JP6446237B2 - Ultrasound system - Google Patents

Description

  The present invention relates to an ultrasound system.

  In the treatment of prostate cancer, brachytherapy using a radioactive substance is known. Brachytherapy is a treatment called brachytherapy, which is performed by inserting a relatively small radioactive substance directly into the prostate. For inserting a radioactive substance into the prostate, an ultrasonic system such as an ultrasonic diagnostic apparatus is extremely useful.

  For example, while seeing an ultrasonic image obtained using an ultrasonic probe, a needle is inserted from the perineum of the subject by a doctor or the like, and the radiation source in the needle is placed in the subject's prostate. The Patent Document 1 discloses an epoch-making technique that is extremely suitable for inserting a needle from the perineum and placing a radiation source in place.

JP 2013-223648 A

  In view of the background art described above, the inventor of the present application has conducted research and development on further improvements of the ground-breaking technique disclosed in Patent Document 1. For example, in addition to the approach of inserting a needle from the perineum of a subject, in order to realize an approach of inserting a needle from another part of the subject, positional information on a plurality of probes suitable for a plurality of approaches is obtained. Focused on the technology used.

  The present invention has been made in the course of research and development, and an object thereof is to provide an improved technique for using position information relating to a plurality of probes.

  A suitable ultrasound system that meets the above-described purpose includes a region where ultrasonic waves are transmitted and received by the first probe, and includes position information (for example, position and inclination) of the first probe obtained from a position sensor associated with the first probe. ), And a reference image forming unit that forms a reference image imaged two-dimensionally or three-dimensionally, and an ultrasonic image formation that forms an ultrasonic image based on an ultrasonic reception signal obtained from the second probe And position information (for example, including position and inclination) of the reference image is derived based on position information of the first probe obtained from the position sensor associated with the first probe, and the position sensor is extracted from the first probe. Based on position information (for example, including position and inclination) of the second probe obtained from the position sensor in association with the second probe, ultrasonic waves at the second probe on the reference image A position information deriving unit for deriving image position information (for example, including position and inclination), and reflecting the position information of the other (for example, including position and inclination) to at least one of the reference image and the ultrasonic image. And a display image forming unit for forming the displayed image.

In a preferred embodiment, the reference image forming unit forms a three-dimensional reference image corresponding to volume data obtained by three-dimensionally transmitting and receiving ultrasonic waves with a first ultrasonic probe, and the ultrasonic image forming unit Forms a two-dimensional ultrasonic image based on a received signal obtained by two-dimensionally transmitting and receiving ultrasonic waves by the second ultrasonic probe, and the display image forming unit scans the two-dimensional ultrasonic image Based on the position information of the surface (including position and inclination, for example), by cutting out the same section as the two-dimensional ultrasound image from the three-dimensional reference image and displaying it in parallel with the two-dimensional ultrasound image A display image is formed by performing a process of displaying different image data acquired by the first ultrasonic probe and the second ultrasonic probe in a common image display form.

  In a preferred embodiment, the reference image forming unit forms a three-dimensional reference image corresponding to volume data obtained by three-dimensionally transmitting and receiving ultrasonic waves with a first ultrasonic probe, and the ultrasonic image forming unit Forms a two-dimensional ultrasonic image based on a received signal obtained by two-dimensionally transmitting and receiving ultrasonic waves by the second ultrasonic probe, and the display image forming unit scans the two-dimensional ultrasonic image Based on the position information of the surface (for example, including position and inclination) and the position information of the three-dimensional reference image (for example, including position and inclination), the image surface of the two-dimensional ultrasound image is positioned on the three-dimensional reference image. A display image showing a relative positional relationship between the reference image and the ultrasonic image is formed by arranging (or superimposing) and compositing at a position corresponding to information.

  In a desirable specific example, the display image forming unit forms a display image on the attention location in the reference image, which has been subjected to display processing indicating the attention location at a position corresponding to the attention location in the ultrasonic image. It is characterized by that.

  In a preferred embodiment, the display image forming unit forms a display image showing a target position of a radiation source in the brachytherapy in the ultrasonic image.

  In a preferred embodiment, the display image forming unit forms a display image in which guidelines for placing a radiation source in brachytherapy are shown in the ultrasonic image.

  In a preferred embodiment, the ultrasound system has a target position for indwelling the source by a perineum approach in which the source is placed from the perineum of the subject toward the prostate as the target position of the source in brachytherapy; A target position for placing the radiation source is set by a rectal approach in which the radiation source is placed from the subject's rectum toward the prostate.

  In a preferred embodiment, the ultrasound system is characterized in that a target position for placing the radiation source by the rectal approach is set at a location where the radiation source could not be placed by the perineum approach.

  In a preferred embodiment, the ultrasound system forms an ultrasound image of the perineum approach based on the ultrasound reception signal obtained from the first probe, and based on the ultrasound reception signal obtained from the second probe. Forming an ultrasound image of a rectal approach.

  According to the present invention, an improved technique for using position information relating to a plurality of probes is provided. For example, according to a preferred embodiment of the present invention, an ultrasound system is provided that is suitable for utilizing a probe suitable for the perineal approach and a probe suitable for the rectal approach in brachytherapy treatment. Further, for example, according to a preferred aspect of the present invention, an ultrasonic system suitable for placing a radiation source by a rectal approach at a location where the radiation source could not be placed by the perineum approach is realized.

1 is an overall configuration diagram of an ultrasonic system suitable for implementing the present invention. It is a figure which shows the specific example of a transperineal probe. It is a figure which shows the specific example of a transrectal probe. It is a figure for demonstrating the specific example of radiation source placement. It is a figure which shows the suitable specific example of a template. It is a figure which shows the specific example which concerns on formation of volume data. It is a figure which shows the specific example of 3D template data. It is a figure which shows the specific example of the display image for confirming the target position of a radiation source. It is a figure which shows the specific example of the display image in a transrectal approach. It is a figure which shows the modification of the display image for confirming the target position of a radiation source. It is a figure which shows the modification of the display image in a transrectal approach. It is a figure which shows the modification of the display which concerns on a volume data 3D image.

  FIG. 1 is an overall configuration diagram of an ultrasonic system suitable for implementing the present invention. The ultrasound system of FIG. 1 has a suitable configuration and function in, for example, prostate cancer brachytherapy (sealed brachytherapy). Of course, the ultrasound system of FIG. 1 may be used for treatment or diagnosis other than brachytherapy.

  The transperineal probe 11 and the transrectal probe 12 are ultrasonic probes having a function of transmitting and receiving ultrasonic waves. The transperineal probe 11 is used, for example, in brachytherapy to place a radiation source from the subject's perineum into the prostate by a needle, and the transrectal probe 12 is used in the ultrasound system from the subject's rectum. Used during a transrectal approach, where the needle is placed in the prostate.

  The transperineal probe 11 and the transrectal probe 12 are selectively electrically connected to the transmission / reception unit 20 via the selector 16. For example, when both the transperineal probe 11 and the transrectal probe 12 are connected to the probe connector, the selector 16 connects one of the probes according to an instruction from a user such as a doctor to the transmission / reception unit 20. To do. Further, for example, when only one of the transperineal probe 11 and the transrectal probe 12 is connected to the probe connector, one of the probes may be connected to the transmitting / receiving unit 20 via the selector 16. .

  The transmission / reception unit 20 has functions as a transmission beamformer and a reception beamformer. That is, the transmission / reception unit 20 forms a transmission beam by outputting a transmission signal to each of a plurality of vibration elements included in a probe (transperineum probe 11 or transrectal probe 12) connected via the selector 16. Further, a received beam is formed by performing phasing addition processing or the like on a plurality of received signals obtained from a plurality of vibration elements. Thereby, the ultrasonic beam (transmission beam and reception beam) is scanned in the scanning plane, and an ultrasonic reception signal is obtained from the scanning plane. The ultrasonic reception signal is subjected to reception signal processing such as detection processing in the transmission / reception unit 20 as necessary.

  The tomographic image forming unit 30 forms ultrasonic tomographic image data corresponding to the scanning surface of the transperineal probe 11 or the transrectal probe 12 based on the ultrasonic reception signal obtained from the transmission / reception unit 20.

  The position information processing unit 40 derives position information of the scanning plane based on information obtained from the position sensor 42 and the position source 44. In other words, the position information processing unit 40 has position information on the scanning plane formed by the transperineal probe 11 and the transrectal probe 12 to which the position sensor 42 is attached in a three-dimensional reference coordinate system with the position source 44 as a reference ( Deriving position and inclination).

  A preferred specific example of the position sensor 42 is a magnetic sensor. In this case, the position sensor 42 detects a magnetic field generated by the position source 44 and the transperineal probe 11 in the reference coordinate system with the position source 44 as a reference. Position information of the transrectal probe 12 (for example, the position and inclination of the probe) is detected, and the detection result is output to the position information processing unit 40. The position sensor 42 is not limited to a magnetic sensor, and may be a sensor such as an optical sensor.

  The position sensor 42 can be attached to the transperineal probe 11 and the transrectal probe 12. For example, when an ultrasonic reception signal is obtained using the transperineal probe 11, the position sensor 42 is attached to the transperineal probe 11, and an ultrasonic reception signal is obtained using the transrectal probe 12. In some cases, the position sensor 42 is replaced from the transperineal probe 11 to the transrectal probe 12.

  The volume data forming unit 50 is based on the plurality of tomographic image data obtained from the tomographic image forming unit 30 and the scanning plane position information (position and inclination) obtained from the position information processing unit 40. Volume data corresponding to the obtained three-dimensional scanning space is formed.

  The reference image forming unit 60 forms image data of the reference image based on the position information (position and inclination) of the scanning plane obtained from the position information processing unit 40 and the volume data obtained from the volume data forming unit 50. The reference image forming unit 60 forms two-dimensional reference image image data (2D reference image data) and three-dimensional reference image image data (3D reference image data) as reference images suitable for brachytherapy.

  The 3D template data generation unit 70 generates 3D template data related to a template used in the brachytherapy using the ultrasound system of FIG. The template is an instrument that serves as a guide for inserting the radiation source with the needle, and the 3D template data generation unit 70 generates 3D template data related to the template.

  The radiation source information processing unit 80 derives information on the radiation source placed in the body of the subject in the brachytherapy, for example, information on a target position where the radiation source should be placed, a route for placing the radiation source, and the like.

  The display image forming unit 90 includes tomographic image data obtained from the tomographic image forming unit 30, reference image data obtained from the reference image forming unit 60, 3D template data obtained from the 3D template data generating unit 70, and radiation source information. A display image is formed based on information about the radiation source obtained from the processing unit 80. The formed display image is displayed on the display unit 92.

  The control unit 100 generally controls the inside of the ultrasound system of FIG. In the control by the control unit 100, an instruction received from the user via the operation device 110 is also reflected.

  Of the configurations (respectively assigned parts) shown in FIG. 1, the selector 16, the transmission / reception unit 20, the tomographic image forming unit 30, the position information processing unit 40, the volume data forming unit 50, the reference image forming unit 60, and the 3D template data. Each unit of the generation unit 70, the radiation source information processing unit 80, and the display image forming unit 90 can be realized by using hardware such as an electric / electronic circuit or a processor, and in the implementation, a memory or the like can be used as necessary. A device may be used. Further, at least a part of the functions corresponding to the above-described units may be realized by a computer. That is, functions corresponding to the above-described units may be realized by cooperation between hardware such as a CPU, a processor, and a memory, and software (program) that defines the operation of the CPU and the processor.

  A preferred specific example of the display unit 92 is a liquid crystal display or the like, and the operation device 110 can be realized by at least one of a mouse, a keyboard, a trackball, a touch panel, and other switches, for example. And the control part 100 is realizable by cooperation with hardwares, such as CPU, a processor, a memory, and the software (program) which prescribes | regulates operation | movement of CPU, a processor, for example. Note that at least a part of the configuration shown in FIG. 1 may be realized by an ultrasonic diagnostic apparatus.

  The overall configuration of the ultrasonic system of FIG. 1 is as described above. Next, functions and the like of the ultrasonic system will be described in detail. In addition, about the structure (each part which attached | subjected the code | symbol) shown in FIG. 1, the code | symbol of FIG. 1 is utilized in the following description.

  FIG. 2 is a diagram illustrating a specific example of the transperineal probe 11. FIG. 2 shows a side view <A> of the transperineal probe 11 and front views <B1> and <B2> of the transperineal probe 11 viewed from the tip side.

  The transperineal probe 11 has a shape that extends in the longitudinal direction as a whole, and includes a convex vibrator C at the tip. The convex vibrator C is composed of a plurality of vibration elements arranged in an arc shape, and the convex scanning surface 11C is formed by controlling the plurality of vibration elements by the transmission / reception unit 20.

  The transperineal probe 11 also includes a linear transducer L. The linear vibrator L is composed of a plurality of vibration elements arranged linearly along the longitudinal direction, and the plurality of vibration elements are controlled by the transmission / reception unit 20 to form the linear scanning surface 11L.

  In the specific example shown in FIG. 2, the convex scanning surface 11 </ b> C and the linear scanning surface 11 </ b> L are orthogonal to each other, and can be switched appropriately according to, for example, an operation from the user input via the operation device 110. A position sensor 42 is attached to the transperineal probe 11.

  FIG. 3 is a diagram showing a specific example of the transrectal probe 12. The transrectal probe 12 has a shape that extends in the longitudinal direction as a whole, and includes a convex vibrator at the tip. The convex vibrator is composed of a plurality of vibration elements arranged in an arc shape, and the plurality of vibration elements are controlled by the transmitting / receiving unit 20 to form a convex scanning surface 12C.

  An adapter A is attached to the transrectal probe 12, and a needle N is inserted into the subject along the guide of the adapter A. The adapter A is attached to the transrectal probe 12 so that the insertion path of the needle N enters the convex scanning surface 12C. Further, the position sensor 42 removed from the transperineal probe 11 is attached to the transrectal probe 12.

  FIG. 4 is a diagram for explaining a specific example of radiation source placement. In prostate cancer brachytherapy using the ultrasound system of FIG. 1, placement is performed by a transperineal approach and a transrectal approach. FIG. 4 shows a specific example <1> of the transperineal approach and a specific example <2> of the transrectal approach.

  In the transperineal approach, the transperineal probe 11 is used, and the source is placed in the prostate by the needle N from the perineum of the subject. In the specific example shown in FIG. 4, the transperineal probe 11 is attached to the treatment jig G. The treatment jig (brachytherapy stepper) G includes a mechanism for translating the transperineal probe 11 in the longitudinal direction thereof. The treatment jig G may include a mechanism for adjusting the angle of the transperineal probe 11.

  The transperineal probe 11 is inserted into the subject's rectum from the distal end side thereof, and transmits and receives ultrasound from the subject's rectum to the treatment area including the prostate. Thereby, the convex scanning surface 11C and the linear scanning surface 11L (FIG. 2) are formed in the treatment region including the prostate, and a display image based on the tomographic image data corresponding to these scanning surfaces is displayed on the display unit 92. .

  A display image obtained by using the transperineal probe 11 is referred to, and a needle N is inserted from the perineum of the subject toward the prostate by a doctor or the like, and the radiation source in the needle N is covered. Detained in the examiner's prostate. In the transperineal approach, the needle N is inserted into the subject's body using the template T.

  In the specific example shown in FIG. 4, the template T is supported by the treatment jig G, and the position information of the template T is known in a three-dimensional reference coordinate system based on the position source 44. For example, the position information of the template T may be obtained using the position sensor 42 prior to the radiation source placement.

  FIG. 5 is a diagram illustrating a preferred specific example of the template T. The template T is provided with a plurality of insertion holes H. The needles N are inserted into the insertion holes H, and the needles N are inserted into the body of the subject through the insertion holes H. In the specific example shown in FIG. 5, a total of 13 × 13 insertion holes H are provided in a matrix in the vertical direction and the horizontal direction, each having 13 equal intervals.

  Returning to FIG. 4, in the transrectal approach, a transrectal probe 12 is utilized and a source is placed in the prostate by needle N from the subject's rectum. The transrectal probe 12 is grasped by, for example, a doctor or the like, inserted into the subject's rectum from the distal end side thereof, and transmits and receives ultrasonic waves from the subject's rectum to the treatment region including the prostate. Thereby, a convex scanning surface 12C (see FIG. 3) is formed in the treatment region including the prostate, and a tomographic image corresponding to the scanning surface is displayed on the display unit 92.

  Then, while referring to a display image obtained using the transrectal probe 12, a needle or the like is inserted from the inside of the subject's rectum into the prostate by a doctor or the like, and the radiation source in the needle N is covered. Detained in the examiner's prostate. In the transrectal approach, the needle N is inserted into the subject's body using an adapter A attached to the transrectal probe 12.

  In prostate cancer brachytherapy using the ultrasound system of FIG. 1, volume data relating to the treatment area including the prostate is formed prior to placement of the radiation source. The volume data is formed using the convex scanning surface 11C (FIG. 2) of the transperineal probe 11.

  FIG. 6 is a diagram showing a specific example relating to the formation of volume data. In forming the volume data, the transperineal probe 11 is inserted into the subject's rectum, and a convex scanning surface 11C is formed in the treatment region including the prostate. Then, the transperineal probe 11 is moved while forming the convex scanning surface 11C. For example, the transperineal probe 11 is moved in the direction of the broken-line arrow shown in FIG. Thereby, the convex scanning surface 11C moves in parallel, and ultrasonic reception signals are collected in a three-dimensional three-dimensional scanning space obtained by the parallel movement of the convex scanning surface 11C.

  For example, at each moving position of the transperineal probe 11 that moves in the direction of the dashed arrow, the transmission / reception unit 20 obtains a reception signal corresponding to the convex scanning surface 11C, and the tomographic image forming unit 30 corresponds to the convex scanning surface 11C. Ultrasonic tomographic image data is formed based on the received signal. The tomographic image forming unit 30 sequentially forms a plurality of tomographic image data corresponding to a plurality of movement positions of the transperineal probe 11. Based on the plurality of tomographic image data, the volume data forming unit 50 forms volume data corresponding to the three-dimensional scanning space.

  Based on the position information (position and inclination) of the convex scanning surface 11C obtained from the position information processing section 40, the volume data forming section 50 converts each tomographic image data into the position and inclination where the tomographic image data was obtained, that is, the convex. By associating with the position and inclination of the scanning surface 11C, volume data composed of a plurality of tomographic image data is formed.

  The volume data forming unit 50 may form volume data by using data (for example, pixel data) constituting a plurality of tomographic image data as it is, or by interpolation processing for data constituting the plurality of tomographic image data. Volume data may be formed.

  Further, the position information (position and inclination) of the convex scanning surface 11 </ b> C used in the volume data forming unit 50 is obtained from the position information processing unit 40. The position information processing unit 40 uses the position information (position and inclination) obtained from the position sensor 42 attached to the transperineum probe 11 to obtain position information on the convex scanning surface 11C. For example, the position information processing unit 40 is obtained from the position sensor 42 based on conversion data obtained from the relative positional relationship between the position sensor 42 attached to the transperineal probe 11 and the convex transducer C (FIG. 2). The position information (position and inclination) of the convex scanning surface 11C is obtained from the position information (position and inclination).

  As described with reference to FIG. 6, the volume data is preferably formed based on a reception signal obtained from the convex scanning surface 11 </ b> C of the transperineal probe 11, but for example, an X-ray computer imaging apparatus (X Volume data may be formed based on image data obtained from a line CT apparatus) or a magnetic resonance imaging apparatus (MRI apparatus).

  The formed volume data is used for processing in the reference image forming unit 60. The reference image forming unit 60 is based on the three-dimensional reference image image data (3D reference image data) corresponding to the volume data and the positional information (position and inclination) of the convex scanning surface 11C from the position information processing unit 40. Image data (2D reference image data) of a two-dimensional reference image having the same cross section as the two-dimensional ultrasound image on the convex scanning plane 11C is formed from the three-dimensional reference image. Further, the display image forming unit 90 forms a display image in which the 3D reference image and the 2D reference image are arranged, and the display image is displayed on the display unit 92.

  Then, based on an instruction from a user such as a doctor who has confirmed the 3D reference image or 2D reference image displayed on the display unit 92, the target position where the radiation source is to be placed is determined. In determining the target position where the radiation source is to be placed, 3D template data is used.

  FIG. 7 is a diagram illustrating a specific example of 3D template data. The 3D (three-dimensional) template data is generated in the 3D template data generation unit 70. The 3D template data generation unit 70 generates 3D template data including a plurality of 2D template data corresponding to the template T (FIG. 5). FIG. 7 shows 3D template data composed of N pieces of 2D template data from 2D-1 to 2D-N.

  Each of the 2D template data is provided with a plurality of grids (+ marks) arranged in a matrix. The position of each grid (+ mark) in the 2D template data is associated with the position of each insertion hole H in the template T (see FIG. 5).

  The template T shown in FIG. 5 is provided with a total of 13 × 13 insertion holes H in a matrix, 13 each in the vertical direction and the horizontal direction. The specific example of FIG. 7 corresponds to the template T of FIG. 5, and each of the 2D template data shown in FIG. 7 is 13 in the vertical direction and 13 in the horizontal direction, for a total of 13 × 13 grids (+). Is granted.

  Each 2D template data is assigned an address for specifying the position of each grid. In the specific example shown in FIG. 7, the vertical direction is a number (1, 1.5, 2,..., 7) and the horizontal direction is an alphabet (A, a, B, b,..., G). An address is attached.

  The plurality of 2D template data is associated with the insertion direction of the needle N in the transperineal approach. In the specific example shown in FIG. 7, N 2D template data of 2D-1 to 2D-N are associated with the insertion direction. That is, numbers 1 to N (N is a natural number) for identifying each of the 2D template data correspond to addresses in the insertion direction. In the specific example shown in FIG. 7, numbers (_1, _2, _3,... _N).

  In the brachytherapy using the ultrasound system of FIG. 1, the target position where the radiation source is to be placed is specified using 3D template data. For example, when a user such as a doctor designates an address (vertical direction, horizontal direction, insertion direction) of 3D template data using the operation device 110, a grid corresponding to the address is specified. Then, the specified grid position, that is, the candidate of the target position where the radiation source is to be placed is reflected in, for example, the display image displayed on the display unit 92, and the user such as the doctor can specify the specified grid position, that is, the line. The target position is designated while visually confirming the target position candidate where the source is to be placed. The radiation source information processing unit 80 sets the grid position designated by a doctor or the like as the target position of the radiation source.

  When the target position of the radiation source is set, first, the radiation source is placed at the target position by the transperineal approach (FIG. 4). In the placement of the radiation source by the transperineum approach, a real-time tomographic image corresponding to the linear scanning surface 11L (FIG. 2) of the transperineum probe 11 is displayed on the display unit 92. Then, the needle N (FIG. 4) inserted into the subject using the template T is displayed in the tomographic image, and a user such as a doctor visually confirms the real-time tomographic image, that is, the needle N The needle N is inserted to the target position while visually confirming the insertion state, and the radiation source is detained at the target position. The transperineal approach places the source at a plurality of target positions identified by the grid of 3D template data (FIG. 7).

  However, there is a pubic bone between the perineum of the subject and the prostate (see FIG. 6), and the pubic bone becomes an obstacle and the needle N may not be inserted to the target position. That is, in the transperineal approach, there are cases where the radiation source cannot be placed at all target positions due to the influence of the pubic bone, for example.

  Therefore, in the brachytherapy using the ultrasonic system of FIG. 1, the radiation source is placed by the transrectal approach to the location where the radiation source could not be placed by the transperineal approach.

  It is desirable that the location where the radiation source could not be placed by the transperineal approach, that is, the target position where the radiation source should be placed by the transrectal approach can be confirmed by the display image displayed on the display unit 92.

  FIG. 8 is a diagram showing a specific example of a display image for confirming the target position of the radiation source. FIG. 8 shows a specific example of a display image formed by the display image forming unit 90 and displayed on the display unit 92.

  The transperineal convex tomographic image (a) is a tomographic image corresponding to the convex scanning surface 11C (FIG. 2) of the transperineal probe 11. The transperineal convex tomographic image (a) is formed in the tomographic image forming unit 30 based on the received signal obtained from the transmitting / receiving unit 20 using the transperineal probe 11. The transperineal convex tomographic image (a) includes a section of the prostate.

  The volume data tomographic image (b) is a tomographic image of the same cross section as the transperineal convex tomographic image (a) cut out from the volume data, and is referred to based on the volume data obtained from the volume data forming unit 50. It is formed in the image forming unit 60. That is, the volume data tomographic image (b) is a preferable specific example of the 2D reference image. The reference image forming unit 60, for example, based on the positional information (position and inclination) of the convex scanning surface 11C of the transperineal probe 11 obtained from the position information processing unit 40, the same cross section as the convex scanning surface 11C, that is, the past time A volume data tomographic image corresponding to the same cross section as the negative convex tomographic image is formed.

  The volume data 3D image (c) is an image in which the treatment area including the prostate is three-dimensionally expressed in the three-dimensional scanning space from which the volume data is obtained, and is based on the volume data obtained from the volume data forming unit 50. The image is formed in the reference image forming unit 60. That is, the volume data 3D image is a preferable specific example of the 3D reference image.

  It is desirable to synthesize a tomographic image plane indicating the cross-sectional position where the transperineal convex tomographic image (a) is obtained with the volume data 3D image. For example, the display image forming unit 90 applies the tomographic image plane corresponding to the transperineal convex tomographic image (a) formed in the tomographic image forming unit 30 to the volume data 3D image obtained from the reference image forming unit 60. The relative positional relationship between the volume data 3D image and the tomographic image plane corresponding to the transperineal convex tomographic image (a) by combining (positioning and superimposing) on the position information (position and inclination) Is formed. Furthermore, an orientation mark indicating the surface direction of the tomographic image surface (front and back, top and bottom) may be displayed in the vicinity of the combined tomographic image surface.

  Further, the display image forming unit 90 uses the trans-perineal approach in the trans-perineum convex tomographic image (a) based on the target position information (position information) obtained from the radiation source information processing unit 80. A target position marker indicating the target position that could not be placed is displayed. In the specific example shown in FIG. 8, the target position marker is a display mode in which the center of the circle is represented by a + mark, but the display mode of the target position marker is not limited to this specific example.

  When there are a plurality of target positions in the transperineal convex tomographic image (a) where the radiation source could not be placed by the transperineal approach, a plurality of target position markers corresponding to the plurality of target positions are displayed. You may let them. Further, the target position marker may be displayed in the volume data tomographic image (b) and the volume data 3D image (c). FIG. 8 shows a specific example of displaying a transperineal convex tomographic image (a), but a tomographic image corresponding to the linear scanning surface 11L (FIG. 2) of the transperineal probe 11 may be displayed. Further, the target position marker may be displayed in the tomographic image corresponding to the linear scanning plane 11L.

  A user such as a doctor confirms the target position of the radiation source by looking at the display image shown in FIG. 8, for example, and designates the target position of the radiation source in the transrectal approach. For example, the target position of the source in the transrectal approach is specified at or near the target position where the source could not be placed in the transperineal approach. The radiation source information processing unit 80 sets a position designated by a doctor or the like as a target position of the radiation source in the transrectal approach. Thus, when the target position where the radiation source could not be placed by the transperineal approach is determined, the placement of the source is performed for the target position by the transrectal approach.

  In the brachytherapy using the ultrasound system of FIG. 1, the transperineal probe 11 is used in the transperineal approach, and the transrectal probe 12 is used in the transrectal approach. That is, in the transition from the transperineal approach to the transrectal approach, the ultrasound probe is changed from the transperineal probe 11 to the transrectal probe 12. In this change, the position sensor 42 attached to the transperineal probe 11 is removed from the transperineal probe 11 and replaced with the transrectal probe 12. In replacing the position sensor 42, it is desirable to replace the position sensor 42 with the transrectal probe 12 while maintaining the output of the position sensor 42 from the state attached to the transperineal probe 11.

  By replacing the position sensor 42, for example, it is possible to obtain position information (position and inclination) related to the two probes, the transperineal probe 11 and the transrectal probe 12, with only one position sensor 42. Further, for example, by replacing one position sensor 42 and using it, there is no detection error between the two position sensors 42 as compared with the case where two position sensors 42 are used. Rise.

  When the position sensor 42 is replaced with the transrectal probe 12, the source is placed by a transrectal approach (FIG. 4) using the transrectal probe 12. At the time of the placement, the position information processing unit 40 uses the position information (position and inclination) obtained from the position sensor 42 attached to the transrectal probe 12 to position information on the convex scanning surface 12C (FIG. 3). Get (position and tilt). For example, the position information processing unit 40 is obtained from the position sensor 42 based on conversion data obtained from the relative positional relationship between the position sensor 42 attached to the transrectal probe 12 and the convex transducer of the transrectal probe 12. The position information (position and inclination) of the convex scanning surface 12C is obtained from the position information (position and inclination).

  FIG. 9 is a diagram showing a specific example of a display image in the transrectal approach. FIG. 9 shows a specific example of a display image formed by the display image forming unit 90 and displayed on the display unit 92.

  The transrectal convex tomographic image (a) is a tomographic image corresponding to the convex scanning surface 12 </ b> C (FIG. 3) of the transrectal probe 12. The transrectal convex tomographic image (a) is formed in the tomographic image forming unit 30 based on the received signal obtained from the transmitting / receiving unit 20 using the transrectal probe 12.

  When the target position where the radiation source is to be placed is included in the transrectal convex tomographic image (a), a target position marker indicating the target position is displayed. In the transrectal approach, a user such as a doctor adjusts the position and posture of the transrectal probe 12 so that the target position where the radiation source is to be placed is included in the transrectal convex tomographic image (a). For example, a user such as a doctor adjusts the position and posture of the transrectal probe 12 so that the target position marker is displayed in the tomographic image while viewing the transrectal convex tomographic image (a).

  In addition, a guideline is also displayed in the transrectal convex tomographic image (a). The guideline is a line indicating an insertion path of the needle N (FIG. 3) inserted into the subject using the adapter A (FIG. 3) attached to the transrectal probe 12. For example, a user such as a doctor adjusts the position and posture of the transrectal probe 12 so that the target position marker is displayed on the guideline while viewing the transrectal convex tomographic image (a).

  The volume data tomographic image (b) is a cross-sectional tomographic image that is the same as the transrectal convex tomographic image (a) cut out from the volume data, and is based on the volume data obtained from the volume data forming unit 50. It is formed in the forming part 60. That is, the volume data tomographic image (b) is a preferable specific example of the 2D reference image. The reference image forming unit 60, for example, based on the position information (position and inclination) of the convex scanning surface 12C of the transrectal probe 12 obtained from the position information processing unit 40, the same cross section as the convex scanning surface 12C, that is, the transrectal convex tomography. A volume data tomographic image (b) corresponding to the same cross section as the image (a) is formed. A target position marker may be displayed in the volume data tomographic image (b).

  The volume data 3D image (c) is an image in which the treatment area including the prostate is three-dimensionally expressed in the three-dimensional scanning space from which the volume data is obtained, and is based on the volume data obtained from the volume data forming unit 50. The image is formed in the reference image forming unit 60. That is, the volume data 3D image (c) is a preferable specific example of the 3D reference image.

  It is desirable that the volume data 3D image (c) is synthesized with a tomographic image plane indicating the cross-sectional position where the transrectal convex tomographic image (a) is obtained. The display image forming unit 90 displays, for example, a tomographic image plane corresponding to the volume data 3D image (c) obtained from the reference image forming unit 60 and the transrectal convex tomographic image (a) formed in the tomographic image forming unit 30. The relative positional relationship between the volume data 3D image (c) and the transrectal convex tomographic image (a) is shown by arranging (superimposing) and synthesizing at positions corresponding to the positional information (position and inclination). The displayed image is formed.

  The tomographic image plane of the transrectal convex tomographic image (a) synthesized by being arranged (superposed) on the volume data 3D image (c) is the shape of the transrectal convex tomographic image (a), that is, the transrectal probe 12. A shape corresponding to the convex scanning surface 12C (FIG. 3) is desirable. Note that the tomographic image plane of the transrectal convex tomographic image (a) synthesized by being arranged (superimposed) on the volume data 3D image (c) may have a rectangular or other planar shape. In addition, an orientation mark indicating the surface direction (front and back, top and bottom of the surface) of the transrectal convex tomographic image (a) may be displayed in the vicinity of the tomographic image surface of the transrectal convex tomographic image (a).

  A user such as a doctor places the radiation source at the target position by the transrectal approach (FIG. 4) while confirming the target position of the radiation source by looking at the display image shown in FIG. 9, for example. In indwelling by the transrectal approach, for example, a real-time image of a transrectal convex tomographic image (a) is displayed on the display unit 92, and the doctor confirms the insertion state of the needle N (FIG. 4) inserted along the guideline. However, the needle N is inserted to the target position where the target position marker is displayed, and the radiation source is left at the target position.

  Thus, the source is placed by the transrectal approach at a plurality of target positions where the source could not be placed by the transperineal approach, preferably for all target positions.

  FIG. 10 is a diagram illustrating a modification of the display image for confirming the target position of the radiation source. The display image shown in FIG. 10 is a modification of the display image shown in FIG. As in the display image of FIG. 8, in FIG. 10, the transperineal convex tomographic image (a) is a tomographic image corresponding to the convex scanning surface 11C (FIG. 2) of the transperineal probe 11 and is a volume data tomographic image. (B) is a tomographic image of the same cross section as the transperineal convex tomographic image (a) cut out from the volume data, and the volume data 3D image (c) is in the three-dimensional scanning space from which the volume data was obtained. Is a three-dimensionally expressed image.

  In comparison with FIG. 8, a grid-like display mode corresponding to the template data (FIG. 7) is synthesized with the transperineal convex tomographic image (a) and the volume data tomographic image (b) of FIG. And the target position marker corresponding to a target position is displayed in the display mode corresponding to template data.

  For example, the display image forming unit 90 synthesizes the display form of the transperineal convex tomographic image (a) and the template data at a position corresponding to the positional information (position and inclination) of the convex scanning surface 11C. As shown in FIG. 10A, a display image showing the relative positional relationship between the transperineal convex tomographic image (a) and the template data is formed. In addition, the display image forming unit 90 arranges the volume data tomographic image (b) and the template data display mode at a position corresponding to the position information (position and inclination) of the convex scanning surface 11C and synthesizes it, for example. As shown in FIG. 10B, a display image showing the relative positional relationship between the volume data tomographic image (b) and the template data is formed.

  For example, in the volume data tomographic image (b) of FIG. 10, the target position (black circle) where the radiation source can be placed by the transperineum approach and the target position (white circle) where the radiation source could not be placed by the transperineum approach. ) Is displayed. By assigning addresses (vertical numbers and horizontal alphabets) to the display mode of the template data, it is possible to confirm the addresses corresponding to the respective target positions. Note that the address of each target position may be displayed in numbers and alphabets without displaying the grid-like display mode of the template data in the volume data tomographic image (b).

  For example, in the transperineal convex tomographic image (a) of FIG. 10, the target position (white circle) where the radiation source could not be placed by the transperineal approach is displayed. That is, the target position in the transrectal approach is displayed. The address corresponding to each target position can be confirmed by the combination with the template data display mode. The target position (black circle) where the radiation source can be placed by the transperineal approach may be displayed in the transperineal convex tomographic image (a).

  Further, in comparison with FIG. 8, the path for placing the radiation source is combined with the volume data 3D image (c) of FIG. In the modification shown in FIG. 10, the black arrow is a path where the radiation source can be placed by the transperineum approach, and the white arrow is a path where the radiation source cannot be placed by the transperineum approach. For example, based on the result of the placement of the radiation source input from the user such as a doctor through the operation device 110, for example, the address of the target position where the radiation source can be placed and the radiation source Is generated in the radiation source information processing unit 80 on the basis of the address of the target position where the position cannot be placed. Furthermore, although the tomographic image plane combined with the volume data 3D image (c) in FIG. 10 is shown as a rectangle, the shape of the transperineal convex tomographic image (a), that is, the convex scanning of the transperineal probe 11 is performed. You may display by the shape corresponding to the surface 11C (FIG. 2). Other planar shapes may also be used. Then, an orientation mark indicating the surface direction of the transperineal convex tomographic image (a) (front and back, top and bottom) may be displayed in the vicinity of the tomographic image surface of the transperineal convex tomographic image (a).

  In the modification shown in FIG. 10, a transperineal linear tomographic image (d) is also displayed. The transperineal linear tomographic image (d) is a tomographic image corresponding to the linear scanning surface 11L (FIG. 2) of the transperineal probe 11. The path for placing the radiation source is also synthesized in the transperineal linear tomographic image (d). For example, a route in which the radiation source can be placed by the transperineum approach is represented by a black arrow, and a route in which the radiation source cannot be placed by the transperineum approach is represented by a white arrow. In addition, it is desirable that a plurality of scales corresponding to intervals of about 5 mm, for example, be displayed at equal intervals in the arrow direction (depth direction in which the needle N is inserted). You may enable it to adjust the space | interval of several graduations. Further, for example, the target position where the radiation source is placed by the transrectal approach is displayed on the path (white arrow) where the radiation source could not be placed by the transperineal approach. Further, an orientation mark indicating the surface direction of the transperineal linear tomographic image (d) (front and back, top and bottom) may be displayed in the vicinity of the transperineal linear tomographic image (d).

  In the specific example of FIG. 10, a display mode is shown in which the difference between the target position where the radiation source could not be placed by the transperineal approach and the target position where the radiation source could be placed is identified by white circles and black circles. The difference in the target position may be expressed by the difference in the display mode. In addition, regarding the route in which the radiation source can be placed by the transperineal approach and the route in which the radiation source cannot be placed, the difference in the route may be expressed by the color of an arrow, for example.

  FIG. 11 is a diagram showing a modification of the display image in the transrectal approach. The display image shown in FIG. 11 is a modification of the display image shown in FIG. Similar to the display image of FIG. 9, in FIG. 11, a transrectal convex tomographic image (a) is a tomographic image corresponding to the convex scanning surface 12C (FIG. 3) of the transrectal probe 12, and a volume data tomographic image (b) ) Is a tomographic image of the same cross section as the transrectal convex tomographic image (a) cut out from the volume data. The volume data 3D image (c) is a three-dimensional image in the three-dimensional scanning space from which the volume data was obtained. It is an image that expresses it.

  In comparison with FIG. 9, the guideline of the transrectal convex tomographic image (a) in FIG. 11 displays a plurality of scales corresponding to intervals of about 5 mm, for example, in the depth direction in which the needle N is inserted. Also good. Moreover, you may enable it to adjust the space | interval of several graduations.

  Further, in comparison with FIG. 9, in the volume data tomographic image (b) of FIG. 11, the types of routes are expressed by different display modes. In other words, a route that is indwelling in the rectal approach is indicated by a solid arrow, and another indwelling route by the rectal approach is indicated by a dashed arrow. Note that the type of the detention route may be expressed by a difference in the coloring process or the like, or either the detention route or another detention route may be selectively displayed.

  Further, in comparison with FIG. 9, the path for placing the radiation source is combined with the volume data 3D image (c) of FIG. In the modification shown in FIG. 11, the type of the detention route is expressed by different display modes. In other words, the black arrow is the path where the source can be placed by the transperineal approach, the solid line arrow is the path that is being placed in the rectal approach, and the dashed arrow is the other placed path in the rectal approach Yes. Note that the type of the detention route may be expressed by a difference in coloring processing or the like, or any detention route may be selectively displayed.

  FIG. 12 is a diagram illustrating a modification of the display related to the volume data 3D image. The volume data 3D image (c) shown in FIG. 12 is synthesized with an image corresponding to the 3D template data (FIG. 7). That is, images corresponding to a plurality of 2D template data constituting the 3D template data are arranged at positions corresponding to each 2D template data.

  Furthermore, a marker indicating the target position of the radiation source is displayed in the volume data 3D image (c) shown in FIG. In the specific example illustrated in FIG. 12, the target position corresponding to the address “B5 — 3” is represented by +. In addition, it is desirable that the 2D template data including the target position address “B5 — 3” is represented by a solid line and visually distinguished from other 2D template data represented by a broken line.

  The target position displayed in the volume data 3D image (c) may be specified by the user, for example, or the target position may be expressed in a display mode other than the + mark. Of course, a plurality of target positions may be displayed in the volume data 3D image (c). Further, 2D template data including the target position and other 2D template data may be identified by a coloring process or the like.

  As mentioned above, although preferred embodiment of this invention was described, embodiment mentioned above is only a mere illustration in all the points, and does not limit the scope of the present invention. The present invention includes various modifications without departing from the essence thereof.

  11 transperineal probe, 12 transrectal probe, 20 transmitting / receiving unit, 30 tomographic image forming unit, 40 position information processing unit, 50 volume data forming unit, 60 reference image forming unit, 70 3D template data generating unit, 80 radiation source information Processing unit, 90 display image forming unit, 100 control unit, 110 operation device.

Claims (9)

A reference image is formed in which a region where ultrasonic waves are transmitted and received by the first probe is imaged two-dimensionally or three-dimensionally based on position information of the first probe obtained from a position sensor associated with the first probe. A reference image forming unit,
An ultrasonic image forming unit that forms an ultrasonic image based on an ultrasonic reception signal obtained from the second probe;
The position information of the reference image is derived based on the position information of the first probe obtained from the position sensor associated with the first probe, and the position sensor is associated with the second probe from the first probe. A position information deriving unit for deriving position information of the ultrasonic image at the second probe on the reference image based on the position information of the obtained second probe;
A display image forming unit that forms a display image in which position information of the other is reflected in at least one of the reference image and the ultrasonic image;
I have a,
The first probe is a transperineal probe used for a transperineal approach,
The second probe is a transrectal probe used for a transrectal approach,
The source is placed from the perineum of the subject toward the prostate at the target position where the source could not be placed in the transperineal approach or in the vicinity thereof. The target position of the radiation source in the transrectal approach for performing indwelling is set,
The ultrasonic image forming unit forms the ultrasonic image based on an ultrasonic reception signal obtained from the transrectal probe,
The display image forming unit, when the target position of the radiation source in the transrectal approach is included in the ultrasound image, to form a display image showing the target position in the ultrasound image;
An ultrasonic system characterized by that. The ultrasound system of claim 1, wherein
The reference image forming unit forms a three-dimensional reference image corresponding to volume data obtained by three-dimensionally transmitting and receiving ultrasonic waves with the first ultrasonic probe,
The ultrasonic image forming unit forms a two-dimensional ultrasonic image based on a reception signal obtained by two-dimensionally transmitting and receiving ultrasonic waves with a second ultrasonic probe,
The display image forming unit cuts out a cross section that is the same as the two-dimensional ultrasonic image from the three-dimensional reference image based on the positional information of the scanning surface of the two-dimensional ultrasonic image, and synchronizes with the two-dimensional ultrasonic image. In parallel display, a display image subjected to processing for displaying different image data acquired by the first ultrasonic probe and the second ultrasonic probe in a common image display form is formed.
An ultrasonic system characterized by that. The ultrasound system according to claim 1 or 2,
The reference image forming unit forms a three-dimensional reference image corresponding to volume data obtained by three-dimensionally transmitting and receiving ultrasonic waves with the first ultrasonic probe,
The ultrasonic image forming unit forms a two-dimensional ultrasonic image based on a reception signal obtained by two-dimensionally transmitting and receiving ultrasonic waves with a second ultrasonic probe,
The display image forming unit arranges an image plane of the two-dimensional ultrasound image on the three-dimensional reference image based on the position information of the scanning plane of the two-dimensional ultrasound image and the position information of the three-dimensional reference image. To form a display image showing the relative positional relationship between the reference image and the ultrasound image,
An ultrasonic system characterized by that. The ultrasound system according to any one of claims 1 to 3,
The display image forming unit forms a display image that has been subjected to a display process that indicates the attention location at a position corresponding to the attention location in the ultrasonic image for the attention location in the reference image.
An ultrasonic system characterized by that. The ultrasound system according to any one of claims 1 to 4,
The display image forming unit forms a display image indicating a position marker indicating a target position of a radiation source in brachytherapy in the ultrasonic image.
An ultrasonic system characterized by that. The ultrasonic system according to any one of claims 1 to 5,
The display image forming unit forms a display image showing guideline of radiation source placement in brachytherapy in the ultrasonic image,
An ultrasonic system characterized by that. The ultrasonic system according to any one of claims 1 to 6,
The display image forming unit displays a display image showing a target position where the radiation source can be placed in the transperineum approach and a target position where the radiation source cannot be placed in the transperineum approach in different display modes. Form,
An ultrasonic system characterized by that. The ultrasound system according to any one of claims 1 to 7,
The display image forming unit is different from the indwelling path to the target position where the radiation source can be placed in the transperineal approach and the indwelling path to the target position where the source could not be placed in the transperineal approach. Forming a display image shown in the display mode;
An ultrasonic system characterized by that. The ultrasound system according to any one of claims 1 to 8 ,
Ultrasonic of the first on the basis of the ultrasonic reception signal obtained from the probe to form an ultrasound image of the through perineal approach, the transrectal approach based on the ultrasonic reception signal obtained from the second probe Forming an image,
An ultrasonic system characterized by that.