Pre-surgery support device, pre-surgery support system, and pre-surgery support program

Abstract

To provide information capable of improving efficiency, safety, and reliability of a surgery.SOLUTION: A pre-surgery support device includes: an acquisition unit that acquires a dynamic image analysis result of a patient and patient information; and an output unit that outputs the pre-surgery support information on the basis of the dynamic image analysis result and the patient information.SELECTED DRAWING: Figure 4

Description

[Technical Field]

[0001] The present invention relates to a preoperative support device, a preoperative support method, and a preoperative support program. [Background technology]

[0002] In surgical operations, tests are usually performed to acquire still radiographic images before surgery. In addition, there have been proposed inventions that acquire dynamic radiographic images before surgery and propose surgical procedures based on the acquired dynamic images (for example, Patent Document 1). [Prior art documents] [Patent documents]

[0003] [Patent Document 1] Patent Publication No. 2021-115188 Summary of the Invention [Problem to be solved by the invention]

[0004] Dynamic images contain more information than still images. Therefore, it is thought that it is possible to provide various information and suggestions to medical professionals based on the information obtained from dynamic images. However, in the past, there has been little consideration given to the use of information obtained from dynamic images, and even in the case of surgery, information other than the surgical procedure has not been suggested.

[0005] An object of the present invention is to provide a preoperative support device, a preoperative support method, and a preoperative support program that are capable of providing information that can improve the efficiency, safety, and reliability of surgery. [Means for solving the problem]

[0006] The preoperative support device according to the present invention comprises: an acquisition unit that acquires the patient's dynamic image analysis results and patient information; an output unit that outputs preoperative support information for surgery based on the acquired dynamic image analysis results and the patient information; Equipped with.

[0007] The preoperative support method according to the present invention comprises: Obtain the patient's dynamic image analysis results and patient information, Preoperative support information for surgery is output based on the acquired dynamic image analysis results and the patient information.

[0008] The preoperative support program according to the present invention comprises: On the computer, A process of acquiring the patient's dynamic image analysis results and patient information; a process of outputting preoperative support information for surgery based on the acquired dynamic image analysis results and the patient information; Execute the following. [Effects of the Invention]

[0009] According to the present invention, it is possible to improve the efficiency, safety, and reliability of surgery. [Brief explanation of the drawings]

[0010] [Figure 1] FIG. 1 is an explanatory diagram illustrating an example of the configuration of a radiation image processing system. [Figure 2] FIG. 2 is a block diagram illustrating an example of the functional configuration of an imaging control unit in a radiation image imaging device that constitutes the radiation image processing system. [Figure 3] FIG. 3 is a block diagram illustrating an example of the functional configuration of a radiation imaging control device that constitutes the radiation image processing system. [Figure 4] FIG. 4 is a block diagram illustrating an example of the functional configuration of a radiation image analysis device that constitutes a radiation image processing system. [Figure 5] FIG. 5 is a block diagram illustrating an example of the functional configuration of a preoperative support device according to an embodiment of the present invention. [Figure 6] FIG. 6 is a flowchart illustrating a preoperative support method performed by the preoperative support device. [Figure 7]FIG. 7 is a diagram showing an example of a dynamic image analysis result acquired by the preoperative support device from the radiological image analysis device. [Figure 8] FIG. 8 is a diagram showing another example of a dynamic image analysis result acquired by the preoperative support device from the radiological image analysis device. [Figure 9] FIG. 9 is a diagram showing another example of a dynamic image analysis result acquired by the preoperative support device from the radiological image analysis device. [Figure 10] FIG. 10 is a diagram showing another example of a dynamic image analysis result acquired by the preoperative support device from the radiological image analysis device. [Figure 11] FIG. 11 is a diagram illustrating an example of preoperative support information provided based on the dynamic image analysis result and patient information. [Figure 12] FIG. 12 is a diagram schematically showing bending and straightening of the knee joint. [Figure 13] FIG. 13 is a diagram showing an artificial knee joint. DETAILED DESCRIPTION OF THE INVENTION

[0011] Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.

[0012] <Configuration of Radiation Image Processing System> 1 is a diagram illustrating a radiological image processing system 1 according to the present embodiment. The radiological image processing system 1 includes a radiological image capturing device 10, a radiological image capturing control device (console device) 20, a radiological image analyzing device 30, an image management device 40, and a client terminal 50.

[0013] 1, the radiographic imaging device 10 is placed in an imaging room, and the radiographic imaging control device 20 is placed in an operation room. The radiographic imaging device 10, the radiographic imaging control device 20, the radiographic image analysis device 30, the image management device 40, and the client terminal 50 are connected to each other via a communication network N. As the communication network N, for example, a communication network conforming to the DICOM (Digital Image and Communications in Medicine) standard or the like is used.

[0014] Additionally, a radiology information terminal 60 and a preoperative support device 70 are connected to the communication network N. The radiology information terminal 60 is a radiology information system, such as a RIS (Radiology Information System), that transmits information related to radiological examinations, such as patient examination order information, to the radiological image processing system 1. The preoperative support device 70 provides preoperative support information based on the analysis results of dynamic images (hereinafter referred to as dynamic image analysis results) and patient information input from the radiological image processing system 1.

[0015] The radiographic imaging device 10 captures dynamic images, which are radiographic images, under the control of the radiographic imaging control device 20. The radiographic imaging control device 20 controls the radiographic imaging device 10 based on examination order information, etc., including patient information, transmitted from the radiographic information terminal 60. The dynamic images generated by the radiographic imaging device 10 undergo predetermined processing in the radiographic imaging control device 20 and are transmitted to the radiographic image analysis device 30. The radiographic image analysis device 30 performs dynamic analysis on the dynamic images. The dynamic images and the results of the dynamic image analysis are transmitted to and managed by an image management device 40, which serves as a medical image management system, such as a PACS (Picture Archiving and Communication System).

[0016] The dynamic images, the dynamic image analysis results, etc. are transmitted to the client terminal 50 and viewed by medical personnel such as doctors. The dynamic images, the dynamic image analysis results, patient information, etc. are transmitted to the preoperative support device 70, and preoperative support information is provided to medical personnel such as doctors.

[0017] The radiographic imaging device 10, the radiographic imaging control device 20, and the radiographic image analysis device 30 each have a processor and memory, and are a type of computer that realizes specified functions by reading, expanding, and executing programs stored in the memory.

[0018] [Radiation imaging device 10] As shown in FIG. 1, the radiographic imaging device 10 includes an imaging control unit 11, a radiation irradiation unit 12, an imaging table 13, a radiation detection unit 14, a display unit 15, and an audio output unit 16.

[0019] The imaging control unit 11 acquires setting information related to settings for radiographic dynamic imaging (hereinafter referred to as dynamic imaging) from the radiation imaging control device 20. The imaging control unit 11 sets imaging conditions for performing dynamic imaging based on the setting information, and controls the radiation irradiator 12 based on the imaging conditions to irradiate radiation to the patient M (subject) and perform imaging. The imaging control unit 11 is composed of a CPU (Central Processing Unit), RAM (Random Access Memory), ROM (Read Only Memory), etc.

[0020] The setting information is information relating to settings for performing dynamic radiography on the patient M. The setting information includes, for example, at least one of multiple types of dynamic analysis that the radiographic image analysis device 30 can perform on dynamic images. When multiple types of dynamic analysis are combined, the setting information may include information relating to the combination. The setting information is set by an operator of the radiographic image processing system 1, for example, a radiographer, in the radiography control device 20 described below.

[0021] The imaging conditions include various conditions such as the pulse rate, pulse width, pulse interval, number of frames captured per imaging, radiation dose per unit time, and the physical condition of the patient M (such as respiratory condition). The pulse rate is the number of radiation exposures per second and corresponds to the frame rate of the image data. The pulse width is the radiation exposure time per radiation exposure. The pulse interval is the time from the start of one radiation exposure to the start of the next radiation exposure and corresponds to the time interval (frame interval) between multiple image data. The imaging conditions may be automatically determined by the imaging control unit 11 of the radiographic imaging device 10 based on the setting information.

[0022] The radiation emitting unit 12 is disposed at a position facing the radiation detecting unit 14 fixed to the imaging table 13. The radiation emitting unit 12 irradiates radiation (X-rays) under the control of the imaging control unit 11.

[0023] The radiation detection unit 14 is composed of a semiconductor image sensor such as an FPD (Flat Panel Detector). The radiation detection unit 14 has a substrate on which a plurality of detection elements (pixels) are arranged in a matrix, which detect radiation irradiated from the radiation irradiation unit 12 according to its intensity, convert the detected radiation into an electrical signal, and store the electrical signal. Each pixel on the substrate is configured to include a switching unit such as a TFT (Thin Film Transistor).

[0024] The radiation detection unit 14 controls the switching unit of each pixel based on the image reading conditions input from the radiation imaging control device 20 to read the electrical signals accumulated in each pixel and output intensity information for each pixel to the image generation unit 113. The image reading conditions include, for example, the frame rate, frame interval, pixel size, image size (matrix size), etc. The frame rate is the number of frame images acquired per second and coincides with the pulse rate. The frame interval is the time from the start of one image data acquisition operation to the start of the next frame image acquisition operation and coincides with the pulse interval.

[0025] The imaging control unit 11 and the radiation detection unit 14 are connected to each other and exchange synchronization signals with each other to synchronize the radiation irradiation operation and the image reading operation.

[0026] In this way, the radiographic imaging device 10 performs dynamic radiographic imaging by controlling the imaging control unit 11 so that the radiation irradiation unit 12 irradiates radiation and the radiation detection unit 14 generates image data based on the intensity of the irradiated radiation.

[0027] The display unit 15 and the audio output unit 16 give instructions to the patient M regarding the posture to be taken, physical condition, respiratory condition, etc. when performing dynamic radiography of the patient M. The display unit 15 is a display device such as a CRT (Cathode Ray Tube), a liquid crystal display (Liquid Crystal Display), or an organic EL (Electro Luminescence) display. The audio output unit 16 is an audio output device such as a speaker. The display unit 15 and the audio output unit 16 may each give the same instructions to the patient M, or only one of them may give instructions.

[0028] 2 is a block diagram illustrating an example of the functional configuration of the imaging control unit 11 in the radiographic image capturing device 10 that constitutes the radiographic image processing system 1. The imaging control unit 11 has a setting information acquisition unit 111, an imaging condition determination unit 112, an image generation unit 113, and a storage unit 114.

[0029] The setting information acquisition unit 111 acquires setting information from the radiation imaging control device 20 .

[0030] The imaging condition determination unit 112 determines imaging conditions for performing dynamic imaging of the patient M based on the setting information. Information indicating the correspondence between multiple types of dynamic analysis and imaging conditions suitable for each dynamic analysis is stored in advance in the storage unit 114. Information indicating the correspondence between combinations of multiple types of dynamic analysis and imaging conditions suitable for that combination is also stored in advance in the storage unit 114. The imaging condition determination unit 112 may determine imaging conditions by reading information indicating the correspondence from the storage unit 114 for the dynamic analysis or combination of multiple types of dynamic analysis indicated in the setting information and comparing it with the setting information.

[0031] Note that, for example, in the case of screening, emergency care, etc., it may be impossible to set dynamic analysis, which is the setting information. In such cases, the imaging condition determination unit 112 determines the imaging conditions by having the operator select at least one imaging condition from a plurality of predefined imaging conditions. In addition, the imaging condition determination unit 112 has the operator select examination order information, and determines the imaging conditions based on the selected examination order information. In this way, when dynamic analysis cannot be set before dynamic imaging, dynamic analysis is set after dynamic imaging under the imaging conditions selected by the operator, and dynamic analysis is performed by the radiographic image analyzer 30, which will be described later.

[0032] The image generation unit 113 performs dynamic imaging of the patient M based on the determined imaging conditions and generates multiple frames of radiographic images. Specifically, the image generation unit 113 controls the operations of the radiation irradiator 12 and the radiation detector 14 based on the imaging conditions, and generates image data by obtaining intensity information on the intensity of radiation that has passed through the subject from the radiation detector 14 for each pixel.

[0033] As described above, the memory unit 114 pre-stores information indicating the correspondence between multiple types of dynamic analysis and the imaging conditions suitable for each dynamic analysis, information indicating the correspondence between combinations of multiple types of dynamic analysis and the imaging conditions suitable for that combination, etc.

[0034] [Radiation imaging control device 20] The radiation imaging control device 20 is, for example, a computer such as a PC (Personal Computer), a workstation, etc. The radiation imaging control device 20 may be a desktop computer as shown in the example of Fig. 1, or may be a portable computer such as a notebook computer or a tablet computer.

[0035] The radiography control device 20 receives examination order information from the radiological information terminal 60 or the like, and transmits it to the radiographic image capturing device 10, thereby controlling dynamic radiography by the radiographic image capturing device 10.

[0036] The examination order information includes various information related to the dynamic imaging to be performed next, such as instruction information related to breathing, patient information, examination information, imaging information, data attributes, etc. The examination information includes information such as the examination ID, the area to be examined (e.g., chest, particularly lungs or heart, etc.), the type of analysis (e.g., ventilation analysis, pulmonary blood flow analysis, measurement of maximum ventilation volume, etc.). The examination order information is generated, for example, when a doctor or the like requests the radiological image processing system 1 to perform dynamic imaging of patient M.

[0037] Furthermore, based on input from the operator, the radiography control device 20 generates setting information indicating at least one of the multiple types of kinetic analyses that can be performed by the radiographic image analyzer 30. When multiple types of kinetic analyses are to be combined, the radiography control device 20 generates setting information indicating a combination of the multiple types of kinetic analyses. The operator, for example, refers to the contents of the examination order information to determine which of the multiple types of kinetic analyses to combine, and performs input operations to generate setting information based on this. Alternatively, the operator may determine which kinetic analyses to combine based on information provided by a doctor or the like in another manner.

[0038] 3 is a block diagram illustrating an example of the functional configuration of the radiation imaging control device 20 that constitutes the radiation image processing system 1. The radiation imaging control device 20 has a control unit 21, a storage unit 22, an operation unit 23, a display unit 24, and a communication unit 25. The components of the radiation imaging control device 20 are connected to each other via a bus 26.

[0039] The radiography control device 20 outputs setting conditions set by an operator or the like and examination order information acquired in advance from a radiation information terminal 60 or the like to the radiography device 10, and controls the radiography processing by the radiography device 10. The radiography control device 20 may, for example, display dynamic images generated by the radiography device 10 so that the operator can check them.

[0040] The control unit 21 is configured with a CPU, RAM, etc. In the control unit 21, the CPU reads out the system program and various processing programs stored in the storage unit 22 in response to an operation of the operation unit 23, loads them into the RAM, and controls the operation of each unit of the radiation imaging control device 20 based on the loaded programs.

[0041] The storage unit 22 is configured with a non-volatile semiconductor memory, a hard disk, etc. The storage unit 22 stores various programs executed by the control unit 21, parameters required for executing processes by the programs, data such as processing results, etc. The various programs are stored in the form of readable program code, and the control unit 21 sequentially executes operations in accordance with the program code.

[0042] The storage unit 22 also stores image reading conditions for performing dynamic radiography. Furthermore, the storage unit 22 stores examination order information transmitted from the radiation information terminal 60, etc. When the radiation imaging control device 20 controls dynamic radiography of the radiation image capturing device 10, it reads out the image reading conditions and examination order information corresponding to the patient M from the storage unit 22 and transmits them.

[0043] The operation unit 23 is an operation device such as a keyboard equipped with cursor keys, numeric input keys, and various function keys, a pointing device such as a mouse or a trackball, and a touch panel. The operation unit 23 generates an instruction signal based on an input from the operator and outputs it to the control unit 21.

[0044] The display unit 24 is configured with a display device such as a CRT, a liquid crystal display, an organic EL display, etc. The display unit 24 displays input instructions from the operation unit 23, image data generated by the radiographic imaging device 10, etc., in accordance with instructions of a display signal input from the control unit 21.

[0045] The communication unit 25 transmits and receives data to and from the radiation image capturing device 10, the radiation image analyzing device 30, the radiation information terminal 60, and the like.

[0046] [Radiation image analyzer 30] The radiation image analysis device 30 is, for example, a computer such as a PC, a workstation, etc. The radiation image analysis device 30 may be a desktop computer or a portable computer such as a notebook computer or a tablet computer.

[0047] The radiographic image analysis device 30 performs dynamic analysis on the dynamic images captured by the radiographic image capturing device 10 based on the setting information set in the radiographic image capturing control device 20. The radiographic image analysis device 30 may perform a combination of multiple types of dynamic analysis.

[0048] 4 is a block diagram illustrating an example of the functional configuration of the radiographic image analysis device 30 that constitutes the radiographic image processing system 1. The radiographic image analysis device 30 has a control unit 31, a storage unit 32, an operation unit 33, a display unit 34, and a communication unit 35. The components of the radiographic image analysis device 30 are connected by a bus 36.

[0049] The control unit 31 is configured with a CPU, RAM, etc. In the control unit 31, the CPU reads out the system program and various processing programs stored in the storage unit 32 in response to an operation of the operation unit 33, expands them in the RAM, and performs operation control of each unit of the radiological image analysis device 30, dynamic analysis, etc. based on the expanded programs.

[0050] The control unit 31 includes an image acquisition unit 311 and an analysis unit 312 .

[0051] The image acquisition unit 311 acquires dynamic images, which are radiographic images of multiple frames generated by the radiographic image capturing device 10.

[0052] The analysis unit 312 performs the dynamic analysis set in the setting information on the dynamic image acquired from the radiographic imaging device 10 and acquires the analysis result. At this time, if the analysis unit 312 cannot analyze the dynamic image (cannot acquire the analysis result), it determines that the analysis is impossible. The analysis by the analysis unit 312 may be performed using a predetermined algorithm or AI (Artificial Intelligence).

[0053] The analysis unit 312 has, as types of dynamic analysis, for example, a blood flow analysis mode, a ventilation analysis mode, an adhesion analysis mode, a diaphragm movement amount analysis mode, an orthopedic-related measurement mode, etc. Each mode will be briefly described below.

[0054] The blood flow analysis mode visualizes signal changes within the lung field that are synchronized with the heartbeat.

[0055] The ventilation analysis mode is a mode in which signal changes in the time direction in a specific time frequency band are extracted and the behavior of lung tissue during breathing is visualized.

[0056] The adhesion analysis mode is a mode for visualizing the degree of tissue adhesion.

[0057] The diaphragm movement amount analysis mode is a mode for tracking the up and down movement of the diaphragm that accompanies breathing.

[0058] The orthopedic measurement mode is a mode in which, for example, the positional change of a designated bone in a limb or the like is measured and the trajectory of the movement is displayed.

[0059] The storage unit 32 is configured with a non-volatile semiconductor memory, a hard disk, etc. The storage unit 32 stores various programs executed by the control unit 31, parameters required for executing processes by the programs, data such as processing results, etc. The various programs are stored in the form of readable program code, and the control unit 31 sequentially executes operations in accordance with the program code.

[0060] The storage unit 32 also stores list information indicating patient information, examination information, and status (e.g., progress status such as receiving, dynamic analysis in progress, analysis completed, etc.) related to each dynamic image generated by the radiographic imaging device 10. Furthermore, the storage unit 32 stores analysis results in association with the dynamic image.

[0061] The operation unit 33 is an operation device such as a keyboard equipped with cursor keys, numeric input keys, and various function keys, a pointing device such as a mouse or a trackball, and a touch panel. The operation unit 33 generates instruction signals based on input by the operator and outputs them to the control unit 31. The operation unit 33 may also be equipped with a touch panel on the display screen of the display unit 34, in which case the operation unit 33 outputs instruction signals input via the touch panel to the control unit 31.

[0062] The display unit 34 is configured with a display device such as a CRT, a liquid crystal display, an organic EL display, etc. The display unit 34 displays input instructions from the operation unit 33, image data generated by the radiographic imaging device 10, etc., in accordance with instructions of a display signal input from the control unit 31.

[0063] The communication unit 35 transmits and receives data to and from the radiation imaging control device 20, the image management device 40, the preoperative support device 70, and the like.

[0064] [Preoperative support device 70] The preoperative support device 70 is, for example, a computer such as a PC, a workstation, etc. The preoperative support device 70 may be a desktop computer or a portable computer such as a notebook computer or a tablet computer.

[0065] The preoperative support device 70 provides preoperative support information based on the dynamic image analysis results and patient information input from the radiation image processing system 1.

[0066] 5 is a block diagram illustrating an example of the functional configuration of the preoperative support device 70. The preoperative support device 70 has a control unit 71, a storage unit 72, an operation unit 73, a display unit 74, and a communication unit 75. The components of the preoperative support device 70 are connected by a bus 76.

[0067] The control unit 71 is composed of a CPU, RAM, etc. In the control unit 71, the CPU reads out the system program and various processing programs stored in the storage unit 72 in response to an operation of the operation unit 73, expands them in the RAM, and executes processing for providing preoperative support information based on the expanded programs.

[0068] The control unit 71 includes an information acquisition unit 711 and an output unit 712 .

[0069] The information acquisition unit 711 acquires patient information regarding the patient to be examined, which is included in the dynamic image analysis results analyzed by the analysis unit 312 of the radiological image analysis device 30 and the examination order information input from the radiological information terminal 60.

[0070] In this embodiment, the dynamic image analysis result includes change information regarding changes in the region of interest in the dynamic image. The change information is, for example, the amount of movement of the region of interest in the dynamic image, and in the case where the dynamic image is a chest dynamic image, the change information may be the area of ​​a region where the amount of movement of the lung field due to breathing is smaller than a threshold, or the amount of change in ventilation or blood flow in the lung field due to breathing.

[0071] The output unit 712 acquires preoperative support information for surgery based on the acquired dynamic image analysis results and patient information, and outputs the information to the display unit 74, which will be described later. For example, the output unit 712 determines the state of the region of interest based on the change information of the region of interest and the patient information, and acquires preoperative support information for the region of interest. The output unit 712 may acquire the preoperative support information using a predetermined algorithm or AI.

[0072] The storage unit 72 is configured with a non-volatile semiconductor memory, a hard disk, etc. The storage unit 72 stores various programs executed by the control unit 71, parameters required for executing processes by the programs, data such as processing results, etc. The various programs are stored in the form of readable program code, and the control unit 71 sequentially executes operations in accordance with the program code.

[0073] The storage unit 72 also stores reference information related to preoperative support information. The reference information includes the surgical procedure, the tools used in the surgery, the time required for the surgery, the operating room, the number of surgical staff required, etc., and is stored in the storage unit 72 based on, for example, past surgical cases. The output unit 712 refers to the reference information stored in the storage unit 72 along with the acquired dynamic image analysis results and patient information, and acquires and outputs appropriate preoperative support information.

[0074] The operation unit 73 is an operation device such as a keyboard equipped with cursor keys, numeric input keys, and various function keys, a pointing device such as a mouse or a trackball, and a touch panel. The operation unit 73 generates instruction signals based on input by the operator and outputs them to the control unit 71. The operation unit 73 may also be equipped with a touch panel on the display screen of the display unit 74, in which case the operation unit 73 outputs instruction signals input via the touch panel to the control unit 71.

[0075] The display unit 74 is composed of a display device such as a CRT, a liquid crystal display, an organic EL display, etc. The display unit 74 displays input instructions from the operation unit 73, preoperative support information output by the output unit 712, etc., in accordance with instructions of a display signal input from the control unit 71.

[0076] The communication unit 75 transmits and receives data to and from the radiation image analysis device 30 and the like.

[0077] [Preoperative support method] 6 is a flowchart illustrating a preoperative support method performed by the preoperative support device 70. The preoperative support method is performed by causing the preoperative support device 70 to execute a preoperative support program.

[0078] Before the processing shown in Figure 6, the input of examination order information from the radiation information terminal 60, dynamic imaging of patient M by the radiation image capturing device 10 and the radiation imaging control device 20, and analysis of the dynamic images by the radiation image analysis device 30 have been completed.

[0079] (Step S11) The control unit 71 (information acquisition unit 711) acquires the dynamic image analysis results from the radiation image analyzer 30, and acquires the examination order information including patient information and the like from the radiation information terminal 60.

[0080] The control unit 71 (information acquisition unit 711) acquires, for example, dynamic image analysis results such as those illustrated in Figs. 7 to 10 (described later) from the radiological image analysis device 30. The control unit 71 (information acquisition unit 711) also acquires patient information included in the examination order information from the radiological image analysis device 30. The patient information includes, for example, the age, sex, chronic illnesses, complications, contraindications, medication details, etc. of patient M, as illustrated in Fig. 10 (described later).

[0081] (Step S12) The control unit 71 (output unit 712) determines whether or not the patient M has undergone surgery based on the dynamic image analysis results and the patient information.

[0082] 7 to 10 are diagrams showing some examples of dynamic image analysis results that the preoperative support device 70 acquires from the radiological image analyzer 30. FIG.

[0083] Figures 7 and 8 show the results of analyzing dynamic images using adhesion analysis mode. Figure 7 shows the results of analyzing dynamic images, extracting signal value patterns within the lung field and measuring the amount of movement of each region associated with breathing, thereby displaying the movement tendency of each region in multiple colors; however, for convenience of the drawing, this is displayed in grayscale. Figure 8 shows the results of analyzing dynamic images, extracting signal value patterns within the lung field, and displaying the amount of movement of each region associated with breathing as multiple color vectors, with the maximum inspiration frame as the reference frame; however, for convenience of the drawing, this is displayed in grayscale.

[0084] In Fig. 7, for ease of understanding, areas where the amount of movement is smaller than a predetermined movement threshold are surrounded by white dotted lines. The control unit 71 (output unit 712) determines whether or not surgery has been performed based on the small amount of movement, the area of ​​the area where the amount of movement is small, etc. Also in Fig. 8, for ease of understanding, areas where the vector is smaller than a predetermined size are surrounded by black dotted lines. The control unit 71 (output unit 712) determines whether or not surgery has been performed based on the small amount of movement, the area of ​​the area where the amount of movement is small, etc.

[0085] The control unit 71 (output unit 712) can determine the degree of adhesion or infiltration of lung tissue based on the dynamic image analysis results shown in Figures 7 and 8, and determines whether or not surgery has been performed based on the degree of adhesion or infiltration of lung tissue. At this time, the control unit 71 (output unit 712) also refers to patient information to determine whether or not surgery has been performed.

[0086] Regarding lung tissue adhesions, the degree of adhesion can be determined by the ratio of the lung field area at maximum inspiration to the area of ​​the region with the smallest amount of movement. Regarding lung tissue infiltration, since the infiltrated area of ​​lung tissue and the ribs move in sync with breathing, the degree of infiltration can be determined by analyzing dynamic images of the synchronization with the movement of the ribs, and thus adhesions and infiltration of lung tissue can be distinguished.

[0087] Figure 9 shows the results of analyzing dynamic images using the ventilation analysis mode as the dynamic image analysis mode. Figure 9 shows the signal value changes of lung tissues accompanying breathing extracted by analyzing the dynamic images, and the signal value changes with the maximum inspiration frame as the reference frame are displayed in monochrome, but for convenience of the drawing, they are displayed in grayscale.

[0088] 9, for ease of understanding, regions where the signal value change is smaller than a predetermined change threshold, i.e., regions where ventilation volume is small, are surrounded by white dotted lines. The control unit 71 (output unit 712) determines whether surgery has been performed based on the smallness of the signal value change, the area of ​​the region where the signal value change is small, etc.

[0089] The control unit 71 (output unit 712) can determine the severity of a chronic respiratory disease based on the dynamic image analysis results shown in Fig. 9, and determines whether or not surgery has been performed based on the severity of the chronic respiratory disease. At this time, the control unit 71 (output unit 712) also references patient information to determine whether or not surgery has been performed. Chronic respiratory diseases include, for example, chronic obstructive pulmonary disease (COPD) and interstitial pneumonia.

[0090] Figure 10 shows the results of analyzing dynamic images using the blood flow analysis mode as the dynamic image analysis mode. Figure 10 shows the signal value changes of lung tissue synchronized with the heartbeat extracted by analyzing the dynamic images, and displayed in monochrome density according to the similarity of the signal value changes to the heartbeat, but for convenience of the drawing, it is displayed in grayscale.

[0091] 10, for ease of understanding, regions where the similarity of signal value changes relative to heartbeats is smaller than a predetermined similarity threshold, i.e., regions where blood flow is small, are surrounded by white dotted lines. The control unit 71 (output unit 712) determines whether surgery has been performed based on the smallness of the similarity, the area of ​​the region where the similarity is small, etc.

[0092] The control unit 71 (output unit 712) can determine the degree of pulmonary embolism and pulmonary hypertension based on the dynamic image analysis results shown in Fig. 10, and determines whether or not surgery is required based on the degree of pulmonary embolism and pulmonary hypertension. At this time, the control unit 71 (output unit 712) also refers to patient information to determine whether or not surgery is required.

[0093] Furthermore, when determining whether or not surgery has been performed, the control unit 71 (output unit 712) may determine whether or not surgery has been performed based on multiple analysis results, rather than on one analysis result. For example, the control unit 71 may determine whether or not surgery has been performed based on different analysis results using the same analysis mode, or may determine whether or not surgery has been performed based on different analysis results using different analysis modes. By determining whether or not surgery has been performed based on multiple analysis results, the control unit 71 (output unit 712) can make a more accurate determination.

[0094] 7 to 10, the chest (lungs) is the subject of examination, but for example, a joint may be used as the subject of examination, dynamic images may be taken, and the presence or absence of surgery for patient M may be determined based on the results of dynamic image analysis and patient information. For example, when the knee joint is the subject of examination, dynamic images may be taken while bending and straightening the knee joint (see FIG. 12, which will be described later). Then, the control unit 71 (output unit 712) may analyze the dynamic images and measure, for example, the positional relationship between the femur and tibia as the dynamic image analysis results, and based on the measurement results, determine whether the function of the knee joint is normal and determine whether surgery is required.

[0095] (Step S13) If surgery is necessary (YES), the control unit 71 (output unit 712) proceeds to step S14, and if surgery is not necessary (NO), the control unit 71 (output unit 712) ends the series of processes.

[0096] (Step S14) The control unit 71 (output unit 712) refers to the reference information stored in the storage unit 72 together with the dynamic image analysis results and patient information, acquires preoperative support information necessary for the surgery, and outputs it to the display unit 74.

[0097] Here, the preoperative support information will be described with reference to Fig. 11. Fig. 11 is a diagram illustrating an example of preoperative support information provided based on dynamic image analysis results and patient information. Note that here, an example will be described in which dynamic images of the chest are taken and the dynamic images are analyzed in adhesion analysis mode.

[0098] When dynamic images of the chest are taken and analyzed in adhesion analysis mode, the dynamic image analysis results shown in Figures 7 and 8 can be obtained. In step S12, the control unit 71 (output unit 712) uses the dynamic image analysis results to determine whether or not surgery is required, and in step S14, the control unit 71 acquires preoperative support information using the same dynamic image analysis results.

[0099] Specifically, the control unit 71 (output unit 712) refers to the reference information stored in the memory unit 72 based on the degree of adhesion and infiltration of the lung tissue determined in step S12, and acquires preoperative support information necessary for the surgery, such as the surgical procedure, tools, etc.

[0100] For example, when performing lung surgery on a patient undergoing reoperation or with a history of pneumonia, the surgical procedure and tools must be selected according to the degree of pleural adhesion. For example, if the area of ​​pleural adhesion is extensive, open thoracotomy is selected. In this case, tools are required to separate the pleura at the site of adhesion.

[0101] On the other hand, if the area of ​​pleural adhesion is small, thoracoscopic surgery is selected. In this case, the location of pleural adhesion can be identified from the dynamic image analysis results, allowing the endoscope to be inserted while avoiding that location. This is also useful when using an endoscopic surgery support robot in thoracoscopic surgery. For example, the dynamic image analysis results include position information regarding the location of the region of interest, and the control unit 71 (output unit 712) outputs the position information as preoperative support information.

[0102] For example, when performing surgery for lung cancer, the surgical procedure and tools must be selected depending on the degree of chest wall invasion. For example, if the degree of chest wall invasion is high, i.e., if the tumor is large, thoracotomy is selected. In this case, combined rib resection is required at the site of tumor invasion, so tools for combined rib resection are required. Furthermore, if there is aortic invasion, a cardiovascular surgeon is required as part of the surgical staff, so the need for a cardiovascular surgeon is provided as preoperative support information.

[0103] On the other hand, if the degree of chest wall invasion is low or absent, i.e., if the tumor is small, thoracoscopic surgery is selected. In this case, the location of the tumor can be determined from the dynamic image analysis results, allowing the endoscope to be inserted from an appropriate position. This is also useful when using an endoscopic surgery support robot during thoracoscopic surgery. For example, the dynamic image analysis results include position information regarding the position of the region of interest, and the control unit 71 (output unit 712) outputs the position information as preoperative support information.

[0104] Once the surgical procedure and tools to be used can be selected in this manner, the control unit 71 (output unit 712) can determine the estimated surgery time, the operating room to be used, and the number of surgical staff required, for example, by referring to reference information stored in the memory unit 72.

[0105] In Fig. 11, an example is described in which preoperative support information is acquired based on the results of dynamic image analysis in which dynamic images of the chest are captured and analyzed in adhesion analysis mode. However, preoperative support information can also be acquired for joints in a similar manner. Here, as an example, a case in which the knee joint is the subject of examination is described. Fig. 12 is a diagram schematically illustrating bending and straightening of the knee joint.

[0106] When the knee joint is the subject of examination, dynamic imaging is performed while bending and straightening the knee joint. The control unit 71 (output unit 712) analyzes the dynamic images, measures the degree of knee deformation as the dynamic image analysis result, and acquires preoperative support information necessary for the surgery, such as the surgical procedure, tools, etc., based on the degree of knee deformation.

[0107] For example, if the degree of knee deformity is small, arthroscopic surgery is selected. In this case, it is necessary to remove damaged meniscus and cartilage from the knee joint, and to repair damaged cartilage and torn meniscus, so tools used for these surgeries are required. In addition, since the dynamic image analysis results include position information regarding the position of the region of interest, the control unit 71 (output unit 712) outputs the position information of the surgical site as preoperative support information.

[0108] If the degree of knee deformity is significant, osteotomy is the recommended procedure. In this case, in order to change the positional relationship between the femur and tibia, it is necessary to make an incision on the front of the knee and cut off the tibia near the knee joint, so the tools required for these surgeries are required.

[0109] If the degree of knee deformity is more severe, total knee replacement surgery is an option. In this case, in order to replace the deformed joint with an artificial knee joint, it is necessary to make an incision on the front of the knee and to shave the femur and tibia, etc., so the tools used for these surgeries are required.

[0110] In total knee replacement surgery, the femur and tibia are reshaped to install the artificial knee joint, and the amount of reshaving required can be determined, for example, according to the length of the posterior cruciate ligament. Because the dynamic image analysis results include position information regarding the position of the region of interest, the control unit 71 (output unit 712) acquires the length of the posterior cruciate ligament and outputs the amount of reshaving required for the femur and tibia as preoperative support information.

[0111] If the length of the posterior cruciate ligament is too short for the artificial knee joint, the anterior side of the artificial knee joint will be raised, making it impossible to flex the knee joint more than 90°. However, if the length of the posterior cruciate ligament is appropriate, the posterior movement of the tibia will enable deep flexion of the knee joint (see Figure 13). In this way, the results of dynamic image analysis not only determine the surgical procedure, but can also provide the numerical targets required for surgery as preoperative support information. Furthermore, by taking and analyzing dynamic images of the knee joint after surgery, it is possible to evaluate the condition of the posterior cruciate ligament before and after surgery.

[0112] Then, the control unit 71 (output unit 712) displays the above-described preoperative support information on the display unit 74 to present it to the doctor.

[0113] The doctor makes a final decision on the surgical procedure and the tools required for the surgery by referring to the surgical procedure and the tools required for the surgery in the preoperative support information displayed on the display unit 74. The doctor also makes a final decision on the surgical procedure and the surgical staff by referring to the estimated surgery time, the operating room, and the number of surgical staff in the preoperative support information displayed on the display unit 74, and for example, reserves the operating room and secures the surgical staff.

[0114] As described above, the preoperative support device 70 includes an information acquisition unit 711 and an output unit 712. The information acquisition unit 711 acquires the dynamic image analysis results analyzed by the analysis unit 312 of the radiological image analysis device 30 and patient information included in the examination order information input from the radiological information terminal 60. The output unit 712 outputs preoperative support information for surgery to the display unit 74 based on the acquired dynamic image analysis results and patient information.

[0115] As described above, the preoperative support device 70 outputs preoperative support information for surgery to the display unit 74 based on the dynamic image analysis results and patient information. In this way, preoperative support information that supports the creation of a surgical plan is provided before surgery, thereby improving the efficiency, safety, and reliability of the actual surgery. Furthermore, because the efficiency, safety, and reliability of the surgery can be improved, the surgery will proceed and end as planned. As a result, anxiety of the patient and their family can be reduced, and the burden on doctors and surgical staff can be reduced by preventing the schedule for the next surgery and reducing long working hours, thereby reducing costs.

[0116] The above-described embodiments are merely examples of specific embodiments for carrying out the present invention, and the technical scope of the present invention should not be construed as being limited by these embodiments. In other words, the present invention can be carried out in various forms without departing from the gist or main features thereof. [Explanation of symbols]

[0117] 1. Radiation image processing system 10 Radiation imaging device 11. Imaging control unit 12 Radiation irradiation unit 13 Photo stand 14 Radiation detection unit 15 Display section 16 Audio output section 20 Radiography control device 21 Control section 22 Memory section 23 Control section 24 Display section 25 Communications Department 26 Bus 30 Radiation image analysis device 31 Control Unit 32 Storage section 33 Operation section 34 Display section 35 Communications Department 36 Bus 40 Image management device 50 client terminals 60 Radiation Information Terminal 70 Preoperative support equipment 71 Control Unit 72 Memory section 73 Operation section 74 Display section 75 Communications Department Bus 76 111 Setting information acquisition unit 112 Shooting condition determination unit 113 Image Generation Unit 114 Storage section 311 Image Acquisition Unit 312 Analysis Department 711 Information Acquisition Department 712 Output section

Claims

1. an acquisition unit that acquires the patient's dynamic image analysis results and patient information; an output unit that outputs preoperative support information for surgery based on the acquired dynamic image analysis results and the patient information; A preoperative support device comprising:

2. the dynamic image analysis result includes change information regarding a change in the region of interest in the dynamic image; the output unit determines a state of the region of interest based on the change information and the patient information, and outputs the preoperative support information for the region of interest. The preoperative support device according to claim 1 .

3. the change information is a movement amount of the region of interest in the dynamic image; The preoperative support device according to claim 2 .

4. the dynamic image is a dynamic image of the chest, The change information is an area of ​​a region in the dynamic image where the amount of movement of the lung field due to breathing is smaller than a threshold. The preoperative support device according to claim 2 .

5. the dynamic image is a dynamic image of the chest, The change information is a change amount related to ventilation or blood flow of a lung field accompanying breathing in the dynamic image. The preoperative support device according to claim 2 .

6. the dynamic image analysis result includes position information regarding the position of the region of interest; the output unit outputs the position information as the preoperative support information. The preoperative support device according to claim 2 .

7. The preoperative support information includes, along with the surgical procedure, at least one of information regarding tools to be used in the surgical procedure, estimated surgical time, operating room, and surgical staff; The preoperative support device according to claim 1 .

8. The patient information includes at least one of information regarding chronic illnesses, contraindications, complications, and medications of the patient to be photographed. The preoperative support device according to claim 1 .

9. Obtain the patient's dynamic image analysis results and patient information, outputting preoperative support information for the surgery based on the acquired dynamic image analysis results and the patient information; Preoperative support methods.

10. On the computer, A process of acquiring the patient's dynamic image analysis results and patient information; a process of outputting preoperative support information for surgery based on the acquired dynamic image analysis results and the patient information; A preoperative support program that enables

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