Radiation image processing device and radiation image processing program

Abstract

To improve the usability of an imaging result and reduce unnecessary re-imaging (exposure) even when a respiratory condition becomes inappropriate for imaging as a result of radiation dynamic imaging.SOLUTION: A radiation image processing device includes: a generation unit which generates a first reference information related to a respiration state of a patient during a dynamic imaging based on inspection order information for the dynamic imaging, including an instruction related to respiration of the patient during a dynamic imaging with radiation; and a determination unit for determining whether the actual respiration during the dynamic imaging follows the instruction or not by comparing a measurement result related to the respiration state by dynamic imaging with the first reference information, and for determining a possibility of a respiratory disease by comparing the measurement result with second reference information related to respiratory diseases.SELECTED DRAWING: Figure 5

Description

[Technical Field]

[0001] The present invention relates to a radiographic image processing apparatus and a radiographic image processing program. [Background technology]

[0002] There is known a device that irradiates a patient's chest with radiation to obtain dynamic images of the chest. To obtain dynamic images of the chest, the patient's breathing must be stable. In the device disclosed in Patent Document 1, after instructing the patient to breathe using guidance, the device detects changes in the size of the lung field from images obtained by weak X-ray exposure, detects the timing when appropriate breathing is occurring, and starts imaging at this timing. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] Japanese Patent Application Laid-Open No. 2005-312776 Summary of the Invention [Problem to be solved by the invention]

[0004] When a patient is forced to breathe in a way that places a burden on them (for example, breath holding, forced breathing, etc.), even if the patient intends to breathe according to the guidance, there is a possibility that the patient may not be able to breathe optimally for dynamic radiography due to a respiratory disease. In such cases, the conventional technology described above may overlook the disease and determine that the patient's breathing state is inappropriate for imaging, resulting in unnecessary imaging (radiation exposure) being repeated.

[0005] The object of the present invention is to provide a radiographic image processing device and a radiographic image processing program that can prevent unnecessary re-imaging (exposure) and improve the usability of the imaging results even if the respiratory condition becomes inappropriate for imaging as a result of radiographic dynamic imaging. [Means for solving the problem]

[0006] The radiation image processing device according to the present invention comprises: a generating unit that generates first reference information regarding a respiratory state of the patient during the dynamic radiography based on examination order information for the dynamic radiography, the first reference information including instructions regarding the patient's breathing during the dynamic radiography; a determination unit that compares a measurement result regarding the respiratory state obtained by the dynamic radiography with the first reference information to determine whether or not the breathing during the actual dynamic radiography was in accordance with the instructions, and that compares the measurement result with second reference information regarding a respiratory disease to determine the possibility of the respiratory disease; Equipped with.

[0007] The radiation image processing program according to the present invention comprises: On the computer, generating first reference information regarding a respiratory state of the patient during the dynamic radiography based on examination order information for the dynamic radiography, the first reference information including instructions regarding the patient's breathing during the dynamic radiography; a process of comparing the measurement results regarding the respiratory state obtained by the dynamic radiography with the first reference information to determine whether the breathing during the actual dynamic radiography was as instructed, and comparing the measurement results with second reference information regarding respiratory diseases to determine the possibility of the respiratory disease; Execute the following. [Effects of the Invention]

[0008] According to the present invention, even if the respiratory condition becomes inappropriate for imaging as a result of performing dynamic radiation imaging, unnecessary re-imaging (exposure) can be suppressed and the usability of the imaging results can be improved. [Brief explanation of the drawings]

[0009] [Figure 1] FIG. 1 is an explanatory diagram showing an example of the configuration of a radiation image processing system according to an embodiment of the present invention. [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 a radiation image processing system and also serves as a radiation image processing device. [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 flowchart illustrating the processing performed by the radiation image capturing device and the radiation image capturing control device. [Figure 6A] FIG. 6A is a diagram illustrating an example of breathing-related instructions and autovoice used in the radiation image capturing device and radiation image capturing control device. [Figure 6B] FIG. 6B is a diagram illustrating a reference waveform of the amount of movement of the diaphragm when taking an image while breathing in accordance with the autovoice during deep breathing. [Figure 6C] FIG. 6C is a diagram illustrating a reference waveform of the amount of movement of the diaphragm when imaging is performed while breathing according to the autovoice during breath holding. [Figure 7A] FIG. 7A is a diagram showing a waveform of a measured value of the amount of movement of the diaphragm when breathing becomes shallower, compared to the reference waveform shown in FIG. 6B. [Figure 7B] FIG. 7B is a diagram showing a waveform of a measured value of the amount of movement of the diaphragm when breath-holding is not possible, in comparison with the reference waveform shown in FIG. 6B. [Figure 8A] FIG. 8A is a diagram showing an example of a waveform of a measured value of the amount of movement of the diaphragm when a healthy person breathes. [Figure 8B] FIG. 8B is a diagram showing an example of a waveform of a measured value of the amount of movement of the diaphragm during breathing of a patient with chronic obstructive pulmonary disease. [Figure 9] FIG. 9 shows examples of waveforms of measured values ​​of lung area during breathing in a healthy subject, a patient with chronic obstructive pulmonary disease, and a patient with interstitial lung disease. DETAILED DESCRIPTION OF THE INVENTION

[0010] Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.

[0011] <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.

[0012] 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.

[0013] Also connected to the communication network N is a radiation information terminal 60, such as a RIS (Radiology Information System), which serves as a radiation information system that transmits information relating to radiation examinations, such as patient examination order information, to the radiation image processing system 1.

[0014] The radiographic imaging device 10 performs radiographic dynamic imaging (hereinafter referred to as dynamic imaging), which is the capturing of dynamic images of 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 and the like transmitted from the radiographic information terminal 60. The dynamic images generated by the radiographic imaging device 10 are subjected to processing described below in the radiographic imaging control device 20, which also serves as the radiographic image processing device of the present invention, and 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 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). The dynamic images and the results of the dynamic analysis are transmitted to a client terminal 50 and viewed by medical professionals such as doctors.

[0015] In this embodiment, dynamic imaging refers to repeatedly irradiating a subject with pulsed radiation (e.g., X-rays) at a predetermined frame rate (pulse irradiation) to obtain multiple frames. Dynamic images refer to a series of frames obtained by dynamic imaging. Dynamic analysis refers to analytical processing performed on dynamic images, and includes processing to analyze the movement of the subject based on the dynamic images, as well as processing to analyze the dynamic images and emphasize or attenuate (remove) predetermined structures.

[0016] 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.

[0017] [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, an audio output unit 16, and an optical imaging unit 17.

[0018] The imaging control unit 11 acquires setting information related to the settings of dynamic imaging from the radiation imaging control device 20. Based on the setting information, the imaging control unit 11 sets imaging conditions for performing dynamic imaging, 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.

[0019] 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.

[0020] 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.

[0021] 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.

[0022] 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).

[0023] 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.

[0024] 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.

[0025] 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.

[0026] 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 audio output unit 16 gives instructions regarding the respiratory condition to the patient M, for example, by autovoice, which will be described later. 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.

[0027] The optical imaging unit 17 is, for example, a camera, and optically captures a moving image of the respiratory state of the patient M during dynamic imaging. In this embodiment, the radiographic imaging device 10 captures moving images as well as dynamic images, and the radiographic imaging control device 20 is configured to acquire the moving images as well as the dynamic images from the radiographic imaging device 10.

[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] It should be noted that, for example, in the case of screening, emergency care, etc., it may not be possible 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. Furthermore, 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 (analysis by the analysis unit 312, which will be described later) is performed in the radiographic image analyzer 30, which will be described later.

[0032] As will be described later, the image generation unit 113 performs dynamic imaging of the patient M breathing in accordance with the autovoice 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, for each pixel, intensity information relating to the intensity of radiation that has passed through the subject from the radiation detector 14.

[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] Furthermore, the radiation imaging control device 20 generates an autovoice that provides breathing guidance based on instruction information related to breathing (see FIG. 6A, which will be described later).

[0039] 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.

[0040] The radiography control device 20 outputs setting conditions set by an operator or the like and examination order information previously acquired 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 and videos captured by the optical imaging unit 17 so that the operator can check them.

[0041] 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.

[0042] The control unit 21 includes a generation unit 211 and a determination unit 212 .

[0043] The generating unit 211 generates first reference information regarding the respiratory state during imaging based on examination order information for dynamic imaging, which includes instructions regarding breathing during imaging. Here, an imaging reference waveform, which will be described later, is exemplified as the first reference information, but the first reference information is not limited to a waveform and may be, for example, numerical data, etc., as long as it is information that serves as a reference for the measurement result of the respiratory state.

[0044] The determination unit 212 compares the respiratory condition measurement results obtained from the dynamic image with the reference waveform for imaging to determine whether the respiratory condition during actual imaging was as instructed by AutoVoice. Here, the respiratory condition measurement results are exemplified by measurement value waveforms, which will be described later, but any respiratory condition measurement results are not limited to waveforms and may be, for example, numerical data.

[0045] Furthermore, the determination unit 212 compares the measurement result of the respiratory condition with second reference information related to respiratory diseases to determine the possibility of a respiratory disease. Here, the second reference information is exemplified by a reference waveform for disease determination, which will be described later, but any information that can be used as a reference for determining the possibility of a respiratory disease is not limited to a waveform and may be, for example, numerical data.

[0046] The generating unit 211 and the determining unit 212 will be described in more detail later with reference to FIG.

[0047] 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, or data such as processing results (dynamic images, videos, 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.

[0048] 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.

[0049] 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.

[0050] The display unit 24 is configured with a display device such as a CRT, a liquid crystal display, an organic EL display, etc. In accordance with instructions of a display signal input from the control unit 21, the display unit 24 displays input instructions from the operation unit 23, image data (dynamic images, videos, etc.) generated by the radiographic image capturing device 10, etc.

[0051] 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.

[0052] [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.

[0053] 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.

[0054] 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.

[0055] 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.

[0056] The control unit 31 includes an image acquisition unit 311 and an analysis unit 312 .

[0057] The image acquisition unit 311 acquires dynamic images, which are radiographic images of multiple frames generated by the radiographic image capturing device 10.

[0058] The analysis unit 312 executes the dynamic analysis set in the setting information on the dynamic image acquired from the radiographic image capturing 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 not possible.

[0059] The analysis unit 312 has, as types of dynamic analysis (analysis modes in the present invention), for example, a blood flow analysis mode, a ventilation analysis mode, an adhesion analysis mode, a diaphragm movement amount analysis mode, etc. Each mode will be briefly described below.

[0060] The blood flow analysis mode visualizes signal changes within the lung field that are synchronized with the heartbeat.

[0061] 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.

[0062] The adhesion analysis mode is a mode for visualizing the degree of tissue adhesion.

[0063] The diaphragm movement amount analysis mode is a mode for tracking the up and down movement of the diaphragm that accompanies breathing.

[0064] 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 processing by the programs, or data such as processing results (dynamic images, videos, analysis 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.

[0065] 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.

[0066] 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.

[0067] The display unit 34 is configured with a display device such as a CRT, a liquid crystal display, an organic EL display, etc. In accordance with instructions of a display signal input from the control unit 31, the display unit 34 displays input instructions from the operation unit 33, image data (dynamic images, videos, etc.) generated by the radiographic image capturing device 10, etc.

[0068] The communication unit 35 transmits and receives data to and from the radiation imaging control device 20, the image management device 40, and the like.

[0069] [Radiation image processing method] Fig. 5 is a flowchart illustrating the processing performed by the radiographic imaging device 10 and the radiographic imaging control device 20. In Fig. 5, the radiographic imaging device 10 is referred to as the "imaging device" and the radiographic imaging control device 20 is referred to as the "control device."

[0070] (Step S11) The radiography control device 20 receives examination order information including examination information, instructions regarding breathing, patient information, radiography information, etc. from the radiography information terminal 60 or the like.

[0071] Here, with reference to FIG. 6A, an example of instructions and autovoice relating to breathing used in the radiation image capturing apparatus 10 and the radiation image capturing control apparatus 20 will be described.

[0072] As shown in Fig. 6A, breathing instructions include deep breathing, breath holding, etc. In the examination order information, for example, deep breathing, breath holding, etc. are set as breathing instructions based on instructions from a doctor, etc. For example, when examining lung ventilation, thoracic movement, and diaphragm movement, deep breathing without breath holding is preferable, and when examining pulmonary blood flow, breath holding is preferable.

[0073] The radiation imaging control device 20 generates an autovoice that provides breathing guidance based on the breathing instructions. The radiation imaging control device 20 stores in advance in the storage unit 22 a breathing guidance pattern corresponding to each breathing instruction for each instruction. When the radiation imaging control device 20 receives examination order information, the radiation imaging control device 20 reads from the storage unit 22 the breathing guidance pattern corresponding to the instruction based on the breathing instruction set in the examination order information, and generates an autovoice. When the breathing instruction is to take a deep breath or hold one's breath, an autovoice such as the one shown in FIG. 6A is generated.

[0074] When generating the autovoice, the radiation imaging control device 20 may change the duration of each autovoice guidance based on, for example, patient information or the like.

[0075] (Step S12) The radiation imaging control device 20 (generation unit 211) generates an imaging reference waveform of the respiratory state during imaging along the imaging time for the measurement values ​​of the region of interest related to respiration based on the examination order information.

[0076] For example, suppose the examination order information indicates that the examination information is for a ventilation analysis mode and that the respiration instruction is to take a deep breath. Furthermore, the amount of diaphragm movement is to be measured as a measurement value of the region of interest related to respiration. In this case, the radiation imaging control device 20 generates, along with the imaging time, a reference waveform for imaging the amount of diaphragm movement when imaging while breathing in accordance with the autovoice for deep breathing, as shown in FIG. 6B.

[0077] FIG. 6C is a reference waveform for imaging of the amount of movement of the diaphragm when imaging while breathing according to the autovoice during breath holding.

[0078] Additionally, here, the amount of diaphragm movement is used as the measurement value of the region of interest related to respiration, but this is not limited to this, and other values ​​such as the diaphragm movement speed, the length of the lung field, the area of ​​the lung field, and the rate of change of the area of ​​the lung field may also be used.

[0079] In addition, when generating the reference waveform for imaging, the radiation imaging control device 20 may take into consideration, for example, patient information, such as the height, weight, age, and gender of patient M, to generate the reference waveform for imaging or to generate an acceptable range for the reference waveform for imaging.

[0080] (Step S13) The radiation imaging control device 20 transmits breathing-related instructions and imaging information to the radiation image capturing device 10 .

[0081] (Step S21) Based on the breathing instructions and imaging information, the radiographic imaging device 10 performs dynamic imaging by providing breathing guidance to the patient M using autovoice. At this time, the radiographic imaging device 10 uses the optical imaging unit 17 to optically capture the breathing state of the patient M during dynamic imaging as a video.

[0082] (Step S22) The radiation image capturing device 10 transmits the dynamic image to the radiation image capturing control device 20. At this time, the radiation image capturing device 10 also transmits the moving image captured by the optical capturing unit 17 to the radiation image capturing control device 20.

[0083] (Step S14) The radiography control device 20 (determining unit 212) acquires measurement values ​​of the region of interest related to respiration from the dynamic image, obtains a measurement value waveform, and compares it with the radiography reference waveform.

[0084] For example, as described above, when measuring the amount of movement of the diaphragm as a measurement value of a region of interest related to respiration, the radiation imaging control device 20 acquires the measurement value of the amount of movement of the diaphragm from a dynamic image and obtains a measurement value waveform along the imaging time.

[0085] Here, Fig. 7A is a diagram showing the measurement value waveform of the amount of diaphragm movement when breathing becomes shallower compared to the reference waveform for imaging shown in Fig. 6B, and Fig. 7B is a diagram showing the measurement value waveform of the amount of diaphragm movement when breath-holding is not possible compared to the reference waveform for imaging shown in Fig. 6B.

[0086] If the patient's breathing becomes shallow or they are unable to hold their breath in response to the autovoice command to take a deep breath, the measurement waveform of the diaphragm movement will deviate from the reference waveform for radiography, as shown in Figures 7A and 7B. By quantitatively comparing the reference waveform for radiography with the measurement waveform, the radiography control device 20 can determine whether the patient's breathing during radiography was in line with the autovoice command.

[0087] 7A and 7B, the radiation imaging control device 20 may display the imaging reference waveform and the measurement value waveform on the display unit 24 so that the operator can visually recognize them. In this case, if the tolerance range for the imaging reference waveform is also displayed on the display unit 24, the operator can more easily compare the imaging reference waveform with the measurement value waveform.

[0088] (Step S15) The radiation imaging control device 20 (determination unit 212) determines whether the breathing is in line with the autovoice. At this time, the radiation imaging control device 20 displays the determination result on the display unit 24. If the breathing is in line with the autovoice (YES), the process proceeds to step S19, and if the breathing is not in line with the autovoice (NO), the process proceeds to step S16.

[0089] The determination of whether or not the result was as expected by the autovoice may be made based on, for example, the amount of deviation between the reference waveform for imaging and the measurement waveform, or based on whether or not the measurement waveform is within the allowable range of the reference waveform for imaging.

[0090] The operator of the radiography control device 20 can easily and quickly determine whether the patient's respiratory condition during imaging was in accordance with the AutoVoice instructions based on the determination result displayed on the display unit 24. Therefore, the operator can determine whether to end dynamic image imaging (whether to re-imaging). Furthermore, if the operator determines based on the determination result displayed on the display unit 24 that the patient's respiratory condition during imaging was in accordance with the AutoVoice instructions, the operator's determination result may be stored in the memory unit 22 together with the above-mentioned determination result in step S19, which will be described later.

[0091] In addition to comparing the measurement waveform with the reference waveform for imaging, video optically captured by the optical imaging unit 17 may be used to determine whether the breathing condition during actual imaging was in line with the autovoice.

[0092] Specifically, the radiation imaging control device 20 (determination unit 212) acquires the respiratory state of the patient M (for example, the timing of inhalation, exhalation, and breath holding) by performing image analysis on the moving image captured by the optical imaging unit 17. Then, the radiation imaging control device 20 (determination unit 212) compares the acquired respiratory state with the measurement value waveform (the timing of inhalation, exhalation, and breath holding in the measurement value waveform) to determine whether the breathing during actual dynamic imaging was as instructed.

[0093] (Step S16) The radiation imaging control device 20 (determination unit 212) compares the measurement waveform with a reference waveform for disease determination, which is used to determine various respiratory diseases.

[0094] Here, Fig. 8A is a diagram showing an example of a measurement waveform of the amount of diaphragm movement in a healthy subject. Fig. 8B is a diagram showing an example of a measurement waveform of the amount of diaphragm movement in a patient with chronic obstructive pulmonary disease. Note that Figs. 8A and 8B show measurement waveforms of the amount of diaphragm movement in both lungs. Fig. 9 is a diagram showing example measurement waveforms of lung area during breathing in a healthy subject, a patient with chronic obstructive pulmonary disease, and an interstitial lung disease.

[0095] As shown in Figures 8A and 8B, there is a difference in the measurement waveform of the amount of diaphragm movement between a healthy subject and a patient with chronic obstructive pulmonary disease (COPD). The radiography control device 20 stores in advance in the storage unit 22 reference waveforms for determining various respiratory diseases. If the radiography control device 20 determines in step S15 that the breathing is not in accordance with the autovoice, it quantitatively compares the reference waveform for determining various respiratory diseases with the measurement waveform.

[0096] 9, differences appear in the measurement waveform of lung area projected by X-rays between a healthy subject and a patient with chronic obstructive pulmonary disease (COPD) or interstitial lung disease (ILD). The radiation imaging control device 20 stores in advance in the storage unit 22 reference waveforms for disease determination used to determine various respiratory diseases. If the radiation imaging control device 20 determines in step S15 that the breathing does not match the autovoice, it quantitatively compares the measurement waveform with the reference waveform for disease determination used to determine various respiratory diseases.

[0097] Here, the amount of diaphragm movement and lung area are used as measurement values ​​for the region of interest related to breathing, but this is not limited to this. Reference waveforms for disease assessment may also be created for the diaphragm movement speed, lung field length, rate of change of lung area, etc., and compared with the measurement waveforms.

[0098] For example, in the case of COPD patients, when taking a deep breath, the lung area tends to increase, the rate of change in lung area tends to decrease, and the amount of diaphragm movement tends to decrease compared to healthy people, and these may be compared between the reference waveform for disease assessment and the measurement waveform.

[0099] Furthermore, in the case of COPD patients, the amount of diaphragm movement and the speed of diaphragm movement tend to increase during quiet breathing compared to healthy individuals, and these may be compared between the reference waveform for disease assessment and the measurement waveform.

[0100] Furthermore, in the case of patients with cystic fibrosis (CF), the speed of movement of the diaphragm tends to decrease when taking a deep breath compared to healthy individuals, and this can be evaluated by comparing the reference waveform for disease assessment with the measurement waveform.

[0101] Furthermore, in the case of ILD patients, lung area and diaphragm movement tend to decrease when taking a deep breath compared to healthy individuals, and these may be compared between the reference waveform for disease assessment and the measurement waveform.

[0102] Not only patients with COPD, CF, and ILD as described above, but also patients with ventilation disorders such as asthma will show differences in the measured values ​​of the region of interest related to breathing compared to healthy individuals. Therefore, by comparing the reference waveform for disease determination with the measured value waveform, it is possible to determine at least the presence or absence of ventilation disorders.

[0103] (Step S17) The radiography control device 20 (determination unit 212) determines whether there is a reference waveform for disease determination that matches the measurement value waveform. If there is a reference waveform for disease determination that matches the measurement value waveform (YES), proceed to step S19. In this case, the radiography control device 20 does not perform dynamic re-imaging. If there is no reference waveform for disease determination that matches the measurement value waveform (NO), proceed to step S18.

[0104] The determination of whether there is a reference waveform for disease determination that matches the measurement waveform may be made, for example, based on the amount of deviation between the reference waveform for disease determination and the measurement waveform, or based on whether the measurement waveform is within the determination range of the reference waveform for disease determination.

[0105] (Step S18) The radiography control device 20 displays the radiography error on the display unit 24 and ends the series of processes. In this case, the radiography control device 20 does not perform dynamic re-imaging, but may perform re-imaging after the operator, doctor, etc. decides whether or not re-imaging is possible.

[0106] For example, if there is no disease assessment reference waveform that matches the measurement waveform, it is possible that patient M is not breathing in accordance with the autovoice even though he or she is able to breathe in accordance with the autovoice. In this case, the operator, doctor, etc. may determine that re-imaging is necessary by, for example, checking a video of patient M during dynamic imaging captured by the optical imaging unit 17 together with the imaging reference waveform and the measurement waveform. Then, the operator, doctor, etc. may operate the operation unit 23 of the radiation imaging control device 20 to return to step S13. At this time, the operator, doctor, etc. may change the autovoice guidance or guidance time, or change the imaging conditions, and then perform re-imaging.

[0107] (Step S19) If it is determined in step S15 that the breathing is in accordance with the autovoice, the radiography control device 20 stores the dynamic image, the radiography reference waveform, and the measurement value waveform in the storage unit 22. At this time, the above-mentioned determination result and the operator's judgment result may also be stored in the storage unit 22.

[0108] Furthermore, in step S17, if there is a reference waveform for disease determination that matches the measurement waveform, the radiation imaging control device 20 stores the reference waveform for disease determination that matches the measurement waveform, along with the dynamic image, the reference waveform for imaging, and the measurement waveform, in the storage unit 22. At this time, the radiation imaging control device 20 may also store in the storage unit 22 a disease that matches the measurement waveform.

[0109] The radiography control device 20 transmits the above-mentioned information stored in the storage unit 22 to the radiography image analysis device 30. The radiography control device 20 may also be configured to allow the radiography image analysis device 30 to acquire the above-mentioned information stored in the storage unit 22.

[0110] The radiographic image analyzer 30 analyzes the dynamic image transmitted from the radiography control device 20, and in the ventilation analysis mode, for example, visualizes the behavior of lung tissue during breathing as the analysis result. At this time, the radiographic image analyzer 30 may display the measurement value waveform indicating the respiratory state, and, if any, diseases that match the measurement value waveform, together with the analysis result, on the display unit 34. The radiographic image analyzer 30 may also display the above-mentioned judgment result, the operator's judgment result, and diseases that match the measurement value waveform on the display unit 34.

[0111] The analysis results obtained by the radiation image analysis device 30 are sent to the image management device 40 together with dynamic images, reference waveforms for imaging, measurement value waveforms, etc., and can be viewed by doctors and others from a client terminal 50, for example.

[0112] A doctor viewing the analysis results from client terminal 50 can confirm that the patient's respiratory condition during imaging was as instructed by AutoVoice from the imaging reference waveform, measurement waveform, the above-mentioned judgment results, and the operator's judgment results. In this case, the analysis results are analysis results of dynamic images captured under the respiratory condition instructed by AutoVoice, so the analysis is highly reliable and the doctor can make a correct diagnosis based on the analysis results.

[0113] Furthermore, when a doctor viewing the analysis results from the client terminal 50 has a disease determination reference waveform that matches the measurement waveform, the doctor will view the analysis results taking into consideration the disease that matches the measurement waveform. In this case, the doctor will make a diagnosis based on the disease that matches the measurement waveform and the analysis results, which can prevent an erroneous diagnosis from being made.

[0114] As described above, the radiation imaging control device 20 includes the generation unit 211 and the determination unit 212. The generation unit 211 generates an imaging reference waveform related to the respiratory state during imaging based on examination order information for dynamic imaging, which includes instructions related to breathing during imaging. The determination unit 212 compares the measurement value waveform with the imaging reference waveform to determine whether the actual respiratory state during imaging was as instructed by AutoVoice. The determination unit 212 also compares the measurement value waveform with a disease determination reference waveform related to respiratory disease to determine the possibility of respiratory disease.

[0115] The radiography control device 20 compares the measurement waveform with the radiography reference waveform to determine whether the respiratory condition during actual radiography was as instructed by AutoVoice. Therefore, the radiography control device 20 can easily determine whether the respiratory condition was appropriate for radiography as a result of performing dynamic radiography.

[0116] The radiography control device 20 then compares the measurement waveform with the disease-determining reference waveform to determine the possibility of respiratory disease, even if the respiratory condition is deemed inappropriate for imaging as a result of dynamic imaging. At this time, if the radiography control device 20 determines that the measurement waveform deemed inappropriate for imaging is due to a respiratory disease, it will not perform dynamic reimaging. This prevents unnecessary reimaging, i.e., radiation exposure, even if the respiratory condition is deemed inappropriate for imaging as a result of dynamic imaging, thereby improving the usability of the imaging results. Furthermore, by not performing dynamic reimaging, the burden on the patient can be reduced.

[0117] In this embodiment, the above-mentioned reference waveform for imaging is generated based on the test order information. However, instead of or in addition to this, past measurement value waveforms of the patient to be imaged may be used as the reference waveform for comparison.

[0118] 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]

[0119] 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 17 Optical imaging 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 111 Setting information acquisition unit 112 Shooting condition determination unit 113 Image Generation Unit 114 Storage section 211 Generation part 212 Judgment section 311 Image Acquisition Unit 312 Analysis Department

Claims

1. a generating unit that generates first reference information regarding a respiratory state of the patient during the dynamic radiography based on examination order information for the dynamic radiography, the first reference information including an instruction regarding the patient's breathing during the dynamic radiography; a determination unit that compares a measurement result regarding the respiratory state obtained by the dynamic radiography with the first reference information to determine whether or not the actual breathing during the dynamic radiography was as instructed, and that compares the measurement result with second reference information regarding a respiratory disease to determine the possibility of the respiratory disease; A radiation image processing device comprising:

2. the test order information includes patient information regarding the patient; the generation unit generates the first reference information based on the instruction and the patient information. The radiation image processing device according to claim 1 .

3. the first reference information is an imaging reference waveform related to the respiratory state, which is generated along an imaging time; The measurement result is a measurement waveform of a measurement value related to the respiratory state measured by the dynamic imaging along the imaging time.

3. The radiation image processing apparatus according to claim 1 or 2.

4. the second reference information is a reference waveform for disease determination related to the respiratory disease, which is generated along the imaging time; The radiation image processing device according to claim 3 .

5. an optical imaging unit that optically captures the respiratory state of the patient as a video; The determination unit further compares the measurement result with the respiratory state obtained by analyzing the moving image to determine whether or not the actual breathing during dynamic imaging was as instructed. The radiation image processing device according to claim 1 .

6. On the computer, generating first reference information regarding a respiratory state of the patient during the dynamic radiography based on examination order information for the dynamic radiography, the first reference information including instructions regarding the patient's breathing during the dynamic radiography; a process of comparing a measurement result regarding the respiratory state obtained by the dynamic radiography with the first reference information to determine whether or not the breathing during the actual dynamic radiography was in accordance with the instructions, and comparing the measurement result with second reference information regarding a respiratory disease to determine the possibility of the respiratory disease; A radiation image processing program that executes the above.

Images