Endoscope system

Abstract

To provide an endoscope system that allows a treatment part to be observed continuously in fluorescent observation while suppressing an increase in the diameter.SOLUTION: An endoscope system 1 of the present invention includes: an illumination light source; a treatment light source for emitting treatment light for allowing a photoreactive reagent accumulated in a treatment target part to react; a guide light source for emitting guide light of a wavelength shorter than that in a wavelength band of the treatment light source; an imaging part having an optical filter for cutting the light of the wavelength band of the treatment light and transmitting part of white light, the guide light, and fluorescent light emitted by the reagent for capturing an optical image; a control part; and an image processing part for generating an image on the basis of the optical image acquired by the light emitted by each light source. The control part causes the image processing part to generate an illumination light image on the basis of the optical image acquired while the illumination light source and the guide light source are turned on, and to generate a fluorescent image on the basis of a fluorescent image acquired while the treatment light source is turned on, and the illumination light source and the guide light source are turned off.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] The present invention relates to an endoscope system. [Background technology]

[0002] In recent years, research has been progressing on photoimmunotherapy (PIT), a cancer treatment method in which antibody drugs are specifically bound to proteins in cancer cells and then activated by irradiation with near-infrared light, a therapeutic light, to destroy the cancer cells. When irradiated with near-infrared light, antibody drugs cause cancer cells to swell and induce cell death. During this process, the antibody drugs are excited to emit fluorescence.

[0003] White light is used to observe the treatment site, and fluorescence observation using excitation light can be used to observe the binding of antibody drugs to tissues and the therapeutic effects. In this case, if a single image sensor is used in the observation optical system, fluorescence observation can be performed using an observation optical system that uses a filter to block the excitation light.

[0004] Even during fluorescence observation, it is important to observe the treatment site and grasp the area irradiated with near-infrared light in order to properly perform PIT treatment. However, because the intensity of fluorescence is weaker than that of white light, it is difficult to simultaneously observe the treatment site with white light and fluorescence observation. Furthermore, because the excitation light is blocked by a filter, it is also difficult to observe the area irradiated with the excitation light (e.g., near-infrared light). One possible solution to this problem is to use light in a wavelength band that is not blocked by the filter as guide light and irradiate it onto approximately the same area as the near-infrared light. However, if the fluorescence is weaker than the light intensity of the guide light, it becomes difficult to observe the fluorescence.

[0005] In response to this, a technique for processing white light or fluorescence is known in which a beam splitter is used to separate fluorescence from other light, and multiple image sensors are provided to receive each light, thereby processing the observation light for each observation (see, for example, Patent Document 1). The configuration of two image sensors disclosed in Patent Document 1 makes it possible to continuously observe the treatment site during fluorescence observation. [Prior art documents] [Patent documents]

[0006] [Patent Document 1] International Publication No. 2019 / 215796 Summary of the Invention [Problem to be solved by the invention]

[0007] However, a configuration with a two-plate imaging element as in Patent Document 1 increases the number of parts in the imaging optical system, leading to an increase in the size of the device. In particular, this configuration cannot be adopted in devices such as endoscopes that have an optical system in a part that is inserted into a subject, as it would increase the diameter of the insertion part.

[0008] The present invention has been made in view of the above, and has an object to provide an endoscope system that can continuously observe a treatment site during fluorescence observation while suppressing an increase in diameter. [Means for solving the problem]

[0009] In order to solve the above-mentioned problems and achieve the object, an endoscopic system according to the present invention comprises an illumination light source that emits illumination light to illuminate a subject, a therapeutic light source that emits therapeutic light that reacts with a photoreactive reagent accumulated in a treatment target region, a guide light source that emits guide light with a wavelength shorter than the wavelength band of the therapeutic light source, an imaging unit that captures optical images and has an optical filter that cuts out light in the wavelength band of the therapeutic light and transmits a portion of white light and the guide light and fluorescence emitted by the reagent, a controller that controls the emission timing of the illumination light source, the therapeutic light source, and the guide light source, and an image processor that generates images based on optical images obtained from the light emitted by the illumination light source, the therapeutic light source, and the guide light source, wherein the controller causes the image processor to generate illumination light images based on optical images acquired while the illumination light source and the guide light source are on and off, and to generate fluorescence images based on fluorescence images acquired while the illumination light source and the guide light source are off.

[0010] In addition, in the endoscope system according to the present invention, in the above invention, the image processing unit generates an illumination light image based on an optical image generated by irradiation with the illumination light and the guide light, and a superimposed image by superimposing a fluorescence image based on an optical image generated by the fluorescence on the illumination light image, and further includes a display device that displays the illumination light image and / or the superimposed image.

[0011] In the endoscope system according to the present invention, the control unit synchronously controls on / off of the illumination light source and the guide light source and the imaging timing of the imaging unit, and the treatment light source is controlled independently of the illumination light source and the guide light source.

[0012] In the endoscope system according to the present invention, the control unit synchronously controls on / off of the illumination light source and the guide light source, on / off of the treatment light source, and the imaging timing of the imaging unit.

[0013] In the endoscope system according to the present invention, in the above invention, the illumination light source is dimmed using a value obtained by subtracting a signal value corresponding to the light amount of the irradiated guide light from the detected light amount.

[0014] In the endoscope system according to the present invention, the illumination light source is dimmed based on the amount of light in a range excluding the irradiation range of the guide light.

[0015] In the endoscope system according to the present invention, the illumination light source emits light in a wavelength band other than the wavelength band of the guide light.

[0016] In the endoscope system according to the present invention, the illumination light source emits light of only blue and green components, or light of only blue component.

[0017] In the endoscope system according to the present invention, the control unit controls the image processing unit to generate an illumination light image based on an optical image acquired while the illumination light source and the guide light source are on and the therapeutic light source is off, and to generate a fluorescence image based on a fluorescence image acquired while the illumination light source and the guide light source are off and the therapeutic light source is on.

[0018] In the endoscope system according to the present invention, in the above invention, the control unit causes the imaging unit to capture a fluorescent image when a signal value of at least one of a blue component and a green component in an optical image acquired while the illumination light source and the guide light source are off becomes equal to or less than a preset threshold value.

[0019] In the endoscope system according to the present invention, the control unit normalizes the fluorescence image using the light intensity or irradiation diameter of the guide light irradiation region in the illumination light image.

[0020] In the endoscope system according to the present invention, the control unit corrects the amount of the therapeutic light using the light intensity or the irradiation diameter of the guide light irradiation region in the illumination light image.

[0021] In the endoscope system according to the present invention, the controller corrects the intensity of the therapeutic light depending on distance using the intensity or irradiation diameter of the guide light, and calculates the treatment time using the corrected light intensity. [Effects of the Invention]

[0022] According to the present invention, it is possible to suppress an increase in diameter and to continuously observe the treatment site during fluorescence observation. [Brief explanation of the drawings]

[0023] [Figure 1] FIG. 1 is a diagram illustrating a schematic configuration of an endoscope system according to a first embodiment of the present invention. [Figure 2] FIG. 2 is a block diagram showing a schematic configuration of the endoscope system according to the first embodiment of the present invention. [Figure 3] FIG. 3 is a diagram illustrating the distal end configuration of the endoscope according to the first embodiment of the present invention. [Figure 4] FIG. 4 is a graph showing an example of the absorption spectrum of therapeutic light. [Figure 5] FIG. 5 shows an example of the excitation spectrum and fluorescence spectrum of an antibody drug, the wavelength spectrum of therapeutic light, and the transmission characteristics of an optical filter. [Figure 6] FIG. 6 is a diagram illustrating the on / off timings of the white light, the guide light, and the therapeutic light according to the first embodiment of the present invention. [Figure 7] FIG. 7 is a diagram showing an example of a white light image. [Figure 8] FIG. 8 is a diagram showing an example of a fluorescent image. [Figure 9] FIG. 9 is a diagram showing an example of a superimposed image in which a fluorescent image is superimposed on a white light image. [Figure 10]FIG. 10 is a diagram illustrating the on / off timings of the white light, the guide light, and the therapeutic light according to the second modification of the first embodiment of the present invention. [Figure 11] FIG. 11 is a diagram illustrating the on / off timings of the white light, the guide light, and the therapeutic light according to the third modification of the first embodiment of the present invention. [Figure 12] FIG. 12 is a diagram showing an example of a display image according to the third modification of the first embodiment of the present invention. [Figure 13] FIG. 13 is a block diagram showing a schematic configuration of an endoscope system according to the second embodiment of the present invention. [Figure 14] FIG. 14 is a diagram illustrating the white light and the guide light according to the second embodiment of the present invention. [Figure 15] FIG. 15 is a diagram showing an example of a white light image. [Figure 16] FIG. 16 is a diagram showing an example of a fluorescent image. [Figure 17] FIG. 17 is a diagram illustrating a dimming process of white light according to the third embodiment of the present invention. [Figure 18] FIG. 18 is a diagram illustrating a light adjustment process according to the second modification of the third embodiment of the present invention. [Figure 19] FIG. 19 is a diagram illustrating correction of the irradiation light intensity of therapeutic light according to the fourth embodiment of the present invention. [Figure 20] FIG. 20 is a diagram for explaining the timing of acquiring a fluorescence image according to the fifth embodiment of the present invention. DETAILED DESCRIPTION OF THE INVENTION

[0024] Hereinafter, modes for carrying out the present invention (hereinafter referred to as "embodiments") will be described. In the embodiments, a medical endoscope system for performing a photoimmunotherapy method, which captures and displays images inside a subject such as a patient, will be described as an example of an endoscope system according to the present invention. However, the present invention is not limited to these embodiments. Furthermore, in the drawings, identical parts will be denoted by the same reference numerals.

[0025] (Embodiment 1) Fig. 1 is a diagram showing a schematic configuration of an endoscope system according to embodiment 1 of the present invention. Fig. 2 is a block diagram showing a schematic configuration of an endoscope system according to embodiment 1. Fig. 3 is a diagram illustrating the configuration of the tip of an endoscope according to this embodiment.

[0026] The endoscopic system 1 shown in Figures 1 and 2 includes an endoscope 2 that captures in-vivo images of a subject by inserting its tip into the subject, a light source device 3 that generates illumination light to be emitted from the tip of the endoscope 2, a processing device 4 that performs predetermined signal processing on the imaging signals captured by the endoscope 2 and controls the overall operation of the endoscopic system 1, a display device 5 that displays the in-vivo images generated by the signal processing of the processing device 4, and a treatment device 6.

[0027] The endoscope 2 comprises an insertion section 21 having a flexible, elongated shape, an operation section 22 connected to the base end of the insertion section 21 and accepting input of various operation signals, and a universal cord 23 extending from the operation section 22 in a direction different from the direction in which the insertion section 21 extends and incorporating various cables connecting to the light source device 3 and the processing device 4.

[0028] The insertion section 21 has a distal end section 24 incorporating an image sensor 244 in which pixels that receive light and perform photoelectric conversion to generate signals are arranged in a two-dimensional manner, a bending section 25 that can be freely bent and is composed of a plurality of bending pieces, and a long, flexible tube section 26 that is connected to the proximal end side of the bending section 25. The insertion section 21 is inserted into a body cavity of a subject, and uses the image sensor 244 to capture an image of a subject such as biological tissue that is in a position where external light cannot reach.

[0029] The operation unit 22 has a bending knob 221 for bending the bending portion 25 in the up-down and left-right directions, a treatment tool insertion portion 222 for inserting treatment tools such as a therapeutic light irradiation device, biopsy forceps, an electric scalpel, and an examination probe into the body cavity of the subject, and a plurality of switches 223 as an operation input portion for inputting operation instruction signals for peripheral devices such as an air supply means, a water supply means, and a screen display control device in addition to the processing device 4. The treatment tool inserted from the treatment tool insertion portion 222 passes through a treatment tool channel (not shown) in the tip portion 24 and emerges from an opening (see FIG. 3).

[0030] The universal cord 23 incorporates at least a light guide 241 and a cable assembly 245 that bundles one or more signal lines. The universal cord 23 branches at the end opposite to the end connected to the operation unit 22. A connector 231 that is detachable to the light source device 3 and a connector 232 that is detachable to the processing device 4 are provided at the branched end of the universal cord 23. A part of the light guide 241 extends from the end of the connector 231. The universal cord 23 transmits illumination light emitted from the light source device 3 to the tip end portion 24 via the connector 231 (light guide 241), the operation unit 22, and the flexible tube portion 26. The universal cord 23 also transmits image signals captured by an image sensor 244 provided at the tip end portion 24 to the processing device 4 via the connector 232. The cable assembly 245 includes a signal line for transmitting an imaging signal, a signal line for transmitting a drive signal for driving the imaging element 244, and a signal line for transmitting and receiving information including unique information related to the endoscope 2 (imaging element 244). Note that, in this embodiment, the signal line is described as transmitting an electrical signal, but the signal line may be used to transmit an optical signal, or may be used to transmit a signal between the endoscope 2 and the processing device 4 by wireless communication.

[0031] The tip portion 24 has a light guide 241 made of glass fiber or the like and forming a light guide path for light emitted by the light source device 3, an illumination lens 242 provided at the tip of the light guide 241, an optical system 243 for collecting light, and an image sensor 244 provided at an imaging position of the optical system 243 and receiving the light collected by the optical system 243, photoelectrically converting it into an electric signal, and performing predetermined signal processing. The optical system 243 and the image sensor 244 form an imaging unit.

[0032] The optical system 243 is configured using one or more lenses. The optical system 243 forms an observation image on the light receiving surface of the image sensor 244. The optical system 243 has an optical filter 243a. The optical characteristics of the optical filter 243a will be described later. The optical system 243 may have an optical zoom function that changes the angle of view and a focus function that changes the focus.

[0033] The image sensor 244 photoelectrically converts light from the optical system 243 to generate an electric signal (image signal). The image sensor 244 is configured with a plurality of pixels arranged in a matrix, each having a photodiode that accumulates an electric charge according to the amount of light, a capacitor that converts the electric charge transferred from the photodiode into a voltage level, and the like. The image sensor 244 photoelectrically converts light incident on each pixel via the optical system 243 to generate an electric signal, sequentially reads out the electric signals generated by pixels arbitrarily set as readout targets among the plurality of pixels, and outputs the electric signals as an image signal. The image sensor 244 is realized using, for example, a CCD (Charge Coupled Device) image sensor or a CMOS (Complementary Metal Oxide Semiconductor) image sensor.

[0034] The endoscope 2 has a memory (not shown) that stores execution programs and control programs for the image sensor 244 to perform various operations, as well as data including identification information of the endoscope 2. The identification information includes the unique information (ID) of the endoscope 2, the model year, specification information, and transmission method. The memory may also temporarily store image data generated by the image sensor 244.

[0035] The endoscope 2 has a memory (not shown) that stores execution programs and control programs for the image sensor 244 to perform various operations, as well as data including identification information of the endoscope 2. The identification information includes the unique information (ID) of the endoscope 2, the model year, specification information, and transmission method. The memory may also temporarily store image data generated by the image sensor 244.

[0036] In the first embodiment, the endoscope system 1 has one of two observation modes: a white image observation mode for observing an image obtained by illumination with white light, and a fluorescence observation mode for observing a fluorescent image obtained by illumination with therapeutic light. The fluorescence observation modes include an intra-treatment fluorescence observation mode and a pre- and post-treatment fluorescence observation mode, which will be described later.

[0037] The following describes the configuration of the light source device 3. The light source device 3 includes a light source section 31, an illumination control section 32, and a light source driver 33. The light source section 31 includes a white light source 311 that emits illumination light under the control of the illumination control section 32.

[0038] The white light source 311 emits light (white light) having a wide visible wavelength band. The white light source 311 is realized using any light source such as an LED light source, a laser light source, a xenon lamp, or a halogen lamp. The white light source 311 may also include one or more lenses. The light generated by the white light source 311 passes through the light guide 241 and is emitted from the tip of the tip portion 24 towards the subject.

[0039] The illumination control unit 32 controls the amount of power supplied to the light source unit 31 based on a control signal (dimming signal) from the processing device 4, and also controls the light source to emit light and the timing at which the light source is driven.

[0040] The light source driver 33, under the control of the illumination control unit 32, supplies current to the light source that is the light source to be emitted, thereby causing the light source unit 31 to emit light.

[0041] The following describes the configuration of the processing device 4. The processing device 4 includes an image processing unit 41, a synchronization signal generating unit 42, an input unit 43, a control unit 44, and a storage unit 45.

[0042] The image processing unit 41 receives from the endoscope 2 an imaging signal that is an imaging signal captured by the imaging element 244 and that includes image data of illumination light of each color. When the image processing unit 41 receives analog image data from the endoscope 2, it performs A / D conversion to generate a digital signal. When the image processing unit 41 receives image data as an optical signal from the endoscope 2, it performs photoelectric conversion to generate digital image data. The image processing unit 41 processes the received imaging signal and generates an image to be displayed on the display device 5.

[0043] The image processing unit 41 performs predetermined image processing on the image data received from the endoscope 2 to generate an image and outputs the image to the display device 5. The image processing unit 41 has a white light image generation unit 411, a fluorescent light image generation unit 412, and a superimposed image generation unit 413.

[0044] The white light image generating unit 411 generates a white light image based on an image formed by white light. The white light image generating unit 411 generates an image based on a signal captured while white light is being irradiated.

[0045] The fluorescence image generator 412 generates a fluorescence image based on an image formed by fluorescence. Fluorescence is emitted, for example, when an antibody drug is excited by irradiation with therapeutic light. The fluorescence image generator 412 generates an image based on signals captured during irradiation with therapeutic light.

[0046] The white-light image generation unit 411 and the fluorescent image generation unit 412 generate images by performing predetermined image processing. Here, the predetermined image processing includes synchronization processing, gradation correction processing, and color correction processing. Synchronization processing is processing for synchronizing image data of each RGB color component. Gradation correction processing is processing for performing gradation correction on image data. Color correction processing is processing for performing color correction on image data. Note that the white-light image generation unit 411 and the fluorescent image generation unit 412 may adjust gain according to the brightness of the image.

[0047] The superimposed image generating unit 413 generates a superimposed image by superimposing the fluorescent image on the white light image. The superimposed image generating unit 413 performs superimposition processing on the white light image and the fluorescent image of adjacent imaging frames that were captured close to each other, for example.

[0048] The white light image generation unit 411, the fluorescent image generation unit 412, and the superimposed image generation unit 413 perform processing according to the observation mode that is set. For example, when the white image observation mode is set, a white light image is generated. When the fluorescent observation mode is set, a superimposed image and / or a fluorescent image is generated.

[0049] The image processing unit 41 is configured using a general-purpose processor such as a CPU (Central Processing Unit) or a dedicated processor such as various arithmetic circuits that execute specific functions, such as an ASIC (Application Specific Integrated Circuit).The image processing unit 41 may also be configured to have a frame memory that stores R image data, G image data, and B image data.

[0050] The synchronization signal generation unit 42 generates a clock signal (synchronization signal) that serves as a reference for the operation of the processing device 4, and outputs the generated synchronization signal to the light source device 3, the image processing unit 41, the control unit 44, and the endoscope 2. Here, the synchronization signal generated by the synchronization signal generation unit 42 includes a horizontal synchronization signal and a vertical synchronization signal. Therefore, the light source device 3, the image processing unit 41, the control unit 44, and the endoscope 2 operate in synchronization with one another by the generated synchronization signal.

[0051] The input unit 43 is realized using a keyboard, a mouse, a switch, and a touch panel, and receives input of various signals such as operation instruction signals that instruct the operation of the endoscope system 1. The input unit 43 may include a switch provided on the operation unit 22 or a portable terminal such as an external tablet computer.

[0052] The control unit 44 controls the drive of each component, including the image sensor 244 and the light source device 3, and controls the input and output of information to and from each component. The control unit 44 references control information data (e.g., readout timing) for image capture control stored in the storage unit 45 and transmits the control information data to the image sensor 244 as a drive signal via a predetermined signal line included in the cable assembly 245. The control unit 44 also sets and switches the observation mode. For example, the control unit 44 sets one of the white image observation mode, the intra-treatment fluorescence observation mode, and the pre- and post-treatment fluorescence observation mode based on an operation input by the operator. In the first embodiment, an example will be described in which the intra-treatment fluorescence observation mode is set as the fluorescence observation mode. The control unit 44 is configured using a general-purpose processor such as a CPU or a dedicated processor such as various arithmetic circuits that execute specific functions, such as an ASIC.

[0053] The storage unit 45 stores various programs for operating the endoscope system 1 and data including various parameters necessary for the operation of the endoscope system 1. The storage unit 45 also stores identification information of the processing device 4. Here, the identification information includes the unique information (ID) of the processing device 4, model year, specification information, etc.

[0054] The storage unit 45 also stores various programs, including an image acquisition processing program for executing the image acquisition processing method of the processing device 4. The various programs can be recorded on computer-readable recording media such as a hard disk, flash memory, CD-ROM, DVD-ROM, or flexible disk, and widely distributed. The various programs can also be obtained by downloading them via a communications network. The communications network referred to here can be realized, for example, by an existing public line network, a LAN (Local Area Network), or a WAN (Wide Area Network), and can be wired or wireless.

[0055] The storage unit 45 having the above configuration is realized using a ROM (Read Only Memory) in which various programs and the like are pre-installed, and a RAM, hard disk, and the like for storing calculation parameters and data for each process.

[0056] The display device 5 displays an image for display corresponding to the image signal received from the processing device 4 (image processing unit 41) via a video cable. The display device 5 is configured using a monitor such as a liquid crystal or organic EL (Electro Luminescence) monitor.

[0057] The treatment device 6 has a treatment tool operating section 61 and a flexible treatment tool 62 extending from the treatment tool operating section 61. The treatment tool 62 used in PIT is a therapeutic light emitting section that emits light for treatment (hereinafter referred to as therapeutic light).

[0058] The treatment tool operating section 61 controls the emission of light from the treatment tool 62 . The treatment tool operating unit 61 includes an operation input unit 611, a treatment light source 612, a guide light source 613, and a treatment tool control unit 614. Each light source is realized using a semiconductor laser, an LED, or the like. In the treatment device 6, the light source that emits the treatment light may be provided in the treatment tool 62 or the treatment tool operating unit 61.

[0059] The operation input unit 611 is configured by, for example, a switch, etc. The treatment tool operation unit 61 causes the treatment tool 62 to emit therapeutic light or guide light in response to an input to the operation input unit 611 (for example, pressing a switch).

[0060] The therapeutic light source 612 is composed of a light source and one or more lenses, and emits light (illumination light) when the light source is driven. The light source of the therapeutic light source 612 emits light in a wavelength range that excites the antibody drug. In the case of PIT, for example, the therapeutic light is light in a wavelength range of 680 nm or more, with a central wavelength of, for example, 690 nm.

[0061] The guide light source 613 is configured with a light source and one or more lenses, and emits light (illumination light) by driving the light source. The light source included in the guide light source 613 emits light in a wavelength band shorter than the wavelength band of light emitted by the therapeutic light source 612 and shorter than the wavelength band blocked by the optical filter 243a.

[0062] The illumination optical system of the treatment tool 62 emits the therapeutic light and the guide light so that the irradiation positions of the therapeutic light and the guide light are the same. For example, the irradiation area of ​​the therapeutic light and the irradiation area of ​​the guide light are substantially the same. The illumination optical system of the treatment tool 62 may be configured to change the irradiation range of the therapeutic light. For example, under the control of the treatment tool operating unit 61, it may be configured with an optical system with a changeable focal length or a DMD (Digital Micromirror Device), and the spot diameter of the light irradiated on the subject and the shape of the irradiation range can be changed.

[0063] The treatment tool control unit 614 controls the drive of each component, including the operation input unit 611, the therapeutic light source 612, and the guide light source 613, and controls the input and output of information to and from each component. The treatment tool control unit 614 causes the therapeutic light source 612 and the guide light source 613 to emit light based on, for example, an operation input by the surgeon. The treatment tool control unit 614 is configured using a general-purpose processor such as a CPU or a dedicated processor such as an ASIC or various arithmetic circuits that perform specific functions.

[0064] The characteristics of the therapeutic light, the antibody drug, the fluorescence, and the optical filter 243a will now be described with reference to FIGS.

[0065] FIG. 4 shows the absorption spectrum of an antibody drug. FIG. 4 shows the absorption spectrum of IRDye® 700DX as an example of an antibody drug. FIG. 4 shows normalized intensity, normalized with the maximum peak intensity set to 1. IRDye® 700DX has a first optical absorption band with a peak at 690 nm in a wavelength range greater than 650 nm, and a second optical absorption band with a peak at 350 nm in a wavelength range less than 450 nm. In particular, the first optical absorption band corresponds to the wavelength range targeted for reaction of the antibody drug during phototherapy. The second optical absorption band is sometimes referred to as the Soret band.

[0066] 5 shows an example of the excitation spectrum and fluorescence spectrum of an antibody drug, the wavelength spectrum of therapeutic light, and the transmission characteristics of an optical filter. E Curve F shows the absorption characteristics of IRDye® 700DX (see FIG. 4). L Curve F shows the intensity distribution of the laser light irradiated as the therapeutic light. F Curve F shows the intensity distribution of the fluorescence emitted by the antibody drug upon excitation. C indicates the absorption characteristics (transmittance) of the optical filter 243a. E , F L , F F indicates the normalized intensity, where the intensity of the maximum peak is set to 1.

[0067] The optical filter 243a is a filter having a curve F CThe optical filter 243a has absorption characteristics shown by the formula (1). That is, the wavelength band of the optical filter 243a is set around 690 nm, taking into consideration the tolerance of the central wavelength of the therapeutic light source 612, the spectral width, and the oblique incidence characteristics of the optical filter 243a in the optical system of the optical filter 243a. For example, the optical filter 243a blocks light in the wavelength band greater than 670 nm and less than 700 nm, and transmits light in other wavelength bands.

[0068] The optical filter 243a filters out light in the above range from the light entering from the distal end portion 24. For example, the characteristics of the optical filter 243a prevent light in the wavelength band of the therapeutic light from entering the image sensor 244, while allowing fluorescent light to enter the image sensor 244.

[0069] Next, image acquisition during treatment using the endoscope 2 will be described with reference to Figs. 6 to 9. Fig. 6 is a diagram illustrating the on / off timing of the white light, guide light, and therapeutic light according to the first embodiment of the present invention. An example of PIT implementation is shown below, in which the insertion section 21 is inserted into the upper gastrointestinal tract to treat the target site.

[0070] During the search for the treatment position, the observation mode is set to the white image observation mode, and white light and guide light are emitted (period T1 in FIG. 6). During this period, white light and guide light are continuously emitted. During the search for the treatment position, the observation mode is set to the white image observation mode, and a white light image is generated based on the white light and guide light. Meanwhile, at time t1, an operation input is made to the treatment tool 62, turning on the therapeutic light source, and white light and guide light are intermittently emitted at predetermined intervals (period T2 in FIG. 6). For example, based on an instruction to turn on the therapeutic light, the observation mode is switched to the in-treatment fluorescence observation mode. At this time, the therapeutic light is continuously emitted. The therapeutic light excites the antibody drug, thereby treating the target area.

[0071] In the first embodiment, the control unit 44 of the processing device 4 acts as a control master and controls the emission timing of the white light source 311 and the guide light source 613, as well as the imaging timing of the image sensor 244. Meanwhile, the therapeutic light source 612 is driven asynchronously with the white light and the guide light under the control of the treatment tool control unit 614. When the control unit 44 controls the illumination of the therapeutic light source 612 in response to an input to the operation input unit 611, it switches the mode to the in-treatment fluorescence observation mode, controls the intermittent emission of the white light and the guide light, and causes the fluorescence image generation unit 412 and the superimposed image generation unit 413 to generate images.

[0072] Specifically, for example, at the time of treatment, the surgeon first administers an antibody drug into a vein by intravenous drip using an injection 20 to 28 hours before treatment (surgery). The antibody drug may be administered using an endoscope 2, another device, or by having the patient swallow the drug.

[0073] The surgeon then inserts the insertion section 21 into the upper gastrointestinal tract. At this time, the observation mode is set to the white image observation mode, and the surgeon causes the light source device 3 to emit white light. Furthermore, the surgeon projects the treatment tool 62 from the tip of the endoscope 2 and irradiates the treatment tool 62 with guide light, and searches for a treatment position while observing the white light image of the upper gastrointestinal tract displayed on the display device 5. At this time, the guide light is depicted in the white light image, and the guide light guides the irradiation position of the treatment light.

[0074] 7 is a diagram showing an example of a white light image. In the white image observation mode, the display device 5 displays, for example, a white light image G W White light image G is displayed. W In the case of the guide light, the tissue in the observation area including the treatment target area and the image TR of the treatment tool 62 are visualized by the reflected light and scattered light of the white light, and the irradiation range R of the guide light is visualized. G The surgeon searches for the target area and adjusts the irradiation position of the therapeutic light while observing the irradiation area of ​​the guide light. The surgeon adjusts the irradiation position of the therapeutic light on the target area by, for example, adjusting the direction of the distal end 24 or the protruding length of the treatment tool 62.

[0075] After adjusting the direction of the distal end portion 24, the surgeon irradiates the target area with the therapeutic light. T The antibody drug bound to the antibody reacts, and treatment is administered to the target area. During irradiation of the therapeutic light, the observation mode is set to in-treatment fluorescence observation mode, and a fluorescent image is generated based on the fluorescent image acquired while white light and guide light are not being irradiated, and a superimposed image is generated from the fluorescent image and the white light image. The generated image is displayed on the display device 5. The surgeon confirms the effectiveness of the treatment by observing the intensity of the fluorescent light, the light-emitting area, etc.

[0076] 8 is a diagram showing an example of a fluorescent image. F The fluorescent image R F At this time, the excitation light (here, the therapeutic light) is cut off by the optical filter 243a and is therefore not visualized as an image.

[0077] FIG. 9 is a diagram showing an example of a superimposed image in which a fluorescent image is superimposed on a white-light image. The superimposed image generating unit 413 brightens the fluorescent image by a predetermined ratio, for example, four times the brightness of the white-light image, and superimposes the fluorescent image on the white-light image in an emphasized state. In this case, since the fluorescent intensity is used to determine the effectiveness of treatment, the same degree of brightness enhancement is applied to images of the same observation site, and the brightness of the fluorescent image is not changed by image processing so that it is possible to see how the fluorescent image darkens over time. Superimposed image G shown in FIG. S is the white light image G W Fluorescent image R on top F is an image on which

[0078] The surgeon continues to treat the target area by repeatedly irradiating the target area with additional therapeutic light and checking the therapeutic effect, as necessary.

[0079] In the first embodiment described above, when a white light image is acquired, both white light and a guide light having a shorter wavelength than the therapeutic light and irradiating substantially the same area as the therapeutic light are irradiated. When a fluorescence image is acquired, the white light and the guide light are turned off, and the excitation light is filtered out by the optical filter 243a to generate a fluorescence image. According to the first embodiment, the therapeutic light irradiation area is guided by the guide light in the white light image, and a superimposed image is generated by superimposing a fluorescent image containing only the fluorescent light on the white light image. This allows continuous observation of the target area even during fluorescence observation. Furthermore, the first embodiment is configured with a single image sensor 244 and an optical filter 243a to filter out excitation light incident on the image sensor 244, thereby suppressing an increase in the diameter compared to a configuration using two image sensors.

[0080] In the first embodiment, an example in which the optical filter 243a is provided in the optical system 243 has been described. However, the optical filter 243a may be provided on the light receiving surface side of the light receiving section 244a in the image sensor 244.

[0081] (First Modification of First Embodiment) Next, a first modification of the first embodiment will be described. The endoscope system according to the first modification is the same as the endoscope system 1 according to the first embodiment, and therefore a description thereof will be omitted. In the first embodiment, the control unit 44 serves as the control master to control the guide light source 613 and the like, but in the first modification, the treatment tool control unit 614 serves as the control master to control the guide light source 613 and the like. The flow of treatment using this endoscope system is the same as in the first embodiment.

[0082] In the first modification, the treatment device 6 has a treatment instrument controller 614 as a control master, which controls the emission timing of the white light source 311 and the guide light source 613 and also controls the imaging timing of the image sensor 244. Meanwhile, the treatment light source 612 is driven asynchronously with the white light and the guide light under the control of the treatment instrument controller 614. In response to an input to the operation input unit 611, the treatment instrument controller 614 controls the illumination of the treatment light source 612 and simultaneously switches to the in-treatment fluorescence observation mode, causes the controller 44 to control the intermittent emission of the white light and the guide light, and causes the fluorescence image generator 412 and the superimposed image generator 413 to perform image generation processing.

[0083] In the above-described first modification, similar to the first embodiment, when a white light image is acquired, the guide light is irradiated together with the white light, whereas when a fluorescent image is acquired, the white light and the guide light are turned off and a fluorescent image is generated in which the excitation light is cut by the optical filter 243a. According to the first modification, even when the treatment tool control unit 614 is used as the control master, observation of the target site can be continued even during fluorescent observation. Furthermore, similar to the first embodiment, the first modification is configured to include one image sensor 244 and cut the excitation light incident on the image sensor 244 by the optical filter 243a, thereby suppressing an increase in diameter compared to a configuration using two image sensors.

[0084] (Modification 2 of Embodiment 1) Next, a description will be given of Modification 2 of Embodiment 1. The endoscope system according to Modification 2 is the same as the endoscope system 1 according to Embodiment 1, and therefore a description thereof will be omitted. The flow of treatment using this endoscope system is the same as in the first embodiment.

[0085] FIG. 10 is a diagram illustrating the on / off timing of the white light, guide light, and therapeutic light according to Modification 2. First, after switching to the in-treatment fluorescence observation mode, the white light and guide light are emitted until the therapeutic light is turned on (period T1 in FIG. 10). In Modification 2, during this period T1, the white light and guide light are emitted intermittently. After that, at time t1, an input is made to the treatment tool 62, and the therapeutic light source is turned on (period T2 in FIG. 10). The therapeutic light excites the antibody drug, thereby treating the target area.

[0086] In the image processing unit 41 of the second modification, the white-light image generating unit 411 generates a white-light image using signals captured while the white light and guide light are on until time t1, when the therapeutic light is turned on. Meanwhile, the fluorescent image generating unit 412 generates a completely dark image because there is no fluorescent image signal. The superimposed image generated by the superimposed image generating unit 413 is a white-light image only, and the white-light image is displayed on the display device 5. A threshold value may be set for the fluorescent image signal, and if the signal does not exceed the threshold, the fluorescent image need not be enhanced. When the therapeutic light is turned on at time t1, the white-light image generating unit 411 generates a white-light image using signals captured while the white light and guide light are on, while the fluorescent image generating unit 412 generates a fluorescent image using signals captured while the therapeutic light is on. The superimposed image generating unit 413 superimposes the generated fluorescent image on the white-light image to generate a superimposed image.

[0087] In the above-described second modification, similar to the first embodiment, when a white light image is acquired, the guide light is irradiated together with the white light, whereas when a fluorescent image is acquired, the white light and the guide light are turned off, and the fluorescent image is generated based on an optical image in which the excitation light is filtered by the optical filter 243a. According to the second modification, it is possible to continue observing the target site even during fluorescent observation. Furthermore, similar to the first embodiment, the second modification is configured to include one image sensor 244 and to filter the excitation light incident on the image sensor 244 with the optical filter 243a, thereby suppressing an increase in diameter compared to a configuration using two image sensors.

[0088] (Third Modification of First Embodiment) Next, a third modification of the first embodiment will be described. The endoscope system according to the third modification is the same as the endoscope system 1 according to the first embodiment, and therefore a description thereof will be omitted. The third modification relates to observation of fluorescence images before or after treatment, and will be described using processing before treatment as an example. Note that the processing described below can also be applied after treatment. The flow of treatment using this endoscope system is the same as in the first embodiment.

[0089] FIG. 11 illustrates the on / off timing of the white light, guide light, and therapeutic light according to Modification 3. Before treatment begins, the pre- and post-treatment fluorescence observation mode is set. In this mode, the controller 44 controls the white light source 311, guide light source 613, and therapeutic light source 612. In this mode, for example, when imaging at 60 fps, the white light and guide light are emitted for 59 fps (period T3 in FIG. 11 ). In Modification 3, the white light and guide light are continuously emitted during this period T3. Thereafter, to check the accumulated amount of antibody drug, the controller 44 turns on the therapeutic light source via the treatment instrument controller 614 at one-frame time t2, and the fluorescent image is generated by the fluorescent image generator 412. In this pre- and post-treatment fluorescence observation mode, the therapeutic light is emitted for a time equivalent to one frame at 60 fps per second (period T4: 1 fps in FIG. 11 ), and the white light and guide light are turned off. During this time, a superimposed image is displayed on the display device 5, allowing the surgeon to observe the fluorescent image. In the subsequent period T5, the white light and guide light are turned on again. Note that the pre- and post-treatment fluorescence observation mode may be maintained until an instruction to switch to the white image observation mode or another observation mode is given. In the pre- and post-treatment fluorescence imaging mode of Modification 3, the therapeutic light is emitted for a period corresponding to one frame, and a fluorescent image is captured based on the therapeutic light. Fluorescence imaging (irradiation of therapeutic light) can be performed intermittently multiple times up to the time limit.

[0090] In the pre- and post-treatment fluorescence observation mode of the third modification, the white-light image generating unit 411 in the image processing unit 41 generates a white-light image using signals captured while the white light and guide light are on. Meanwhile, the fluorescence image generating unit 412 generates a fluorescence image using signals captured while the therapeutic light is on, and the white-light image generating unit 411 generates a white-light image using signals captured while the white light and guide light are on. The superimposed image generating unit 413 superimposes the generated fluorescence image on the white-light image to generate a superimposed image.

[0091] 12 is a diagram showing an example of a display image according to the third modification of the first embodiment of the present invention. The display image G1 includes a white light image G W and superimposed image G S At this time, the white light image G W and superimposed image G S For example, during the period when the fluorescent image mode is set, the white light image G W is updated at 59 fps, but the superimposed image G S is updated at 1fps.

[0092] At this time, the valid period of the pre- and post-treatment fluorescence observation mode may be displayed. For example, the valid period display section G shown in FIG. T The remaining time remaining since the pre- and post-treatment fluorescence observation mode was first selected is displayed in the display area. This is the remaining valid period for this mode. During this period, it is possible to repeatedly irradiate with therapeutic light and observe fluorescence images. However, once this valid period has expired, requests for therapeutic light irradiation, for example, before treatment, are no longer accepted.

[0093] In the third modification described above, as in the first embodiment, when acquiring a white light image, the guide light is irradiated together with the white light, whereas when acquiring a fluorescence image, the white light and the guide light are turned off and the fluorescence image is generated based on an optical image in which the excitation light is filtered by the optical filter 243a. According to the third modification, it is possible to continue observing the target site even during fluorescence observation. Furthermore, according to the third modification, as in the first embodiment, a single image sensor 244 is provided and the optical filter 243a filters out the excitation light incident on the image sensor 244, thereby suppressing an increase in diameter compared to a configuration using two image sensors.

[0094] Furthermore, according to the third modification, during fluorescence observation (irradiation of therapeutic light) before and after treatment, the therapeutic light is irradiated for only one frame period, so that the progress of treatment by the therapeutic light can be suppressed while the fluorescent image produced by the therapeutic light can be confirmed.

[0095] (Embodiment 2) Next, a second embodiment will be described. In the second embodiment, the same components as those in the endoscope system 1 according to the first embodiment are denoted by the same reference numerals, and the description thereof will be omitted. Fig. 13 is a block diagram showing a schematic configuration of the endoscope system according to the second embodiment of the present invention.

[0096] 13 includes an endoscope 2 that captures in-vivo images of a subject by inserting a tip thereof into the subject, a light source device 3 that generates illumination light to be emitted from the tip of the endoscope 2, a processing device 4 that performs predetermined signal processing on the image signal captured by the endoscope 2 and comprehensively controls the operation of the entire endoscope system 1, a display device 5 that displays the in-vivo images generated by the signal processing of the processing device 4, and a treatment device 6A. Note that the endoscope 2 will be described as including a first light guide 246 instead of the light guide 241.

[0097] The treatment device 6A has a treatment tool operating section 61 and a second light guide 63 extending from the treatment tool operating section 61 and connecting to the first light guide 246. The first light guide 246 and the second light guide 63 form a bifurcated light guide. The second light guide 63 may be configured to connect to at least some of the fibers of the first light guide 246, or may be configured to extend to the tip of the tip section 24 together with the first light guide 246.

[0098] The second light guide 63 transmits the light emitted by the therapeutic light source 612 and the guide light source 613. In this case, the second light guide 63 outputs the light emitted by the therapeutic light source 612 and the guide light source 613 to the outside using, for example, a common fiber. Alternatively, the light emitted by each light source may be transmitted using a different fiber.

[0099] Furthermore, the first irradiation range of the light emitted from the white light source 311 from the distal end portion 24 is larger than the second irradiation range of the light emitted from the therapeutic light source 612 and the guide light source 613, and the entire second irradiation range is included in the first irradiation range. The irradiation range of each light can be adjusted by the angle of incidence onto the fiber, etc. Furthermore, it is preferable that the entire second irradiation range is within the angle of view of the image captured by the image sensor 244.

[0100] 14 is a diagram illustrating the white light and the guide light according to the second embodiment of the present invention. FIG. 14 is a diagram illustrating a cross section of the light irradiation range for explaining the light irradiation range. W and guide light L G The figure shows the case where the light is emitted from the laser.

[0101] 15 is a diagram showing an example of a white light image. In the white light image G2, the irradiation range R of the guide light is set against a background including tissue illuminated with white light. G At this time, the guide light irradiation range R G is preferably contained within the white light image G2.

[0102] 16 is a diagram showing an example of a fluorescent image. In the fluorescent image G3, the fluorescent image R F In this case, for example, the irradiation range of the therapeutic light substantially coincides with the irradiation range of the guide light.

[0103] 14 and 15, the first irradiation range of the light emitted by the white light source 311 is larger than the second irradiation range of the light emitted by the guide light source 613, and the first irradiation range includes the entire second irradiation range. Note that the therapeutic light is also irradiated to the same range as the guide light, and a fluorescent image is depicted in the image (see FIG. 16).

[0104] In the second embodiment described above, as in the first embodiment, when acquiring a white light image, the guide light is irradiated together with the white light, whereas when acquiring a fluorescence image, the white light and the guide light are turned off and the fluorescence image is generated based on an optical image in which the excitation light is filtered by the optical filter 243a. According to the second embodiment, it is possible to continue observing the target site even during fluorescence observation. Furthermore, according to the second embodiment, as in the first embodiment, a single image sensor 244 is provided and the optical filter 243a filters out the excitation light incident on the image sensor 244, so that the diameter can be prevented from increasing compared to a configuration using two image sensors.

[0105] Furthermore, according to the second embodiment, the white light and the guide light or the treatment light are emitted from the same exit port, which reduces deviation of the irradiation position due to the irradiation angle, and eliminates the need for the treatment tool 62, thereby improving usability.

[0106] (Embodiment 3) Next, a third embodiment will be described. The endoscope system according to the third embodiment is the same as the endoscope system 1 according to the first embodiment, and therefore the description will be omitted. In the third embodiment, the control related to dimming is different from that in the first embodiment. The dimming process will be described below. The flow of treatment is the same as in the first embodiment.

[0107] When automatic white light dimming is performed using an image, if the light intensity of the guide light is high, the amount of white light is adjusted to be reduced depending on the magnitude of its signal value. If the amount of white light is reduced, the entire image becomes dark. If the entire image is dark, the background image other than the guide light becomes unclear, making it difficult to determine the position of the tumor. Therefore, in the third embodiment, dimming control is performed so that the image does not become dark.

[0108] FIG. 17 is a diagram for explaining the dimming process according to the third embodiment of the present invention. (a) of FIG. 17 shows a case where dimming control is performed including the signal value of the guide light. (b) of FIG. 17 shows a case where dimming control is performed excluding the influence of the guide light. In this case, the illumination control unit 32 generates a white light image G including an optical image of the guide light. 11 In this case, the guide light irradiation range R G and detects the irradiation range R G The range including this is called the dimming exclusion area R GF (See (a) of FIG. 17). The illumination control unit 32 sets the dimming excluded area R GF The signal value for the white light dimming is calculated using the signal value (for example, luminance value) of the area excluding the dimming exclusion area R GF The signal value of the dimming exclusion area R is reduced based on a preset condition, and the signal value for the white light dimming is calculated using the signal values ​​of the entire image including the changed signal value. GF By setting the value of the signal in the corresponding area and generating a dimming signal by adjusting the signal value in the corresponding area, a clear image can be obtained in which the decrease in brightness of the white light image caused by the guide light is suppressed (see (b) of Figure 17).

[0109] In the third embodiment described above, as in the first embodiment, when acquiring a white light image, the guide light is irradiated together with the white light, whereas when acquiring a fluorescence image, the white light and the guide light are turned off and the fluorescence image is generated based on an optical image in which the excitation light is filtered by the optical filter 243a. According to the third embodiment, it is possible to continue observing the target site even during fluorescence observation. Furthermore, according to the third embodiment, as in the first embodiment, a single image sensor 244 is provided and the optical filter 243a filters out the excitation light incident on the image sensor 244, thereby suppressing an increase in diameter compared to a configuration using two image sensors.

[0110] Furthermore, according to the third embodiment, the dimming excluded region R GF and adjusts the handling of the signal value of the relevant area to generate a dimming signal, thereby suppressing the decrease in image brightness caused by the guide light, thereby suppressing the decrease in brightness of the white light image and clarifying the illumination range of the guide light.

[0111] (Modification 1 of Embodiment 3) Next, a first modification of the third embodiment will be described. The endoscope system according to the first modification is the same as the endoscope system 1 according to the first embodiment, and therefore the description will be omitted. In the third embodiment, an example in which the illumination range of the guide light is clarified by controlling the brightness of the white light image on the premise that white light is irradiated, but in the first modification, the guide light is clarified by illuminating the guide light by limiting the color components of the illuminating light. The flow of treatment using this endoscope system is the same as in the first embodiment.

[0112] In this first modification, when emitting guide light, the color components of the light emitted by the white light source are limited to blue and green components, or only blue components, and light consisting of these color components is irradiated as illumination light. By using illumination light with limited color components as the background of an image, an image can be created in which the guide light is emphasized. In this case, when outputting an image, an image in which the green guide light is emphasized can be generated by using only blue and green signals.

[0113] (Modification 2 of Embodiment 3) Next, a second modification of the third embodiment will be described. The endoscopic system according to the second modification is the same as the endoscopic system 1 according to the first embodiment except that the treatment tool 62 is replaced with a treatment tool 62A, and therefore a description of the configuration other than the treatment tool 62A will be omitted. In the third embodiment, an example was described in which white light is irradiated and the brightness of the white light image is controlled to clarify the irradiation range of the guide light. However, in the second modification, a cylindrical type fiber (cylindrical diffuser) is used to irradiate the guide light. Note that the cylindrical diffuser may also be used to irradiate the treatment light. The flow of treatment using this endoscope system is the same as in the first embodiment.

[0114] 18 is a diagram illustrating a light control process according to a second modification of the third embodiment of the present invention. In this second modification, a treatment tool 62A has a cylindrical diffuser 621 provided at the end opposite to the end connected to the treatment tool operation unit 61. The cylindrical diffuser 621 uniformly irradiates light in the circumferential direction of the optical fiber using a cylindrical irradiation tip. In the second modification, for example, uniform light is emitted circumferentially in the longitudinal direction of the cylindrical diffuser 621.

[0115] According to the second modification, the guide light is irradiated by the cylindrical diffuser 621, so that the guide light can be irradiated over a wide area. Because the irradiation range of the guide light is wide, the structure around the treatment area can also be depicted by the guide light. In this case, because the illumination range is wide, the white light image generating unit 411 may generate a white light image (illumination light image) without irradiating white light.

[0116] (Fourth embodiment) Next, a fourth embodiment will be described. The endoscope system according to the fourth embodiment is the same as the endoscope system 1 according to the first embodiment, and therefore a detailed description will be omitted. In the fourth embodiment, the treatment effect is corrected using an optical image of the guide light. In the fourth embodiment, the white light and the guide light are irradiated simultaneously with the treatment light, and the treatment is performed while observing the white light image.

[0117] 19 is a diagram illustrating the correction of the irradiation light intensity of the therapeutic light according to the fourth embodiment of the present invention. 21 The illumination range R of the guide light reflected inside G1 The controller 44 measures the diameter R1 (spot diameter) of the therapeutic light beam (see FIG. 19(a)). For example, if the therapeutic light intensity required for treatment is set to 100 J, the controller 44 calculates the treatment time using the relationship between the preset reference spot diameter and the therapeutic light intensity. For example, the controller 44 calculates the light intensity to be 0.15 J from the diameter R1 shown in FIG. 19(a), and the treatment time to be 667 seconds. The controller 44 then displays the calculated treatment time on the display device 5.

[0118] Thereafter, when the position of the treatment tool 62 (treatment tool image TR) changes and the spot diameter changes, for example, as shown in (b) of FIG. 19, the irradiation range R G2 If the diameter R2 becomes smaller than the diameter R1, the amount of light in the irradiation area increases. For example, if the light amount is calculated to be 0.20 J from the diameter R2, the cumulative light amount at the time of the diameter R1 is subtracted from 100 J to calculate the treatment time to reach the remaining irradiation light amount.

[0119] Furthermore, when the position of the treatment tool 62 is changed and the spot diameter is changed, for example, as shown in FIG. 19(c), the irradiation range R G3 If diameter R3 becomes larger than diameter R1, the amount of light in the irradiation area decreases. For example, if the light amount is calculated to be 0.10 J from diameter R3, the cumulative light amount at diameters R1 and R2 is subtracted from 100 J to calculate the treatment time to reach the remaining irradiation light amount.

[0120] In the fourth embodiment described above, similar to the first embodiment, when a white light image is acquired, the guide light is irradiated together with the white light, whereas when a fluorescent image is acquired, the white light and the guide light are turned off, and the fluorescent image is generated based on an optical image in which the excitation light is cut by the optical filter 243a. According to the fourth embodiment, it is possible to continue observing the target site even during fluorescent observation. Furthermore, similar to the first embodiment, the fourth embodiment is configured to include one image sensor 244 and cut the excitation light incident on the image sensor 244 by the optical filter 243a, thereby suppressing an increase in diameter compared to a configuration using two image sensors.

[0121] Furthermore, according to the fourth embodiment, the treatment time is calculated and displayed from the irradiation range of the guide light in the white light image, thereby preventing excessive irradiation and ensuring that the amount of light required for treatment is irradiated.

[0122] In the fourth embodiment, an example has been described in which the treatment time is calculated from the irradiation range (irradiation diameter) of the guide light, but the treatment time may be calculated using the intensity (light intensity) of the guide light.

[0123] Furthermore, in the fourth embodiment, an example has been described in which the treatment time is calculated based on the optical image of the guide light, but the treatment time may be fixed and controlled by calculating the intensity (light amount) of the guide light.

[0124] (Embodiment 5) Next, a fifth embodiment will be described. The endoscope system according to the fifth embodiment is the same as the endoscope system 1 according to the first embodiment, and therefore a description thereof will be omitted. In the fifth embodiment, the timing of acquiring a fluorescent image is controlled using the signal values ​​of the white light and the guide light.

[0125] The control unit 44 monitors the signal values ​​of the white light and the guide light, and after both signal values ​​decrease to a predetermined value, irradiates the therapeutic light or captures a fluorescent image. Specifically, the control unit 44 monitors the signal value of the guide light by detecting the signal value of the blue component and / or the green component in the region irradiated with the guide light. The control unit 44 also monitors the signal value of the white light by detecting the signal value in a region other than the region irradiated with the guide light.

[0126] 20 is a diagram for explaining the timing of acquiring a fluorescence image according to the fifth embodiment of the present invention. In FIG. 20, the curve Q W indicates the signal value of white light, and the curve Q G indicates the signal value of the guide light. The white light and the guide light are provided in different devices, and even if synchronized, the timing at which they are turned off may differ. The control unit 44 monitors the signal value after each light source is turned off, and determines the time t when both signal values ​​have decreased to a predetermined value. OFF The process of acquiring a fluorescent image is executed in step 1. The predetermined values ​​set for each step may be the same or different from each other.

[0127] In the fifth embodiment described above, similar to the first embodiment, when a white light image is acquired, the guide light is irradiated together with the white light, whereas when a fluorescent image is acquired, the white light and the guide light are turned off, and the fluorescent image is generated based on an optical image in which the excitation light is filtered by the optical filter 243a. According to the fifth embodiment, it is possible to continue observing the target site even during fluorescent observation. Furthermore, similar to the first embodiment, the fifth embodiment is configured to include one image sensor 244 and to filter the excitation light incident on the image sensor 244 by the optical filter 243a, thereby suppressing an increase in diameter compared to a configuration using two image sensors.

[0128] Furthermore, according to the fifth embodiment, by controlling the timing of acquiring a fluorescence image based on the signal values ​​of the white light and the guide light, it is possible to acquire a fluorescence image in which the mixing of the white light and the guide light is suppressed.

[0129] In the above-described embodiments and variants, examples of antibody drugs have been described using those used in PIT, but the present invention can also be applied to drugs used in other optical treatments such as photodynamic therapy (PDT).

[0130] In the above-described embodiment and modifications, the light source device 3 is separate from the treatment device 4, but the light source device 3 and the treatment device 4 may be integrated into one unit. In the above-described embodiment and modifications, the treatment light is irradiated by a treatment tool, but the light source device 3 may emit the treatment light.

[0131] Furthermore, in the above-described embodiment and modified examples, the endoscopic system of the present invention has been described as an endoscopic system 1 using a flexible endoscope 2 whose observation object is biological tissue inside a subject, but the present invention can also be applied to an endoscopic system using a rigid endoscope, an industrial endoscope for observing material properties, a fiberscope, an optical endoscope such as an optical endoscope with a camera head connected to the eyepiece.

[0132] As described above, the endoscope system according to the present invention is useful for continuously observing a treatment site during fluorescence observation while suppressing an increase in diameter. [Explanation of symbols]

[0133] 1. 1A Endoscope System 2 Endoscopy 3 Light source device 4 Processing equipment 5 Display device 6, 6A Treatment Device 21 Insertion section 22 Control section 23 Universal Code 24 Tip 25 Curved section 26 Flexible tube section 31 Light source section 32 Lighting control unit 33 Light Source Driver 41 Image processing section 42 Synchronization signal generator 43 Input section 44 Control Unit 45 Storage section 61 Treatment tool operation unit 62A Treatment tools 311 White light source 411 White light image generation unit 412 Fluorescence Image Generation Unit 413 Superimposed Image Generation Unit 611 Operation input unit 612 Treatment light source 613 Guide light source 614 Treatment tool control unit

Claims

1. an illumination light source that emits illumination light to illuminate an object; a therapeutic light source that emits therapeutic light that causes a photoreactive reagent accumulated in the treatment area to react; a guide light source that emits guide light having a wavelength shorter than the wavelength band of the therapeutic light source; an imaging unit for capturing an optical image, the imaging unit having an optical filter that cuts out light in the wavelength band of the therapeutic light and transmits a portion of the white light, the guide light, and the fluorescence emitted by the reagent; a control unit that controls emission timings of the illumination light source, the treatment light source, and the guide light source; an image processing unit that generates an image based on optical images obtained by the light emitted from the illumination light source, the therapeutic light source, and the guide light source; Equipped with the control unit controls the image processing unit to generate an illumination light image based on an optical image acquired while the illumination light source and the guide light source are on, and to generate a fluorescence image based on a fluorescence image acquired while the therapeutic light source is on and the illumination light source and the guide light source are off. Endoscopy system.

2. the image processing unit generates an illumination light image based on an optical image obtained by irradiation with the illumination light and the guide light, and a superimposed image by superimposing, on the illumination light image, a fluorescence image based on an optical image obtained by irradiation with the fluorescence; a display device that displays the illumination light image and / or the superimposed image; The endoscope system of claim 1 further comprising:

3. The control unit synchronously controlling the on / off of the illumination light source and the guide light source and the image capturing timing of the image capturing unit; the therapeutic light source is controlled independently of the illumination light source and the guide light source; The endoscope system according to claim 1 .

4. The control unit synchronously controlling the on / off of the illumination light source, the guide light source, the treatment light source, and the imaging timing of the imaging unit; The endoscope system according to claim 1 .

5. The illumination light source is dimmed using a value obtained by subtracting a signal value corresponding to the light amount of the irradiated guide light from the detected light amount. The endoscope system according to claim 1 .

6. The illumination light source is dimmed based on the amount of light in a range excluding the irradiation range of the guide light. The endoscope system according to claim 1 .

7. the illumination light source emits light of a wavelength band other than the wavelength band of the guide light; The endoscope system according to claim 1 .

8. the illumination light source emits light of only blue and green components, or light of only blue component; The endoscope system according to claim 1 .

9. the control unit causes the image processing unit to generate an illumination light image based on an optical image acquired while the illumination light source and the guide light source are on and the therapeutic light source is off, and to generate a fluorescence image based on a fluorescence image acquired while the illumination light source and the guide light source are off and the therapeutic light source is on. The endoscope system according to claim 1 .

10. the control unit causes the imaging unit to capture a fluorescent image when a signal value of at least one of a blue component and a green component in an optical image acquired while the illumination light source and the guide light source are off becomes equal to or less than a preset threshold. The endoscope system according to claim 1 .

11. the control unit normalizes the fluorescence image using the light intensity or the irradiation range of the guide light irradiation region in the illumination light image. The endoscope system according to claim 1 .

12. the control unit corrects the amount of the therapeutic light using the light intensity or the irradiation range of the guide light irradiation region in the illumination light image. The endoscope system according to claim 1 .

13. the control unit corrects the intensity of the therapeutic light depending on the distance, using the intensity or the irradiation range of the guide light, and calculates the treatment time using the corrected light intensity. The endoscope system according to claim 1 .

14. The control unit: a first observation mode in which the illumination light source and the guide light source are continuously turned on, optical images obtained by the light emitted from the illumination light source and the guide light source are continuously captured by an image sensor, and a white light image is generated based on the optical images; a second observation mode in which the illumination light source and the guide light source are turned off, the therapeutic light source is turned on, optical images obtained by the light emitted from the therapeutic light source are continuously captured by the image sensor, and a fluorescence image is generated based on the optical images; Set the pre-treatment observation mode including a frame rate of the image sensor in the second observation mode is lower than a frame rate of the image sensor in the first observation mode; The endoscope system according to claim 1 .

15. The imaging element captures images at 60 frames per second, the second observation mode has a length corresponding to one frame of the imaging timing of the imaging element, the first observation mode has a length of 59 frames of imaging timing of the imaging element, The endoscope system according to claim 14.

16. The control unit causes a display unit to display the white light image generated in the first observation mode and a superimposed image obtained by superimposing the fluorescent image generated in the second observation mode on the white light image. The endoscope system according to claim 14.

Images