Image processing device, image processing method, and image processing program

Abstract

To provide an image processing device, an image processing method, and an image processing program that enable a distance of an inner cannula in which a puncture needle projects to be easily checked as compared to a case of manually measuring the distance.SOLUTION: A control part performs processing of displaying a virtual position 36 that a distal end of an inner cannula reaches so as to be superimposed on a CT image 38 on the basis of predetermined distance information to the distal end of the inner cannula when the inner cannula projects from an outer cannula 32.SELECTED DRAWING: Figure 4

Description

[Technical Field]

[0001] The present disclosure relates to an image processing device, an image processing method, and an image processing program. [Background technology]

[0002] Patent Document 1 proposes a three-dimensional image display device that reconstructs a three-dimensional image of a subject, including a needle, using a three-dimensional original image of the subject, including a needle to be inserted into the subject, and displays the three-dimensional image, and that includes: a designation means for designating the needle on the three-dimensional image; a means for determining the current position of the needle based on the designation by the designation means and calculating an extension line of the needle in the long axis direction; and a means for displaying the calculated extension line of the needle on the three-dimensional image.

[0003] Patent document 2 proposes a system and method for assisting or performing image-guided transjugular intrahepatic portosystemic shunting in a portion of a patient's anatomy, the system comprising a guide needle portion having a hollow tube with a bend toward its distal tip and a puncture needle portion including at least one position-indicating element at its tip.

[0004] Patent document 3 proposes an image display device that includes a detection means for detecting the end point of a needle from an X-ray tomographic image that includes an image of the needle, and a notification means for identifying, among multiple display units, the display unit that displays the end point of the needle detected by the detection means and notifying that display unit. [Prior art documents] [Patent documents]

[0005] [Patent Document 1] Japanese Patent Application Laid-Open No. 2000-217814 [Patent Document 2] Japanese Patent Application Laid-Open No. 2012-518453 [Patent Document 3] Japanese Patent Application Laid-Open No. 2003-325503 Summary of the Invention [Problem to be solved by the invention]

[0006] When inserting a puncture needle while checking a radiological image, such as in a CT-guided biopsy, the outer sheath of the puncture needle is inserted first while checking the position with radiation, and when the tip approaches the target, manual distance measurement is performed on the radiological image. Then, after the tip of the outer sheath reaches a position taking into account the distance of the inner sheath protruding from the outer sheath, the inner sheath is inserted and protruded from the outer sheath to collect tissue.

[0007] Conventionally, distance measurement is performed manually on a radiographic image, so distance measurement must be performed every time the positional relationship between the tip of the coat and the target changes, which is time-consuming.

[0008] Therefore, the present disclosure aims to provide an image processing device, an image processing method, and an image processing program that make it easier to check the distance of the inner sheath from which the puncture needle protrudes, compared to when performing manual distance measurement. [Means for solving the problem]

[0009] In order to achieve the above object, an image processing device according to a first aspect of the present disclosure includes a processor that acquires a radiological image of a subject, including a puncture needle with an inner sheath protruding from an outer sheath, detects the area of ​​the puncture needle in the radiological image, and performs processing to cause the inner sheath to protrude from the outer sheath and display a virtual position where the tip of the inner sheath reaches, superimposed on the radiological image.

[0010] An image processing device according to a second aspect of the present disclosure is an image processing device according to the first aspect, in which a processor displays a virtual position superimposed on a radiological image based on predetermined distance information to the tip of the inner sheath when the inner sheath is protruded from the outer sheath.

[0011] An image processing device according to a third aspect of the present disclosure is an image processing device according to the second aspect, in which the processor calculates the position of the tip of the inner sheath according to the display magnification based on predetermined distance information, and displays the virtual position superimposed on the radiographic image.

[0012] An image processing device according to a fourth aspect of the present disclosure is the image processing device according to the second aspect, in which the processor calculates the position of the tip of the inner sheath corresponding to the cross-section of the radiographic image to be displayed based on predetermined distance information, and displays the virtual position superimposed on the radiographic image.

[0013] An image processing device according to a fifth aspect of the present disclosure is an image processing device according to the first aspect, in which a processor performs labeling processing and edge processing on a radiological image, calculates an average radiation concentration value at each pixel within an object labeled by the labeling processing, and detects at least one of objects having a concentration value range equal to or greater than a predetermined threshold, which have an area radially extending from the center of the image at a distance greater than a predetermined distance from the center of the image, and objects having an area at the boundary between the air and the body surface and in the air-side area at a distance greater than a predetermined distance from the center of the image, and designates the detected object as a puncture needle area.

[0014] An image processing device according to a sixth aspect of the present disclosure is an image processing device according to the fifth aspect, wherein when detecting objects having an area radially extending at a predetermined distance or more from the center of the image, and objects having an area at a predetermined distance or more in the boundary area between the air and the body surface and in the area on the air side, among objects having a density value range above a predetermined threshold, the processor first detects objects having an area at a predetermined distance or more in the boundary area between the air and the body surface and in the area on the air side, and when the object is detected, the object is designated as the puncture needle area.

[0015] An image processing device according to a seventh aspect of the present disclosure is an image processing device according to the sixth aspect, wherein the processor detects an object that exists in an area that is more than a predetermined distance away in the boundary region between the air and the body surface and in the area on the air side, and if the object is not detected, detects an object that exists in an area that is more than a predetermined distance away in the boundary region between the air and the body surface and in the area on the air side.

[0016] An image processing device according to an eighth aspect of the present disclosure is the image processing device according to the fifth aspect, wherein the processor calculates the central pixel between the edges of the area of ​​the puncture needle, sets this as the pixel of the central axis of the puncture needle, and displays the virtual position superimposed on the radiographic image in a display mode of at least one of a predetermined color and a predetermined transparency as an inner sheath that protrudes from the pixel of the tip of the puncture needle in the direction of the central axis of the puncture needle by a distance equal to the protrusion distance of the inner sheath.

[0017] An image processing device according to a ninth aspect of the present disclosure is the image processing device according to the eighth aspect, wherein the processor calculates a central pixel by interpolating pixels when edge information is insufficient at the tip of the puncture needle.

[0018] An image processing device according to a tenth aspect of the present disclosure is an image processing device according to the first aspect, in which a processor acquires designation information of a puncture needle area on a radiological image designated by a user, and based on the designation information, extracts the area of ​​the puncture needle by filling in pixels in a density value range above a preset threshold around the designation information, and after extracting the area of ​​the puncture needle, the tip of the area toward the center of the radiological image is designated as the tip of the puncture needle.

[0019] An image processing method according to an eleventh aspect of the present disclosure includes a computer acquiring a radiological image of a subject including a puncture needle with an inner sheath protruding from an outer sheath, detecting the area of ​​the puncture needle in the radiological image, and performing processing to superimpose on the radiological image the position of the tip of the inner sheath when it is protruding from the outer sheath before the inner sheath is protruding from the outer sheath.

[0020] An image processing program according to a twelfth aspect of the present disclosure causes a computer to acquire a radiological image of a subject including a puncture needle with an inner sheath protruding from an outer sheath, detect the area of ​​the puncture needle in the radiological image, and superimpose on the radiological image the position of the tip of the inner sheath when it is protruding from the outer sheath before the inner sheath is protruding from the outer sheath. [Effects of the Invention]

[0021] According to the present disclosure, it is possible to provide an image processing device, an image processing method, and an image processing program that make it easier to check the distance of the inner sheath from which the puncture needle protrudes, compared to when performing manual distance measurement. [Brief explanation of the drawings]

[0022] [Figure 1] 1 is a diagram showing a medical image inspection apparatus according to an embodiment of the present invention; [Figure 2] 1 is a block diagram showing the configuration of a medical image inspection apparatus according to an embodiment of the present invention. [Figure 3] FIG. 1 is a diagram showing an example of a puncture needle used for CT-guided biopsy. [Figure 4] FIG. 10 is a diagram showing an example in which a virtual position where the tip of an inner sheath reaches when the inner sheath is protruded from the outer sheath is superimposed on a CT image. [Figure 5] FIG. 10 is a diagram illustrating pixel interpolation of the edge portion of the tip of the coat. [Figure 6] FIG. 10 is a diagram showing an example of a virtual position of an inner cannula displayed on a sagittal cross section. [Figure 7] FIG. 10 is a diagram showing an example of a virtual position of an inner cannula displayed on an axial cross section. [Figure 8] FIG. 10 is a diagram showing an example of a distance at which a virtual position of an inner cannula is displayed in an axial cross section. [Figure 9] FIG. 10 is a diagram showing an example of a virtual position of an inner cannula displayed on a coronal section. [Figure 10] 10 is a flowchart showing an example of the flow of processing performed by a control unit of the medical image inspection apparatus according to the present embodiment. DETAILED DESCRIPTION OF THE INVENTION

[0023] Hereinafter, an embodiment of the present invention will be described in detail with reference to the drawings. Note that the present invention is not limited to this embodiment. Fig. 1 is a diagram showing a medical image inspection device according to this embodiment, and Fig. 2 is a block diagram showing the configuration of the medical image inspection device according to this embodiment.

[0024] The medical image inspection device 10 of this embodiment includes a gantry (mounting) 12 that acquires CT images as an example of a radiation image, a bed 14 on which a subject 18, which is an example of a subject 18, lies, and a console 16, which is a computer that is operated.

[0025] As is well known, the gantry 12 uses radiation (e.g., X-rays) to irradiate the subject 18 on the bed 14 with radiation to perform computed tomography (CT) to obtain CT images. The CT images obtained are tomographic images of the axial, sagittal, and coronal sections. The gantry 12 is installed, for example, in an imaging room in the radiology department of a medical facility.

[0026] The console 16 includes a monitor 20 that displays CT images acquired by the gantry 12, and an operation panel 22 that is operated by an operator such as a radiological technologist.

[0027] As shown in FIG. 2, the gantry 12, the monitor 20, and the operation panel 22 are connected to a control unit 24, which includes a CPU 24A as an example of a processor, a memory 24B, and a storage unit 24C.

[0028] The control unit 24 also functions as an image processing device that performs image processing on the data output from the gantry 12 and generates a tomographic image by expanding the image processing program stored in the storage unit 24C into the memory 24B and executing it with the CPU 24A.

[0029] Furthermore, a communication I / F (interface) unit 26 is connected to the control unit 24, allowing for the exchange of information such as CT images with external devices.

[0030] The console 16 is an example of an "image processing device" according to the technology of the present disclosure. The console 16 also functions as an image display device that displays the generated tomographic images.

[0031] The medical image inspection device 10 according to this embodiment is used, for example, for CT-guided biopsy, in which a puncture needle is inserted into the skin surface to collect a portion of tissue while the location of the lesion is confirmed using a CT image displayed on the monitor 20.

[0032] FIG. 3 is a diagram showing an example of a puncture needle used for CT-guided biopsy.

[0033] As shown in Figure 3, the puncture needle 30 comprises an outer sheath 32 and an inner sheath 34. By inserting the inner sheath 34 into the outer sheath 32 and pushing the rear end portion 34B of the inner sheath 34, the inner sheath 34 protrudes from the tip 32A of the outer sheath 32.

[0034] Here, the examination procedure of CT-guided biopsy, which is performed while checking the CT image displayed on the monitor 20, will be described.

[0035] First, the lesion is photographed using the gantry 12, and based on the CT image obtained by the gantry 12, the needle insertion path is determined taking into consideration factors such as the distance to the lesion, the angle at which the needle will be inserted, and whether the large trachea and blood vessels can be avoided.

[0036] After administering local anesthesia, the mantle 32 of the puncture needle 30 is inserted, and the mantle 32 of the puncture needle 30 is carefully advanced while checking the direction of advancement of the mantle 32 of the puncture needle 30 by CT imaging.

[0037] Once it is confirmed that the needle has been inserted directly above the target, such as a tumor, the inner sheath 34 is inserted into the outer sheath 32, and the rear end portion 34B of the inner sheath 34 is pushed, causing the inner sheath 34 to protrude from the tip 32A of the outer sheath 32 and collect the target tissue.

[0038] In conventional CT-guided biopsy, the outer sheath 32 of the puncture needle 30 is inserted first while checking the position using a CT image, and when the tip 32A of the puncture needle approaches the target, manual distance measurement is performed on the CT image. For example, conventionally, distance measurement must be performed by performing a manual operation such as designating two points on the screen of the monitor 20. Then, after the tip 32A of the outer sheath 32 reaches a position taking into account the distance of the inner sheath 34 protruding from the outer sheath 32, the inner sheath 34 is inserted to sample tissue.

[0039] As described above, in conventional CT-guided biopsy, the distance measurement of the inner sheath 34 protruding from the outer sheath 32 is performed manually, and therefore, the measurement must be re-measured every time the positional relationship between the tip 32A of the outer sheath 32 of the puncture needle 30 and the target changes, which takes time to collect the target tissue.

[0040] Furthermore, when measuring the distance, it is necessary to consider the position of the tip 32A of the outer jacket 32 ​​and whether the outer jacket 32 ​​and the target are on the same straight line, which also requires time for confirmation.

[0041] Therefore, in the medical image inspection device 10 according to this embodiment, the control unit 24 acquires a CT image of the subject 18, including the puncture needle 30, detects the area of ​​the puncture needle 30 in the CT image, and performs a process of protruding the inner sheath 34 from the outer sheath 32 and displaying a virtual position where the tip of the inner sheath 34 will reach, superimposed on the CT image. For example, as shown in FIG. 4, a virtual position 36 of the inner sheath 34 protruding from the outer sheath 32 may be displayed superimposed on a CT image 38. FIG. 4 is a diagram showing an example in which the virtual position 36 where the tip of the inner sheath 34 will reach, protruding from the outer sheath 32, is displayed superimposed on a CT image 38. In FIG. 4, the virtual position 36 where the tip of the inner sheath will reach is the tip of an arrow.

[0042] Specifically, the control unit 24 performs processing to superimpose and display a virtual position 36 where the tip of the inner sheath 34 reaches on the CT image 38, based on predetermined distance information to the tip of the inner sheath 34 when the inner sheath 34 protrudes from the outer sheath 32. That is, since the distance where the inner sheath 34 protrudes from the outer sheath 32 is determined by the type of puncture needle 30, etc., the virtual position 36 can be identified and displayed from the distance information predetermined for each puncture needle 30.

[0043] More specifically, the control unit 24 performs labeling and edge extraction processes on the CT image 38 that includes the puncture needle 30. The average density value (CT value) of each pixel within the object labeled by the labeling process is calculated, and objects within a CT value range equal to or greater than a preset threshold are extracted. To distinguish between the puncture needle 30 (metal) and bones whose CT values ​​are close to each other, only objects that meet at least one of the following conditions 1 and 2 are extracted and treated as the puncture needle region. Condition 1: There is an area radially extending from the center of the image that is at least a predetermined distance away. Condition 2: There is an area between the air and the body surface, and an area on the air side that is greater than a predetermined distance.

[0044] When extracting objects that satisfy both condition 1 and condition 2, if the object that satisfies condition 1 and the object that satisfies condition 2 are different, the object that satisfies condition 2 is determined to be the puncture needle region. Alternatively, for conditions 1 and 2, an area that satisfies condition 2 may be extracted, and if an area that satisfies condition 2 exists, the area that satisfies condition 2 may be determined to be the puncture needle region, and if an area that satisfies condition 2 does not exist, the area under condition 1 may be extracted, and if an area that satisfies condition 1 exists, the area that satisfies condition 1 may be determined to be the puncture needle region.

[0045] After extracting the needle region, the tip of the region toward the center of the image is designated as the needle tip. The center pixel between the edges of the needle region is calculated and treated as the pixel of the central axis of the needle 30. If edge information is insufficient at the needle tip, pixels are interpolated to calculate the center pixel. For example, at the tip of the mantle 32, as shown by the dotted line in Figure 5, edge information is insufficient and the center pixel cannot be calculated. Therefore, pixels in the edge portion of the needle up to the needle tip are interpolated to calculate the center pixel and derive the central axis pixel. Figure 5 is a diagram for explaining pixel interpolation of the edge portion of the tip of the mantle 32.

[0046] When displaying the virtual position 36 where the tip of the inner sheath 34 reaches, the inner sheath 34 may be displayed superimposed on the CT image 38 in a display mode of at least one of a predetermined color and transparency as the inner sheath 34 protruding from the pixel of the needle tip in the direction of the central axis of the needle 30 by a distance equal to a predetermined protrusion distance of the inner sheath 34. As the display mode, the inner sheath 34 is displayed in a display mode of at least one of a color and transparency that can be distinguished from the inner sheath 34 actually displayed in the CT image 38.

[0047] Furthermore, if the display magnification can be changed, the virtual position 36 reached by the tip of the inner sheath 34 changes depending on the display magnification, and therefore the control unit 24 may calculate and display the virtual position 36 reached by the tip of the inner sheath 34 according to the display magnification based on predetermined distance information to the tip of the inner sheath 34 when the inner sheath 34 is protruded from the outer sheath 32.

[0048] Furthermore, since the virtual position 36 reached by the tip of the inner sheath 34 differs depending on the cross-section to be displayed, the control unit 24 calculates the position of the tip of the inner sheath 34 corresponding to the cross-section of the CT image 38 to be displayed based on predetermined distance information to the tip of the inner sheath 34 when the inner sheath 34 is protruded from the outer sheath 32, and displays the virtual position 36 superimposed on the CT image 38.

[0049] For example, it is assumed that CT images 38 can be displayed in an axial plane perpendicular to the puncture needle 30, a sagittal plane passing through the central axis of the puncture needle 30 and perpendicular to the axial plane, and a coronal plane perpendicular to the sagittal plane of the needle tip. Also, in the sagittal plane (sagittal plane), as shown in FIG. 6, the angle of the outer sheath 32 is inclined at an angle θ1 from the axial plane (body axis plane). In this case, in the sagittal plane, the distance of the superimposed inner sheath 34 is fixed at a predetermined distance. FIG. 6 is a diagram showing an example of a virtual position 36 of the inner sheath 34 displayed in the sagittal plane.

[0050] On the other hand, as shown in Fig. 7, in the axial section, the outer sheath 32 is tilted by an angle θ1 in the sagittal section (Fig. 6), so when viewed in the axial section, the displayed distance AB is the predetermined distance (AC) × cos θ1 by which the inner sheath 34 protrudes, as shown in Fig. 8. Fig. 7 is a diagram showing an example of the virtual position 36 of the inner sheath 34 displayed in the axial section, and Fig. 8 is a diagram showing an example of the distance at which the virtual position 36 of the inner sheath 34 is displayed in the axial section.

[0051] In addition, in the coronal section (oblique), only the needle tip point is displayed as shown in Fig. 9. Fig. 9 is a diagram showing an example of a virtual position 36 of the inner cannula 34 displayed in the coronal section.

[0052] Next, specific processing performed by the control unit 24 of the medical image inspection apparatus 10 according to this embodiment configured as described above will be described. Fig. 10 is a flowchart showing an example of the flow of processing performed by the control unit 24 of the medical image inspection apparatus 10 according to this embodiment. The processing in Fig. 10 starts, for example, when the operation panel 22 is operated to issue an instruction to capture a CT image 38 for CT-guided biopsy.

[0053] In step 100, the control unit 24 acquires the CT image 38, and the process proceeds to step 102. That is, the CT image 38 acquired by the gantry 12 is acquired.

[0054] In step 102 , the control unit 24 performs labeling processing and edge processing on the acquired CT image 38 , and then the process proceeds to step 104 .

[0055] In step 104, the control unit 24 extracts objects that are equal to or greater than a predetermined threshold, and proceeds to step 106. That is, the control unit 24 calculates the average density value (CT value) of each pixel in the object labeled by the labeling process, and extracts objects in the CT value range that is equal to or greater than the predetermined threshold.

[0056] In step 106, the control unit 24 performs a puncture needle region extraction process, and then the process proceeds to step 108. The puncture needle region extraction process extracts an object that satisfies at least one of the above-mentioned conditions 1 and 2 in order to distinguish between the puncture needle 30 (metal) and bones that have similar CT values. Here, when extracting objects that satisfy both conditions 1 and 2, if the object that satisfies condition 1 and the object that satisfies condition 2 are different, the object that satisfies condition 2 may be determined to be the puncture needle region. Alternatively, for conditions 1 and 2, a region that satisfies condition 2 may be extracted, and if a region that satisfies condition 2 exists, the region that satisfies condition 2 may be determined to be the puncture needle region; if a region that satisfies condition 2 does not exist, the region under condition 1 may be extracted, and if a region that satisfies condition 1 exists, the region that satisfies condition 1 may be determined to be the puncture needle region.

[0057] In step 108, the control unit 24 determines the tip of the puncture needle region on the image center side as the puncture needle tip, and proceeds to step 110.

[0058] In step 110, the control unit 24 calculates the tip position of the inner sheath 34 and proceeds to step 112. For example, the tip position is calculated as a number of pixels from the pixel of the needle tip to a predetermined projection distance of the inner sheath 34 in the direction of the central axis of the puncture needle 30. Furthermore, if the display magnification is changeable, a virtual position 36 to which the tip of the inner sheath 34 will reach is calculated based on predetermined distance information to the tip of the inner sheath 34 when it is projected from the outer sheath 32. Furthermore, the position of the tip of the inner sheath 34 corresponding to the cross section of the CT image 38 to be displayed is calculated based on predetermined distance information to the tip of the inner sheath 34 when it is projected from the outer sheath 32.

[0059] In step 112, the control unit 24 superimposes a virtual position 36 of the tip of the inner sheath 34 on the CT image 38, and then proceeds to step 114. For example, as shown in FIG. 4, the inner sheath 34 protruding from the outer sheath 32 may be displayed as a virtual position 36 using an arrow, and the virtual position 36 where the tip of the inner sheath 34 reaches as the inner sheath 34 protrudes from the outer sheath 32 may be displayed as the tip of the arrow. Furthermore, when displaying the virtual position 36 where the tip of the inner sheath 34 reaches, the inner sheath 34 may be superimposed on the CT image 38 in a display mode of at least one of a predetermined color and transparency as protruding pixels of the inner sheath 34 in the direction of the central axis of the puncture needle 30 from the pixel of the needle tip.

[0060] In step 114, the control unit 24 determines whether or not an instruction to end the display has been issued. If the determination is negative, the process returns to step 100 and the above-described processing is repeated. If the determination is positive, the series of processing steps ends.

[0061] By performing processing in this manner by the control unit 24, it is possible to confirm the virtual position 36 where the inner sheath 34 will reach on the CT image 38 without manually measuring the distance of the inner sheath 34 protruding from the outer sheath 32. Furthermore, even if the positional relationship between the tip 32A of the outer sheath 32 of the puncture needle 30 and the target changes, there is no need to manually remeasure the distance, and the time required for CT-guided biopsy can be reduced compared to conventional methods.

[0062] Furthermore, since the virtual position 36 where the inner sheath 34 will reach is displayed on the CT image 38, it is easy to confirm whether the outer sheath 32 and the target are on the same straight line, which also reduces the time required for CT-guided biopsy compared to conventional methods.

[0063] In the above embodiment, the puncture needle region is extracted by performing labeling processing, edge extraction processing, etc., but this is not limiting. For example, the user may click once on the region inside the puncture needle on the CT image, and image processing may be used to fill in pixels with nearby CT values ​​and treat them as the puncture needle region. That is, the user may specify the puncture needle region by clicking once on the region inside the puncture needle on the CT image, etc., obtain designation information for the puncture needle region on the radiographic image designated by the user, and extract the puncture needle region by filling in pixels with density values ​​in a range equal to or greater than a preset threshold value around the designation information based on the designation information.

[0064] In the above embodiment, the CT image 38 has been described as an example of a radiological image to be acquired, but the radiological image is not limited to the CT image 38. For example, an X-ray image acquired using an X-ray fluoroscopy table may be applied, or a CR (Computed Radiography) image may be applied. Alternatively, an image using XR (Extended Reality) technology may be applied.

[0065] In the above embodiment, the processing performed by the control unit 24 is described as being performed by software, but it may also be realized by a dedicated hardware circuit. In this case, it may be executed by one piece of hardware or by multiple pieces of hardware.

[0066] Furthermore, in the above embodiments, the term "processor" refers to a processor in a broad sense, and includes general-purpose processors (e.g., CPU: Central Processing Unit, etc.) and dedicated processors (e.g., GPU: Graphics Processing Unit, ASIC: Application Specific Integrated Circuit, FPGA: Field Programmable Gate Array, programmable logic device, etc.).

[0067] Furthermore, the operations of the processors in the above embodiments may not only be performed by a single processor, but may also be performed by multiple processors located at physically separate locations working together. Furthermore, the order of the operations of the processors is not limited to the order described in the above embodiments, and may be changed as appropriate.

[0068] The program may be provided by a computer-readable non-transitory recording medium such as a USB (Universal Serial Bus) memory, a flexible disk, or a CD-ROM (Compact Disc Read Only Memory), or may be provided online via a network such as the Internet. In this case, the program recorded on the computer-readable non-transitory recording medium is typically transferred to and stored in a memory or storage device. The program may be provided as standalone application software, or may be incorporated into the software of each device as a function of the device.

[0069] The program of the present disclosure can be provided as a program product. The program product includes any product for providing the program. For example, the program product includes a program provided over a network such as the Internet, and a non-transitory computer-readable recording medium such as a CD-ROM or DVD on which the program is stored.

[0070] Furthermore, the configuration, operation, etc. of the medical image inspection device 10 described in the above embodiment are merely examples, and it goes without saying that they can be modified according to the circumstances within the scope of the gist of this disclosure.

[0071] The following additional notes are provided regarding the above-described embodiments. (Appendix 1) a processor, the processor comprising: acquiring a radiological image of the subject, including the needle with an inner sheath protruding from an outer sheath; Detecting the region of the puncture needle in the radiation image; an image processing device that performs processing to project the inner sheath from the outer sheath and display a virtual position where the tip of the inner sheath reaches, superimposed on the radiation image;

[0072] (Appendix 2) The image processing device described in Appendix 1, wherein the processor displays the virtual position superimposed on the radiological image based on predetermined distance information to the tip of the inner sheath when the inner sheath is protruded from the outer sheath.

[0073] (Appendix 3) The image processing device according to claim 2, wherein the processor calculates the position of the tip of the inner cannula according to the display magnification based on the predetermined distance information, and displays the virtual position superimposed on the radiographic image.

[0074] (Appendix 4) The image processing device described in Appendix 2, wherein the processor calculates the position of the tip of the inner cannula corresponding to the cross-section of the radiological image to be displayed based on the predetermined distance information, and displays the virtual position superimposed on the radiological image.

[0075] (Appendix 5) The processor: performing labeling processing and edge processing on the radiation image; Calculating an average density value of radiation at each pixel within the object labeled by the labeling process; An image processing device according to any one of appendices 1 to 4, which detects at least one of objects among objects in a density value range equal to or greater than a predetermined threshold, which have an area radially extending from the center of the image at a distance greater than a predetermined distance, and objects which have an area at the boundary between the air and the body surface and in the air-side area at a distance greater than a predetermined distance, and defines the detected object as a puncture needle area.

[0076] (Appendix 6) The image processing device described in Appendix 5, wherein the processor detects, among objects within a density value range equal to or greater than a preset threshold, objects that have an area radially extending from the center of the image at a distance greater than a predetermined distance, and objects that have an area at the boundary between the air and the body surface and in the area on the air side at a distance greater than a predetermined distance, first detects objects that have an area at the boundary between the air and the body surface and in the area on the air side at a distance greater than a predetermined distance, and when such objects are detected, designates such objects as puncture needle areas.

[0077] (Appendix 7) The image processing device described in Appendix 6, wherein the processor detects an object that exists in an area that is more than a predetermined distance away from the boundary region between the air and the body surface and the area on the air side, and if the object is not detected, detects an object that exists in an area that is more than a predetermined distance away from the boundary region between the air and the body surface and the area on the air side.

[0078] (Appendix 8) The processor: Calculate the center pixel between the edges of the region of the puncture needle, and set it as the pixel of the central axis of the puncture needle; 6. The image processing device according to claim 5, wherein the virtual position is superimposed on the radiation image in a display mode of at least one of a predetermined color and a predetermined transparency as an inner sheath that protrudes from a pixel at the tip of the puncture needle in a direction of the central axis of the puncture needle by a distance equal to the protrusion distance of the inner sheath.

[0079] (Appendix 9) 9. The image processing device according to claim 8, wherein the processor calculates the central pixel by interpolating pixels when edge information is lacking at the tip of the puncture needle.

[0080] (Appendix 10) The processor: acquiring designation information of a puncture needle region on the radiation image designated by a user; extracting the area of ​​the puncture needle by filling in pixels in a density range of the surrounding area of ​​the specified information that is equal to or greater than a preset threshold value, based on the specified information; 5. The image processing device according to any one of Supplementary Note 1 to Supplementary Note 4, wherein after the region of the puncture needle is extracted, the tip of the region on the center side of the radiation image is set as the tip of the puncture needle.

[0081] (Appendix 11) The computer acquiring a radiological image of the subject, including the needle with an inner sheath protruding from an outer sheath; Detecting the region of the puncture needle in the radiation image; An image processing method that performs processing to superimpose on the radiation image the position of the tip of the inner sheath when the inner sheath is protruded from the outer sheath before the inner sheath is protruded from the outer sheath.

[0082] (Appendix 12) On the computer, acquiring a radiological image of the subject, including the needle with an inner sheath protruding from an outer sheath; Detecting the region of the puncture needle in the radiation image; An image processing program for executing a process of superimposing and displaying on the radiation image the position of the tip of the inner sheath when the inner sheath is protruded from the outer sheath before the inner sheath is protruded from the outer sheath. [Explanation of symbols]

[0083] 10 Medical imaging inspection equipment 12 Gantry 16 Console 20 monitors 24 Control Unit 24A CPU 30 puncture needle 32 cloak 34 Inner cloak 36 Virtual Position 38 CT images

Claims

1. a processor, the processor comprising: acquiring a radiological image of the subject, including the needle with an inner sheath protruding from an outer sheath; Detecting the region of the puncture needle in the radiation image; an image processing device that performs processing to project the inner sheath from the outer sheath and display a virtual position where the tip of the inner sheath reaches, superimposed on the radiation image;

2. The image processing device according to claim 1 , wherein the processor displays the virtual position superimposed on the radiation image based on predetermined distance information to the tip of the inner sheath when the inner sheath is protruded from the outer sheath.

3. The image processing device according to claim 2 , wherein the processor calculates the position of the tip of the inner cannula according to the display magnification based on the predetermined distance information, and displays the virtual position superimposed on the radiographic image.

4. The image processing device according to claim 2 , wherein the processor calculates the position of the tip of the inner cannula corresponding to the cross section of the displayed radiographic image based on the predetermined distance information, and displays the virtual position superimposed on the radiographic image.

5. The processor: performing labeling processing and edge processing on the radiation image; Calculating an average density value of radiation at each pixel within the object labeled by the labeling process; 2. The image processing device according to claim 1, wherein at least one of the following objects is detected among objects having a density value range equal to or greater than a predetermined threshold value: an object having an area radially extending from the center of the image at a distance greater than a predetermined distance; and an object having an area at a boundary between the air and the body surface and an area on the air side at a distance greater than a predetermined distance; and the detected object is designated as a puncture needle area.

6. 6. The image processing device according to claim 5, wherein when detecting objects having an area radially extending from the center of the image at a distance greater than a predetermined distance from the center of the image, and objects having an area at a distance greater than a predetermined distance in the boundary region between the air and the body surface and in the air-side region, among objects having a density value range greater than a predetermined threshold, the processor first detects objects having an area at a distance greater than a predetermined distance in the boundary region between the air and the body surface and in the air-side region, and when the object is detected, the processor designates the object as a puncture needle region.

7. The image processing device described in claim 6, wherein the processor detects an object that has an area that is more than a predetermined distance away in the boundary region between the air and the body surface and in the air-side region, and if the object is not detected, detects an object that has an area that is more than a predetermined distance away in the boundary region between the air and the body surface and in the air-side region.

8. The processor: Calculate the center pixel between the edges of the region of the puncture needle, and set it as the pixel of the central axis of the puncture needle; 6. The image processing device according to claim 5, wherein the virtual position is superimposed on the radiation image in a display mode of at least one of a predetermined color and a predetermined transparency as an inner sheath that protrudes from a pixel at the tip of the puncture needle in the direction of the central axis of the puncture needle by a distance equal to a protrusion distance of the inner sheath.

9. The image processing device according to claim 8 , wherein the processor calculates the central pixel by interpolating pixels when edge information is insufficient at the tip of the puncture needle.

10. The processor: acquiring designation information of a puncture needle region on the radiation image designated by a user; extracting the area of ​​the puncture needle by filling in pixels in a density range of the surrounding area of ​​the specified information that is equal to or greater than a preset threshold value, based on the specified information; The image processing apparatus according to claim 1 , wherein after the region of the puncture needle is extracted, the tip of the region on the center side of the radiation image is set as the tip of the puncture needle.

11. The computer acquiring a radiological image of the subject, including the needle with an inner sheath protruding from an outer sheath; Detecting the region of the puncture needle in the radiation image; An image processing method that performs processing to superimpose on the radiation image the position of the tip of the inner sheath when the inner sheath is protruded from the outer sheath before the inner sheath is protruded from the outer sheath.

12. On the computer, acquiring a radiological image of the subject, including the needle with an inner sheath protruding from an outer sheath; Detecting the region of the puncture needle in the radiation image; An image processing program for executing a process of superimposing and displaying on the radiation image the position of the tip of the inner sheath when the inner sheath is protruded from the outer sheath before the inner sheath is protruded from the outer sheath.

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