Program, information processing method, and information processing device

Abstract

The program causes the computer to execute the following processes: acquiring a perspective image of a patient to be subjected to a process relating to the artificial hip joint; identifying an inner plate line in the pelvis of the patient in the acquired perspective image, the inner plate line representing a maximum cutting site when cutting the pelvis in order to configure an acetabular cup included in the artificial hip joint; identifying a bid line in the patient's pelvis, the bid line representing a minimum cutting site when cutting the pelvis in order to configure the acetabular cup; deriving the CE angle of the acetabular cup when the disposition of the acetabular cup is assumed in a state in which the pelvis of the patient is cut with a bone digging reamer for the treatment related to the artificial hip joint; displaying the identified inner plate line and the identified necessary line on the perspective image in an overlapping manner; and attaching the exported CE angle of the acetabular cup to the perspective image for displaying.

Description

TECHNICAL FIELD

[0001] The present disclosure relates to a program, an information processing method, and an information processing apparatus.

[0002] This application claims priority based on Japanese Application No. 2023-130401 filed on August 9, 2023, and incorporates by reference all of the content described in the Japanese Application. BACKGROUND

[0003] A hip joint socket angle setting device in artificial hip joint replacement surgery (for example, Patent Literature 1) is known. According to the hip joint socket angle setting device in artificial hip joint replacement surgery described in Patent Literature 1, a method of setting a hip joint socket angle with a pelvic surface and a teardrop line as a reference is provided.

[0004] PRIOR ART DOCUMENTS

[0005] PATENT LITERATURE

[0006] Patent Literature 1: Japanese Patent Application Publication No. 2022-031047 SUMMARY

[0007] PROBLEMS TO BE SOLVED BY THE INVENTION

[0008] However, in the hip joint socket angle setting device in artificial hip joint replacement surgery of Literature 1, there is no consideration of superimposing an inner plate line on a perspective image of a patient to be subjected to a process related to artificial hip joint replacement, where the inner plate line indicates a maximum cutting position when cutting a pelvis in order to dispose a hip joint cup included in the artificial hip joint.

[0009] The present disclosure is made in view of such a situation, and aims to provide a program or the like that can superimpose an inner plate line on a perspective image of a patient to be subjected to a process related to artificial hip joint replacement, where the inner plate line indicates a maximum cutting position when cutting a pelvis in order to dispose a hip joint cup included in the artificial hip joint.

[0010] SOLUTION TO PROBLEM

[0011] In one aspect, a program causes a computer to execute the following process: acquires a fluoroscopic image of a patient to be subjected to a process related to an artificial hip joint; identifies an inner plate line in the pelvis of the patient in the acquired fluoroscopic image, the inner plate line indicating a maximum cutting site when the pelvis is cut for the purpose of disposing a femoral head included in the artificial hip joint; identifies a must reach line in the pelvis of the patient, the must reach line indicating a minimum cutting site when the pelvis is cut for the purpose of disposing the femoral head; derives a femoral head CE angle when disposition of the femoral head is assumed in a state where the pelvis of the patient is cut with a reamer for a process related to the artificial hip joint; and displays the identified inner plate line and must reach line superimposed on the fluoroscopic image, and displays the derived femoral head CE angle attached to the fluoroscopic image.

[0012] In one aspect, an information processing method causes a computer to execute the following process: acquires a fluoroscopic image of a patient to be subjected to a process related to an artificial hip joint; identifies an inner plate line in the pelvis of the patient in the acquired fluoroscopic image, the inner plate line indicating a maximum cutting site when the pelvis is cut for the purpose of disposing a femoral head included in the artificial hip joint; identifies a must reach line in the pelvis of the patient, the must reach line indicating a minimum cutting site when the pelvis is cut for the purpose of disposing the femoral head; derives a femoral head CE angle when disposition of the femoral head is assumed in a state where the pelvis of the patient is cut with a reamer for a process related to the artificial hip joint; and displays the identified inner plate line and must reach line superimposed on the fluoroscopic image, and displays the derived femoral head CE angle attached to the fluoroscopic image.

[0013] In one aspect, an information processing apparatus includes: an acquisition section that acquires a fluoroscopic image of a patient to be subjected to a process related to an artificial hip joint; an inner plate line identification section that identifies an inner plate line in the pelvis of the patient in the acquired fluoroscopic image, the inner plate line indicating a maximum cutting site when the pelvis is cut for the purpose of disposing a femoral head included in the artificial hip joint; a must reach line identification section that identifies a must reach line in the pelvis of the patient, the must reach line indicating a minimum cutting site when the pelvis is cut for the purpose of disposing the femoral head; a derivation section that derives a femoral head CE angle when disposition of the femoral head is assumed in a state where the pelvis of the patient is cut with a reamer for a process related to the artificial hip joint; and a display section that displays the identified inner plate line and must reach line superimposed on the fluoroscopic image, and displays the derived femoral head CE angle attached to the fluoroscopic image.

[0014] Effects of Invention

[0015] According to this disclosure, an inner plate line can be overlaid on a fluoroscopic image of a patient to be treated with an artificial hip joint. This inner plate line represents the maximum cutting area when the pelvis is cut to accommodate the acetabular cup included in the artificial hip joint. Attached Figure Description

[0016] Figure 1 This is a schematic diagram showing an outline of an intraoperative support system including the information processing apparatus of Embodiment 1.

[0017] Figure 2 This is a block diagram illustrating an example of the configuration of an information processing device.

[0018] Figure 3 This is an illustrative diagram showing an example of a learning model (inner plate line model).

[0019] Figure 4 This is a flowchart illustrating an example of the processing steps (during model learning) of the processing unit of an information processing device.

[0020] Figure 5 This is a flowchart illustrating an example of the processing steps (when the model is used) of the processing unit of an information processing device.

[0021] Figure 6 This is a diagram illustrating the CE angle of the acetabular cup.

[0022] Figure 7 This is a diagram illustrating the relevant information about the inner panel lines.

[0023] Figure 8 This is a diagram illustrating the relevant information about the Bida Line.

[0024] Figure 9 This is an explanatory diagram related to the upward movement of the boundary line.

[0025] Figure 10 This is an explanatory map of the strike zone.

[0026] Figure 11 This is a diagram illustrating the anteversion and abduction angles of the acetabular cup (a hypothetical configuration after the pelvis has been cut with a reamer).

[0027] Figure 12 This is an explanatory diagram illustrating an example of a display screen for auxiliary information (an overlay screen for auxiliary information).

[0028] Figure 13 This is an explanatory diagram illustrating an example of a display screen (distortion correction screen) showing auxiliary information. Detailed Implementation

[0029] The present invention will now be described in detail with reference to the accompanying drawings illustrating embodiments thereof.

[0030] (Implementation Method 1)

[0031] Figure 1 This is a schematic diagram showing an outline of the intraoperative support system S, which includes the information processing apparatus of Embodiment 1. Figure 2 This is a block diagram illustrating an example of the configuration of the information processing device 1. The intraoperative support system S is configured with the information processing device 1 as its main unit. This information processing device 1 is communicatively connected to fluoroscopic image capturing devices such as an X-ray device 62 and tomographic image capturing devices such as a CT device 61. The information processing device 1 acquires X-ray images (fluoroscopic images) captured by the X-ray device 62 in real time. The information processing device 1 also acquires CT images (tomographic images) captured by the CT device 61. The information processing device 1 can also communicatively connect to an electronic medical record server used for storing and managing various medical data related to the patient K.

[0032] Before the pelvic excavation based on the osteotomy reamer 7, the patient K undergoing the procedure for artificial hip joint 8 has CT images (composite images) taken using a CT device 61. During the pelvic excavation based on the osteotomy reamer 7, the patient K has X-ray images (fluoroscopic images) taken using an X-ray device 62. Therefore, the X-ray images will include the osteotomy reamer 7 used for excavation of the pelvis (during excavation).

[0033] After the physician has properly excavated the pelvis using a bone-digging reamer 7, an artificial hip joint 8, including an acetabular cup 81, is inserted (implanted) into the patient K's body. The artificial hip joint 8 includes a hemispherical acetabular cup 81 that fits into the excavated pelvis and a handle that inserts into the femur. The bone-digging reamer 7 has a hemispherical front end for excavation, the outer edge of which is shaped and sized to match the outer edge of the acetabular cup 81 of the artificial hip joint 8.

[0034] As detailed later, the processing unit 2 of the information processing device 1 uses, for example, object detection system models such as YOLO or edge detection to perform shape recognition on the bone-removing reamer 7 (the hemispherical front end for excavation) contained in the acquired X-ray image, and determines the position and tilt of the bone-removing reamer 7 in the pelvis. The processing unit 2 of the information processing device 1 calculates and outputs various information related to the hypothetical position and tilt of the acetabular cup 81 in the state where the determined position and tilt of the bone-removing reamer 7 have been cut by the bone-removing reamer 7. Furthermore, the processing unit 2 of the information processing device 1 uses the corresponding points (markers) of the inner plate derived from multiple CT images taken before surgery through the learning model 101 (inner plate line model) to overlay the inner plate line (reached area) used to assist in excavation based on the bone-removing reamer 7 onto the X-ray image.

[0035] Information processing device 1 is a computer capable of various information processing and information transmission and reception, such as a server device or a personal computer. A server device includes not only a single server device but also a cloud server device or virtual server device composed of multiple computers. When information processing device 1 is configured as, for example, a cloud server device, it does not need to be installed in the same medical facility where patient K is located, as medical equipment such as CT scanner 61 or X-ray machine 62, but can be communicatively connected to these medical devices via external networks such as the Internet. Information processing device 1 includes a processing unit 2, a storage unit 3, an input / output (I / O) unit 4, and a communication unit 5.

[0036] The processing unit 2 has one or more arithmetic processing devices with timing functions, such as CPU (Central Processing Unit), MPU (Micro-Processing Unit), and GPU (Graphics Processing Unit). It reads and executes the program P (program product) stored in the storage unit 3 to perform various information processing and control processing involved in the information processing device 1.

[0037] Storage unit 3 includes volatile storage areas such as SRAM (Static Random Access Memory), DRAM (Dynamic Random Access Memory), and flash memory, as well as non-volatile storage areas such as EEPROM or hard disk. Storage unit 3 pre-stores a program P (program product) and data referenced during processing. The program P (program product) stored in storage unit 3 can also be obtained by the information processing device 1 storing a program P (program product) read from a readable storage medium M. Alternatively, the program P (program product) can be downloaded from an external computer (not shown) connected to a communication network (not shown) and stored in storage unit 3.

[0038] Storage unit 3 stores various medical data related to patient K, as well as various values ​​determined in the preoperative plan. Storage unit 3 also stores entity files that constitute learning model 101 (inner plate line model). These entity files can also be part of program P (program product).

[0039] Communication unit 5 is a communication module or communication interface used to communicate with the electronic medical record server or information terminals such as smartphones held by medical personnel via wired or wireless means. Examples include wired communication modules such as Ethernet connectors, narrow-area wireless communication modules such as WiFi and Bluetooth, or wide-area wireless communication modules such as 4G and 5G. Processing unit 2 communicates with the electronic medical record server or information terminals via communication unit 5, for example, through a local network within the medical institution or an external network such as the Internet.

[0040] The input / output I / F4 is, for example, a communication interface conforming to communication standards such as RS232C or USB. The input / output I / F4 can be connected to input devices such as a keyboard, or display devices 41 such as an LCD screen. Furthermore, the input / output I / F4 can also be connected to medical equipment such as a CT scanner 61 or an X-ray machine 62.

[0041] Figure 3 This is an illustrative diagram showing an example of learning model 101 (inner plate line model). Learning model 101 (inner plate line model) is composed of, for example, RCNN (Regions with Convolutional Neural Network), Fast RCNN, Faster RCNN, or SSD (Single Shot Multibook Detector), YOLO (You Only Look Once), etc., and is a neural network (NN) that performs object detection, semantic segmentation, or instance segmentation.

[0042] Learning model 101 (inner plate line model) outputs whether the input image (CT image or other tomographic image) contains corresponding points of the inner plate (present or absent), and if the corresponding points of the inner plate are present (present or absent), the region (location information) of the corresponding points of the inner plate in the input image. That is, learning model 101 functions as a region extraction model to extract the region of the corresponding points of the inner plate contained in the input image (CT image or other tomographic image).

[0043] When the learning model 101 (inner plate line model) is composed of a neural network such as RCNN that includes a CNN (Convolutional Neural Network) for extracting image features, the input layer of the learning model 101 (inner plate line model) has multiple neurons for receiving pixel values ​​of the image as input and passing the input pixel values ​​to the intermediate layer. The intermediate layer has multiple neurons for extracting image features and passing the extracted image features to the output layer. The output layer has one or more neurons for outputting region information including the position of the corresponding point of the inner plate, and outputs the position (region coordinates or pixel number, etc.) of the corresponding point of the inner plate based on the image features output by the intermediate layer.

[0044] Imagine using a neural network (learning model 101) that has learned from training data as part of an artificial intelligence software program module. As described above, the learning model 101 is used in an information processing device 1 having a processing unit 2 (CPU, etc.) and a storage unit 3. Thus, by being executed by the information processing device 1 with computational processing capabilities, a neural network system is constructed. That is, the processing unit 2 of the information processing device 1 performs calculations to extract feature quantities of the image input to the input layer according to instructions from the learning model 101 stored in the storage unit 3, and outputs the position (region) of the corresponding point on the inner plate from the output layer.

[0045] Training data, obtained by associating CT images (problem data) including pelvic (hip joint) with labels (response data) representing the locations (regions) of points on the inner plate line in the pelvis, i.e., corresponding points on the inner plate, can be used to train an unlearned neural network to perform machine learning, thereby generating a learning model 101 (inner plate line model). The training data is stored, for example, in the storage unit 3 of the information processing device 1, and can be generated by aggregating images and doctors' opinions contained in a large number of diagnostic or surgical results stored in electronic medical record servers of medical institutions such as hospitals. In other words, the location (internal part) of the inner plate line in the pelvis (points on the inner plate line, i.e., corresponding points on the inner plate) is determined based on the opinions of doctors, etc. By inputting CT images (such as CT images) into the learning model 101 (inner plate line model) learned in this way, information representing the location (region coordinates in the image coordinate system) of the corresponding points on the inner plate contained in the CT image can be obtained.

[0046] Furthermore, in this embodiment, the case where the learning model 101 (inner plate line model) is RCNN has been described. However, the learning model 101 is not limited to RCNN, and can also be a learning model 101 constructed by other learning algorithms such as neural networks other than RCNN, SVM (Support Vector Machine), transformers, YOLO, Bayesian networks, and regression trees. The dataset of question data and answer data included in the training data used by the learning model 101 is synonymous with the dataset of input data and output data when using the learning model 101. As long as it has been defined in any dataset, it is of course applicable to the dataset of the other.

[0047] Figure 4 This is a flowchart illustrating an example of the processing steps (during model learning) of the processing unit 2 of the information processing device 1. The processing unit 2 of the information processing device 1 receives, for example, operations performed by an operator via a keyboard connected to the input / output I / F4, and performs the following processing based on the received operations.

[0048] The processing unit 2 of the information processing device 1 acquires training data (S11). The processing unit 2 of the information processing device 1 acquires training data for a tomographic image (CT image, etc.) with positional information of corresponding points (markers) of the inner plate attached to the inner plate line. The positional information of the corresponding points (markers) of the inner plate can be obtained, for example, by marking the position of the corresponding points of the inner plate (the pelvic region) on the tomographic image with a circle or other graphic.

[0049] The processing unit 2 of the information processing device 1 generates a learning model 101 (inner plate line model) using the acquired training data (S12). The processing unit 2 of the information processing device 1 learns the neural network and generates the learning model 101 (inner plate line model) by inputting training data (for tomographic images, images in which the positions representing the corresponding points of the inner plate are marked) into the unlearned neural network.

[0050] In this embodiment, a learning model 101 is configured to output, based on the input CT image, the position information of the corresponding points (markers) of the inner plate on the inner plate line (overlaying the corresponding points (markers) on the CT image), but is not limited to this. In addition to outputting the corresponding points (markers) of the inner plate on the inner plate line based on the input CT image, the learning model 101 can also output the corresponding points of the reachable line (described later) and the upper limit points of the upper movement boundary line. In this case, in addition to the CT image, the target CE angle can also be input into the learning model 101. That is, the learning model 101 can function as an arrival area model that outputs points (corresponding points of the inner plate, corresponding points of the reachable line, and upper limit points) on the inner plate line, the reachable line, and the upper movement boundary line respectively, based on the input CT image (or, CT image and target CE angle). In this case, the arrival area model learns using training data that includes answer data for the CT image used as question data, annotated with the corresponding points of the inner plate, the corresponding points of the reachable line, and the upper limit points.

[0051] Figure 5 This is a flowchart illustrating an example of the processing steps (when the model is used) of the processing unit 2 of the information processing device 1. For example, the processing unit 2 of the information processing device 1 starts processing the flowchart when the input of a perspective image is used as a trigger condition, or when it receives a start command from an input device such as a keyboard connected to the input / output I / F4.

[0052] The processing unit 2 of the information processing device 1 acquires a tomographic image (CT image) of the pelvis of patient K (S101). Before undergoing a bone-removing surgery based on a bone-removing reamer 7 (preoperative), patient K takes tomographic images (CT images or MRI images) of internal parts including the pelvis and hip joint using a tomographic imaging device, for example, via a CT device 61 or an MRI device. The tomographic images taken preoperatively are stored, for example, in the storage unit 3 of the information processing device 1. Alternatively, these tomographic images (CT images, etc.) are stored in an electronic medical record server, and the processing unit 2 of the information processing device 1 can access the electronic medical record server, for example, using the patient KID that uniquely identifies patient K, and acquire the tomographic images (CT images, etc.) from the electronic medical record server. The tomographic images include multiple tomographic images obtained by slicing the body at a predetermined slice width (the vertical (Y-axis) direction of the human body). That is, in this embodiment, the Y-axis represents the upper limit direction of the human body, and the positive direction in the Y-axis represents the upper direction. The X-axis represents the left-right direction of the human body (the positive direction is the right side of the paper), and the Z-axis represents the front-back direction of the human body (the positive direction is the front).

[0053] The processing unit 2 of the information processing device 1 inputs the tomographic image into the learning model 101 (inner plate line model) (S102). The processing unit 2 of the information processing device 1 inputs the acquired multiple tomographic images into the learning model 101 (inner plate line model) respectively. The learning model 101 (inner plate line model) learns by outputting the position information (markers) of the inner plate (corresponding points of the inner plate on the inner plate line) when the tomographic image is input. The learning model 101 (inner plate line model) overlays the position information (markers) of the inner plate onto the input tomographic image and outputs it according to the input tomographic image.

[0054] The processing unit 2 of the information processing device 1 acquires the corresponding points (markers) of the inner plate representing the points on the inner plate line from the learning model 101 (S103). The processing unit 2 of the information processing device 1 acquires the tomographic images of the corresponding points (markers) of the inner plate representing the points on the inner plate line superimposed on the learning model 101, and stores the acquired multiple tomographic images (tomographic images of the corresponding points of the inner plate superimposed on each other) in the storage unit 3.

[0055] The processing unit 2 of the information processing device 1 acquires various values ​​determined in the preoperative plan via the reference storage unit 3 (S104). The various values ​​determined in the preoperative plan include, for example, the radius of the acetabular cup 81 of the artificial hip joint 8 disposed in the body, the target CE angle, the target distance between the outer edge of the acetabular cup 81 and the inner plate line preset as target values, the target anteversion angle, and the target abduction angle.

[0056] The target CE angle represents the CE angle of the acetabular cup 81 when configured as a target value. The target distance represents the distance between the acetabular cup 81 and the inner plate line derived from the tomographic image using the learning model 101 (inner plate line model), which is preset as a target value. The target anteversion angle represents the anteversion angle of the acetabular cup 81 when configured as a target value. The target abduction angle represents the abduction angle of the acetabular cup 81 when configured as a target value. These various values ​​determined in the preoperative plan are determined by the physician, etc., and pre-input into the information processing device 1 and stored in the storage unit 3. Alternatively, the processing unit 2 of the information processing device 1 retrieves the various values ​​determined in the preoperative plan for patient K from the electronic medical record system based on the patient KID, etc.

[0057] During the surgical procedure of patient K undergoing artificial hip joint 8, the processing unit 2 of the information processing device 1 acquires a fluoroscopic image (X-ray image) of the pelvis of patient K obtained by taking a photograph (S105). During the surgical procedure of patient K undergoing artificial hip joint 8, i.e., while the pelvis is being excavated using the bone-digging reamer 7, the processing unit 2 of the information processing device 1 acquires a fluoroscopic image (X-ray image) of the pelvis of patient K in real time. The processing unit 2 of the information processing device 1 can also acquire the fluoroscopic image (X-ray image) in video format while acquiring it in real time. Thus, the fluoroscopic image (X-ray image) of patient K taken in real time during the surgical procedure includes the bone-digging reamer 7 cutting the pelvis, thereby enabling the determination of the current position and tilt of the bone-digging reamer 7 (the outer edge of the hemispherical front end used for digging) in the pelvis. If an acetabular cup 81 is conceived to be positioned at the current position of the bone-digging reamer 7 in the pelvis, that is, at the depression (setting space) of the bone dug by the bone-digging reamer 7, the acetabular cup CE angle, anteversion angle and abduction angle of the acetabular cup 81 conceived to be positioned can be derived.

[0058] Figure 6 This is an explanatory diagram of the acetabular cup CE angle. In the accompanying drawings of this embodiment, a semi-circular graphic object of the acetabular cup 81, which is envisioned to be positioned according to the current position of the bone-removing reamer 7 in the pelvis, is displayed overlaid on a perspective image. The processing unit 2 of the information processing device 1 derives the acetabular cup CE angle as the angle formed by the line connecting the center (COR: Center of Rotation) of the acetabular cup 81, which is envisioned to be positioned after the pelvis has been cut by the bone-removing reamer 7, to the intersection of the white line (Acetabularsourcil) on the pelvic load surface, and the line perpendicular to the pelvic reference line (Y-axis) relative to the line connecting the lower ends of the left and right teardrops in the pelvis.

[0059] The processing unit 2 of the information processing device 1 derives the inner plate line in the perspective image based on the inner plate corresponding points (markers) output by the learning model 101 (S106). The learning model 101 outputs a tomographic image (CT image, etc.) with overlapping inner plate corresponding points (markers) for the input tomographic image. These inner plate corresponding points are points located on the inner plate line, which represents the maximum cutting area during pelvic cutting, i.e., the insurmountable excavation boundary line. The processing unit 2 of the information processing device 1 extracts the points (markers) shown on each tomographic image and derives (determines) the inner plate line by forming (connecting) a line connecting these extracted points (markers).

[0060] Figure 7 This is an explanatory diagram of the inner plate line. The illustrations in this embodiment show multiple (three in this embodiment) tomographic images, each with multiple positions in the Y-axis direction (vertical direction of the human body) corresponding to a fluoroscopic image (X-ray image) (same Y-coordinate). These tomographic images are output from the learning model 101 (inner plate line model), and each tomographic image is superimposed with 〇 (markers) representing corresponding points (markers) of the inner plate. The processing unit 2 of the information processing device 1 uses these tomographic images with superimposed inner plate corresponding points (markers) to determine multiple inner plate corresponding points (markers) in the fluoroscopic image, and forms an inner plate line by connecting the determined multiple inner plate corresponding points into a line.

[0061] The processing unit 2 of the information processing device 1 can generate (reconstruct) a three-dimensional medical image including the pelvis and hip joint of patient K by using volume data composed of multiple tomographic images. Based on this, the processing unit 2 of the information processing device 1 can set a three-dimensional body coordinate system in the tomographic image or three-dimensional medical image including the pelvis of patient K. In this body coordinate system, the processing unit 2 of the information processing device 1 defines, for example, the line connecting the lower ends of the two teardrops of the pelvis as a pelvic reference line, defines the horizontal direction (relative to the left-right direction of the human body) relative to the pelvic reference line as the X-axis, defines the vertical direction (relative to the up-down direction of the human body) relative to the pelvic reference line as the Y-axis, and defines the direction perpendicular to both the X-axis and Y-axis (relative to the front-back direction of the human body) as the X-axis, and performs various calculations. The processing unit 2 of the information processing device 1 can normalize, or align, the internal coordinate system between the acquired fluoroscopic images (X-ray images) and the acquired tomographic images (CT images) by utilizing the shape recognition results of the same internal parts (e.g., teardrops) commonly contained in the acquired fluoroscopic images (X-ray images) and tomographic images (CT images). Thus, the processing unit 2 of the information processing device 1 applies the internal coordinate system set in multiple tomographic images (or reconstructed three-dimensional medical images) to the fluoroscopic images (X-ray images) taken in real time during surgery, and derives the inner plate line obtained by connecting multiple inner plate corresponding points in the fluoroscopic images (X-ray images) based on the corresponding points (markers) of the inner plate determined in each tomographic image. Furthermore, regarding the current position of the bone-removing reamer 7 contained in the fluoroscopic images (X-ray images), the processing unit 2 of the information processing device 1 can also determine it in the internal coordinate system, which is a common coordinate system with the tomographic images (CT images), by converting the image coordinate system of the fluoroscopic images to the internal coordinate system.

[0062] The processing unit 2 of the information processing device 1 derives the minimum reach line in the fluoroscopic image based on the radius of the acetabular cup 81 and the target CE angle (S107). The radius of the acetabular cup 81 of the artificial hip joint 8 inserted into the patient K and the target CE angle are stored in the storage unit 3 as various values ​​determined in the preoperative planning. The processing unit 2 of the information processing device 1 derives the minimum reach line in the fluoroscopic image based on the white line (acetabular sourcil) based on the inner edge of the pelvic loading surface contained in the fluoroscopic image, based on the radius of the acetabular cup 81 and the target CE angle. This white line (acetabular sourcil) based on the inner edge of the pelvic loading surface can be determined (position determined) by performing shape recognition processing on the fluoroscopic image. The minimum reach line represents the minimum cutting area in the pelvis of the patient K when cutting the pelvis to accommodate the acetabular cup 81.

[0063] Figure 8This is an explanatory diagram related to the acetabular line. The storage unit 3 of the information processing device 1 stores various values ​​(parameters) determined in the preoperative plan when performing related procedures for the artificial hip joint 8, such as the preset minimum CE angle (e.g., 10 degrees) for stabilizing the configured acetabular cup 81 and the radius of the implanted acetabular cup 81. The processing unit 2 of the information processing device 1 obtains these various values ​​determined in the preoperative plan by referring to the storage unit 3.

[0064] The processing unit 2 of the information processing device 1 defines the intersection point (X, Y) between the center (x, y) of the acetabular cup 81, which is envisioned to be positioned in the depression (setting space) of the bone excavated by the bone-digging reamer 7, and the white line (Acetabularsourcil) of the inner edge of the pelvic load surface during excavation. In this case, the center (x, y) of the acetabular cup 81 is expressed using the intersection point (X, Y), the radius (r) of the acetabular cup 81, and the acetabular cup CE angle (Θ) by the following formulas. The X coordinate (x) of the center of the acetabular cup 81 is calculated by subtracting the sine of the radius (r) of the acetabular cup 81 and the acetabular cup CE angle (Θ) from the X coordinate (X) of the intersection point (x) (x=Xr*sinΘ). The Y coordinate (y) of the center of the acetabular cup 81 is calculated by subtracting the sine of the radius (r) of the acetabular cup 81 and the acetabular cup CE angle (Θ) from the Y coordinate (Y) of the intersection point (y) (y=Yr*cosΘ). In this way, the center (x, y) of the acetabular cup 81 corresponds one-to-one with the intersection point (X, Y). When the intersection point (X, Y) changes, that is, when the excavation amount of the bone-digging reamer 7 changes the white line (acetabular sourcil) of the inner edge of the pelvic load surface during excavation, the center (x, y) of the acetabular cup 81 will also change. Thus, when the intersection point (X, Y) changes, the CE angle (Θ) of the acetabular cup exceeds the minimum CE angle (10 degrees) (Θ>10), which becomes an implantation condition. Within the range where this condition (Θ>10) is met, the processing unit 2 of the information processing device 1 determines the range of variation that allows the intersection point (X, Y) to change.

[0065] The processing unit 2 of the information processing device 1 determines the area where the center (x, y) of the acetabular cup 81 can exist using the above formula, based on the range of variation of the determined intersection point (X, Y). The processing unit 2 of the information processing device 1 adds the radius (r) of the acetabular cup 81 to the center (x, y) of the acetabular cup 81 determined according to the varying intersection point (X, Y), thereby obtaining the edge line representing the range of (x', y') of each point on the outer edge of the acetabular cup 81. This line (the line that must be reached) is derived as the line that must touch the outer edge of the bone-digging reamer 7 (the outer edge of the front end of the hemisphere for digging) in order to meet the condition (Θ>10). When deriving this line, the processing unit 2 of the information processing device 1 selects an arbitrary point (x1, y1) in the acetabular floor of the pelvis before digging with the bone-digging reamer 7, and takes the angle of the X-axis relative to the line connecting the center (x, y) of the acetabular cup 81 and the arbitrary point as α. The coordinates of the arbitrary point are (x+rcosα, y+rsinα). Furthermore, the processing unit 2 of the information processing device 1 can derive a reachable line by adding the radius (r) of the acetabular cup 81 to the center (x, y) of the acetabular cup 81 corresponding to the changing intersection point (X, Y), resulting in a point (x+rcosα, y+rsinα) greater than the coordinates (x1, y1) of any point (x+rcosα>x1 and y+rsinα>y2). That is, the processing unit 2 of the information processing device 1 derives a reachable line by adding the center (x, y) of the acetabular cup 81, which satisfies the conditions "(x+rcosα>x1 and y+rsinα>y2)" and "acetabular cup CE angle; Θ>10", to the obtainable range (x', y'), i.e., the radius (r) of the acetabular cup 81, thus making it the edge of the range obtainable as the outer edge of the acetabular cup 81. This reachable line is equivalent to the line reaching the inner side of the region (in the digging direction of the bone-removing reamer 7, it becomes the inner side of the anterior side).

[0066] The processing unit 2 of the information processing device 1 derives an upward displacement boundary line in the fluoroscopic image based on the center of the healthy side's bone (S108). The processing unit 2 of the information processing device 1 identifies the healthy side's bone included in the fluoroscopic image and derives an upward displacement boundary line in the fluoroscopic image based on the center of the healthy side's bone. The upward displacement boundary line represents the limit of upward displacement that the center of the affected side's bone (the center of the head of the artificial hip joint 8) can achieve relative to the center of the healthy side's bone.

[0067] Figure 9This is an explanatory diagram of the upward displacement boundary line. In the illustrations of this embodiment, four line diagrams ((1) to (4)) are shown for reference. These line diagrams are shown below. Line diagram (1) represents "a line parallel to the X-axis passing through y'=y2+10mm+acetabular cup radius mm (the upward displacement boundary line of the acetabular cup edge)". Line diagram (2) represents "a line parallel to the X-axis passing through y=y2+10mm (the upward displacement boundary line of the acetabular cup center)". Line diagram (3) represents "a line parallel to the X-axis passing through the center of the healthy side bone (x2, y2)". Line diagram (4) represents "the pelvic reference line (X-axis) connecting the lower end of the teardrop". The patient K who is to undergo the treatment of the artificial hip joint 8 is generally assumed to have the treatment of the artificial hip joint 8 (implantation) in either the left or right leg. In this case, the affected side where the treatment of the artificial hip joint 8 is performed is called the affected side, and the healthy side where the treatment of the artificial hip joint 8 is not performed is called the healthy side.

[0068] The processing unit 2 of the information processing device 1 uses, for example, an object detection system model such as YOLO or edge detection to perform shape recognition on the healthy side of the bone contained in the acquired perspective image (X-ray image), and calculates the center of curvature based on the arc-shaped outer edge formed in the bone, for example, through multiple points located on the outer edge, thereby deriving the center of the healthy side of the bone. The processing unit 2 of the information processing device 1 derives an upward displacement boundary line (line segment (2)) of the acetabular cup center (the bone center of the implant on the affected side) that is parallel to the X-axis (line segment (4)) and passes through the derived healthy side of the bone center (x2, y2). This line is located in the positive direction (upward) on the Y-axis and is within a predetermined value (e.g., 10 mm). The upward displacement boundary line of the acetabular cup center (the bone center of the implant on the affected side) becomes a reference line when determining the upward displacement boundary line (line segment (1)) of the edge of the acetabular cup, i.e., the upward displacement boundary line (line segment (1)) in the strike zone.

[0069] The center of the bone on the affected side where the relevant treatment of the artificial hip joint 8 is implemented corresponds to the center (x, y) of the acetabular cup 81 arranged. The Y axis represents the upper limit direction in the human body, and the positive direction in the Y axis represents upward. The Y coordinate (y) of the center (x, y) of the arranged acetabular cup 81 is set within a range such that it is upward relative to the Y coordinate (y2) of the center of the bone on the healthy side, for example, not exceeding 10 mm (y < y2 + 10 [mm]). Therefore, the processing unit 2 of the information processing device 1 derives the following upper shift limit line (line segment (2)) of the acetabular cup center (the center of the bone ball head of the artificial hip joint 8 on the affected side): a point after moving upward (along the positive direction of the Y axis) by the upper shift limit value (for example, 10 mm) relative to the Y coordinate (y2) of the center of the bone on the healthy side, and perpendicular to the Y coordinate. Moreover, it determines (derives) an upper shift limit line (line segment (1)) of the acetabular cup edge that is parallel to the upper shift limit line (line segment (2)) of the acetabular cup center (the center of the bone implant on the affected side) (that is, parallel to the X axis) and is located above (the positive direction on the Y axis) by the amount of the acetabular cup radius, that is, the upper shift limit line (line segment (1)) in the strike zone. Thus, based on the center of the bone on the healthy side, the upper shift limit line (line segment (1): the upper shift limit line of the acetabular cup edge) in the strike zone is derived, enabling a rough standard (the upper limit line during pelvic excavation) to be provided to a doctor or the like when configuring the center of the bone on the affected side (the center of the bone ball head of the artificial hip joint 8).

[0070] The processing unit 2 of the information processing device 1 derives the strike zone (S109) based on the derived inner plate line, must - reach line, and upper shift limit line. The processing unit 2 of the information processing device 1 derives the region enclosed by these lines as the strike zone based on the derived upper shift limit line, inner plate line, and must - reach line.

[0071] Figure 10 It is an explanatory diagram related to the strike zone. This strike zone represents the region where, when a part of the acetabular cup 81 is contacted when the acetabular cup 81 is arranged, stable fixation of the acetabular cup 81 can be ensured. In the strike zone, the upper shift limit line and the inner plate line represent the limit lines that cannot be exceeded when excavating with the bone - excavating reamer 7. By overlapping and displaying the thus - derived strike zone on the fluoroscopic image, the position relationship between the current position of the bone - excavating reamer 7 and the region (strike zone) that the bone - excavating reamer 7 should reach through excavation can be provided to the doctor in real time using the bone - excavating reamer 7 included in the real - time displayed fluoroscopic image.

[0072] The processing unit 2 of the information processing device 1 outputs various measured values, target values, and differences between these values ​​at the current moment (S110). Using a perspective image, the processing unit 2 of the information processing device 1 outputs the measured values ​​of the acetabular cup 81, assuming it has been positioned after the pelvis has been cut using the osteotomy reamer 7. The target CE angle and the target distance between the outer edge of the acetabular cup 81 and the inner plate line are preset as target values ​​and stored in the storage unit 3 of the information processing device 1 as various values ​​determined in the preoperative plan when performing related procedures for the artificial hip joint 8. The processing unit 2 of the information processing device 1 obtains these various values ​​determined in the preoperative plan by referring to the storage unit 3.

[0073] The processing unit 2 of the information processing device 1 uses the acquired fluoroscopic image to determine, based on the current position and tilt of the bone-digging reamer 7 (the outer edge of the hemispherical anterior end for digging) in the pelvis of the patient K, the position and tilt of the acetabular cup 81 when it is hypothetically positioned after the pelvis has been cut using the bone-digging reamer 7. This tilt includes, for example, the anteversion angle and abduction angle of the acetabular cup 81.

[0074] Figure 11 This is an explanatory diagram of the anteversion angle and abduction angle of the acetabular cup 81 (in a hypothetical configuration where the pelvis has been cut using the bone-digging reamer 7). The processing unit 2 of the information processing device 1 determines the three points (A, A', B) of the ellipse through shape recognition processing. In this case, when the angle between A-A' and A'-B is X in the perspective image, the anteversion angle is represented by "sin^(-1)*tanX". In the perspective image, the processing unit 2 can identify the shape and current position of the bone-digging reamer 7 (the outer edge of the hemispherical front end for digging) corresponding to the hypothetical configuration of the acetabular cup 81 by using calculations using the image coordinate system in the perspective image, and calculate the anteversion angle and abduction angle.

[0075] The processing unit 2 of the information processing device 1 can derive the target pitch angle and target flare angle as target values ​​based on a preset target CE angle. The processing unit 2 of the information processing device 1 can derive the target pitch angle and target flare angle by referring to a table (target CE angle table) obtained by associating the various values ​​of the target CE angle with the values ​​of the target pitch angle and target flare angle. This target CE angle table and other lookup tables referenced by the processing unit 2 of the information processing device 1 during various calculations are stored in the storage unit 3.

[0076] The processing unit 2 of the information processing device 1 overlays various derived auxiliary information (arrival area, difference between measured value and target value) onto the perspective image and outputs it (S111). Auxiliary information includes, for example, the arrival area and the difference between the measured value and the target value. The processing unit 2 of the information processing device 1 overlays the derived arrival area onto the perspective image and outputs it to the display device 41. The processing unit 2 of the information processing device 1 also attaches various measured values, target values, and the difference between the measured value and the target value to the perspective image and outputs them to the display device 41. When outputting this information, the processing unit 2 of the information processing device 1 can generate and output image data constituting the display screen (auxiliary information overlay screen). The processing unit 2 of the information processing device 1 compares the derived measured values ​​(acetabular cup CE angle, measured distance between the outer edge of the acetabular cup 81 and the inner plate line, anteversion angle, and abduction angle) with the corresponding target values ​​(target CE angle, target distance between the outer edge of the acetabular cup 81 and the inner plate line, target anteversion angle, and target abduction angle) and displays them along with the fluoroscopic image (e.g., in a sub-screen or other frame). This allows doctors and others to efficiently grasp the differences between various measured values ​​and target values ​​at the current moment.

[0077] The processing unit 2 of the information processing device 1 extracts a tomographic image including the current position of the bone-digging reamer 7 from multiple tomographic images obtained by photographing the pelvis of patient K (S112). The processing unit 2 of the information processing device 1 determines the current position of the bone-digging reamer 7 (the outer edge of the hemispherical front end used for digging) in the pelvis of patient K by performing shape recognition, for example, using an object detection system model such as YOLO or edge detection, in the acquired fluoroscopic image. By aligning the fluoroscopic image with the tomographic image (CT image, etc.), the processing unit 2 of the information processing device 1 can apply the body coordinate system defined in the tomographic image to the fluoroscopic image.

[0078] The processing unit 2 of the information processing device 1 can obtain the current position of the bone-removing reamer 7 (the outer edge of the hemispherical front end used for excavation) contained in the fluoroscopic image by determining it in the body coordinate system defined in the tomographic image. The storage unit 3 of the information processing device 1 stores multiple tomographic images (CT images, etc.) obtained by taking pictures of the patient K with the CT device 61 before using the bone-removing reamer 7 for pelvic excavation. These multiple tomographic images (CT images, etc.) are images sliced ​​along the Y-axis direction, that is, the anterior-posterior direction of the human body, and each tomographic image (CT image, etc.) is represented by the X-axis (the left-right direction of the human body) and the Z-axis (the anterior-posterior direction of the human body).

[0079] The processing unit 2 of the information processing device 1 extracts one or more tomographic images (CT images, etc.) containing the current position of the bone-digging reamer 7 determined in the fluoroscopic image. The processing unit 2 of the information processing device 1 extracts a tomographic image (CT image, etc.) corresponding to the Y-coordinate (y) of the center (x, y) of the acetabular cup 81 at the location where the acetabular cup 81 is assumed to be set in the current digging state, based on the outer edge of the hemispherical front end of the bone-digging reamer 7 (the part used for digging). Alternatively, each tomographic image is associated with the Y-axis coordinates corresponding to that tomographic image and the region (range) of the XZ plane using an internal coordinate system. Therefore, the processing unit 2 of the information processing device 1 can, for example, extract a tomographic image corresponding to the current position of the bone-digging reamer 7 in the internal coordinate system.

[0080] The processing unit 2 of the information processing device 1 overlays an image of the outer edge of the acetabular cup 81, assuming it is positioned when the pelvis has been cut using the bone-removing reamer 7, onto the extracted tomographic image and outputs it (S113). The processing unit 2 of the information processing device 1 overlays a semi-circular image (the outer edge of the acetabular cup's outer edge) representing the current position of the bone-removing reamer 7 (the outer edge of the hemispherical front end used for excavation) onto one or more extracted tomographic images (CT images, etc.) and outputs it. The processing unit 2 of the information processing device 1 can also use a perspective image to derive the setting angle and depth of the acetabular cup 81 at the position where it is assumed to be positioned during the current excavation state, and further overlay it onto the tomographic image (CT image, etc.) for output. In this way, the processing unit 2 of the information processing device 1 extracts the corresponding tomographic image (CT image, etc.) based on the current position of the bone-removing reamer 7 determined in the fluoroscopic image (assuming the position of the acetabular cup 81 is set in the current excavation state), and overlays the outer edge image (a semi-circular graphic object) of the assumed acetabular cup 81, the setting angle of the acetabular cup 81, and the depth onto the tomographic image and outputs it. Thus, information that assists in three-dimensional intraoperative identification, including information about the Z-axis (the anteroposterior direction of the human body), can be provided to doctors and others.

[0081] Figure 12 This is an explanatory diagram illustrating an example of a display screen for auxiliary information (an overlay screen for auxiliary information). The processing unit 2 of the information processing device 1 generates image data constituting the overlay screen for auxiliary information as a result of the various processes described above, and outputs the image data to the display device 41. The overlay screen for auxiliary information includes a perspective image display area, a tomographic image display area, and an auxiliary information display area.

[0082] The fluoroscopic image display area shows a real-time fluoroscopic image (X-ray image) of the pelvis of patient K taken during the surgical procedure of cutting the pelvis using the osteotome 7. The reached area is overlaid on this fluoroscopic image. The tomographic image display area shows a tomographic image (CT image) including the current position of the osteotome 7 as determined in the fluoroscopic image. The tomographic image overlaid with a view of the outer edge (semi-circular graphic object) of the acetabular cup 81 assuming it is positioned after the pelvis has been cut using the osteotome 7. The reached area may also be overlaid on the tomographic image.

[0083] When the pelvis has been cut using the bone-removing reamer 7, and the acetabular cup 81 is presumably positioned, the anteversion angle, abduction angle, CE angle of the presumed acetabular cup 81, and the remaining distance between the cup and the inner plate line are displayed in a list in the auxiliary information display area. These anteversion angle, abduction angle, CE angle, and remaining distance between the acetabular cup 81 and the inner plate line are calculated based on the measured values ​​(target values) determined in the preoperative plan, the values ​​determined in the fluoroscopic plan, and the differences between the target values ​​and the measured values, all calculated based on the current position and tilt of the bone-removing reamer 7 as determined by shape recognition processing in the fluoroscopic image.

[0084] Figure 13 This is an explanatory diagram illustrating an example display screen (distortion correction screen) for auxiliary information. The processing unit 2 of the information processing device 1 generates image data constituting the distortion correction screen as a result of the various processes described above, and outputs this image data to the display device 41. The distortion correction screen includes a display area before distortion correction and a display area after distortion correction. Thus, by comparing and displaying the perspective image before distortion correction (auxiliary information overlay) and the perspective image after distortion correction (auxiliary information overlay), the distortion correction screen can provide doctors and others with information regarding the distortion correction before and after the target area (strike zone), thus providing useful information for the doctor during each surgery.

[0085] The distortion correction screen can be output in a different screen than the aforementioned auxiliary information overlap screen, or it can be included in the auxiliary information overlap screen. When the distortion correction screen is output in a different screen than the auxiliary information overlap screen, the display device 41 displaying the distortion correction screen and the display device 41 displaying the auxiliary information overlap screen can be different display devices 41. In this case, the information processing device 1 is connected to both the display device 41 displaying the distortion correction screen and the display device 41 displaying the auxiliary information overlap screen.

[0086] The image displayed in the perspective image display area of ​​the aforementioned auxiliary information overlay screen before distortion correction is displayed in the display area before distortion correction (overlay display of the perspective image of the reached area). Moreover, the image displayed in the display area before distortion correction (the image before correction) displays a grid-like auxiliary line composed of multiple curves used during distortion correction.

[0087] The distortion-corrected image is displayed in the distortion-corrected display area (overlaying a perspective image of the strike zone). Furthermore, in the image displayed in the distortion-corrected display area (the corrected image), the auxiliary lines used during distortion correction are displayed as straight lines according to the correction deformation. Thus, the strike zone is also displayed with its shape (the area in the pelvis) changed according to the distortion correction.

[0088] When performing distortion correction, the processing unit 2 of the information processing device 1 can, for example, install a template containing straight lines below the perspective image (image before correction) to perform distortion correction processing. At this time, the processing unit 2 of the information processing device 1 is a device that converts X-rays passing through the human body into digital images, and a flat panel with distortion correction function can be used.

[0089] Alternatively, the processing unit 2 of the information processing device 1 can perform distortion correction processing on the fluoroscopic image (image before correction) based on the distortion aberrations determined by the X-ray imaging characteristics of the X-ray device 62, etc. The X-ray device 62 that captures the fluoroscopic image (X-ray image) has various characteristics depending on its model or type, and can also determine the distortion aberrations corresponding to the amount of distortion in the captured fluoroscopic image (X-ray image). The storage unit 3 of the information processing device 1 stores parameters such as distortion aberrations corresponding to various X-ray devices 62, and the processing unit 2 of the information processing device 1 can use these parameters to perform distortion correction. In this case, there is no need to use a tablet as a dedicated device for hardware-based distortion correction; a relatively inexpensive display (a display device without hardware-based distortion correction functionality) can be used to display the distortion-corrected fluoroscopic image.

[0090] According to this embodiment, the processing unit 2 of the information processing device 1 acquires a fluoroscopic image (X-ray image) of a patient K who is to undergo related treatments for an artificial hip joint 8. This fluoroscopic image is, for example, an X-ray image. As part of the related treatments for the artificial hip joint 8, when a bone recess (setting space) is formed using a bone-removing reamer 7 as a pelvic support (excavating the pelvis) for setting the acetabular cup 81 of the artificial hip joint 8, a real-time motion image is captured of the fluoroscopic image (X-ray image), and the processing unit 2 of the information processing device 1 sequentially acquires this real-time captured fluoroscopic image (X-ray image). In the acquired fluoroscopic image of the patient K's pelvis, the processing unit 2 of the information processing device 1 identifies (derives) the inner plate line and the minimum cutting line (the line that should be exceeded). The inner plate line represents the maximum cutting area when cutting the pelvis to accommodate the acetabular cup 81 included in the artificial hip joint 8, and the minimum cutting area when cutting the pelvis to accommodate the acetabular cup 81. Furthermore, the processing unit 2 of the information processing device 1 outputs the acetabular cup CE angle when the acetabular cup 81 is configured under the condition that the pelvis has been cut using the bone-removing reamer 7 (in real time). The processing unit 2 of the information processing device 1 overlays these identified (output) inner plate lines and Bida lines on the fluoroscopic image, and displays the output acetabular cup CE angle along with the fluoroscopic image, for example, through a sub-screen, thus providing useful auxiliary information to the physician performing related procedures on the artificial hip joint 8 for patient K. The processing unit 2 of the information processing device 1 uses, for example, an object detection system model such as YOLO or edge detection to perform shape recognition on the outer edge of the bone-removing reamer 7 (the outer edge of the hemispherical anterior end being excavated) contained in the fluoroscopic image (X-ray image). The processing unit 2 of the information processing device 1 regards the outer edge of the bone-removing reamer 7 as the outer edge of the acetabular cup 81, and outputs the acetabular cup CE angle when the acetabular cup 81 is configured under the condition that the pelvis has been cut using the bone-removing reamer 7. The processing unit 2 of the information processing device 1 derives the acetabular cup CE angle as the angle formed by the line connecting the center (COR) of the acetabular cup 81 (i.e., the intersection of the outer edge of the acetabular cup 81 and the white line (Acetabular sourcil) of the acetabular cup 81 with the line connecting the lower ends of the left and right teardrops in the pelvis with respect to the vertical line (Y-axis) of the pelvic reference line. The processing unit 2 of the information processing device 1 uses, for example, object detection system models such as YOLO or edge detection to perform shape recognition on the lower ends of the left and right teardrops contained in the fluoroscopic image (X-ray image) and determines the pelvic reference line passing through the lower ends of the left and right teardrops. The processing unit 2 of the information processing device 1 determines a vertical line that is perpendicular to the determined pelvic reference line and passes through the center (COR) of the acetabular cup 81 (i.e., the center of rotation of the acetabular cup 81) with ...The processing unit 2 of the information processing device 1 derives the acetabular cup CE angle by calculating the angle formed by the vertical line passing through the center (COR) of the acetabular cup 81 and the line connecting the center of the acetabular cup 81 to the intersection of the outer edge of the acetabular cup 81 and the white line (acetabular sourcil) on the pelvic load surface. The processing unit 2 of the information processing device 1 acquires real-time fluoroscopic images and derives the acetabular cup CE angle based on the outer edge of the bone-removing reamer 7 contained in the acquired fluoroscopic images. Thus, it is possible to track the current position of the bone-removing reamer 7, i.e., the digging state based on the bone-removing reamer 7, and to provide the surgeon with the acetabular cup CE angle at the current moment when the acetabular cup 81 is configured. In other words, it is possible to construct an intraoperative support system S that can perform real-time assessment of the acetabular cup 81's setup and coverage during surgery.

[0091] According to this embodiment, one or more tomographic images, such as CT or MRI images, are obtained by taking pictures of the pelvis of patient K before pelvic excavation using a bone-removing reamer 7. The processing unit 2 of the information processing device 1 acquires these multiple tomographic images and stores them in the storage unit 3. The storage unit 3 of the information processing device 1 stores a physical file of a learning model 101 (inner plate line model), which is learned to output the position information (markers) of the inner plate when a tomographic image is input. The processing unit 2 of the information processing device 1 inputs the acquired tomographic image (CT image, etc.) into the learning model 101 (inner plate line model), thereby the learning model 101 (inner plate line model) overlays the position information of the inner plate onto the tomographic image and outputs it. The position information of the inner plate is output as points (markers). By outputting multiple points (markers) to the tomographic image, a line connecting the multiple points (markers) is formed, thereby determining the inner plate line. In this way, by using a learning model 101 (inner plate line model) that learns to output the position information (marker) of the inner plate when given a tomographic image, the inner plate line, which represents the maximum cutting area when cutting the pelvis to accommodate the acetabular cup 81 included in the artificial hip joint 8, can be efficiently determined (derived). The processing unit 2 of the information processing device 1 can align the tomographic image (CT image, etc.) and the fluoroscopic image (X-ray image) based on the same internal body part (e.g., teardrop) determined using shape recognition, define the two images (tomographic image and fluoroscopic image) in the same internal coordinate system, and perform various operations such as image overlay display. The processing unit 2 of the information processing device 1 overlays the inner plate line derived from the tomographic image (CT image, etc.) onto the fluoroscopic image (X-ray image) in such a way that it is at the same position (internal coordinate value) as the inner plate line shown in the tomographic image, and displays (outputs) it. The fluoroscopic image (X-ray image) displayed in real time during the operation shows the bone-removing reamer 7 at the current moment, while also overlaying the inner plate line. Therefore, it can efficiently prompt the surgeon operating the bone-removing reamer 7 to draw the inner plate line (excavation boundary line) obtained by connecting the maximum cutting point when cutting the pelvis, that is, the boundary point that cannot be exceeded.

[0092] The embodiments disclosed herein are illustrative in all respects and should not be considered as limiting this disclosure. The scope of the invention is set forth in the claims, and not in the foregoing, and is intended to include all modifications having the same meaning and scope as the claims.

[0093] The claims listed in the claims statement can be combined with each other regardless of their form of reference. The claims statement may also include multiple dependent claims that are subordinate to the multiple claims. Even if multiple dependent claims are not listed, this does not limit the inclusion of such dependent claims.

[0094] Explanation of reference numerals in the attached figures:

[0095] S Intraoperative Assist System

[0096] Patient K

[0097] 1. Information processing device

[0098] 2 Processing Department

[0099] 3. Storage Section

[0100] M storage medium

[0101] P program (program product)

[0102] 4. Input / Output (I / F)

[0103] 41 Display device

[0104] 5 Ministry of Communications

[0105] 101 Learning Model (Inner Plate Line Model)

[0106] 61 CT device (computed tomography imaging device)

[0107] 62. X-ray device (fluoroscopic imaging device)

[0108] 7. Reamer for bone removal

[0109] 8. Artificial hip joint

[0110] 81 Achilles cup

Claims

1. A program, characterized in that, The computer will perform the following processing: Obtain fluoroscopic images of patients who are to undergo procedures related to artificial hip joint replacement; In the acquired fluoroscopic image, an inner plate line is identified in the patient's pelvis, the inner plate line representing the maximum cutting area when the pelvis is cut to accommodate the acetabular cup included in the artificial hip joint; Identify the Bida line in the patient’s pelvis, the Bida line representing the minimum cutting area when cutting the pelvis to accommodate the acetabular cup; The acetabular cup CE angle was derived when the patient's pelvis was cut using a bone-removing reamer for related treatments of the artificial hip joint. The identified inner plate line and the Bida line are superimposed on the perspective image; The derived acetabular cup CE angle is displayed along with the perspective image.

2. The procedure according to claim 1, characterized in that, Obtain tomographic images of the patient's pelvis. The location information of the inner plate is derived by inputting the acquired tomographic image into the learning model. The learning model is trained to output the location information of the inner plate given the tomographic image as input. The inner plate lines in the perspective image are identified based on the output of multiple sets of inner plate position information.

3. The procedure according to claim 1, characterized in that, Based on the bone center of the healthy side where the aforementioned artificial hip joint treatment was not performed, an upward displacement boundary line relative to the bone center of the affected side where the aforementioned artificial hip joint treatment was performed is derived. Based on the derived upper boundary line, inner plate line, and reachable line, the reachable area is derived. The exported arrival area is overlaid on the perspective image.

4. The procedure according to claim 1, characterized in that, The Bida line is derived based on the target CE angle predetermined for stabilizing the configured acetabular cup, the intersection point between the outer edge of the acetabular cup (as a reference) and the inner edge of the load surface in the patient's pelvis when ensuring the target CE angle, and the radius of the acetabular cup.

5. The procedure according to claim 1, characterized in that, The exported acetabular cup CE angle is compared with the preset target CE angle as the target value and then output. The measured distance between the outer edge of the acetabular cup and the inner plate line was derived when the patient's pelvis was cut using the aforementioned osteotomy reamer, assuming the configuration of the acetabular cup. Derive the target distance between the outer edge of the acetabular cup and the inner plate line, which is preset as a target value. The exported measured distance is compared with the target distance and then output.

6. The procedure according to claim 1, characterized in that, The anteversion and abduction angles of the acetabular cup were derived under the condition that the patient's pelvis had been cut using the osteotomy reamer. Output the derived tilt angle and abduction angle.

7. The procedure according to claim 5, characterized in that, Based on the target CE angle, the target forward tilt angle and target outward tilt angle are derived. The derived target tilt angle and target abduction angle are combined and output.

8. The procedure according to claim 7, characterized in that, The derived acetabular cup anteversion and abduction angles are compared with the target anteversion and abduction angles and then output.

9. The procedure according to claim 2, characterized in that, Based on the acquired fluoroscopic image, the current position of the bone-removing reamer in the patient's pelvis is determined. Extract the tomographic image containing the current position of the bone-removing reamer from the multiple tomographic images obtained by photographing the patient's pelvis. The outer edge of the acetabular cup, with the patient's pelvis cut using the bone-removing reamer, is overlaid onto the extracted tomographic image and output.

10. An information processing method, characterized in that, The computer will perform the following processing: Obtain fluoroscopic images of patients who are to undergo procedures related to artificial hip joint replacement; In the acquired fluoroscopic image, an inner plate line is identified in the patient's pelvis, the inner plate line representing the maximum cutting area when the pelvis is cut to accommodate the acetabular cup included in the artificial hip joint; Identify the Bida line in the patient’s pelvis, the Bida line representing the minimum cutting area when cutting the pelvis to accommodate the acetabular cup; The acetabular cup CE angle was derived when the patient's pelvis was cut using a bone-removing reamer for related treatments of the artificial hip joint. The identified inner plate line and the Bida line are superimposed on the perspective image; The derived acetabular cup CE angle is displayed along with the perspective image.

11. An information processing device, characterized in that, include: The acquisition department acquires fluoroscopic images of patients who are to undergo procedures related to artificial hip joints. The inner plate line identification unit identifies the inner plate line in the patient's pelvis in the acquired fluoroscopic image, the inner plate line representing the maximum cutting area when the pelvis is cut in order to configure the acetabular cup included in the artificial hip joint. A Bida line identification unit is used to identify a Bida line in the patient’s pelvis, the Bida line representing the minimum cutting area when cutting the pelvis to configure the acetabular cup; The export section exports the acetabular cup CE angle when the acetabular cup is configured, assuming the patient's pelvis has been cut using a bone-removing reamer for related treatments of the artificial hip joint; and The display unit overlays the identified inner plate line and the Bida line onto the perspective image, and displays the derived acetabular cup CE angle along with the perspective image.

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