JP6945293B2 - X-ray diagnostic equipment and medical diagnostic imaging system - Google Patents

Description

Embodiments of the present invention relate to an X-ray diagnostic apparatus and a medical diagnostic imaging system.

When performing catheter treatment, the user displays an X-ray fluoroscopic image or an X-ray photographed image (hereinafter referred to as an X-ray image) based on X-ray imaging by an X-ray diagnostic device during the procedure, and is visualized on the X-ray image. The procedure may be performed while checking the position of devices such as catheters and guide wires. For example, in catheter ablation, a procedure is performed in which a treatment target site is selectively cauterized by applying high-frequency current to an electrode provided at the tip of the catheter.

It is important for the user who performs this kind of procedure to accurately and quickly grasp the position of the operation target device he / she is operating on the X-ray image. However, the user may lose track of the position of the operation target device on the X-ray image. In addition, when operating a device using a remote catheter system equipped with a plurality of devices, if the plurality of devices are visualized on an X-ray image, the user can determine which device is the operation target device. It is difficult to judge on an X-ray image.

JP-A-2015-37572

The present invention has been made in consideration of the above-mentioned circumstances, and an X-ray diagnostic apparatus and a medical image diagnosis that allow the user to easily grasp the correspondence between the device on the X-ray image and the device of the remote catheter system. The purpose is to provide a system.

The medical image diagnosis system according to an embodiment of the present invention includes a plurality of devices inserted into the body of a subject, an operation unit capable of operating at least one of the devices, and an operation unit capable of operating at least one of the devices in order to solve the above-mentioned problems. Identification that identifies the operating device based on the movement of the device in the medical image when the device is operated by the operation unit and the image acquisition unit that acquires the medical image obtained by photographing the subject. It is provided with a unit and a display for identifiablely displaying the device operated by the operation unit based on the result specified by the specific unit.

The block diagram which shows an example of the medical image diagnosis system including the X-ray diagnostic apparatus which concerns on 1st Embodiment of this invention. Explanatory drawing which shows one configuration example of the remote catheter provided with two devices. The block diagram which shows one configuration example of the image processing apparatus which concerns on 1st Embodiment. An example of a procedure for performing processing for the user to easily grasp the correspondence between each of the plurality of devices on the X-ray image and each of the plurality of devices of the remote catheter system by the processing circuit shown in FIG. Flow chart to show. An explanatory diagram showing an example of how the entire operation target device on the X-ray image is identified and displayed by the procedure shown in FIG. (A) is an explanatory diagram showing a first modification of the identification display, (b) is an explanatory diagram showing a second modification of the identification display, and (c) is an explanatory diagram showing a third modification of the identification display. In addition to the procedure shown in FIG. 4, a flowchart showing an example of a procedure for following the identification display when the C-arm or the top plate of the bed moves. An explanatory view showing an example of how the identification display follows when the C-arm or the top plate of the bed is moved by the procedure shown in FIG. 7. In addition to the procedure shown in FIG. 4, a flowchart showing an example of a procedure for following the identification display based on the feed amount of the device. An explanatory diagram showing an example of how the identification display follows the feed amount of the device according to the procedure shown in FIG. It is explanatory drawing which shows an example of how to specify the correspondence relationship between each of two devices on an X-ray image and each of a plurality of actual devices 22 by using the feed movement amount of the device. The block diagram which shows one configuration example of the image processing apparatus which concerns on 2nd Embodiment. FIG. 2 is a flowchart showing an example of a procedure for setting an operation target device according to a user's device selection information via a remote console by the processing circuit shown in FIG. 12. An explanatory diagram showing an example of how an operation target device is set according to a user's device selection information via a remote console according to the procedure shown in FIG. The block diagram which shows one configuration example of the image processing apparatus which concerns on 3rd Embodiment. The block diagram which shows one configuration example of the image processing apparatus which concerns on 4th Embodiment.

An embodiment of the X-ray diagnostic apparatus and the medical image diagnostic system according to the present invention will be described with reference to the accompanying drawings.

(First Embodiment)
FIG. 1 is a block diagram showing an example of a medical image diagnosis system 10 including an X-ray diagnostic apparatus 11 according to the first embodiment of the present invention.

The X-ray diagnostic device 11 is configured as, for example, an X-ray angio device, and includes an image processing device 12, an X-ray detector 13, an X-ray source 14, a C arm 15, a sleeper 16, a top plate 17 of the sleeper 16, a display 18, and a controller. Has 19.

The X-ray detector 13 is provided at one end of the C arm 15 so as to face the X-ray source 14 with the subject O supported by the top plate (for example, a catheter table or the like) 17 of the bed 16 interposed therebetween. The X-ray detector 13 is composed of a flat panel detector (FPD), detects X-rays transmitted to the X-ray detector 13 through the subject O, and is based on the detected X-rays. Outputs X-ray projection data. This projection data is given to the image processing device 12 via the controller 19. The X-ray detector 13 may include an image intensifier, a TV camera, and the like.

The X-ray source 14 is provided at the other end of the C-arm 15 and has an X-ray tube and an X-ray diaphragm. The X-ray diaphragm is, for example, an X-ray irradiation field diaphragm composed of a plurality of lead blades. The X-ray diaphragm is controlled by the controller 19 to adjust the irradiation range of X-rays emitted from the X-ray tube.

The C-arm 15 holds the X-ray detector 13 and the X-ray source 14 together. When the C-arm 15 is controlled and driven by the controller 19, the X-ray detector 13 and the X-ray source 14 move together around the subject O.

When the X-ray diagnostic apparatus 11 is used as an X-ray angio apparatus, the X-ray diagnostic apparatus 11 has two X-ray irradiation systems including an X-ray detector 13, an X-ray source 14, and a C-arm 15. It may be a plain type. In the case of the biplane type, the X-ray diagnostic apparatus 11 individually irradiates the X-ray beam from two directions, the F (Frontal) side having the floor-standing C arm and the L (Lateral) side having the ceiling traveling type Ω arm. The biplane image (F side image and L side image) can be acquired.

The sleeper 16 is installed on the floor and has a top plate 17. The sleeper 16 is controlled by the controller 19 to move the top plate 17 in the horizontal direction and the vertical direction.

The display 18 is composed of one or a plurality of display areas, and is controlled by the controller 19 to display an X-ray image or the like. The display 18 is composed of a general display output device such as a liquid crystal display or an OLED (Organic Light Emitting Diode) display. The X-ray image is an example of a medical image in the present application.

The controller 19 is controlled by the image processing device 12, and by controlling the X-ray detector 13, X-ray imaging of the subject O is executed, projection data is generated, and the projection data is given to the image processing device 12. The controller 19 is controlled by the image processing device 12, and for example, generates projection data before and after administration of the contrast medium and gives the projection data to the image processing device 12.

When the X-ray diagnostic apparatus 11 is configured to be capable of rotating DSA (Digital Subtraction Angiography) imaging, the controller 19 is controlled by the image processing apparatus 12 to perform rotary DSA imaging and perform projection before and after administration of the contrast medium. Each data is generated and given to the image processing apparatus 12. In rotary DSA imaging, image data (mask image data) before injection of the contrast medium and image data (contrast image data) after injection of the contrast medium are generated for the same site of the subject O, respectively. When rotational DSA imaging is possible, the X-ray diagnostic apparatus 11 can also obtain a three-dimensional blood vessel image (3D blood vessel image) based on the contrast image data and mask image obtained by rotational DSA imaging.

The controller 19 has at least a processor and a storage circuit. The controller 19 is controlled by the image processing device 12 according to the program stored in the storage circuit, executes X-ray imaging such as fluoroscopic imaging of the subject O by controlling the X-ray irradiation system, and outputs projection data. do.

Although FIG. 1 shows an example in which the controller 19 and the image processing device 12 are connected by wire, the controller 19 and the image processing device 12 may be connected so as to be able to transmit and receive data via a network.

The storage circuit of controller 19 provides a work area for temporarily storing programs and data executed by the processor of controller 19. Further, the storage circuit of the controller 19 stores various programs and various data necessary for executing these programs. The storage circuit of the controller 19 has a configuration including a recording medium that can be read by a processor, such as a magnetic or optical recording medium or a semiconductor memory, and a part or all of the programs and data in these storage circuits. May be configured to be downloaded over an electronic network.

The medical diagnostic imaging system 10 further includes a remote catheter 20 and a remote console 30. The remote catheter 20 and the remote console 30 form a so-called remote catheter system.

The remote catheter 20 has a robot arm 21 and a device 22, and is controlled by a remote console 30 to insert the device 22 into a predetermined site (for example, an affected area) of the subject O. Further, the remote catheter 20 may be provided with a display 23 on a support member constituting the robot arm 21.

Further, the remote catheter 20 may have an injector function, in which case the remote catheter 20 injects a contrast medium through a catheter (catheter tube, not shown) as a device 22. The timing of injection and stop of the contrast medium and the concentration and injection rate of the contrast medium may be automatically controlled by the remote console 30. Further, an instruction by the user may be received via the remote input circuit 33 of the remote console 30, and the contrast medium may be injected at a concentration, speed, and timing according to the instruction.

FIG. 2 is an explanatory diagram showing a configuration example of a remote catheter 20 including two devices 22. The remote catheter 20 is configured to be able to remotely control a plurality of devices 22.

The remote console 30 includes display input circuits 31 and 32, a remote input circuit 33 for remotely controlling the device 22 of the remote catheter 20, and a control device 34.

The display input circuits 31 and 32 include a display and a touch sensor provided in the vicinity of the display. The display is composed of a general display output device such as a liquid crystal display or an OLED (Organic Light Emitting Diode) display. The touch sensor gives information on the position indicated on the touch sensor by the user to the processing circuit of the control device 34. For example, when composed of a projection type capacitance type panel, the touch sensor has a row of electrodes arranged vertically and horizontally. In this case, the touch sensor can acquire the contact position based on the output change of the electrode row according to the change of the capacitance near the contact position of the contact object.

The display of the display input circuit 31 is controlled by the processing circuit of the control device 34, and for example, an image similar to that of the display 18 is displayed.

The display of the display input circuit 32 is controlled by the processing circuit of the control device 34, and displays, for example, information on the current operation target device of the remote input circuit 33.

The remote input circuit 33 is provided by, for example, a general pointing device such as a trackball, a trackball mouse, a keyboard, a touch panel, a ten key, a voice input circuit, or a line-of-sight input circuit, or a hand switch for instructing an X-ray exposure timing. It is configured and outputs a signal to the remote catheter 20 for remote operation of the device 22 via the control device 34 by wire or wirelessly. The user can operate at least one of the devices 22 via the remote input circuit 33. Specifically, the user can operate the plurality of devices 22 at the same time or selectively operate the plurality of devices 22 via the remote input circuit 33. Further, the medical image diagnosis system 10 may include a plurality of remote input circuits 33. In this case, one of the plurality of remote input circuits 33 may be provided in the operating room where the X-ray diagnostic apparatus 11 is installed, in a room adjacent to the operating room, or via a network. It may be installed in a remote location.

The control device 34 has at least a processor and a storage circuit. The processing circuit of the control device 34 cooperates with the image processing device 12 according to the program stored in the storage circuit. For example, the processing circuit of the control device 34 gives information on the feed movement amount of the device 22 to the image processing device 12. When there are a plurality of devices 22, the processing circuit of the control device 34 gives the setting information of the operation target device of the current remote input circuit 33 to the image processing device 12. The image processing device 12 controls the processing circuit of the control device 34 so that an image in which at least a part of the device image is emphasized is displayed on at least one of the displays of the display input circuits 31 and 32.

FIG. 3 is a block diagram showing a configuration example of the image processing device 12 according to the first embodiment.

The image processing device 12 includes a display 41, an input circuit 42, a storage circuit 43, and a processing circuit 44.

The display 41 is composed of a general display output device such as a liquid crystal display or an OLED (Organic Light Emitting Diode) display, and displays various information according to the control of the processing circuit 44. The input circuit 42 is composed of general input devices such as a keyboard, a touch panel, a numeric keypad, a voice input circuit, and a line-of-sight input circuit, and outputs an operation input signal corresponding to the user's operation to the processing circuit 44.

The storage circuit 43 has a configuration including a recording medium that can be read by a processor, such as a magnetic or optical recording medium or a semiconductor memory. Some or all of the programs and data in these storage media may be configured to be downloaded by communication via an electronic network.

By reading and executing the program stored in the storage circuit 43, the processing circuit 44 makes it easy for the user to establish a correspondence relationship between each of the plurality of devices on the X-ray image and each of the plurality of devices 22 of the remote catheter system. It is a processor that executes processing for grasping.

As shown in FIG. 3, the processing circuit 44 includes an X-ray image acquisition function 51, a specific function 52, an identification function 53, a switching function 54, a follow-up function 55, a bed movement amount acquisition function 56, and a C-arm movement amount acquisition function 57. The 3D image acquisition function 58 and the feed amount acquisition function 59 are realized. Each of these functions is stored in the storage circuit 43 in the form of a program. Hereinafter, the details of the operation of each function will be described with reference to FIG. 4-9.

In FIG. 4, the processing circuit 44 shown in FIG. 3 performs processing for the user to easily grasp the correspondence between each of the plurality of devices on the X-ray image and each of the plurality of devices 22 of the remote catheter system. It is a flowchart which shows an example of the procedure at the time. In FIG. 4, reference numerals with numbers attached to S indicate each step of the flowchart.

Further, FIG. 5 is an explanatory diagram showing an example of how the entire operation target device on the X-ray image is identified and displayed by the procedure shown in FIG.

Note that FIGS. 4 and 5 include images of two devices on the X-ray image, one of which is the device to be operated by the user and the other is a stationary device. Indicated.

First, the X-ray image acquisition function 51 acquires a medical image obtained by photographing the subject O. For example, the X-ray image acquisition function 51 sequentially acquires time-series continuous X-ray images generated based on the projection data obtained by X-ray imaging of the subject O that is continuous in time series ( Step S1).

Next, in step S2, the specific function 52 subtracts the second X-ray image captured a predetermined time before the first X-ray image from the first X-ray image. For example, the specific function 52 treats the latest X-ray image as the first X-ray image each time a continuous X-ray image is sequentially acquired, and is a predetermined time before the first X-ray image. It is advisable to treat the X-ray image captured in the above as a second X-ray image.

Next, the identification function 52 identifies the operation target device based on the movement of the device in the medical image when the device 22 is operated by the remote input circuit 33. For example, the specific function 52 extracts a device that has moved during a predetermined time from a plurality of devices included in the first X-ray image (step S3). The extracted device is a device that has been moved within a predetermined time by the user's operation, that is, a user's operation target device (active device). On the other hand, the device that was not extracted, that is, the device that was stationary is a device that is not operated by the user (inactive device). The specific function 52 identifies the extracted device as an active device and stores it in the storage circuit 43, and identifies the non-extracted device as an inactive device and stores it in the storage circuit 43. (Step S4).

The method of identifying the operation target device and the non-operation target device will be described more specifically. The processing circuit 44 identifies in advance which device 22 each of the images of the plurality of devices on the X-ray image is. The processing circuit 44 includes information indicating each of the images of the plurality of devices on the X-ray image, and information of IDs defined for each of the plurality of devices 22 (for example, "category 1" and "category 2"). Is stored in the storage circuit 43 in association with each other. In step S4, the specific function 52 further associates the information that the device extracted in step S3 is an active device with the information that a device other than the extracted device is a non-active device with respect to this association information. ..

Next, in step S5, the identification function 53 generates an image capable of identifying the device 22 operated by the remote input circuit 33 based on the specific result of the specific function 52. Specifically, the identification function 53 generates an image in which the entire operation target device specified by the specific function 52 is identifiablely displayed on the first X-ray image. Then, the identification function 53 superimposes an image that displays the entire operation target device in an identifiable manner on the first X-ray image and displays it on the display 18 or the display of the display input circuit 31 (hereinafter, identification display of the operation target device). ).

Examples of the identification display include coloring the entire operation target device, superimposing or bordering with a thick line, increasing the brightness, blinking, displaying character information indicating that the operation target device is the operation target device, or a combination thereof. , Various aspects can be used that can identify the device to be operated (see, for example, the bottom of FIG. 5). Further, the identification display may be periodically switched between the identification display and the normal display (cancellation of the identification display), and the identification display may blink periodically.

When the display 23 is provided on the support member of the robot arm 21, the identification function 53 presents at least information that can identify the operation target device among the plurality of devices 22 to the user via the display 23. The display 23 may be, for example, an indicator composed of a plurality of LEDs.

Next, in step S6, the switching function 54 determines whether or not to turn off the identification display. When the identification display is turned off, a series of procedures is completed. On the other hand, when the identification display is ON, the process returns to step S1 to acquire a new X-ray image.

The switching function 54 has a function of automatically switching whether to turn on or off the identification display of the operation target device. Specifically, the switching function 54 turns on the identification display when a predetermined superposition condition is satisfied, and turns off the identification display when a predetermined erasing condition is satisfied.

Predetermined superimposition conditions include a change in the imaging position, a start of imaging, a user instruction (including voice recognition) via an input circuit 42 indicating that identification and display should be performed, and the like. Further, a predetermined superposition condition may be that the tip position of the device is changed by a predetermined distance. Further, when the device is a so-called active catheter in which the angle of the tip portion thereof is variably configured, the switching function 54 determines when the angle of the tip portion of the device included in the first X-ray image changes. It may be determined that the superposition condition is satisfied, and the identification display may be turned ON.

Predetermined erasing conditions include the elapse of a certain period of time from turning on the identification display, a user instruction (including voice recognition) via an input circuit 42 indicating that the identification display should be terminated, and the like.

By the above procedure, the user can easily grasp the correspondence between each of the plurality of devices on the X-ray image and each of the plurality of devices 22 of the remote catheter system.

When step S3 is executed, as shown in the middle part of FIG. 5, the specific function 52 identifies only the portion of the image of the operation target device that has moved during the predetermined time. However, the size of the moving part is often small. Therefore, even if the portion specified by the execution of step S3 is presented to the user, it is difficult for the user to find the specified portion on the first X-ray image. It is also difficult to identify which of the endpoints of this identified portion is the tip.

In this regard, since the entire operation target device is identified and displayed according to the above procedure, when the X-ray image contains images of a plurality of devices, the user can remotely contact each of the plurality of devices on the X-ray image. The correspondence with each of the plurality of devices 22 of the catheter system can be easily grasped. Therefore, the user can intuitively grasp which device the operation target device he / she is operating is by simply checking the X-ray image. Therefore, the user is freed from the burden of memorizing the position of the operation target device and the burden of chasing with the eyes, and can concentrate on the procedure. In addition, it is possible to prevent erroneous operation due to erroneous recognition of the operation target device. Further, when the identification display is unnecessary, the identification display can be turned off, and for example, the identification display does not hinder the user's procedure.

Further, FIG. 4 shows an example in which the X-ray image acquisition function 51 sequentially acquires X-ray images in real time, but the procedure of FIG. 4 is executed as a post process for a plurality of X-ray images acquired in advance. You may.

FIG. 6A is an explanatory diagram showing a first modified example of the identification display, FIG. 6B is an explanatory diagram showing a second modified example, and FIG. 6C is an explanatory diagram showing a third modified example. As shown in FIG. 6, the identification display may be performed not only on the operation target device but also on the non-operation target device. For example, as shown in FIG. 6A, the display 18 or the display of the display input circuit 31 may display information indicating the role of each device, or may be predetermined as shown in FIG. 6B. The entire device may be colored with different colors. Further, as shown in FIG. 6C, the display 18 and the display of the display input circuit 31 may be identified and displayed so as to color a part of each device. FIG. 6C shows an example in which the identification display is performed by a predetermined length from the tip of each device.

FIG. 7 is a flowchart showing an example of a procedure for following the identification display when the C arm 15 and the top plate 17 of the bed 16 are further moved in addition to the procedure shown in FIG. The steps equivalent to those in FIG. 4 are designated by the same reference numerals, and duplicate description will be omitted.

Further, FIG. 8 is an explanatory diagram showing an example of how the identification display follows when the C arm 15 and the top plate 17 of the bed 16 move according to the procedure shown in FIG. 7.

In step S11, the tracking function 55 stores the current position of the operation target device specified by the specific function 52 on the X-ray image in the storage circuit 43.

In step S12, the sleeper movement amount acquisition function 56 acquires the movement amount of the top plate 17 of the sleeper 16 on which the subject O is placed. Further, the C-arm movement amount acquisition function 57 acquires the movement amount of the X-ray irradiation axis of the imaging system that performs X-ray imaging by acquiring the movement amount of the C-arm 15. The amount of movement of the top plate 17 of the sleeper 16 and the amount of movement of the C-arm 15 are composed of the amount of parallel movement along the three orthogonal axes (for example, a three-dimensional vector) and the amount of rotational movement around the three orthogonal axes.

Next, in step S13, the follow-up function 55 determines the operation target device after the movement of the top plate 17 of the bed 16 and the C arm 15 based on the movement amount of the top plate 17 of the bed 16 and the movement amount of the C arm 15. Find the position on the X-ray image. At this time, the tracking function 55 may correct the movement amount based on the height of the sleeper 16 and the enlargement ratio of the X-ray image on the display.

Next, in step S14, the identification function 53 identifies and displays the entire operation target device at the position after movement (see FIG. 8).

Here, the processing of step S11 and step S13 will be described more specifically. For example, when the top plate 17 and the C arm 15 of the sleeper 16 move in parallel, the tracking function 55 may obtain the coordinates on the X-ray image of the operation target device after the movement based on the information on the amount of translation.

On the other hand, when it is assumed that the movement of the top plate 17 and the C arm 15 of the sleeper 16 includes rotational movement, the 3D image acquisition function 58 acquires the three-dimensional medical image data of the subject O in step S11. .. As the three-dimensional medical image data, a CT image of a subject O or a volume data of an MRI image acquired in advance by an X-ray CT (computed tomography) device, an MRI (Magnetic Resonance Imaging) device, or the like can be used. Further, in this case, in step S11, the operation target device specified by the specific function 52 is inserted into the follow-up function 55 for each of the blood vessel on the three-dimensional medical image and the blood vessel shape of the first X-ray image. The position in the blood vessel is specified, and the three-dimensional coordinates on the X-ray image of this device are specified. Then, in step S13, the follow-up function 55 is on the X-ray image of the operation target device after the top plate 17 of the bed 16 and the C arm 15 are moved, based on the information of the rotational movement amount of the top plate 17 of the bed 16. The position coordinates may be obtained.

By the above procedure, even when the top plate 17 of the C arm 15 or the bed 16 moves and the field of view of the X-ray image moves, the identification display can be made to follow.

When the X-ray image is executed every time the X-ray image is sequentially acquired in real time, the identification display can be made to follow in real time. Further, even if X-ray irradiation is not performed during the movement of the C-arm 15 and the top plate 17 of the bed 16, the procedure shown in FIG. 7 is applied to the X-ray images captured before and after the movement. By doing so, the identification display can be made to follow.

The procedure shown in FIG. 7 has the same effect as the procedure shown in FIG. Further, according to the procedure shown in FIG. 7, even when the top plate 17 of the C arm 15 or the bed 16 is moved, the entire operation target device is identified and displayed on the X-ray image, so that the user can further use it. You can concentrate on the procedure.

FIG. 9 is a flowchart showing an example of a procedure for following the identification display based on the feed amount of the device, in addition to the procedure shown in FIG. The steps equivalent to those in FIGS. 4 and 7 are designated by the same reference numerals, and duplicate description will be omitted.

Further, FIG. 10 is an explanatory diagram showing an example of how the identification display follows the feed amount of the device according to the procedure shown in FIG.

In step S11, the 3D image acquisition function 58 acquires three-dimensional medical image data of the subject O. Further, the tracking function 55 determines the position in the blood vessel into which the operation target device specified by the specific function 52 is inserted for each of the blood vessel on the three-dimensional medical image and the blood vessel shape of the first X-ray image. Specify and specify the three-dimensional coordinates on the X-ray image of this device.

In step S21, the tracking function 55 acquires information on the shape of the blood vessel in which the operation target device is located based on the three-dimensional medical image.

Next, in step S22, the tracking function 55 identifies the course of the operation target device based on the information on the blood vessel shape in which the operation target device is located and the running of the contrast medium on the X-ray image.

Next, in step S23, the feed amount acquisition function 59 acquires information on the feed movement amount of the operation target device from the processing circuit of the control device 34 of the remote console 30.

Next, in step S24, the tracking function 55 obtains a position on the first X-ray image after the feed movement based on the information on the course and the feed movement amount of the specified operation target device. At this time, the tracking function 55 may correct the movement amount based on the height of the sleeper 16 and the enlargement ratio of the X-ray image on the display.

Next, in step S25, the identification function 53 identifies and displays the entire operation target device at the position after movement (see FIG. 10).

By the above procedure, the identification display can be made to follow based on the feed amount of the device. The procedure shown in FIG. 9 has the same effect as the procedure shown in FIG. Further, according to the procedure shown in FIG. 9, even when the operation target device is moved, the entire operation target device is tracked and identified and displayed on the X-ray image, so that the user can perform the procedure even more. You can concentrate. Further, the procedure shown in FIG. 9 can be executed in combination with the procedure shown in FIG. 7 in parallel.

As described above, FIGS. 4, 7 and 9 include images of two devices on an X-ray image, and an example in which one is a moving device and the other is a stationary device. As shown, both of the two devices included in the X-ray image may be moving devices.

For example, the remote input circuit 33 may be configured so that the two devices 22 can be operated at the same time. Further, two remote input circuits 33, a first remote input circuit 33 and a second remote input circuit 33, corresponding to each of the two devices 22 may be provided. In this case, the two devices 22 may be operated at the same time.

In this case, for example, when two devices 22 are operated at the same time in the procedure shown in FIG. 9, the tracking function 55 predicts the position of each device 22 on the X-ray image based on the feed movement amount of each device 22. Then, the entire device 22 may be identified and displayed at the predicted position after the movement.

Further, the specific function 52 may associate each of the two devices moving simultaneously on the X-ray image with each of the plurality of devices 22 based on, for example, the feed amount of the device.

FIG. 11 is an explanatory diagram showing an example of how the correspondence between each of the two devices on the X-ray image and each of the actual plurality of devices 22 is specified by using the feed movement amount of the devices. For example, the tracking function 55 predicts the position on the X-ray image after the feed movement based on the information on the course and the feed movement amount of each device 22 in the same manner as the method described with reference to FIG. .. Then, the specific function 52 compares the predicted position based on the feed movement amount with the movement amount of the image of each device 22 actually moved on the X-ray image, so that the two devices on the X-ray image can be moved. It is possible to specify the correspondence between each of the devices 22 and each of the actual plurality of devices 22 (FIG. 11).

(Second Embodiment)
Next, a second embodiment of the X-ray diagnostic apparatus and the medical diagnostic imaging system according to the present invention will be described.

FIG. 12 is a block diagram showing a configuration example of the image processing device 12 according to the second embodiment.

Compared to the processing circuit 44 shown in the first embodiment, the processing circuit 44A of the image processing device 12 shown in the second embodiment sets the operation target device according to the device selection information of the user via the remote console 30. Functions have been added. Since other configurations and operations are not substantially different from those of the processing circuit 44 shown in FIG. 3, the same configurations are designated by the same reference numerals and description thereof will be omitted.

As shown in FIG. 12, the processing circuit 44A further realizes the selection reception function 61, the operation target setting function 62, and the operation target presentation function 63 in addition to the respective functions 51 to 59. Each of these functions is stored in the storage circuit 43 in the form of a program. Hereinafter, the details of the operation of each function will be described with reference to FIGS. 13 and 14.

Further, similarly to the processing circuit 44 according to the first embodiment, the processing circuit 44A identifies in advance which device 22 is each of the images of the plurality of devices on the X-ray image. The processing circuit 44A includes information indicating each of the images of the plurality of devices on the X-ray image, and information of IDs defined for each of the plurality of devices 22 (for example, "category 1" and "category 2"). Is stored in the storage circuit 43 in association with each other.

FIG. 13 is a flowchart showing an example of a procedure for setting the operation target device according to the device selection information of the user via the remote console 30 by the processing circuit 44A shown in FIG. This procedure can be performed in parallel with the procedures shown in FIGS. 4, 7, and 9. Further, FIG. 14 is an explanatory diagram showing an example of how the operation target device is set according to the device selection information of the user via the remote console 30 according to the procedure shown in FIG.

In step S31, the selection acceptance function 61 accepts the user's selection for the device included in the first X-ray image. For example, the user instructs the processing circuit of the control device 34 the device that he / she wants to operate through the touch panel of the display input circuit 31 or 32, the hard key of the remote input circuit 33, or the like (see the middle part of FIG. 14). The processing circuit of the control device 34 gives this instruction information to the selection reception function 61. The user can switch the active device, for example, by this selection instruction.

When the selection instruction is received via the hard key of the remote input circuit 33, the selection reception function 61 may sequentially switch the device 22 to be operated, for example, each time the hard key is pressed. At this time, the order of patrol is preferably the order in which the number of times used in the past is large.

Next, in step S32, the operation target setting function 62 sets the device selected by the user as the operation target device of the remote input circuit 33 by assigning the operation authority of the remote input circuit 33 to the device selected by the user. do. For example, when the remote input circuit 33 is configured so that any one of the two devices 22 can be operated selectively, the device 22 selected by the user is set as the operation target device of the remote input circuit 33. , The other device 22 is set so that it cannot be operated by the remote input circuit 33. Further, when the remote input circuit 33 corresponding to each of the two devices 22 is provided, the operation by the remote input circuit 33 corresponding to the device other than the operation target device may be prohibited.

Next, in step S33, the operation target presentation function 63 cooperates with the processing circuit of the control device 34 and presents the information of the current operation target device of the remote input circuit 33 to the user of the remote input circuit 33.

As a method of this presentation, for example, a method of displaying an image 65 showing the operation target device on the display of the display input circuit 32, a method of guiding the operation target device by voice through a speaker (not shown) of the remote console 30, and the like can be considered. (See the lower left of FIG. 14). The image 65 may be an image that can identify the current operation target device after the selection instruction, and may be, for example, a symbol or an arrow. The image 65 may also include information indicating the role of each device (eg, information indicating whether it is a main catheter or a subcatheter).

Of course, the operation target device on the X-ray image displayed on the display of the display input circuit 31 or 32 may be identified and displayed (see the lower right of FIG. 14). As the mode of the identification display, at least a part of the selected operation target device is colored, superimposed or bordered with a thick line, the brightness is increased, the blinking is performed, and the character information indicating that the operation target device is displayed is displayed. , Or a combination thereof, and various other aspects capable of identifying the selected device to be operated can be used. Further, the information of the current operation target device of the remote input circuit 33 may be presented on the display 18 of the X-ray diagnostic apparatus 11. Further, the information of the current operation target device after the selection instruction may be displayed on the display 23 provided on the support member constituting the robot arm 21.

The "voice" refers to a sound obtained by reading out text data by a sound recognized by the listener as a human voice. In addition, the "sound" includes "sound" as well as "music" and "sound effect (beep sound, etc.)".

By the above procedure, the operation target device can be set according to the device selection information of the user via the remote console 30.

In addition, when the two devices included in the first X-ray image are close to each other, the user grasps the correspondence relationship between each of the two devices on the X-ray image and each of the actual two devices 22. It can be difficult to do. In this case, the processing circuit 44A may, for example, move one device slightly automatically, for example, in the direction in which the device returns. The movement of one device makes it easier for the user to grasp the target device. This automatic movement process is performed by the processing circuit 44A, for example, when there is an input from the user that he / she wants to give a selection instruction or that the two devices are close to each other on the image before step S31. It is good.

According to the medical image diagnosis system 10 according to the second embodiment, the same effect as that of the medical image diagnosis system 10 according to the first embodiment can be obtained, and the user can easily switch the operation target device. The device to be operated can be easily grasped.

(Third Embodiment)
Next, a third embodiment of the X-ray diagnostic apparatus and the medical image diagnostic system according to the present invention will be described.

In the medical diagnostic imaging system 10 shown in the third embodiment, as compared with the first embodiment, the non-operated devices of the plurality of devices 22 of the remote catheter system can take a plurality of states, and the subject O and the operator It differs in that it includes an optical camera 70 for photographing at least one of them. Since other configurations and operations are not substantially different from those of the medical image diagnosis system 10 shown in FIG. 1, the same configurations are designated by the same reference numerals and description thereof will be omitted.

In the third embodiment, the non-operated device has one or a combination of four states: free, weakly fixed, strongly fixed, and pressure-applied.

Here, "free" means a state in which no force is applied to the device not to be operated. Further, the weak fixation and the strong fixation refer to a state in which the non-operated device tries to keep the current state. Weak fixing is a state in which a force that repels an external force within a predetermined range is applied to the non-operation target device so that the non-operation target device does not move even if an external force is applied. On the other hand, strong fixing is a state in which a force that repels an external force exceeding a predetermined range is applied to the non-operation target device so that the non-operation target device does not move even if an external force is applied.

Further, the pressure application means a state in which a device not to be operated tries to keep being caught in a predetermined object. The pressure-applied state of the non-operated device is used to hold the other non-operated device, for example, from jumping out of the aneurysm. The pressure application needs to control the direction and magnitude of the force applied to the non-operated device in order to maintain the state of being caught on a predetermined object.

The user gives an instruction to set the state of the non-operated device to the processing circuit of the control device 34 via the touch panel of the display input circuit 31 or 32, the hard key of the remote input circuit 33, or the like. The processing circuit of the control device 34 controls the state of the non-operated device in response to this setting instruction.

FIG. 15 is a block diagram showing a configuration example of the image processing device 12 according to the third embodiment. The camera 70 does not have to be included in the X-ray diagnostic apparatus 11.

The camera 70 captures at least one of an image capable of detecting the movement of the subject O and an image capable of detecting the operator's line of sight. When photographing the operator's line of sight, an image sensor included in a glasses-type device worn on the head of the subject O may be used as the camera 70.

The processing circuit 44B further realizes the automatic transition function 71 in addition to the functions 51 to 59. Each of these functions is stored in the storage circuit 43 in the form of a program.

Further, similarly to the processing circuit 44 according to the first embodiment, the processing circuit 44B identifies in advance which device 22 is each of the images of the plurality of devices on the X-ray image. The processing circuit 44B includes information indicating each of the images of the plurality of devices on the X-ray image, and information of IDs defined for each of the plurality of devices 22 (for example, "category 1" and "category 2"). Is stored in the storage circuit 43 in association with each other.

The automatic transition function 71 automatically transitions the state of the non-operated device between the weak fixed state and the strong fixed state based on the image captured by the camera 70.

For example, when the image captured by the camera 70 is an image capable of detecting the movement of the subject O, the automatic transition function 71 is set to be weakly fixed when the movement of the subject O is larger than a predetermined degree, and the movement is more than a predetermined degree. When it is small, it is better to fix it strongly. When the image captured by the camera 70 is an image capable of detecting the operator's line of sight, the automatic transition function 71 makes the operator's line of sight weakly fixed when the operator's line of sight is separated, and strongly fixed when the operator's line of sight is not separated. It is good to say.

Further, similarly to the method of presenting the information of the current operation target device according to the second embodiment, the automatic transition function 71 cooperates with the processing circuit of the control device 34 and remotely inputs to the user of the remote input circuit 33. Information to the effect that the state of the non-operated device of the circuit 33 has been automatically changed may be presented.

The medical image diagnosis system 10 according to the third embodiment has the same effect as the medical image diagnosis system 10 according to the first embodiment, and is an operation target based on at least one of the movement of the subject O and the line of sight of the operator. The state of the external device can be automatically transitioned between a weak fixed state and a strong fixed state. Further, the processing circuit 44B according to the third embodiment may realize the functions 61-63 according to the second embodiment.

(Fourth Embodiment)
Next, a fourth embodiment of the X-ray diagnostic apparatus and the medical image diagnostic system according to the present invention will be described.

FIG. 16 is a block diagram showing a configuration example of the image processing device 12 according to the fourth embodiment.

Compared to the processing circuit 44 shown in the first embodiment, the processing circuit 44C of the image processing apparatus 12 shown in the fourth embodiment has a function of setting a device to be exchanged according to the device selection information to be exchanged by the user. Is added. Since other configurations and operations are not substantially different from those of the processing circuit 44 shown in FIG. 3, the same configurations are designated by the same reference numerals and description thereof will be omitted.

As shown in FIG. 16, the processing circuit 44C further realizes the exchange reception function 81 and the exchange target presentation function 82 in addition to the functions 51 to 59. Each of these functions is stored in the storage circuit 43 in the form of a program.

Further, similarly to the processing circuit 44 according to the first embodiment, the processing circuit 44C identifies in advance which device 22 is each of the images of the plurality of devices on the X-ray image. The processing circuit 44C includes information indicating each of the images of the plurality of devices on the X-ray image, and information of IDs defined for each of the plurality of devices 22 (for example, "category 1" and "category 2"). Is stored in the storage circuit 43 in association with each other.

The exchange acceptance function 81 accepts the user's selection of the device to be exchanged for the device included in the first X-ray image. The device to be exchanged refers to a device inserted into the subject O and included in the first X-ray image, which is removed from the robot arm 21 by exchange. For example, the user instructs the processing circuit of the control device 34 to indicate the device to be replaced via the touch panel of the display input circuit 31 or 32, the hard key of the remote input circuit 33, or the like (see the middle stage of FIG. 14). The processing circuit of the control device 34 gives instruction information of the device to be exchanged to the exchange reception function 81.

Further, the exchange reception function 81 may receive input of information such as the use of the device by the user. In this case, the exchange reception function 81 identifies the device 22 to be exchanged based on the information such as this use.

Similar to the method of presenting the information of the current operation target device according to the second embodiment, the exchange target presentation function 82 cooperates with the processing circuit of the control device 34 and is the first to the user of the remote input circuit 33. Information on the device to be exchanged among the devices included in the X-ray image is presented.

When the medical diagnostic imaging system 10 includes a plurality of remote input circuits 33, the exchange target presentation function 82 is displayed on the display of the display input circuit 32 of the remote input circuit 33 corresponding to at least the device 22 to be exchanged. It is advisable to present the information of the device that becomes.

Further, the exchange acceptance function 81 may accept information on the exchanged device instead of the device included in the first X-ray image. The replaced device is a device that is attached to the robot arm 21 by replacement. In this case, the storage circuit 43 may store information such as the product name, model number, manufacturer, shape, and the like of the device that is a device candidate after replacement as a table in advance. Similarly in this case, the exchange target presenting function 82 cooperates with the processing circuit of the control device 34 and presents the information of the exchanged device to the user of the remote input circuit 33.

Further, the exchange reception function 81 may specify information such as the exchange time, the device to be exchanged, and the device after exchange according to the progress of the procedure, for example, when the workflow of the procedure is preset. .. In this case, the exchange target presenting function 82 presents to the user information such as the specified exchange time, the device to be exchanged, and the device after exchange.

The medical image diagnosis system 10 according to the fourth embodiment has the same effect as the medical image diagnosis system 10 according to the first embodiment, and presents information on the device to be exchanged and information on the device after exchange to the user. can do. Further, the processing circuit 44C according to the fourth embodiment may realize the functions 61-63 according to the second embodiment, may realize the function 71 according to the third embodiment, or all of them. May be realized. When the function 71 according to the third embodiment is realized, the medical image diagnosis system 10 includes a camera 70.

According to the X-ray diagnostic apparatus 11 according to at least one embodiment described above, at least a part of the operation target device can be identifiablely displayed on the X-ray image. Therefore, the user can easily grasp the correspondence between each of the plurality of devices on the X-ray image and each of the plurality of devices 22 of the remote catheter system.

The touch panel or remote input circuit 33 of the display input circuit 31 or 32 in the present embodiment corresponds to the operation unit within the scope of the claims. Further, the display of the display 18, the display input circuit 31 or the display input circuit 32 in the present embodiment corresponds to the display within the scope of the claims. Further, the X-ray image acquisition function 51, the specific function 52, the identification function 53, the switching function 54, the follow-up function 55, the sleeper movement amount acquisition function 56, the C-arm movement amount acquisition function 57, and the 3D image of the processing circuit 44 in the present embodiment. The acquisition function 58 and the feed amount acquisition function 59 are an X-ray image acquisition unit, a specific unit, an identification unit, a switching unit, a follow-up unit, a sleeper movement amount acquisition unit, an irradiation axis movement amount acquisition unit, and a three-dimensional image within the scope of claims. Corresponds to the acquisition unit and the feed amount acquisition unit, respectively. Further, the selection reception function 61, the operation target setting function 62, and the operation target presentation function 63 of the processing circuit 44A in the present embodiment correspond to the selection reception unit, the operation target setting unit, and the operation target presentation unit in the claims, respectively. .. Further, the automatic transition function 71 of the processing circuit 44B, the exchange reception function 81 and the exchange target presentation function 82 of the processing circuit 44C in the present embodiment are in the automatic transition unit, the exchange reception unit and the exchange target presentation unit, respectively, within the scope of the claims. handle.

Further, the word "processor" relating to the processing circuits 44, 44A, 44B, 44C of the image processing device 12 and the processing circuit of the control device 34 of the remote console 30 in the present embodiment means, for example, a dedicated or general-purpose CPU (Central Processing). Unit), GPU (Graphics Processing Unit), or application specific integrated circuit (ASIC), programmable logic device (for example, Simple Programmable Logic Device (SPLD)), composite programmable logic device (SPLD) It means a circuit such as a Complex Programmable Logic Device (CPLD) and a Field Programmable Gate Array (FPGA). The processor realizes various functions by reading and executing a program stored in a storage circuit.

Instead of storing the program in the storage circuit, the program may be directly embedded in the circuit of the processor. In this case, the processor realizes various functions by reading and executing a program embedded in the circuit. Further, in the above embodiment, an example in which a single processing circuit realizes each function has been shown, but each function is configured by combining a plurality of independent processors and each processor executes a program. May be realized. When a plurality of processors are provided, the storage medium for storing the programs may be provided individually for each processor, or one storage circuit collectively stores the programs corresponding to the functions of all the processors. May be good.

Although some embodiments of the present invention have been described, these embodiments are presented as examples and are not intended to limit the scope of the invention. These novel embodiments can be implemented in various other embodiments, and various omissions, replacements, and changes can be made without departing from the gist of the invention. These embodiments and modifications thereof are included in the scope and gist of the invention, and are also included in the scope of the invention described in the claims and the equivalent scope thereof. Furthermore, components over different embodiments may be combined as appropriate.

Further, in the embodiment of the present invention, each step of the flowchart shows an example of processing performed in chronological order according to the described order, but the processing is not necessarily performed in chronological order, but in parallel or individually. It also includes the processing to be executed.

10 Medical image diagnosis system 11 X-ray diagnostic device 16 Sleeper 22 Device 31, 32 Display input circuit (display, operation unit)
33 Remote input circuit (operation unit)
44, 44A Processing circuit 51 X-ray image acquisition function 52 Specific function 53 Identification function 54 Switching function 55 Follow-up function 56 Bed movement amount acquisition function 57 C-arm movement amount acquisition function 58 3D image acquisition function 59 Feed amount acquisition function 61 Selection reception function 62 Operation target setting function 63 Operation target presentation function 71 Automatic transition function 81 Exchange reception function 82 Exchange target presentation function

Claims (7)

The first device and the second device inserted into the body of the subject,
An operation unit capable of operating the first device and the second device,
A feed amount acquisition unit that acquires information on the feed movement amount of the first device and the second device from the operation unit, respectively.
An image acquisition unit that acquires a medical image of the subject, and an image acquisition unit.
The first device and the second device are based on the acquired feed movement amount of the first device and the second device and the movement of the images of the two devices included in the medical image. For each of the above, a specific unit that specifies the correspondence relationship of which of the two devices included in the medical image is supported, and
A medical image diagnosis system including an identification unit that displays the medical image on a display so that the specified correspondence can be identified. The operation unit
A first operation unit for operating the first device and a second operation unit for operating the second device are provided.
The medical diagnostic imaging system according to claim 1. The specific unit identifies the correspondence relationship based on the result of subtraction processing of the medical images taken at different times.
The medical diagnostic imaging system according to claim 1 or 2. The medical image is an X-ray image acquired continuously in time series.
The medical diagnostic imaging system according to any one of claims 1 to 3. A bed movement amount acquisition unit that acquires the movement amount of the bed on which the subject is placed, and a bed movement amount acquisition unit.
The identification unit obtains the positions of the first device and the second device specified by the specific unit on the medical image after the movement of the bed based on the amount of movement of the bed. In the display of the medical image, the tracking unit that makes the correspondence follow the movement of the bed, and
The medical diagnostic imaging system according to any one of claims 1 to 4, further comprising. The operation unit is further provided, and at least a system for remotely controlling the first device and the second device is provided.
The medical diagnostic imaging system according to any one of claims 1 to 5. An image acquisition unit that acquires a medical image of a subject with a first device and a second device inserted in the body, and an image acquisition unit.
And operation unit can operate the first device and the second device,
A feed amount acquisition unit that acquires information on the feed movement amount of the first device and the second device from the operation unit, respectively.
The first device and the second device are based on the acquired feed movement amount of the first device and the second device and the movement of the images of the two devices included in the medical image. For each of the above, a specific unit that specifies the correspondence relationship of which of the two devices included in the medical image is supported, and
An identification unit that displays the medical image on a display so that the specified correspondence can be identified.
X-ray diagnostic device equipped with.

Images