Medical device, medical system, method for operating medical device, and program

Abstract

Provided are a medical device, a medical system, a method for operating a medical device, and a program with which it is possible to confirm the state of coagulation degeneration with respect to blood vessels. This medical device is provided with a processor that performs: a process for acquiring a display image in which a blood vessel region of a blood vessel in a subject is identified, and a fluorescence image that overlaps at least a part of a field-of-view region of the display image; determining thermal denaturation information in the blood vessel region on the basis of the display image and the fluorescence image; and outputting the thermal denaturation information.

Description

Technical Field

[0001] The present disclosure relates to a medical device, a medical system, an operating method of the medical device, and a program. Background Art

[0002] Conventionally, a technique for visualizing the state of cauterization of a subject, such as biological tissue, using an energy device or the like is known in the medical field (see, for example, Patent Document 1). This technique irradiates the subject with excitation light and displays an image and information containing fluorescence image data generated based on an imaging signal acquired by capturing fluorescence generated from a heat-affected region of the subject in response to the excitation light, thereby visualizing the state of cauterization for a user, such as a surgeon.

[0003] Prior art literature

[0004] Patent Literature

[0005] Patent Document 1: International Publication No. 2020 / 054723 Summary of the Invention

[0006] Problems to be solved by the invention

[0007] Endoscopic submucosal dissection (ESD) is also a widely used treatment for early-stage gastric cancer. During ESD, the surgeon uses an energy device, such as a hemostatic forceps, to pre-coagulate blood vessels in the dissection area to prevent bleeding.

[0008] However, since operators judge the state of coagulation and degeneration of blood vessels to be subjected to preliminary coagulation treatment based on their own experience, a technique capable of confirming the state of coagulation and degeneration of blood vessels is desired.

[0009] The present disclosure has been made in view of the above, and an object of the present disclosure is to provide a medical device, a medical system, an operating method of the medical device, and a program that can confirm the state of coagulation and denaturation of a blood vessel.

[0010] Solutions for solving problems

[0011] In order to solve the above-mentioned problems and achieve the purpose, the medical device involved in the present disclosure is a medical device equipped with a processor, wherein the processor performs the following processing: obtaining a display image that determines the vascular area of ​​the blood vessels in the subject and a fluorescence image that overlaps at least a portion of the field of view area of ​​the display image; determining thermal denaturation information in the vascular area based on the display image and the fluorescence image; and outputting the thermal denaturation information.

[0012] In the medical device according to the present disclosure, in the above disclosure, the processor performs the following processing: generating a composite image by combining the thermal denaturation information and the blood vessel region of the display image; and outputting the composite image.

[0013] Furthermore, in the medical device according to the present disclosure, in the above disclosure, the processor superimposes the thermal denaturation information on the blood vessel region of the display image and outputs the resultant information.

[0014] In the medical device according to the present disclosure, in the above disclosure, the processor performs the following processing: acquiring an imaging signal capturing fluorescence emitted from the thermally denatured region; and generating the fluorescence image based on the imaging signal.

[0015] In the medical device according to the present disclosure, in the above disclosure, the fluorescence is generated from advanced glycation end products produced by heat treatment of biological tissue.

[0016] In the medical device according to the present disclosure, in the above disclosure, the processor determines the thermal denaturation information based on a signal value of each pixel constituting the fluorescent image.

[0017] Furthermore, in the medical device according to the present disclosure, in the above disclosure, the processor specifies, as the thermal denaturation information, a region having a low thermal coagulation level based on a signal value of each pixel constituting the fluorescent image.

[0018] In the medical device according to the present disclosure, the processor performs the following processing: determining whether the signal value of each pixel constituting the fluorescent image is less than a predetermined value; and determining a region of pixels having signal values ​​less than the predetermined value as a region with a low thermal coagulation level.

[0019] Furthermore, in the medical device according to the present disclosure, in the above disclosure, the processor determines the thermal coagulation level in the blood vessel region.

[0020] In the medical device according to the present disclosure, in the above disclosure, the processor outputs the region where the thermal coagulation level is lower than a predetermined value so as to be distinguishable from the region where the thermal coagulation level is higher than the predetermined value.

[0021] In the medical device according to the present disclosure described above, the display image is an image in which the blood vessel region is specified based on a feature value in a white-light image.

[0022] Furthermore, in the medical device according to the present disclosure described above, the display image is an image in which the blood vessel region is specified based on a feature value in the special light image.

[0023] In the medical device according to the present disclosure described above, the display image is an image in which the blood vessel region is specified based on a feature value in a white-light image.

[0024] Furthermore, in the medical device according to the present disclosure described above, the display image is an image in which the blood vessel region is specified based on a feature value in the special light image.

[0025] In the medical device according to the present disclosure, in the above disclosure, the processor generates the display image based on a white light image and a blood vessel identification image in the same field of view area as the white light image.

[0026] In the medical device according to the present disclosure, in the above disclosure, the processor performs the following processing: acquiring a blood vessel identification image; and superimposing a blood vessel region identified based on the blood vessel identification image on a white light image to generate the display image.

[0027] In the medical device according to the present disclosure described above, the blood vessel identification image is an image acquired using narrowband light determined based on the absorbance of blood.

[0028] In the medical device according to the present disclosure, in the above disclosure, the blood vessel identification image is a narrow-band light observation image.

[0029] In the medical device according to the present disclosure, in the above disclosure, the blood vessel identification image is a red light observation image.

[0030] In addition, the medical system involved in the present disclosure is a medical system comprising a light source device, an imaging device, and a medical device, wherein the light source device has a light source that emits excitation light, the excitation light being used to excite glycation end products produced by heat treatment of biological tissue, the imaging device has an imaging element that generates an imaging signal by capturing fluorescence emitted by the excitation light, and the medical device has a processor that performs the following processing: acquiring, from the imaging element, a display image that identifies a vascular region of a blood vessel in a subject and a fluorescence image that overlaps at least a portion of a field of view area of ​​the display image; determining thermal denaturation information in the vascular region based on the display image and the fluorescence image; and outputting the thermal denaturation information.

[0031] In addition, the operating method of the medical device involved in the present disclosure is an operating method of a medical device equipped with a processor, wherein the processor performs the following processing: acquiring a display image that identifies a vascular area of ​​a blood vessel in a subject and a fluorescence image that overlaps at least a portion of the field of view area of ​​the display image; determining thermal denaturation information in the vascular area based on the display image and the fluorescence image; and outputting the thermal denaturation information.

[0032] In addition, the program involved in the present disclosure is a program executed by a medical device equipped with a processor, and the program causes the processor to perform the following processing: obtaining a display image that identifies a vascular area of ​​a blood vessel in a subject and a fluorescence image that overlaps at least a portion of the field of view area of ​​the display image; determining thermal denaturation information in the vascular area based on the display image and the fluorescence image; and outputting the thermal denaturation information.

[0033] Effects of the Invention

[0034] According to the present disclosure, it is possible to confirm the state of coagulation and denaturation of blood vessels. BRIEF DESCRIPTION OF THE DRAWINGS

[0035] Figure 1 This is a diagram showing a schematic configuration of an endoscope system according to one embodiment.

[0036] Figure 2 This is a block diagram showing the functional configuration of a main portion of an endoscope system according to one embodiment.

[0037] Figure 3 This is a diagram schematically showing the wavelength characteristics of excitation light emitted by a light source unit according to one embodiment.

[0038] Figure 4 A diagram schematically showing a structure of a pixel portion according to one embodiment.

[0039] Figure 5 Schematic diagram of the structure of a color filter according to one embodiment.

[0040] Figure 6 This is a diagram schematically showing the sensitivity and wavelength range of each filter according to one embodiment.

[0041] Figure 7A Schematically shows the signal value of the R pixel of the imaging element according to one embodiment.

[0042] Figure 7B Schematically shows the signal value of the G pixel of the image sensor according to one embodiment.

[0043] Figure 7C Schematically shows the signal value of the B pixel of the image sensor according to one embodiment.

[0044] Figure 8 It is a diagram schematically showing the structure of a cut filter according to one embodiment.

[0045] Figure 9 This is a diagram schematically showing the transmission characteristics of a cut filter according to one embodiment.

[0046] Figure 10 This is a flowchart showing an overview of processing executed by a control device according to one embodiment.

[0047] Figure 11 This is a diagram showing an example of a white-light image generated by a generating unit according to one embodiment.

[0048] Figure 12 FIG. 1 is a diagram schematically showing a detection result of a blood vessel region in a white-light image by a detection unit according to one embodiment.

[0049] Figure 13 This is a diagram schematically showing the correspondence between the signal value of a fluorescence image, the degree of thermal denaturation, and the thermal coagulation level of a blood vessel according to one embodiment.

[0050] Figure 14 This is a diagram showing an example of a synthesized image generated by a synthesizing unit according to one embodiment. DETAILED DESCRIPTION

[0051] The following is a method for implementing the present disclosure and the attached Figure 1 Detailed description will be given below. In addition, the present disclosure is not limited to the following embodiments. In addition, the figures referred to in the following description are merely schematic illustrations of shapes, sizes and positional relationships to the extent that the contents of the present disclosure can be understood. That is, the present disclosure is not limited to the shapes, sizes and positional relationships illustrated in the figures. Moreover, in the description of the drawings, the same parts are marked with the same figure numbers for description. In addition, as an example of the endoscope system involved in the present disclosure, an endoscope system including a rigid endoscope and a medical imaging device is described.

[0052] [Structure of the endoscope system]

[0053] Figure 1 This is a diagram showing a schematic configuration of an endoscope system according to one embodiment. Figure 1 The endoscope system 1 shown is a system used in the medical field to observe and treat biological tissues in a subject such as a living body. Figure 1 The rigid endoscope system shown in FIG. 1 is a rigid endoscope system having a rigid endoscope (insertion portion 2), but the present invention is not limited thereto and may also include, for example, an endoscope system having a flexible endoscope. Furthermore, the endoscope system 1 can also be applied to a medical microscope or medical surgical robot system that includes a medical imaging device for imaging a subject and performs surgery or treatment while displaying an observation image based on an imaging signal (image data) captured by the medical imaging device on a display device. Furthermore, in recent years, minimally invasive treatments using endoscopes and laparoscopes have become widespread in the medical field. For example, as minimally invasive treatments using endoscopes and laparoscopy, endoscopic submucosal dissection (ESD), laparoscopic endoscopic combined gastrectomy (LECS), non-exposed endoscopic wall-inversion surgery (NEWS), and transurethral resection of the bladder tumor (TUR-bt) are widely performed. In these minimally invasive treatments, when performing treatments on living tissue, for example, doctors use treatment instruments that emit energy such as high-frequency waves, ultrasound waves, and microwaves to remove characteristic areas (pathogenic areas) of the lesion by cauterization or mark the characteristic areas (pathogenic areas) of the lesion by thermal treatment, thereby marking the surgical area as a preliminary treatment. In addition, in the case of actual treatment, the surgeon also uses energy devices to perform treatments such as excision and coagulation of the subject's biological tissue. Figure 1 The endoscope system 1 shown is used when performing surgery or treatment on a subject using a treatment instrument (not shown) such as an energy device capable of performing heat treatment. Figure 1 The endoscope system 1 shown is used for endoscopic submucosal dissection (ESD).

[0054] Figure 1 The endoscope system 1 shown includes an insertion portion 2, a light source device 3, a light guide 4, an endoscopic camera 5 (an imaging device for an endoscope), a first transmission cable 6, a display device 7, a second transmission cable 8, a control device 9, a third transmission cable 10, an irrigation device 11, and a fourth transmission cable 12.

[0055] The insertion portion 2 is rigid or at least partially flexible and has an elongated shape. The insertion portion 2 is inserted into a subject such as a patient via a cannula. The insertion portion 2 is internally provided with an optical system such as a lens for forming an observation image.

[0056] The light source device 3 is connected to one end of the light guide 4. Under the control of the control device 9, the light source device 3 supplies illumination light to the one end of the light guide 4 to irradiate the subject. The light source device 3 is implemented using the following components: any one or more light sources such as LED (Light Emitting Diode: Light Emitting Diode) light source, xenon lamp and LD (Laser Diode: Laser Diode) semiconductor laser element; a processor as a processing device having hardware such as FPGA (Field Programmable Gate Array: Field Programmable Gate Array), CPU (Central Processing Unit: Central Processing Unit); and a memory as a temporary storage area used by the processor. In addition, the light source device 3 and the control device 9 can be as follows: Figure 1 Although the structure is set as a structure in which communication is performed individually as shown, it can also be an integrated structure.

[0057] One end of the light guide 4 is detachably connected to the light source device 3 , and the other end is detachably connected to the insertion portion 2 . The light guide 4 guides illumination light supplied from the light source device 3 from one end to the other end, and supplies the illumination light to the insertion portion 2 .

[0058] The endoscope camera head 5 is detachably connected to the eyepiece portion 21 of the insertion portion 2. Under the control of the control device 9, the endoscope camera head 5 receives the observation image formed by the insertion portion 2 and performs photoelectric conversion to generate an imaging signal (RAW data). The imaging signal is output to the control device 9 via the first transmission cable 6.

[0059] One end of the first transmission cable 6 is detachably connected to the control device 9 via a video connector 61, and the other end is detachably connected to the endoscopic camera 5 via a camera connector 62. The first transmission cable 6 transmits the imaging signal output from the endoscopic camera 5 to the control device 9, and transmits setting data and power output from the control device 9 to the endoscopic camera 5. Here, the setting data refers to control signals, synchronization signals, clock signals, and the like for controlling the endoscopic camera 5.

[0060] The display device 7 displays an observation image based on an imaging signal processed by the control device 9 and various information related to the endoscope system 1 under the control of the control device 9. The display device 7 is implemented using a display monitor such as liquid crystal or organic EL (Electro Luminescence).

[0061] One end of the second transmission cable 8 is detachably connected to the display device 7 , and the other end is detachably connected to the control device 9 . The second transmission cable 8 transmits the image signal processed by the control device 9 to the display device 7 .

[0062] The control device 9 is implemented using the following components: a processor (including hardware such as a GPU (Graphics Processing Unit), FPGA, or CPU) as a processing device; and memory as a temporary storage area used by the processor. The control device 9 comprehensively controls the operation of the light source device 3, the endoscopic camera head 5, and the display device 7 via the first transmission cable 6, the second transmission cable 8, and the third transmission cable 10, in accordance with a program stored in the memory. Furthermore, the control device 9 performs various image processing on the imaging signal input via the first transmission cable 6 and outputs it to the second transmission cable 8.

[0063] One end of the third transmission cable 10 is detachably connected to the light source device 3 , and the other end is detachably connected to the control device 9 . The third transmission cable 10 transmits control data from the control device 9 to the light source device 3 .

[0064] [Functional structure of the main parts of the endoscope system]

[0065] Next, the functional configuration of the main parts of the endoscope system 1 will be described. Figure 2 1 is a block diagram showing the functional configuration of the main parts of the endoscope system 1 .

[0066] [Structure of the insertion part]

[0067] First, the structure of the insertion portion 2 will be described. The insertion portion 2 includes an optical system 22 and an illumination optical system 23 .

[0068] The optical system 22 forms an image of the subject by converging reflected light from the subject, return light from the subject, excitation light from the subject, and fluorescent light emitted from thermally denatured areas thermally denatured by heat treatment with an energy device, etc. The optical system 22 is implemented using one or more lenses, etc.

[0069] The illumination optical system 23 irradiates the subject with illumination light supplied from the light guide 4. The illumination optical system 23 is implemented using one or more lenses and the like.

[0070] [Structure of light source device]

[0071] Next, a description will be given of a configuration of the light source device 3 . The light source device 3 includes a condenser lens 30 , a first light source unit 31 , a third light source unit 33 , and a light source control unit 34 .

[0072] The condenser lens 30 condenses the light emitted from the first light source unit 31 and the third light source unit 33 and emits the light toward the light guide 4 .

[0073] Under the control of the light source control unit 34, the first light source unit 31 emits white light (normal light) as visible light, thereby supplying white light as illumination light to the light guide 4. The first light source unit 31 is constructed using a collimating lens, a white LED lamp, and a driver. Alternatively, the first light source unit 31 can simultaneously emit red, green, and blue LED lamps to supply visible white light. Of course, the first light source unit 31 can also be constructed using a halogen lamp, a xenon lamp, or the like.

[0074] Under the control of the light source control unit 34, the second light source unit 32 emits first narrowband light having a predetermined wavelength range, thereby supplying the first narrowband light as illumination light to the light guide 4. The wavelength of the first narrowband light is 530 nm to 550 nm (with a center wavelength of 540 nm). The second light source unit 32 is constructed using a green LED lamp, a collimating lens, a transmission filter that transmits light in the 530 nm to 550 nm range, and a driver.

[0075] Under the control of the light source control unit 34, the third light source unit 33 emits a second narrowband light having a wavelength range different from that of the first narrowband light, thereby supplying the second narrowband light as illumination light to the light guide 4. The wavelength range of the second narrowband light is 400 nm to 430 nm (with a center wavelength of 415 nm). The third light source unit 33 is implemented using a collimating lens, a semiconductor laser such as a violet laser diode (LD), and a driver. Furthermore, in one embodiment, the second narrowband light functions as excitation light for advanced glycation end products (AGEs) produced by heat treatment of biological tissue using an energy device or the like. Furthermore, when amino acids and reducing sugars are heated, a glycation reaction (Maillard reaction) occurs. The end products produced as a result of this Maillard reaction are collectively referred to as advanced glycation end products (AGEs). AGEs are known to contain substances with fluorescent properties. Specifically, AGEs are generated when heat treatment of biological tissue using an energy device heats amino acids and reducing sugars in the tissue, causing the Maillard reaction. The AGEs generated by this heating can be used to visualize the state of the heat treatment by fluorescence observation. In addition, it is known that AGEs emit stronger fluorescence than the autofluorescent substances originally present in the biological tissue. That is, in one embodiment, the fluorescence characteristics of AGEs generated in the biological tissue by heat treatment by an energy device or the like are used to visualize the thermal denaturation area caused by the heat treatment. Therefore, in one embodiment, excitation light of blue light with a wavelength of about 415 nm for exciting AGEs is irradiated from the third light source unit 33 to the biological tissue. Thus, one embodiment can observe a fluorescence image (thermal denaturation image) based on an imaging signal that captures fluorescence (for example, green light with a wavelength of 490 nm to 625 nm) emitted from the thermal denaturation area generated by AGEs.

[0076] The light source control unit 34 is implemented using a processor having hardware such as an FPGA or a CPU, and a memory serving as a temporary storage area used by the processor. The light source control unit 34 controls the light emission timing and light emission duration of each of the first light source unit 31 and the third light source unit 33 based on control data input from the control device 9.

[0077] Here, the wavelength characteristics of the light emitted by each of the second light source unit 32 and the third light source unit 33 will be described. Figure 3 Schematically shows the wavelength characteristics of the light emitted by the second light source unit 32 and the third light source unit 33. Figure 3 In the figure, the horizontal axis represents wavelength (nm) and the vertical axis represents wavelength characteristics. Figure 3 Middle, broken line L NGThe broken line L represents the wavelength characteristic of the first narrowband light emitted by the second light source unit 32. V represents the wavelength characteristics of the second narrowband light (excitation light) emitted by the third light source unit 33. Figure 3 In the middle, curve L B Indicates the wavelength range of blue, curve L G Indicates the wavelength range of green, curve L R Indicates the wavelength range of red.

[0078] like Figure 3 The broken line L NG As shown, the second light source unit 32 emits narrowband light with a central wavelength (peak wavelength) of 540 nm and a wavelength range of 530 nm to 550 nm. In addition, the third light source unit 33 emits excitation light with a central wavelength (peak wavelength) of 415 nm and a wavelength range of 400 nm to 430 nm.

[0079] In this manner, the second light source unit 32 and the third light source unit 33 respectively emit the first narrowband light and the second narrowband light (excitation light) having wavelength ranges different from each other.

[0080] Furthermore, the first narrowband light serves as light for layer discrimination in living tissue. Specifically, the difference in absorbance of the first narrowband light by the mucous membrane layer, the subject, and the muscularis layer, the subject, is large enough to allow for identification of the two subjects. Therefore, in the second layer discrimination image obtained by irradiating the first narrowband light for layer discrimination, the region capturing the mucous membrane layer has smaller and darker pixel values ​​(brightness values) than the region capturing the muscularis layer. In other words, in one embodiment 1, by using the second layer discrimination image for display image generation, the mucous membrane layer and muscularis layer can be displayed in a manner that makes them easily distinguishable.

[0081] Furthermore, the second narrowband light (excitation light) is different from the first narrowband light and is used for layer discrimination in living tissue. Specifically, the difference in absorbance of the second narrowband light by the muscle layer, the subject, and the fat layer, the subject, is large enough to allow for identification of the two subjects. Therefore, in the second light layer discrimination image obtained by irradiating the second narrowband light for layer discrimination, the areas capturing the muscle layer have smaller and darker pixel values ​​(brightness values) than the areas capturing the fat layer. In other words, by using the second layer discrimination image for display image generation, the muscle layer and fat layer can be easily distinguished.

[0082] The mucosal layer (organism mucosa) and the muscular layer are both subjects that contain a large amount of myoglobin. However, the concentration of myoglobin contained in the mucosal layer is relatively high and relatively low in the muscular layer. The reason for the difference in the light absorption characteristics of the mucosal layer and the muscular layer is the difference in the myoglobin concentration contained in the mucosal layer (organism mucosa) and the muscular layer. Moreover, the difference in absorbance between the mucosal layer and the muscular layer is greatest near the wavelength at which the absorbance of the organism mucosa reaches its maximum. In other words, the first narrowband light used for layer discrimination becomes light that more significantly shows the difference between the mucosal layer and the muscular layer than light with a peak wavelength in other wavelength ranges.

[0083] Furthermore, because the absorbance of the second narrowband light by fat is lower than that of the muscle layer, in the second image captured by irradiation with the second narrowband light for layer discrimination, the pixel values ​​(brightness values) of the region capturing the muscle layer are smaller than the pixel values ​​(brightness values) of the region capturing the fat layer. In particular, since the second narrowband light for layer discrimination corresponds to a wavelength where the absorbance of the muscle layer reaches a maximum, the difference between the muscle layer and the fat layer is prominent. Specifically, the difference between the pixel values ​​(brightness values) of the muscle layer region and the fat layer region in the second image for layer discrimination is large enough to be discernible.

[0084] In this manner, the light source device 3 irradiates the living tissue with each of the first narrowband light and the second narrowband light. Thus, the endoscopic camera head 5, described later, can capture the return light from the living tissue to obtain an image capable of identifying each of the mucosal, muscular, and fat layers that constitute the living tissue and identifying the vascular region.

[0085] [Structure of endoscope camera]

[0086] return Figure 2 , the structure of the endoscope system 1 is further described.

[0087] Next, the configuration of the endoscopic camera head 5 will be described. The endoscopic camera head 5 includes an optical system 51, a drive unit 52, an imaging element 53, a cut filter 54, an A / D converter 55, a P / S converter 56, an imaging and recording unit 57, and an imaging control unit 58.

[0088] The optical system 51 forms an image of the subject, focused by the optical system 22 of the insertion portion 2, onto the light-receiving surface of the imaging element 53. The optical system 51 is capable of changing the focal length and focus position. The optical system 51 is constructed using a plurality of lenses 511. The optical system 51 changes the focal length and focus position by moving each of the plurality of lenses 511 along the optical axis L1 via the drive unit 52.

[0089] The drive unit 52 moves the multiple lenses 511 of the optical system 51 along the optical axis L1 under the control of the imaging control unit 58. The drive unit 52 is configured using a motor such as a stepping motor, a DC motor, or a voice coil motor, and a transmission mechanism such as gears that transmits the motor's rotation to the optical system 51.

[0090] The imaging element 53 is implemented using a CCD (Charge Coupled Device) or CMOS (Complementary Metal Oxide Semiconductor) image sensor having a plurality of pixels arranged in a two-dimensional matrix. Under the control of the imaging control unit 58, the imaging element 53 receives the subject image (light) formed by the optical system 51 and passed through the cut filter 54, performs photoelectric conversion on the subject image, generates an imaging signal (RAW data), and outputs it to the A / D converter 55. The imaging element 53 includes a pixel unit 531 and a color filter 532.

[0091] Figure 4 Schematic diagram showing the structure of the pixel portion 531. Figure 4 As shown, the pixel portion 531 is composed of a plurality of pixels P such as photodiodes that store charges according to the amount of light. nm (n=integer greater than or equal to 1, m=integer greater than or equal to 1) are arranged in a two-dimensional matrix. The pixel unit 531 is controlled by the imaging control unit 58 to obtain a plurality of pixels P nm The pixel P in the reading area arbitrarily set as the reading object nm The image signal is read as image data and output to the A / D conversion unit 55 .

[0092] Figure 5 Schematically shows the structure of the color filter 532. Figure 5 As shown, the color filter 532 is formed of a Bayer array with 2×2 units. The color filter 532 is composed of a filter R that transmits light in the red wavelength range, two filters G that transmit light in the green wavelength range, and a filter B that transmits light in the blue wavelength range.

[0093] Figure 6 is a diagram schematically showing the sensitivity and wavelength range of each filter. Figure 6 In the figure, the horizontal axis represents wavelength (nm) and the vertical axis represents transmission characteristics (sensitivity characteristics). Figure 6 In the middle, curve L B Indicates the transmission characteristics of filter B, curve L G Indicates the transmission characteristics of filter G, curve L R Indicates the transmission characteristics of filter R.

[0094] like Figure 6 The curve L B As shown in FIG, filter B transmits light in the blue wavelength range. Figure 6 The curve L G As shown in FIG, the filter G transmits light in the green wavelength range. Figure 6 The curve L R As shown, the filter R transmits light in the red wavelength range. In the following, the filter R is arranged on the light receiving surface to form a pixel P. nm The pixel P is formed by placing the filter G on the light receiving surface. nm The pixel P is formed by placing the filter B on the light receiving surface. nm This will be described as a B pixel.

[0095] According to the imaging element 53 configured in this manner, when receiving the subject image formed by the optical system 51, Figures 7A to 7C As shown, color signals (R signal, G signal, and B signal) are generated for each of the R pixel, the G pixel, and the B pixel.

[0096] return Figure 2 , the structure of the endoscope system 1 is further described.

[0097] The cutoff filter 54 is disposed on the optical axis L1 between the optical system 51 and the imaging element 53. The cutoff filter 54 is provided on the light-receiving surface side (incident surface side) of at least the G pixel of the color filter 532, which is provided with the filter G that transmits the green wavelength range. The cutoff filter 54 blocks light in the short wavelength range including the wavelength range of the excitation light, and transmits light in the long wavelength range that is longer than the wavelength range of the excitation light.

[0098] Figure 8 Schematically shows the structure of the cut filter 54. Figure 8 As shown, the filter F constituting the cutoff filter 54 11 Configured on filter G 11 (Refer to Figure 5 ) is configured at a position where the filter G 11 The light-receiving side directly above the .

[0099] Figure 9 is a diagram schematically showing the transmission characteristics of the cut filter 54. Figure 8 In the figure, the horizontal axis represents wavelength (nm) and the vertical axis represents transmittance. Figure 8 Middle, broken line L F The transmission characteristics of the cut filter 54 are shown in FIG. NGThe wavelength characteristic of fluorescence, the broken line L V Indicates the wavelength characteristics of the excitation light.

[0100] like Figure 9 As shown, the cutoff filter 54 blocks light in the wavelength range of the excitation light and transmits light in a wavelength range longer than the wavelength range of the excitation light. Specifically, the cutoff filter 54 blocks light in a wavelength range shorter than the wavelength range of 400 nm to 430 nm, which includes the excitation light, and transmits light in a wavelength range longer than the wavelength range of 400 nm to 430 nm, which includes the excitation light.

[0101] return Figure 2 , continue to explain the structure of the endoscope camera 5.

[0102] Under the control of the imaging control unit 58, the A / D converter 55 performs A / D conversion processing on the analog imaging signal input from the imaging element 53 and outputs the resulting signal to the P / S converter 56. The A / D converter 55 is implemented using an A / D conversion circuit or the like.

[0103] Under the control of the camera control unit 58, the P / S conversion unit 56 performs parallel / serial conversion on the digital camera signal input from the A / D conversion unit 55, and outputs the camera signal after the parallel / serial conversion to the control device 9 via the first transmission cable 6. The P / S conversion unit 56 is implemented using a P / S conversion circuit, etc. In one embodiment, an E / O conversion unit that converts the camera signal into an optical signal can be provided instead of the P / S conversion unit 56, and the camera signal can be output to the control device 9 via an optical signal. Alternatively, the camera signal can be transmitted to the control device 9 via wireless communication such as Wi-Fi (Wireless Fidelity) (registered trademark).

[0104] The image recording unit 57 records various information related to the endoscopic camera head 5 (e.g., pixel information of the image sensor 53 and characteristics of the cutoff filter 54). Furthermore, the image recording unit 57 records various setting data and control parameters transmitted from the control device 9 via the first transmission cable 6. The image recording unit 57 is configured using a nonvolatile memory or a volatile memory.

[0105] The imaging control unit 58 controls the operation of the drive unit 52, the imaging element 53, the A / D converter 55, and the P / S converter 56 based on the setting data received from the control device 9 via the first transmission cable 6. The imaging control unit 58 is implemented using the following components: a TG (Timing Generator); a processor including hardware such as an ASIC (Application Specific Integrated Circuit) or a CPU; and a memory serving as a temporary storage area used by the processor.

[0106] [Structure of control device]

[0107] Next, the configuration of the control device 9 will be described.

[0108] The control device 9 includes an S / P conversion unit 91 , an image processing unit 92 , an input unit 93 , a recording unit 94 , and a control unit 95 .

[0109] Under the control of the control unit 95, the S / P converter 91 performs serial / parallel conversion on the image data received from the endoscopic camera 5 via the first transmission cable 6 and outputs the data to the image processing unit 92. Furthermore, if the endoscopic camera 5 outputs the imaging signal via an optical signal, an O / E converter that converts the optical signal into an electrical signal may be provided in place of the S / P converter 91. Furthermore, if the endoscopic camera 5 transmits the imaging signal via wireless communication, a communication module capable of receiving wireless signals may be provided in place of the S / P converter 91.

[0110] Under the control of the control unit 95, the image processing unit 92 performs predetermined image processing on the parallel data imaging signal input from the S / P conversion unit 91 and outputs the resulting image to the display device 7. The predetermined image processing herein includes processing such as demosaicing, white balance, gain adjustment, gamma correction, and format conversion. The image processing unit 92 is implemented using a processor comprising hardware such as a GPU or FPGA as a processing device, and a memory serving as a temporary storage area used by the processor. Specifically, the image processing unit 92 includes an acquisition unit 921, a generation unit 922, a detection unit 923, a determination unit 924, a synthesis unit 925, and a display control unit 926.

[0111] The acquisition unit 921 acquires an imaging signal generated by the endoscopic camera 5 through the insertion portion 2. Specifically, the acquisition unit 921 acquires, from the endoscopic camera 5 via the S / P conversion unit 91, an imaging signal generated by the imaging element 53 of the endoscopic camera 5 when the light source device 3 irradiates any one of white light, narrowband light, and excitation light toward living tissue.

[0112] The generation unit 922 generates a white light image, a special light image, and a fluorescence image based on the imaging signals acquired by the acquisition unit 921. Specifically, the generation unit 922 performs demosaicing, white balance, gain adjustment, and gamma correction on the imaging signals acquired by the acquisition unit 921 to generate a white light image. More specifically, the generation unit 922 performs demosaicing and other processing on the imaging signals acquired by the acquisition unit 921 when the light source device 3 irradiates white light toward living tissue, thereby generating a white light image. Furthermore, the generation unit 922 performs image processing on the signal values ​​of G pixels and B pixels contained in the imaging signals acquired by the acquisition unit 921 when the light source device 3 irradiates narrowband light toward living tissue, thereby generating a blood vessel identification image as a pseudo-color image (a narrowband image, which is a special light image). Furthermore, the generating unit 922 generates a fluorescence image by performing a demosaicing process or the like on the imaging signal acquired by the acquiring unit 921 when the light source device 3 irradiates the excitation light toward the living tissue.

[0113] The detection unit 923 detects the blood vessel region in the white light image based on the white light image and the blood vessel identification image generated by the generation unit 922. Specifically, the detection unit 923 detects the blood vessel region in the white light image based on the feature value of the blood vessel identification image generated by the generation unit 922. For example, the detection unit 923 performs binarization processing or edge extraction processing on the blood vessel identification image using known techniques to extract feature values, and then detects the blood vessel region in the white light image based on the extracted feature values. The detection unit 923 detects the blood vessel region in the white light image by performing binarization processing based on the feature value of the blood vessel identification image, but is not limited to this. For example, a learned model that has been trained on multiple blood vessel identification images through machine learning such as deep learning may also be used to detect the blood vessel region in the white light image. In this case, the learned model is trained using multiple blood vessel identification images and training data (learning data) as input parameters. The training data is data that includes annotations specifying positions such as pixel addresses for the blood vessel regions included in each of the multiple blood vessel identification images. The model then detects and outputs the positions of the blood vessel regions in the white-light image as output parameters (learning results). Specifically, the detection unit 923 may be configured to use the learned model described above, input the white-light image and the blood vessel identification image as input parameters, and output the positions of the blood vessel regions in the white-light image as output parameters.

[0114] The determination unit 924 determines thermal denaturation information in the blood vessel region of the white light image based on the blood vessel region detected by the detection unit 923 and the fluorescence image generated by the generation unit 922. Specifically, the determination unit 924 determines the thermal denaturation information based on the signal value of each pixel in the region of the fluorescence image corresponding to the blood vessel region in the white light image.

[0115] The synthesis unit 925 generates a synthesized image by synthesizing the thermal denaturation information identified by the identification unit 924 and the blood vessel region of the white light image detected by the detection unit 923 .

[0116] The display control unit 926 outputs various information related to the endoscope system 1 to the display device 7 under the control of the control unit 96. In addition, the display control unit 926 outputs the synthesized image generated by the synthesizing unit 925 to the display device 7.

[0117] The input unit 93 receives input of various operations related to the endoscope system 1 and outputs the received operations to the control unit 95. The input unit 93 is configured using a mouse, a foot switch, a keyboard, buttons, switches, a touch panel, and the like.

[0118] The recording unit 94 is implemented using a recording medium such as a volatile memory, a nonvolatile memory, an SSD (Solid State Drive), an HDD (Hard Disk Drive), or a memory card. The recording unit 94 records data including various parameters required for the operation of the endoscope system 1. The recording unit 94 also includes a program recording unit 941 for recording various programs used to operate the endoscope system 1.

[0119] The control unit 95 is implemented using a processor comprising hardware such as an FPGA or CPU, and a memory serving as a temporary storage area for the processor. The control unit 95 comprehensively controls the various components that comprise the endoscope system 1. Specifically, the control unit 95 reads the program stored in the program storage unit 941 into the working area of ​​the memory and executes it. The processor executes the program to control the various components, thereby achieving functional modules that meet the specified objectives through the coordination of hardware and software.

[0120] 〔Control device processing〕

[0121] Next, the processing executed by the control device 9 will be described. Figure 10 It is a flowchart showing an outline of the processing executed by the control device 9 .

[0122] First, if Figure 10 As shown, the control unit 96 causes the first light source unit 31 of the light source device 3 to emit light to supply white light to the insertion portion 2 , thereby irradiating the living tissue with the white light (step S101 ).

[0123] Next, the control unit 96 causes the imaging element 53 of the endoscopic camera head 5 to capture the return light from the living tissue and the reflected light from the living tissue (step S102 ).

[0124] Thereafter, the acquisition unit 921 acquires an imaging signal generated by imaging performed by the imaging element 53 of the endoscopic camera 5 (step S103 ).

[0125] Next, the generator 922 generates a white-light image of the subject based on the imaging signal acquired by the acquirer 921 (step S104 ). Figure 11 : is a diagram showing an example of a white light image generated by the generating unit 922. Figure 11 As shown, the generating unit 922 performs demosaicing, white balance, gain adjustment, and γ correction on the imaging signal acquired by the acquiring unit 921 to generate a white light image P1 of a blood vessel region B1 including blood vessels in the biological tissue within the subject.

[0126] Thereafter, the control unit 96 causes the second light source unit 32 and the third light source unit 33 of the light source device 3 to emit light, thereby supplying narrowband light (first narrowband light and second narrowband light) to the insertion portion 2, thereby irradiating narrowband light for identifying blood vessels in living tissue (step S105).

[0127] Next, the control unit 96 causes the imaging element 53 of the endoscopic camera head 5 to capture the return light from the living tissue and the reflected light from the living tissue (step S106 ).

[0128] Thereafter, the acquisition unit 921 acquires an imaging signal from the imaging element 53 of the endoscopic camera 5 (step S107 ).

[0129] Next, the generator 922 generates a blood vessel identification image based on the imaging signal acquired by the acquisition unit 921 (step S108). Specifically, the generator 922 performs image processing on the signal values ​​of the G and B pixels contained in the imaging signal acquired by the acquisition unit 921 to generate a blood vessel identification image as a pseudo-color image (narrow-band image). In this case, the signal values ​​of the G pixels include information about the deep layers of the subject's mucosa. Furthermore, the signal values ​​of the B pixels include information about the surface layers of the subject's mucosa. Therefore, the generator 922 performs image processing such as gain control, pixel interpolation, and mucosal enhancement on the signal values ​​of the G and B pixels contained in the imaging signal to generate the blood vessel identification image as a pseudo-color image. Here, the blood vessel identification image refers to an image generated using only the signal values ​​of the G and B pixels. Furthermore, the generator 922 does not use the signal values ​​of the R pixels contained in the imaging signal acquired by the acquisition unit 921 when generating the blood vessel identification image, but instead deletes these R pixel signal values.

[0130] Thereafter, the detection unit 923 detects a blood vessel region in the white-light image based on the white-light image and the blood vessel identification image generated by the generation unit 922 (step S109 ). Figure 12 FIG is a diagram schematically showing the detection result of the blood vessel region in the white light image detected by the detection unit 923. Figure 12 As shown, the detection unit 923 detects the blood vessel region B1 in the white-light image P1 based on the feature values ​​of the blood vessel identification image generated by the generation unit 922. For example, the detection unit 923 performs binarization processing or edge extraction processing on the blood vessel identification image using known techniques to extract feature values, and then detects the blood vessel region B1 in the white-light image P1 based on the extracted feature values. In this case, the detection unit 923 detects the region of pixel addresses in the white-light image P1 corresponding to the pixel addresses of the blood vessel region B1 detected in the blood vessel identification image as the blood vessel region B1 in the white-light image P1.

[0131] Next, the control unit 96 causes the third light source unit 33 of the light source device 3 to emit light to supply excitation light to the insertion portion 2 , thereby irradiating the living tissue with the excitation light for causing the thermally denatured region to emit light (step S110 ).

[0132] Thereafter, the control unit 96 causes the imaging element 53 of the endoscopic camera head 5 to capture light emission from the living tissue (step S111 ).

[0133] Next, the acquisition unit 921 acquires an imaging signal from the imaging element 53 of the endoscopic camera 5 (step S112 ).

[0134] Thereafter, the generating unit 922 generates a fluorescent image based on the imaging signal acquired by the acquiring unit 921 (step S113 ).

[0135] Next, the determination unit 924 determines the thermal denaturation information for the blood vessel region in the white light image P1 based on the blood vessel region B1 detected by the detection unit 923 and the fluorescence image generated by the generation unit 922 (step S114). Specifically, the determination unit 924 determines the thermal denaturation information based on the signal value of each pixel in the region of the fluorescence image corresponding to the blood vessel region B1 in the white light image P1.

[0136] Figure 13 Schematically shows the relationship between the signal value of the fluorescence image, the degree of thermal denaturation, and the thermal coagulation level of the blood vessel. Figure 13 As shown, the determination unit 924 identifies regions with low thermal coagulation levels based on the signal values ​​of each pixel in the region of the fluorescence image corresponding to the vascular region B1 of the white-light image P1 as thermal denaturation information. Specifically, the determination unit 924 determines whether the signal value of each pixel in the region of the fluorescence image corresponding to the vascular region B1 of the white-light image P1 is less than a predetermined value. Furthermore, the determination unit 924 determines that the region of pixels in the region of the fluorescence image corresponding to the vascular region B1 of the white-light image P1 where the signal value is less than the predetermined value is a region with low thermal coagulation levels. Conversely, the determination unit 924 determines that the region of pixels in the region of the fluorescence image corresponding to the vascular region B1 of the white-light image P1 where the signal value is not less than the predetermined value, that is, the signal value is greater than the predetermined value, is a region with high thermal coagulation levels.

[0137] Thereafter, the synthesis unit 925 generates a synthesized image by synthesizing the thermal denaturation information identified by the identification unit 924 and the blood vessel region B1 of the white-light image P1 detected by the detection unit 923 (step S115 ). Figure 14 925 is a diagram showing an example of a composite image generated by the composite unit 925. Figure 14 As shown, the synthesis unit 925 generates a synthetic image P2 by synthesizing the thermal denaturation information D1 and D2 determined by the determination unit 924 and the blood vessel area B1 of the white light image P1 detected by the detection unit 923. In this case, the synthesis unit 925 synthesizes the outline of the blood vessel area B1 of the white light image P1 detected by the detection unit 923 into the synthetic image P2. Here, the thermal denaturation information D1 is a region where the thermal coagulation level obtained by the determination unit 924 is higher than a specified value. And, the thermal denaturation information D2 is a region where the thermal coagulation level obtained by the determination unit 924 is lower than a specified value. In addition, Figure 14 In order to distinguish the thermal denaturation information D1 and D2, they are expressed with different shades. That is, the synthesis unit 925 synthesizes the thermal denaturation information D1 and the thermal denaturation information D2 with the blood vessel area B1 of the white light image P1 detected by the detection unit 923 using different colors so that they can be distinguished from each other, thereby generating a synthesized image P2.

[0138] Next, the display control unit 926 outputs the synthesized image P2 generated by the synthesizing unit 925 to the display device 7 (step S116 ). This allows the operator to intuitively grasp the thermal coagulation level of the vascular region B1 without relying on their own empirical rules.

[0139] The control unit 96 then determines whether a termination signal for terminating observation of the subject by the endoscope system 1 has been input from the input unit 93 (step S117). If the control unit 96 determines that a termination signal for terminating observation of the subject by the endoscope system 1 has been input from the input unit 93 (step S117: "Yes"), the endoscope system 1 terminates this processing. On the other hand, if the control unit 96 determines that a termination signal for terminating observation of the subject by the endoscope system 1 has not been input from the input unit 93 (step S117: "No"), the endoscope system 1 returns to step S101 described above.

[0140] According to the embodiment described above, the display control unit 926 outputs the thermal denaturation information of the blood vessel region B1 in the white-light image P1 identified by the identification unit 924 to the display device 7 , so that the operator can understand the state of coagulation denaturation of the blood vessel.

[0141] Furthermore, according to one embodiment, the display control unit 926 outputs the synthesized image P2 generated by the synthesizing unit 925 to the display device 7 , so that the operator can intuitively grasp the state of coagulation and denaturation of the blood vessel.

[0142] Furthermore, according to one embodiment, the identification unit 924 identifies the thermal denaturation information based on the signal value of each pixel constituting the fluorescence image, and thus can identify the region where thermal denaturation has occurred with high accuracy.

[0143] Furthermore, according to one embodiment, the identification unit 924 identifies a region of pixels having a signal value less than a predetermined value in the region of the fluorescence image corresponding to the blood vessel region B1 of the white-light image P1 as a region with a low thermal coagulation level. This makes it possible to distinguish and identify regions with a high thermal coagulation level and regions with a low thermal coagulation level.

[0144] Furthermore, according to one embodiment, the determination unit 924 determines the thermal coagulation level in the blood vessel region B1 of the white-light image P1 , and thus can present the state of thermal denaturation of the blood vessel region most desired by the operator.

[0145] Furthermore, in one embodiment, the display control unit 926 may superimpose the thermal denaturation information on the blood vessel region B1 of the white-light image P1 identified by the identification unit 924 and output the result to the display device 7 .

[0146] In one embodiment, the detection unit 923 may also determine the blood vessel region based on the feature value of the white light image generated by the generation unit 922. For example, the detection unit 923 may perform binarization processing or edge extraction processing on the signal value of a specific component of the white light image, such as a G pixel, using known techniques to extract the feature value, and detect the blood vessel region in the white light image based on the extracted feature value.

[0147] In one embodiment, narrow-band imaging (NBI) is used as special light observation, in which narrow-band light consisting of a first narrow-band light (530 nm to 550 nm) and a second narrow-band light (400 nm to 430 nm) is irradiated onto living tissue. However, this is not limiting and, for example, other special light observation methods can also be applied. For example, red dichromatic imaging (RDI) can also be applied as special light observation. In this red light observation, special light consisting of light in the green, amber, and red wavelength ranges is irradiated onto living tissue to detect blood vessels and bleeding areas located deep within mucous membranes, for example. In this case, the detection unit 923 detects blood vessel areas from the blood vessel identification image of the red light observation image. This makes it possible to easily detect blood vessels located deep within mucous membranes, for example.

[0148] (Other embodiments)

[0149] By appropriately combining the multiple components disclosed in the endoscope system according to one embodiment of the present disclosure, various inventions can be formed. For example, some components may be deleted from all the components described in the endoscope system according to one embodiment of the present disclosure. Furthermore, the components described in the endoscope system according to one embodiment of the present disclosure may be appropriately combined.

[0150] Furthermore, in the endoscope system according to one embodiment of the present disclosure, the devices are connected to each other by wires, but they may be connected wirelessly via a network.

[0151] Furthermore, in one embodiment of the present disclosure, the functions of the image processing unit 92 included in the endoscope system, namely, the functional modules of the acquisition unit 921, the generation unit 922, the detection unit 923, the determination unit 924, the synthesis unit 925, and the display control unit 926, may be installed on a server connected via a network. Of course, a server may be installed for each functional module.

[0152] Furthermore, in one embodiment of the present disclosure, an example of application to transurethral bladder tumor resection has been described, but the present disclosure is not limited thereto and can be applied to various surgeries for resecting lesions using energy devices or the like, for example.

[0153] In the endoscope system according to one embodiment of the present disclosure, the above-mentioned “unit” can be replaced by “unit” or “circuit”, etc. For example, the control unit can be replaced by a control unit or a control circuit.

[0154] Furthermore, although expressions such as "first," "afterwards," and "next" are used in the descriptions of the flowcharts in this specification to clarify the sequential relationship between the processes in the steps, the order of the processes required to implement the present invention is not solely defined by these expressions. In other words, the order of the processes in the flowcharts described in this specification can be changed within a range consistent with the order in which they are performed.

[0155] While several embodiments of the present application have been described in detail above based on the accompanying drawings, they are all examples and the present invention can be implemented in other ways represented by the methods described in the columns of this disclosure, with various modifications and improvements based on the knowledge of those skilled in the art.

[0156] Description of Reference Numerals

[0157] 1: Endoscope system; 2: Insertion unit; 3: Light source device; 4: Light guide; 5: Endoscope camera head; 6: First transmission cable; 7: Display device; 8: Second transmission cable; 9: Control device; 10: Third transmission cable; 11: Medical device; 12: Fourth transmission cable; 21: Eyepiece unit; 22: Optical system; 23: Illumination optical system; 30: Converging lens; 31: First light source unit; 32: Second light source unit; 33: Light source control unit; 51: Optical system; 52: Drive unit; 53: Image sensor; 54: Cutoff filter; 55: A / D conversion unit; 56: P / S conversion unit; 57: Camera recording unit; 58: Camera control unit; 61: Video connector; 62: Camera connector; 91: S / P conversion unit; 92: Image processing unit; 93: Input unit; 94: Recording unit; 95: Output unit; 96: Control unit; 111: Communication I / F; 113a: Program recording unit; 511: Lens; 531: Pixel unit; 532: Color filter; 921: Acquisition unit; 922: Generation unit; 923: Detection unit; 924: Determination unit; 925: Synthesis unit; 926: Display control unit.

Claims

1. A medical device comprising a processor, wherein: The processor performs the following processing: acquiring a display image in which a blood vessel region in a subject is identified and a fluorescence image overlapping at least a portion of a field of view region of the display image; determining thermal denaturation information in the blood vessel region based on the display image and the fluorescent image; as well as The thermal denaturation information is output.

2. The medical device according to claim 1, wherein the processor generates a composite image by combining the thermal denaturation information and the blood vessel region of the display image; and The composite image is output.

3. The medical device according to claim 1, wherein The processor superimposes the thermal denaturation information on the blood vessel region of the display image and outputs the resultant image.

4. The medical device according to claim 1, wherein The processor performs the following processing: acquiring an imaging signal capturing fluorescence emitted from the thermally denatured region; and The fluorescent image is generated based on the imaging signal.

5. The medical device according to claim 4, wherein The fluorescence is generated from advanced glycation end products produced by heat treatment of biological tissue.

6. The medical device according to claim 1, wherein The processor determines the thermal denaturation information based on a signal value of each pixel constituting the fluorescent image.

7. The medical device according to claim 6, wherein: The processor specifies a region with a low thermal coagulation level as the thermal denaturation information based on a signal value of each pixel constituting the fluorescent image.

8. The medical device according to claim 7, wherein: The processor performs the following processing: determining, for each pixel constituting the fluorescent image, whether the signal value is less than a prescribed value; and A region of pixels having signal values ​​smaller than a predetermined value is determined as a region with a low thermal coagulation level.

9. The medical device according to claim 8, wherein The processor determines the level of thermal coagulation in the blood vessel region.

10. The medical device according to claim 9, wherein The processor outputs a region where the thermal coagulation level is lower than a prescribed value in a manner that can be distinguished from a region where the thermal coagulation level is higher than the prescribed value.

11. The medical device according to claim 1, wherein The display image is an image in which the blood vessel region is specified based on a feature value in the white-light image.

12. The medical device according to claim 1, wherein The display image is an image in which the blood vessel region is specified based on a feature value in the special light image.

13. The medical device according to claim 1, wherein The processor generates the display image based on a white-light image and a blood vessel identification image in the same field of view area as the white-light image.

14. The medical device according to claim 1, wherein The processor performs the following processing: Acquiring an image for blood vessel identification; and The display image is generated by superimposing a blood vessel region identified from the blood vessel identification image on a white light image.

15. The medical device according to claim 14, wherein The blood vessel identification image is an image acquired using narrow-band light determined based on the absorbance of blood.

16. The medical device according to claim 15, wherein The blood vessel identification image is a narrow-band light observation image.

17. The medical device according to claim 15, wherein The blood vessel identification image is a red light observation image.

18. A medical system comprising a light source device, an imaging device, and a medical device, wherein: The light source device includes a light source for emitting excitation light for exciting advanced glycation end products generated by heat treatment of biological tissue. The imaging device includes an imaging element that generates an imaging signal by capturing fluorescence emitted by the excitation light. The medical device includes a processor. The processor performs the following processing: acquiring, from the imaging element, a display image of a blood vessel region in which a blood vessel in the subject is identified, and a fluorescence image overlapping at least a portion of a field of view region of the display image; determining thermal denaturation information in the blood vessel region based on the display image and the fluorescent image; as well as The thermal denaturation information is output.

19. A method for operating a medical device, the medical device comprising a processor, wherein: The processor performs the following processing: acquiring a display image in which a blood vessel region in a subject is identified and a fluorescence image overlapping at least a portion of a field of view region of the display image; determining thermal denaturation information in the blood vessel region based on the display image and the fluorescent image; as well as The thermal denaturation information is output.

20. A program executed by a medical device having a processor, wherein: The program causes the processor to execute the following processing: acquiring a display image in which a blood vessel region in a subject is identified and a fluorescence image overlapping at least a portion of a field of view region of the display image; determining thermal denaturation information in the blood vessel region based on the display image and the fluorescent image; as well as The thermal denaturation information is output.

Images