apparatus, it is necessary to suppress the influence of the X-ray exposure on the subject. Therefore, there is known a radiation exposure dose management system capable of preventing an excessive radiation exposure to a subject by managing a radiation dose such as X-rays.

JP 2007-97909 A

  However, since future exposure to the subject is not taken into consideration, it is necessary to determine the examination conditions with an eye on the future when performing the examination. For this reason, there is a problem that it takes time and effort to determine the inspection conditions.

  The embodiment has been made to solve the above-described problems, and an object thereof is to provide an exposure dose management system and an image diagnostic apparatus capable of easily determining an inspection condition when performing an inspection.

  In order to achieve the above object, the exposure dose management system according to the embodiment is stored in an exposure information storage unit that stores exposure information when the subject is irradiated with X-rays by an examination, and the exposure information storage unit. Based on the exposure information, a dose prediction unit that predicts the transition of future integrated dose within the specific period from a plurality of integrated doses obtained by integrating past exposure doses within the specific period, and the future integrated dose is preset. If the value is less than or equal to the upper limit value calculated, the exposure dose at which the integrated dose after the test is less than or equal to the upper limit value is calculated during the test performed within the specified period, and the test condition of the calculated exposure dose is obtained. A dose management unit for obtaining candidates, and a display unit for displaying the transition of the accumulated dose and the candidates for the examination conditions side by side are provided.

The block diagram which shows the structure of the exposure dose management system which concerns on embodiment. 1 is a block diagram showing a configuration of an X-ray CT apparatus according to an embodiment. The figure which shows an example of the test condition list | wrist preserve | saved at the test condition memory | storage part which concerns on embodiment. The figure which shows an example of the inspection technique list | wrist preserve | saved at the inspection technique memory | storage part which concerns on embodiment. The flowchart which shows operation | movement of the exposure dose management system which concerns on embodiment. The figure which shows an example of the past effective dose and integrated dose of the subject in the specific period which concerns on embodiment. The figure which shows an example of the graph of the relationship between the inspection date which concerns on embodiment, and an integrated dose. The figure for demonstrating how to obtain | require the allowable effective dose which concerns on embodiment. The figure which shows an example of the graph which added the bar graph which shows the integrated dose of the last day which concerns on embodiment. The figure which shows an example of the screen by which the exposure management information of the subject was displayed on the display part which concerns on embodiment. The figure which shows an example of the screen by which the exposure management information was displayed on the display part according to the input which designates the 1st test | inspection condition which concerns on embodiment. The figure which shows an example of the screen by which exposure management information is displayed on a display part according to the input which designates the 2nd test | inspection condition which concerns on embodiment. The figure which shows an example of the screen by which exposure management information is displayed on a display part according to the input which designates the 1st test | inspection condition which concerns on embodiment, and the input which displays a similar image. The figure which shows an example of the screen by which exposure management information is displayed on a display part according to the input which designates the 2nd test | inspection condition which concerns on embodiment, and the input which displays a similar image. The figure which shows an example of the screen by which exposure management information is displayed on a display part according to the input which designates the 2nd test | inspection condition which concerns on embodiment, and the input which displays the slide bar after the input which displays a some similar image . The figure which shows an example of the screen by which exposure management information is displayed on a display part according to the input which designates the 2nd test | inspection condition which concerns on embodiment, and the input which displays a some similar image. The flowchart which shows operation | movement of the exposure dose management system which concerns on embodiment. The figure which shows an example of the graph of the relationship between the inspection date displayed on the display part which concerns on embodiment, and an average irradiation dose. The figure which shows an example of the graph of the dose reduction displayed on the display part which concerns on embodiment. The figure which shows an example of the graph of the some dose reduction displayed on the display part which concerns on embodiment. The figure which shows an example of the several icon which shows the graph of the dose reduction displayed on the display part which concerns on embodiment, and the safety bell. The figure which shows an example of the graph of the relationship between the test | inspection date and the integrated dose in the specific period after the test | inspection technique confirmation which concerns on embodiment.

  Hereinafter, embodiments will be described with reference to the drawings.

  FIG. 1 is a block diagram illustrating a configuration of an exposure dose management system according to the embodiment. The exposure dose management system 400 includes a plurality of image diagnostic apparatuses 100 that generate image data by irradiating a subject with X-rays by examination, and image information including image data obtained from each image diagnostic apparatus 100 by examination. An image information storage device 200 to be stored and an exposure dose management device 300 for managing an exposure dose by X-ray irradiation of each image diagnostic device 100 are provided.

  Each diagnostic imaging apparatus 100 transmits image information to the image information storage apparatus 200 connected via the network 500. In addition, each diagnostic imaging apparatus 100 transmits examination information including examination conditions relating to X-ray irradiation to the subject that has been examined to the exposure dose management apparatus 300 connected via the network 500. Further, the exposure dose management apparatus 300 transmits exposure dose management information (exposure management information) to each image diagnostic apparatus 100 via the network 500.

  The diagnostic imaging apparatus 100 includes an X-ray CT apparatus 110, an X-ray diagnostic apparatus 120, a mammography apparatus 130, and the like. Hereinafter, the configuration of the X-ray CT apparatus 110 will be described in detail as an example of the image diagnostic apparatus 100.

  FIG. 2 is a block diagram showing the configuration of the X-ray CT apparatus 110. The X-ray CT apparatus 110 includes a bed 10 on which the subject P is movably mounted, and an imaging unit 20 that performs imaging by irradiating the subject P mounted on the bed 10 with X-rays. ing. Further, a rotation driving unit 27 that rotates the imaging unit 20 and an image processing unit 30 that generates image data from projection data collected by imaging of the imaging unit 20 are provided.

  Further, the X-ray CT apparatus 110 includes a display unit 40 that displays the image data generated by the image processing unit 30. In addition, input of patient information for identifying the subject P, irradiation conditions such as tube current, tube voltage, and irradiation time related to X-ray irradiation to the subject P, and a site (examination site) and irradiation of the subject P to be X-ray irradiated An operation unit 50 is provided for performing input and the like for setting inspection conditions including a range.

  Furthermore, the X-ray CT apparatus 110 includes a communication unit 60 that communicates with the image information storage device 200 and the exposure dose management device 300 via the network 500, the bed unit 10, the imaging unit 20, the rotation driving unit 27, And a system control unit 70 that controls the image processing unit 30, the display unit 40, and the communication unit 60 in an integrated manner. Then, the system control unit 70 performs imaging of the subject by controlling each unit based on the set examination conditions.

  The imaging unit 20 includes an X-ray tube 21 that irradiates the subject P with X-rays while rotating around the X-ray detector 22, and an X-ray detector 22 that detects X-rays transmitted through the subject P by irradiation from the X-ray tube 21. And a data collection unit 23 that collects projection data based on the signals detected by the X-ray detector 22. In addition, a data transmission unit 24 that transmits projection data collected by the data collection unit 23 to the image processing unit 30, a high voltage generation unit 25 that supplies a high voltage to the X-ray tube 21, an X-ray tube 21, and an X-ray A detector 22, a data collection unit 23, a data transmission unit 24, and a rotating body 26 that rotatably holds the high voltage generation unit 25 are provided.

  The communication unit 60 transmits image information including the image data generated by the image processing unit 30 to the image information storage device 200 for each examination. Further, examination information including patient information and examination conditions of the subject P input from the operation unit 50 for each examination is transmitted to the exposure dose management apparatus 300. Also, the exposure management information transmitted from the exposure dose management apparatus 300 is received.

  An image information storage device 200 illustrated in FIG. 1 includes a communication unit 201 that communicates with each image diagnostic device 100 via a network 500, and an image information storage unit that stores image information obtained from each image diagnostic device 100. 202. Then, the communication unit 201 outputs the image information transmitted from each image diagnostic apparatus 100 to the image information storage unit 202. Also, the image information stored in the image information storage unit 202 is transmitted to each image diagnostic apparatus 100.

  The image information storage unit 202 stores the image information output from the communication unit 201. Further, the stored image information is output to the communication unit 201. In addition, you may implement so that the image information storage part 202 may be provided in each image diagnostic apparatus 100. FIG.

  The exposure dose management apparatus 300 includes an exposure information storage unit 310 that stores exposure information when the subject P is irradiated with X-rays from each diagnostic imaging apparatus 100 and an exposure information stored in the exposure information storage unit 310. And a dose predicting unit 320 for predicting the transition of the future exposure dose within a specific period. Moreover, the dose management part 330 which manages a future exposure dose is provided.

  In addition, the exposure dose management apparatus 300 can reduce exposure by using an inspection condition storage unit 340 that stores inspection conditions including irradiation conditions necessary for X-ray irradiation of each diagnostic imaging apparatus 100 and each diagnostic imaging apparatus 100. And an inspection technique storage unit 350 that stores information on various inspection techniques. In addition, a display unit 360 that displays the transition of the exposure dose predicted by the dose prediction unit 320 and an operation unit 370 that inputs an examination technique and the like that can be used by each image diagnostic apparatus 100 are provided.

  Furthermore, the exposure dose management apparatus 300 includes a communication unit 380 that communicates with each diagnostic imaging apparatus 100 via the network 500. The exposure information storage unit 310, the dose prediction unit 320, the dose management unit 330, the inspection condition storage unit 340, the inspection technology storage unit 350, and the control unit 390 that controls the communication unit 380 are provided.

  The exposure information storage unit 310 stores information on the date when the examination of the subject P was performed, dose information such as the exposure dose and irradiation dose in the examination, and information on the examination site of the subject P in the examination. Is stored as exposure information in association with patient information for identifying the patient.

  Based on the exposure information stored in the exposure information storage unit 310, the dose prediction unit 320 predicts the transition of the future integrated dose within the specific period from a plurality of integrated doses obtained by integrating past exposure doses within the specific period. To do. Below, the relational expression showing the relationship between the past multiple examination dates within the specified period and the accumulated dose obtained by integrating the exposure doses up to this examination date is shown as a statistical method such as regression analysis, moving average method, neutral network, etc. Ask for. And the transition of the future integrated dose within the specific period is predicted using the obtained relational expression.

  In addition, the dose prediction unit 320 determines that the irradiation period stored in the exposure information storage unit 310 is a past period from the relationship between a plurality of examination dates in the past period and the irradiation dose to be investigated on the examination date. The projection of the future irradiation dose and the future irradiation dose including the days when the inspection technology can be used are predicted.

  The dose management unit 330 calculates an exposure dose such as an effective dose and an irradiation dose based on the inspection conditions included in the inspection information transmitted in response to the completion of the inspection of each diagnostic imaging apparatus 100, and inspects the calculated exposure dose. The exposure information storage unit 310 stores the information in association with the patient information included in the information. Further, it is determined whether or not the future integrated dose within a specific period predicted by the dose prediction unit 320 is at a level considered safe.

  Then, when the accumulated dose on the last day within a specific period is calculated from the relational expression obtained by the dose prediction unit 320, and the calculated accumulated dose on the last day is a value equal to or less than a preset upper limit value considered safe. It is determined that the future accumulated dose within a specific period is at a safe level. Then, an inspection condition in which the accumulated dose after the inspection is a value equal to or lower than the upper limit value is searched from the inspection condition storage unit 340 for the inspection performed within the specific period. Further, when the integrated dose on the last day in the specific period is a value larger than the upper limit value, it is determined that the future integrated dose in the specific period is the warning level. Then, warning information to be output to each diagnostic imaging apparatus 100 to be inspected within a specific period is created.

  Here, when it is determined that the future integrated dose within the specific period is equal to or less than the upper limit value, the integrated dose on the examination day performed within the specific period is calculated using the relational expression obtained by the dose prediction unit 320. Next, post-inspection integration performed within a specific period based on the exposure dose obtained by subtracting the integrated dose on the previous inspection date from the integrated dose on the inspection date and the exposure dose obtained by subtracting the integrated dose on the inspection date from the upper limit. Calculate the exposure dose (allowable exposure dose) that is allowed at the time of the inspection when the dose is below the upper limit. Then, at least one examination condition candidate that is an allowable exposure dose is retrieved from the examination condition storage unit 340 and obtained.

  The inspection condition storage unit 340 includes irradiation conditions such as tube current, tube voltage, irradiation interval, and irradiation time necessary for X-ray irradiation of each diagnostic imaging apparatus 100, information on the inspection site and irradiation range for X-ray irradiation, and the like. Save the inspection conditions.

  FIG. 3 is a diagram showing an example of the inspection condition list stored in the inspection condition storage unit 340. This inspection condition list 341 includes a “target model” column, “inspection name” column, “effective dose [mSv]” column, “irradiation dose [mGy]” column, and “tube current [mA]”. Column, “tube voltage [kV]” column, “interval [fps]” column, “part” column, and the like.

  In the “target model” column, “CT” indicating the X-ray CT apparatus 110 and “Angio” indicating the X-ray diagnostic apparatus 120 are stored. Further, in the “examination name” column, “abdominal general examination”, “chest precise examination”, and the like, which are names of examinations performed by the X-ray CT apparatus 110, are stored. In addition, “cerebral angiography examination”, “cerebral aneurysm embolization”, “PCI”, and the like, which are names of examinations performed by the X-ray diagnostic apparatus 120, are stored.

  In the column of “effective dose [mSv]”, “0.5” and “2.4” indicating effective dose in “abdominal general examination”, “9.0” indicating effective dose in “thoracic close examination”, etc. Is saved. Further, “18.1” indicating an effective dose in “cerebral angiography”, “41.0” indicating an effective dose in “cerebral aneurysm embolization”, and “53.5” indicating an effective dose in “PCI”. Etc. are saved.

  In the “irradiation dose [mGy]” column, “8” and “3” indicating the irradiation dose in the “abdominal general examination”, “13” indicating the irradiation dose in the “thoracic close examination”, and the like are stored. In addition, “352” indicating the irradiation dose in “cerebral angiography”, “1209” indicating the irradiation dose in “cerebral aneurysm embolization”, “2091” indicating the irradiation dose in “PCI”, and the like are stored. .

  In the “tube current [mA]” column, “100” indicating the tube current in the “abdominal general examination” as the X-ray irradiation condition, “150” indicating the tube current in the “thoracic thorough examination”, and the like are stored. ing. Also, “35” indicating the tube current in “cerebral angiography examination” and “cerebral aneurysm embolization”, “50” indicating the tube current in “PCI”, and the like are stored.

  In the column of “tube voltage [kV]”, “80” and “120” indicating tube voltages in “abdominal general examination” as X-ray irradiation conditions, and “120” indicating tube voltages in “thoracic thorough examination”. Etc. "are stored. Further, “80” indicating the tube voltage in “cerebral angiography examination” and “cerebral aneurysm embolization”, “120” indicating the tube voltage in “PCI”, and the like are stored.

  In the “interval [fps]” column, “15” indicating an irradiation interval in “cerebral angiography examination” and “PCI” as X-ray irradiation conditions, and an irradiation interval in “cerebral aneurysm embolization” are shown. “30” or the like is stored.

  In the “part” column, “abdomen” indicating an examination part in “abdominal general examination”, “chest” showing an examination part in “chest detailed examination”, and the like are stored. In addition, a “brain” indicating an examination site in “cerebral angiography examination” and “cerebral aneurysm embolization”, a “heart” indicating an examination site in “PCI”, and the like are stored.

  The examination technique storage unit 350 shown in FIG. 1 is currently used by each diagnostic imaging apparatus 100 input from the operation unit 370 by an administrator of the facility provided with each diagnostic imaging apparatus 100 or an engineer of each diagnostic imaging apparatus 100 manufacturer. The inspection technique that can reduce the exposure dose by X-ray irradiation by using the present inspection technique and the current and future use in each diagnostic imaging apparatus 100 is stored.

  FIG. 4 is a diagram showing an example of a table of inspection techniques stored in the inspection technique storage unit 350. The inspection technology list 351 includes a “available date” column, a “target model” column, a “technology” column, and a “dose [mGy]” column. In the column “Available Date”, “2011/04/01”, “2013/03/01”, “2013/07/01”, “2013/12/01” indicating the date when the service can be used is displayed. Etc. are saved.

  The “target model” column indicates that the model usable from “2011/04/01”, “2013/03/01”, and “2013/12/01” is the X-ray CT apparatus 110. “Angio” indicating that the model available for “CT” and “2013/07/01” is the X-ray diagnostic apparatus 120 is stored.

  In the column of “Technology”, “First Technology”, “2013/03 /” indicating that the inspection technology that can be used in the X-ray CT apparatus 110 from “2011/04/01” is the first CT technology. 01 "indicates that the inspection technique that can be used in the X-ray CT apparatus 110 is the second CT technique, and" 2013/07/01 "can be used in the X-ray diagnostic apparatus 120. “Second pulse” indicating that the inspection technique is the second pulse fluoroscopy, and “2013/12/01” indicate that the inspection technique that can be used in the X-ray CT apparatus 110 is the new chest CT protocol. "New chest protocol" etc. are preserved.

  In the column of “Dose [mGy]”, “3.50” indicating the irradiation dose when the “first technology” is used, and “1.75” indicating the irradiation dose when the “second technology” is used. “5.67” indicating the irradiation dose when using the “second pulse”, “3.45” indicating the irradiation dose when using the “new chest protocol”, and the like are stored.

  Hereinafter, the operation of the exposure dose management system 400 will be described with reference to FIGS. 1 to 22.

  First, referring to FIG. 1 to FIG. 16, the transition of the accumulated dose in the future of the subject PA identified by the patient information A is predicted, and the latest accumulated dose is calculated based on the upper limit value considered safe. The operation of presenting candidate inspection conditions for the inspection of the subject PA will be described.

  The image information storage device 200 stores image data including image data and patient information A generated by each image diagnostic device 100 by a past examination of the subject PA. In addition, the exposure information storage unit 310 of the exposure dose management apparatus 300 stores exposure information obtained when each image diagnostic apparatus 100 has been examined in the past.

FIG. 5 is a flowchart showing the operation of the exposure dose management system 400.
As of October 22, 2013, patient information A such as name, age, gender, weight, height, disease, etc. for examination of the subject PA by operators such as engineers, radiologists, and requesting physicians When the examination information such as the examination site information and the information on the specific period including the current day when the examination of the subject PA is entered from the operation unit 50 of the X-ray CT apparatus 110, the exposure dose management system 400 operates. Is started (step S1).

  The communication unit 60 of the X-ray CT apparatus 110 transmits the examination information, the current date, and information on the specific period input from the operation unit 50 to the exposure dose management apparatus 300. The communication unit 380 of the exposure dose management apparatus 300 outputs the examination information, the current date, and information on the specific period transmitted from the X-ray CT apparatus 110 to the dose prediction unit 320 and the dose management unit 330.

  The dose prediction unit 320 is the past exposure dose of the subject PA related to the patient information A stored in the exposure information storage unit 310 based on the examination information from the communication unit 380, the current date, and the information of the specific period. For example, the effective dose of each examination date included in the specific period is acquired from the effective dose. Next, the acquired effective dose is integrated every inspection day to calculate the integrated dose (step S2).

  FIG. 6 is a diagram showing an example of the past effective dose and accumulated dose of the subject PA in the specific period. Examination date from the first day of the subject PA to the previous day of the current day until October 21, 2013, and the effective dose when each diagnostic imaging apparatus 100 is irradiated with X-rays by examination on this examination day To get.

  Here, the subject PA has been examined four times in the past within a specific period, the first examination date is April 1, 2013, and the effective dose on this examination date is 9.1 mSv. The second inspection date is May 14, 2013, and the effective dose on this inspection date is 14.3 mSv. The third inspection date is July 16, 2013, and the effective dose on this inspection date is 57.8 mSv. The fourth inspection date is September 20, 2013, and the effective dose on this inspection date is 14.4 mSv.

  The accumulated dose on the first examination day is 9.1 mSv, and the accumulated dose on the first examination day is integrated with the effective dose on the second examination day, and the accumulated dose on the second examination date is 23.4 mSv. . In addition, the integrated dose on the third inspection date, which is obtained by adding the effective dose on the third inspection date to the integrated dose on the second inspection date, is 81.2 mSv. Further, the integrated dose on the fourth inspection day, which is obtained by adding the effective dose on the fourth inspection date to the integrated dose on the third inspection date, is 95.6 mSv.

  After step S2 in FIG. 5, the dose prediction unit 320 predicts the transition of the integrated dose from the current date to the last day of the specific period as the future within the specific period (step S3).

  When the number of past examinations of the subject PA that has been examined in the specific period saved in the exposure information storage unit 310 is less than a predetermined number, the subject PA and the age saved in the exposure information storage unit 310 Alternatively, the prediction may be made based on the effective dose in a specific period other than the subject PA having a similar body weight, height, or disease.

  Here, in order to predict the transition of accumulated dose in the future, a relational expression showing the relationship between past examination dates in the specified period and the accumulated dose until this examination date is obtained by a statistical method, and the obtained relationship A graph of the relationship between the examination date and the accumulated dose in a specific period is created using the formula.

  FIG. 7 is a diagram illustrating an example of a graph of the relationship between the examination date and the accumulated dose. This graph 321 is represented on coordinates with the horizontal axis as the examination date and the vertical axis as the integrated dose. Then, the four bar graphs 3211 showing the accumulated doses of the four examination days shown in FIG. 6 in the specific period, and the transition of the accumulated doses in the specific period according to the relationship between the four examination days and the accumulated dose on the examination day. The transition graph 3212 to be shown and a line 3213 showing the upper limit value of the integrated dose considered to be safe in the specific period.

  After step S3 in FIG. 5, the dose management unit 330 determines whether or not the future integrated dose within the specific period predicted by the dose prediction unit 320 is at a safe level (step S4).

  Here, the dose management unit 330 calculates the integrated dose on the last day within the specific period using the relational expression obtained by the dose prediction unit 320. If the accumulated dose on the last day is equal to or lower than the upper limit value (Yes in step S5), the process proceeds to step S6. When the accumulated dose on the last day is larger than the upper limit value (No in step S5), the process proceeds to step S7.

  After “Yes” in step S5, the dose management unit 330 calculates the integrated dose DA of the current day using the relational expression obtained by the dose prediction unit 320, as shown in FIG. Next, based on the effective dose DL obtained by subtracting the integrated dose on the fourth inspection date, which is the previous inspection date, from the integrated dose DA, and the effective dose DH obtained by subtracting the integrated dose DA from the upper limit, the post-inspection integration on the current day An effective dose (allowable effective dose) allowed at the time of the examination on the current day in which the dose falls within the predetermined range W, for example, which is equal to or lower than the upper limit value (step S6).

  After “No” in step S5, the dose management unit 330 creates warning information such as “it is predicted that the upper limit will be exceeded in the future within a specific period” (step S7). Then, as shown in FIG. 9, the exposure management information of the subject PA including the graph 321 a created by the dose prediction unit 320 in which a bar graph indicating the accumulated dose on the last day exceeding the upper limit value is added to the graph 321 and warning information, for example. Is output to the communication unit 380. Thereafter, the process proceeds to step S9.

  After step S <b> 6, the dose management unit 330 searches for inspection condition candidates that are allowable effective doses from the inspection conditions of the X-ray CT apparatus 110 stored in the inspection condition storage unit 340 (step S <b> 8). Then, the exposure management information of the subject PA including the retrieved examination condition candidates, the relational expression obtained by the dose prediction unit 320, and the graph 321 is output to the communication unit 380. Thereafter, the process proceeds to step S9.

  The communication unit 380 transmits the exposure management information of the subject PA output from the dose management unit 330 to the X-ray CT apparatus 110. The communication unit 60 of the X-ray CT apparatus 110 outputs the exposure management information of the subject PA returned in response to the transmission of the patient information A to the display unit 40. The display unit 40 displays the exposure management information of the subject PA (step S9).

FIG. 10 is a diagram illustrating an example of a screen on which the exposure management information of the subject PA is displayed on the display unit 40, and is a screen for setting examination conditions for imaging the subject PA.
The screen 41 includes first to fourth areas 511 to 514, and is displayed in response to input of examination information on the subject PA. In the first area 511, patient information A such as the name, age, and sex of the subject PA and examination information including the examination site are displayed. In the second area 512, an imaging unit model simulating the imaging unit 20, an object model simulating the subject P to be imaged by the imaging unit 20, and the moving direction of the object model are displayed. .

  In the third area 513, for example, a graph 321 created by the dose prediction unit 320 of the exposure dose management apparatus 300 is displayed. In addition, in the fourth area 514, two examination condition candidates searched by the dose management unit 330 are displayed.

  In this way, by displaying the graph 321 on the display unit 40 in response to the input of the patient information A of the subject PA to be examined, it is easy to determine whether or not the future integrated dose in the specific period exceeds the upper limit value. Can be confirmed. Further, by displaying on the display unit 40 candidates for examination conditions that are allowable effective doses, the examination conditions for the subject PA can be easily determined.

  Note that if “No” in step S5 of FIG. 5, the graph 321a is displayed in the third area 513 and the warning information is displayed in the fourth area 514. As described above, when it is predicted that the accumulated dose of the subject PA will exceed the upper limit value in the future within the specific period, the warning information is displayed on the display unit 40, thereby determining the examination condition in consideration of safety. can do.

  In the graph 321 displayed in the third area 513, the upper limit is, for example, 100 mSv, and the effective dose obtained by subtracting the accumulated dose on the current day from the upper limit is 2.0 mSv. Further, the examination condition candidates displayed in the fourth area 514 are, for example, 0.5 mSv effective dose stored in the “effective dose [mSv]” column of the examination condition list 341 shown in FIG. The first inspection condition and the second inspection condition that is 2.4 mSv larger than the calculated effective dose.

  Here, when an input for specifying the first inspection condition is performed from the operation unit 50, a graph 321b is displayed in the third area 513 of the screen 41a as shown in FIG. The difference between the graph 321b and the graph 321 displayed on the screen 41 in FIG. 10 is that the first dose is the accumulated dose on the fourth examination day, at the current position on October 22, 2013, which is the fifth examination date. It is expressed in the relational expression obtained from the point that the accumulated dose bar graph that integrates the effective dose of the inspection conditions is added, the accumulated dose that is accumulated the effective dose of the 1st to 4th doses, and the first dose. This is a change to the transition graph. In the graph 321b, the integrated dose on the last day within the specific period indicates a value equal to or lower than the upper limit value.

  In this way, the graph 321 and the examination condition candidates are displayed side by side on the display unit 40, and the bar graph indicating the accumulated dose after the examination on the current day is input by designating one examination condition from the displayed candidates. It can be confirmed by displaying it on 321.

  In addition, when an input for specifying the second inspection condition is performed from the operation unit 50, a graph 321c is displayed in the third area 513 of the screen 41b as illustrated in FIG. This graph 321c is different from the graph 321b displayed on the screen 41a of FIG. 11 in that the transition graph obtained from the integrated dose obtained by integrating the first to fourth integrated dose and the effective dose of the second inspection condition is specified. Since the accumulated dose on the last day in the period exceeds the upper limit value, for example, a bar graph indicating the accumulated dose obtained by integrating the effective dose of the second inspection condition blinks and is displayed as a warning.

  Thus, even if the accumulated dose after the examination on the current day is less than or equal to the upper limit value by the input designating one examination condition from the candidates displayed on the display unit 40, the upper limit is set after the current day within the specific period. When it is predicted that the value will be exceeded, the warning information can be displayed on the display unit 40.

  When an input for specifying the first inspection condition and an input for displaying a similar image are performed from the operation unit 50, the graph 321b illustrated in FIG. 11 is displayed in the third area 513 of the screen 41c as illustrated in FIG. In addition, pseudo image data 61 generated by simulation by the image processing unit 60, which is expected when the inspection is performed under the first inspection condition, is displayed in the second area 512.

  The pseudo image data 61 is an image generated from imaging of the same examination region by the X-ray CT apparatus 110 by a past examination of the subject PA transmitted from the image information storage apparatus 200 in response to an input for displaying a similar image. This is image data generated by performing processing such as sinogram, addition of noise according to the first inspection condition, and back-projection.

  In addition, it is generated by a past examination other than the subject PA in which at least one of the age, weight, height, or disease of the subject PA scheduled to be examined during the specific period stored in the image information storage device 200 is similar. Alternatively, pseudo image data may be generated by simulation of the image data.

  As described above, by displaying the pseudo image data 61 corresponding to the designated examination condition among the examination condition candidates displayed on the display unit 40, the examination condition considering the balance between the image quality and the exposure dose is determined. Can do. Accordingly, it is possible to easily confirm whether or not the image quality necessary for diagnosis can be maintained, and re-examination due to insufficient image quality can be prevented.

  When an input for selecting the second inspection condition and an input for displaying a similar image are performed from the operation unit 50, the graph 321c illustrated in FIG. 12 is displayed in the third area 513 of the screen 41d as illustrated in FIG. In addition, pseudo image data 61a generated by simulation by the image processing unit 60, which is predicted when the inspection is performed under the second inspection condition, is displayed in the second area 512.

  Further, when an input for specifying the second inspection condition and an input for displaying a similar image are performed from the operation unit 50, an input for displaying a slide bar capable of changing a parameter that affects the image quality is performed. As shown in FIG. 15, a slide bar 62 is displayed in the second area 512 of the screen 41e together with the pseudo image data 61a shown in FIG. When an input for sliding the slide bar 62 is performed from the operation unit 50, image data in which the image quality of the pseudo image data 61a is changed by the image processing unit 60 according to the change of the parameters is displayed.

  As described above, by using the slide bar 62 displayed on the display unit 40, it is possible to determine detailed inspection conditions in consideration of the balance between the image quality and the exposure dose. Accordingly, it is possible to easily confirm whether or not the image quality necessary for diagnosis can be maintained, and re-examination due to insufficient image quality can be prevented.

  When an input for selecting the second inspection condition and an input for displaying a plurality of similar images are performed from the operation unit 50, as shown in FIG. 16, the second area 512 of the screen 41f is displayed in FIG. For example, three pseudo image data 61b, 61c, and 61d generated by the image processing unit 60 in the order similar to the pseudo image data 61a are displayed together with the pseudo image data 61a.

  Based on the exposure management information displayed on, for example, the screen 41a of the display unit 40, after the input for confirming the first inspection condition is performed from the operation unit 50, the inspection is executed, and the inspection end is input. When the X-ray CT apparatus 110 ends the examination, the exposure dose management system 400 ends the operation (step S10 in FIG. 5).

  It should be noted that the exposure information storage unit 310, the dose prediction unit 320, the dose management unit 330, and the examination condition storage unit 340 are provided in the X-ray CT apparatus 110 so as to predict the transition of the exposure dose in the future of the subject PA. Also good.

  Next, with reference to FIG. 1 thru | or FIG. 22, the transition of the future exposure dose is estimated and the operation | movement which supports a future low exposure plan is demonstrated. Hereinafter, an inspection technique that can be used now or in the future is determined from inspection techniques stored in the inspection technique storage unit 350 of the exposure dose management apparatus 300 by a manager of a radiation department or the like who has advanced knowledge. And the integrated dose in the future of the subject PA is predicted by setting the use start date of the examination technique determined based on the low exposure plan.

FIG. 17 is a flowchart showing the operation of the exposure dose management system 400.
As of May 1, 2013, when the dose reduction is planned, for example, a period from May 1, 2012 to April 30, 2013 is input as a past period, and all diagnostic imaging apparatuses 100 are investigated. When the input specifying all examinations is performed from the operation unit 370 of the dose management apparatus 300, the dose management system 400 starts operation (step S11).

  Note that the survey target can be narrowed down by input classified into age, sex, weight, height, disease, examination site, and the like.

  The dose prediction unit 320 acquires the irradiation dose of all examinations in the past period input from the operation unit 370 among the irradiation doses stored in the exposure information storage unit 310. Next, an average irradiation dose obtained by averaging the acquired irradiation dose for each inspection date is calculated (step S12).

  Next, the dose prediction unit 320 predicts the transition of the average irradiation dose in the future after the past period from the relationship between each inspection date in the past period and the average irradiation dose on this inspection day (step S13).

  Here, in order to predict the transition of the average irradiation dose, a relational expression indicating the relationship between the inspection date and the average irradiation dose in the past period is obtained by statistical processing, and a graph of the relationship between the inspection date and the average irradiation dose is created. To do. The display unit 360 displays the graph created by the dose prediction unit 320.

  FIG. 18 is a diagram illustrating an example of a graph of the relationship between the examination date and the average irradiation dose displayed on the display unit 360. This graph 322 includes a plurality of bar graphs 3221 indicating the average irradiation dose for each inspection day in the past period represented on the coordinate with the horizontal axis as the inspection date and the vertical axis as the average irradiation dose, the inspection date and the average It consists of a transition graph 3222 drawn by the relational expression with the irradiation dose.

  Thus, by displaying the graph 322 on the display unit 360, the transition of the average irradiation dose in the future can be confirmed.

  After the graph 322 is displayed on the display unit 360, the input for designating the second CT technique as an examination technique capable of reducing the dose without deteriorating the image quality by adopting the graph 322 and the use start date of the second CT technique For example, when the input on June 1, 2013 is performed from the operation unit 370, the dose management unit 330 is related to the second CT technique from the examination technique list 351 stored in the examination technique storage unit 350. Information on the irradiation dose and the irradiation dose related to, for example, the first CT technique used in the past period before the second CT technique is adopted is searched (step S14 in FIG. 17).

  In addition, when the input start date of the second CT technique is before the date when the examination technique storage unit 350 can use the second CT technique, the second CT technique is invalidated.

  The dose management unit 330 can be reduced by adopting the second CT technique based on the irradiation dose information related to the first and second CT techniques in the past period stored in the exposure information storage unit 310. A reasonable dose (reduced dose) is calculated. Based on the reduced dose calculated by the dose management unit 330, the dose prediction unit 320 predicts the transition of the average irradiation dose after the use start date of the input inspection technique (step S15 in FIG. 17).

  Here, in order to predict the transition of the average irradiation dose after the use start date of the inspection technique, the transition graph 3222 of the graph 322 shown in FIG. 18 is reduced for each inspection day after the use start date of the second CT technique. Create a graph of dose reduction that is replaced by the transition of the average irradiation dose minus the dose. The display unit 360 displays the dose reduction graph created by the dose prediction unit 320.

  FIG. 19 is a diagram illustrating an example of a dose reduction graph displayed on the display unit 360. This graph 322 a is different from the graph 322 shown in FIG. 18 in that a first reduction transition graph 3223 is added to the transition graph 3222. In this first reduction transition graph 3222, the average irradiation dose after June 1, 2013, which is the start date of use of the second CT technology, is a transition in which the average irradiation dose shown in the transition graph 3222 is reduced by, for example, 5%. It is a graph to show.

  Here, the irradiation dose of the first CT technique in the inspection technology list 351 shown in FIG. 16 is 3.50 mGy, and the irradiation dose of the second CT technique is 50% of the irradiation dose of the first CT technique. Reduced to 1.75 mGy. The total number of examinations in the past period is, for example, 10,000, and the number of examinations of the X-ray CT apparatus 110 using the first CT technique occupies 10% of the total number of examinations. Accordingly, since 50% of 10% can be reduced, the average irradiation dose for each examination day after June 1, 2013, which is the start date of the use of the second CT technique, shows a transition that is reduced by 5%. .

  If the use start date of the second CT technique is not entered, the date when the available date stored in the examination technique storage unit 350 can be reduced is entered. May 1, 2013 Since it is before the day, the graph shows a transition in which the average irradiation dose for each examination day after May 1, 2013 is reduced by 5%.

  Thus, by specifying one available inspection technique, the graph 322a reflecting the inspection technique can be displayed on the display unit 360. From the graph 322a, it is possible to confirm the transition of the average irradiation dose that can be reduced in the future by adopting the one inspection technique.

  After step S15 in FIG. 17, when a confirmation input is made from the operation unit 370 (Yes in step S16), the process proceeds to step S17. In addition, when an undetermined input is made from the operation unit 370 (No in step S16), the process returns to step S14.

  When the process returns to step S14 after “No” in step S16, it is possible to input the designation of the inspection technique stored in the inspection technique storage unit 350 by further employing it. And, for example, by the second pulse fluoroscopy and July 22, 2013, and the chest new CT protocol and the input on January 4, 2014, the transition of the average irradiation dose after subtracting the reduced dose for each examination day after the start date of use A plurality of dose reduction graphs replaced with are displayed on the display unit 360.

  FIG. 20 is a diagram illustrating an example of a plurality of dose reduction graphs displayed on the display unit 360. This graph 322b is different from the graph 322a shown in FIG. 19 in that the second reduction transition graph 3224 is replaced with the second reduction transition graph 3224 after July 22, 2013 in the first reduction transition graph 3223. The third reduction transition graph 3225 has been replaced after January 4, 2014.

  The second reduction transition graph 3224 is an average in which the average irradiation dose after July 22, 2013 is reduced from the average irradiation dose shown in the first reduction transition graph 3223 by adopting the second pulse fluoroscopy. It is a graph which shows transition of irradiation dose. In addition, in the third reduction transition graph 3225, the average irradiation dose after January 4, 2014 was reduced from the average irradiation dose shown in the second reduction transition graph 3224 by adopting the new chest CT protocol. It is a graph which shows transition of average irradiation dose.

  As described above, by specifying a plurality of available inspection techniques, the graph 322b reflecting the inspection techniques can be displayed on the display unit 360. From the graph 322b, it is possible to confirm the transition of the average irradiation dose that can be reduced in the future by adopting the plurality of inspection techniques.

  In addition, as shown in FIG. 21, for example, a plurality of icons 3226 indicating a safety bell of the average irradiation dose referring to a guideline such as a diagnostic reference level issued by the International Commission on Radiological Protection (ICRP) are displayed on the display unit. 360 may be displayed together with the graph 322b.

  As described above, by displaying the icon 3226 on the display unit 360 together with the graph 322b, the level of safety by adopting the inspection technique can be easily confirmed.

  After “Yes” in step S16 shown in FIG. 17, the exposure dose management system 400 operates when the draft of the dose reduction plan is completed and an input for determining, for example, the second CT technique is performed from the operation unit 370. Is finished (step S17).

  In step S11, for example, when an input for designating all examinations by the X-ray CT apparatus 110 is performed from the operation unit 370, when returning to step S14 after “NO” in step S16, the designated X-ray CT apparatus Since it is not possible to input the inspection technique of each diagnostic imaging apparatus 100 other than 110, the transition of the reduction of the average irradiation dose by adopting the second pulse fluoroscopy, which is the inspection technique of the X-ray diagnostic apparatus 120 shown in FIG. Excluded.

  After the adoption of the second CT technique, which is an inspection technique capable of reducing the exposure dose, to the X-ray CT apparatus 110 is confirmed, the operation unit 50 performs an inspection of the subject PA on October 22, 2013. When the specific period, the inspection information, and the future use start date within the specific period of the inspection technique are input, the dose prediction unit 320 uses the specific period to predict the transition of the future integrated dose within the specific period. Create a graph of the relationship between the examination date and the accumulated dose.

  FIG. 22 is a diagram illustrating an example of a graph of the relationship between the examination date and the accumulated dose in a specific period after the examination technique is determined. This graph 321d is different from the graph 321 shown in FIG. 7 in that the transition of the integrated dose indicated by the solid line after the use start date of the second CT technique is after the use start date of the second CT technique of the graph 321. This is a point that is less than the transition of the accumulated dose shown by the broken line.

  Thus, in steps S11 to S17, the graph 321d reflecting the exposure dose by the second CT technique that has been adopted can be displayed on the display unit 40. As a result, it is possible to confirm a reduction in the transition of the accumulated dose due to the adoption of the second CT technique.

  According to the embodiment described above, the transition of the accumulated dose in the future is predicted from a plurality of accumulated doses in the specific period, and it is determined whether or not the accumulated dose in the future is at a level considered safe. Can do.

  If the future integrated dose within the specified period is less than or equal to the upper limit, candidates and identification of inspection conditions that cause the accumulated dose after the inspection to be less than or equal to the upper limit during an inspection performed within the specified period A graph 321 predicting the transition of the accumulated dose in the future within the period can be arranged and displayed on the display unit 40. Thereby, an inspection condition can be determined easily.

  Further, when it is predicted that the upper limit value will be exceeded in the future within the specific period, the graph 321a predicted to exceed the upper limit value in the future and the warning information thereof can be displayed on the display unit 40. Thereby, the inspection conditions considering safety can be determined.

  Moreover, since the pseudo image data 61 corresponding to the inspection condition displayed on the display unit 40 can be displayed, the inspection condition considering the balance between the image quality and the exposure dose can be determined. Accordingly, it is possible to easily confirm whether or not the image quality necessary for diagnosis can be maintained, and re-examination due to insufficient image quality can be prevented.

  In addition, by specifying an available inspection technique stored in the inspection technique storage unit 350, a graph 322a reflecting the inspection technique can be created and displayed on the display unit 360. Thereby, transition of the average irradiation dose that can be reduced in the future by adopting the inspection technique can be confirmed.

  In addition, a graph 321d reflecting the inspection technique that has been adopted can be created and displayed on the display unit 40. Thereby, transition of the integrated dose reduced by adoption of an inspection technique can be confirmed.

  Although several embodiments of the present invention have been described, these embodiments are presented by way of example and are not intended to limit the scope of the invention. These novel embodiments can be implemented in various other forms, and various omissions, replacements, and changes can be made without departing from the scope of the invention. These embodiments and modifications thereof are included in the scope and gist of the invention, and are included in the invention described in the claims and the equivalents thereof.

21 X-ray tube 22 X-ray detector 30 Image processing unit 40, 360 Display unit 60, 201, 380 Communication unit 100 Image diagnostic apparatus 110 X-ray CT apparatus 120 X-ray diagnostic apparatus 200 Image information storage apparatus 300 Exposure dose management apparatus 310 Exposure information storage unit 320 Dose prediction unit 330 Dose management unit 340 Inspection condition storage unit 350 Inspection technology storage unit 400 Exposure dose management system 500 Network

Claims (13)

An exposure information storage unit for storing exposure information when the subject is irradiated with X-rays by examination;
Based on the exposure information stored in the exposure information storage unit, a dose prediction unit that predicts a transition of a future integrated dose within the specific period from a plurality of integrated doses obtained by integrating past exposure doses within the specific period; ,
When the future accumulated dose is a value equal to or less than a preset upper limit value, an exposure dose that causes the accumulated dose after the examination to be equal to or less than the upper limit value during the examination performed within the specific period is calculated. A dose management unit that obtains candidates for the inspection conditions that will result in the exposure dose,
An exposure dose management system comprising: a display unit that displays the accumulated dose transition and the inspection condition candidates side by side.   The dose prediction unit obtains a relational expression indicating a relation between the plurality of past examination dates and an accumulated dose obtained by integrating the exposure doses up to the examination date by a statistical method, and predicts using the relational expression The exposure dose management system according to claim 1.   When the future integrated dose is a value equal to or less than the upper limit, the dose management unit calculates an integrated dose on the inspection date performed within the specific period using the relational expression, and further calculates the integrated integration on the inspection date. During the examination, the accumulated dose after the examination is less than or equal to the upper limit value based on the exposure dose obtained by subtracting the accumulated dose on the previous examination date from the dose and the exposure dose obtained by subtracting the accumulated dose on the examination date from the upper limit value. The exposure dose management system according to claim 2, wherein an allowable exposure dose that is allowed to be calculated is calculated, and a candidate for the inspection condition that becomes the allowable exposure dose is obtained. An inspection condition storage unit for storing inspection conditions including irradiation conditions necessary for X-ray irradiation to the subject;
The exposure dose management system according to claim 3, wherein the dose management unit searches and obtains the inspection condition candidate that is the allowable exposure dose from the inspection condition storage unit. The dose management unit creates warning information when the accumulated dose on the last day in the specific period is greater than the upper limit value,
The exposure dose management system according to claim 1, wherein the display unit displays the warning information.   The dose prediction unit is configured to store the exposure information stored in the exposure information storage unit when the number of past examinations of the subject to be examined within the specific period stored in the exposure information storage unit is smaller than a predetermined number. The transition of the future integrated dose is predicted based on exposure information in the specific period other than the subject whose age, weight, height, or disease is similar to the subject. The exposure dose management system according to any one of claims 1 to 5. An image processing unit that generates similar image data based on a simulation of image data generated in a past examination of a subject to be examined within the specific period based on the examination condition candidate obtained by the dose management unit; Have
7. The display unit according to claim 1, wherein the display unit displays the transition of the integrated dose, the examination condition candidates obtained by the dose management unit, and the similar image data side by side. Dose management system. Based on the examination condition candidates obtained by the dose management unit, other than the subject whose age, weight, height, or disease is similar to the subject scheduled to be examined within the specific period Having an image processing unit for generating predicted image data by simulation for image data generated by inspection;
7. The display unit according to claim 1, wherein the display unit displays the transition of the integrated dose, the examination condition candidates obtained by the dose management unit, and the similar image data side by side. Dose management system.   The exposure dose management system according to any one of claims 1 to 8, wherein the exposure dose is an effective dose. An inspection technology storage unit that stores information on an inspection technology capable of reducing the exposure dose due to X-ray irradiation on the subject, a past period, the inspection technology, and a start date of use of the inspection technology and confirmation of adoption A first operation unit capable of input; and a second operation unit capable of inputting a future use start date within the specific period, the inspection technique and the specific period of the inspection technique,
The dose prediction unit
Of the irradiation dose included in the exposure information stored in the exposure information storage unit according to the past period from the first operation unit, the inspection technique, and the input of the use start date, the past period Predicting the transition of irradiation dose in the future including the use start date from the plurality of inspection dates and the irradiation dose on this inspection date,
According to the specific period from the second operation unit after the confirmation of adoption of the inspection technology is input from the first operation unit, the inspection technology and the use start date input of the inspection technology, the past The transition of the future integrated dose including the transition in which the integrated dose is reduced due to the exposure reduction after the start date of use is predicted from a plurality of integrated doses obtained by integrating the exposure doses of Item 9. The exposure dose management system according to any one of Items 8. An X-ray tube that irradiates the subject with X-rays by examination;
An X-ray detector for detecting X-rays irradiated from the X-ray tube and transmitted through the subject;
An exposure information storage unit for storing exposure information when the subject is irradiated with X-rays by the X-ray tube;
Based on the exposure information stored in the exposure information storage unit, a dose prediction unit that predicts a transition of a future integrated dose within the specific period from a plurality of integrated doses obtained by integrating past exposure doses within the specific period; ,
When the future integrated dose is a value equal to or lower than a preset upper limit value, the subject whose cumulative dose after the test becomes a value equal to or lower than the upper limit value during an examination performed within the specific period And a display unit that displays warning information when the future accumulated dose is larger than the upper limit value, along with the candidate of the examination conditions related to the X-ray irradiation to the display. A diagnostic imaging apparatus. An exposure information storage unit for storing exposure information when the subject is irradiated with X-rays by examination;
Based on the exposure information stored in the exposure information storage unit, from the past exposure dose in the specific period, a dose prediction unit that predicts the transition of the future integrated dose in the specific period;
Using the predicted transition of the accumulated dose, the condition of the dose at which the accumulated dose after the examination is less than or equal to a preset upper limit value during the examination performed within the specific period is calculated, and the calculated exposure A dose management unit for obtaining at least one examination condition candidate that satisfies the dose condition;
An exposure dose management system comprising: a display unit configured to display the at least one obtained examination condition candidate side by side. An X-ray tube that irradiates the subject with X-rays by examination;
An X-ray detector for detecting X-rays irradiated from the X-ray tube and transmitted through the subject, and an exposure information storage for storing exposure information when the subject is irradiated with X-rays by the X-ray tube And
Based on the exposure information stored in the exposure information storage unit, from the past exposure dose in the specific period, a dose prediction unit that predicts the transition of the future integrated dose in the specific period;
Using the predicted transition of the accumulated dose, the condition of the dose at which the accumulated dose after the examination is less than or equal to a preset upper limit value during the examination performed within the specific period is calculated, and the calculated exposure A dose management unit for obtaining at least one examination condition candidate that satisfies the dose condition;
An image diagnostic apparatus comprising: a display unit that displays the obtained candidates for at least one inspection condition side by side.

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