X-ray fluoroscopic imaging apparatus, control method therefor, and storage medium

Abstract

To provide an X-ray fluoroscopic imaging apparatus for improving operability by moving the visual field of an X-ray fluoroscopic image to an area desired to be visually recognized by a user, and to provide its control method and a program.SOLUTION: The X-ray fluoroscopic imaging apparatus according to the present disclosure detects a device from an X-ray fluoroscopic image, controls a collimator that sets an irradiation region in which an X-ray is irradiated to a subject according to a position of a tip of the device in the X-ray fluoroscopic image to change the irradiation region, and controls movement of an arm that supports an X-ray source, the collimator, and an X-ray detector to change the fluoroscopic region when the position of the tip of the device is a position of an end of the fluoroscopic region that is the irradiation region when the collimator is fully opened or a position within a predetermined distance from the end of the fluoroscopic region.SELECTED DRAWING: Figure 3

Description

[Technical Field]

[0001] The present invention relates to an X-ray fluoroscopic imaging apparatus and a control method and program therefor, and more particularly to a technique for changing the field of view of an X-ray fluoroscopic image. [Background technology]

[0002] 2. Description of the Related Art Examinations or treatments that combine a fluoroscopic table apparatus with an endoscope, such as ERCP (endoscopic retrograde cholangiopancreatography) examinations, are known.

[0003] Patent document 1 describes a radiographic imaging device that reduces the amount of radiation exposure to a subject by automatically setting the irradiation range and radiation irradiation conditions according to the position of a treatment instrument inserted into the subject within the subject and capturing a radiological image.

[0004] Patent document 2 describes an X-ray fluoroscopy device that detects devices from each frame of an X-ray fluoroscopic image, sets an X-ray irradiation field to follow the detected device, and, if there are multiple devices, calculates the X-ray irradiation field using a calculation method according to the number of devices. [Prior art documents] [Patent documents]

[0005] [Patent Document 1] Japanese Patent Application Laid-Open No. 2008-220480 [Patent Document 2] Japanese Patent Application Publication No. 2018-33818 Summary of the Invention [Problem to be solved by the invention]

[0006] In an ERCP examination, after inserting an endoscope, the doctor advances devices such as guidewires from the tip of the endoscope. It is important that the tip of the device is visible in the X-ray fluoroscopy image. If the tip of the device falls outside the field of view of the X-ray fluoroscopy image, the field of view must be widened or the doctor operating the endoscope must instruct the X-ray technician to adjust the X-ray irradiation position.

[0007] However, widening the field of view of an X-ray fluoroscopic image has the problem of increasing the amount of radiation exposure received by the subject, and also of making the instructions to the X-ray technician complicated.

[0008] The present invention has been made in consideration of the above circumstances, and aims to provide an X-ray fluoroscopy apparatus, a control method thereof, and a program that improve operability by allowing the user to move the field of view of the X-ray fluoroscopy image to the area that the user wants to view. [Means for solving the problem]

[0009] In order to achieve the above object, an X-ray fluoroscopy apparatus according to a first aspect of the present disclosure includes an X-ray source that irradiates X-rays toward a subject, a collimator that is arranged between the X-ray source and the subject and sets an irradiation area where the X-rays are irradiated onto the subject, an X-ray detector that detects transmitted X-rays that have passed through the subject, an arm that supports the X-ray source, collimator, and X-ray detector and is movable relative to the subject in a direction intersecting the X-rays, and a processor, wherein the processor generates an X-ray fluoroscopy image based on the transmitted X-rays, displays the X-ray fluoroscopy image on a display, detects a device from the X-ray fluoroscopy image, controls the collimator according to the position of the tip of the device in the X-ray fluoroscopy image to change the irradiation area, and controls the movement of the arm to change the fluoroscopy area when the position of the tip of the device is at the edge of the fluoroscopy area, which is the irradiation area when the collimator is fully open, or within a predetermined distance from the edge of the fluoroscopy area.

[0010] An X-ray fluoroscopy apparatus according to a second aspect of the present disclosure is preferably the X-ray fluoroscopy apparatus according to the first aspect, wherein the processor controls the movement of the arm to move the position of the tip of the device to the center of the fluoroscopic area.

[0011] An X-ray fluoroscopy apparatus according to a third aspect of the present disclosure is the X-ray fluoroscopy apparatus according to the first or second aspect, wherein the processor preferably controls the movement speed of the arm in accordance with the movement speed of the tip of the device.

[0012] An X-ray fluoroscopic imaging apparatus according to a fourth aspect of the present disclosure is the X-ray fluoroscopic imaging apparatus according to any one of the first to third aspects, wherein the processor preferably controls movement of the arm when permission is given by a user.

[0013] An X-ray fluoroscopic imaging apparatus according to a fifth aspect of the present disclosure is the X-ray fluoroscopic imaging apparatus according to the fourth aspect, wherein the processor preferably notifies a user of the need to move the arm.

[0014] In an X-ray fluoroscopy apparatus according to a sixth aspect of the present disclosure, in the X-ray fluoroscopy apparatus according to any one of the first to fifth aspects, it is preferable that the processor controls the movement of the arm when there is no obstacle in the direction of movement of the arm.

[0015] An X-ray fluoroscopic imaging apparatus according to a seventh aspect of the present disclosure is the X-ray fluoroscopic imaging apparatus according to the sixth aspect, wherein the processor preferably determines the presence or absence of an obstacle from a captured image of the moving direction of the arm.

[0016] An X-ray fluoroscopic imaging apparatus according to an eighth aspect of the present disclosure is the X-ray fluoroscopic imaging apparatus according to any one of the first to seventh aspects, wherein the processor preferably changes the fluoroscopic area during a button operation by the user.

[0017] An X-ray fluoroscopy apparatus according to a ninth aspect of the present disclosure is an X-ray fluoroscopy apparatus according to any one of the first to eighth aspects, wherein the processor preferably displays the trajectory of the movement of the tip of the device superimposed on the X-ray fluoroscopy image when controlling the movement of the arm to change the fluoroscopic area.

[0018] An X-ray fluoroscopy apparatus according to a tenth aspect of the present disclosure is an X-ray fluoroscopy apparatus according to any one of the first to ninth aspects, wherein the processor preferably stops emitting X-rays from the X-ray source and changes the fluoroscopy area.

[0019] An X-ray fluoroscopy apparatus according to an eleventh aspect of the present disclosure is an X-ray fluoroscopy apparatus according to the tenth aspect, wherein the processor displays an X-ray fluoroscopy image before X-ray irradiation is stopped on the display, and preferably changes the fluoroscopy area according to the amount of movement on the display in response to a user's scrolling operation of the X-ray fluoroscopy image before X-ray irradiation is stopped.

[0020] An X-ray fluoroscopy apparatus according to a twelfth aspect of the present disclosure is an X-ray fluoroscopy apparatus according to any one of the first to eleventh aspects, wherein the processor preferably detects a contrast agent region where the contrast agent injected into the subject is present from the X-ray fluoroscopic image, and changes the fluoroscopic region according to the detected contrast agent region.

[0021] In order to achieve the above object, a control method for an X-ray fluoroscopy apparatus according to a thirteenth aspect of the present disclosure is a control method for an X-ray fluoroscopy apparatus including an X-ray source that irradiates X-rays toward a subject, a collimator that is arranged between the X-ray source and the subject and sets an irradiation area where the X-rays are irradiated on the subject, an X-ray detector that detects transmitted X-rays that have passed through the subject, and an arm that supports the X-ray source, collimator, and X-ray detector and is movable relative to the subject in a direction intersecting the X-rays, the control method for an X-ray fluoroscopy apparatus generating an X-ray fluoroscopy image based on the transmitted X-rays, displaying the X-ray fluoroscopy image on a display, detecting a device from the X-ray fluoroscopy image, controlling the collimator in accordance with the position of the tip of the device in the X-ray fluoroscopy image to change the irradiation area, and controlling the movement of the arm to change the fluoroscopy area when the position of the tip of the device is at the edge of a fluoroscopy area, which is the irradiation area when the collimator is fully open, or at a position within a predetermined distance from the edge of the fluoroscopy area.

[0022] A program according to a 14th aspect of the present disclosure is a program that causes a computer to execute the control method for the X-ray fluoroscopy apparatus according to the 13th aspect. A non-transitory computer-readable storage medium that stores the program according to the 14th aspect is also included in the present disclosure. The program according to the 13th aspect and the storage medium that stores the program according to the 13th aspect may be configured to include the same specific aspects as the X-ray fluoroscopy apparatus described above. [Effects of the Invention]

[0023] According to the present invention, the field of view of the X-ray fluoroscopic image can be moved to an area that the user wants to view, thereby improving operability. [Brief explanation of the drawings]

[0024] [Figure 1] FIG. 1 is a diagram showing the configuration of an X-ray fluoroscopic imaging device. [Figure 2] FIG. 2 is a flowchart showing the process of the control method for the X-ray fluoroscopic imaging apparatus according to the first embodiment. [Figure 3]FIG. 3 is a diagram for explaining the device tip tracking control according to the first embodiment. [Figure 4] FIG. 4 is a flowchart showing the process of the control method for the X-ray fluoroscopic imaging apparatus according to the second embodiment. [Figure 5] FIG. 5 is a flowchart showing the process of the control method for the X-ray fluoroscopic imaging apparatus according to the third embodiment. [Figure 6] FIG. 6 is a diagram for explaining device tip tracking control according to the third embodiment. [Figure 7] FIG. 7 is a flowchart showing the process of the control method of the X-ray fluoroscopic imaging apparatus according to the fourth embodiment. [Figure 8] FIG. 8 is a diagram for explaining device tip tracking control according to the fourth embodiment. [Figure 9] FIG. 9 is a flowchart showing the process of the control method of the X-ray fluoroscopic imaging apparatus according to the fifth embodiment. [Figure 10] FIG. 10 is a diagram for explaining the control of tracking the leading edge of the contrast agent region according to the fifth embodiment. DETAILED DESCRIPTION OF THE INVENTION

[0025] Hereinafter, preferred embodiments of an X-ray fluoroscopic imaging apparatus, a control method thereof, and a program according to the present disclosure will be described with reference to the accompanying drawings. In this specification, the same components are designated by the same reference numerals, and duplicated descriptions will be omitted as appropriate.

[0026] First Embodiment [Configuration of X-ray fluoroscopy equipment] Fig. 1 is a diagram showing the configuration of an X-ray fluoroscopy apparatus. As shown in Fig. 1, the X-ray fluoroscopy apparatus 1 includes a high-voltage generator 101, an X-ray tube 102, a collimator 103, a table 105, an X-ray detector 106, an arm 108, a system controller 120, an X-ray controller 121, an image processor 122, a memory 123, a display 130, and an operation unit 131.

[0027] The high voltage generating unit 101 and the X-ray tube 102 constitute an "X-ray source" of the present disclosure. The high voltage generating unit 101 and the X-ray tube 102 may be configured separately or integrally. The X-ray tube 102 receives power supply from the high voltage generating unit 101 and generates X-rays. The X-ray source may be provided with an X-ray filter or the like that selectively transmits X-rays of a specific energy.

[0028] The operation of the X-ray source is controlled by the X-ray control unit 121. The X-ray control unit 121 controls the X-ray tube current and the X-ray tube voltage in accordance with an X-ray control signal transmitted from the system control unit 120.

[0029] The collimator 103 includes a plurality of aperture blades (not shown in FIG. 1) which are flat light-shielding members for forming an aperture in a path through which the X-rays generated from the X-ray tube 102 pass. The collimator 103 opens and closes the plurality of aperture blades in accordance with a control signal from the system control unit 120 to change the position of the X-ray aperture, which is the aperture. In this way, the collimator 103 changes an irradiation area, which is an area of ​​the X-rays generated from the X-ray tube 102 that is irradiated onto the subject 3 laid on the table 105. Note that, hereinafter, the irradiation area when the plurality of aperture blades are fully opened (an example of "when the collimator is fully opened") is referred to as a fluoroscopy area. The collimator 103 may be configured integrally with the X-ray tube 102.

[0030] The X-ray detector 106 is configured with a plurality of detection elements for detecting X-rays arranged in a two-dimensional array. The X-ray detector 106 detects an X-ray signal according to the incident amount of transmitted X-rays that have passed through the subject 3 out of the X-rays irradiated from the X-ray tube 102, and sends the signal to the image processing unit 122.

[0031] The image processing unit 122 performs image processing on the X-ray signal output from the X-ray detector 106 to generate an X-ray fluoroscopic image. The image processing includes gamma conversion, gradation conversion processing, image enlargement / reduction processing, etc. The X-ray fluoroscopic image generated by the image processing unit 122 is output to the storage unit 123 and the display unit 130. The X-ray fluoroscopic imaging device 1 generates a moving image by continuously irradiating the subject 3 with X-rays. The image processing unit 122 generates a moving image made up of multiple frames, with one X-ray fluoroscopic image being one frame, and outputs the moving image sequentially to the storage unit 123 and the display unit 130.

[0032] The storage unit 123 includes a storage device such as a hard disk, a solid state drive (SSD), etc. The storage unit 123 is not limited to one built into the X-ray fluoroscopy apparatus 1, but may be an external storage device connected to the X-ray fluoroscopy apparatus 1. The external storage device may be connected via a network (not shown).

[0033] The storage unit 123 stores the X-ray fluoroscopic images generated by the image processing unit 122. The storage unit 123 also stores programs related to fluoroscopy and imaging, various fluoroscopy conditions, imaging conditions, programs and data required to execute processing related to control of the irradiation area, programs and data required to execute various imaging procedures, and the like.

[0034] The display unit 130 includes a display device (an example of a "display") such as a liquid crystal panel. The display unit 130 displays the X-ray fluoroscopic image of the subject 3 generated by the image processing unit 122, imaging conditions, setting information, an operation screen for setting the imaging conditions, and the like. The display unit 130 may also display an endoscopic image in an ERCP examination.

[0035] The operation unit 131 includes input devices such as a keyboard, a mouse, a joystick, etc. The operation unit 131 inputs commands from a user such as a doctor to the system control unit 120. The operation unit 131 may be a touch panel type operation unit formed integrally with the display unit 130.

[0036] The system control unit 120 controls the operation of X-ray irradiation based on an input signal input from an operation unit 131, and controls the detection of X-rays transmitted through the subject 3 and the operation of collecting data.

[0037] The X-ray source (high voltage generator 101, X-ray tube 102) and X-ray detector 106, which are the imaging system of the X-ray fluoroscopy apparatus 1, are fixed to an arm 108 in a state facing each other via a table 105. The arm 108 is configured to be movable relative to the table 105 in directions intersecting the X-ray irradiation direction (left-right and front-rear directions in FIG. 1) by a movement mechanism (not shown). A system control unit 120 controls the movement of the arm 108. As a result, the high voltage generator 101, X-ray tube 102, and X-ray detector 106 supported by the arm 108 move relative to the subject 3.

[0038] Furthermore, the movement mechanism is capable of tilting the position of the X-ray tube 102 to a predetermined tilt angle with respect to the subject 3 by tilting the arm 108. In conjunction with the tilt of the X-ray tube 102, the X-ray detector 106 is also rotated and moved.

[0039] ERCP examinations use devices such as endoscopes, stents (stent grafts), guidewires, and balloons. The endoscope is inserted orally and image-guided to the entrance of the bile duct. The guidewire protrudes from the tip of the endoscope and ensures its passage through the bile duct. The stent and balloon dilate the narrowed area in the event of bile duct stricture.

[0040] The X-ray fluoroscopic imaging apparatus 1 has a device tip tracking function that automatically tracks the irradiation area according to the position of the tip of the device detected from the X-ray fluoroscopic image. As a functional configuration for this function, the image processing unit 122 includes a device detection unit 21, an X-ray aperture position calculation unit 22, an X-ray aperture control unit 23, an arm movement determination unit 24, an arm position calculation unit 25, and an arm control unit 26.

[0041] The device detection unit 21 detects a device from the X-ray fluoroscopic image and calculates information about the position of the tip of the detected device in the X-ray fluoroscopic image, i.e., information about the position within the irradiation area. A known method may be used to detect the device. Information about the position of the tip of the detected device is stored in the storage unit 123. That is, the storage unit 123 functions as a storage area for storing information about the position within the irradiation area of ​​the device detected by the device detection unit 21 from the X-ray fluoroscopic image.

[0042] The X-ray aperture position calculation unit 22 calculates the X-ray aperture position that becomes the irradiation area according to the position of the tip of the device detected by the device detection unit 21. The X-ray aperture position calculation unit 22 calculates an appropriate X-ray aperture position for each frame of the X-ray fluoroscopic image or for each set of frames.

[0043] The X-ray aperture control unit 23 generates a control signal to move the multiple aperture blades to the X-ray aperture position calculated by the X-ray aperture position calculation unit 22, and notifies the system control unit 120. The system control unit 120 transmits the notified control signal to the collimator 103. The collimator 103 moves the positions of the multiple aperture blades in accordance with the control signal. As a result, the X-ray aperture position is adjusted and the irradiation area is changed.

[0044] The arm movement determination unit 24 determines whether or not it is necessary to move the arm 108. The arm movement determination unit 24 determines that it is necessary to move the arm 108 when the position of the tip of the device detected by the device detection unit 21 is a predetermined position in the fluoroscopy area.

[0045] When the arm movement determination unit 24 determines that the arm 108 needs to move, the arm position calculation unit 25 calculates the position of the arm 108 to which it should be moved.

[0046] The arm control unit 26 generates a control signal to move the arm 108 to the arm position calculated by the arm position calculation unit 25, and notifies the system control unit 120. The system control unit 120 transmits the notified control signal to the movement mechanism. The movement mechanism moves the position of the arm 108 in accordance with the control signal. This adjusts the position of the imaging system with respect to the subject 3, and changes the fluoroscopy-enabled region.

[0047] [Configuration of the control unit] The system control unit 120, the X-ray control unit 121, and the image processing unit 122 may be configured separately from each other, or may be configured integrally.

[0048] The hardware structure of the processing units that execute various processes in the system control unit 120, the X-ray control unit 121, and the image processing unit 122 is the following various processors: The various processors include a CPU (Central Processing Unit), which is a general-purpose processor that executes software (programs) and functions as various processing units, a GPU (Graphics Processing Unit), which is a processor specialized for image processing, a programmable logic device (PLD), which is a processor whose circuit configuration can be changed after manufacture such as an FPGA (Field Programmable Gate Array), and a dedicated electric circuit, which is a processor having a circuit configuration designed specifically for executing specific processes such as an ASIC (Application Specific Integrated Circuit).

[0049] A single processing unit may be configured with one of these various processors, or may be configured with two or more processors of the same or different types (e.g., multiple FPGAs, a combination of a CPU and an FPGA, or a combination of a CPU and a GPU). Also, multiple processing units may be configured with a single processor. Examples of multiple processing units configured with a single processor include, first, a form in which a single processor is configured with a combination of one or more CPUs and software, as typified by computers such as servers and clients, and this processor functions as multiple processing units. Second, a form in which a processor is used to realize the functions of an entire system including multiple processing units on a single IC (Integrated Circuit) chip, as typified by a system-on-chip (SoC). In this way, the various processing units are configured with one or more processors of each type as a hardware structure.

[0050] Furthermore, the hardware structure of these various processors is, more specifically, an electric circuit that combines circuit elements such as semiconductor elements. The processor may have a memory used as a working area. The memory may consist of a single memory, or may consist of two or more memories of the same or different types.

[0051] [Device tip tracking control] 2 is a flowchart showing the processing of the control method of the X-ray fluoroscopy apparatus according to the first embodiment. Here, the device tip tracking control in an ERCP examination will be described as an example. The control method of the X-ray fluoroscopy apparatus is realized by a processor executing a control program stored in the memory or storage unit 123. The control program may be provided by a computer-readable non-transitory storage medium. In this case, the X-ray fluoroscopy apparatus 1 may read the control program from the non-transitory storage medium and store it in the memory or storage unit 123.

[0052] When the subject 3 is laid on the table 105 and the examination is started, the system control unit 120 starts continuous capturing of X-ray fluoroscopic images. The position of the arm 108 and the position of the X-ray aperture at the start of capturing may be adjusted to predetermined initial positions. The image processing unit 122 performs image processing on the X-ray signals sequentially output from the X-ray detector 106, and generates a video of the X-ray fluoroscopic images.

[0053] The user inserts an endoscope into the subject 3. Therefore, the endoscope appears in the X-ray fluoroscopic image. Furthermore, the user protrudes a device from the tip of the endoscope. Therefore, the endoscope and the device appear in the X-ray fluoroscopic image. The subsequent processing may be performed for each frame or every few frames.

[0054] In step S1, the device detection unit 21 of the image processing unit 122 detects a device from the input X-ray fluoroscopic image. The detected device may include an endoscope. The device detection unit 21 calculates the position of the detected device within the irradiation area and stores the position in the storage unit 123.

[0055] In step S2, the X-ray aperture position calculation unit 22 calculates the X-ray aperture position at which the position of the tip of the device detected by the device detection unit 21 is at the center of the irradiation area. The center of the irradiation area is not limited to the center of the irradiation area itself, and may be a concept that includes the center and its vicinity.

[0056] Furthermore, the X-ray aperture control unit 23 generates a control signal for moving the plurality of aperture blades to the X-ray aperture position calculated by the X-ray aperture position calculation unit 22, and notifies the system control unit 120. The system control unit 120 transmits the notified control signal to the collimator 103. The collimator 103 moves the positions of the plurality of aperture blades in accordance with the control signal. As a result, the irradiation area of ​​the next X-ray fluoroscopic image to be captured is adjusted so that the position of the tip of the device is at the center. The image processing unit 122 may automatically enlarge the irradiation area and display it on the display unit 130.

[0057] In step S3, the arm movement determination unit 24 determines whether the position of the tip of the device has reached the edge of the fluoroscopy region. Here, the arm movement determination unit 24 determines whether the irradiation region has reached the edge of the fluoroscopy region and whether the tip of the device has reached the edge of the irradiation region on the fluoroscopy region side.

[0058] If the position of the tip of the device has not reached the edge of the see-through region, the process of this flowchart ends. If the position of the tip of the device has reached the edge of the see-through region, the process proceeds to step S4.

[0059] In step S4, the arm position calculation unit 25 calculates the position of the arm 108 where the tip of the device is at the center of the fluoroscopy region. The center of the fluoroscopy region is not limited to the center of the fluoroscopy region itself, but may be a concept that includes the center and its vicinity.

[0060] Furthermore, arm control unit 26 generates a control signal to move arm 108 to the arm position calculated by arm position calculation unit 25, and notifies system control unit 120. System control unit 120 transmits the notified control signal to the movement mechanism. The movement mechanism moves the position of arm 108 in accordance with the control signal. As a result, the tip of the device moves to the center of the visualization area.

[0061] Next, the X-ray aperture position calculation unit 22 calculates the X-ray aperture position. Here, since the tip of the device has moved to the center of the fluoroscopy area, the X-ray aperture position calculation unit 22 calculates a position including the center of the fluoroscopy area.

[0062] The X-ray aperture control unit 23 generates a control signal so that the irradiation area is limited to the X-ray aperture position calculated by the X-ray aperture position calculation unit 22, and notifies the system control unit 120. The system control unit 120 transmits the notified control signal to the collimator 103. The collimator 103 moves the position of the aperture blades in accordance with the control signal.

[0063] This completes the process of device tip tracking control for one X-ray fluoroscopic image. By repeating the process of this flowchart, device tip tracking control for moving images becomes possible.

[0064] The condition for moving the arm 108 may be when the tip of the device reaches a position within a predetermined distance from the edge of the fluoroscopic region. The predetermined distance may be changed depending on the surgical procedure and the position of the tip of the device within the subject. The arm control unit 26 may also change the movement speed of the arm 108 depending on the movement speed of the tip of the device. The device detection unit 21 may calculate the movement speed of the tip of the device from the amount of movement of the device detected from multiple frames and the frame rate of the moving image.

[0065] Fig. 3 is a diagram for explaining device tip tracking control according to the first embodiment. F3A in Fig. 3 shows a fluoroscopy area AV. The fluoroscopy area AV is an irradiation area when the aperture blades of the collimator 103 are in a fully open position. The fluoroscopy area AV shown in F3A includes devices D1 and D2. Device D1 is an endoscope, and device D2 is a guidewire. Device D2, which is a guidewire, has a tip TD.

[0066] 3 shows an irradiation area AI relative to the see-through area AV. The collimator 103 sets the irradiation area from the see-through area AV by opening and closing the aperture blades. The irradiation area AI shown in F3B is formed by opening a rectangular area relative to the see-through area AV by aperture blades 103A, 103B, and 103C, each of which includes a linear shape.

[0067] The illumination area AI shown in F3B is set at a position including the tip TD by the aperture blades 103A, 103B, and 103C. Furthermore, the illumination area AI shown in F3B reaches the edge of the see-through area AV, and the tip TD of the device reaches the edge of the illumination area AI on the see-through area AV side. Therefore, in the case of the illumination area AI shown in F3B, the arm movement determination unit 24 determines that movement of the arm 108 is necessary.

[0068] 3 shows the irradiation area AI in a state where the arm 108 and the X-ray aperture position have been adjusted from the state shown in F3B. Here, the fluoroscopy-enabled area AV is set at a position where the tip TD is at the center by moving the arm 108. Furthermore, the irradiation area AI is set as a rectangular area at a position where the tip TD is at the center by the aperture blades 103A, 103B, 103C, and 103D, respectively.

[0069] According to the X-ray fluoroscopic imaging device 1, the X-ray aperture control unit 23 adjusts the X-ray aperture position for each frame or for each plurality of frames of the moving X-ray fluoroscopic image so that the tip of the device is at the center of the irradiation area.

[0070] Furthermore, according to the X-ray fluoroscopic imaging apparatus 1, when the tip of the device reaches the edge of the fluoroscopic area, the fluoroscopic area is changed by the arm control unit 26. This makes it possible to control the irradiation area so that it follows the tip of the device, even if the tip of the device cannot be placed in the center of the irradiation area by simply adjusting the X-ray aperture position.

[0071] In this way, the X-ray fluoroscopic imaging apparatus 1 can improve operability by moving the field of view of the X-ray fluoroscopic image to an area that the user wants to visually recognize.

[0072] Second Embodiment 4 is a flowchart showing the process of the control method for the X-ray fluoroscopic imaging apparatus according to the second embodiment. The subsequent processes may be performed following step S3 of the flowchart shown in FIG.

[0073] In step S11, when it is determined that movement of the arm 108 is necessary, the arm movement determination unit 24 notifies the user of the necessity of movement of the arm 108. The notification may be made by displaying that fact on the display unit 130, or by outputting a sound from a speaker (not shown).

[0074] In step S12, the arm movement determination unit 24 determines whether or not the user has permission to move the arm 108. The user can permit movement of the arm 108 by pressing a dedicated permission button (not shown) provided on the operation unit 131. If permission to move the arm 108 is not granted, the process proceeds to step S13. On the other hand, if permission to move the arm 108 is granted, the process proceeds to step S14. If a predetermined time limit has elapsed while permission to move the arm 108 is not granted, the arm movement determination unit 24 may determine that permission to move the arm 108 is not granted, and proceed to step S13.

[0075] In step S13, the arm control unit 26 does not move the arm 108. On the other hand, in step S14, the arm position calculation unit 25 calculates the destination position of the arm 108. Subsequently, the arm control unit 26 generates a control signal to move the arm 108 to the arm position calculated by the arm position calculation unit 25. Furthermore, the system control unit 120 moves the position of the arm 108 using the movement mechanism.

[0076] According to the second embodiment, it is possible to ensure safety when the arm 108 moves. In addition, since the arm 108 does not move until the user gives permission, this is also effective when it is not desired to move the arm 108.

[0077] Note that permission to move the arm 108 is not limited to pressing the permission button, and the following mechanisms may be used. For example, permission may be granted by stepping on a foot switch (not shown) provided on the operation unit 131. Permission may also be granted by performing a combination of multiple operations, such as pressing a permission button and stepping on a foot switch.

[0078] Furthermore, an image of the surroundings of the arm 108 captured by a camera (not shown) may be analyzed, and movement of the arm 108 may be permitted if there is no obstacle in the direction of movement of the arm 108. If an obstacle is present in the direction of movement of the arm 108, the X-ray fluoroscopy apparatus 1 may notify the user of what is obstructing the movement on the camera image displayed on the display unit 130. The image processing unit 122 may include a trained model that identifies the type of obstacle from the camera image. The camera (not shown) may be fixed to the arm 108 as part of the X-ray fluoroscopy apparatus 1.

[0079] Third Embodiment The device tip tracking control may not be fully automatic, but may be performed in response to a user's operation. Fig. 5 is a flowchart showing the process of a control method for an X-ray fluoroscopic imaging apparatus according to the third embodiment.

[0080] In step S21, the system control unit 120 stops the irradiation of X-rays. This causes the X-ray fluoroscopic imaging apparatus 1 to interrupt fluoroscopy. The X-ray fluoroscopic imaging apparatus 1 may stop fluoroscopy when the user performs an operation to stop fluoroscopy using the operation unit 131.

[0081] In step S22, the image processing unit 122 acquires an LIH (Last Image Hold) image, which is the last X-ray fluoroscopic image taken before the fluoroscopic imaging was interrupted, and causes the display unit 130 to display it.

[0082] In step S23, the image processing unit 122 displays a center display button, which is a software key, on the display unit 130. The center display button may have been displayed on the display unit 130 before the fluoroscopy was interrupted. The center display button is not limited to a software key, and may be provided on the operation unit 131 or on an endoscope control unit (not shown).

[0083] In step S24, the user presses the center display button using the operation unit 131 to move the tip of the device to the center of the irradiation area while viewing the LIH image displayed on the display unit 130. The image processing unit 122 may superimpose a marker on the LIH image to display the position of the tip of the device detected by the device detection unit 21, thereby notifying the user of the tip of the device.

[0084] In step S25, the system control unit 120 determines whether the center display button is being pressed (an example of "button operation in progress"). If the button is being pressed, the process proceeds to step S26, and if the pressing has ended, the process proceeds to step S27.

[0085] In step S26, the X-ray fluoroscopic imaging apparatus 1 moves the arm 108 in a direction such that the tip of the device in the LIH image is at the center of the irradiation area. That is, the arm position calculation unit 25 calculates the position of the arm 108 where the tip of the device is at the center of the irradiation area. The arm control unit 26 generates a control signal to move the arm 108 to the arm position calculated by the arm position calculation unit 25, and notifies the system control unit 120. The system control unit 120 transmits the notified control signal to the movement mechanism. The movement mechanism moves the position of the arm 108 in accordance with the control signal.

[0086] Thereafter, the process proceeds again to step S25. Therefore, the arm 108 moves while the center display button is being pressed. Furthermore, when the tip of the device reaches the center of the irradiation area, the X-ray fluoroscopic imaging apparatus 1 stops the movement of the arm 108.

[0087] The trajectory of the tip of the device may be displayed superimposed on the LIH image. The trajectory may be, for example, an arrow. During the movement of the arm 108, the trajectory becomes shorter as the tip of the device approaches the center of the irradiation area.

[0088] In step S27, the system control unit 120 stops the movement of the arm 108 and starts irradiating X-rays. This causes the X-ray fluoroscopic imaging apparatus 1 to resume fluoroscopy. A newly captured X-ray fluoroscopic image is displayed on the display unit 130. The X-ray fluoroscopic imaging apparatus 1 may resume fluoroscopy when the user performs an operation to resume fluoroscopy using the operation unit 131.

[0089] Here, the X-ray fluoroscopy apparatus 1 moves the arm 108 to move the tip of the device to the center of the irradiation area, but the tip of the device may also be moved to the center of the irradiation area by moving the position of the aperture blades of the collimator 103. The X-ray fluoroscopy apparatus 1 may move the tip of the device to the center of the irradiation area by moving the position of the aperture blades of the collimator 103, and move the arm 108 when the position of the tip of the device reaches the edge of the fluoroscopy area.

[0090] Fig. 6 is a diagram for explaining device tip tracking control according to the third embodiment. F6A in Fig. 6 is a diagram showing the display unit 130 in step S23. On the display unit 130, an image IM, which is an LIH image, is displayed in a frame FR indicating the irradiation area. The image IM includes devices D1 and D2. The device D2 has a tip TD. In addition, a center display button BC is displayed superimposed on the image IM.

[0091] F6B in Fig. 6 is a diagram showing the display unit 130 when the center display button has been pressed. On the display unit 130, an image IM, which is an LIH image, is displayed in a frame FR indicating the irradiation area. The tip TD of the image IM is located in the center of the frame FR indicating the irradiation area. As the arm 108 moves, the image IM moves toward the lower right of the frame FR, and therefore the upper and left portions of the frame FR, which do not contain image information, are blacked out.

[0092] As described above, in the third embodiment, the operation is not fully automatic, and when a center display button on a user interface or the like is operated, the aperture position is adjusted and the arm is moved so that the tip of the detected device is located at the center of the irradiation area. According to the third embodiment, the irradiation area can be changed at a timing desired by the user. Furthermore, according to the third embodiment, the amount of radiation exposure to the subject can be reduced by moving the tip of the device to the center of the irradiation area while X-ray irradiation is interrupted. Note that the tip of the device may also be moved to the center of the irradiation area during fluoroscopy.

[0093] <Fourth embodiment> 7 is a flowchart showing the process of the control method for the X-ray fluoroscopic imaging apparatus according to the fourth embodiment. The processes in steps S31 and S32 are the same as steps S21 and S22 shown in FIG.

[0094] In step S33, the image processing unit 122 displays a movement cursor, which is a software key, on the display unit 130. The movement cursor may be displayed on the display unit 130 before the fluoroscopy is interrupted. A display time limit may be set for the movement cursor so that the display is terminated after a certain time has elapsed.

[0095] Here, the LIH image is displayed in a scrollable (pannable) state. The user scrolls the screen of the display unit 130 by using a movement cursor with the operation unit 131, and moves the LIH image to a desired position. For example, the user scrolls the LIH image so that the tip of the device is at the center of the irradiation area.

[0096] In step S34, the arm position calculation unit 25 calculates the arm position based on the amount of movement of the LIH image by the movement cursor (an example of "amount of movement on the display"), and calculates the amount of movement of the arm 108. The amount of movement of the LIH image may be the amount of pixel movement converted into the pixel size of the LIH image.

[0097] In step S35, arm control unit 26 generates a control signal to move arm 108 by the arm movement amount calculated by arm position calculation unit 25, and notifies system control unit 120. System control unit 120 transmits the notified control signal to the movement mechanism. The movement mechanism moves the position of arm 108 in accordance with the control signal.

[0098] In step S36, the system control unit 120 starts irradiating X-rays. This causes the X-ray fluoroscopic imaging apparatus 1 to resume fluoroscopy. The X-ray fluoroscopic imaging apparatus 1 may resume fluoroscopy when the user uses the operation unit 131 to perform an operation to resume fluoroscopy.

[0099] Here, the X-ray fluoroscopy apparatus 1 moves the arm 108 to move the tip of the device to the center of the irradiation area, but the tip of the device may also be moved to the center of the irradiation area by moving the position of the aperture blades of the collimator 103. The X-ray fluoroscopy apparatus 1 may move the tip of the device to the center of the irradiation area by moving the position of the aperture blades of the collimator 103, and move the arm 108 when the position of the tip of the device reaches the edge of the fluoroscopy area.

[0100] FIG. 8 is a diagram illustrating device tip tracking control according to the fourth embodiment. F8A in FIG. 8 is a diagram illustrating the display unit 130 in step S33. The display unit 130 displays an image IM, which is an LIH image, in a frame FR indicating the irradiation area. The image IM includes devices D1 and D2. The device D2 has a tip TD. A palm-shaped cursor CM for movement is also displayed superimposed on the image IM. The user can scroll the image IM within the frame FR by sliding the cursor CM for movement.

[0101] F8B in Fig. 8 is a diagram showing the display unit 130 when the movement of the image IM has finished. The display unit 130 displays the image IM, which is an LIH image, in a frame FR indicating the projection area. The leading edge TD of the image IM is located in the center of the frame FR indicating the projection area. Because the image IM has moved in the lower right direction of the frame FR, the upper and left portions of the frame FR, which do not contain image information, are blacked out.

[0102] The shape of the movement cursor CM is not limited to a palm shape, but may be a cross shape, or the image may be moved by pinching on a touch panel display, etc. The movement cursor is not limited to a software key, but may be provided on the operation unit 131 or on an endoscope control unit (not shown). Also, instead of the movement cursor, the LIH image may be configured to be scrolled based on voice input from a microphone (not shown).

[0103] According to the fourth embodiment, the irradiation area can be changed to a position desired by the user. Also, according to the fourth embodiment, the amount of radiation exposure to the subject can be reduced by moving the irradiation area while X-ray irradiation is suspended.

[0104] Fifth Embodiment So far, we have explained the device tip tracking control, but tracking of the irradiation area is not limited to the tip of the device. In an ERCP examination, a contrast agent may be injected from the device. The X-ray fluoroscopy apparatus 1 according to the fifth embodiment detects a contrast agent area where a contrast agent is present, and controls the irradiation area and the fluoroscopic area according to the tip of the contrast agent area.

[0105] 9 is a flowchart showing the process of the control method for the X-ray fluoroscopic imaging apparatus according to the fifth embodiment. When a contrast agent is injected into the subject 3, in step S41, the device detection unit 21 detects a contrast agent region from the input X-ray fluoroscopic image.

[0106] In step S42, X-ray aperture position calculation unit 22 calculates the X-ray aperture position where the tip of the contrast agent region detected by device detection unit 21 enters the irradiation region. The tip of the contrast agent region is the end of the contrast agent region, and may be the position in the contrast agent region that is farthest from the tip of the device that injected the contrast agent. Furthermore, X-ray aperture control unit 23 generates a control signal to control the position of the aperture blades to the X-ray aperture position calculated by X-ray aperture position calculation unit 22, and notifies system control unit 120. System control unit 120 transmits the notified control signal to collimator 103. Collimator 103 moves the position of the aperture blades in accordance with the control signal. This adjusts the irradiation region to a range that includes the contrast agent region.

[0107] In step S43, the arm movement determination unit 24 determines whether the tip of the contrast agent region has reached the edge of the visible region. If the tip of the contrast agent region has not reached the edge of the visible region, the processing of this flowchart ends. If the tip of the contrast agent region has reached the edge of the visible region, the processing proceeds to step S44.

[0108] In step S44, arm position calculation unit 25 calculates the position of arm 108 where the tip of the contrast agent region is included in the visualization region. Arm control unit 26 generates a control signal to move arm 108 to the arm position calculated by arm position calculation unit 25, and notifies system control unit 120. System control unit 120 transmits the notified control signal to the movement mechanism. The movement mechanism moves the position of arm 108 in accordance with the control signal. As a result, the tip of the contrast agent region moves into the visualization region.

[0109] Next, the X-ray aperture position calculation unit 22 calculates the X-ray aperture position. The X-ray aperture control unit 23 generates a control signal so that the irradiation area is limited to the X-ray aperture position calculated by the X-ray aperture position calculation unit 22, and notifies the system control unit 120. The system control unit 120 transmits the notified control signal to the collimator 103. The collimator 103 moves the position of the aperture blades in accordance with the control signal.

[0110] This completes the process of controlling the leading edge of the contrast agent region for one fluoroscopic X-ray image. By repeating the process of this flowchart, it becomes possible to control the leading edge of the contrast agent region for moving images.

[0111] The condition for moving arm 108 may be when the tip of the contrast medium region reaches a position within a predetermined distance from the edge of the visible region.

[0112] Fig. 10 is a diagram for explaining the control of tracking the leading edge of the contrast agent region according to the fifth embodiment. F10A in Fig. 10 shows a state in which the leading edge of the contrast agent region RC has deviated from the irradiation region AI. F10B in Fig. 10 shows a state in which the leading edge of the contrast agent region RC has been included in the irradiation region AI due to the control of the irradiation region.

[0113] According to the fifth embodiment, the field of view of the X-ray fluoroscopic image can be automatically moved so as to include the tip of the contrast agent region.

[0114] <Other> The technical scope of the present invention is not limited to the scope described in the above embodiments. The configurations and the like in each embodiment can be appropriately combined with each other within the scope that does not deviate from the spirit of the present invention. [Explanation of symbols]

[0115] 1...X-ray fluoroscopy device 3...Subject 21...Device detection section 22...Position calculation section 23...Control unit 24...Arm movement determination unit 25...Arm position calculation unit 26...Arm control unit 101...High voltage generating unit 102...X-ray tube 103...Collimator 103A...Aperture blades 103B...Aperture blades 103C...Aperture blades 103D...Aperture blades 105...Table 106...X-ray detector 108...Arm 120...System control unit 121...X-ray control unit 122...Image processing unit 123...Storage section 130...Display section 131...Operation unit AI…irradiation area AV…Visible area BC: Center display button CM...Movement cursor D1...Device D2...Device FR...frame IM…Image RC: Contrast agent field S1 to S4: Processing steps of the control method for the X-ray fluoroscopy device S11 to S14: Processing steps of the control method for the X-ray fluoroscopy device S21 to S27: Processing steps of the control method for the X-ray fluoroscopy device S31 to S36: Processing steps of the control method for the X-ray fluoroscopy device S41 to S44: Processing steps of the control method for the X-ray fluoroscopy device TD...tip

Claims

1. an X-ray source that irradiates X-rays toward the subject; a collimator disposed between the X-ray source and the subject, the collimator setting an irradiation area where the X-rays are irradiated onto the subject; an X-ray detector that detects transmitted X-rays that have passed through the subject; an arm supporting the X-ray source, the collimator, and the X-ray detector, the arm being movable relative to the subject in a direction intersecting the X-rays; a processor; Equipped with The processor: generating an X-ray fluoroscopic image based on the transmitted X-rays; Displaying the X-ray fluoroscopic image on a display; Detecting a device from the fluoroscopic image; changing the irradiation area by controlling the collimator according to the position of the tip of the device in the X-ray fluoroscopic image; When the position of the tip of the device is at the edge of a fluoroscopic region, which is the irradiation region when the collimator is fully opened, or at a position within a predetermined distance from the edge of the fluoroscopic region, the movement of the arm is controlled to change the fluoroscopic region. X-ray fluoroscopy equipment.

2. the processor controls the movement of the arm to move the position of the tip of the device to the center of the visible area; 2. The X-ray fluoroscopic imaging apparatus according to claim 1.

3. the processor controls the movement speed of the arm in accordance with the movement speed of the tip of the device.

2. The X-ray fluoroscopic imaging apparatus according to claim 1.

4. the processor controls movement of the arm with user permission; 2. The X-ray fluoroscopic imaging apparatus according to claim 1.

5. the processor notifying a user of the need to move the arm; 5. The X-ray fluoroscopic imaging apparatus according to claim 4.

6. the processor controls the movement of the arm when no obstacle is present in the movement direction of the arm.

2. The X-ray fluoroscopic imaging apparatus according to claim 1.

7. the processor determines whether or not the obstacle exists based on a captured image of the moving direction of the arm.

7. The X-ray fluoroscopic imaging apparatus according to claim 6.

8. The processor changes the viewable area during a button operation by a user.

2. The X-ray fluoroscopic imaging apparatus according to claim 1.

9. the processor controls the movement of the arm to change the fluoroscopic region, and displays a trajectory of a movement destination of the tip of the device superimposed on the X-ray fluoroscopic image.

2. The X-ray fluoroscopic imaging apparatus according to claim 1.

10. the processor stops emitting the X-rays from the X-ray source to change the visible region. The X-ray fluoroscopic imaging apparatus according to any one of claims 1 to 9.

11. The processor: displaying the X-ray fluoroscopic image on the display before the X-ray irradiation is stopped; changing the fluoroscopic area in accordance with a movement amount on the display in response to a user's scroll operation of the X-ray fluoroscopic image before the X-ray irradiation is stopped; The X-ray fluoroscopic imaging apparatus according to claim 10.

12. The processor: detecting a contrast agent region where the contrast agent injected into the subject is present from the X-ray fluoroscopic image; changing the visible region in accordance with the detected contrast agent region; 2. The X-ray fluoroscopic imaging apparatus according to claim 1.

13. an X-ray source that irradiates X-rays toward the subject; a collimator disposed between the X-ray source and the subject, the collimator setting an irradiation area where the X-rays are irradiated onto the subject; an X-ray detector that detects transmitted X-rays that have passed through the subject; an arm supporting the X-ray source, the collimator, and the X-ray detector, the arm being movable relative to the subject in a direction intersecting the X-rays; A control method for an X-ray fluoroscopic imaging apparatus comprising: generating an X-ray fluoroscopic image based on the transmitted X-rays; Displaying the X-ray fluoroscopic image on a display; Detecting a device from the fluoroscopic image; changing the irradiation area by controlling the collimator according to the position of the tip of the device in the X-ray fluoroscopic image; When the position of the tip of the device is at the edge of a fluoroscopic region, which is the irradiation region when the collimator is fully opened, or at a position within a predetermined distance from the edge of the fluoroscopic region, the movement of the arm is controlled to change the fluoroscopic region. A method for controlling an X-ray fluoroscopic imaging device.

14. A program that causes a computer to execute the control method for an X-ray fluoroscopic imaging apparatus according to claim 13.

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