Medical image acquisition device, mammography apparatus, and control program

Abstract

To increase execution accuracy of biopsy.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 associated with each of execution steps R toward the photographing surface of the photographing table 14 from the projector 40, at each of the execution steps R of biopsy.SELECTED DRAWING: Figure 2

Description

[Technical field]

[0001] The present invention relates to a medical image acquisition apparatus, a mammography apparatus, 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. [Prior art documents] [Patent documents]

[0008] [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 Summary of the Invention [Problem to be solved by the invention]

[0009] Since a biopsy involves inserting a biopsy needle into the 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 placed on the patient.

[0010] Therefore, a medical image acquisition device compatible with biopsy may display relevant information regarding the biopsy procedure to inform medical personnel during the procedure.

[0011] However, the displayed related information may include, for example, related information that a medical professional will refer to in the next stage of the biopsy. Therefore, the medical professional must find related information related to the current stage of the biopsy from among the displayed related information, which may affect the medical professional's procedure.

[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 can improve the accuracy of biopsy compared to when relevant information related to biopsy procedures is shown to medical professionals performing the biopsy regardless of the stage at which the biopsy is performed. [Means for solving the problem]

[0013] The medical image acquisition apparatus of the first embodiment includes 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 projector to project related information associated with each of the implementation stages for each stage of a biopsy performed on the living body using the biopsy device onto the imaging surface of the imaging stand.

[0014] In the second aspect of the medical image acquisition device, when the biopsy stage is a positioning stage in which the living body is placed on the imaging surface of the imaging stand, the processor controls the projector to project the position of the living body on the imaging surface of the imaging stand and the collection position for collecting biological tissue from the living body onto the imaging surface of the imaging stand.

[0015] A third aspect of the medical image acquisition device is the medical image acquisition device of the second aspect, in which the processor controls the projector to project the position of the living body, adjusted so that the collection position is in the center of the opening of the second compression plate, onto the imaging surface of the imaging table, based on the difference in how the living body spreads on the imaging surface of the imaging table due to the difference between the type and pressure of a first compression plate used when taking a medical image of the living body using the imaging device before biopsy and pressing the living body against the imaging surface of the imaging table, and the type and pressure of a second compression plate used during biopsy and having an opening on the surface opposite the imaging surface of the imaging table and pressing the living body against the imaging surface of the imaging table.

[0016] In the medical image acquisition device of the fourth aspect, in the medical image acquisition device of the third aspect, when the outline of the body is included in the opening of the second compression plate when the body is placed in a position adjusted so that the collection position is in the center of the opening of the second compression plate, the medical image acquisition device controls the projector to project the body's position adjusted so that the outline of the body is not included in the opening and the collection position is within the range of the opening of the second compression plate onto the imaging surface of the imaging stand.

[0017] In a fifth aspect of the medical image acquisition device, in the medical image acquisition device of the third aspect, when there are multiple collection positions, the processor controls the projector to project the position of the living body, adjusted so that each collection position is within the range of the opening of the second compression plate, onto the imaging surface of the imaging table.

[0018] In a sixth aspect of the medical image acquisition device, in the medical image acquisition device of the first aspect, when the biopsy stage is a pre-treatment stage in which anesthesia is administered to the living body, the processor controls the projector to further project information regarding the position to insert the anesthetic needle and the depth to which the anesthetic needle is to be inserted along a direction intersecting with the imaging surface of the imaging table onto the imaging surface of the imaging table.

[0019] A seventh aspect of the medical image acquisition device is the medical image acquisition device of the first aspect, wherein when the biopsy stage is a puncture stage in which a biopsy needle attached to the biopsy device is punctured into the living body along the imaging surface of the imaging table, the processor controls the projector to project the position of the biopsy needle, a collection position at which biological tissue is collected from the living body, and the distance from the tip of the biopsy needle to the collection position onto the imaging surface of the imaging table.

[0020] A medical image acquisition device according to an eighth aspect is the medical image acquisition device according to the seventh 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.

[0021] In a ninth aspect of the medical image acquisition device, in the medical image acquisition device of the first aspect, when the biopsy stage is a needle removal stage in which the biopsy needle that has been inserted into the living body is removed from the living body, the processor controls the projector to project the elapsed time since the biopsy needle has been removed from the living body onto the imaging surface of the imaging stand.

[0022] A medical image acquisition device according to a tenth aspect is the medical image acquisition device according to the ninth aspect, wherein the processor controls the projector to project the elapsed time from when the tip of the biopsy needle, which has been inserted into the living body, moves a predetermined distance away from a collection position where biological tissue of the living body is collected, onto the imaging surface of the imaging stand.

[0023] A medical image acquisition device according to an eleventh aspect is a medical image acquisition device according to the ninth aspect, wherein the processor controls the projector to project the elapsed time from when the tip of the biopsy needle, which has been inserted into the living body, appears outside the living body onto the imaging surface of the imaging stand.

[0024] A medical image acquisition device according to a 12th aspect is a medical image acquisition device according to any one of the 1st to 11th aspects, wherein the imaging device is a radiation imaging device that irradiates radiation to the living body to capture a radiation image of the living body, and the living body is a breast.

[0025] The control program of the thirteenth 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 by an imaging device, a projector for projecting an image, and at least one processor, and causes a computer to execute a process of controlling the projector to project related information associated with each of the implementation stages of a biopsy performed on the living body using the biopsy device onto the imaging surface of the imaging stand. Effect of the Invention

[0026] According to the present disclosure, the accuracy of performing a biopsy can be improved compared to a case where relevant information related to a biopsy procedure is shown to a medical professional performing a biopsy regardless of the stage at which the biopsy is performed. [Brief description of the drawings]

[0027] [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. 13 is a diagram showing an example of R1-related information projected in the implementation stage R1. [Figure 9] FIG. 13 is a diagram showing an example of R2-related information projected in the implementation stage R2. [Figure 10] FIG. 13 is a diagram showing an example of R3 related information projected in implementation stage R3. [Figure 11] FIG. 13 is a diagram showing an example of R4 related information projected in implementation stage R4. [Figure 12] FIG. 13 is a diagram showing an example of R5 related information projected in the implementation stage R5. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0028] 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.

[0029] 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.

[0030] The medical image acquisition apparatus 1 includes, for example, an image storage system 3 and a radiation image capturing system 4.

[0031] 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.

[0032] 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.

[0033] 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.

[0034] 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).

[0035] 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.

[0036] FIG. 2 is a schematic diagram showing an example of a mammography apparatus 2 according to this embodiment.

[0037] 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.

[0038] 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.

[0039] The imaging surface with which the breast of the subject comes into contact is made of, for example, carbon from the viewpoints of radiation transparency and strength.

[0040] 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.

[0041] 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.

[0042] 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.

[0043] 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.

[0044] 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.

[0045] 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.

[0046] 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.

[0047] 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.

[0048] 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.

[0049] 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.

[0050] 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.

[0051] 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.

[0052] 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.

[0053] 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.

[0054] 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.

[0055] 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.

[0056] 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.

[0057] 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.

[0058] 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.

[0059] 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.

[0060] 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.

[0061] 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.

[0062] 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.

[0063] 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.

[0064] 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.

[0065] 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.

[0066] 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.

[0067] 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.

[0068] 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.

[0069] 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.

[0070] 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.

[0071] 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.

[0072] 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.

[0073] The output unit 61 outputs the information processed by the control unit 60 to a medical professional.

[0074] 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.

[0075] 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.

[0076] 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.

[0077] 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.

[0078] 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.

[0079] Next, the operation of the mammography device 2 when a medical professional performs a biopsy on a breast will be described in detail.

[0080] 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.

[0081] 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.

[0082] It is assumed that, prior to the biopsy, a radiographic 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 specified in advance by diagnosis of the radiographic image. For example, a medical professional may select a radiographic image close to the angle of the arm 13 when performing the biopsy from among the radiographic images taken from various irradiation angles, and specify the position of the target T from the selected radiographic image. In addition, the position of the target T may be specified from the radiographic image using CAD (Computer Aided Diagnosis). The position of the target T is expressed as a coordinate value in three-dimensional coordinates that are virtually set on the imaging surface of the imaging table 14, for example. The specified position of the target T is input, for example, by a medical professional from the console 5 or the operation panel 29, and stored in the memory unit 50B of the control unit 50.

[0083] When, for example, a medical professional operates the console 5 to register subject information as a trigger for an instruction to start a biopsy, in step S10, the control unit 50 sets an index n stored in the RAM 50C to “1.” The index n is an identifier indicating the implementation stage R of the biopsy.

[0084] A biopsy is divided into various implementation steps R, for example, "positioning," "anesthesia," "biopsy needle position adjustment," "biopsy needle insertion," and "biopsy needle removal," and is performed in the order of "positioning," "anesthesia," "biopsy needle position adjustment," "biopsy needle insertion," and "biopsy needle removal."

[0085] Positioning is a process of adjusting the position of the subject's breast so that biological tissue of the target T can be collected by the biopsy needle 21. In other words, positioning is a stage in which the living body is placed on the imaging surface of the imaging table 14.

[0086] Anesthesia is a process in which 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 order to alleviate the pain that occurs when biological tissue is collected from the target T using the biopsy needle 21.

[0087] Biopsy needle position adjustment is a process of adjusting the position of the tip of biopsy needle 21 before biopsy needle 21 is inserted into the breast so that the tip of biopsy needle 21 reaches target T.

[0088] Biopsy needle puncturing is a process of moving the tip of biopsy needle 21 to the position of target T and sampling biological tissue of target T.

[0089] The biopsy needle removal is a process of removing the biopsy needle 21 from the breast after the biological tissue of the target T has been sampled.

[0090] The index n indicates the implementation stage R of the biopsy being performed by the medical staff depending on the value of n. For example, index n=1 corresponds to the implementation stage R1 of positioning, index n=2 corresponds to the implementation stage R2 of anesthesia, index n=3 corresponds to the implementation stage R3 of adjusting the position of the biopsy needle, index n=4 corresponds to the implementation stage R4 of inserting the biopsy needle, and index n=5 corresponds to the implementation stage R5 of removing the biopsy needle. For convenience of explanation, when the steps of each implementation stage R are to be described separately, the implementation stage R may be expressed as "implementation stage Rn" (n=1 to 5). The upper limit value of index n, i.e., the number of steps included in the implementation stage R of the biopsy (in this case, "5"), is stored in advance in, for example, the storage unit 50B.

[0091] The classification of the biopsy implementation stages R of the present disclosure is an example, and classification different from the above example may be performed. In this case, the value of the index n may be associated with each step in ascending order according to the order of the biopsy implementation stages R. In addition, the trigger for starting the biopsy is not limited to the registration operation of the subject information, and may be, for example, the operation of the compression plate controller 34.

[0092] In step S20, the control unit 50 controls the projector 40 to project the related information associated with each implementation stage Rn onto the imaging surface of the imaging stand 14.

[0093] The related information associated with each implementation stage Rn is information that is preferable for medical personnel to refer to when performing a procedure in the biopsy implementation stage Rn. Hereinafter, the related information associated with each implementation stage Rn will be referred to as "Rn related information." The Rn related information includes only information used in the biopsy implementation stage Rn.

[0094] When the index n is set to “1”, the control unit 50 controls the projector 40 to project the R1 related information onto the imaging surface of the imaging stand 14.

[0095] Specifically, the control unit 50 controls the projection unit 40A of the projector 40 to project the position of the target T and the placement position of the breast onto the imaging surface of the imaging stand 14. The placement position of the breast is represented by a skin line 32 that represents the outline of the breast displayed on the imaging surface of the imaging stand 14.

[0096] FIG. 8 is a diagram showing an example of the position of the target T and the skin line 32 projected onto the imaging surface of the imaging stand 14.

[0097] 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 position information of the opening 25 obtained from the type of compression paddle 18 attached to the mammography device 2, the position of the target T identified from the radiographic image, and the position of the breast when the radiographic image was captured. The control unit 50 performs control to project the skin line 32 at the calculated position.

[0098] Therefore, compared to having the subject place her breast on the imaging surface of the imaging table 14 and then checking whether the target T falls within the range of the opening 25 of the compression plate 18 at that position, there is no need to have the subject change the position of her breast multiple times, reducing the burden on the subject.

[0099] The position of the target T is information identified from the medical examination image, but when photographing the medical examination image, a different type of compression plate (hereinafter referred to as the "imaging compression plate") is used from the compression plate 18 used for biopsy. Also, the compression force on the breast by the compression plate 18 used for biopsy may differ from the compression force on the breast by the imaging compression plate.

[0100] In addition, the way in which the breast compressed by the compression plate 18 spreads may differ from the way in which the breast compressed by the imaging compression plate spreads. If the way in which the breast spreads is different, even if the patient places the breast at the calculated position of the skin line 32, the target T may not be within the range of the opening 25 of the compression plate 18.

[0101] Therefore, the control unit 50 adjusts the projection position of the skin line 32 on the imaging surface of the imaging table 14 so that the target T is located in the center of the opening 25 of the compression plate 18, even if the breast is compressed with a compression force different from that of the compression plate for imaging using a compression plate 18 of a different type than that of the compression plate for imaging.

[0102] For this reason, a conversion table is stored in advance in the storage unit 50B. The conversion table is a table in which the combination of the type of compression plate for imaging and the compression force of the breast by the compression plate for imaging is associated with the combination of the type of compression plate 18 and the compression force of the breast by the compression plate 18, and indicates the amount of deviation of the target T when the breast is compressed with the corresponding compression force by the corresponding type of compression plate 18. The amount of deviation of the target T is the amount of deviation between the position of the target T when the breast is placed in the position where the breast was placed when the medical examination image was captured, and the position of the target T when the breast is compressed by the compression plate 18 with the breast placed in the same position as the position where the breast was placed when the medical examination image was captured.

[0103] The control unit 50 adjusts the position of the skin line 32 so that when the subject places her breast on the imaging surface of the imaging table 14, the target T is located in the center of the opening 25 of the compression plate 18, based on the amount of deviation of the target T obtained from a conversion table corresponding to the combination of the position of the breast when the medical examination image is taken, the type of imaging compression plate and breast compression force used to take the medical examination image, and the type of compression plate 18 used for the biopsy and breast compression force, and the position information of the opening 25 of the compression plate 18 used for the biopsy.

[0104] Information on the placement position of the breast when the medical examination image is captured and the position of the opening 25 of the compression paddle 18 is stored in advance in, for example, the storage unit 50B.

[0105] 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, but the type of compression plate 18 may also be obtained by reading a barcode label affixed to the compression plate 18 using a barcode reader (not shown) provided in the mammography device 2. 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.

[0106] The center of the opening 25 of the compression plate 18 refers to the center of the opening 25 of the compression plate 18 when the compression plate 18 is viewed from the radiation storage section 16 toward the imaging table 14 along the Z direction. The center of the opening 25 of the compression plate 18 is represented by a predetermined range including the center of the opening 25. When the position of the target T is included in this range, it is said that "the target T is at the center of the opening 25 of the compression plate 18." The imaging compression plate is an example of a first compression plate, and the compression plate 18 is an example of a second compression plate.

[0107] If the subject positions her breast along skin line 32 that has been adjusted so that target T is located at the center of opening 25 of compression plate 18, when the breast is compressed by compression plate 18, the contour of the breast may be included in opening 25 of compression plate 18, making it impossible to compress the breast. In such a case, control unit 50 adjusts the position of skin line 32 so that the contour of the breast is not included in opening 25 of compression plate 18 and target T is included within the range of opening 25 of compression plate 18. Then, control unit 50 controls projector 40 to project a projection image including skin line 32 whose position has been adjusted toward the imaging surface of imaging stand 14.

[0108] In addition, when multiple targets T are present on the breast, the control unit 50 controls the projector 40 to project a projection image including the skin line 32, the position of which has been adjusted so that all targets T are within the range of the opening 25 of the compression plate 18, onto the imaging surface of the imaging table 14.

[0109] Depending on the position of the target T, there may be cases where not all of the targets T fall within the range of the opening 25 of the compression plate 18. In such a case, the control unit 50 refers to the priority of the targets T, and controls the projector 40 to project a projection image including the skin line 32, the position of which has been 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 plate 18, onto the imaging surface of the imaging stand 14.

[0110] 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.

[0111] In this case, after biopsy of the breast arranged along the current skin line 32 is completed, the control unit 50 controls the projector 40 to project a projection image including the skin line 32, with the remaining targets T that did not fall within the range of the opening 25 of the compression paddle 18 being adjusted in position so that they fall within the range of the opening 25, onto the imaging surface of the imaging table 14. By prioritizing the targets T with higher priority to be placed within the range of the opening 25 of the compression paddle 18, the biopsy can be performed earlier for the targets T with higher priority, and test results can be obtained.

[0112] When the subject positions her breast along the skin line 32 projected onto the imaging surface of the imaging table 14, the medical staff issues a compression instruction to the mammography device 2, for example, from the console 5 or the operation panel 29, instructing the mammography device 2 to compress the breast. In response, 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 compresses the breast positioned on the imaging surface along the skin line 32.

[0113] 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.

[0114] 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 captured radiological image 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.

[0115] Thus, the positions of the skin line 32 and the target T are examples of R1-related information associated with the performance stage R1.

[0116] When the implementation stage R1 is completed, the medical staff sends a transition instruction to the mammography apparatus 2, for example, from the console 5 or the operation panel 29, to instruct the mammography apparatus 2 to proceed to the next implementation stage R. Since the next implementation stage R is anesthesia, the transition instruction is, for example, an operation to transmit the coordinate values ​​of the position M where the anesthetic needle is inserted.

[0117] Therefore, in step S30, the control unit 50 judges whether or not a transition instruction has been received. If a transition instruction has not been received, the control unit 50 repeatedly executes the judgment process of step S30 and waits until the currently performed process of the implementation stage R is completed. On the other hand, if a transition instruction has been received, the process proceeds to step S40.

[0118] In step S40, the control unit 50 updates the index n by adding "1" to the index n. That is, the biopsy implementation stage R is advanced by one.

[0119] In step S50, the control unit 50 judges whether the index n exceeds the upper limit value. If the index n exceeds the upper limit value, it means that all the implementation stages R of the biopsy are completed. Therefore, the control unit 50 ends the biopsy support process shown in FIG.

[0120] On the other hand, if the index n is equal to or less than the upper limit, it means that there is an unperformed biopsy stage R, that is, the biopsy is in progress. Therefore, the process proceeds to step S20, and the control unit 50 controls the projector 40 to project Rn-related information associated with the next implementation stage Rn onto the imaging surface of the imaging stand 14.

[0121] In the case where index n=2, since the process has shifted to implementation stage R2, in step S20, the control unit 50 controls the projector 40 to project R2 related information onto the imaging surface of the imaging stand 14.

[0122] The medical staff inserts the anesthetic needle into the breast through the opening 25 of the compression plate 18. Therefore, 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.

[0123] The control unit 50 may control the projection unit 40A to project a projection image including the position of the target T in addition to 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. As a result, as shown in Fig. 9, the insertion position M of the anesthetic needle and the position of the target T are displayed on the breast exposed through the opening 25 of the compression plate 18. The control unit 50 may also control the projection unit 40A to project a projection image including the skin line 32 onto the imaging surface of the imaging table 14 so that the medical staff can confirm that the position of the breast is not deviated from the skin line 32.

[0124] 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 and the position of the target T, it is preferable that the control unit 50 display the insertion depth of the anesthetic needle in a location other than the breast exposed within the opening 25 of the compression plate 18. In the example shown in Fig. 9, the insertion depth of the anesthetic needle is displayed on the compression plate 18 under the item name "Depth M".

[0125] When 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. 9, 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] 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, for example, using 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 because 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.

[0127] Thus, the position M for inserting the anesthetic needle, the depth at which the anesthetic needle is inserted, the skin line 32, and the position of the target T are examples of R2-related information associated with the implementation stage R2. For example, if the position M for inserting the anesthetic needle is not displayed on the breast, a medical professional may insert the anesthetic needle about 1 mm into a location that is thought to be the position M for inserting the anesthetic needle so that the anesthetic needle is inserted at the targeted position, mark the breast, and then administer anesthesia. However, in the mammography device 2 of the present disclosure, R2-related information that is useful for administering anesthesia in the implementation stage R2 is displayed, so that a medical professional can refer to the R2-related information while inserting the anesthetic needle into a specified position on the breast, and advance the anesthetic needle to the specified depth to inject the anesthetic liquid.

[0128] When implementation stage R2 is completed, the medical staff sends a transition instruction to the mammography apparatus 2, for example, via the console 5 or the operation panel 29, to transition to the next implementation stage R. Since the next implementation stage R is biopsy needle position adjustment, the transition instruction is, for example, to attach the biopsy needle 21 to the lateral adapter 27.

[0129] 7 results in an affirmative determination, and the process of step S40 results in index n = 3. Since index n is equal to or less than the upper limit, the process of step S50 results in a negative determination, and the process proceeds to step S20.

[0130] In the case where index n=3, since the process has shifted to implementation stage R3, in step S20, the control unit 50 controls the projector 40 to project R3 related information onto the imaging surface of the imaging stand 14.

[0131] Specifically, the control unit 50 controls the projection unit 40A of the projector 40 to project the position of the target T on 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. Because the position of the target T on 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 display provided on the operation panel 29, 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.

[0132] 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.

[0133] Furthermore, 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 stand 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.

[0134] 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.

[0135] Therefore, the medical worker takes measures such as changing the attachment direction of the lateral adapter 27 so that the target T is included in the puncture-enabled range 33. That is, based on the positional relationship between the target T and the puncture-enabled range 33, the medical worker can determine whether biological tissue of the target T can be sampled from the current attachment direction of the lateral adapter 27 before puncturing the breast with the biopsy needle 21. Therefore, for example, after the biopsy needle 21 has been punctured into the breast in implementation stage R4, which is the later implementation stage R, it is not possible to sample biological tissue of the target T with the current attachment direction of the lateral adapter 27, and therefore it is not necessary to burden the subject with changing the attachment direction of the lateral adapter 27 and puncturing the biopsy needle 21 again.

[0136] In addition, if the target T is not included in the puncture range 33, the control unit 50 may control the operation panel 29 to output a warning on the display of the operation panel 29 informing the medical staff to change the attachment direction of the lateral adapter 27 and then adjust the position of the biopsy needle 21.

[0137] Fig. 10 is a diagram showing an example of R3-related information projected from projector 40 onto the imaging surface of imaging stand 14 in implementation stage R3. In Fig. 10, the depth of target T is displayed under the item name "Depth T" as an example. Target T is included in puncturable range 33.

[0138] There are no restrictions on the display position of the depth of the target T as long as it is within the range of 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. 10, it is preferable to display the depth of the target T at a location other than the breast exposed within the opening 25 of the compression plate 18. Specifically, the depth of the target T is displayed on either the compression plate 18, the imaging surface of the imaging table 14 on which the breast is not positioned, or the breast protruding outside the compression plate 18 when the compression plate 18 is viewed from above.

[0139] In addition, the control unit 50 may control the projection unit 40A to project a projection image including the skin line 32 onto the imaging surface of the imaging table 14 so that a medical professional can confirm that the position of the breast is not deviated from the skin line 32.

[0140] The medical professional operates the position adjustment mechanism of the lateral adapter 27 to adjust the position of the biopsy needle 21 while referring to the position of the target T, so that the position of the tip of the biopsy needle 21 in the Y direction in Fig. 10 becomes the same as the position of the target T in the Y direction. The medical professional also operates the position adjustment mechanism of the lateral adapter 27 to adjust the position of the biopsy needle 21 while referring to the depth of the target T, so that the position of the tip of the biopsy needle 21 in the Z direction perpendicular to the XY plane in Fig. 10 becomes the same as the position of the target T in the Z direction.

[0141] 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 Y coordinate value of the biopsy needle 21 becomes the same as the Y coordinate value of the target T and 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 Y direction and the Z direction will become the same as the position of the target T.

[0142] Thus, the position of the target T, the depth of the target T, the puncture possible range 33, and the skin line 32 are examples of R3-related information associated with the implementation stage R3. If the R3-related information is not displayed, the medical staff will adjust the position of the tip of the biopsy needle 21 while imagining in their mind the positional relationship between the biological tissue sampling position and the biopsy needle 21. However, in the mammography device 2 of the present disclosure, the R3-related information that is helpful in adjusting the position of the biopsy needle 21 is displayed, so that the medical staff can adjust the position of the tip of the biopsy needle 21 while visually checking the positional relationship between the biological tissue sampling position and the biopsy needle 21.

[0143] When the implementation stage R3 is completed, the medical staff issues a transition instruction to the mammography apparatus 2, for example, from the console 5 or the operation panel 29, to transition to the next implementation stage R. Since the next implementation stage R is biopsy needle insertion, the transition instruction is, for example, the medical staff operating the handle 27A of the lateral adapter 27.

[0144] 7 results in an affirmative determination, and the process of step S40 results in index n = 4. Since index n is equal to or less than the upper limit, the process of step S50 results in a negative determination, and the process proceeds to step S20.

[0145] In the case where index n=4, since the process has shifted to implementation stage R4, in step S20, the control unit 50 controls the projector 40 to project R4 related information onto the imaging surface of the imaging stand 14.

[0146] Specifically, the control unit 50 controls the projection unit 40A of the projector 40 to project the position of the target T on 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.

[0147] 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."

[0148] 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 "biological distance." When the biopsy needle 21 enters the breast, the biological distance takes a negative value.

[0149] The control unit 50 may control the projection unit 40A to project a projection image including the skin line 32 onto the imaging surface of the imaging table 14 so that a medical professional can confirm that the position of the breast is not misaligned with the skin line 32.

[0150] Furthermore, the control unit 50 can obtain the amount of movement of the biopsy needle 21 in the X direction measured by a 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.

[0151] After the biopsy needle 21 reaches the epidermis of the breast, if the medical professional further moves the biopsy needle 21 toward the breast, the biopsy needle 21 will enter the breast, so the medical professional moves the biopsy needle 21 while imagining the position of the biopsy needle 21. Therefore, 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 table 14. Specifically, the control unit 50 controls the projector 40 to project an image of the part of the biopsy needle 21 that has entered the breast (hereinafter referred to as 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. That is, the control unit 50 controls the display position of the biopsy needle image G to be updated in real time in accordance with the movement of the biopsy needle 21. The control unit 50 may determine whether the biopsy needle 21 has entered the breast using, for example, a biopsy distance or a visible image captured by the camera 23.

[0152] 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.

[0153] 11 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. Since 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 position of the target T, the target distance, the biological distance, the biopsy needle image G, and the skin line 32 without taking their eyes off the imaging surface of the imaging table 14, and collect biological tissue of the target T.

[0154] Thus, the position of the target T, the target distance, the biopsy needle image G, and the skin line 32 are examples of R4-related information associated with the performance step R4.

[0155] When implementation stage R4 is completed, the medical staff notifies the mammography apparatus 2, for example from the console 5 or the operation panel 29, of a transition instruction to transition to the next implementation stage R. Since the next implementation stage R is to remove the biopsy needle, the transition instruction is, for example, to operate the handle 27A in the opposite direction to the operation direction of the handle 27A in implementation stage R4.

[0156] The transition instruction from implementation stage R4 to implementation stage R5 is not limited to this, and the control unit 50 may determine that the transition instruction has been issued, for example, when the tip of the biopsy needle 21 appears outside the breast. The control unit 50 may also determine that the transition instruction has been issued, when the handle 27A is operated in a direction opposite to the operation direction in implementation stage R4 and moved in the opposite direction along the X direction by a predetermined distance (referred to as a "prescribed distance") from the position of the target T. The prescribed distance can be changed by a medical professional, and is stored in the memory unit 50B, for example.

[0157] 7 results in an affirmative determination, and the process of step S40 results in index n = 5. Since index n is equal to or less than the upper limit, the process of step S50 results in a negative determination, and the process proceeds to step S20.

[0158] In the case where index n=5, since the process has shifted to implementation stage R5, in step S20, the control unit 50 controls the projector 40 to project R5 related information onto the imaging surface of the imaging stand 14.

[0159] Specifically, 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.

[0160] After removing the biopsy needle 21, the medical staff stops the blood coming out from the needle removal site, but 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, so the medical staff does not need to start a timer while removing the needle, improving convenience.

[0161] Fig. 12 is a diagram showing an example of a projection image including the time that has elapsed since the biopsy needle 21 was removed from the breast. In Fig. 12, 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.

[0162] The time elapsed since the biopsy needle 21 was removed from the breast is the time elapsed since the instruction to transition to the implementation stage R5 was received. Therefore, if the instruction to transition to the implementation stage R5 is that the handle 27A has been operated in the opposite direction to the operation direction of the handle 27A in the implementation stage R4, the time from when the biopsy needle 21 started to move in the direction away from the target T is displayed as the elapsed time. If the instruction to transition to the implementation stage R5 is that the tip of the biopsy needle 21 has appeared on the outside of the breast, the time from when the tip of the biopsy needle 21 that has punctured the breast has appeared on the outside of the breast is displayed as the elapsed time. Also, if the instruction to transition to the implementation stage R5 is that the handle 27A has been operated in the opposite direction to the operation direction in the implementation stage R4 and has moved in the opposite direction along the X direction by a specified distance from the position of the target T, the time from when the tip of the biopsy needle 21 has moved away from the target T by a specified distance along the X direction is displayed as the elapsed time.

[0163] In addition, the control unit 50 may control the projection unit 40A to project a projection image including the skin line 32 onto the imaging surface of the imaging table 14 so that a medical professional can confirm that the position of the breast is not deviated from the skin line 32.

[0164] In addition, in order to clearly show the positional relationship of the biopsy needle 21, the control unit 50 may control the projection unit 40A to project a projection image including the position of the target T, the biopsy needle image G, the target distance, and the living body distance onto the imaging surface of the imaging table 14.

[0165] Thus, the elapsed time, the position of the target T, the target distance, the biopsy needle image G, and the skin line 32 are examples of R5-related information associated with the performance step R5.

[0166] When execution stage R5 is completed, the medical staff issues an end instruction to end the biopsy to the mammography apparatus 2, for example, from the console 5 or the operation panel 29. The end instruction is an example of a transition instruction to transition to the biopsy termination process.

[0167] In this case, the determination process in step S30 in Fig. 7 is positive, and the process in step S40 results in index n = 6. Because index n exceeds the upper limit, the determination process in step S50 is positive, and the control unit 50 ends the biopsy support process shown in Fig. 7. With the end of the biopsy support process, the control unit 50 stops the projection of the projection image by the projector 40, and controls the compression paddle moving mechanism 19 to move the compression paddle 18 toward the radiation irradiator 17, thereby releasing compression of the breast.

[0168] In this way, according to the mammography device 2 of the present disclosure, for each biopsy implementation stage R, relevant information related to the procedure performed by the medical professional at each implementation stage R is projected from the projector 40 onto the imaging surface of the imaging table 14. This makes it easier for the medical professional to perform the procedure, improving the accuracy of the biopsy implementation, compared to a case in which information unrelated to the procedure performed by the medical professional at each implementation stage R is also displayed.

[0169] Note that the control unit 50 may include the positions of blood vessels and mammary glands in the R2-R4 related information to prevent the anesthetic needle and biopsy needle 21 from puncturing blood vessels or mammary glands in implementation stages R2 to R4. That is, the control unit 50 may perform control to project a projection image including the positions of blood vessels and mammary glands from the projection unit 40A onto the imaging surface of the imaging table 14. The positions of blood vessels and mammary glands included in the projection image may be specified in advance by the control unit 50 from the examination image using, for example, a known image recognition process.

[0170] In addition, in the biopsy support process shown in FIG. 7, the control unit 50 increments the index n by one in step S40, but the control unit 50 may set the index n to a value corresponding to the content of the transition instruction received. For example, when the control unit 50 receives an operation of the handle 27A of the lateral adapter 27, the control unit 50 sets the index n to "4" and transitions to the implementation stage R4. The value of the index n may also be set by a medical professional. In this way, for example, when a medical professional determines that anesthesia is not necessary in the implementation stage R2, the mammography device 2 can display related information according to the procedure of the medical professional, such as displaying R1 related information and then displaying R3 related information without displaying R2 related information.

[0171] 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.

[0172] 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.

[0173] 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.

[0174] 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.).

[0175] 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.

[0176] 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.

[0177] 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.

[0178] 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.

[0179] The following are notes related to this embodiment.

[0180] (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, For each implementation stage of a biopsy performed on the living body using the biopsy device, control is performed to project related information associated with each implementation stage from the projector onto an imaging surface of the imaging stand. Medical image acquisition equipment.

[0181] (Appendix 2) When the biopsy step is a placement step of placing the living body on the imaging surface of the imaging table, The processor controls the projector to project a position of the living body on the imaging surface of the imaging table and a sampling position for sampling a living tissue from the living body onto the imaging surface of the imaging table. 2. A medical image acquisition device as described in claim 1.

[0182] (Appendix 3) The processor, in order to confirm the sampling position, determines a type and a pressure of a first compression plate used when taking a medical examination image of the living body using the imaging device before biopsy, which presses the living body against the imaging surface of the imaging table; A second compression plate is used for biopsy and has an opening on a surface facing the imaging surface of the imaging table. Based on the difference in the way the living body spreads on the imaging surface of the imaging table due to the difference in the type and pressure of a second compression plate that presses the living body against the imaging surface of the imaging table, the position of the living body is adjusted so that the collection position is located at the center of the opening of the second compression plate. Based on the difference in the way the living body spreads on the imaging surface of the imaging table due to the difference in the type and pressure of the second compression plate, the position of the living body is controlled to be projected from the projector onto the imaging surface of the imaging table. 3. A medical image acquisition device as described in appendix 2.

[0183] (Appendix 4) When the living body is placed at a placement position of the living body adjusted so that the collection position is at the center of the opening of the second compression plate, if a contour of the living body falls within the opening of the second compression plate, the placement position of the living body adjusted so that the contour of the living body does not fall within the opening and the collection position falls within the range of the opening of the second compression plate is controlled to be projected from the projector onto the imaging surface of the imaging table. 4. A medical image acquisition apparatus as described in claim 3.

[0184] (Appendix 5) When there are a plurality of collection locations, The processor controls the projector to project the arrangement position of the living body, which is adjusted so that each of the sampling positions is within the range of the opening of the second compression plate, onto the imaging surface of the imaging table. 5. The medical image acquisition device according to claim 3 or 4.

[0185] (Appendix 6) When the biopsy step is a pre-treatment step of anesthetizing the living body, The processor controls the projector to project information on the position of the anesthesia needle and the depth of the anesthesia needle along a direction intersecting with the imaging surface of the imaging table onto the imaging surface of the imaging table. 2. A medical image acquisition device as described in claim 1.

[0186] (Appendix 7) When the biopsy step is a puncturing step of puncturing the living body with a biopsy needle attached to the biopsy device along the imaging surface of the imaging table, The processor controls the projector to project the position of the biopsy needle, a sampling position for sampling biological tissue from the living body, and a distance from the tip of the biopsy needle to the sampling position onto the imaging surface of the imaging stand. 2. A medical image acquisition device as described in claim 1.

[0187] (Appendix 8) 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. 8. A medical image acquisition apparatus as described in claim 7.

[0188] (Appendix 9) When the biopsy step is a needle removal step of removing the biopsy needle that has been inserted into the living body from the living body, The processor controls the projector to project the time elapsed since the biopsy needle was removed from the living body onto the imaging surface of the imaging stand. 2. A medical image acquisition device as described in claim 1.

[0189] (Appendix 10) The processor, The projector controls the time that has elapsed since the tip of the biopsy needle that has been punctured into the living body has moved a predetermined distance away from a sampling position for sampling a biological tissue of the living body, so that the projector projects the time that has elapsed since the tip of the biopsy needle that has been punctured into the living body is projected onto the imaging surface of the imaging table. 10. A medical image acquisition apparatus as described in claim 9.

[0190] (Appendix 11) The processor, The projector controls the time that has elapsed since the tip of the biopsy needle that has been inserted into the living body appears outside the living body, so that the projector projects the time on the imaging surface of the imaging stand. 10. A medical image acquisition apparatus as described in claim 9.

[0191] (Appendix 12) 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. A medical image acquisition device according to any one of claims 1 to 11. Mammography machine.

[0192] (Appendix 13) 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 projector to project, for each implementation stage of a biopsy performed on the living body using the biopsy device, related information associated with each of the implementation stages onto an imaging surface of the imaging stand. Control program. [Explanation of symbols]

[0193] 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 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 R Biopsy implementation stage R1 Positioning implementation stage R2 Anesthesia administration phase R3: Biopsy needle position adjustment stage R4 Biopsy needle insertion stage R5 Biopsy needle removal stage T Target n index

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, For each implementation stage of a biopsy performed on the living body using the biopsy device, control is performed to project related information associated with each implementation stage from the projector onto an imaging surface of the imaging stand. Medical image acquisition equipment.

2. When the biopsy step is a placement step of placing the living body on the imaging surface of the imaging table, The processor controls the projector to project a position of the living body on the imaging surface of the imaging table and a sampling position for sampling a living tissue from the living body onto the imaging surface of the imaging table. The medical image acquisition device according to claim 1 .

3. The processor, in order to confirm the sampling position, determines a type and a pressure of a first compression plate used when taking a medical examination image of the living body using the imaging device before biopsy, the first compression plate pressing the living body against the imaging surface of the imaging table; A plate having an opening on a surface facing the imaging surface of the imaging table used in biopsy, and based on the difference in the way the living body spreads on the imaging surface of the imaging table due to the difference in the type and pressure of a second compression plate for pressing the living body against the imaging surface of the imaging table, the position of the living body adjusted so that the sampling position is located at the center of the opening of the second compression plate is projected from the projector onto the imaging surface of the imaging table. The medical image acquisition device according to claim 2 .

4. When the living body is placed at a placement position adjusted so that the sampling position is located at the center of the opening of the second compression plate, if a contour of the living body falls within the opening of the second compression plate, the placement position of the living body adjusted so that the contour of the living body does not fall within the opening and the sampling position falls within the range of the opening of the second compression plate is controlled to be projected from the projector onto the imaging surface of the imaging stand. The medical image acquisition device according to claim 3 .

5. When there are a plurality of collection locations, The processor controls the projector to project the arrangement position of the living body, which is adjusted so that each of the sampling positions is within the range of the opening of the second compression plate, onto the imaging surface of the imaging table. The medical image acquisition device according to claim 3 .

6. When the biopsy step is a pre-treatment step of anesthetizing the living body, The processor controls the projector to project information on the position of the anesthesia needle and the depth of the anesthesia needle along a direction intersecting with the imaging surface of the imaging table onto the imaging surface of the imaging table. The medical image acquisition device according to claim 1 .

7. When the biopsy step is a puncturing step of puncturing the living body with a biopsy needle attached to the biopsy device along the imaging surface of the imaging table, The processor controls the projector to project the position of the biopsy needle, a sampling position for sampling biological tissue from the living body, and a distance from the tip of the biopsy needle to the sampling position onto the imaging surface of the imaging stand. The medical image acquisition device according to claim 1 .

8. 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.

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

9. When the biopsy step is a needle removal step of removing the biopsy needle that has been inserted into the living body from the living body, The processor controls the projector to project the time elapsed since the biopsy needle was removed from the living body onto the imaging surface of the imaging stand. The medical image acquisition device according to claim 1 .

10. The processor, The projector controls the time that has elapsed since the tip of the biopsy needle that has been punctured into the living body moves away from a sampling position for sampling a biological tissue of the living body by a predetermined distance, so as to project the time from the projector onto the imaging surface of the imaging stand.

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

11. The processor, The projector controls the time that has elapsed since the tip of the biopsy needle that has been inserted into the living body appears outside the living body, so that the projector projects the time on the imaging surface of the imaging stand.

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

12. 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. A medical image acquisition device according to any one of claims 1 to 11. Mammography machine.

13. A program executed in a medical image acquisition device including a biopsy device, an imaging table used for imaging 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 projector to project, for each implementation stage of a biopsy performed on the living body using the biopsy device, related information associated with each of the implementation stages onto an imaging surface of the imaging stand. Control program.

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