Medical image acquisition device, mammography apparatus, and control program

Abstract

To make biopsy progress by referring to reference information on biopsy without averting visual lines remarkably from a photographing surface on which a living body is placed.SOLUTION: A mammography apparatus 2 comprises: a biopsy unit 26; a photographing table 14 used to take an image of a living body placed on a photographing table, by a photographing device; a projector 40 which projects the image; and a control unit 50. The control unit 50 performs control to project information on biopsy to be performed on the living body by using the biopsy unit 26, toward the photographing surface of the photographing table 14 from the projector 40.SELECTED DRAWING: Figure 2

Description

[Technical field]

[0001] The present disclosure relates to a medical image acquisition device, a mammography device, and a control program. [Background technology]

[0002] 2. Description of the Related Art A biopsy may be performed in a medical institution to collect biological tissue from a patient's body, and a biopsy may be performed on the collected biological tissue.

[0003] Patent document 1 discloses a biopsy method including the steps of performing a tomosynthesis scan on a portion of an object, reconstructing the tomosynthesis scan results on a display screen so that markers are visible, determining a location of a lesion based on the markers, correlating the location of the lesion with the markers, and using the correlation between the location of the lesion and the markers to suggest a puncture point for a biopsy tool.

[0004] Patent document 2 discloses an imaging system including an X-ray tube head, a support arm, a compression system coupled to the support arm and rotatable independently with respect to the X-ray tube head, the compression system including a compression paddle, a support platform, and an X-ray receptor, and a light assembly coupled to the support arm and positioned above the compression paddle, the light assembly configured to direct one or more beams of light toward the support platform.

[0005] Patent Document 3 discloses a mammography device that creates a virtual mask in which the area to be biopsy is marked from an X-ray image of the breast, and indicates the position of the breast so that the marked area coincides with the puncture position.

[0006] Patent Document 4 discloses a biopsy site extraction device that detects a lesion site in an object to be examined in at least two images, and if the lesion site in one image and the lesion site in the other image are the same lesion site, matches the lesion site to calculate the three-dimensional position of the lesion site, determines whether it is possible to insert a biopsy needle into the lesion site to extract biological tissue from the lesion site, and if so, extracts the lesion site as a candidate biopsy site.

[0007] Patent Document 5 discloses a mammography apparatus equipped with a laser device for projecting a position mark onto an examination object.

[0008] Patent document 6 discloses a puncture support device that sets a puncture-enabled area on a body surface image that reaches from the body surface to the puncture target, calculates the safety of the puncture path from the puncture-enabled area on the body surface image to the puncture target, groups the puncture-enabled areas according to the safety, sets candidate areas for the puncture insertion point in the puncture-enabled areas that belong to the group, and displays the set candidate areas. [Prior art documents] [Patent documents]

[0009] [Patent Document 1] US Patent Application Publication No. 2016 / 0310215 [Patent Document 2] Special Publication No. 2022-502138 [Patent Document 3] US Patent Application Publication No. 2010 / 0054402 [Patent Document 4] Special Publication No. 2010-194194 [Patent Document 5] US Patent Application Publication No. 2009 / 0299218 [Patent Document 6] International Publication No. 2014 / 073649 Summary of the Invention [Problem to be solved by the invention]

[0010] Since a biopsy involves inserting a biopsy needle into a patient in front of the patient, it is preferable to perform the biopsy as quickly as possible without making any mistakes in the procedure in order to reduce the burden and fear of the patient. For this reason, it is preferable for the medical staff performing the biopsy to keep their eyes on the area where the biopsy is to be performed as little as possible.

[0011] However, up until now, information about biopsy, such as the location where biological tissue is taken, has been displayed on a display panel provided in the biopsy unit, a monitor placed at the feet of the medical staff, etc. Therefore, when visually checking the information about biopsy, the medical staff must take their eyes off the part where the biopsy is to be performed, and furthermore, the size of the display panel or monitor is limited by constraints such as the size of the biopsy unit and the area of ​​the location where biological tissue is taken, making it difficult to see.

[0012] The present disclosure has been made in consideration of the above circumstances, and aims to provide a medical image acquisition device, a mammography device, and a control program that enable a biopsy to be performed by referring to reference information related to the biopsy without having to significantly move your gaze away from the imaging surface on which the living body is placed. [Means for solving the problem]

[0013] The medical image acquisition apparatus of the first embodiment comprises a biopsy device, an imaging stand used to capture an image of a living body placed on an imaging surface by an imaging device, a projector that projects an image, and at least one processor, wherein the processor controls the projection of information relating to a biopsy performed on the living body using the biopsy device from the projector onto the imaging surface of the imaging stand.

[0014] In a second aspect of the medical image acquisition device, in the medical image acquisition device of the first aspect, the processor controls the projector to project, onto the imaging surface of the imaging stand, the position of the living body when the living body is placed on the imaging surface of the imaging stand, the position of a biopsy needle attached to the biopsy device that has been inserted into the living body, and the collection position at which biological tissue is collected using the biopsy needle.

[0015] A medical image acquisition device according to a third aspect is the medical image acquisition device according to the second aspect, wherein when the biopsy needle is inserted into the living body along the imaging surface of the imaging table, the processor controls the projector to project the position of the living body, the position of the biopsy needle, and the collection position onto the imaging surface of the imaging table.

[0016] A medical image acquisition device according to a fourth aspect is the medical image acquisition device according to the third aspect, wherein the processor controls the projector to project the puncture range of the biopsy needle by the biopsy device onto the imaging surface of the imaging stand.

[0017] A medical image acquisition device according to a fifth aspect is the medical image acquisition device according to the fourth aspect, wherein the processor controls the projector to project the puncture range of the biopsy needle, which corresponds to the direction in which the biopsy needle is inserted into the living body, onto the imaging surface of the imaging stand.

[0018] A sixth aspect of the medical image acquisition device is the medical image acquisition device of the fifth aspect, wherein the processor controls to output a warning to instruct the biopsy needle to puncture the living body from a different direction if the sampling position is not included in the puncture range of the biopsy needle.

[0019] A seventh aspect of the medical image acquisition device is the medical image acquisition device of the third aspect, wherein the processor controls the projector to project the position of the biopsy needle onto the imaging surface of the imaging table in accordance with the movement of the biopsy needle.

[0020] A medical image acquisition device according to an eighth aspect is a medical image acquisition device according to the seventh aspect, wherein the processor controls the projector to project information regarding the distance from the tip of the biopsy needle to the epidermis of the living body and the depth of the collection position along a direction intersecting with the imaging surface of the imaging table onto the imaging surface of the imaging table.

[0021] A ninth aspect of the medical image acquisition device is the medical image acquisition device of the eighth aspect, wherein the processor controls the projector to project the positions of blood vessels in the living body onto the imaging surface of the imaging stand using an image of the living body captured by the imaging device.

[0022] A medical image acquisition device according to a tenth aspect is a medical image acquisition device according to the ninth aspect, wherein the processor controls the projector to project the positions of blood vessels having a predetermined thickness or larger onto the imaging surface of the imaging stand.

[0023] A medical image acquisition device according to an 11th aspect is a medical image acquisition device according to the 10th aspect, wherein the processor controls to change the display form of the position of the blood vessel projected from the projector onto the imaging surface of the imaging table depending on the thickness of the blood vessel.

[0024] A medical image acquisition device according to a 12th aspect is a medical image acquisition device according to the 10th aspect, wherein the processor controls to change the display form of the position of the blood vessel projected from the projector onto the imaging surface of the imaging table depending on the depth of the blood vessel along a direction intersecting with the imaging surface of the imaging table.

[0025] A medical image acquisition device according to a 13th aspect is a medical image acquisition device according to the 10th aspect, wherein the processor controls the projector to project the position of blood vessels passing between the collection position and the epidermis of the living body where the biopsy needle is inserted onto the imaging surface of the imaging stand.

[0026] A medical image acquisition device according to a fourteenth aspect is a medical image acquisition device according to the third aspect, wherein the processor controls the projector to project the position of the living body onto the imaging surface of the imaging table so that the collection position is within the range of an opening of a compression plate which presses the living body against the imaging surface of the imaging table and has an opening on a surface facing the imaging surface of the imaging table.

[0027] In the medical image acquisition device of the 15th aspect, in the medical image acquisition device of the 14th aspect, when there are multiple collection positions and each of the collection positions is not within the range of the opening of the compression plate, the processor controls the projector to project the position of the living body, adjusted so that the collection position having a higher priority for collecting biological tissue than the other collection positions, falls within the range of the opening, onto the imaging surface of the imaging table.

[0028] A medical image acquisition device according to a 16th aspect is a medical image acquisition device according to any one of the second to fifteenth aspects, wherein the processor controls the projector to further project information regarding the position at which the anesthetic needle is to be inserted and the depth at which the anesthetic needle is to be inserted along a direction intersecting with the imaging surface of the imaging table before the biopsy needle is inserted into the living body, onto the imaging surface of the imaging table.

[0029] A medical image acquisition device according to a 17th aspect is a medical image acquisition device according to any one of the second to fifteenth aspects, wherein the processor controls the projector to project the elapsed time since the biopsy needle that has been inserted into the living body is removed from the living body onto the imaging surface of the imaging stand.

[0030] The mammography device of the 18th aspect is a radiation imaging device that irradiates radiation to the living body to take a radiation image of the living body, the living body being a breast, and constitutes a medical image acquisition device of any one of the 1st to 15th aspects.

[0031] A mammography apparatus according to a 19th aspect is a mammography apparatus according to the 18th aspect, in which the processor controls the projector to project the positions of blood vessels and mammary glands in the living body onto the imaging surface of the imaging table using a radiation image of the living body captured by the radiation imaging device.

[0032] The control program of the 20th aspect is a program executed in a medical image acquisition device having a biopsy device, an imaging stand used to capture an image of a living body placed on an imaging surface using an imaging device, a projector for projecting images, and at least one processor, and causes a computer to execute a process of controlling the projector to project information regarding a biopsy to be performed on the living body using the biopsy device onto the imaging surface of the imaging stand. Effect of the Invention

[0033] According to the present disclosure, a biopsy can be performed by referring to reference information related to the biopsy without significantly changing one's line of sight from the imaging surface on which the living body is placed. [Brief description of the drawings]

[0034] [Figure 1] FIG. 1 is a diagram illustrating an example of the configuration of a medical image acquisition apparatus. [Diagram 2] FIG. 1 is a schematic diagram showing an example of a mammography apparatus. [Diagram 3] FIG. 13 is a diagram showing an example of a compression plate as viewed from above. [Figure 4] FIG. 13 illustrates an example of a lateral adaptor. [Diagram 5] FIG. 1 is a diagram showing an example of the configuration of a mammography apparatus and a console. [Figure 6] FIG. 1 illustrates an example of the configuration of an image storage system. [Figure 7] 13 is a flowchart showing an example of the flow of a biopsy support process. [Figure 8] FIG. 2 is a diagram showing an example of a skin line. [Figure 9] FIG. 13 is a diagram showing an example of a projection image including a biopsy needle image. [Figure 10] FIG. 13 is a diagram showing an example of a display of the elapsed time since the biopsy needle was removed. [Figure 11] 1 is an example of a projection image showing the positions of blood vessels. [Figure 12] FIG. 13 is a diagram showing an example of a projection image in which blood vessels are selected for display according to their thickness. [Figure 13] 13A and 13B are diagrams showing an example of a projected image in which the display form of the blood vessel position is changed according to the thickness of the blood vessel. [Figure 14] FIG. 13 is a diagram showing an example of a projection image that displays only the positions of blood vessels that pass between a target and a puncture point. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0035] Hereinafter, the present embodiment will be described with reference to the drawings. Note that the same components and processes are given the same reference numerals throughout the drawings, and duplicated explanations will be omitted. Also, the dimensional ratios in the drawings are exaggerated for the convenience of explanation, and may differ from the actual ratios.

[0036] 1 is a diagram showing an example of the configuration of a medical image acquisition device 1. The medical image acquisition device 1 is a device that acquires images used in medical treatment or examination. There is no restriction on the type of image acquired by the medical image acquisition device 1, and the image may be any image, such as a radiological image, an ultrasonic image, or a magnetic resonance imaging (MRI) image. Hereinafter, the medical image acquisition device 1 will be described using an example in which the medical image acquisition device 1 acquires a radiological image.

[0037] The medical image acquisition apparatus 1 includes, for example, an image storage system 3 and a radiation image capturing system 4.

[0038] The radiation image capturing system 4 is a system that captures images of the inside of a subject's body using radiation. For example, the radiation image capturing system 4 includes a mammography device 2 and a console 5. That is, the radiation image capturing system 4 captures radiation images of the breast using the mammography device 2, which is an example of a radiation image capturing device. Note that the part of the subject captured by the radiation image capturing system 4 is not limited to the breast, and may be other parts such as the chest or abdomen. In this case, the mammography device 2 is replaced with a chest X-ray device, a CT (Computed Tomography) device, or the like.

[0039] If the type of image acquired by the medical image acquisition device 1 is an ultrasound image, the radiation image capture system 4 becomes an ultrasound image capture system, and the mammography device 2 is replaced with an ultrasound image capture device. If the type of image acquired by the medical image acquisition device 1 is a magnetic resonance image, the radiation image capture system 4 becomes an MRI capture system, and the mammography device 2 is replaced with an MRI device. In this way, the mammography device 2, the ultrasound image capture device, and the MRI device that capture images are examples of capture devices.

[0040] The console 5 is an operation desk for operating the mammography apparatus 2, and is connected to the mammography apparatus 2 and the image storage system 3, for example.

[0041] The image storage system 3 is a system that stores, for example, radiation images captured by the radiation image capturing system 4. The image storage system 3 extracts a radiation image from among the stored radiation images in response to a request from the console 5 and transmits it to the console 5. A specific example of the image storage system 3 is a PACS (Picture Archiving and Communication System).

[0042] The console 5 has the function of controlling the mammography apparatus 2 using imaging orders and various information obtained from a RIS (Radiology Information System) 6 via a communication line such as a LAN, and instructions received from medical personnel.

[0043] FIG. 2 is a schematic diagram showing an example of a mammography apparatus 2 according to this embodiment.

[0044] 2, in the mammography apparatus 2 according to this embodiment, for example, a radiation storage unit 16 that stores a radiation irradiator 17 therein and an imaging table 14 are connected to an arm 13 so that they face each other. A subject's breast is placed on the upper surface of the imaging table 14 (hereinafter referred to as the "imaging surface"), and the radiation irradiator 17 irradiates the breast with radiation according to instructions from the console 5.

[0045] An image recording medium such as a radiation detector 15 is set inside the imaging stand 14 and housed in a recording medium holding section such as a cassette, and a radiation image of the breast is obtained by the radiation detector 15 detecting radiation that has passed through the breast, which is the subject.

[0046] The imaging surface that comes into contact with the breast of the subject is made of, for example, carbon from the viewpoints of radiation transparency and strength.

[0047] Arm 13 is attached to base 11 by C-axis 12. In addition, C-axis 12, which serves as the center of rotation, is attached to the center position of radiation detector 15 so that the center of rotation of arm 13 becomes the center of radiation detector 15 in the X direction (see FIG. 3), and arm 13 is attached to base 11.

[0048] The base 11 is provided with an operation unit 28 that receives radiation irradiation instructions for the radiation irradiator 17 and enables medical personnel to adjust the height of the imaging table 14 (i.e., the height of the arm 13) and the inclination of the imaging table 14 (i.e., the inclination of the arm 13), and an arm control unit 31 that moves the arm 13 up and down and rotates it in accordance with input from the operation unit 28.

[0049] The arm control unit 31 adjusts the inclination of the arm 13 by rotating the C-axis 12 attached to the base 11, and adjusts the height of the imaging table 14 by moving the arm 13 up and down.

[0050] At the center of the arm 13, there are provided a compression plate 18, which is a plate arranged above the imaging table 14 and presses down on the breast, a support section 20 that supports the compression plate 18, and a compression plate moving mechanism 19 that moves the support section 20 in the vertical direction along the arm 13. The position and compression force of the compression plate 18 are controlled by a compression plate controller 34 provided in the compression plate moving mechanism 19. The compression plate 18 is made of a material that is excellent in radiation permeability. As the material of the compression plate 18, for example, resins such as polymethylpentene, polycarbonate, acrylic, and polyethylene terephthalate can be used. Note that the material constituting the compression plate 18 is not limited to the above example. For example, the material constituting the compression plate 18 may be a film-like member.

[0051] 3 is a view of the compression plate 18 as seen from above, that is, as seen from the radiation storage section 16 toward the imaging table 14 along the Z direction. As shown in FIG. 3, the compression plate 18 has an opening 25 so that a biopsy can be performed with the breast fixed by the imaging table 14 and the compression plate 18.

[0052] As an example, a biopsy unit 26 as a biopsy device of the present disclosure shown in Fig. 2 has a biopsy needle 21 that is inserted into the breast and a biopsy needle unit 22, and further includes a moving mechanism 24 that moves the biopsy needle unit 22 in the X, Y, and Z directions. The position of the tip of the biopsy needle 21 of the biopsy needle unit 22 is controlled by a needle position controller 35 provided in the moving mechanism 24. Note that the horizontal direction in Fig. 2 is the Y direction, the vertical direction is the Z direction, and the direction perpendicular to the YZ plane is the X direction. The Z direction is also the vertical direction.

[0053] Biopsy unit 26 inserts hollow biopsy needle 21 into the site to be biopsied, i.e., the sampling position (hereinafter referred to as "target T") from which biological tissue is sampled, and cuts out the biological tissue of target T with an inner blade provided on biopsy needle 21 by utilizing the force of a spring. Biopsy unit 26 may obtain the biological tissue of target T by suctioning through the hollow part of biopsy needle 21.

[0054] The biopsy unit 26 shown in Fig. 2 shows an example in which the biopsy needle 21 is moved in the Z direction to puncture the breast from above, so-called vertical puncture, but the biopsy unit 26 also supports lateral puncture. Lateral puncture is a method in which the biopsy needle 21 is moved in the X direction in Fig. 3 to puncture the breast from the side. Whether to perform vertical or lateral puncture is determined by the medical staff in consideration of the ease of extracting biological tissue based on the position of the target T.

[0055] When puncturing in the lateral direction, for example, a lateral adapter 27 is attached to the biopsy needle unit 22, and the biopsy needle 21 is attached to the lateral adapter 27.

[0056] 4 is a diagram showing an example of the lateral adapter 27 attached to the biopsy needle unit 22. In the lateral adapter 27, the position of the tip of the biopsy needle 21 in the YZ plane is adjusted by a medical professional operating a position adjustment mechanism (not shown) of the lateral adapter 27. The biopsy needle 21 attached to the lateral adapter 27 moves in the X direction in conjunction with the movement along the X direction of a handle 27A operated by the medical professional, for example.

[0057] That is, in the case of puncturing using the lateral adapter 27, the position of the tip of the biopsy needle 21 is not controlled by the needle position controller 35 but is determined by the operation of the medical professional. After determining the position of the biopsy needle 21 in the Y and Z directions taking into consideration the position of the target T, the medical professional moves the handle 27A along the X direction toward the breast while checking the scale 27B, for example, to puncture the biopsy needle 21 from the side of the breast to the position of the target T.

[0058] The lateral adapter 27 is equipped with a displacement sensor (not shown) that measures the amount of movement of the biopsy needle 21 along the X direction, and the measurement value of the displacement sensor is notified to, for example, the needle position controller 35. That is, in the case of puncturing using the lateral adapter 27, the biopsy unit 26 cannot adjust the position of the tip of the biopsy needle 21 by the needle position controller 35, but can obtain the position of the tip of the biopsy needle 21 in the X direction.

[0059] The lateral adapter 27 shown in FIG. 4 is attached so that the biopsy needle 21 can be moved from left to right. However, if the attachment direction of the lateral adapter 27 is changed, the biopsy needle 21 can be moved from right to left.

[0060] 2, inside the radiation storage unit 16, a projector 40 having a projection unit 40A is built in on the underside of the radiation storage unit 16 and near the exit of the radiation irradiator 17. The projector 40 projects an image showing various information (hereinafter referred to as a "projected image") toward the imaging surface. Therefore, if a breast is placed on the imaging surface, the projected image is projected onto the breast. Also, if the compression plate 18 is compressing the breast, the projected image is also projected onto the compression plate 18. Note that since the compression plate 18 has an opening 25, in this case, the projected image is projected onto the compression plate 18, the breast not covered by the compression plate 18, and the imaging surface in an area where the breast is not placed.

[0061] As the projector 40, a known projector such as a liquid crystal projector, a DLP (Digital Light Processing) (registered trademark) projector, or a laser projector can be used.

[0062] In this way, the mammography device 2 is provided with a biopsy unit 26, and an arm 13 at one end of which is provided with a radiation irradiator 17 and a projector 40 for emitting radiation for capturing a radiographic image toward the imaging surface of the imaging table 14, and at the other end of which is provided with the imaging table 14.

[0063] Before puncturing, the mammography device 2 obtains scout images captured from two directions so as to include the area of ​​the breast to be biopsied, which will be the target T. The scout images are radiological images taken from different viewpoints in order to confirm the position of the target T. From the deviation of the target T in the two scout images, the distance from the bottom surface (the side that presses the breast) of the compression paddle 18 to the target T and its position on the XY plane can be obtained, thereby obtaining three-dimensional position information of the target T.

[0064] The method of acquiring the three-dimensional position information of the target T in the breast is not limited to the method using the scout image. The mammography device 2 can also perform stereoscopic imaging. In stereoscopic imaging, radiation is irradiated from the radiation irradiator 17 toward the breast from two irradiation positions with different irradiation angles, and two radiation images of the breast are taken. That is, in stereoscopic imaging, the angles of the imaging table 14, compression plate 18, breast, etc. are kept fixed, and imaging is performed by changing the rotation angle of the radiation irradiator 17 relative to the base 11.

[0065] Furthermore, the mammography device 2 can also perform tomosynthesis imaging. In tomosynthesis imaging, radiation is irradiated from a plurality of irradiation positions with different irradiation angles toward the breast by the radiation irradiator 17, and a plurality of radiation images of the breast are taken. That is, in tomosynthesis imaging, the angles of the imaging table 14, the compression plate 18, the breast, etc. are kept fixed, and imaging is performed by changing the rotation angle of the radiation irradiator 17 relative to the base 11.

[0066] Next, a description will be given of an example of the configuration of the radiation image capturing system 4. Fig. 5 is a diagram showing an example of the configuration of the mammography apparatus 2 and the console 5 included in the radiation image capturing system 4.

[0067] As an example, the mammography device 2 is configured by a computer. As shown in Fig. 5, the mammography device 2 includes a radiation detector 15, a radiation irradiator 17, a compression paddle 18, a compression paddle movement mechanism 19, a camera 23, a biopsy unit 26, an operation panel 29, an arm control unit 31, a projector 40, a control unit 50, and an I / F (Interface) unit 59. The radiation detector 15, the radiation irradiator 17, the compression paddle movement mechanism 19, the camera 23, the biopsy unit 26, the operation panel 29, the arm control unit 31, the projector 40, the control unit 50, and the I / F unit 59 are connected via a bus 9 so as to be able to exchange various information with each other.

[0068] The control unit 50 controls the operation of the mammography apparatus 2 based on instructions from a medical professional. The control unit 50 includes a CPU (Central Processing Unit) 50A, which is an example of a processor, a storage unit 50B, and a RAM (Random Access Memory) 50C. The storage unit 50B stores in advance various programs including a control program 56 that the CPU 50A loads to control radiographic imaging and biopsy, as well as various parameters that the CPU 50A refers to when controlling the operation of the mammography apparatus 2. The RAM 50C is used as a temporary work area for the CPU 50A.

[0069] The operation panel 29 has a function that allows a medical professional to set various types of operation information such as exposure conditions and posture information, and various operation instructions such as the rotation angle of the arm 13. For example, the exposure conditions set on the operation panel 29 include information such as tube voltage, tube current, and irradiation time. The operation panel 29 is equipped with a display that displays various information and responses from the mammography apparatus 2 to the settings made by the medical professional.

[0070] When the control unit 50 receives instructions from a medical professional via the operation panel 29 or the console 5, it controls the operation of each component constituting the mammography apparatus 2 in accordance with the instructions. For example, when the control unit 50 receives an instruction to irradiate radiation from a medical professional, it controls the radiation irradiator 17 so that the radiation source 30 provided in the radiation irradiator 17 irradiates radiation onto the imaging surface of the imaging table 14 in accordance with the specified exposure conditions.

[0071] The radiation detector 15 detects radiation that has passed through the breast, which is the subject, in accordance with instructions from the control unit 50. The radiation detector 15 is disposed inside the imaging table 14. When capturing a radiation image in the mammography device 2, the subject's breast is placed on the imaging surface of the imaging table 14. The loading surface with which the subject's breast comes into contact is made of, for example, carbon from the viewpoints of radiation transparency and strength.

[0072] The compression plate moving mechanism 19 moves the compression plate 18 up and down in the Z direction in accordance with instructions from the control unit 50, which receives operations performed by a medical professional through the compression plate controller 34, and compresses and releases compression of the breast using the compression plate 18.

[0073] The arm control unit 31, in accordance with instructions from the control unit 50, controls the rotation angle of the C-axis 12 so that the rotation angle of the arm 13 becomes an angle appropriate for imaging.

[0074] In the biopsy unit 26, the moving mechanism 24 moves the biopsy needle 21 in accordance with instructions from the needle position controller 35 controlled by the control unit 50, and samples biological tissue of the target T in the breast. The biopsy unit 26 also notifies the control unit 50 of position information of the tip of the biopsy needle 21 through the needle position controller 35. As already described, when the lateral adapter 27 is attached to the biopsy needle unit 22 of the biopsy unit 26 and puncture is performed in the lateral direction, the movement of the biopsy needle 21 is performed by a medical professional operating the handle 27A.

[0075] The camera 23 is attached to a position facing the imaging surface of the imaging table 14 so that the entire breast placed on the imaging surface of the imaging table 14 is included within the angle of view, and captures the state of the breast placed on the imaging surface of the imaging table 14 and the medical staff's procedure on the breast according to instructions from the control unit 50. The image captured by the camera 23 may be a visible image or an infrared image, and may be a still image or a video. In the following, as an example, the camera 23 captures a visible image. Note that the camera 23 shown in FIG. 2 is attached to the radiation storage unit 16, but this is an example, and there is no restriction on the mounting position of the camera 23 as long as the entire breast can be captured along the Z direction. For example, the camera 23 may be attached to the arm 13 or the biopsy unit 26.

[0076] The projector 40 includes a projection unit 40A and a power supply unit 40B, and the on / off of the power supply unit 40B is controlled according to instructions from the control unit 50, and a projection image including information regarding the biopsy notified by the control unit 50 is projected from the projection unit 40A onto the imaging surface of the imaging stand.

[0077] The I / F unit 59 communicates various information with an external device connected to a communication line such as a LAN by wireless or wired communication. For example, the control unit 50 transmits radiographic images and visible images of the captured breast to the console 5 via the I / F unit 59.

[0078] The console 5 is, for example, configured by a computer. As shown in Fig. 5, the console 5 includes a control unit 60, an output unit 61, an operation unit 62, and an I / F unit 69. The control unit 60, the output unit 61, the operation unit 62, and the I / F unit 69 are connected via a bus 8 so as to be able to transmit and receive various information to and from each other.

[0079] The control unit 60 controls the operation of the entire console 5. The control unit 60 includes a CPU 60A, a storage unit 60B, and a RAM 60C. Various programs executed by the CPU 60A are stored in advance in the storage unit 60B. Radiographic images and visible images captured by the mammography device 2, as well as various other information, are stored in the storage unit 60B. The storage unit 60B is an example of a storage device that maintains stored information even if the power supplied to the storage unit 60B is cut off, and is, for example, a semiconductor memory such as an SSD, but a hard disk may also be used. The RAM 60C is used as a temporary work area for the CPU 60A.

[0080] The output unit 61 outputs the information processed by the control unit 60 to a medical professional.

[0081] The operation unit 62 is used by a medical professional to input instructions regarding radiographic imaging, including instructions for irradiating radiation, and various information, such as exposure conditions and posture information. Therefore, the operation unit 62 includes an irradiation instruction button that is pressed by a medical professional when instructing irradiation of radiation. There are no restrictions on the type of operation on the operation unit 62, and it is possible to accept operations using, for example, a switch, a touch panel, a touch pen, a mouse, etc.

[0082] The I / F unit 69 communicates various types of information via wireless or wired communication with the mammography apparatus 2, RIS 6, and image storage system 3, which are connected to a communication line such as a LAN. For example, the console 5 receives radiographic images and visible images captured by the mammography apparatus 2 via the I / F unit 69, transmits the received radiographic images and visible images to the image storage system 3 via the I / F unit 69, and stores the radiographic images and visible images in the image storage system 3.

[0083] On the other hand, Fig. 6 is a diagram showing an example of the configuration of the image storage system 3. As shown in Fig. 6, the image storage system 3 includes a control unit 70 and an I / F unit 79. The control unit 70 and the I / F unit 79 are connected via a bus 7 so as to be able to transmit and receive various information to and from each other.

[0084] The control unit 70 controls the operation of the image storage system 3. The control unit 70 includes a CPU 70A, a storage unit 70B, and a RAM 70C. The storage unit 70B stores in advance various programs that the CPU 70A loads to control the storage of radiographic images and visible images, and various parameters that the CPU 70A refers to when controlling the operation of the image storage system 3. The storage unit 70B also stores radiographic images and visible images in association with radiography orders, information about subjects, and the like. In other words, the storage unit 70B functions as an image database. The RAM 70C is used as a temporary work area for the CPU 70A.

[0085] The I / F unit 79 communicates various information with an external device connected to a communication line such as a LAN by wireless communication or wired communication. For example, the control unit 70 transmits a radiographic image requested through the console 5 to the console 5 via the I / F unit 79.

[0086] Next, the operation of the mammography device 2 when a medical professional performs a biopsy on a breast will be described in detail.

[0087] 7 is a flow chart showing an example of the flow of biopsy support processing for medical personnel, which is executed by the mammography apparatus 2 when an instruction to start a biopsy is received. The CPU 50A of the mammography apparatus 2 reads the control program 56 from the storage unit 50B and executes the biopsy support processing.

[0088] Here, as an example, a case will be described in which a lateral adapter 27 is attached to the biopsy needle unit 22 of the biopsy unit 26, and puncture in the lateral direction is performed by the biopsy needle 21.

[0089] It is assumed that prior to carrying out a biopsy, a radiological image of the breast to be used as a screening image is taken by the mammography device 2, and the position of the target T in the breast is identified in advance by diagnosis of the radiological image. The position of the target T is expressed, for example, as coordinate values ​​in three-dimensional coordinates virtually set on the imaging surface of the imaging table 14. The identified position of the target T is input, for example, by a medical professional via the console 5 or the operation panel 29, and stored in the memory unit 50B of the control unit 50.

[0090] First, in step S10, the control unit 50 controls the projection unit 40A of the projector 40 to project the position of the breast onto the imaging surface of the imaging stand 14. The position of the breast is represented by a skin line 32 representing the outline of the breast displayed on the imaging surface of the imaging stand 14.

[0091] In this case, the control unit 50 calculates the position of the skin line 32 such that the target T falls within the range of the opening 25 of the compression paddle 18, based on the position information of the opening 25 obtained from the type of compression paddle 18 attached to the mammography device 2 and the position of the target T. The control unit 50 performs control to project the skin line 32 at the calculated position. Therefore, compared to the case where the subject places the breast on the imaging surface of the imaging table 14 and then it is confirmed whether the target T is within the range of the opening 25 of the compression paddle 18 at that position, it is not necessary to have the subject change the position of the breast many times, reducing the burden on the subject.

[0092] The type of compression plate 18 attached to the mammography device 2 may be input in advance by a medical professional via the console 5 or operation panel 29, or a barcode reader (not shown) provided in the mammography device 2 may read a barcode label affixed to the compression plate 18 to obtain the type of compression plate 18. The barcode reader is provided, for example, in a position where it can read the barcode label with the compression plate 18 attached to the support part 20.

[0093] When multiple targets T are present on the breast, the control unit 50 performs control to project the skin line 32 at a position where all of the targets T are within the range of the opening 25 of the compression paddle 18. This allows the subject to position the breast at a position where the contour of the breast follows the skin line 32. Determining the position of the breast on the imaging surface of the imaging table 14 is also called "positioning." Figure 8 is a diagram showing an example of the skin line 32 projected onto the imaging surface of the imaging table 14.

[0094] Depending on the position of the target T, not all of the targets T may fall within the range of the opening 25 of the compression paddle 18. In such a case, the control unit 50 refers to the priority of the targets T and performs control to project the skin line 32 with the position adjusted so that as many of the targets T with high priority as possible fall within the range of the opening 25 of the compression paddle 18.

[0095] The priority of the targets T is set in advance by a medical professional and stored in the storage unit 50B in association with each target T. The medical professional may set a higher priority for a target T with a higher degree of malignancy, or may set a higher priority for a target T with a larger size, for example.

[0096] After biopsy of the breast arranged along the current skin line 32 is completed, the control unit 50 controls the projection of the skin line 32 with the position adjusted so that the remaining targets T that did not fall within the range of the opening 25 of the compression paddle 18 are within the range of the opening 25, thereby supporting the biopsy of all targets T. By giving priority to targets T with higher priority and placing them within the range of the opening 25 of the compression paddle 18, the targets T with higher priority can be biopsied earlier and test results can be obtained.

[0097] In step S20 of FIG. 7, the control unit 50 controls the compression plate moving mechanism 19 to move the compression plate 18 toward the imaging surface of the imaging table 14 and compress the breast placed on the imaging surface along the skin line 32.

[0098] The control unit 50 controls the camera 23 to capture a visible image of the breast compressed by the compression plate 18, and if an area in the visible image is identified where the position of the breast contour in the XY plane deviates from the skin line 32 by more than a predetermined distance, it controls the compression plate moving mechanism 19 to release the compression of the breast by the compression plate 18 and have the subject reposition the breast.

[0099] Furthermore, the control unit 50 may control the radiation irradiator 17 according to instructions from a medical professional to capture a radiological image of the breast compressed by the compression plate 18. If the position of the target T identified from the radiological image captured as the process of step S20 deviates from the position of the target T previously identified from the medical examination image by a predetermined distance or more, the control unit 50 controls the compression plate moving mechanism 19 to release the compression of the breast by the compression plate 18 and have the subject reposition the breast.

[0100] In step S30, the control unit 50 controls the projection unit 40A of the projector 40 to project the biopsy reference information onto the imaging surface of the imaging stand 14.

[0101] Specifically, the control unit 50 controls the projection unit 40A of the projector 40 to project the position of the target T in the XY plane onto the imaging surface of the imaging table 14. As a result, the position of the target T is displayed on the breast exposed through the opening 25 of the compression plate 18 (see FIG. 8). Because the position of the target T in the XY plane is displayed on the breast, the medical staff does not need to check the position of the target T by looking at the examination image displayed on a monitor (not shown) placed at their feet, for example. Therefore, the medical staff can check the position of the target T without taking their eyes off the imaging surface of the imaging table 14.

[0102] In addition, the control unit 50 controls the projection unit 40A of the projector 40 to project the distance along the traveling direction of the biopsy needle 21 from the tip of the biopsy needle 21 that punctures the breast to the target T (in this case, the X direction because the puncture is in the lateral direction) onto the imaging surface of the imaging table 14. The distance along the traveling direction of the biopsy needle 21 from the tip of the biopsy needle 21 that punctures the breast to the target T is referred to as the "target distance."

[0103] The control unit 50 also controls the projection unit 40A of the projector 40 to project the distance along the traveling direction of the biopsy needle 21 from the tip of the biopsy needle 21 on the side that punctures the breast to the epidermis of the breast that is punctured by the biopsy needle 21 onto the imaging surface of the imaging table 14. The distance along the traveling direction of the biopsy needle 21 from the tip of the biopsy needle 21 on the side that punctures the breast to the epidermis of the breast that is punctured by the biopsy needle 21 is called the "biopsy distance."

[0104] The control unit 50 also controls the projection unit 40A of the projector 40 to project the depth of the target T in the breast along a direction perpendicular to the imaging surface of the imaging table 14 (i.e., the Z direction) onto the imaging surface of the imaging table 14. In other words, the depth of the target T represents the distance along the Z direction from the position of the compression surface of the compression plate 18 that compresses the breast to the target T.

[0105] The position of the target T, the target distance, the biological body distance, and the depth of the target T are examples of biopsy reference information, since they are information that medical personnel can refer to when performing a biopsy, together with the position of the target T. In Fig. 8, the target distance, the biological body distance, and the depth of the target T are displayed, for example, under the item names "LenA", "LenB", and "DepthT", respectively.

[0106] There are no restrictions on the display positions of the target distance, biological distance, and depth of the target T as long as they are within the imaging surface of the imaging table 14, but to avoid overlapping with the display of the position of the target T as shown in Fig. 8, it is preferable to display the target distance, biological distance, and depth of the target T in a location other than the breast exposed within the opening 25 of the compression plate 18. Specifically, the target distance, biological distance, and depth of the target T are displayed on the compression plate 18, on the imaging surface of the imaging table 14 on which the breast is not placed, and at least one location on the breast protruding outside the compression plate 18 when the compression plate 18 is viewed from above.

[0107] In this way, the target distance, the living body distance, and the depth of the target T are displayed within the range of the imaging surface of the imaging table 14, so the medical staff does not need to perform the biopsy by looking at the biopsy reference information displayed on a monitor placed at the feet, for example. Therefore, the medical staff can check the target distance, the living body distance, and the depth of the target T without taking their eyes off the imaging surface of the imaging table 14. The medical staff adjusts the position of the biopsy needle 21 with reference to the depth of the target T so that the position of the tip of the biopsy needle 21 in the Z direction is the same as the position of the target T in the Z direction.

[0108] In this case, the control unit 50 may control the projection unit 40A of the projector 40 to project some kind of mark onto the imaging surface of the imaging table 14 when the Z coordinate value of the biopsy needle 21 becomes the same as the Z coordinate value of the target T. If the medical staff adjusts the position of the biopsy needle 21 so that the mark is displayed, the position of the tip of the biopsy needle 21 in the Z direction will become the same as the position of the target T in the Z direction.

[0109] The control unit 50 can obtain the amount of movement of the biopsy needle 21 in the X direction measured by the displacement sensor provided in the lateral adapter 27 through the needle position controller 35. Therefore, the control unit 50 updates the target distance and living body distance that change with the movement of the biopsy needle 21 due to the medical staff's operation of the handle 27A, and performs control to project the updated target distance and living body distance onto the imaging surface of the imaging table 14 in real time.

[0110] 7, the control unit 50 controls the projection unit 40A of the projector 40 to adjust the position of the biopsy needle 21 in the X and Y directions, thereby projecting the range that the tip of the biopsy needle 21 can reach, i.e., the puncture possible range 33, onto the imaging surface of the imaging table 14. There are no restrictions on the display form of the puncture possible range 33, and for example, the puncture possible range 33 may be colored.

[0111] If the target T is not included in the puncture possible range 33, it means that even if the position of the biopsy needle 21 is adjusted, the tip of the biopsy needle 21 will not reach the target T and biological tissue cannot be sampled.

[0112] Therefore, in step S50, the control unit 50 judges whether the target T is included in the puncture-enabled range 33. If the target T is not included in the puncture-enabled range 33, the biopsy cannot be performed as it is. Therefore, in step S60, the control unit 50 controls the operation panel 29 to output a warning to the display of the operation panel 29 to notify the medical staff to change the attachment direction of the lateral adapter 27 and puncture the breast with the biopsy needle 21 from a different direction. This makes it possible to determine whether the biological tissue of the target T can be collected from the current attachment direction of the lateral adapter 27 before the biopsy needle 21 is punctured into the breast. Therefore, after the biopsy needle 21 is punctured into the breast, it is not possible to collect biological tissue of the target T with the current attachment direction of the lateral adapter 27, so that the subject does not have to bear the burden of changing the attachment direction of the lateral adapter 27 and puncturing the biopsy needle 21 again.

[0113] If the operation panel 29 is equipped with a speaker, the control unit 50 may output the warning by voice from the speaker of the operation panel 29.

[0114] The medical staff who recognizes the warning from the mammography apparatus 2 operates, for example, the operation panel 29 to notify the control unit 50 that the attachment direction of the lateral adapter 27 relative to the biopsy needle unit 22 has been changed.

[0115] In step S70, the control unit 50 determines whether or not a change completion notification indicating that the attachment direction of the lateral adapter 27 has been changed has been received from the operation panel 29. If the change completion notification has not been received, this means that the medical staff has not yet changed the attachment direction of the lateral adapter 27. Therefore, the control unit 50 repeats the determination process of step S70 and waits until the medical staff changes the attachment direction of the lateral adapter 27.

[0116] On the other hand, if a change completion notice has been received, the process proceeds to step S40, and the control unit 50 controls the projection of the puncture range 33 of the biopsy needle 21 in the lateral adapter 27 after the attachment direction has been changed, onto the imaging surface of the imaging stand 14. That is, the control unit 50 controls the projection unit 40A of the projector 40 to project the puncture range 33 of the biopsy needle 21, which corresponds to the direction in which the biopsy needle 21 is inserted into the breast, onto the imaging surface of the imaging stand 14.

[0117] If it is determined in the determination process of step S50 that target T is included in punctureable range 33, the process proceeds to step S80. In this case, control unit 50 may control projection unit 40A of projector 40 to stop displaying punctureable range 33.

[0118] Since the target T is included in the punctureable range 33, the medical professional adjusts the position of the biopsy needle 21 so that the position of the tip of the biopsy needle 21 in the Y direction is the same as the position of the target T in the Y direction.

[0119] In this case, the control unit 50 may control the projection unit 40A of the projector 40 to project a straight line along the X direction passing through the Y coordinate value of the biopsy needle 21, i.e., a guideline, onto the imaging surface of the imaging table 14. If the medical professional adjusts the position of the biopsy needle 21 so that the guideline passes through the target T, the position of the tip of the biopsy needle 21 in the Y direction will be the same as the position of the target T in the Y direction.

[0120] Meanwhile, in order to alleviate the pain that occurs when biological tissue is sampled with biopsy needle 21, an anesthetic needle (not shown) is inserted into the breast and an anesthetic liquid is injected before the biopsy needle 21 is inserted into the breast. In this case, the medical staff inserts the anesthetic needle into the breast through the opening 25 of the compression plate 18.

[0121] Therefore, in step S80, the control unit 50 controls the projection unit 40A of the projector 40 to project the anesthesia reference information onto the imaging surface of the imaging stand .

[0122] Specifically, the control unit 50 controls the projection unit 40A of the projector 40 to project the insertion position M of the anesthetic needle and the insertion depth of the anesthetic needle onto the imaging surface of the imaging table 14. The insertion depth of the anesthetic needle refers to the distance along the Z direction from the epidermis of the breast at the insertion position M of the anesthetic needle to the injection position of the anesthetic liquid. As a result, the insertion position M of the anesthetic needle is displayed on the breast exposed through the opening 25 of the compression plate 18, as shown in Fig. 8.

[0123] The position M at which the anesthetic needle is inserted and the depth at which the anesthetic needle is inserted are calculated by the control unit 50 using, for example, the position of the target T and the compression force on the breast by the compression plate 18. The reason that the compression force on the breast is taken into consideration when calculating the position M at which the anesthetic needle is inserted and the depth at which the anesthetic needle is inserted is that the position of the target T may change depending on the degree of compression force on the breast. The compression force on the breast is detected, for example, by a compression force detection sensor (not shown) provided in the mammography device 2.

[0124] Furthermore, there are no restrictions on the display position of the insertion depth of the anesthetic needle, but to avoid overlapping with the display of the insertion position M of the anesthetic needle as shown in Fig. 8, it is preferable to display the insertion depth of the anesthetic needle in a location other than the breast exposed within the opening 25 of the compression paddle 18. In Fig. 8, the insertion depth of the anesthetic needle is displayed under the item name "DepthM" as an example.

[0125] Since two types of positions, the position of the target T and the position M for inserting the anesthetic needle, are displayed on the breast, it is preferable to change the display form of the mark indicating each position so that medical personnel can easily distinguish between the positions. In the example shown in FIG. 8, the position of the target T is represented by a circle mark, and the position M for inserting the anesthetic needle is represented by a square mark, but the display color may be changed. In addition, the depth of the anesthetic needle does not necessarily need to be represented by a numerical value. For example, different colors may be associated with each range of the depth of the anesthetic needle, which is previously classified, such as red for 0 mm or more and less than 5 mm, and blue for 5 mm or more and less than 10 mm, and the color corresponding to the depth of the anesthetic needle in the subject may be used as the color of the mark indicating the position M for inserting the anesthetic needle.

[0126] In this way, the anesthesia reference information is displayed within the range of the imaging surface of the imaging table 14, so the medical staff does not need to administer anesthesia by looking at the anesthesia reference information displayed on a monitor placed at the feet, for example. Therefore, the medical staff can confirm the insertion position M of the anesthetic needle and the insertion depth of the anesthetic needle without taking their eyes off the imaging surface of the imaging table 14.

[0127] The medical professional, while referring to the anesthesia reference information, inserts the anesthesia needle into the breast and injects the anesthesia liquid. After that, the medical professional operates handle 27A to move biopsy needle 21 closer to the breast in the X direction. Note that when biopsy needle 21 has moved in the X direction, this indicates that anesthesia of the breast has already been completed, so it is preferable that control unit 50 controls projection unit 40A of projector 40 to stop displaying the insertion position M of the anesthesia needle and the insertion depth of the anesthesia needle.

[0128] In step S90 in Fig. 7, the control unit 50 judges whether the biopsy needle 21 has reached the epidermis of the breast. Specifically, the control unit 50 judges that the biopsy needle 21 has reached the epidermis of the breast when the biopsy distance becomes "0". If the biopsy needle 21 has not reached the epidermis of the breast, the control unit 50 repeatedly executes the judgment process of step S90 to monitor the state of the biopsy needle 21 reaching the epidermis of the breast. On the other hand, if the biopsy needle 21 has reached the epidermis of the breast, the process proceeds to step S100. Note that if the biopsy needle 21 has entered the breast, the biopsy distance takes a negative value.

[0129] After the biopsy needle 21 reaches the epidermis of the breast, the medical professional moves the biopsy needle 21 further toward the breast so that the biopsy needle 21 enters the breast. Therefore, the medical professional moves the biopsy needle 21 while imagining the position of the biopsy needle 21.

[0130] Therefore, in step S100, the control unit 50 controls the projection unit 40A of the projector 40 to project the position of the biopsy needle 21 that has entered the breast onto the imaging surface of the imaging stand 14. Specifically, the control unit 50 controls the projector 40 to project an image of the portion of the biopsy needle 21 that has entered the breast (hereinafter referred to as "biopsy needle image G") onto the imaging surface of the imaging stand 14 in accordance with the position of the biopsy needle 21 inside the breast. In other words, the control unit 50 controls the updating of the display position of the biopsy needle image G in real time in accordance with the movement of the biopsy needle 21.

[0131] The position of the biopsy needle 21 in the breast is estimated by a displacement sensor provided in the lateral adapter 27, but even if there is no displacement sensor, it is possible to estimate the position of the biopsy needle 21 in the breast. For example, when the biopsy needle 21 moves in the breast, a bulge may occur in the breast due to the biopsy needle 21 as the biopsy needle 21 moves. Therefore, the control unit 50 may estimate the position of the biopsy needle 21 in the breast by performing a known image recognition process on the visible image captured by the camera 23 and extracting the bulging part of the breast.

[0132] 9 is a diagram showing an example of a projection image that displays the position of the biopsy needle 21 inserted into the breast as a biopsy needle image G. Because the position of the biopsy needle 21, which is actually invisible to the naked eye, is displayed superimposed on the breast, the medical staff does not need to operate the handle 27A while checking the scale 27B of the lateral adapter 27. Therefore, the medical staff can move the tip of the biopsy needle 21 to the position of the target T while referring to the target distance and the biopsy needle image G without taking their eyes off the imaging surface of the imaging table 14, and collect biological tissue from the target T.

[0133] When sampling of the biological tissue of the target T is completed, the medical professional operates the handle 27A to move the biopsy needle 21 away from the breast along the X direction, and removes the biopsy needle 21 from the breast.

[0134] Therefore, in step S110, the control unit 50 judges whether or not the biopsy needle 21 has been removed from the breast. Specifically, the control unit 50 judges that the biopsy needle 21 has been removed when the biopsy distance becomes "0" from a negative value. If the biopsy needle 21 has not been removed, the process proceeds to step S100, and the control unit 50 continues to control the projector 40 to project a biopsy needle image G onto the imaging surface of the imaging table 14 in accordance with the position of the biopsy needle 21 inside the breast. On the other hand, if the biopsy needle 21 has been removed from the breast, the process proceeds to step S120.

[0135] In step S120, the control unit 50 controls the projection unit 40A of the projector 40 to project the time that has elapsed since the biopsy needle 21 was removed from the breast onto the imaging surface of the imaging stand 14. Fig. 10 is a diagram showing an example of a display of the time that has elapsed since the biopsy needle 21 was removed from the breast. In Fig. 10, the time displayed together with the item name "Elapsed Time" indicates the time that has elapsed since the biopsy needle 21 was removed from the breast. There are no restrictions on the position where the elapsed time is displayed, and it may be displayed at any position within the range of the imaging surface of the imaging stand 14.

[0136] After the biopsy needle 21 is removed, the blood coming out from the needle removal site must be stopped, and the time it takes to stop the bleeding is important. The mammography device 2 displays the time that has passed since the biopsy needle 21 was removed, eliminating the need for medical personnel to start a timer while removing the needle, improving convenience.

[0137] After removing the biopsy needle 21 from the breast, the medical staff issues an instruction from the console 5 or the operation panel 29 to end the biopsy assisted processing.

[0138] Therefore, in step S130, the control unit 50 determines whether or not an instruction to end the biopsy support process has been received. If an instruction to end the biopsy support process has not been received, the control unit 50 repeatedly executes the determination process of step S130 and continues to display the elapsed time.

[0139] On the other hand, when an end instruction is received, the control unit 50 controls the projection unit 40A of the projector 40 to stop the projection of the projection image onto the imaging surface of the imaging stand 14, and ends the biopsy assisting process shown in FIG.

[0140] In this way, with the mammography apparatus 2 according to this embodiment, information useful for performing a biopsy is projected from the projector 40 onto the imaging surface of the imaging table 14. Therefore, medical personnel can perform a biopsy without taking their eyes off the imaging surface of the imaging table 14.

[0141] <Modification of Biopsy Assisted Processing> When inserting the biopsy needle 21 and the anesthetic needle into the breast, it is preferable to avoid inserting the needle into blood vessels as much as possible. Therefore, when controlling the projection of biopsy reference information onto the imaging surface of the imaging table 14 in the process of step S30 of the biopsy support process shown in Fig. 7, the control unit 50 may display the positions of blood vessels 36 in the breast as an example of the biopsy reference information.

[0142] 11 is an example of a projected image showing the positions of blood vessels 36. The control unit 50 performs image analysis on the medical examination image to identify the positions of blood vessels 36 in the breast, and controls the projection unit 40A of the projector 40 so that the blood vessels 36 are displayed at the identified positions.

[0143] In this case, if all the identified blood vessels 36 are displayed, the blood vessels 36 may cross each other in a location where the blood vessels 36 are densely packed, making it difficult to determine the positions of the blood vessels 36. Therefore, the control unit 50 may perform control to project a projection image displaying the positions of blood vessels 36 having a predetermined thickness or more from the projector 40 onto the imaging surface of the imaging stand 14. The threshold value that specifies the thickness of the blood vessels 36 to be displayed is preset by a medical professional via the console 5 or the operation panel 29, and is stored in the storage unit 50B.

[0144] Fig. 12 is a diagram showing an example of a projection image in which blood vessels 36 are selected for display according to their thickness. In Fig. 12, blood vessel 36A shown by a dotted line has a thickness less than the threshold and is therefore not displayed in the projection image, and only blood vessels 36 shown by a solid line having a thickness equal to or greater than the threshold are displayed in the projection image.

[0145] Furthermore, the control unit 50 may change the display form of the position of the blood vessel 36 in the projection image according to at least one of the thickness and depth of the blood vessel 36. The depth of the blood vessel 36 indicates the distance from the epidermis of the breast to the blood vessel 36 in the Z direction.

[0146] Fig. 13 is a diagram showing an example of a projection image in which the display form of the position of blood vessel 36 is changed according to the thickness of blood vessel 36. In the example shown in Fig. 13, blood vessels 36C having a thickness of 0.1 mm or more and less than 1 mm are displayed by a dashed line, and blood vessels 36B having a thickness of 1 mm or more and less than 2 mm are displayed by a solid line. Naturally, the line type of blood vessels 36B and 36C may be the same, but the line color may be different.

[0147] Similarly, at least one of the type and color of the line representing the position of the blood vessel 36 may be changed depending on the depth of the blood vessel 36. In this case, the same blood vessel 36 is displayed in a different display form if the depth of the blood vessel 36 is different.

[0148] Furthermore, at least one of the type of line and the color of the line representing the position of the blood vessel 36 may be changed depending on the thickness and depth of the blood vessel 36. In this case, even if the blood vessel 36 has the same thickness, if the blood vessel 36 is at a different depth, the blood vessel 36 is displayed in a different display form.

[0149] Furthermore, the control unit 50 may change the display form of the position of the blood vessel 36 in the projection image according to the type of the blood vessel 36. For example, the control unit 50 may change the display form of the position of the blood vessel 36 for each type of blood vessel 36, such as an artery, a vein, an arteriole (also called an "arteriole"), and a capillary.

[0150] The path along which the biopsy needle 21 passes within the breast is limited to the area from the puncture position of the biopsy needle 21 in the epidermis of the breast to the target T.

[0151] Therefore, the control unit 50 may control the projector 40 to project, onto the imaging surface of the imaging table 14, a projection image that displays only the positions of blood vessels 36 that pass between the target T and the epidermis of the breast punctured by the biopsy needle 21, out of all identified blood vessels 36. Blood vessels 36 that pass between the target T and the epidermis of the breast punctured by the biopsy needle 21 means that the X coordinate value of at least one point of blood vessel 36 is included in the value between the X coordinate value of the puncture point U on the epidermis of the breast and the X coordinate value of the target T.

[0152] Fig. 14 is a diagram showing an example of a projection image that displays only the positions of blood vessels 36 that pass between the target T and the puncture point U. The projection image shown in Fig. 11 and the projection image shown in Fig. 14 both display the positions of blood vessels 36 identified from a screening image of the same breast. However, compared to the projection image shown in Fig. 11, the projection image shown in Fig. 14 does not display the positions of blood vessels 36 that do not pass between the target T and the puncture point U.

[0153] Even in this case, the control unit 50 may change the display form of the position of the blood vessel 36 in the projection image shown in FIG. 14 according to at least one of the thickness and depth of the blood vessel 36, as already described.

[0154] In this way, by displaying the position of blood vessels 36 on the breast, medical personnel can adjust the position of biopsy needle 21 so that target T is located at the destination of biopsy needle 21 and biopsy needle 21 reaches target T while avoiding blood vessels 36 as much as possible.

[0155] Since the position of the mammary glands can also be identified from the examination image, the control unit 50 may control the projector 40 to project a projection image indicating the positions of the blood vessels 36 and the mammary glands onto the imaging surface of the imaging table 14. In this case, the medical staff can adjust the position of the biopsy needle 21 so that the target T is located at the advancement destination of the biopsy needle 21 and the biopsy needle 21 reaches the target T while avoiding the blood vessels 36 and the mammary glands as much as possible.

[0156] Although one form of the medical image acquisition device 1 has been described above using the embodiment, the disclosed form of the medical image acquisition device 1 is merely an example, and the form of the medical image acquisition device 1 is not limited to the scope described in the embodiment. Various modifications or improvements can be made to the embodiment without departing from the gist of the present disclosure, and forms with such modifications or improvements are also included in the technical scope of the disclosure.

[0157] For example, the internal process order in the flowchart of the biopsy support process shown in FIG. 7 may be changed without departing from the gist of the present disclosure.

[0158] In the above embodiment, as an example, the biopsy support process shown in FIG. 7 is realized by software processing. However, the process equivalent to the flow chart of the biopsy support process may be processed by hardware. In this case, the processing speed is increased compared to the case where the biopsy support process is realized by software processing.

[0159] In the above embodiment, the term "processor" refers to a processor in a broad sense, including a general-purpose processor (e.g., CPU 50A) and a dedicated processor (e.g., GPU: Graphics Processing Unit, ASIC: Application Specific Integrated Circuit, FPGA: Field Programmable Gate Array, programmable logic device, etc.).

[0160] In addition, the operations of the processor in the above embodiment may be performed not only by one processor but also by multiple processors located at physically separate locations working together. The order of the operations of the processor is not limited to the order described in the above embodiment and may be changed as appropriate.

[0161] In the above embodiment, an example has been described in which the control program 56 is stored in the storage unit 50B. However, the storage destination of the control program 56 is not limited to the storage unit 50B. The control program 56 of the present disclosure may also be provided in a form recorded in a computer-readable storage medium.

[0162] For example, the control program 56 may be provided in a form recorded on an optical disk such as a CD-ROM (Compact Disk Read Only Memory), a DVD-ROM (Digital Versatile Disk Read Only Memory), or a Blu-ray disk. The control program 56 may also be provided in a form recorded on a portable semiconductor memory such as a Universal Serial Bus (USB) memory or a memory card. The storage unit 50B, a CD-ROM, a DVD-ROM, a Blu-ray disk, a USB, and a memory card are examples of non-transitory storage media.

[0163] Furthermore, the control unit 50 may download the control program 56 from an external device connected to a communication line through the I / F unit 59, and store the downloaded control program 56 in the storage unit 50B of the control unit 50. In this case, the CPU 50A of the control unit 50 reads the control program 56 downloaded from the external device from the storage unit 50B and executes the biopsy support process.

[0164] The following are notes related to this embodiment.

[0165] (Appendix 1) The present invention comprises a biopsy device, an imaging table used for capturing an image of a living body placed on an imaging surface by an imaging device, a projector for projecting the image, and at least one processor; The processor, and controlling the projection of information regarding a biopsy to be performed on the living body using the biopsy device from the projector onto the imaging surface of the imaging stand. Medical image acquisition equipment.

[0166] (Appendix 2) The processor controls the projector to project, onto the imaging surface of the imaging table, a position of the living body when the living body is placed on the imaging surface of the imaging table, a position of the biopsy needle attached to the biopsy device that is inserted into the living body, and a sampling position where biological tissue is sampled using the biopsy needle. 2. A medical image acquisition device as described in claim 1.

[0167] (Appendix 3) When the biopsy needle is inserted into the living body along the imaging surface of the imaging table, the processor controls the projector to project the placement position of the living body, the position of the biopsy needle, and the sampling position onto the imaging surface of the imaging table. 3. A medical image acquisition device as described in appendix 2.

[0168] (Appendix 4) The processor controls the projector to project a puncture range of the biopsy needle by the biopsy device onto an imaging surface of the imaging stand. 4. A medical image acquisition apparatus as described in claim 3.

[0169] (Appendix 5) The processor controls the projector to project a puncture range of the biopsy needle according to a direction in which the biopsy needle is inserted into the living body onto an imaging surface of the imaging stand. 5. A medical image acquisition apparatus as described in claim 4.

[0170] (Appendix 6) The processor performs control to output a warning to instruct the biopsy needle to puncture the living body from a different direction when the sampling position is not included in a puncture range of the biopsy needle. 6. A medical image acquisition device as described in appendix 5.

[0171] (Appendix 7) The processor controls the projector to project the position of the biopsy needle onto the imaging surface of the imaging table in accordance with the movement of the biopsy needle. 7. The medical image acquisition device according to claim 3, wherein the first and second components are arranged in a same plane.

[0172] (Appendix 8) The processor controls the projector to project information on the distance from the tip of the biopsy needle to the epidermis of the living body and the depth of the sampling position along a direction intersecting with the imaging surface of the imaging table. 8. A medical image acquisition apparatus as described in claim 7.

[0173] (Appendix 9) The processor controls the projector to project positions of blood vessels in the living body onto an imaging surface of the imaging stand using an image of the living body captured by the imaging device. 9. The medical image acquisition device according to claim 7 or 8.

[0174] (Appendix 10) The processor controls the projector to project the positions of blood vessels having a predetermined diameter or larger onto the imaging surface of the imaging stand. 10. A medical image acquisition apparatus as described in claim 9.

[0175] (Appendix 11) The processor performs control to change the display form of the blood vessel position projected from the projector onto the imaging surface of the imaging stand according to the thickness of the blood vessel. 11. A medical image acquisition apparatus as described in claim 10.

[0176] (Appendix 12) The processor performs control to change a display form of the position of the blood vessel projected from the projector onto the imaging surface of the imaging table according to a depth of the blood vessel along a direction intersecting with the imaging surface of the imaging table. 12. The medical image acquisition device according to claim 10 or 11.

[0177] (Appendix 13) The processor controls the projector to project the position of a blood vessel passing between the sampling position and the epidermis of the living body where the biopsy needle is punctured, onto the imaging surface of the imaging stand. 13. The medical image acquisition device according to claim 10, wherein the first and second components are arranged in a first direction.

[0178] (Appendix 14) The processor performs control to project the placement position of the living body from the projector onto the imaging surface of the imaging table so that the collection position falls within the range of an opening of a compression plate that is a plate for pressing the living body against the imaging surface of the imaging table and has an opening on a surface facing the imaging surface of the imaging table. The medical image acquisition device according to any one of Supplementary Note 3 to Supplementary Note 13.

[0179] (Appendix 15) When there are a plurality of collection positions and each of the collection positions does not fall within the range of the opening of the compression plate, The processor controls the projector to project the position of the living body, which is adjusted so that the collection position having a higher priority for collection of living tissue than other collection positions, falls within the range of the opening, onto the imaging surface of the imaging table. 15. A medical image acquisition apparatus as described in claim 14.

[0180] (Appendix 16) The processor controls the projector to project information on a position to insert the anesthetic needle and a depth to insert the anesthetic needle along a direction intersecting with the imaging surface of the imaging table before the biopsy needle is inserted into the living body. 16. The medical image acquisition device according to claim 2,

[0181] (Appendix 17) The processor controls the projector to project the time that has elapsed since the biopsy needle that has been inserted into the living body is removed from the living body onto the imaging surface of the imaging stand. 17. The medical image acquisition device according to claim 2, wherein the first and second components are arranged in a same plane.

[0182] (Appendix 18) The imaging device is a radiation imaging device that irradiates radiation onto the living body to capture a radiation image of the living body, and the living body is a breast. The medical image acquisition device according to any one of claims 1 to 17 Mammography machine.

[0183] (Appendix 19) The processor controls the projector to project positions of blood vessels and mammary glands in the living body onto an imaging surface of the imaging stand using a radiation image of the living body captured by the radiation imaging device. 19. The mammography apparatus of claim 18.

[0184] (Appendix 20) A program executed in a medical image acquisition device including a biopsy device, an imaging table used for capturing an image of a living body placed on an imaging surface by an imaging device, a projector for projecting an image, and at least one processor, and causing a computer to execute a process of controlling the projection of information regarding a biopsy to be performed on the living body using the biopsy device from the projector onto the imaging surface of the imaging stand. Control program. [Explanation of symbols]

[0185] 1 Medical image acquisition device 2 Mammography equipment 3. Image storage system 4. Radiation imaging system 5 Console 6 RIS 7 Image storage system bus 8 Console Bus 9 Mammography Machine Bus 11 Foundation 12 C-axis 13 Arm 14. Shooting stand 15 Radiation detector 16 Radiation storage section 17 Radiation Irradiator 18 Compression plate 19 Compression plate movement mechanism 20 Support part 21 Biopsy Needle 22 Biopsy Needle Unit 23 Camera 24 Moving mechanism 25 Compression plate opening 26 Biopsy Unit 27 Lateral Adapter 27A Handle 27B Scale 28 Control section 29 Operation Panel 30 Radiation source 31 Arm control section 32 Skin Line 33 Punctureable range 34 Compression plate controller 35 Needle Position Controller 36, 36A, 36B, 37C Blood vessels 40 Projector 40A Projector projection section 40B Projector power supply 50 Mammography device control unit 50A Mammography Machine CPU 50B Mammography device memory unit 50C Mammography Machine RAM 56 Control Program 59 Mammography device I / F section 60 Console Controls 60A Console CPU 60B Console memory 60C Console RAM 61 Output section 62 Operation section 69 Console I / F section 70 Image storage system control unit 70A CPU of image storage system 70B Memory section of image storage system 70C RAM for Image Storage System 79 Image storage system I / F section G Biopsy needle image M Position for inserting anesthesia needle T Target U Biopsy needle insertion point

Claims

1. The present invention comprises a biopsy device, an imaging table used for capturing an image of a living body placed on an imaging surface by an imaging device, a projector for projecting the image, and at least one processor, The processor, and controlling the projection of information regarding a biopsy to be performed on the living body using the biopsy device from the projector onto the imaging surface of the imaging stand. Medical image acquisition equipment.

2. The processor controls the projector to project, onto the imaging surface of the imaging table, a position of the living body when the living body is placed on the imaging surface of the imaging table, a position of the biopsy needle attached to the biopsy device that is inserted into the living body, and a sampling position where biological tissue is sampled using the biopsy needle. The medical image acquisition device according to claim 1 .

3. When the biopsy needle is inserted into the living body along the imaging surface of the imaging table, the processor controls the projector to project the placement position of the living body, the position of the biopsy needle, and the sampling position onto the imaging surface of the imaging table. The medical image acquisition device according to claim 2 .

4. The processor controls the projector to project a puncture range of the biopsy needle by the biopsy device onto an imaging surface of the imaging stand. The medical image acquisition device according to claim 3 .

5. The processor controls the projector to project a puncture range of the biopsy needle according to a direction in which the biopsy needle is inserted into the living body onto an imaging surface of the imaging stand.

5. The medical image acquisition device according to claim 4.

6. The processor performs control to output a warning to instruct the biopsy needle to puncture the living body from a different direction when the sampling position is not included in a puncture range of the biopsy needle.

6. The medical image acquisition device according to claim 5.

7. The processor controls the projector to project the position of the biopsy needle onto the imaging surface of the imaging table in accordance with the movement of the biopsy needle. The medical image acquisition device according to claim 3 .

8. The processor controls the projector to project information on the distance from the tip of the biopsy needle to the epidermis of the living body and the depth of the sampling position along a direction intersecting with the imaging surface of the imaging table.

8. The medical image acquisition device according to claim 7.

9. The processor controls the projector to project positions of blood vessels in the living body onto an imaging surface of the imaging stand using an image of the living body captured by the imaging device.

9. The medical image acquisition device according to claim 8.

10. The processor controls the projector to project the positions of blood vessels having a predetermined diameter or larger onto the imaging surface of the imaging stand.

10. The medical image acquisition device of claim 9.

11. The processor performs control to change the display form of the blood vessel position projected from the projector onto the imaging surface of the imaging stand according to the thickness of the blood vessel. The medical image acquisition device according to claim 10.

12. The processor performs control to change a display form of the position of the blood vessel projected from the projector onto the imaging surface of the imaging table according to a depth of the blood vessel along a direction intersecting with the imaging surface of the imaging table. The medical image acquisition device according to claim 10.

13. The processor controls the projector to project the position of a blood vessel passing between the sampling position and the epidermis of the living body where the biopsy needle is punctured, onto the imaging surface of the imaging stand. The medical image acquisition device according to claim 10.

14. The processor performs control to project the placement position of the living body from the projector onto the imaging surface of the imaging table so that the collection position falls within the range of an opening of a compression plate that is a plate for pressing the living body against the imaging surface of the imaging table and has an opening on a surface facing the imaging surface of the imaging table. The medical image acquisition device according to claim 3 .

15. When there are a plurality of collection positions and each of the collection positions does not fall within the range of the opening of the compression plate, The processor controls the projector to project the position of the living body, which is adjusted so that the collection position having a higher priority for collection of living tissue than other collection positions, falls within the range of the opening, onto the imaging surface of the imaging table.

15. A medical image acquisition device according to claim 14.

16. The processor controls the projector to project information on a position to insert the anesthetic needle and a depth to insert the anesthetic needle along a direction intersecting with the imaging surface of the imaging table before the biopsy needle is inserted into the living body. The medical image acquisition device according to any one of claims 2 to 15.

17. The processor controls the projector to project the time that has elapsed since the biopsy needle that has been inserted into the living body is removed from the living body onto the imaging surface of the imaging stand. The medical image acquisition device according to any one of claims 2 to 15.

18. The imaging device is a radiation imaging device that irradiates radiation onto the living body to capture a radiation image of the living body, and the living body is a breast. The medical image acquisition device according to any one of claims 1 to 15 is configured Mammography machine.

19. The processor controls the projector to project positions of blood vessels and mammary glands in the living body onto an imaging surface of the imaging stand using a radiation image of the living body captured by the radiation imaging device.

20. The mammography apparatus of claim 18.

20. A program executed in a medical image acquisition device including a biopsy device, an imaging table used for capturing an image of a living body placed on an imaging surface by an imaging device, a projector for projecting an image, and at least one processor, and causing a computer to execute a process of controlling the projection of information regarding a biopsy to be performed on the living body using the biopsy device from the projector onto the imaging surface of the imaging stand. Control program.

Images