Light treatment device, treatment effect confirmation method, and recording medium

Abstract

The light treatment device of the present application has: a treatment light emission section that emits treatment light that causes a medicament to react; a narrow-band light emission section that emits narrow-band light composed of a light of a partial waveband of a visible light region; an excitation light emission section that emits excitation light that excites a medicament; a narrow-band light image acquisition section that acquires a narrow-band light image obtained by irradiating the narrow-band light to an irradiation position of the treatment light; a fluorescent light image acquisition section that acquires a fluorescent light image obtained by irradiating the excitation light to the irradiation position of the treatment light; and a display image generation section that generates an overlapping image obtained by overlapping the narrow-band light image and the fluorescent light image.

Description

Technical Field

[0001] This invention relates to phototherapy devices, phototherapy methods, and phototherapy procedures. Background Technology

[0002] In recent years, research on photoimmunotherapy (PIT) has been progressing (see, for example, Patent Document 1). This therapy involves the specific binding of antibody agents to proteins in cancer cells. Irradiation with near-infrared light, used as therapeutic light, activates the antibody agents, thereby destroying the cancer cells and treating the cancer. The antibody agents irradiated with near-infrared light absorb the light energy and undergo molecular vibrations, generating heat. This heat destroys the cancer cells. At this point, the antibody agents are excited and emit fluorescence. The intensity of this fluorescence is used as an indicator of the therapeutic effect.

[0003] Here, the therapeutic effect is considered to have the following three functions.

[0004] 1. Direct damage to cancer cells

[0005] 2. Indirect damage caused by changes in blood flow

[0006] 3. Indirect disruptive effects caused by immune activation

[0007] Furthermore, it is known that as cancer expands, capillaries increase, transforming into a mixed pattern on the mucosal surface. Through the indirect damage caused by the blood flow changes described in point 2, changes occur in the capillaries and micropatterns of the mucosa around the site of treatment. Therefore, changes in the capillaries and micropatterns of the mucosa are important indicators for confirming treatment effectiveness.

[0008] Existing technical documents

[0009] Patent documents

[0010] Patent Document 1: Japanese Patent Application Publication No. 2017-71654 Summary of the Invention

[0011] The problem that the invention aims to solve

[0012] However, in Patent Document 1, since the reduction in fluorescence is used to evaluate the therapeutic effect, it is sometimes impossible to properly assess the therapeutic effect. Typically, the light intensity of a fluorescent reagent decreases over time, making it difficult to determine whether the decrease in light intensity is caused by the treatment or by changes in the drug over time.

[0013] The present invention was made in view of the above circumstances, and its object is to provide a phototherapy device, a phototherapy method, and a phototherapy procedure capable of appropriately confirming the therapeutic effect.

[0014] Methods for solving problems

[0015] To address the aforementioned issues and achieve the objectives, the phototherapy apparatus of the present invention comprises: a therapeutic light emitting unit that emits therapeutic light that causes a drug to react; a narrowband light emitting unit that emits narrowband light composed of a portion of the visible light spectrum; an excitation light emitting unit that emits excitation light that excites the drug; a narrowband light image acquisition unit that acquires a narrowband light image obtained by the narrowband light irradiating an irradiation position of the therapeutic light; a fluorescence image acquisition unit that acquires a fluorescence image obtained by the excitation light irradiating the irradiation position of the therapeutic light; and a display image generation unit that generates an overlay image obtained by superimposing the narrowband light image and the fluorescence image.

[0016] Furthermore, in the above-described invention, the phototherapy device of the present invention further includes an image change calculation unit that calculates the temporal changes of the narrowband light image before and after the therapeutic light irradiation.

[0017] Furthermore, in the phototherapy apparatus of the present invention, the image change calculation unit calculates the temporal change in fluorescence intensity in the fluorescence image before and after treatment light irradiation.

[0018] Furthermore, in the phototherapy apparatus of the present invention described above, the display image generation unit generates the overlapping image by overlapping the narrowband light image and the fluorescence image with brightness or transparency settings respectively for the narrowband light image and the fluorescence image.

[0019] Furthermore, in the phototherapy apparatus of the present invention, the image change calculation unit divides the narrowband light image into multiple regions and calculates the amount of image change in each of the divided regions.

[0020] Furthermore, in the phototherapy apparatus of the present invention, the display image generation unit generates a display image obtained by arranging an overlapping image before the treatment light irradiation and an overlapping image after the treatment light irradiation.

[0021] Furthermore, in the above-described invention, the phototherapy device of the present invention further includes an estimation unit that estimates the output of the therapeutic light based on the changes in the image calculated by the image change calculation unit.

[0022] Furthermore, in the above-described invention, the phototherapy device of the present invention further includes an estimation unit that estimates the irradiation time of the therapeutic light based on the image changes calculated by the image change calculation unit.

[0023] Furthermore, the phototherapy method of the present invention is used to confirm the therapeutic effect after irradiating a treatment site with therapeutic light that causes a drug reaction. The phototherapy method includes the following steps: a narrowband light image acquisition step, acquiring a narrowband light image obtained by passing narrowband light, which irradiates the irradiation position of the therapeutic light that causes a drug reaction, and is composed of a portion of the visible light region; a fluorescence image acquisition step, acquiring a fluorescence image obtained by passing excitation light, which irradiates the irradiation position of the therapeutic light and excites the drug; and a display image generation step, generating an overlay image obtained by superimposing the narrowband light image and the fluorescence image.

[0024] Furthermore, the phototherapy procedure of the present invention enables the phototherapy device to perform the following steps, wherein the phototherapy device generates information to confirm the therapeutic effect after irradiating the treatment site with therapeutic light that causes a drug reaction. The steps performed by the phototherapy device include: a narrowband light image acquisition step, acquiring a narrowband light image obtained by passing narrowband light through which the narrowband light irradiates the irradiation position of the therapeutic light that causes a drug reaction, and consisting of light in a portion of the visible light region; a fluorescence image acquisition step, acquiring a fluorescence image obtained by passing excitation light through which the excitation light irradiates the irradiation position of the therapeutic light and excites the drug; and a display image generation step, generating an overlay image obtained by superimposing the narrowband light image and the fluorescence image.

[0025] Invention Effects

[0026] According to the present invention, it is possible to appropriately confirm the therapeutic effect. Attached Figure Description

[0027] Figure 1 This is a diagram showing a schematic structure of the endoscope system according to Embodiment 1 of the present invention.

[0028] Figure 2 This is a block diagram illustrating the schematic structure of an endoscope system according to Embodiment 1 of the present invention.

[0029] Figure 3 This is a diagram illustrating the front end structure of the endoscope according to Embodiment 1 of the present invention.

[0030] Figure 4 This is a diagram used to illustrate an example of a wavelength band used as narrowband light.

[0031] Figure 5 This is a diagram illustrating an example of a treatment process using the endoscope of Embodiment 1 of the present invention.

[0032] Figure 6 This is a flowchart illustrating an example of the processing of the processing apparatus according to Embodiment 1 of the present invention.

[0033] Figure 7 This diagram illustrates the normal state of an organization.

[0034] Figure 8A This is a diagram illustrating the state of tissue containing cancer cells (part 1).

[0035] Figure 8B This is a diagram illustrating the state of tissue containing cancer cells (part 2).

[0036] Figure 8C This is a diagram illustrating the state of tissue containing cancer cells (part 3).

[0037] Figure 9 It is a diagram illustrating the state of the tissue before and after treatment.

[0038] Figure 10 This is an example of a display screen.

[0039] Figure 11 This is a block diagram illustrating the schematic structure of the endoscope system according to Embodiment 2 of the present invention.

[0040] Figure 12 This is a flowchart illustrating an example of the processing of the processing apparatus according to Embodiment 2 of the present invention.

[0041] Figure 13A It is a constructed graph extracted from the state of the tissue before and after treatment (part 1).

[0042] Figure 13B The constructed graph (part 2) is extracted based on the state of the tissue before and after treatment.

[0043] Figure 14 This is an example of a display screen.

[0044] Figure 15 This is a diagram used to illustrate the process for determining the therapeutic effect of Embodiment 3 of the present invention.

[0045] Figure 16 This is a block diagram illustrating the schematic structure of the endoscope system according to Embodiment 4 of the present invention.

[0046] Figure 17A This is a diagram (part 1) used to explain the estimation process of Embodiment 5 of the present invention.

[0047] Figure 17B This is a diagram (part 2) used to explain the estimation process of Embodiment 5 of the present invention.

[0048] Figure 18A This is a diagram (part 1) used to explain the estimation process of Embodiment 6 of the present invention.

[0049] Figure 18B This is a diagram (part 2) used to illustrate the estimation process of Embodiment 6 of the present invention.

[0050] Figure 19 This is a block diagram illustrating the schematic structure of the endoscope system according to Embodiment 7 of the present invention. Detailed Implementation

[0051] Hereinafter, embodiments for carrying out the present invention (hereinafter referred to as "implementations") will be described. In these embodiments, as an example of a system including the phototherapy apparatus of the present invention, a medical endoscope system for capturing and displaying images of a patient or other subject body will be described. However, the present invention is not limited to these embodiments. Furthermore, in the accompanying drawings, the same reference numerals are used to describe the same parts.

[0052] (Implementation Method 1)

[0053] Figure 1 This is a diagram showing a schematic structure of the endoscope system according to Embodiment 1 of the present invention. Figure 2 This is a block diagram showing the general structure of the endoscope system of Embodiment 1. Figure 3 This is a diagram illustrating the front end structure of the endoscope in Embodiment 1.

[0054] Figure 1 and Figure 2 The endoscope system 1 shown includes: an endoscope 2 that takes internal images of the subject by inserting its tip into the subject's body; a light source device 3 that generates illumination light emitted from the tip of the endoscope 2; a processing device 4 that performs prescribed signal processing on the image signals captured by the endoscope 2 and uniformly controls the overall operation of the endoscope system 1; a display device 5 that displays the internal images generated by the signal processing of the processing device 4; and a treatment device 6.

[0055] The endoscope 2 has: an insertion part 21, which is flexible and elongated; an operation part 22, which is connected to the base end of the insertion part 21 and receives input of various operation signals; and a universal cable 23, which extends from the operation part 22 in a direction different from the direction of extension of the insertion part 21, and contains various cables for connection to the light source device 3 and the processing device 4.

[0056] The insertion part 21 has: a front end 24, which houses an imaging element 244 composed of pixels arranged in a two-dimensional pattern, the pixels receiving light and performing photoelectric conversion to generate signals; a flexible bending part 25 composed of multiple bending blocks; and a long, flexible tube part 26 connected to the base end of the bending part 25, which is flexible. The insertion part 21 is inserted into the body cavity of the subject, and the imaging element 244 captures images of the subject, such as biological tissue, located in a position not reached by external light.

[0057] The operating unit 22 includes: a bending knob 221 that bends the bending part 25 in the vertical and horizontal directions; a treatment instrument insertion part 222 that inserts treatment instruments such as a therapeutic light irradiation device, biopsy forceps, an electrosurgical scalpel, and an examination probe into the body cavity of the subject; and multiple switches 223 serving as operation inputs that input operation indication signals to the processing device 4 and peripheral devices such as the air supply unit, water supply unit, and screen display control. Treatment instruments inserted from the treatment instrument insertion part 222 protrude from the opening through the treatment instrument channel (not shown) at the front end 24 (see reference). Figure 3 ).

[0058] The universal cable 23 incorporates at least a light guide 241 and a bundled cable 245 that combines one or more signal lines. The universal cable 23 branches at its end opposite to the side connected to the operation unit 22. A connector 231, detachable from the light source device 3, and a connector 232, detachable from the processing unit 4, are provided at the branch ends of the universal cable 23. A portion of the light guide 241 extends from the end of the connector 231. The universal cable 23 propagates illumination light emitted from the light source device 3 towards the front end 24 via the connector 231 (light guide 241), the operation unit 22, and the flexible tube portion 26. Additionally, the universal cable 23 transmits image signals captured by the imaging element 244 located at the front end 24 to the processing unit 4 via the connector 232. The manifold cable 245 includes signal lines for transmitting camera signals, signal lines for transmitting drive signals for driving the camera element 244, and signal lines for transmitting and receiving information, including inherent information related to the endoscope 2 (camera element 244). Furthermore, while this embodiment describes the use of signal lines to transmit electrical signals, optical signals can also be transmitted, and signals can also be transmitted between the endoscope 2 and the processing device 4 via wireless communication.

[0059] The front end 24 includes: a light guide 241, which is made of glass fiber or the like and serves as a light guide for the light emitted by the light source device 3; an illumination lens 242, which is disposed at the front end of the light guide 241; an optical system 243 for focusing light; and an imaging element 244, which is disposed at the imaging position of the optical system 243, receives the light focused by the optical system 243 and converts it into an electrical signal to perform the prescribed signal processing.

[0060] The optical system 243 is constructed using one or more lenses. The optical system 243 forms the observed image on the light-receiving surface of the imaging element 244. In addition, the optical system 243 may also have an optical zoom function that changes the field of view and a focusing function that changes the focal point.

[0061] The image sensor 244 performs photoelectric conversion on light from the optical system 243 to generate an electrical signal (image signal). The image sensor 244 is composed of multiple pixels arranged in a matrix. Each pixel has a photodiode that stores a charge corresponding to the amount of light, and a capacitor that converts the charge transferred from the photodiode into a voltage level. Each pixel of the image sensor 244 performs photoelectric conversion on light incident via the optical system 243 to generate an electrical signal. The electrical signal generated by any pixel arbitrarily selected as the readout target is sequentially read out and output as an image signal. The image sensor 244 can be implemented using, for example, a CCD (Charge Coupled Device) image sensor or a CMOS (Complementary Metal-Oxide Semiconductor) image sensor.

[0062] Additionally, the endoscope 2 has a memory (not shown) that stores execution programs and control programs for the imaging element 244 to perform various actions, as well as data including the endoscope 2's identification information. The identification information includes the endoscope 2's inherent information (ID), year, specifications, and transmission method, etc. Furthermore, the memory can also temporarily store image data generated by the imaging element 244.

[0063] The structure of the light source device 3 will be described. The light source device 3 includes a light source unit 31, an illumination control unit 32, and a light source driver 33. Under the control of the illumination control unit 32, the light source unit 31 sequentially switches and emits illumination light to the subject (examined object).

[0064] The light source unit 31 is constructed using a light source, one or more lenses, etc., and emits light (illumination light) by driving the light source. The light generated by the light source unit 31 is emitted from the front end of the front end 24 towards the subject via the light guide 241. The light source unit 31 has a white light source 311 and a narrowband light source 312. The emission section is composed of each light source unit, the light guide 241, and the illumination lens 242. For example, the narrowband light emission section is composed of the narrowband light source 312, the light guide 241, and the illumination lens 242.

[0065] The white light source 311 emits light (white light) in the visible light spectrum. The white light source 311 can be implemented using any light source such as an LED light source, a laser light source, a xenon lamp, or a halogen lamp.

[0066] The narrowband light source 312 emits light consisting of a portion of the wavelengths or bands in the visible light region (narrowband light). Figure 4 This diagram illustrates an example of a wavelength band used as narrowband light. Narrowband light, for example, is light in the band above 390 nm and below 445 nm. B Light in the wavelength band above 530nm and below 550nm G Light can be any light source or combination thereof. As narrowband light, examples include light sources used in NBI (Narrow Band Imaging) observations. B and light L G The light constituted. In this embodiment, light L is used. B And light L G The light source 312 is illustrated as an example of narrowband light. Furthermore, it can be defined as a combination of any light source or a portion thereof, occurring in the wavelength ranges of 490nm to 590nm, 590nm to 620nm, and 620nm to 780nm. The narrowband light source 312 is implemented using LED light sources, laser light sources, or the like.

[0067] Additionally, in the case of antibody agents that stimulate PIT, for example, near-infrared light with a center wavelength of 690 nm (e.g.) is used. Figure 4 The light L in the band above 660nm and below 710nm shown P ).

[0068] Here, by irradiating light in the wavelength range of 390 nm to 445 nm and obtaining its scattered and reflected light, blood vessels in the mucosal surface can be depicted with high contrast. Furthermore, by irradiating light in the wavelength ranges of 530 nm to 550 nm, 590 nm to 620 nm, or 620 nm to 780 nm and obtaining its scattered and reflected light, deeper blood vessels in the mucosal surface can be depicted with high contrast.

[0069] The excitation light source 313 emits excitation light to excite the target object (e.g., an antibody drug if it is PIT). The excitation light source 313 can be implemented using a light source such as an LED or a laser. When stimulating the antibody drug of PIT, for example, near-infrared light is used... P .

[0070] The lighting control unit 32 controls the electrical power supplied to the light source unit 31 based on the control signal (dimming signal) from the processing device 4, and controls the light source and the timing of the light source's operation.

[0071] Under the control of the lighting control unit 32, the light source driver 33 supplies current to the light source of the light-emitting object, causing the light source unit 31 to emit light.

[0072] The structure of the processing device 4 will be described. The processing device 4 includes an image processing unit 41, a synchronization signal generation unit 42, an input unit 43, a control unit 44, and a storage unit 45.

[0073] The image processing unit 41 receives image data of various colors of illumination light captured by the imaging element 244 from the endoscope 2. When receiving analog image data from the endoscope 2, the image processing unit 41 performs A / D conversion to generate a digital imaging signal. Furthermore, when receiving image data as a light signal from the endoscope 2, the image processing unit 41 performs photoelectric conversion to generate digital image data.

[0074] The image processing unit 41 performs prescribed image processing on the image data received from the endoscope 2 to generate an image and output it to the display device 5, or sets a boundary region determined based on the image, or calculates the time change of fluorescence intensity. The image processing unit 41 includes a white light image generation unit 411, a narrow band light image generation unit 412, a fluorescence image generation unit 413, and a display image generation unit 414.

[0075] The white light image generation unit 411 generates a white light image based on an image formed by white light.

[0076] The narrowband light image generation unit 412 generates a narrowband light image based on the image formed by the narrowband light.

[0077] Here, the image acquisition unit is composed of the optical system 243, the imaging element 244, and the image generation unit. For example, in the case of acquiring an image formed by illumination through narrowband light, the optical system 243, the imaging element 244, and the narrowband light image generation unit 412 constitute the narrowband light image acquisition unit.

[0078] The fluorescence image generation unit 413 generates a fluorescence image based on the image formed by fluorescence.

[0079] The image generation unit 414 generates an image to be displayed on the display device 5. The image may be based on white light, a narrowband light image, or an image obtained by overlaying a narrowband light image with a fluorescent image.

[0080] The white light image generation unit 411, narrowband light image generation unit 412, fluorescence image generation unit 413, and display image generation unit 414 generate images by performing prescribed image processing. Here, the prescribed image processing includes simulcasting, grayscale correction, and color correction. Simulcasting is the process of simulcasting image data of each color component of the RGB spectrum. Grayscale correction is the process of correcting the grayscale of the image data. Color correction is the process of correcting the color tone of the image data. Furthermore, the white light image generation unit 411, narrowband light image generation unit 412, fluorescence image generation unit 413, and display image generation unit 414 can also adjust the gain according to the brightness of the image.

[0081] The image processing unit 41 is configured using a general-purpose processor such as a CPU (Central Processing Unit) or a special-purpose processor such as an ASIC (Application Specific Integrated Circuit) that performs specific functions. Alternatively, the image processing unit 41 may be configured to have a frame memory that stores R-image data, G-image data, and B-image data.

[0082] The synchronization signal generation unit 42 generates a clock signal (synchronization signal) that serves as the reference for the operation of the processing device 4, and outputs the generated synchronization signal to the light source device 3, the image processing unit 41, the control unit 44, and the endoscope 2. Here, the synchronization signal generated by the synchronization signal generation unit 42 includes a horizontal synchronization signal and a vertical synchronization signal.

[0083] Therefore, the light source device 3, the image processing unit 41, the control unit 44, and the endoscope 2 operate synchronously with each other based on the generated synchronization signal.

[0084] The input unit 43 is implemented using a keyboard, mouse, switch, or touch panel, and accepts various signals such as action instruction signals that instruct the operation of the endoscope system 1. Alternatively, the input unit 43 may include a switch installed on the operation unit 22, or a portable terminal such as an external tablet computer.

[0085] The control unit 44 performs drive control of each structural component including the imaging element 244 and the light source device 3, as well as input / output control of information for each structural component. The control unit 44 refers to control information data (e.g., readout timing) for image control stored in the storage unit 45 and sends it as a drive signal to the imaging element 244 via a predetermined signal line included in the cable 245. Alternatively, it switches between a normal viewing mode, a narrowband light viewing mode, and a fluorescence viewing mode. The normal viewing mode is for viewing images obtained through white light illumination; the narrowband light viewing mode is for viewing images obtained through narrowband light illumination; and the fluorescence viewing mode is for calculating the fluorescence intensity of the excitation object. The control unit 44 is configured using a general-purpose processor such as a CPU, or a dedicated processor such as an ASIC that performs specific functions using various arithmetic circuits.

[0086] The storage unit 45 stores various programs used to operate the endoscope system 1, as well as data including various parameters required for the operation of the endoscope system 1. Additionally, the storage unit 45 stores identification information for the processing device 4. This identification information includes the processing device 4's unique ID, year, and specifications.

[0087] In addition, the storage unit 45 stores various programs, including image acquisition processing programs for executing the image acquisition processing method of the processing device 4. These programs can also be widely distributed by recording on computer-readable recording media such as hard disks, flash memory, CD-ROMs, DVD-ROMs, and floppy disks. Furthermore, these programs can also be obtained by downloading via a communication network. The communication network mentioned here can be implemented through existing public landline networks, LANs (Local Area Networks), WANs (Wide Area Networks), etc., and can be either wired or wireless.

[0088] The storage unit 45 with the above structure is implemented using ROM (Read Only Memory) pre-installed with various programs, RAM, hard disk, etc., which store the operation parameters and data of each process.

[0089] The display device 5 displays a display image corresponding to the image signal received from the processing device 4 (image processing unit 41) via the image cable. The display device 5 is configured using a monitor such as a liquid crystal or an organic EL (electroluminescence) display.

[0090] The treatment device 6 includes a treatment device operation unit 61 and a flexible treatment device 62 extending from the treatment device operation unit 61. The treatment device 62 used in PIT is a treatment light emitting unit that emits light for treatment (hereinafter referred to as treatment light). The treatment device operation unit 61 controls the emission of the treatment light from the treatment device 62. The treatment device operation unit 61 includes an operation input unit 611. The operation input unit 611 is, for example, a switch. The treatment device operation unit 61 causes the treatment device 62 to emit the treatment light by inputting to the operation input unit 611 (e.g., pressing a switch). Furthermore, in the treatment device 6, the light source emitting the treatment light can be provided in the treatment device 62 or in the treatment device operation unit 61. The light source is implemented using a semiconductor laser, LED, etc. The treatment light, for example in the case of PIT, is light in the wavelength range of 680 nm or higher, for example, light with a center wavelength of 690 nm (e.g.) Figure 4 The light L shown P ).

[0091] Here, the illumination optical system of the treatment device 62 can also be configured to change the irradiation range of the therapeutic light. For example, under the control of the treatment device operation unit 61, it can be configured with an optical system that can change the focal length, a DMD (Digital Micromirror Device), etc., and can change the spot diameter and the shape of the irradiation range of the light irradiating the subject.

[0092] Next, refer to Figure 5 The treatment procedure using endoscope 2 is explained. Figure 5 This is a diagram illustrating an example of a treatment process using the endoscope of Embodiment 1 of the present invention. Figure 5 This diagram illustrates an example of the implementation of PIT, in which the insertion part 21 is inserted into the gastric ST for treatment.

[0093] First, the surgeon inserts the insertion part 21 into the gastric ST (refer to...). Figure 5 (a) At this time, the surgeon illuminates the light source device 3 with white light and searches for the treatment location while observing the white light image of the gastric ST displayed on the display device 5. Here, tumors B1 and B2, which are the targets of treatment, are treated. At this time, antibody drugs are administered to tumors B1 and B2, which are the targets of treatment. The administration of antibody drugs can be performed using endoscope 2, other equipment, or by having the patient swallow the drug.

[0094] The surgeon observes the white light image and determines the area containing tumors B1 and B2 as the irradiation area. Additionally, as needed, the irradiation area is illuminated with narrowband light or excitation light to obtain narrowband light images and fluorescence images.

[0095] The surgeon positions the anterior end 24 toward the tumor B1, allowing the treatment instrument 62 to protrude from the front end of the endoscope 2 and irradiate the tumor B1 with therapeutic light (see reference). Figure 5 (b)). By irradiating with therapeutic light, the antibody agent that binds to tumor B1 reacts, thus treating tumor B1.

[0096] Then, the surgeon positions the tip 24 toward the tumor B2, allowing the treatment instrument 62 to protrude from the tip of the endoscope 2 and irradiate the tumor B2 with therapeutic light (see reference). Figure 5 (c)). By irradiating with therapeutic light, the antibody agent that binds to tumor B2 reacts, thus treating tumor B2.

[0097] The surgeon then positions the anterior end 24 toward tumor B1 and illuminates tumor B1 with narrow-band light and excitation light from the tip of endoscope 2 (see reference). Figure 5 (d) The surgeon confirms the treatment effect at tumor B1 by obtaining narrowband light and fluorescence images after treatment. The surgeon confirms the treatment effect, for example, by observing the images described later.

[0098] Additionally, the surgeon positions the anterior end 24 towards tumor B2 and illuminates the tumor B2 with narrow-band light from the tip of endoscope 2 (see reference). Figure 5 (e)). The surgeon confirms the treatment effect at tumor B2 by obtaining narrowband light images after treatment.

[0099] The surgeon may repeatedly apply additional light therapy as needed and confirm the therapeutic effect.

[0100] Next, refer to Figure 6 The processing in processing device 4 will be explained. Figure 6 This is a flowchart illustrating an example of the processing of the processing apparatus of Embodiment 1.

[0101] First, through the operator's manipulation, therapeutic light is irradiated from the treatment instrument 62 onto the antibody drug that binds to cancer cells, causing the drug to react (step S101: drug reaction process). In this drug reaction process, treatment is performed by irradiating the antibody drug with near-infrared light, which serves as the therapeutic light, to activate and destroy cancer cells.

[0102] Then, narrowband light is irradiated from the front end 24 toward the treatment position to obtain a narrowband light image after treatment (second narrowband light image) (step S102: narrowband light image acquisition process). The control unit 44 causes the light source device 3 to emit narrowband light, so that the endoscope 2 can capture a narrowband light image.

[0103] Then, the light source device 3 emits excitation light to detect the fluorescence of the antibody drug (step S103: fluorescence detection process). Through the emission of excitation light, the endoscope 2 illuminates the subject, exciting the antibody drug before treatment and causing it to fluoresce. At this time, the processing device 4 acquires the imaging signal (fluorescence image) generated by the imaging element 244.

[0104] Here, by alternately switching the narrowband light and the excitation light for illumination in the order of steps S102 and S103, light leakage and other issues can be suppressed, thereby improving the image quality of the acquired image. Furthermore, while it is preferable to illuminate the narrowband light and the excitation light separately to improve image quality, steps S102 and S103 can also be performed simultaneously.

[0105] Here, we will explain the state of the organization as depicted by NBI observation. Figure 7 This diagram illustrates tissue in its normal state. Under normal conditions without cancer cells, the fine structure is shown. S The whole is uniform and unstructured, with microvessels (in) Figure 7 M as a microvascular V (Illustrated with dashed lines) Not visible.

[0106] Figures 8A to 8C This is a diagram illustrating tissue containing cancer cells. Relative to... Figure 7 The image shows the normal state, containing the fine structure of tissue containing cancer cells. S The surface pattern and the state of the blood vessels differ from the normal state. For example, for a regular, finely structured pattern, the blood vessels B... V A vascular pattern surrounding each fine structure (see reference) Figure 8A For irregular, finely structured patterns, blood vessel B V A vascular pattern with a mesh pattern surrounding each fine structure (see reference) Figure 8B The microstructure pattern is unclear, and the blood vessels B... V The thickness becomes uneven (refer to...) Figure 8C ).

[0107] Furthermore, when the antibody drug is bound to the proteins of cancer cells, it is excited and emits fluorescence upon irradiation with excitation light. Figure 8A (Illustrated with shaded lines). Fluorescence was detected when treatment was incomplete and the antibody agent was still binding. On the other hand, no fluorescence was detected when treatment was completed and no antibody agent remained.

[0108] In PIT, for example, to Figure 8C The tissue irradiation treatment light shown, return Figure 7 The normal state shown. Figure 9 It is a diagram illustrating the state of the tissue before and after treatment. Figure 9 (a) shows a narrowband light image obtained by NBI observation before treatment. Figure 9 Images (b) and (c) show narrowband light images obtained in stages through NBI observation after treatment. The surgeon confirms... Figure 9 The state shown in (a) is due to the irradiation of the tissue with therapeutic light. Figure 9 The state transition shown in (c) is used to determine the treatment effect and success. At this time, Figure 9 The state shown in (b) is uniformly unstructured overall, and fluorescence was detected in a portion of it, indicating that it was treated with additional irradiation light.

[0109] return Figure 6 The display image generation unit 414 generates an image to be displayed on the display device 5 (step S104: display image generation process). The display image generation unit 414 generates a display image, which includes an overlay image obtained by overlaying the narrowband light image and the fluorescence image obtained in steps S102 and S103 (e.g., Figure 9 (Image shown in (b) or (c)).

[0110] The control unit 44 causes the display device 5 to display the image generated in S104 (step S105: display process). By displaying the image on the display device 5, the surgeon can confirm the treatment effect. The surgeon confirms the treatment effect by referring to the image and determines whether to add additional treatment light, or determines the portion of the treatment light to be applied. The surgeon operates the input unit 43 to input the determination result.

[0111] Figure 10 This diagram illustrates an example of a displayed screen. In the display device 5, for example, a screen with an image display unit W is displayed. 11 The displayed image W 1， In the image display section W 11 The image displayed is an overlay image obtained by superimposing a narrowband light image and a fluorescence image after treatment. In the image display unit W... 11 The image shown is obtained by overlaying the narrowband light image obtained in step S102 after treatment and the fluorescence image obtained in step S103 after treatment. Figure 10 In the image shown, fluorescence was observed ( Figure 10 The shadowed area in the image suggests the presence of residual antibody agents, so the surgeon used the image to study additional irradiation.

[0112] After the input unit 43 receives the judgment result, the control unit 44 determines whether additional irradiation with therapeutic light should be performed (step S106). If the control unit 44 determines that additional irradiation with therapeutic light is not required based on the input judgment result (step S106: No), the process ends. Conversely, if the control unit 44 determines that additional irradiation with therapeutic light should be performed (step S106: Yes), the process proceeds to step S107.

[0113] When additional irradiation is performed, for example in an illumination optics system, control is exercised to ensure that the shape of the irradiated area matches the boundary region, or the surgeon adjusts the spot diameter to irradiate the therapeutic area.

[0114] The control unit 44 determines whether the amount of light already irradiated in the area where additional irradiation of the therapeutic light is performed is within the allowable range (step S107). Here, the allowable range is a preset light amount, at least with an upper limit. This upper limit is a value set to prevent tissue damage due to excessive irradiation. For example, the control unit 44 determines whether the amount of light already irradiated (cumulative light amount value) in the target area specified by the surgeon or others exceeds the upper limit. The amount of light already irradiated is calculated, for example, based on the output of the therapeutic light input by the surgeon and the irradiation time.

[0115] If the control unit 44 determines that the amount of light irradiated is below the allowable range (upper limit) (step S107: Yes), it returns to step S101 and repeats the above process. Alternatively, if the control unit 44 determines that the amount of light irradiated exceeds the allowable range (upper limit) (step S107: No), it moves to step S108.

[0116] In step S108, the control unit 44 outputs an alarm indicating that the amount of illumination light exceeds the permissible range. This alarm can be displayed as text on the display device 5, or it can be configured to emit sound, light, or a combination of these. After the display device 5 displays the alarm, the control unit 44 terminates the process.

[0117] In Embodiment 1 described above, by displaying an image obtained by overlaying a narrow-band light image depicting the tissue structure and a fluorescence image depicting the presence or absence of antibody drugs on the display device 5, the surgeon can determine whether additional treatment light irradiation is necessary. According to Embodiment 1, the treatment effect can be appropriately confirmed based on the views of changes in tissue and blood vessels after treatment and the residual state of antibody drugs.

[0118] Furthermore, in Embodiment 1 described above, when additional irradiation is performed, the cumulative light intensity of the therapeutic light irradiated onto the area is compared with an allowable range. If the cumulative light intensity exceeds the allowable range, an alarm indicating that the cumulative light intensity exceeds the allowable range is output. According to Embodiment 1, tissue damage due to excessive irradiation by therapeutic light can be suppressed.

[0119] Furthermore, in Embodiment 1 described above, a multi-band image sensor can be used to construct the imaging element 244, acquiring multiple light bands that are different from each other individually. For example, by acquiring scattered and returned light in the band of light above 380 nm and below 440 nm, and scattered and returned light in the band of light above 530 nm and below 550 nm, the multi-band image sensor can generate individual narrowband light images. This allows for the separate generation of vascular images at different depths from the mucosal surface, enabling the calculation of image changes with higher precision using images of blood vessels and tissues at each depth. Moreover, even when narrowband light and excitation light are simultaneously irradiated, narrowband light images and fluorescence images can be acquired separately.

[0120] (Implementation Method 2)

[0121] Next, refer to Figures 11-14 Implementation method 2 will be described. Figure 11 This is a block diagram illustrating the schematic structure of an endoscope system according to Embodiment 2 of the present invention. The endoscope system 1A of Embodiment 2 has a processing device 4A instead of the processing device 4 of the endoscope system 1 of Embodiment 1. The structure other than the processing device 4A is the same as that of the endoscope system 1, and therefore description is omitted.

[0122] The structure of the processing device 4A will be described. The processing device 4A includes an image processing unit 41A, a synchronization signal generation unit 42, an input unit 43, a control unit 44, and a storage unit 45.

[0123] The image processing unit 41A includes a white light image generation unit 411, a narrow band light image generation unit 412, a fluorescence image generation unit 413, a display image generation unit 414, and an image change calculation unit 415.

[0124] The image change calculation unit 415 calculates the temporal change of the image. Specifically, the image change calculation unit 415 calculates the temporal change of the narrowband light image generated by the narrowband light image generation unit 412 and captured at different times, and / or the temporal change of the fluorescence image generated by the fluorescence image generation unit 413 and captured at different times.

[0125] Next, refer to Figure 12 The processing in processing device 4A will be explained. Figure 12 This is a flowchart illustrating an example of the processing of the processing apparatus of Embodiment 2.

[0126] First, narrowband light is irradiated from the front end 24 toward the treatment position to obtain a narrowband light image before treatment (first narrowband light image) (step S201: narrowband light image acquisition process). Here, the control unit 44 causes the light source device 3 to emit narrowband light, causing the endoscope 2 to capture an image of the narrowband light. After capturing the image, the narrowband light image generation unit 412 generates the narrowband light image.

[0127] Furthermore, excitation light is irradiated from the front end 24 towards the treatment position to obtain a fluorescence image (first fluorescence image) before treatment (step S202: fluorescence image acquisition process). Here, the control unit 44 causes the light source device 3 to emit excitation light, causing the endoscope 2 to capture an image of the fluorescence emitted by the antibody drug. After capturing the image, the fluorescence image generation unit 413 generates the fluorescence image.

[0128] Alternatively, the processing order of steps S201 and S202 can be reversed.

[0129] Subsequently, through the surgeon's operation, treatment light is irradiated from the treatment instrument 62 onto the antibody drug that binds to cancer cells, and the drug reacts (step S203: drug reaction process).

[0130] After the treatment light is irradiated, narrowband light is irradiated from the front end 24 to the treatment position to obtain a narrowband light image (second narrowband light image) (step S204: narrowband light image acquisition process). In step S204, the control unit 44 also causes the light source device 3 to emit narrowband light in the same way as in step S201, so that the endoscope 2 can capture a narrowband light image.

[0131] In addition, excitation light is irradiated from the front end 24 toward the treatment position to obtain a fluorescence image (second fluorescence image) after treatment (step S205: fluorescence image acquisition process). In step S205, the control unit 44 also causes the light source device 3 to emit excitation light in the same way as in step S202, so that the endoscope 2 can capture an image of the fluorescence emitted by the antibody drug.

[0132] Alternatively, the processing order of steps S204 and S205 can be reversed.

[0133] Subsequently, the image change calculation unit 415 calculates the temporal changes in the images before and after treatment (step S206: image change calculation process). The image change calculation unit 415 calculates values ​​representing the clarity, uniformity, uniformity of blood vessel thickness, and visibility of the surface tissue pattern as image changes by comparing narrow-band light images before and after treatment. Additionally, the image change calculation unit 415 can also calculate the difference in fluorescence intensity before and after treatment as image changes.

[0134] At this time, the image change calculation unit 415 separately calculates the vascular structure and fine structure O in the obtained narrowband light image. SThe image changes the state of any structure within the image. The object of the change calculation can be set, and can be selected from only vascular structures, only microstructures, vascular structures, and microstructures. The image change calculation unit 415 extracts feature points from the image and calculates the change by comparing the changes in the position, size, and distribution of these feature points.

[0135] Figure 13A and Figure 13B It is a diagram constructed from narrowband light images showing the state of the tissue before and after treatment. Figure 13A The image shows a case where the vascular structure has been extracted. Figure 13B The image shown illustrates the case where fine structures have been extracted. The image change calculation unit 415 extracts blood vessel B from narrowband light images before and after treatment. V After calculating the contrast value of the blood vessel, the B-value of the blood vessel is then calculated. V The contrast ratio with its surroundings. Then, the image change calculation unit 415 calculates the difference in contrast ratio between the narrowband light images before and after treatment as the image change (refer to...). Figure 13A ).

[0136] Furthermore, the image change calculation unit 415 extracts the fine structure O of the mucosal surface layer from narrowband light images before and after treatment. S Calculate the fine structure O S The image sharpness is then calculated. The image change calculation unit 415 calculates the difference in sharpness between the narrowband light images before and after treatment as the image change (refer to...). Figure 13B At this time, in the narrowband light image, the fine structures after treatment are depicted more clearly than the fine structures before treatment. Additionally, the image change calculation unit 415 can also extract the fine structures O, for example. S To calculate the fine structure between images O S Consistency is used as a measure of change.

[0137] Furthermore, when the image change calculation unit 415 calculates the image change of the narrowband light image and the image change (change in fluorescence intensity) of the fluorescence image, it can use each image change to calculate a value representing the image change, or it can calculate each image change as a separate independent value.

[0138] Then, the display image generation unit 414 generates an image to be displayed on the display device 5 (step S207: display image generation process). The display image generation unit 414 generates an overlay image of the narrowband light image and the fluorescence image, as well as an image that visually represents the calculated image changes.

[0139] The control unit 44 causes the display device 5 to display the image generated in step S207 (step S208: display process). By displaying the image on the display device 5, the surgeon can confirm the treatment effect. The surgeon confirms the treatment effect by referring to the image and determines whether to add additional treatment light, or determines the portion of the treatment light to be applied. The surgeon operates the input unit 43 to input the determination result.

[0140] Figure 14 This diagram illustrates an example of a display screen showing images representing the state of tissue before and after treatment. Display device 5 displays a display image W2, which, for example, has a first image display unit W1 displaying an image before treatment. 21 The second image display unit W displays images after treatment. 22 And an information display unit W that displays changes in images before and after treatment (e.g., the contrast value mentioned above). 23 Displayed on the first image display unit W 21 and the second image display unit W 22 The image is obtained by overlaying a narrowband light image with a fluorescence image. At this time, the first image display unit W... 21 and the second image display unit W 22 The size and transparency of each image when the narrowband light image and the fluorescence image are superimposed can be set appropriately.

[0141] After the input unit 43 receives the judgment result, the control unit 44 determines whether additional irradiation with therapeutic light should be performed (step S209). If the control unit 44 determines that additional irradiation with therapeutic light is not required based on the input judgment result (step S209: No), the process ends. Conversely, if the control unit 44 determines that additional irradiation with therapeutic light should be performed (step S209: Yes), the process proceeds to step S210.

[0142] When additional irradiation is performed, for example in an illumination optics system, control is exercised to ensure that the shape of the irradiated area matches the boundary region, or the surgeon adjusts the spot diameter to irradiate the therapeutic area.

[0143] The control unit 44 determines whether the amount of light already irradiated in the area where additional treatment light is applied is within the permissible range (step S210). Here, the permissible range is a preset light amount, at least with an upper limit. This upper limit is a value set to prevent tissue damage due to excessive irradiation. For example, the control unit 44 determines whether the amount of light already irradiated (cumulative light amount value) in the target area designated by the surgeon or others exceeds the upper limit.

[0144] If the control unit 44 determines that the amount of light irradiated is below the allowable range (upper limit) (step S210: Yes), it returns to step S203 and repeats the above process. At this time, the latest narrowband light image in the narrowband light images obtained before the new drug reaction process (step S203) is used as the first narrowband light image before treatment, and the narrowband light image obtained after the drug reaction process is used as the second narrowband light image.

[0145] In addition, if the control unit 44 determines that the amount of light irradiated exceeds the allowable range (upper limit) (step S210: no), it moves to step S211.

[0146] In step S211, the control unit 44 outputs an alarm indicating that the amount of irradiated light exceeds the permissible range. This alarm can be displayed as text on the display device 5, or it can be configured to emit sound, light, or a combination of these. After the display device 5 displays the alarm, the control unit 44 terminates the process.

[0147] In Embodiment 2 described above, similar to Embodiment 1, the surgeon determines whether additional treatment light irradiation is needed by displaying an image obtained by overlaying a narrow-band light image depicting the tissue structure and a fluorescence image depicting the presence or absence of antibody agents on the display device 5. According to Embodiment 2, the treatment effect can be appropriately confirmed based on both changes in the tissue and blood vessels after treatment and the residual state of the antibody agents.

[0148] Furthermore, in Embodiment 2, changes in images before and after treatment are calculated using narrowband light images and fluorescence images, and these changes are displayed, allowing the surgeon to determine whether additional treatment light irradiation is necessary. According to Embodiment 2, regarding changes in tissues and blood vessels before and after treatment, the treatment effect is calculated at the tissue level based on narrowband light images depicting the tissues and blood vessels, and changes in fluorescence, which are difficult to perceive visually, are calculated as the amount of change, thus enabling appropriate determination of whether additional irradiation to the treatment area is necessary.

[0149] (Implementation Method 3)

[0150] Next, refer to Figure 15 Embodiment 3 will be described. The endoscope system in Embodiment 3 is the same as the endoscope system 1A in Embodiment 2, therefore, the description is omitted. Hereinafter, the processing that differs from Embodiment 2 will be described.

[0151] In embodiment 3, the image change calculation unit 415 divides the image into multiple regions and calculates the image change in each region. Figure 15 This is a diagram illustrating the process for determining the therapeutic effect of Embodiment 3 of the present invention. Figure 15In the example shown, the image change calculation unit 415 divides the images before and after treatment into four parts, and calculates the changes in each region (region R). A ~R D Image changes. In Figure 15 In the middle, region R A and region R B The tissue returns to a normal state through treatment, region R C and region R D The tissue, after treatment, also became a state containing cancer cells and antibody drugs. The surgeon observed narrowband light images and image changes to determine whether additional irradiation was needed for each region.

[0152] In Embodiment 3 described above, similar to Embodiment 1, the surgeon determines whether additional treatment light irradiation is needed by displaying an image obtained by overlaying a narrow-band light image depicting the tissue structure and a fluorescence image depicting the presence or absence of antibody agents on the display device 5. According to Embodiment 3, the treatment effect can be appropriately confirmed based on both changes in the tissue and blood vessels after treatment and the residual state of the antibody agents.

[0153] Furthermore, according to this embodiment 3, the narrowband light is divided into multiple regions, and the image changes of each region are calculated. Therefore, it is possible to suppress the over-irradiation of the treatment light to the part where the treatment is completed, and to continue to irradiate the part where the treatment is not completed.

[0154] (Implementation Method 4)

[0155] Next, refer to Figure 16 Implementation method 4 will be described. Figure 16 This is a block diagram illustrating the schematic structure of an endoscope system according to Embodiment 4 of the present invention. The endoscope system 1B of Embodiment 4 has a processing device 4B instead of the processing device 4A of the endoscope system 1A of Embodiment 2. The structure other than the processing device 4B is the same as that of the endoscope system 1, and therefore description is omitted.

[0156] The structure of the processing device 4B will be described. The processing device 4B includes an image processing unit 41B, a synchronization signal generation unit 42, an input unit 43, a control unit 44, and a storage unit 45.

[0157] The image processing unit 41B includes a white light image generation unit 411, a narrow band light image generation unit 412, a fluorescence image generation unit 413, a display image generation unit 414, an image change calculation unit 415, and an estimation unit 416.

[0158] The estimation unit 416 estimates the treatment effect based on the image changes calculated by the image change calculation unit 415. For example, the estimation unit 416 calculates the difference in contrast values ​​calculated as image changes of narrowband light images before and after treatment, and compares this difference with a preset threshold to estimate the treatment effect. If the difference is less than the threshold, the estimation unit 416 estimates that additional irradiation is needed. Conversely, if the difference is greater than or equal to the threshold, the estimation unit 416 estimates that treatment is complete. This estimation process can be set to... Figure 12 The processing in step S209 can also be set up as part of the change calculation processing in step S206 and the estimated result can be displayed in the display process in step S208.

[0159] When the image generation unit 414 displays the estimation result in the display process of step S208, it generates an image... Figure 14 The information display unit W2 shown in the image W2 will be displayed. 23 The information displayed is transformed into the image obtained from the estimation result. Alternatively, it can be set to display both the estimation result and the image change information.

[0160] In Embodiment 4 described above, similar to Embodiment 1, the surgeon determines whether additional treatment light irradiation is needed by displaying an image obtained by overlaying a narrow-band light image depicting the tissue structure and a fluorescence image depicting the presence or absence of antibody agents on the display device 5. According to Embodiment 4, the treatment effect can be appropriately confirmed based on both changes in the tissue and blood vessels after treatment and the residual state of the antibody agents.

[0161] Furthermore, according to this embodiment 4, the treatment effect is estimated based on the changes in the narrowband light image, and the estimation result can serve as appropriate judgment material for the surgeon to judge the treatment effect by observing the narrowband light image and the changes in the image.

[0162] (Implementation Method 5)

[0163] Next, refer to Figure 17A , 17B Embodiment 5 will be described. The endoscope system in Embodiment 5 is the same as the endoscope system 1B in Embodiment 4, therefore, the description is omitted. Hereinafter, the processing that differs from Embodiment 4 will be described.

[0164] In embodiment 5, the image change calculation unit 415 calculates the changes in the narrowband light image before and after treatment, or the image changes between the narrowband light image before treatment and the narrowband light image of normal tissue obtained in advance.

[0165] The estimation unit 416 estimates the output (irradiation intensity) of the therapeutic light based on the image changes calculated by the image change calculation unit 415. Figure 17A and Figure 17B This diagram illustrates the estimation process in Embodiment 5 of the present invention. The estimation unit 416 estimates the intensity of the therapeutic light based on the magnitude of the image change. For example, in Figure 17A In the narrowband light image shown in (a), when the image changes significantly compared to normal tissue, the estimation unit 416 sets the output of the therapeutic light to the maximum value P. MAX (Refer to Figure 17A (b)). Additionally, in Figure 17B In the narrowband light image shown in (a), when the image change is relatively small compared to normal tissue, the estimation unit 416 sets the output of the therapeutic light to a value greater than the maximum value P. MAX Small value (reference) Figure 17B (b)). At this point, a threshold corresponding to the output value is pre-set for image changes. This estimation process... Figure 12 The procedure is performed before the reagent reaction process in step S203 and after the determination in step S209 that additional irradiation will be performed (step S209: Yes).

[0166] The image generation unit 414 generates an image when displaying the estimation results. Figure 14 The information display unit W2 shown in the image W2 is... 23 The image displays information representing the output of the therapeutic light as the estimation result. Alternatively, it can be configured to display an image showing both the estimation result and information about image changes.

[0167] The surgeon observes the narrowband light image and its changes, and, referring to the estimated output value of the therapeutic light, determines whether additional irradiation is needed for each area and the output (energy) of the therapeutic light.

[0168] In Embodiment 5 described above, similar to Embodiment 1, the surgeon determines whether additional treatment light irradiation is needed by displaying an image obtained by overlaying a narrow-band light image depicting the tissue structure and a fluorescence image depicting the presence or absence of the antibody drug on the display device 5. According to Embodiment 5, the treatment effect can be appropriately confirmed based on both changes in the tissue and blood vessels after treatment and the residual state of the antibody drug.

[0169] Furthermore, according to this embodiment 5, the output of the therapeutic light is estimated based on a narrowband light image, and the estimation result can serve as appropriate judgment material for the surgeon when irradiating the therapeutic light.

[0170] (Implementation Method 6)

[0171] Next, refer to Figure 18A , 18BEmbodiment 6 will be described. The endoscope system in Embodiment 6 is the same as the endoscope system 1B in Embodiment 4, therefore, the description is omitted. Hereinafter, the processing that differs from Embodiment 4 will be described.

[0172] In embodiment 6, the image change calculation unit 415 calculates the changes in the narrowband light image before and after treatment, or the image changes between the narrowband light image before treatment and the narrowband light image of normal tissue obtained in advance.

[0173] The estimation unit 416 estimates the required intensity of the therapeutic light based on the image changes calculated by the image change calculation unit 415. Figure 18A and Figure 18B This diagram illustrates the estimation process of Embodiment 6 of the present invention. The estimation unit 416 estimates the irradiation time of the therapeutic light based on the magnitude of the image change. At this time, the therapeutic light is a pre-set output. For example, in... Figure 18A In the narrowband light image shown in (a), when the image changes significantly compared to normal tissue, the estimation unit 416 sets an irradiation time corresponding to the magnitude of the image change, for example, 70 minutes. Furthermore, in Figure 18B In the narrowband light image shown in (a), where the image change is relatively small compared to normal tissue, the estimation unit 416 is set to, for example, 15 minutes. At this time, a threshold corresponding to the irradiation time is preset for image changes. This estimation process... Figure 12 The procedure is performed before the reagent reaction process in step S203 and after the determination in step S209 that additional irradiation will be performed (step S209: Yes).

[0174] The image generation unit 414 generates an image when displaying the estimation results. Figure 14 The information display unit W2 shown in the image W2 is... 23 An image showing the irradiation time of the therapeutic light as an estimation result (e.g., reference image). Figure 18A (b) and Figure 18B (b)). Alternatively, it can be set to display information about both the estimation results and image changes on both sides of the image.

[0175] The surgeon observes the narrowband light image and its changes, and, referring to the estimated irradiation time of the treatment light, determines whether additional irradiation is needed for each area and the irradiation time of the treatment light.

[0176] In Embodiment 6 described above, similar to Embodiment 4, changes in tissue before and after treatment are calculated using narrowband light images, and information based on these changes is displayed, allowing the surgeon to determine whether additional treatment light irradiation is necessary. According to Embodiment 6, the treatment effect is calculated at the tissue level based on narrowband light images depicting tissue and blood vessels, taking into account changes in tissue and blood vessels before and after treatment; therefore, appropriate light irradiation can be applied to the treatment area.

[0177] Furthermore, according to Embodiment 6, the irradiation time of the therapeutic light is estimated based on a narrowband light image, and the estimation result can serve as appropriate judgment material for the surgeon when irradiating the therapeutic light.

[0178] In addition, in this embodiment 6, it can also be combined with embodiment 5 to output an estimated result that combines the output of the therapeutic light and the irradiation time.

[0179] In addition, in the above embodiments 5 and 6, the estimation unit 416 may also be configured to prepare a narrowband light image for comparison corresponding to the output and irradiation time of the therapeutic light in advance, and compare the features of the narrowband light image for comparison with the feature quantities of the narrowband light image of the processing object, etc., to estimate the output and irradiation time of the therapeutic light.

[0180] (Implementation Method 7)

[0181] Next, refer to Figure 19 Implementation method 7 will be described. Figure 19 This is a block diagram illustrating the schematic structure of the endoscope system according to Embodiment 7 of the present invention. The endoscope system 1C of Embodiment 7 has the same structure as the endoscope system 1B of Embodiment 4. In the endoscope system 1C, the processing device 4B is electrically connected to the treatment device 6, and the emission of therapeutic light from the treatment device 62 is controlled by the control unit 44.

[0182] In the case of PIT implementation, processing unit 4B follows Figure 12 The process is executed. During the irradiation of the therapeutic light, the control unit 44 controls the irradiation range, timing, and duration of the therapeutic light. Specifically, the control unit 44, for example, sets the light intensity (output value) of the preset irradiation amount and the irradiation time for the irradiation range set by the surgeon. The control unit 44 initiates the irradiation control of the therapeutic light by pressing the switch of the operation input unit 611. Furthermore, during additional irradiation, the control unit 44 sets the shape of the irradiation range of the therapeutic light emitted from the treatment device 62 according to the boundary area of ​​the object, and initiates the irradiation control of the therapeutic light by pressing the switch of the operation input unit 611.

[0183] Furthermore, in this embodiment 7, the control unit 44 follows... Figure 12 The flowchart describes the alternating emission of narrowband light and therapeutic light. Alternatively, narrowband light and therapeutic light can be emitted simultaneously.

[0184] In Embodiment 7 described above, similar to Embodiment 4, changes in tissue before and after treatment are calculated using narrowband light images, and information based on these changes is displayed, allowing the surgeon to determine whether additional treatment light irradiation is necessary. According to Embodiment 7, the treatment effect is calculated at the tissue level based on narrowband light images depicting tissue and blood vessels, taking into account changes in tissue and blood vessels before and after treatment; therefore, appropriate light irradiation can be applied to the treatment area.

[0185] Furthermore, according to this embodiment 7, the irradiation process of the therapeutic light is controlled by the control unit 44, thereby reducing the burden on the surgeon.

[0186] In the embodiments 1 to 7 described above, an example of separate light source device 3 and processing device 4 was described, but it is also possible to configure a structure in which the light source device 3 and processing device 4 are integrated. Furthermore, in embodiments 1 to 7, an example of irradiating therapeutic light by a treatment device was described, but it is also possible to configure a structure in which therapeutic light is emitted by the light source device 3.

[0187] Furthermore, in embodiments 1 to 7 described above, the excitation light and the treatment light can be the same wavelength (same center wavelength) or different wavelengths (center wavelength). Additionally, when the excitation light and treatment light are used together, the treatment light (excitation light) can be irradiated simply by the treatment device 62 or the excitation light source; it is also possible to configure the device without either the excitation light source or the treatment device 62. When stimulating the antibody agent for PIT, for example, near-infrared light with a center wavelength of 690 nm is used. P .

[0188] Furthermore, in the above embodiments 1 to 7, it was described that the endoscope system of the present invention is an endoscope system 1 using a flexible endoscope 2, and the object of observation of the endoscope 2 is living tissue in the body being examined. However, it can also be applied to endoscope systems that use a structure that connects the eyepiece of an optical endoscope such as a rigid endoscope, an industrial endoscope for observing material properties, a fiber endoscope, or an optical viewing tube to a camera.

[0189] (Additional Notes)

[0190] A phototherapy method includes the following steps:

[0191] Apply phototherapy medication to the treatment area;

[0192] Irradiate the treatment area with therapeutic light to cause a reaction of the drug that is bound to the treatment area;

[0193] Irradiate the treatment area with narrowband light and obtain a narrowband light image after treatment;

[0194] Excitation light is irradiated onto the treatment site to obtain a fluorescence image after treatment;

[0195] Generate an overlay image obtained by superimposing the narrowband light image and the fluorescence image; and

[0196] The overlapping image is used to determine whether to continue irradiating the treatment light.

[0197] Industrial availability

[0198] As described above, the phototherapy device, phototherapy method, and phototherapy procedure of the present invention are useful for properly confirming the therapeutic effect.

[0199] Explanation of reference numerals in the attached figures

[0200] 1. 1A~1C Endoscopic Systems

[0201] 2 Endoscope

[0202] 3 Light Source Device

[0203] 4. Processing devices 4A and 4B

[0204] 5 display devices

[0205] 6. Handling equipment and devices

[0206] 21 Insertion section

[0207] 22 Operations Department

[0208] 23 General purpose cables

[0209] 24. Front end

[0210] 25. Bend

[0211] 26 Flexible tube section

[0212] 31 Light Source Section

[0213] 32 Lighting Control Department

[0214] 33 Light source driver

[0215] Image processing units 41, 41A, and 41B

[0216] 42 Synchronization Signal Generation Unit

[0217] 43 Input Section

[0218] 44 Control Department

[0219] 45 Storage Section

[0220] 61. Handling Equipment Operation Section

[0221] 62. Handling equipment

[0222] 241 Optical Guide

[0223] 242 Illumination Lens

[0224] 243 Optical System

[0225] 244 camera elements

[0226] 311 White light source

[0227] 312 Narrowband Light Source

[0228] 411 White Light Image Generation Unit

[0229] 412 Narrowband Light Image Generation Unit

[0230] 413 Fluorescence Image Generation Unit

[0231] 414 Display Image Generation Unit

[0232] 415 Image Change Calculation Unit

[0233] 416 Estimation Department

Claims

1. A phototherapy device, comprising: The therapeutic light emitting section emits therapeutic light that causes the drug to react. Narrowband light emitting section, which emits narrowband light consisting of a portion of the wavelength range of the visible light region; An excitation light emitting section emits excitation light that excites the drug. A narrowband light image acquisition unit acquires a narrowband light image obtained by the narrowband light illuminating the irradiation position of the therapeutic light; A fluorescence image acquisition unit acquires a fluorescence image obtained by excitation light irradiating the irradiation position of the therapeutic light; The image change calculation unit calculates the temporal changes of the narrowband light image before and after the treatment light irradiation; as well as The display image generation unit generates an overlay image obtained by superimposing the narrowband light image and the fluorescence image, as well as an image that visually represents the temporal changes of the narrowband light image.

2. The phototherapy device according to claim 1, wherein, The image change calculation unit calculates the time-varying changes in fluorescence intensity in the fluorescence images before and after therapeutic light irradiation.

3. The phototherapy device according to claim 1, wherein, The display image generation unit generates the overlapping image by overlapping the narrowband light image and the fluorescence image with brightness or transparency settings respectively for the narrowband light image and the fluorescence image.

4. The phototherapy device according to claim 1, wherein, The image change calculation unit divides the narrowband light image into multiple regions and calculates the amount of change in the image in each of the divided regions.

5. The phototherapy device according to claim 1, wherein, The display image generation unit generates a display image formed by arranging the overlapping image before the treatment light irradiation and the overlapping image after the treatment light irradiation.

6. The phototherapy device according to claim 1, wherein, The phototherapy device also includes an estimation unit that estimates the output of the therapeutic light based on changes in the image calculated by the image change calculation unit.

7. The phototherapy device according to claim 1, wherein, The phototherapy device also includes an estimation unit that estimates the irradiation time of the therapeutic light based on the image changes calculated by the image change calculation unit.

8. A computer program product comprising a computer program that, when executed by a processor, performs the following steps for confirming the therapeutic effect after irradiating a treatment site with therapeutic light that causes a pharmaceutical response: The narrowband light image acquisition step involves acquiring a narrowband light image obtained by passing through narrowband light, which illuminates the irradiation position of the therapeutic light that causes the drug to react, and is composed of a portion of the wavelength of light in the visible light region; The fluorescence image acquisition step involves acquiring a fluorescence image obtained by excitation light, which illuminates the irradiation position of the therapeutic light and excites the drug. The image change calculation step calculates the temporal changes in the narrowband light image before and after the therapeutic light irradiation; and The image generation step involves generating an overlay image obtained by superimposing the narrowband light image and the fluorescence image, as well as an image that visually represents the temporal changes of the narrowband light image.

9. A computer-readable storage medium storing a computer program that, when executed by a processor, performs the following steps to generate information for confirming the therapeutic effect after irradiating a treatment site with therapeutic light that causes a drug reaction, the steps including: The narrowband light image acquisition step involves acquiring a narrowband light image obtained by passing through narrowband light, which illuminates the irradiation position of the therapeutic light that causes the drug to react, and is composed of a portion of the wavelength of light in the visible light region; The fluorescence image acquisition step involves acquiring a fluorescence image obtained by excitation light, which illuminates the irradiation position of the therapeutic light and excites the drug. The image change calculation step calculates the temporal changes of the narrowband light image before and after the treatment light irradiation; as well as The image generation step involves generating an overlay image obtained by superimposing the narrowband light image and the fluorescence image, as well as an image that visually represents the temporal changes of the narrowband light image.

Images