Image processing device and image processing method

Abstract

To provide an image processing device and an image processing method capable of further improving operability of image processing.SOLUTION: An image processing device includes an image acquisition unit 3 for acquiring an X-ray image 10 of the organ of a subject M and an image processing unit 5 for processing the X-ray image 10 acquired by the image acquisition unit 3. The image processing unit 3 includes: a position indicator display part 29 for displaying a position indicator 49 indicating a predetermined position in the organ of the subject M in the X-ray image 10; an operation indicator display part 31 for displaying an operation indicator 51 corresponding to the position indicator 49 in a region where it is superposed neither on the position indicator 49 nor on the organ in the X-ray image 10; an input reception part 25 for receiving indicator moving operation of an operator for moving the position of the operation indicator 51 in the X-ray image 10; and a position indicator changing part 33 for changing the position where the position indicator 49 corresponding to the operation indicator 51 is displayed in the X-ray image 10 so as to reflect the indicator moving operation received by the input reception part 25.SELECTED DRAWING: Figure 1

Description

Technical Field

[0001] The present invention relates to an image processing apparatus and an image processing method.

[0002] In the medical field, when determining the presence or absence of a fracture in the vertebral body of a subject, an X-ray image of the thoracic and lumbar vertebrae of the subject is used. As a method for determining the vertebral body using an X-ray image, a quantitative evaluation method or a semi-quantitative evaluation method is used. An example of the quantitative evaluation method is the QM method (QM: Quantitative Measurement).

[0003] When performing determination of the vertebral body by the QM method, the thoracic and lumbar vertebrae of the subject are imaged from the side using an X-ray imaging apparatus. Then, using an image processing apparatus, the height of each of the front end portion, the central portion, and the rear end portion of the vertebral body shown in the X-ray image obtained by the imaging is measured. Finally, based on the ratio of the height (A) of the front end portion of the vertebral body, the height (C) of the central portion of the vertebral body, and the height (P) of the rear end portion of the vertebral body, the presence or absence of a fracture in the vertebral body is determined. As an example, when the ratio (C / A) of the height C of the central portion of the vertebral body to the height A of the front end portion of the vertebral body or the ratio (C / P) of the height C of the central portion of the vertebral body to the height P of the rear end portion of the vertebral body is less than 0.8, it is determined that the vertebral body of the subject is fractured.

[0004] When measuring the height of the front end portion of the vertebral body using an image processing apparatus, a measurement mark for displaying a predetermined position in the vertebral body is displayed in the X-ray image. That is, a first measurement mark indicating the position of the upper edge portion of the front end portion of the vertebral body is displayed in the X-ray image, and a second measurement mark indicating the position of the lower edge portion of the front end portion of the vertebral body is displayed in the X-ray image. Based on the distance between the first measurement mark and the second measurement mark in the X-ray image, the height A of the front end portion of the vertebral body can be measured.

[0005] Similarly, a third measurement marker indicating the position of the upper edge portion of the central part of the vertebral body, a fourth measurement marker indicating the position of the lower edge portion of the central part of the vertebral body, a fifth measurement marker indicating the position of the upper edge portion of the posterior end of the vertebral body, and a sixth measurement marker indicating the position of the lower edge portion of the posterior end of the vertebral body are displayed in the X-ray image. Based on the distance between the third measurement marker and the fourth measurement marker, the height C of the central part of the vertebral body can be measured. Based on the distance between the fifth measurement marker and the sixth measurement marker, the height P of the posterior end of the vertebral body can be measured (for example, Patent Document 1). These six measurement markers are displayed in the X-ray image as points having a predetermined size, color, and shape. As an example, each measurement marker is displayed in the X-ray image as a white circular point.

[0006] The image processing apparatus is configured to be able to correct the position of each measurement marker in the X-ray image. As an example, when correcting the position of the measurement marker, the operator aligns the cursor displayed on the display for displaying the X-ray image with the measurement marker and can correct the position of the measurement marker in the X-ray image by performing a drag-and-drop operation. By performing an operation to correct the position of the measurement marker, the position of the measurement marker can be accurately matched to a predetermined position of the vertebral body in the X-ray image. Then, by executing an image processing operation based on the measurement marker whose position has been corrected, the height of the vertebral body at each site can be measured more accurately.

Prior Art Documents

Patent Documents

[0007]

Patent Document 1

Summary of the Invention

Problems to be Solved by the Invention

[0008] However, in the case of a conventional example having such a configuration, there are the following problems.

[0009] When correcting the position of a measurement marker on an X-ray image in a conventional image processing apparatus, the operator needs to perform a drag-and-drop operation while aligning the cursor with the measurement marker while checking the image of the vertebral body reflected in the X-ray image. Since the measurement marker is displayed on the X-ray image as a point having a predetermined size and color, the measurement marker may cover at least a part of the image of the vertebral body in the X-ray image. That is, when performing the drag-and-drop operation, the measurement marker or the cursor hinders the work of checking the image of the vertebral body. As a result, due to the measurement marker or the cursor, the time required for the image processing operation to correct the position of the measurement marker becomes longer, and the fatigue of the operator increases.

[0010] As an example of a means for avoiding a situation in which a measurement marker or the like hinders the confirmation work of the vertebral body, reducing the size of the measurement marker displayed on the X-ray image can be cited. However, when the display range of the measurement marker is reduced, it becomes more difficult to accurately align the cursor with the measurement marker. That is, since it becomes difficult to perform a drag-and-drop operation by aligning the cursor with the measurement marker, the time required for the image processing operation to correct the position of the measurement marker becomes longer, and the fatigue of the operator increases.

[0011] Also, as another example of a means for avoiding a situation in which a measurement marker or the like hinders the confirmation work of the vertebral body, temporarily hiding the measurement marker on the X-ray image can be cited. However, when the measurement marker is hidden, while it becomes easier to check the image of the vertebral body, it becomes difficult to grasp the position of the measurement marker. Therefore, the operator needs to perform an operation of checking the vertebral body and the measurement marker while switching between a state in which the measurement marker is displayed on the X-ray image and a state in which the measurement marker is not displayed many times. As a result, the time required for the image processing operation to correct the position of the measurement marker becomes longer, and the fatigue of the operator increases. Thus, it is difficult to improve the operability of image processing in a conventional image processing apparatus.

[0012] The present invention has been made in view of such circumstances, and an object thereof is to provide an image processing apparatus and an image processing method capable of further improving the operability of image processing.

Means for Solving the Problem

[0013] In order to achieve such an object, the present invention has the following configuration. That is, a first aspect of the present invention includes an image acquisition unit that acquires a radiation image showing a target organ, and an image processing unit that processes the radiation image acquired by the image acquisition unit. The image processing unit includes a position marker display unit that displays a position marker indicating a predetermined position in the organ on the radiation image, an operation marker corresponding to the position marker, and an operation marker display unit that displays the operation marker in an area of the radiation image that does not overlap with either the position marker or the organ, and an input reception unit that receives a marker movement operation of an operator that moves the position of the operation marker in the radiation image, and a position marker change unit that changes the position at which the position marker corresponding to the operation marker is displayed on the radiation image so as to reflect the marker movement operation received by the input reception unit. The present invention relates to an image processing apparatus including these components.

[0014] Further, a second aspect of the present invention is an image processing method using an image processing apparatus according to any one of claims 1 to 5, a first image file of a radiation image, a second image file of the radiation image which is generated based on the first image file and has a file format with a smaller capacity than the first image file, and an image server which stores and associates an identifier capable of identifying the second image file. The method includes: a first startup step of starting, on a terminal of the image processing apparatus, first software capable of displaying a thumbnail image of the radiation image; a first acquisition step of acquiring a plurality of the second image files and the identifiers from the image server; a thumbnail image generation step of generating a thumbnail image of the radiation image based on the second image file and associating the generated thumbnail image with the identifier; a thumbnail display step of causing the first software to display the thumbnail images of the radiation images generated for each of the plurality of the second image files; a second startup step of starting, on the terminal of the image processing apparatus, second software capable of performing image processing for changing the position of the position identifier using the position identifier changing unit on the first image file; a selection step of selecting one of the thumbnail images displayed on the first software; a transmission step of transmitting the identifier associated with the thumbnail image selected in the selection step to the image server; a specification step of specifying the first image file associated with the identifier transmitted to the image server in the transmission step from among the plurality of the first image files stored in the image server; a second acquisition step of transmitting the first image file specified in the specification step from the image server to the terminal of the image processing apparatus to acquire the first image file; and an image processing step of performing image processing using the position identifier display unit, the operation identifier display unit, the input reception unit, and the position identifier changing unit on the first image file of the radiation image acquired in the second acquisition step.

Advantages of the Invention

[0015] In the image processing apparatus according to the first aspect of the present invention and the image processing method according to the second aspect, by having a position marker display unit and an operation marker display unit, a position marker and an operation marker are displayed on a radiation image showing a target organ. The position marker indicates a predetermined position in the target organ. The operation marker corresponds to the position marker. The position where the operation marker is displayed in the radiation image is set to be a region that does not overlap with either the position marker or the organ. When the operator executes a marker movement operation for moving the operation marker displayed on the radiation image, the position marker changing unit changes the position where the position marker corresponding to the operation marker is displayed on the radiation image so as to reflect the marker movement operation.

[0016] With such a configuration, by executing a marker movement operation for moving the operation marker corresponding to the position marker, the position where the position marker is displayed on the radiation image is changed. Therefore, it is not necessary to perform an operation of directly selecting and moving the position marker using a cursor or the like. And since the operation marker is displayed in a region that does not overlap with either the organ or the position marker, even when the size of the operation marker is increased to improve the operability such as a drag-and-drop operation, it is possible to avoid a decrease in the visibility of the organ and the position marker. Therefore, even when the size of the position marker is reduced, it is possible to avoid a reduction in the operability of the operation for changing the position of the position marker. That is, it is possible to improve the operability of the operation for changing the position of the position marker while avoiding a decrease in the visibility of the organ due to the position marker.

Brief Description of the Drawings

[0017]

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MODE FOR CARRYING OUT THE INVENTION

[0018] Hereinafter, the image processing apparatus 1 according to the first embodiment of the present invention will be described with reference to the drawings. In the image processing apparatus 1 according to the first embodiment, image processing for determining the presence or absence of a fracture in a vertebral body using the QM method is performed.

[0019] <Description of the overall configuration> In the first embodiment, as shown in FIG. 1, the image processing apparatus 1 constitutes an X-ray imaging system 100 together with an X-ray imaging apparatus 101 and an image server 102. The X-ray imaging apparatus 101 performs X-ray imaging on a subject M to generate an X-ray image 10. The image server 102 is a server equipped with a large-scale storage medium and collects and records medical image data. The X-ray image 10 taken by the X-ray imaging apparatus 101 is transmitted to and stored in the image server 102. An example of the image server 102 is a PACS (Picture Archiving and Communication System).

[0020] The configuration of the data of the X-ray image 10 stored in the image server 102 will be described. As shown in FIG. 1, a plurality of first image files 85 of the X-ray image 10 are stored in the image server 102. An example of the file format of the first image file 85 is the DICOM format (DICOM: Digital Imaging and Communications in Medicine). Each of the first image files 85 is stored in the image server 102 in a state where identification information 11, a second image file 95 in the JPEG format, and an identifier 97 that can identify the second image file 95 are associated with each other. The second image file 95 is an image file generated from the first image file 85 of the X-ray image 10. The second image file 95 is used for generating a thumbnail image 91, which will be described later. A specific example of the identifier 97 is information on the file name (SOP Instance UID) of the second image file 95.

[0021] The identification information 11 is information for specifying the X-ray image 10, and examples thereof include the name of the subject M who is the imaging target, the imaging date, and an ID number that is different for each X-ray image. The information of the identification information 11 is different for each X-ray image 10 to which it is associated. In FIG. 1, of the two X-ray images 10 stored in the image server 102, one is designated as the X-ray image 10a and the other as the X-ray image 10b. Also, the identification information 11 associated with the X-ray image 10a is designated as the identification information 11a. And the identification information 11 associated with the X-ray image 10b is designated as the identification information 11b to distinguish the two.

[0022] In FIG. 1, of the two first image files 85 stored in the image server 102, the first image file 85 of the X-ray image 10a is designated as the first image file 85a. Also, the first image file 85 of the X-ray image 10b is designated as the first image file 85b to distinguish the two first image files 85. Similarly, when distinguishing the second image files 95 corresponding to each of the X-ray images 10a and 10b among the second image files 95, they are designated as the second image files 95a and 95b. When distinguishing the identifiers 97 corresponding to each of the X-ray images 10a and 10b among the identifiers 97, they are designated as the identifiers 97a and 97b.

[0023] The image processing apparatus 1 includes an image acquisition unit 3, an image processing unit 5, a storage unit 7, an input unit 8, a display unit 9, and a display control unit 12. The image acquisition unit 3 acquires the X-ray image 10 from the X-ray imaging apparatus 101 or the image server 102. The image processing unit 5 performs image processing on the X-ray image 10 acquired by the image acquisition unit 3. The image processing unit 5 includes information processing means exemplified by a CPU (Central Processing Unit) and a GPU (Graphics Processing Unit), and is a processor that executes various arithmetic processes.

[0024] The storage unit 7 stores various types of information, taking various programs executed in the image processing apparatus 1 as an example. As an example of the storage unit 7, a non-volatile memory can be mentioned. The storage unit 7 also stores a first learned model 13, a second learned model 14, analysis software 16, and reading software 18. The first learned model 13 and the second learned model 14 are models learned using teacher data, learning models, and the like.

[0025] The analysis software 16 is software that can perform various image processes on the X-ray image 10 and execute image analysis using methods such as the QM method. When performing various image processes on the X-ray image 10 by the image processing unit 5, the analysis software 16 is launched on the terminal of the image processing apparatus 1. When analyzing the X-ray image 10 using the analysis software 16, the image acquisition unit 3 acquires the first image file 85 of the X-ray image 10.

[0026] The reading software 18 is software used when reading the X-ray image 10 and the like. When simply displaying the X-ray image 10 on the display unit 9 for confirmation without performing image processing on the data of the X-ray image 10, the operator launches the reading software 18 instead of the analysis software 16 on the terminal of the image processing apparatus 1. The reading software 18 is configured to generate a thumbnail image 91 using the second file 95 of the X-ray image 10. The reading software 18 is also configured to generate a reading image 93 using the first image file 85 of the X-ray image 10. When the reading software 18 is launched, the thumbnail image 91 and the reading image 93 are displayed on the display unit 9, and the operator checks these images to read the X-ray image 10. The reading software 18 corresponds to the first software in this embodiment. The analysis software 16 corresponds to the second software in this embodiment.

[0027] The first learned model 13 estimates the region in the X-ray image 10 where the vertebral body 40 appears, and individually identifies a plurality of vertebral bodies 40. The second learned model 14 estimates the part (target part) that is focused on in the evaluation of the vertebral body 40 for the vertebral body 40 shown in the X-ray image 10, and identifies the position of the target part in the X-ray image 10. The vertebral body 40 corresponds to the organ in the present embodiment.

[0028] FIG. 2 shows the target parts of the vertebral body 40 in the first embodiment. When evaluating the vertebral body 40 by the QM method, the upper edge part 42a at the front end, the upper edge part 43a at the center, the upper edge part 44a at the rear end, the lower edge part 42b at the front end, the lower edge part 43b at the center, and the upper edge part 44b at the rear end of the vertebral body 40 become the target parts. In the vertebral body 40, the side in contact with the vertebral arch 41 corresponds to the rear end.

[0029] The input unit 8 inputs operation instructions by an operator such as a medical staff. Examples of the input unit 8 include a keyboard input type device, a touch input type device, or a mouse input type device. The display unit 9 displays various data such as image information or document information, and an example is a liquid crystal display. The X-ray image 10 and the like acquired by the image acquisition unit 3 are displayed on the display unit 9. The display control unit 12 controls the display unit 9. According to the control of the display control unit 12, various data such as the X-ray image 10 are displayed on the display unit 9. When the reading software 18 is activated in the image processing apparatus 1, the display control unit 12 causes the window 81 of the reading software 18 to be displayed on the display unit 9. When the analysis software 16 is activated in the image processing apparatus 1, the display control unit 12 causes the window 83 of the analysis software 16 to be displayed on the display unit 9.

[0030] As shown in FIG. 1, the X-ray imaging apparatus 101 includes a top plate 15, an X-ray tube 17, an X-ray detector 19, and an X-ray image generation unit 21. The top plate 15 places the subject M in a lying position. In FIG. 1, an example where the subject M is in a supine position is shown, but the position of the subject M can be changed to a lateral position or a prone position according to the imaging conditions.

[0031] The X-ray tube 17 irradiates the subject M placed on the top plate 15 with X-rays. The X-ray detector 19 detects the X-rays irradiated from the X-ray tube 17 and converts them into an electrical signal. The X-ray detector 19 is disposed opposite to the X-ray tube 17 with the top plate 15 interposed therebetween. Examples of the X-ray detector 19 include an FPD (Flat Panel Detector).

[0032] The X-ray image generation unit 21 is provided downstream of the X-ray detector 19 and generates an X-ray image 10 based on the X-ray detection signal output from the X-ray detector 19. The data of the X-ray image 10 is first generated as a first image file 85 in DICOM format. Further, the X-ray image generation unit 21 generates a second image file 95 in JPEG format based on the first image file 85 of the generated X-ray image 10. The first image file 85 of the X-ray image 10 generated by the X-ray image generation unit 21 is associated with the identification information 11, the second image file 95, and the identifier 97 and transmitted to the image server 102. Note that the image acquisition unit 3 can also directly transmit the data of the X-ray image 10 generated by the X-ray image generation unit 21 to the image processing apparatus 1.

[0033] The image processing unit 5 of the image processing apparatus 1 includes a vertebral body image generation unit 23, an input reception unit 25, a determination image generation unit 27, a position label display unit 29, an operation label display unit 31, an operation label change unit 32, a position label change unit 33, a vertebral body height calculation unit 35, a vertebral body determination unit 37, and an evaluation image generation unit 39. As shown in FIG. 5, the vertebral body image generation unit 23 generates a vertebral body image 45 by extracting the vertebral body 40 from the X-ray image 10 using the first learned model 13. The vertebral body image 45 is an image in which a plurality of vertebral bodies 40 in the image reflected in the X-ray image 10 are displayed together with a label 46 for individually identifying the vertebral body 40.

[0034] The input reception unit 25 receives various operations performed by the operator using the input unit 8. Examples of the operations received by the input reception unit 25 include an operation in which the operator selects the vertebral body 40 to be determined in the vertebral body image 45, or an operation in which the position of the operation label 51a on the screen is moved.

[0035] The determination image generation unit 27 generates a determination image 47 based on the operation performed by the operator on the vertebral body image 45. The determination image 47 is an image in which a predetermined vertebral body 40 among a plurality of vertebral bodies 40 shown in the vertebral body image 45 is arranged at the center in an enlarged state. The determination image generation unit 27 corresponds to the central display processing unit in the present embodiment.

[0036] The position marker display unit 29 displays a position marker 49 on the determination image 47. The position marker 49 is displayed as a marker indicating the position of the site of interest. In the first embodiment, since there are six sites of interest on the vertebral body 40, the position marker display unit 29 displays six position markers 49. The X-ray image 10 and the determination image 47 correspond to the radiation image in the present invention.

[0037] FIG. 3 is a diagram showing a method for determining the presence or absence of a fracture in the vertebral body 40. In the first embodiment, position markers 49 are respectively displayed at the upper edge 42a of the front end, the upper edge 43a of the center, the upper edge 44a of the rear end, the lower edge 42b of the front end, the lower edge 43b of the center, and the upper edge 44b of the rear end, which are the sites of interest of the vertebral body 40.

[0038] Among the position markers 49, the position marker 49 indicating the upper edge 42a of the front end is defined as the position marker 49A. Similarly, the position marker 49 indicating the lower edge 42b of the front end is defined as the position marker 49B. The position marker 49 indicating the upper edge 43a of the center is defined as the position marker 49C. The position marker 49 indicating the lower edge 43b of the center is defined as the position marker 49D. The position marker 49 indicating the upper edge 44a of the rear end is defined as the position marker 49E. The position marker 49 indicating the lower edge 44b of the rear end is defined as the position marker 49F.

[0039] Further, the position marker 49 functions as a measurement point serving as a reference for measuring the height when calculating the height of the vertebral body 40. That is, the distance from the position marker 49A to the position marker 49B is calculated as the height A of the front end portion in the vertebral body 40. Also, the distance from the position marker 49C to the position marker 49D is calculated as the height C of the central portion in the vertebral body 40. And the distance from the position marker 49E to the position marker 49F is calculated as the height P of the rear end portion in the vertebral body 40. Hereinafter, the height A of the front end portion in the vertebral body 40 is referred to as "front end height A". The height C of the central portion in the vertebral body 40 is referred to as "central height C". The height P of the rear end portion in the vertebral body 40 is referred to as "rear end height P".

[0040] The operation marker display unit 31 displays the operation marker 51 on the determination image 47. The operation marker 51 is a marker used in the operation of changing the position of the position marker 49. That is, for each of the position markers 49, a corresponding operation marker 51 is displayed. In the first embodiment, since six position markers 49 are displayed, the operation marker display unit 31 displays six operation markers 51 on the determination image 47. Each of the operation markers 51 is configured to be able to change its position in the determination image 47. Details of the operation for changing the position of the operation marker 51 will be described later.

[0041] The operation marker change unit 32 changes the position of the operation marker 51 in the determination image 47 in response to an operation in which the position of the operation marker 51 is changed. The position marker change unit 33 changes the position of the position marker 49 in the determination image 47 according to the direction and distance in which the position of the operation marker 51 in the determination image 47 is changed. Details of the operation of changing the positions of the operation marker 51 and the position marker 49 in the determination image 47 in response to the operation of changing the position of the operation marker 51 will be described later.

[0042] The vertebral body height calculation unit 35 calculates the height of the vertebral body 40 using each of the position markers 49 as a measurement point. That is, the vertebral body height calculation unit 35 calculates the front-end height A using the position marker 49A and the position marker 49B as measurement points. Then, the vertebral body height calculation unit 35 calculates the central height C using the position marker 49C and the position marker 49D as measurement points, and calculates the rear-end height P using the position marker 49E and the position marker 49F as measurement points. The vertebral body determination unit 37 determines the presence or absence of a fracture in the vertebral body 40 based on the information calculated by the vertebral body height calculation unit 35. The evaluation image generation unit 39 generates an evaluation image 53 indicating the evaluation result of the vertebral body 40 using the determination result by the vertebral body determination unit 37 and the like.

[0043] <Explanation of the image processing step> Here, a series of operations for performing image processing to evaluate the vertebral body 40 of the subject M using the image processing apparatus 1 according to the first embodiment will be described with reference to the flowchart shown in FIG. 4.

[0044] Step S1 (Acquisition of X-ray image) When the operation of the image processing apparatus 1 is started, first, the operator activates the analysis software 16 on the terminal of the image processing apparatus 1. Then, the image acquisition unit 3 acquires the X-ray image 10 of the subject M from the image server 102 or the like. In the first embodiment, the operator acquires the X-ray image 10 by copying the first image file 85 of the X-ray image 10 stored in the image server 102 to the client terminal. That is, the image acquisition unit 3 receives the first image files 85 of all the X-ray images 10 stored in the image server 102. Then, the operator performs an operation of selecting the first image file 85 of one X-ray image 10 to be analyzed from among the received multiple first image files 85. The X-ray image 10 selected as the target of the selection operation is displayed on the display unit 9. The X-ray image 10 acquired by the image acquisition unit 3 is in a file format (e.g., DICOM format) that enables image processing by the image processing unit 5.

[0045] In the first embodiment, as shown in FIG. 5, the X-ray image 10 is an image obtained by photographing the vertebral body 40 of the subject M from the side. That is, a plurality of vertebral bodies 40 are shown together with the vertebral arches 41 in the X-ray image 10. In each image such as the X-ray image 10, the left-right direction is the x-direction, and the up-down direction is the y-direction. Also, among the x-directions, the left direction is indicated by the symbol x1, and the right direction is indicated by the symbol x2. Among the y-directions, the up direction is indicated by the symbol y1, and the down direction is indicated by the symbol y2. When the X-ray image 10 is acquired, step S1 ends.

[0046] Step S2 (Generation of vertebral body image) After acquiring the X-ray image 10, in step S2, the vertebral body image generation unit 23 generates a vertebral body image 45 from the X-ray image 10. The vertebral body image generation unit 23 uses the first learned model 13 to estimate the region in the X-ray image 10 where the vertebral body 40 is shown. By estimating the region of the vertebral body 40, each of the plurality of vertebral bodies 40 is extracted from the X-ray image 10. When the vertebral body 40 in the X-ray image 10 is extracted, the vertebral body image 45 is generated. The generated vertebral body image 45 is displayed on the display unit 9.

[0047] Also, in the vertebral body image 45, a label 46 for identifying each of the vertebral bodies 40 is displayed near the vertebral body 40. In the vertebral body image 45 according to the first embodiment, as shown in FIG. 5 and the like, labels 46 indicating the second thoracic vertebra (T2) to the eighth thoracic vertebra (T8) are respectively displayed near the seven vertebral bodies 40. Here, among the seven vertebral bodies 40 shown in the vertebral body image 45, the vertebral body 40 with the label 46 of T2 is defined as the vertebral body 40a. Similarly, the vertebral bodies 40 with the labels of T3 to T8 are defined as the vertebral bodies 40b to 40g and are distinguished from each other. When the vertebral body image 45 is generated, step S2 ends.

[0048] Step S3 (Generation of determination image) When the vertebral body image 45 is generated, the determination image 47 is generated in step S3. First, the operator performs an operation (selection operation Se) of selecting the vertebral body 40 to be determined from among the vertebral bodies 40a to 40g displayed in the vertebral body image 45. Here, it is assumed that the vertebral body 40d with the label of T5 is selected. As an example of the operation of selecting the vertebral body 40, as shown in the left figure of FIG. 6, the operator moves the cursor CS displayed on the display unit 9 to the position of the vertebral body 40d to be determined and performs a click operation. The operation of selecting the vertebral body 40d is performed using the input unit 8 or the like. By the operation of selecting the vertebral body 40d, an instruction indicating that the vertebral body 40d is to be determined is input to the image processing apparatus 1.

[0049] The instruction of the operator input using the input unit 8 is received by the input reception unit 25. The input reception unit 25 transmits information indicating that the determination target is the vertebral body 40d to the determination image generation unit 27. The determination image generation unit 27 generates a determination image 47 for the vertebral body 40 selected by the operator based on the transmitted information.

[0050] The determination image 47 is an image in which the vertebral body 40 selected as the determination target is arranged at the center. Also, in the determination image 47, the image of the vertebral body 40 selected as the determination target is enlarged at a predetermined magnification compared to the vertebral body image 45. That is, when the selection operation Se of selecting the vertebral body 40d as the determination target is executed, as shown in the right figure of FIG. 6, an enlarged image of the vertebral body 40d is displayed at the center of the determination image 47. By enlarging and displaying the determination target vertebral body 40 at the center of the determination image 47, the accuracy of the operation of correcting the position of the position marker 49 in step S6 can be improved. When the determination image 47 is generated, step S3 ends.

[0051] Step S4 (display of position marker) When the determination image 47 is generated, the position marker 49 is displayed on the determination image 47 in step S4. In FIG. 7, the left determination image 47 shows the state before the position marker 49 is displayed, and the right determination image 47 shows the state after the position marker 49 is displayed.

[0052] When step S4 starts, the position marker display unit 29 estimates the positions of the attention parts of the vertebral body 40d in the determination image 47 using the second learned model 14. That is, the position marker display unit 29 estimates the positions of the upper edge part 42a at the front end, the upper edge part 43a at the center, the upper edge part 44a at the rear end, the lower edge part 42b at the front end, the lower edge part 43b at the center, and the upper edge part 44b at the rear end in the vertebral body 40d using the second learned model 14.

[0053] After the positions of the attention parts are estimated, the position marker display unit 29 displays the position markers 49 at the estimated positions of the attention parts. That is, as shown in FIG. 7, the position marker display unit 29 displays the position marker 49A in the region estimated to be the upper edge part 42a at the front end of the vertebral body 40d. Similarly, the position marker display unit 29 displays the position marker 49B in the region estimated to be the lower edge part 42b at the front end. In addition, the position markers 49C to 49F are respectively displayed in the regions estimated to be the upper edge part 43a at the center, the lower edge part 43b at the center, the upper edge part 44a at the rear end, and the upper edge part 44b at the rear end. When the position marker 49 is displayed on the determination image 47, step S4 ends.

[0054] Step S5 (display of operation markers) When the position marker 49 is displayed on the determination image 47, the operation marker 51 is displayed on the determination image 47 in step S5. In FIG. 7, the left determination image 47 shows the state before the operation marker 51 is displayed in step S5, and the right determination image 47 shows the state after the operation marker 51 is displayed in step S5.

[0055] When step S5 starts, the operation marker display unit 31 displays the operation markers 51 corresponding to each of the position markers 49. In the first embodiment, for each of the operation markers 51 corresponding to the position markers 49A to 49F, reference numerals 51A to 51F are respectively attached to distinguish each of them. That is, among the six operation markers 51, the operation marker 51A corresponds to the position marker 49A. The operation marker 51B is the operation marker corresponding to the position marker 49B. The operation markers 51C to 51F respectively correspond to the position markers 49C to 49F.

[0056] Each of the operation identifiers 51 is displayed at a position different from both the position identifier 49 and the vertebral body 40d that is the object of determination. By displaying the operation identifier 51 at a position different from the position identifier 49, the operability of the operation for correcting the position of the position identifier 49 using the operation identifier 51 can be improved. Further, by displaying the operation identifier 51 at a position different from the vertebral body 40d, it is possible to avoid the visibility of the vertebral body 40d being reduced by the operation identifier 51.

[0057] Each of the position identifier 49 and the operation identifier 51 is displayed as a symbol having a predetermined size, color, and shape in the determination image 47. In FIG. 8 and the like, as an example, each of the position identifiers 49 is shown as a black circular symbol. Also, each of the operation identifiers 51 is shown as a black circular symbol having a size larger than that of the position identifier 49. By making the size of the position identifier 49 displayed in the determination image 47 smaller, it is possible to avoid the position identifier 49 reducing the visibility of the vertebral body 40 when the position of the position identifier 49 is corrected to the attention part of the vertebral body 40.

[0058] The position at which the operation identifier display unit 31 displays each of the operation identifiers 51 in the determination image 47 is preferably set according to the position of the corresponding position identifier 49. That is, the position of the operation identifier 51A is preferably set according to the position of the position identifier 49A, and the position of the operation identifier 51B is preferably set according to the position of the position identifier 49B. In this case, since the relative positional relationship of the plurality of operation identifiers 51A to 51F is the same as the relative positional relationship of the plurality of position identifiers 49A to 49F, the correspondence relationship between the operation identifier 51 and the position identifier 49 can be grasped accurately and quickly.

[0059] In the determination image 47, the positions where the operation sign display unit 31 displays each of the operation signs 51 are set as follows as an example. In FIG. 8, an example of setting the display positions of the operation signs 51 is shown based on the center line F parallel to the x direction passing through the center point Ce of the determination image 47 and the positions of the position signs 49. The operation signs 51 are displayed at positions facing the center line F with the corresponding position signs 49 in between, and at positions where the distance from the corresponding position signs 49 is a predetermined value d1. That is, in FIG. 8, the operation sign 51A is displayed at a position facing the center line F with the position sign 49A in between, and at a position where the distance from the position sign 49A is a predetermined value d1. In other words, the position where the operation sign 51A is displayed by the operation sign display unit 31 is a position that is a predetermined value d1 away from the position where the position sign display unit 29 displays the position sign 49A in the y1 direction as the initial position.

[0060] Similarly, the position that is a predetermined value d1 away from the display position of the position sign 49C in the y1 direction is the position where the operation sign 51C is displayed by the operation sign display unit 31. The position that is a predetermined value d1 away from the display position of the position sign 49E in the y1 direction is the position where the operation sign 51E is displayed by the operation sign display unit 31. Note that the initial positions of the position signs 49B, 49D, and 49F are positions away from the center line F in the y2 direction. Therefore, the positions where the operation sign display unit 31 displays the operation signs 51B, 51D, and 51F as the initial positions are positions that are a predetermined value d1 away from the initial positions of the position signs 49B, 49D, and 49F in the y2 direction.

[0061] For each of the plurality of operation signs 51 to 51F in this way, by setting the distances from the corresponding position signs 49A to 49F to the same value d1, the correspondence between the operation signs 51A to 51F and the position signs 49A to 49F can be easily grasped. That is, by a glance at the positional relationship between the position sign 49 and the operation sign 51, the operator can quickly grasp that the operation sign 51 corresponding to the position sign 49A is the operation sign 51A rather than the operation signs 51B to 51F. Also, the operation sign 51 is displayed at a position facing the center line F with the position sign 49 in between. Since the vertebral body 40 to be determined in the determination image 47 is displayed in the central part of the image, the operation sign 51 can be surely displayed at a position away from the vertebral body 40.

[0062] Note that the method for determining the position where the operation sign display unit 31 displays the operation sign 51 as the initial position is not limited to the method shown in FIG. 8. As an example, the distance between the operation sign 51 and the position sign 49 may be determined so that the ratio to the distance from the center line F to the position sign 49 is constant. Also, the initial display positions of the operation signs 51 may be set so that each of them faces the center point Ce of the determination image 47 with the position sign 49 in between. When each of the operation signs 51 is displayed on the determination image 47 by the operation sign display unit 31, step S5 ends.

[0063] Step S6 (modification of position sign) After the operation sign 51 is displayed on the determination image 47, the position of the position sign 49 is modified using the operation sign 51. Each of the position signs 49 displayed by the position sign display unit 29 using the second learned model 14 may deviate from the position of the attention part of the vertebral body 40. As an example, the position sign display unit 29 displays the position sign 49A at a position estimated to be the upper edge part 42a of the front end in the vertebral body 40d. However, as shown in FIG. 10, there may be a case where the position where the position sign display unit 29 displays the position sign 49A is actually deviated from the upper edge part 42a of the front end. In this case, the operator needs to visually confirm the position of the upper edge part 42a of the front end and modify the position of the position sign 49A so that the position sign 49A coincides with the upper edge part 42a of the front end.

[0064] When the position of the position identifier 49 is to be corrected, the operator performs an operation to change the position of the operation identifier 51 corresponding to the position identifier 49 to be corrected. That is, when the position of the position identifier 49A is to be corrected, an operation to change the position of the operation identifier 51A is performed. When changing the position of the operation identifier 51A, as shown in FIG. 11, the operator operates the input unit 8 to align the cursor CS displayed on the display unit 9 with the operation identifier 51A. Then, by a drag-and-drop operation, the operator inputs an instruction to move the operation identifier 51A. In FIG. 11, the direction and distance of moving the operation identifier 51A are shown as a movement vector Va. The instruction of the operator input using the input unit 8 is received by the input reception unit 25.

[0065] The input reception unit 25 transmits the content of the received instruction, that is, the instruction to move the operation identifier 51A, to the operation identifier change unit 32. The operation identifier change unit 32 changes the position of the operation identifier 51A in the determination image 47 according to the content of the instruction received by the input reception unit 25. As a result, as shown in FIGS. 10 and 11, the position of the operation identifier 51A in the determination image 47 is changed according to the direction and distance of the movement vector Va. The position of the operation identifier 51A in FIG. 10, that is, the position of the operation identifier 51A before the operator performs the movement operation, is shown using a dotted line and reference sign Be in FIG. 11.

[0066] Here, the information of the movement vector Va input to the input unit 8 is also transmitted to the position identifier change unit 33 via the input reception unit 25. The position identifier change unit 33 changes the position of the position identifier 49A corresponding to the operation identifier 51A according to the information of the movement vector Va received by the input reception unit 25. As a result, as shown in FIG. 12, the position of the position identifier 49A is changed according to the direction and distance of the movement vector Va.

[0067] The operation of the position identification changing unit 33 is performed immediately after the operation of the operation identification changing unit 32. That is, the operator can confirm that the position of the position identification 49A is changed almost simultaneously by operating to move the operation identification 51A. And the movement vectors of the operation identification 51A and the position identification 49A are the same. Therefore, the operator can accurately and easily grasp the direction and distance for moving the operation identification 51A necessary to align the position identification 49A with the upper edge portion 42a at the front end.

[0068] The operator performs an operation to appropriately change the position of the operation identification 51A using the input unit 8, thereby correcting the position of the position identification 49A to accurately match the position of the upper edge portion 42a at the front end in the vertebral body 40d. FIG. 12 shows a state where the position identification 49A moves according to the movement vector Va in the same manner as the operation identification 51A and matches the position of the upper edge portion 42a at the front end in the vertebral body 40d. The position of the position identification 49A in FIG. 10, that is, the position of the position identification 49A before the operator performs the movement operation, is indicated by the reference sign Bn in FIG. 12.

[0069] After correcting the position of the position identification 49A, the operator corrects the positions of the position identifications 49B to 49F in the same procedure. That is, by aligning the cursor CS with the operation identification 51B and performing a drag-and-drop operation, the position of the position identification 49B is changed. At this time, the movement vector of the operation identification 51B is reflected in the movement direction and movement distance of the position identification 49B. Therefore, the position of the position identification 49B is accurately corrected to the position of the lower edge portion 42b at the front end in the vertebral body 40d. Then, the operator executes an operation to change the positions of the operation identifications 51C to 51F, thereby correcting the positions of the position identifications 49C to 49F. By aligning each of the position identifications 49 serving as measurement points with the attention part of the vertebral body 40d, the height of the vertebral body 40d can be accurately measured.

[0070] FIG. 13 shows a state in which each of the position identifiers 49A to 49F is corrected. That is, by operating the operation identifier 51C, the position of the position identifier 49C coincides with the upper central edge 43a of the vertebral body 40d. By operating the operation identifier 51D, the position of the position identifier 49D coincides with the lower central edge 43b of the vertebral body 40d. By operating the operation identifier 51E, the position of the position identifier 49E coincides with the upper rear edge 44a of the vertebral body 40d. By operating the operation identifier 51F, the position of the position identifier 49F coincides with the lower rear edge 44b of the vertebral body 40d.

[0071] Each of the operation identifiers 51 is shown as a symbol having a size larger than that of the position identifier 49. By making the size of the operation identifier 51 displayed on the determination image 47 relatively large, it becomes easier for the operator to perform an operation of aligning the position of the cursor CS with the operation identifier 51 and an operation of moving the operation identifier 51. Therefore, the accuracy and operability of the operation of moving the position identifier 49 together with the operation identifier 51 can be improved.

[0072] And the position identifier 49 to be matched to the target part of the vertebral body 40 is not an object for the operator to directly perform a moving operation. Therefore, even when the size of the position identifier 49 is reduced, it is possible to avoid a decrease in the operability of the operation of moving the position of the position identifier 49. That is, by making the size of the position identifier 49 smaller than the size of the operation identifier 51, it is possible to avoid the position identifier 49 covering the target part of the vertebral body 40 and reducing the visibility of the target part, and to improve the operation of moving the position of the position identifier 49. By operating to move the operation identifier 51, each of the position identifiers 49 is matched to the target part of the vertebral body 40d, and step S6 ends.

[0073] Step S7 (Determination of Vertebral Body) After making corrections to match each of the position identifiers 49 to the target part of the vertebral body 40d, the operator operates the input unit 8 to input an instruction to perform a determination of the vertebral body 40d. The instruction to perform a determination of the vertebral body 40d is received by the input reception unit 25, and the input reception unit 25 causes the measurement by the vertebral body height calculation unit 35 to start based on the instruction.

[0074] The vertebral body height calculation unit 35 calculates the height of each part of the vertebral body 40d with each of the position markers 49 as a measurement reference. That is, the vertebral body height calculation unit 35 calculates the front end height A of the vertebral body 40d using the position marker 49A and the position marker 49B as measurement points (see FIG. 3). Then, the vertebral body height calculation unit 35 calculates the central height C of the vertebral body 40d using the position marker 49C and the position marker 49D as measurement points. Further, the rear end height P of the vertebral body 40d is calculated using the position marker 49E and the position marker 49F as measurement points. The information calculated by the vertebral body height calculation unit 35 is transmitted to the vertebral body determination unit 37.

[0075] The vertebral body determination unit 37 analyzes the numerical values of the transmitted front end height A, central height C, and rear end height P, and determines the presence or absence of a fracture in the vertebral body 40d. The criteria for determining a fracture of the vertebral body 40 are input in advance by the input unit 8. In the first embodiment, when the ratio (C / A) of the central height C to the front end height A is less than 0.8, when the ratio (C / P) of the central height C to the rear end height P is less than 0.8, and when the ratio (A / P) of the front end height A to the rear end height P is less than 0.75, if at least one of the conditions is satisfied, it is determined that the vertebral body 40d to be determined is fractured.

[0076] The vertebral body determination unit 37 calculates the evaluation parameters (C / A, C / P, and A / P) of the vertebral body 40d, and determines the presence or absence of a fracture in the vertebral body 40d using the evaluation parameters. As shown in FIG. 14, the vertebral body determination unit 37 causes the display unit 9 to display the evaluation parameters and the data indicating the presence or absence of a fracture as a determination image 52. As an example, the determination image 52 displays a list of the evaluation parameters and the presence or absence of a fracture for each of the vertebral bodies 40. If the vertebral body 40d satisfies the condition for determining that a fracture has occurred in the vertebral body 40, a character (G1) indicating that a fracture has occurred is entered in the column (SQ) corresponding to the vertebral body 40d. If the vertebral body 40d does not satisfy the condition for determining that a fracture has occurred in the vertebral body 40, a character (G0) indicating that no fracture has occurred is entered in the column SQ corresponding to the vertebral body 40d.

[0077] The evaluation image generation unit 39 generates an evaluation image 53 based on the evaluation result obtained for the vertebral body 40d and causes it to be displayed on the display unit 9. As shown in FIG. 15, the evaluation image 53 includes the X-ray image 10 acquired by the image acquisition unit 3, the determination image 47 generated by the determination image generation unit 27, and the determination image 52 generated by the vertebral body determination unit 37. By checking the evaluation image 53, the operator can grasp the state of the vertebral body 40 of the subject M. When the evaluation image 53 regarding the vertebral body 40d is generated, step S7 ends.

[0078] If the operator needs to perform a determination for another vertebral body 40, the process returns to step S3 to analyze another vertebral body 40. As an example, when analyzing the vertebral body 40b next, the vertebral body image 45 is displayed on the display unit 9, and a selection operation is performed by aligning the cursor CS with the region of the vertebral body 40b. By this selection operation, a determination image 47 is generated in which the vertebral body 40b is centered and the vertebral body 40b is enlarged (step S3). The determination image 47 displays a position marker 49 and an operation marker 51 (steps S4 and S5). The operator performs a correction to match each of the position markers 49 with the attention part of the vertebral body 40b by operating to move the position of the operation marker 51 displayed on the determination image 47 (step S6). Then, when the operator performs an operation to start the analysis, evaluation parameters and the like for the vertebral body 40b are calculated (step S7). Thereafter, by analyzing all the vertebral bodies 40, the operations related to a series of image processing are completed.

[0079] Here, the effects of the configuration of the image processing apparatus 1 according to the present embodiment will be described while comparing with the conventional configuration. In a conventional image processing apparatus, as shown in FIG. 16, when performing a correction to match the position marker 149 with the attention part of the vertebral body 140, the operator aligns the cursor CS with the position marker 149 and performs an operation to directly move the position marker 149 using a drag-and-drop operation or the like.

[0080] In this case, when the position marker 149 is brought closer to the target site of the vertebral body 140, the position marker 149 or the cursor CS overlaps the vertebral body 140. As a result, it becomes difficult to grasp the positional relationship between the position marker 149 and the target site, so the accuracy of the operation to correct the position of the position marker 149 decreases, and the time required for the correction operation becomes longer. FIG. 16 shows a state in which the upper end portion 142a of the front end of the vertebral body 140, which is the target site, is hidden by the position marker 149 and the cursor CS. In this case, since the visibility of the upper end portion 142a of the front end decreases, it is difficult to accurately align the position marker 149 with the upper end portion 142a of the front end.

[0081] As a first method of avoiding the reduction in the visibility of the vertebral body 140 due to the position marker 149, there is a method of reducing the size of the position marker 149. However, when the position marker 149 is reduced in size, it becomes difficult to align the cursor CS with the position marker 149, so that the operation of correcting the position of the position marker 149 is rather prolonged.

[0082] As a second method of avoiding the reduction in the visibility of the vertebral body 140 due to the position marker 149, there is a method as shown in FIG. 17. That is, while reducing the size of the position marker 149, a reception area 150 capable of receiving a selection operation by the cursor CS is widely set around the position marker 149. In this case, since the position marker 149 can be selected and moved by performing a drag-and-drop operation with the cursor CS aligned with the wide reception area 150, the movement operation can be simplified while reducing the size of the position marker 149.

[0083] However, in the comparative example according to the second method, a new problem occurs. That is, as shown in FIG. 18, when the two position markers 149a and 149b are close to each other, a part of the reception area 150a of the position marker 149a and the reception area 150b of the position marker 149b overlap. In this case, an operation intended to perform a drag-and-drop operation with the cursor CS aligned with the reception area 150a for the purpose of selecting the position marker 149a actually results in a situation where the drag-and-drop operation is performed with the cursor CS aligned with the reception area 150b. As a result, contrary to the intention of moving the position marker 149a, an operation of actually moving the position marker 149b is executed, so the operability is greatly reduced. When the height of the vertebral body 140 is low, the position marker 149 to be moved to the upper end of the vertebral body 140 and the position marker 149 to be moved to the lower end of the vertebral body 140 are close to each other, so the situation shown in FIG. 18 occurs frequently. Also, in both the first method and the second method, it is difficult to solve the problem that the visibility of the vertebral body 140 is reduced by the cursor CS.

[0084] Compared with such a conventional configuration, in the image processing apparatus 1 according to the present embodiment, the operation marker 51 is displayed together with the position marker 49. The operation marker 51 is displayed at a position different from both the vertebral body 40 and the position marker 49. By performing an operation of moving the operation marker 51, the position of the position marker 49 is changed according to the direction and distance in which the operation marker 51 moves. In other words, the position of the position marker 49 in the image can be changed without directly performing a position change operation such as a drag-and-drop operation on the position marker 49. With such a configuration, when changing the position of the position marker 49 in the image, the cursor CS is arranged near the operation marker 51, so it is possible to avoid the cursor CS from reducing the visibility of the vertebral body 40. Also, by making the position marker 49 smaller than the operation marker 51, since the operation marker 51 is relatively large, the operability of the operation of moving the operation marker 51 can be improved. On the other hand, since the size of the position marker 49 can be reduced, it is possible to avoid the visibility of the vertebral body 40 being reduced by the position marker 49. Second Embodiment

[0085] Next, the image processing apparatus 1A according to the second embodiment of the present invention will be described. Note that the same components as those of the image processing apparatus 1 according to the first embodiment are only given the same reference numerals, and different components will be described in detail.

[0086] In the first embodiment, image processing is performed on the X-ray image 10 of the vertebral body 40 as the imaging target, and the configuration for evaluating the vertebral body 40 of the subject M by the QM method has been described as an example. In the second embodiment, as shown in FIG. 19 and the like, image processing is performed on the X-ray image 10 of the heart 57 and the chest cage 59 as the imaging targets, and the configuration for evaluating the heart 57 of the subject M based on the cardiothoracic ratio will be described as an example.

[0087] FIG. 19 shows the site of interest in the second embodiment. When evaluating the heart 57 using the cardiothoracic ratio as an evaluation parameter, the left end 64a of the heart 57, the right end 64b of the heart 57, the left end 65a of the chest cage 59, and the right end 65b of the chest cage 59 are the sites of interest. The left end 64a of the heart 57 corresponds to the left end in the x direction among the regions where the heart 57 appears in the X-ray image 10. The right end 64b of the heart 57 corresponds to the right end in the x direction among the regions where the heart 57 appears in the X-ray image 10.

[0088] FIG. 20 is a diagram showing a method for calculating the cardiothoracic ratio. In the second embodiment, the length in the x direction from the left end 64a of the heart 57 to the right end 64b of the heart 57 is calculated as the heart width S. Then, the length in the x direction from the left end 65a of the chest cage 59 to the right end 65b of the chest cage 59 is calculated as the chest cage width L. Then, the ratio (S / L) of the heart width S to the chest cage width L is calculated as the cardiothoracic ratio.

[0089] Therefore, in the second embodiment, position markers 69 are displayed at each of the left end 64a of the heart 57, the right end 64b of the heart 57, the left end 65a of the chest cage 59, and the right end 65b of the chest cage 59, which are the sites of interest, and the heart width S and the chest cage width L are calculated using each of the position markers 69 as a measurement reference. Each of the position markers 69 is displayed as a linear symbol extending in the y direction passing through the site of interest.

[0090] Of the position markers 69, the position marker 69 indicating the left end 64a of the heart 57 is distinguished from the other position markers 69 as the position marker 69A. Similarly, the position marker 69 indicating the right end 64b of the heart 57 is defined as the position marker 69B. The position marker 69 indicating the left end 65a of the chest cage 59 is defined as the position marker 49C. The position marker 69 indicating the right end 65b of the chest cage 59 is defined as the position marker 69D.

[0091] FIG. 21 is a schematic diagram for explaining the configuration of the image processing apparatus 1A according to the second embodiment. In the first embodiment, the vertebral body image 45 and the determination image 47 are generated, and the image processing for displaying the position marker 49 and the operation marker 51 on the determination image 47 is described as an example. In the second embodiment, the generation of the vertebral body image 45 and the determination image 47 is omitted, and the image processing for displaying the position marker 49 and the operation marker 51 on the X-ray image 60 is described as an example. Therefore, in the image processing apparatus 1A shown in FIG. 21, the vertebral body image generation unit 23 and the determination image generation unit 27 can be omitted. Further, the image processing apparatus 1A for evaluating the cardiothoracic ratio includes a cardiothoracic ratio calculation unit 61 instead of the vertebral body height calculation unit 35. Further, the image processing apparatus 1A includes a cardiothoracic ratio determination unit 63 instead of the vertebral body determination unit 37.

[0092] The cardiothoracic ratio calculation unit 61 calculates the cardiothoracic ratio (S / L) by calculating the heart width S and the chest cage width L using the position markers 69A to 69D as measurement points. The cardiothoracic ratio determination unit 63 compares the calculated value of the cardiothoracic ratio (S / L) with a condition input in advance to determine the presence or absence of an abnormality in the heart 57 and the chest cage 59 of the subject M.

[0093] <Explanation of the image processing step> Here, a series of operations for performing image processing to evaluate the heart 57 and rib cage 59 of the subject M using the image processing apparatus 1A according to the second embodiment will be described with reference to the flowchart shown in FIG. 22. Note that, unlike the flowchart according to the first embodiment shown in FIG. 4, in the second embodiment, the steps of generating the vertebral body image 45 and the determination image 47 are omitted. That is, in the second embodiment, image processing is performed along the steps from step S201 to step S205.

[0094] Step S201 (Acquisition of X-ray image) When the operation of the image processing apparatus 1A is started, first, the operator activates the analysis software 16 on the terminal of the image processing apparatus 1. Then, the image acquisition unit 3 acquires the X-ray image 10 of the subject M from the image server 102 or the like. In the second embodiment, the operator uses the search function in the analysis software 16 to acquire the image file of the X-ray image 10 stored in the image server 102. That is, as shown in FIG. 23, the operator activates the analysis software 16 to display the search window 71 on the display unit 9.

[0095] The search window 71 includes a search condition input area 72 and a search result display area 73. The search condition input area 72 is configured to be able to input conditions for searching the X-ray image 10. Examples of the search conditions include the name of the patient who is the subject of the X-ray image 10, the date of shooting of the X-ray image 10, and the like. The search result display area 73 displays a list of information regarding the X-ray image 10 that corresponds to the search conditions input in the search condition input area. Note that in the search result display area 73, the information of the identification information 11 associated with the first image file 85 of the X-ray image 10 is displayed as character information in a list.

[0096] After the operator displays the search window 71 on the display unit 9, the operator operates the input unit 8 to input a predetermined search condition into the search condition input area 72. In FIG. 23, an X-ray image 10 whose patient name, which is the object to be photographed, is "Saburo Shimazu" is input as the search condition. By inputting the search condition, information of the identification information 11 associated with the first image file 85 of the X-ray image 10 corresponding to the search condition is displayed in a list in the search result display area 73. In FIG. 23, six X-ray images 10 correspond to the search condition, and six pieces of identification information 11 associated with the first image files 85 of the X-ray images 10 are displayed in the search result display area 73.

[0097] In the second embodiment, the identification information 11 shall include information of "patient name", "date of shooting", "date and time of shooting", "type (shooting part)", and "image ID". Each of the six pieces of identification information 11 is distinguished as identification information 11a to 11f. Also, for the six X-ray images 10, the X-ray image 10 associated with the identification information 11a is referred to as the X-ray image 10a. Hereinafter, the X-ray images 10 associated with the respective identification information 11b to 11f are referred to as X-ray images 10b to 10f.

[0098] The operator checks the identification information 11a to 11f displayed in the search result display area 73 and performs an operation of selecting the X-ray image 10 to be analyzed. As an example of the selection operation, as shown in FIG. 23, the operation is executed by performing a double-click operation with the cursor CS aligned with the area where the identification information 11 related to the X-ray image 10 to be selected is displayed. In the second embodiment, it is assumed that the X-ray image 10f is the object to be analyzed. That is, the operator moves the cursor CS to the area where the identification information 11f is displayed and performs a double-click operation.

[0099] When the selection operation is executed, the image acquisition unit 3 identifies the first image file 85 of the target X-ray image 10. That is, the image acquisition unit 3 determines that the X-ray image 10f associated with the identification information 11f is the analysis target. The image acquisition unit 3 acquires the first image file 85 of the X-ray image 10f specified as the analysis target from the image server 102. The X-ray image 10 corresponding to the acquired first image file 85, that is, the X-ray image 10f, is displayed on the display unit 9.

[0100] In the second embodiment, as shown in FIG. 24, the X-ray image 10f is an image obtained by photographing the chest of the subject M from the front. That is, the heart 57 is shown together with the rib cage 59 in the X-ray image 10f. When the first image file 85 of the X-ray image 10 that is the analysis target is acquired, step S201 ends.

[0101] Step S202 (Display of position markers) After acquiring the X-ray image 10 that is the analysis target, in the second embodiment, image processing for displaying the position markers 69 on the X-ray image 10 is performed. The position marker display unit 29 displays each of the position markers 69A to 69D at a predetermined position in the X-ray image 10f. FIG. 25 shows the position markers 69A to 69D displayed on the X-ray image 10f by the position marker display unit 29.

[0102] The initial positions of the position markers 69A to 69B shown in FIG. 25 are preferably positions that do not overlap the heart 57. Since the range in which the heart 57 is generally displayed in the chest X-ray image can be predicted, an area outside the range in the x direction can be set as the initial positions of the position markers 69A to 69B. That is, as an example, the initial position of the position marker 69A is preferably a position on the x1 direction side of the range where the heart 57 is expected to be displayed in the X-ray image 10f.

[0103] Also, the initial positions of the position markers 69C to 69D shown in FIG. 25 are preferably positions that do not overlap with the rib cage 59. Since the range in which the rib cage 59 is generally displayed in the chest X-ray image can be predicted, the initial positions of the position markers 69C to 69D can be set as regions outside the rib cage 59 in the x direction. As an example, the initial position of the position marker 69D is preferably a position on the x2 direction side of the range where the rib cage 59 is expected to be displayed in the X-ray image 10f. By determining the initial positions of the position markers 69A to 69D in advance in this way, the operator can quickly grasp the positions of the position markers 69A to 69D, so that the operation of changing the positions of the position markers 69A to 69D to the target site can be executed more easily. In the second embodiment, each of the position markers 69 is displayed as a thin linear symbol extending in the y direction. When the position markers 69 are displayed on the X-ray image 10, step S202 ends.

[0104] Step S203 (Display of operation markers) When each of the position markers 69 is displayed on the X-ray image 10, the operation marker 75 is displayed on the X-ray image 10 in step S203. The operation marker display unit 31 displays the operation markers 75 corresponding to each of the position markers 69 on the X-ray image 10f. In the second embodiment, for the operation markers 75 corresponding to each of the position markers 69A to 69D, reference numerals 75A to 75D are respectively attached to distinguish each of them. That is, among the four operation markers 75, the operation marker 75A corresponds to the position marker 69A. The operation marker 75B is the operation marker corresponding to the position marker 69B. The operation markers 75C and 75D correspond to the position markers 69C and 69D, respectively. FIG. 26 shows the operation markers 75A to 75D displayed on the X-ray image 10f by the operation marker display unit 31.

[0105] Each of the operation marks 75 is displayed as a symbol including, as an example, a linear region St extending in the y direction and a circular region Cr disposed at one end of the linear region St. The linear region St constituting the operation mark 75 is wider than the straight line constituting the position mark 69. Also, the circular region Cr constituting the operation mark 75 is displayed as a symbol having a circular shape wider than the linear region St.

[0106] The initial position of each of the operation marks 75 shown in FIG. 26 is a position different from both the corresponding position mark 69 and the organ that is the determination target. That is, the operation mark 75A is displayed at a position different from both the position mark 69A and the heart 57. The operation mark 75C is displayed at a position different from both the position mark 69C and the rib cage 59.

[0107] In step S203, the position where the operation mark display unit 31 displays each of the operation marks 75 is set according to the initial position of the corresponding position mark 69. That is, the position of the operation mark 75A is set according to the position of the position mark 69A, and the position of the operation mark 75B is set according to the position of the position mark 69B. As an example, the initial position of the operation mark 75 is set to face the center Ce of the X-ray image 10f across the corresponding position mark 69 and have a distance of a predetermined value d2 from the corresponding position mark 69, as shown in FIG. 27. That is, the initial position of the operation mark 75A is a position facing the center Ce across the position mark 69A and having a distance of d2 from the position mark 69A. In other words, the initial position of the operation mark 75A is a position separated from the initial position of the position mark 69A by a predetermined value d2 in the x1 direction. The initial position of the operation mark 75B is a position separated from the initial position of the position mark 69B by a predetermined value d2 in the x2 direction. In FIG. 27, descriptions such as the heart 57 and the rib cage 59 are omitted for convenience of explanation. Step S203 ends when each of the operation marks 75 is displayed on the X-ray image 10 by the operation mark display unit 31.

[0108] Step S204 (Modification of Position Mark) After displaying the operation target marker 75 on the X-ray image 10, the position of the position marker 69 is corrected using the operation target marker 75. Each of the displayed position markers 69 in the position marker display unit 29 is deviated from the position of the target site in the heart 57 and the rib cage 59. Therefore, the operator visually corrects the position of the position marker 69.

[0109] When correcting the position of the position marker 69, the operator performs an operation to change the position of the operation target marker 75 corresponding to the position marker 69 to be corrected. That is, when correcting the position of the position marker 69A, an operation to change the position of the operation target marker 75A is performed. When changing the position of the operation target marker 75A, as shown in FIG. 28, the operator operates the input unit 8 to align the cursor CS displayed on the display unit 9 with the circular region Cr of the operation target marker 75A. Then, by a drag-and-drop operation, the operator inputs an instruction to move the operation target marker 75A. The instruction of the operator input using the input unit 8 is received by the input reception unit 25.

[0110] The input reception unit 25 transmits the content of the received instruction, that is, an instruction to move the operation target marker 75A, to the operation target marker change unit 32. The operation target marker change unit 32 changes the position of the operation target marker 75A in the X-ray image 10f according to the content of the instruction received by the input reception unit 25. As a result, as shown in FIG. 29, the operation target marker 75A moves from the initial position indicated by the dotted line to the position indicated by the solid line. In the present embodiment, as shown in FIG. 29, the operator moves the operation target marker 75A in the x2 direction so that the moving distance becomes G1.

[0111] Here, the content of the instruction of the operator input to the input unit 8 is also transmitted to the position marker change unit 33 via the input reception unit 25. The position marker change unit 33 changes the position of the position marker 69A corresponding to the operation target marker 75A according to the content of the instruction of the operator received by the input reception unit 25. As a result, as shown in FIG. 29, the position marker 69A moves in the x2 direction by the distance G1 in the same manner as the operation target marker 75A.

[0112] The operation of the position identification changing unit 33 is performed immediately after the operation of the operation identification changing unit 32. That is, the operator can confirm that the position of the position identification 69A is changed almost simultaneously by operating to move the operation identification 75A. And the movement vectors of the operation identification 75A and the position identification 69A are the same. Therefore, the operator can accurately and easily grasp the direction and distance for moving the operation identification 75A necessary to align the position identification 69A with the left end portion 64a of the heart 57.

[0113] The operator performs an operation to appropriately change the position of the operation identification 75A using the input unit 8, thereby correcting the position of the position identification 69A and aligning the position identification 69A with the left end portion 64a of the heart 57. FIG. 29 shows a state where the position identification 69A moves according to the same movement vector as the operation identification 75A and coincides with the position of the left end portion 64a of the heart 57.

[0114] After correcting the position of the position identification 69A, the operator corrects the positions of the position identifications 69B to 69D in the same procedure. That is, by aligning the cursor CS with the circular region Cr of the operation identification 75B and performing a drag-and-drop operation, the position of the position identification 69B is changed. At this time, the movement vector of the operation identification 75B is reflected in the movement direction and movement distance of the position identification 69B. Therefore, the position of the position identification 69B is accurately corrected to the position of the right end portion 64b of the heart 57. Also, the operator executes an operation to change the position of the operation identification 75C to align the position of the position identification 69C with the position of the left end portion 65a of the rib cage 59. And the operator executes an operation to change the position of the operation identification 75D to align the position of the position identification 69D with the position of the right end portion 65b of the rib cage 59.

[0115] By aligning each of the position identifications 69 serving as measurement points with the target site of the heart 57 or the target site of the rib cage 59, the cardiothoracic ratio can be accurately measured. FIG. 30 shows a state where the correction for aligning each of the position identifications 69 with the target site is completed by performing an operation to move each of the operation identifications 75.

[0116] Since each of the operation indicators 75 is shown as a symbol having a size larger than that of the position indicator 69, it becomes easier for the operator to align the position of the cursor CS with the operation indicator 75 and to move the operation indicator 75. In particular, when the operation indicator 75 includes a straight region St and a circular region Cr wider than the straight region St, and a drag-and-drop operation is performed with the cursor CS aligned with the circular region Cr, even when the operation indicator 75 is linear as a whole, it becomes easier to move the operation indicator 75. That is, compared with the operation of aligning the cursor CS with the narrow linear region St, the operation of aligning the cursor CS with the wide circular region Cr is easier. Therefore, even when the operation indicator 75 is linear as a whole, the time required for the moving operation of the operation indicator 75 can be significantly shortened. Accordingly, the accuracy and operability of the operation of moving the position indicator 69 together with the operation indicator 75 can be improved.

[0117] And the position indicator 69 to be matched with the target site is not an object directly operated by the operator. Therefore, even when the size of the position indicator 69 is reduced, it is possible to avoid a decrease in the operability of the operation of moving the position of the position indicator 69. That is, by making the size of the position indicator 49 smaller than the size of the operation indicator 51, it is possible to avoid the position indicator 69 covering the target site of the heart 57 or the target site of the rib cage 59 and reducing the visibility, and to improve the operation of moving the position of the position indicator 69. The step S204 ends by correcting the position of each of the position indicators 69 by the operation of moving the operation indicator 75.

[0118] Step S7 (Determination of cardiothoracic ratio) After making corrections to match each of the position indicators 69 with the target site of the heart 57 or the target site of the rib cage 59, the operator operates the input unit 8 to input an instruction to perform the determination of the cardiothoracic ratio. The instruction to perform the determination of the cardiothoracic ratio is received by the input reception unit 25, and the input reception unit 25 causes the cardiothoracic ratio calculation unit 61 to start measurement based on the instruction.

[0119] The cardiothoracic ratio calculation unit 61 calculates the heart width S and the thoracic cage width L using each of the position markers 69 as a measurement reference. That is, the cardiothoracic ratio calculation unit 61 calculates the heart width S using the position marker 69A and the position marker 69B as measurement points (see Fig. 20). Then, the cardiothoracic ratio calculation unit 61 calculates the thoracic cage width L using the position marker 69C and the position marker 69D as measurement points. Then, the ratio of the heart width S to the thoracic cage width L is calculated as the cardiothoracic ratio (S / L). The information calculated by the cardiothoracic ratio calculation unit 61 is transmitted to the cardiothoracic ratio determination unit 63.

[0120] The cardiothoracic ratio determination unit 63 analyzes the transmitted numerical value of the cardiothoracic ratio (S / L) and determines the presence or absence of abnormalities in the heart 57 and the thoracic cage 59. The criteria for determining the presence or absence of abnormalities in the heart 57 and the thoracic cage 59 are input in advance by the input unit 8. As an example, when the cardiothoracic ratio (S / L) is 0.5 or more, it is determined that an abnormality such as cardiomegaly has occurred in the heart 57.

[0121] The cardiothoracic ratio determination unit 63 causes the display unit 9 to display, as a determination image 52, the numerical value of the cardiothoracic ratio (S / L) which is an evaluation parameter, and data indicating the presence or absence of abnormalities in the heart 57 and the thoracic cage 59. The evaluation image generation unit 39 generates an evaluation image 53 based on the evaluation results obtained for the heart 57 and the thoracic cage 59 and causes the display unit 9 to display it. The evaluation image 53 includes the X-ray image 10 on which the operation target marker 75 and the position marker 69 are displayed, the determination image 52 generated by the cardiothoracic ratio determination unit 63, and the like. The operator can grasp the states of the heart 57 and the thoracic cage 59 by checking the evaluation image 53. When the evaluation image 53 is generated, step S205 ends. Through the above steps, a series of operations using the image processing apparatus 1A are completed.

[0122] In this way, in the second embodiment, similar to the first embodiment, by performing an operation of selecting and moving the operation target marker 75, the position of the position marker 69 corresponding to the operation target marker 75 can be changed. Then, the size of the position marker 69 which is the measurement point is reduced while the size of the operation target marker 75 is made larger than that of the position marker 69. With such a configuration, while avoiding a decrease in the visibility of the organ or the target site due to the position marker 69, the operability of the operation for changing the position of the position marker 69 can be improved. In the first embodiment, a configuration for measuring the height of the vertebral body 40 was exemplified, and in the second embodiment, a configuration for measuring the cardiothoracic ratio was exemplified. However, the configuration of the present invention can also be applied to a configuration for performing arbitrary measurements on other organs. As an example, it can be applied to a configuration for measuring the Cobb angle of the spine for the purpose of diagnosing scoliosis. Third Embodiment

[0123] Next, the image processing apparatus 1B according to the third embodiment of the present invention will be described. FIG. 32 is a schematic diagram showing the configuration of the image processing apparatus 1B according to the third embodiment. Note that the same components as those of the image processing apparatus 1 according to the first embodiment are only given the same reference numerals, and different components will be described in detail. As an overview, in the third embodiment, the first image file 85 used for the analysis software 16 is acquired from the image server 102 using the thumbnail image 91 displayed in the reading using the reading software 18.

[0124] In the third embodiment, the organ to be analyzed is the vertebral body 40, similar to the first embodiment, and the image processing performed on the X-ray image 10 of the vertebral body 40 is also the same as that in the first embodiment. That is, in the third embodiment, image processing for determining the presence or absence of a fracture in the vertebral body using the QM method is performed. Therefore, the configuration of the image processing unit 5 according to the third embodiment is the same as that of the image processing unit 5 according to the first embodiment. However, there is a difference in the step of acquiring the image data of the X-ray image 10 which is the target for performing the image processing. Therefore, the configuration of the image acquisition unit 3B according to the third embodiment will be described in detail.

[0125] Here, when distinguishing the first image files 85 corresponding to each of the X-ray images 10a to 10f among the X-ray images 10, they are denoted as first image files 85a to 85f with symbols a to f. As an example, for the first image file 85 of the X-ray image 10c showing the vertebral body 40, it is denoted as the first image file 85c to distinguish it from the first image files 85 of the other X-ray images 10. Similarly, when distinguishing the second image files 95 corresponding to each of the X-ray images 10a to 10f among the JPEG format image files 95, they are denoted as second image files 95a to 95f. When distinguishing the identifiers 97 corresponding to each of the X-ray images 10a to 10f among the identifiers 97, they are denoted as identifiers 97a to 97f.

[0126] As an example, the first image file 85c of the X-ray image 10c showing the vertebral body 40 is stored in the image server 102 in a state where it is associated with the second image file 95c and the identifier 97c. The second image file 95c is a JPEG format image file generated from the first image file 85c. The identifier 97c is an identifier capable of identifying the second image file 95c. Similarly, the first image file 85b of the X-ray image 10b showing the subject's head is stored in the image server 102 in a state where it is associated with the second image file 95b and the identifier 97b.

[0127] As shown in FIG. 32, the image acquisition unit 3B according to the third embodiment includes a radiography file acquisition unit 74, an image selection reception unit 77, a selected image transmission unit 78, an image data identification unit 79, and an image data input unit 80. When the radiography software 18 is launched in the image processing apparatus 1B, the radiography file acquisition unit 74 acquires a second image file 95 and an identifier 97 associated with each of the second image files 95 from the image server 102. The radiography software 18 generates a thumbnail image 91 based on each of the second image files 95 acquired by the radiography file acquisition unit 74. The generated thumbnail image 91 is associated with the identifier 97. That is, the same content identifier 97 is associated with the second image file 95 and the thumbnail image 91 generated based on the second image file. Note that the radiography file acquisition unit 74 is also disposed in the image acquisition unit 3 according to the first embodiment and the image acquisition unit 3A according to the second embodiment.

[0128] The image selection reception unit 77 receives an operation of selecting a thumbnail image 91 in the radiography software 18, which is executed by the operator using the input unit 8. The identifier transmission unit 78 transmits data of the identifier 97 corresponding to the thumbnail image 91 selected by the operator in the radiography software 18 to the image server 102. The image data identification unit 79 searches the image server 102 and identifies the first image file 85 of the X-ray image 10 associated with the identifier 97 transmitted by the identifier transmission unit 78. The image data input unit 80 inputs the first image file 85 of the X-ray image 10 identified by the image data identification unit 79 into the analysis software 16 launched on the client terminal of the image processing apparatus 1. By the input operation of the image data input unit 80, the first image file 85 of the X-ray image 10 is acquired from the image server 102.

[0129] Here, the window 81 of the reading software 18 will be described. As shown in FIG. 33, the window 81 of the reading software 18 is provided with a thumbnail image display area 87 and a reading image display area 89. The thumbnail image display area 87 is an area where thumbnail images 91 are displayed. That is, the thumbnail images 91 corresponding to the JPEG format image files 95 are listed and displayed in the thumbnail image display area 87. The reading image display area 89 is an area where the reading image 93 is displayed. Among the thumbnail images 91 listed in the thumbnail image display area 87, the reading image 93 corresponding to the thumbnail image 91 selected by the operator is displayed in the reading image display area 89.

[0130] <Explanation of the image acquisition process> The outline of the operation of performing image processing for analyzing the vertebral body 40 of the subject M using the image processing apparatus 1B according to the third embodiment is the same as the flowchart of the first embodiment shown in FIG. 4. However, in the third embodiment, the details of the step of acquiring the X-ray image 10 according to step S1 are different from those of the first embodiment. FIG. 31 is a flowchart for explaining the details of step S1 according to the third embodiment. The image acquisition unit 3B according to the third embodiment acquires the image data of the X-ray image 10 that is the object of image processing by performing a series of steps from step S1A to step S1E. Hereinafter, the details of the steps of step S1 according to the third embodiment will be described along the flowchart shown in FIG. 31.

[0131] Step S1A (Activation of the reading software) When the operation of the image processing apparatus 1 is started, first, the operator activates the reading software 18 on the terminal of the image processing apparatus 1. When the reading software 18 is activated, the reading file acquisition unit 74 of the image acquisition unit 3B acquires a plurality of JPEG format image files 95 and the identifiers 97 associated with each of the image files 95 from the image server 102. Also, as shown in FIG. 33, when the reading software 18 is activated, the window 81 of the reading software 18 is opened on the display unit 9.

[0132] Based on the plurality of JPEG format image files 95 acquired by the image reading file acquisition unit 74, the image reading software 18 generates thumbnail images 91 corresponding to each of the image files 95. The display control unit 12 controls the display unit 9 to display a list of the plurality of thumbnail images 91 in the thumbnail image display area 87 of the window 81. FIG. 33 illustrates a case where the thumbnail image 91c and the thumbnail image 91f are displayed. The thumbnail image 91c is a thumbnail image 91 generated based on the image file 95c of the X-ray image 10c that shows the vertebral body 40. The image file 95c of the X-ray image 10c is a JPEG format image file 95 generated from the first image file 85c of the X-ray image 10c. The thumbnail image 91f is a thumbnail image 91 generated based on the image file 95f of the X-ray image 10f that shows the chest including the rib cage 59.

[0133] When the thumbnail image 91 is displayed in the window 81 of the image reading software 18, the operator selects the thumbnail image 91 to be read. That is, the operator performs an operation of selecting a thumbnail image to be read from among the plurality of thumbnail images 91 displayed in the thumbnail image display area 87. As an example of the operation of selecting the thumbnail image 91 as the object to be read, an operation of double-clicking with the cursor CS placed on the thumbnail image 91 can be mentioned. FIG. 34 illustrates an operation of selecting the thumbnail image 91c as the object to be read. That is, the operator places the cursor CS on the thumbnail image 91c and performs a double-click operation.

[0134] When an operation to select the thumbnail image 91 as the object to be read is executed, the image processing apparatus 1B transmits the identifier 97 associated with the selected thumbnail image 91 to the image server 102. The image server 102 identifies the first image file 85 of the X-ray image 10 corresponding to the received identifier 97, and transmits the identified first image file 85 to the image processing apparatus 1B. The reading software 18 generates a reading image 93 based on the first image file 85. The display control unit 12 causes the reading image 93 to be displayed in the reading image display area 89 in the window 81.

[0135] Specifically, when the thumbnail image 91c is selected as the object to be read, the image processing apparatus 1B transmits information on the identifier 97c associated with the thumbnail image 91c to the image server 102. The image server 102 identifies the first image file 85c of the X-ray image 10c as the first image file 85 associated with the identifier 97c from among the stored first image files 85 of the X-ray image 10. The image server 102 transmits the identified first image file 85c to the image processing apparatus 1B.

[0136] The reading software 18 generates a reading image 93, which is a reading X-ray image, based on the first image file 85c of the X-ray image 10c. The reading image 93 is displayed in the reading image display area 89 as shown in FIG. 34. The reading image 93 is image data that shows the vertebral body 40 in the same manner as the X-ray image 10c. The operator checks the reading image 93 displayed in the reading image display area 89 and performs various diagnoses. When the thumbnail image 91 is displayed in the window 81 of the reading software 18, step S1A ends.

[0137] Step S1B (Activation of analysis software) When the reading software 18 is launched and the thumbnail image 91 is displayed in the thumbnail display area 87, the operator launches the analysis software 16 on the terminal of the image processing apparatus 1. When the analysis software 16 is launched, as shown in FIG. 35, a window 83 of the analysis software 16 is further displayed on the display unit 9. By displaying the window 83 on the display unit 9, step S1B ends.

[0138] Step S1C (Selection of X-ray image) When the window 83 of the analysis software 16 is displayed on the display unit 9, an operation is performed to specify the X-ray image 10 to be analyzed by image processing using the image processing unit 5. In the third embodiment, the X-ray image 10 to be analyzed is specified by selecting the thumbnail image 91 of the X-ray image 10 to be analyzed. That is, the operator selects one thumbnail image 91 to be analyzed from among the plurality of thumbnail images 91 displayed in the thumbnail display area 87. The operation of selecting the thumbnail image 91 to be analyzed is different from the operation of selecting the thumbnail image 91 to be read. As an example of the operation of selecting the thumbnail image 91 to be analyzed, an operation of inputting the thumbnail image 91 into the window 83 by a drag-and-drop operation can be cited.

[0139] FIGS. 36 and 37 show the operations in the case of specifying the X-ray image 10c showing the vertebral body 40 as the analysis target. When specifying the X-ray image 10c as the analysis target, an operation of selecting the thumbnail image 91c of the X-ray image 10c is performed. First, as shown in FIG. 36, the cursor CS is placed on the thumbnail image 91c among the thumbnail images 91 displayed in the thumbnail display area 87. After the cursor CS is placed on the thumbnail image 91c, as shown in FIG. 37, the thumbnail image 91c is input into the window 83 of the analysis software 16 by a drag-and-drop operation. FIG. 37 shows a state where the icon SP of the thumbnail image 91c is being moved to the window 83 by a drag-and-drop operation.

[0140] Step S1D (Transmission of Identifier) When the thumbnail image 91 to be selected is input into the window 83 of the analysis software 16, the identifier 97 corresponding to the thumbnail image 91 is transmitted from the image processing apparatus 1B to the image server 102. Specifically, the operation of selecting the thumbnail image 91c and inputting it into the window 83 is received by the image selection reception unit 77. In other words, the operation of specifying the X-ray image 10 to be analyzed is received by the image selection reception unit 77.

[0141] When the image selection reception unit 77 receives an operation of selecting the thumbnail image 91 of the X-ray image 10 to be analyzed, the image selection reception unit 77 transmits information on the identifier 97 associated with the thumbnail image 91 that is the target of the selection operation to the identifier transmission unit 78. The identifier transmission unit 78 transmits the received information on the identifier 97 to the image server 102.

[0142] Similar to the JPEG format image file 95c, an identifier 97c is associated with the thumbnail image 91c. When the thumbnail image 91c is input into the window 83 as shown in FIG. 37, the image selection reception unit 77 transmits information on the identifier 97c to the identifier transmission unit 78. The identifier transmission unit 78 transmits the information on the identifier 97c to the image server 102.

[0143] Step S1E (Specification of Image Data) When the identifier 97 is sent to the image server 102, the image data specifying unit 79 specifies the first image file 85 of the X-ray image 10 to be acquired from among the data group stored in the image server 102. That is, when the identifier transmission unit 78 transmits the information of the identifier 97c to the image server 102, the image data specifying unit 79 searches for the first image file 85 of the X-ray image 10 using the data of the identifier 97c transmitted by the identifier transmission unit 78 as a clue. Then, the image data of the X-ray image 10 associated with the transmitted identifier 97c is specified. Among the first image files 85 of the X-ray image 10 stored in the image server 102, the one associated with the identifier 97c is the first image file 85c of the X-ray image 10c. Therefore, when the identifier 97c is sent to the image server 102, the image data specifying unit 79 specifies the first image file 85c of the X-ray image 10c as the acquisition target (see reference symbol KB in FIG. 37).

[0144] Step S1F (Input of Image Data) When the image data specifying unit 79 specifies the first image file 85 of the X-ray image 10 to be acquired from among the data stored in the image server 102, the image data input unit 80 causes the specified first image file 85 of the X-ray image 10 to be input to the analysis software 16. That is, the image data input unit 80 in the image acquisition unit 3B acquires the first image file 85c of the X-ray image 10c specified by the image data specifying unit 79 (see reference symbol KC in FIG. 37).

[0145] The image data input unit 80 inputs the first image file 85c of the X-ray image 10c acquired from the image server 102 to the analysis software 16. By this input operation, as shown in FIG. 38, the X-ray image 10c is displayed in the window 83 of the analysis software 16 as an analysis image. The operator can execute the image processing operations related to steps S2 and subsequent steps on the X-ray image 10c by operating the input unit 8 and the like. When the steps from S1A to S1E are executed, step S1 according to the third embodiment is completed. After the completion of step S1, step S2 is started.

[0146] Regarding the steps after step S2 according to the third embodiment, they are common to the steps after step S2 according to the first embodiment shown in FIG. 4. That is, a vertebral body image 45 is generated based on the first image file 85c of the X-ray image 10c obtained in step S1 (step S2). Then, a determination image 47 is generated using the vertebral body image 45 (step S3). A position marker 49 and an operation marker 51 are displayed on the determination image 47 (steps S4, S5). The operator corrects the position of the position marker 49 in the determination image 47 by performing an operation of moving the operation marker 51 (step S6). The vertebral body 40 is determined by measuring the height of the vertebral body 40 based on the position marker 49 whose position has been corrected to match the target site (step S7).

[0147] In the image processing apparatus 1B according to the third embodiment, similar to the first embodiment and the like, by selecting and moving the operation marker 51, the position of the position marker 49 corresponding to the operation marker 51 can be changed. Then, the size of the position marker 49 which is the measurement point is reduced and the size of the operation marker 51 is made larger than that of the position marker 49. With such a configuration, it is possible to improve the operability of the operation for changing the position of the position marker 49 while avoiding a decrease in the visibility of the organ or the target site due to the position marker 49.

[0148] And in the third embodiment, the step of obtaining the first image file 85 of the X-ray image 10, which is a file format capable of executing the image processing necessary for analyzing the organ, can be performed more simply. That is, in the third embodiment, the first image file 85 of the X-ray image 10 used for the analysis software 16 is obtained from the image server 102 using the thumbnail image 91 of the X-ray image 10 displayed in the reading using the reading software 18.

[0149] When an operator, taking a doctor as an example, visually diagnoses an X-ray image 10 using the radiography software 18, there may be a case where it is determined that image processing for analyzing the size of the organ shown in the X-ray image 10 is necessary. In this case, the analysis software 16 needs to acquire the first image file 85 of the X-ray image 10 that is the target of the image processing.

[0150] As methods for newly acquiring the first image file 85 of the X-ray image 10, mainly two methods have been conventionally used. As the first method, there is a method as shown in the first embodiment. In the first method, after starting the analysis software 16 on the terminal of the image processing apparatus 1, the image processing apparatus 1 receives all of the first image files 85 of the X-ray image 10 stored in the image server 102. And after the image processing apparatus 1 has received all of the first image files 85, one of the first image files 85 is selected as the analysis target from among the numerous first image files 85. However, the first image file 85 of the X-ray image 10 is in the DICOM format with a large capacity. Therefore, it takes a very long time for the image processing apparatus 1 to receive all of the first image files 85. Thus, it is not practical to acquire the first image file 85 of the X-ray image 10 to be analyzed using the first method.

[0151] Next, as the second conventional method, there is a method as shown in the second embodiment. That is, after starting the analysis software 16 on the terminal of the image processing apparatus 1, the first image file 85 of the X-ray image 10 is directly acquired from the image server 102 by using the search function of the analysis software 16. In the second method, since there is no need to newly copy the first image file 85 of the X-ray image 10 to the terminal of the image processing apparatus 1, it is possible to avoid the lengthening of the required time due to the operation of copying the image data.

[0152] However, with the second method, new problems arising from using the search function are a concern. That is, when searching for the first image file 85 of the X-ray image 10 stored in the image server 102, the searchable information is limited. That is, as shown in FIG. 23, only the character information of the identification information 11 associated with the X-ray image 10 is displayed in the search window 71. That is, since the image server 102 stores a vast amount of data, it is extremely difficult to display the thumbnail image of the X-ray image 10 in the search window 71.

[0153] Therefore, the operator cannot search for the first image file 85 of the X-ray image 10 using image information such as a thumbnail image as a clue, and needs to search for the first image file 85 of the X-ray image 10 using limited character information such as the patient name or the imaging date as a clue. As a result, especially when a plurality of X-ray images 10 are taken of the same patient (subject M) on the same day, there is a concern that an image file different from the first image file 85 of the target X-ray image 10 may be erroneously acquired.

[0154] As a specific example of the problem, as shown in FIG. 23, a case where the X-ray images 10c, 10d, and 10e are images taken of the same patient on the same day is cited. In this case, the character information of the identification information 11c, 11d, and 11e associated with each of the X-ray images 10c, 10d, and 10e is displayed in the search window 71. The operator needs to visually recognize the character information of these three pieces of identification information 11c to 11e and accurately select the identification information 11c associated with the target X-ray image 10c.

[0155] However, the clues that an operator generally uses to distinguish the X-ray image 10 are information such as the patient name and the imaging date, and the patient name and the imaging date are the same in the identification information 11c to 11e. Therefore, it is difficult for the operator to accurately select the target identification information 11c even by visually recognizing the character information of the identification information 11c to 11e. Since different image IDs are assigned to each of the X-ray images 10, the image ID information in the identification information 11c to 11e is different. However, even if the operator visually recognizes the character information of the image ID in the identification information 11, it is difficult to determine what kind of image data the X-ray image 10 associated with the identification information 11 is. Therefore, for the purpose of acquiring the first image file 85c of the X-ray image 10c, as a result of executing the acquisition method by the conventional second method, there is a case where the first image file 85d of the X-ray image 10d different from the target is erroneously acquired.

[0156] For such a conventional image data acquisition method, the image acquisition unit 3B according to the third embodiment includes an image selection reception unit 77, an identifier transmission unit 78, an image data specifying unit 79, and an image data input unit 80. In the third embodiment, when specifying the analysis target by the analysis software 16, the thumbnail image 91 displayed on the reading software 18 is used as visual information. By using the thumbnail image 91 as visual information and specifying the analysis target by the analysis software 16, the X-ray image 10 that is the analysis target can be accurately selected.

[0157] <Effects of the Configuration of the Embodiment> (1) The image processing apparatus 1 according to this embodiment includes an image acquisition unit 3 that acquires an X-ray image 10 showing an organ of a subject M, and an image processing unit 5 that processes the X-ray image 10 acquired by the image acquisition unit 3. The image processing unit 3 includes a position marker display unit 29 that causes a position marker 49 indicating a predetermined position in the organ of the subject M to be displayed on the X-ray image 10, an operation marker display unit 31 that causes an operation marker 51 corresponding to the position marker 49 to be displayed in a region of the X-ray image 10 that does not overlap with either the position marker 49 or the organ, an input reception unit 25 that receives a marker movement operation by an operator to move the position of the operation marker 51 in the X-ray image 10, and a position marker change unit 33 that changes the position at which the position marker 49 corresponding to the operation marker 51 is displayed on the X-ray image 10 so as to reflect the marker movement operation received by the input reception unit 25.

[0158] According to the image processing apparatus described in (1), by having the position marker display unit 29 and the operation marker display unit 31, the position marker 49 and the operation marker 51 are displayed on the X-ray image 10 showing the organ of the subject M. The position marker 49 indicates a site of interest in the organ of the subject M. The operation marker 51 corresponds to the position marker 49. The position at which the operation marker 51 is displayed in the X-ray image 10 is set to be a region that does not overlap with either the position marker 49 or the organ. When the operator performs a marker movement operation to move the operation marker 51 displayed on the X-ray image 10, the position marker change unit 33 changes the position at which the position marker 49 corresponding to the operation marker 51 is displayed on the X-ray image 10 so as to reflect the marker movement operation.

[0159] With such a configuration, when the operator performs a marker movement operation to move the operation marker 51 corresponding to the position marker 49, the position where the position marker is displayed on the radiation image is changed. Therefore, there is no need to perform an operation of directly selecting and moving the position marker using a cursor or the like. And since the operation marker is displayed in an area that does not overlap with either the organ or the position marker, even when the size of the operation marker is increased to improve the operability such as a drag-and-drop operation, it is possible to avoid a decrease in the visibility of the organ and the position marker. Accordingly, even when the size of the position marker is reduced, it is possible to avoid a reduction in the operability of the operation for changing the position of the position marker. That is, it is possible to avoid a decrease in the visibility of the organ due to the position marker while improving the operability of the operation for changing the position of the position marker.

[0160] (Item 2) Further, in the image processing apparatus according to Item 1, the position marker display unit 29 displays a plurality of position markers 49 at a plurality of corresponding predetermined positions, and the operation marker display unit 31 displays a plurality of operation markers 51 corresponding to each of the plurality of position markers 49 at positions corresponding to the positional relationship of the plurality of position markers 49 displayed on the X-ray image 10.

[0161] According to the image processing apparatus described in Item 2, the plurality of position markers 49 are respectively displayed at a plurality of corresponding predetermined positions in the X-ray image 10. The operation marker display unit 31 displays a plurality of operation markers 51 corresponding to each of the plurality of position markers 49 on the X-ray image 10. The position where the operation marker display unit 31 displays each of the plurality of operation markers 51 is a position corresponding to the positional relationship of the plurality of position markers 49. In this case, the relationship between the positions where the plurality of position markers 49 are displayed and the positions where the plurality of operation markers 51 are displayed is similar. Therefore, even when the plurality of position markers 49 and the plurality of operation markers 51 are displayed on the X-ray image 10, the operator can easily determine which of the plurality of operation markers 51 is the operation marker 51 corresponding to one position marker 49. As a result, the process of changing the position of the position marker 49 by the operation of moving the operation marker 51 can be executed quickly and accurately.

[0162] (3) In the image processing apparatus according to claim 1, the image processing unit 5 includes a determination image generation unit 27 that causes an organ to be displayed at the center of the determination image 47, and the operation target display unit 31 is configured to set the position at which each of the operation targets 51 corresponding to the position target 49 is displayed on the determination image 47 according to the distance and direction from the center of the determination image 47 to the position target 49.

[0163] According to the image processing apparatus described in claim 3, the image processing unit 5 includes a determination image generation unit 27 that causes an organ to be displayed at the center of the determination image 47. The position at which the operation target 51 is displayed on the determination image 47 is set according to the distance and direction from the center of the determination image 47 to the position target 49. In this case, the positional relationship between the operation target 51 displayed on the determination image 47 and the position target 49 corresponding to the operation target 51 can be easily determined. Further, since the organ is displayed at the center of the determination image 47, the position at which the operation target 51 is displayed can be surely set to a position different from the organ. Therefore, it is also possible to avoid a decrease in the visibility of the organ due to the operation target 51.

[0164] (Item 4) Further, in the image processing apparatus according to Item 1, the organ is the vertebral body 40, and the position markers 49 include a position marker 49A indicating the upper edge portion 42a at the front end of the vertebral body 40, a position marker 49B indicating the lower edge portion 42b at the front end of the vertebral body 40, a position marker 49C indicating the upper edge portion 43a at the center of the vertebral body 40, a position marker 49D indicating the lower edge portion 43b at the center of the vertebral body 40, a position marker 49E indicating the upper edge portion 44a at the rear end of the vertebral body 40, and a position marker 49F indicating the lower edge portion 44b at the rear end of the vertebral body 40. A vertebral height calculation unit 35 calculates the height A of the front end portion of the vertebral body 40 based on the distance between the position marker 49A and the position marker 49B, calculates the height C of the central portion of the vertebral body 40 based on the distance between the position marker 49C and the position marker 49D, and calculates the height P of the rear end portion of the vertebral body 40 based on the distance between the position marker 49E and the position marker 49F. A vertebral determination unit 37 determines the presence or absence of a fracture in the vertebral body 40 based on at least one parameter among the ratio of the height C of the central portion to the height A of the front end portion, the ratio of the height C of the central portion to the height P of the rear end portion, and the ratio of the height P of the rear end portion to the height A of the front end portion.

[0165] According to the image processing apparatus described in Item 4, the height A of the front end portion of the vertebral body 40 is calculated based on the distance between the position marker 49A indicating the upper edge portion 42a at the front end of the vertebral body 40 and the position marker 49B indicating the lower edge portion 42b at the front end of the vertebral body 40. Since the position markers 49A and 49B can be accurately and quickly positioned by an operation of moving the corresponding operation markers 51A and 51B, the height A of the front end portion can be accurately and quickly measured. Similarly, the height C of the central portion and the height P of the rear end portion can also be accurately and quickly measured, so that the time required for the process of determining the presence or absence of a fracture in the vertebral body 40 can be shortened and the accuracy of the determination can be improved.

[0166] (5) Further, in the image processing apparatus according to claim 1, the organs are the heart 57 and the rib cage 59, and the position markers 49 include a position marker 69A indicating the left end 64a of the heart 57, a position marker 69B indicating the right end 64b of the heart 57, a position marker 69C indicating the left end 65a of the rib cage 59, and a position marker 69D indicating the right end 65b of the rib cage 59. A cardiothoracic ratio calculation unit 61 is provided that calculates the cardiothoracic ratio (S / L) based on the distance S between the position marker 69A and the position marker 69B, and the distance L between the position marker 69C and the position marker 69D.

[0167] According to the image processing apparatus described in claim 5, the cardiothoracic ratio calculation unit 61 calculates the distance S between the position marker 69A indicating the left end 64a of the heart 57 and the position marker 69B indicating the right end 64b of the heart 57. The cardiothoracic ratio calculation unit 61 calculates the distance L between the position marker 69C indicating the left end 65a of the rib cage 59 and the position marker 69D indicating the right end 65b of the rib cage 59. Then, the cardiothoracic ratio calculation unit 61 calculates the cardiothoracic ratio (S / L) based on the distance S and the distance L. The position markers 69A, 69B, 69C, and 69D can have their positions accurately and quickly corrected by an operation of moving the corresponding operation markers 75. Therefore, the distances S and L can be measured quickly and accurately. Accordingly, the time required for the step of determining the cardiothoracic ratio can be shortened, and the accuracy of the determination can be improved.

[0168] (6) The image processing method according to this embodiment further includes the image processing apparatus 1 described in any one of claims 1 to 5, a first image file 85 of the X-ray image 10, a second image file 95 of the X-ray image which is generated based on the first image file 85 and has a file format with a smaller capacity than the first image file 85, and an image server 102 that stores the second image file 95 and an identifier 97 that can identify the second image file 95 in association with each other. The image processing method uses the following steps: a first activation step of activating, on the terminal of the image processing apparatus 1, the reading software 18 capable of displaying the thumbnail image 91 of the X-ray image 10; a first acquisition step of acquiring a plurality of the second image files 95 and the identifiers 97 from the image server 102; a thumbnail image generation step of generating the thumbnail image 91 of the X-ray image based on the second image file 95 and associating the generated thumbnail image 91 with the identifier 97; a thumbnail display step of displaying, on the reading software 18, the plurality of thumbnail images 91 of the X-ray images generated for each of the plurality of second image files 95; a second activation step of activating, on the terminal of the image processing apparatus 1, the analysis software 16 capable of performing image processing for changing the position of the position marker 49 using the position marker changing unit 33 on the first image file 85; a selection step of selecting one of the plurality of thumbnail images 97 displayed on the reading software 18; a transmission step of transmitting the identifier 97 associated with the thumbnail image 91 selected in the selection step to the image server 102; a specifying step of specifying, from the plurality of first image files 85 stored in the image server 102, the first image file 85 associated with the identifier 97 transmitted to the image server 102 in the transmission step; a second acquisition step of transmitting the first image file 85 specified in the specifying step from the image server 102 to the terminal of the image processing apparatus 1 to acquire the first image file 85; and an image processing step of performing image processing using the position marker display unit 29, the operation marker display unit 31, the input reception unit 25, and the position marker changing unit 33 on the first image file 85 of the X-ray image acquired in the second acquisition step.

[0169] According to the image processing method described in claim 6, when performing image processing on the first image file 85 of the X-ray image 10 using the analysis software 16, the reading software 18 is used when acquiring the first image file 85 from the image server 102. That is, the reading software 18 is launched on the terminal of the image processing apparatus 1, and a plurality of second image files 95 and identifiers 97 are acquired from the image server 102. Since the image server 102 stores the first image file 85, the second image file 95, and the identifier 97 of the X-ray image 10 in an associated state, the second image file can be acquired together with the identifier 97 associated with the second image file 95. In the thumbnail image generation step, a thumbnail image 91 of the X-ray image 10 is generated based on the second image file 95. Similar to the second image file 95, an identifier 97 is associated with the thumbnail image 91. The thumbnail image generation step is executed for a plurality of second image files 95, and a plurality of thumbnail images 91 are generated. The generated thumbnail images 91 are displayed on the reading software 18.

[0170] After the thumbnail image 91 is displayed on the reading software 18, the analysis software 16 is launched on the terminal of the image processing apparatus 1. Then, a thumbnail image 97 of the X-ray image 10 to be subjected to image processing is selected from the plurality of thumbnail images 97 displayed on the reading software 18. The identifier 97 associated with the selected thumbnail image 91 is transmitted to the image server 102. In the identification step, the first image file 85 associated with the identifier 97 transmitted to the image server 102 is identified from among the plurality of first image files 85 stored in the image server 102. By performing a search based on the identifier 97, the first image file 85 of the X-ray image 10 to be subjected to image processing can be accurately identified from among the plurality of first image files 85 stored in the image server 102.

[0171] By transmitting the first image file 85 specified in a specific step from the image server 102 to the terminal of the image processing apparatus 1, the first image file 85 of the X-ray image 10 to be the object of image processing is acquired. Image processing using the analysis software 16 is performed on the acquired first image file 85 of the X-ray image. That is, image processing using the position marker display unit 29, the operation marker display unit 31, the input reception unit 25, and the position marker change unit 33 is performed on the first image file 85. In such a configuration, when specifying the X-ray image 10 that is the object of the image processing using the analysis software 16, the thumbnail image 91 displayed on the reading software 18 is used as visual information. By using the thumbnail image 91 as visual information and specifying the object of the image processing by the analysis software 16, the target X-ray image 10 can be accurately selected.

[0172] <Other embodiments> Note that the embodiments disclosed this time are illustrative in all respects and not restrictive. The scope of the present invention includes the claims and all modifications within the meaning and scope equivalent to the claims. As an example, the present invention can be implemented in the following modified forms.

[0173] (1) In the image processing apparatus described above, although the case where the organ to be the object of analysis or evaluation by image processing is the vertebral body 40, the heart 57, or the rib cage 59 has been described as an example, the target organ is not limited to these. That is, the image processing apparatus according to the present embodiment can be applied to the case where image processing is performed on an arbitrary organ for analysis. Also, the attention sites of the vertebral body 40 are not limited to the upper edge portion 42a and the lower edge portion 42b at the front end, and other sites may be used as the attention sites.

[0174] (2) In the above-described image processing apparatus, after generating the X-ray image 10 that shows the vertebral body 40, the vertebral body image 45 and the determination image 47 are generated, and the configuration in which the position marker 49 and the operation marker 51 are displayed on the determination image 47 has been described as an example, but it is not limited to this. The position marker display unit 29 and the operation marker display unit 31 may display the position marker 49 and the operation marker 51 on the X-ray image 10 that shows the vertebral body 40. In such a configuration, the first learned model 13, the vertebral body image generation unit 23, the determination image generation unit 27, etc. can be omitted.

[0175] (3) In the above-described image processing apparatus, the configuration including the evaluation image generation unit 39 and generating the evaluation image 53 has been described as an example, but it is not necessary to generate the evaluation image 53. When the evaluation image 53 is not generated, the evaluation image generation unit 39 can be omitted. Also, even when the evaluation image 53 is generated, the information to be displayed on the evaluation image 53 is not limited to the content described in each embodiment and may be appropriately changed.

Explanation of Reference Numerals

[0176] 1... Image processing apparatus 3... Image acquisition unit 5... Image processing unit 7... Storage unit 8... Input unit 9... Display unit 10... X-ray image 11... Identification information 13... First learned model 14... Second learned model 15... Top plate 16... Analysis software 17... X-ray tube 18... Reading software 19... X-ray detector 21... X-ray image generation unit 23... Vertebral body image generation unit 25... Input reception unit 27... Determination image generation unit 29... Position marker display unit 31... Operation marker display unit 32... Operation marker change unit 33 … Position identification change section 35 … Vertebral body height calculation section 37 … Vertebral body determination section 39 … Evaluation image generation section 40 … Vertebral body 41 … Pedicle 45 … Vertebral body image 47 … Image for determination 49 … Position identification 51 … Operation identification 53 … Evaluation image 57 … Heart 59 … Thorax 61 … Heart-thorax ratio calculation section 63 … Heart-thorax ratio determination section 69 … Position identification 71 … Search window 75 … Operation identification 77 … Image selection reception section 78 … Identifier transmission section 79 … Image data specification section 80 … Image data input section 85 … First image file 87 … Thumbnail image display area 89 … Image for reading X-ray films display area 91 … Thumbnail image 93 … Image for reading X-ray films 95 … Second image file 97 … Identifier

Claims

1. An image acquisition unit that acquires a radiation image showing a target organ; An image processing unit that processes the radiation image acquired by the image acquisition unit; Comprising: The image processing unit: A position marker display unit that displays a position marker indicating a predetermined position in the organ on the radiation image; An operation marker display unit that displays an operation marker corresponding to the position marker in an area of the radiation image that does not overlap with either the position marker or the organ; An input reception unit that receives an operator's marker movement operation for moving the position of the operation marker in the radiation image; A position marker change unit that changes the position at which the position marker corresponding to the operation marker is displayed on the radiation image so as to reflect the marker movement operation received by the input reception unit; An image processing apparatus comprising the above.

2. In the image processing apparatus according to Claim 1, The position marker display unit displays a plurality of the position markers at a plurality of corresponding predetermined positions respectively, The operation marker display unit displays a plurality of the operation markers corresponding to each of the plurality of the position markers at positions according to the positional relationship of the plurality of the position markers displayed on the radiation image. An image processing apparatus.

3. In the image processing apparatus according to Claim 2, The image processing unit: Comprises a central display processing unit that displays the organ at the central part of the radiation image, The operation marker display unit: Is configured to set the position at which each of the operation markers corresponding to the position markers is displayed on the radiation image according to the distance and direction from the center of the radiation image to the position marker. An image processing apparatus.

4. In the image processing apparatus according to Claim 1, The organ is a vertebral body, The position markers include a first marker indicating the upper edge of the front end of the vertebral body, a second marker indicating the lower edge of the front end of the vertebral body, a third marker indicating the upper edge of the center of the vertebral body, a fourth marker indicating the lower edge of the center of the vertebral body, a fifth marker indicating the upper edge of the rear end of the vertebral body, and a sixth marker indicating the lower edge of the rear end of the vertebral body, A vertebral body height calculation unit that calculates the height of the front end part of the vertebral body based on the distance between the first marker and the second marker, calculates the height of the central part of the vertebral body based on the distance between the third marker and the fourth marker, and calculates the height of the rear end part of the vertebral body based on the distance between the fifth marker and the sixth marker. A vertebral body determination unit that determines the presence or absence of a fracture in the vertebral body based on at least one parameter among the ratio of the height of the central portion to the height of the front end portion, the ratio of the height of the central portion to the height of the rear end portion, and the ratio of the height of the rear end portion to the height of the front end portion; An image processing apparatus comprising the same.

5. In the image processing apparatus according to claim 1, The organ is the heart and the chest wall, The position markers include a seventh marker indicating the left end of the heart, an eighth marker indicating the right end of the heart, a ninth marker indicating the left end of the chest wall, and a tenth marker indicating the right end of the chest wall, An image processing apparatus comprising a cardiothoracic ratio calculation unit that calculates a cardiothoracic ratio based on the distance between the seventh marker and the eighth marker and the distance between the ninth marker and the tenth marker.

6. An image processing method using the image processing apparatus according to any one of claims 1 to 5, a first image file of a radiographic image, a second image file of the radiographic image that is generated based on the first image file and has a file format with a smaller capacity than the first image file, and an image server that stores and associates an identifier capable of identifying the second image file, A first activation step of activating, on a terminal of the image processing apparatus, first software capable of displaying a thumbnail image of the radiographic image; A first acquisition step of acquiring a plurality of the second image files and the identifiers from the image server; A thumbnail image generation step of generating a thumbnail image of the radiographic image based on the second image file and associating the generated thumbnail image with the identifier; A thumbnail display step of displaying, on the first software, the thumbnail images of the radiographic images generated for each of the plurality of the second image files; A second activation step of activating, on a terminal of the image processing apparatus, second software capable of performing image processing for changing the position of the position marker using the position marker changing unit on the first image file; A selection step of selecting one of the thumbnail images displayed on the first software; A transmission step of transmitting the identifier associated with the thumbnail image selected in the selection step to the image server; A specifying step of specifying the first image file associated with the identifier transmitted to the image server in the transmission step from the plurality of the first image files stored in the image server; A second acquisition step of transmitting the first image file specified in the specifying step from the image server to the terminal of the image processing apparatus to acquire the first image file; An image processing step of performing image processing on the first image file of the radiation image acquired in the second acquisition step using the position marker display unit, the operation marker display unit, the input reception unit, and the position marker change unit; An image processing method comprising the above.

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