X-ray diagnostic equipment, systems, and programs

Abstract

To enable more accurate notification of the timing of device operations. [Solution] The X-ray diagnostic apparatus according to the embodiment comprises an acquisition unit, a generation unit, and a notification unit. The acquisition unit acquires the timing of X-ray irradiation to a subject. The generation unit generates timing information relating to the operation of a device inserted into the subject based on the acquired X-ray irradiation timing. The notification unit notifies the timing of the operation based on the generated timing information.

Description

[Technical Field]

[0001] Embodiments disclosed herein and in the drawings relate to X-ray diagnostic apparatus, systems, and programs. [Background technology]

[0002] When blockage or narrowing occurs in any blood vessel in the body, such as the heart or brain, various problems can arise due to insufficient or complete interruption of blood supply. For such blocked or narrowed blood vessels, catheter treatment is widely performed, for example, under fluoroscopic imaging using an X-ray diagnostic device. In catheter treatment, the operator advances a guidewire to the blocked or narrowed area and performs a procedure to treat the blockage or narrowing of the blood vessel. For example, when performing a procedure to penetrate a coronary artery CTO (chronic total occlusion) lesion, the operator controls the tip of the guidewire to be applied perpendicularly to the blocked area.

[0003] On the other hand, in X-ray diagnostic equipment that supports catheter treatment, electrocardiogram-gated irradiation is widely used for blood vessels in the cardiac region from the perspective of reducing radiation exposure while generating easy-to-view X-ray images. With electrocardiogram-gated irradiation, low-rate X-ray irradiation synchronized with the electrocardiogram waveform intermittently generates X-ray images that reduce the movement of the heart.

[0004] While the above-described X-ray diagnostic device is otherwise without particular problems, the inventors' research suggests that there is room for improvement in the following respects. For example, when X-ray irradiation is performed at a low rate, if the timing of X-ray irradiation and the timing of operating a device such as a guidewire overlap, the tip of the device becomes blurred and difficult to see, even in X-ray images where cardiac movement is minimal. This phenomenon occurs not only with electrocardiogram-gated irradiation of blood vessels in the cardiac region, but also with any low-rate X-ray irradiation. In other words, when performing X-ray irradiation at a low rate, the appropriate timing for device operation is difficult to determine, and the operator needs to become accustomed to the procedure, which is an area where X-ray diagnostic devices have room for improvement. Therefore, it is desirable for X-ray diagnostic devices to be able to more appropriately notify the timing of device operation. [Prior art documents] [Patent Documents]

[0005] [Patent Document 1] Japanese Patent Publication No. 2008-220641 [Overview of the project] [Problems that the invention aims to solve]

[0006] One of the problems that the embodiments disclosed herein and in the drawings aim to solve is to enable more appropriate notification of the timing of device operation. However, the problems that the embodiments disclosed herein and in the drawings aim to solve are not limited to the above problem. Problems corresponding to the effects of each configuration shown in the embodiments described later can also be positioned as other problems. [Means for solving the problem]

[0007] The X-ray diagnostic apparatus according to the embodiment comprises an acquisition unit, a generation unit, and a notification unit. The acquisition unit acquires the timing of X-ray irradiation to a subject. The generation unit generates timing information related to the operation of a device inserted into the subject based on the acquired X-ray irradiation timing. The notification unit notifies the timing of the operation based on the generated timing information. [Brief explanation of the drawing]

[0008] [Figure 1] Figure 1 is a block diagram showing the configuration of a system comprising an X-ray diagnostic device and an electrocardiograph according to one embodiment. [Figure 2] Figure 2 is a flowchart illustrating the operation in one embodiment. [Figure 3] Figure 3 is a schematic diagram illustrating an electrocardiogram waveform according to one embodiment. [Figure 4] Figure 4 is a schematic diagram illustrating the reaction time in a first modified example of one embodiment. [Figure 5]FIG. 5 is a schematic diagram for explaining the reaction time to sound in the first modification of one embodiment. [Figure 6] FIG. 6 is a flowchart for explaining the operation in the first modification of one embodiment. [Figure 7] FIG. 7 is a schematic diagram for explaining the notification timing in the first modification of one embodiment. [Figure 8] FIG. 8 is a schematic diagram for explaining the setting of the recommended timing in the first modification of one embodiment. [Figure 9] FIG. 9 is a schematic diagram for explaining each timing when the rate of X-ray irradiation is changed in the second modification of one embodiment. [Figure 10] FIG. 10 is a table showing an example of each timing etc. for each rate of X-ray irradiation in the second modification of one embodiment. [Figure 11] FIG. 11 is a schematic diagram for explaining the notification timing every three heartbeats in the third modification of one embodiment. [Figure 12] FIG. 12 is a schematic diagram for explaining the reaction time to the screen display in the fourth modification of one embodiment. [Figure 13] FIG. 13 is a schematic diagram for explaining the form of notification by the screen display in the fourth modification of one embodiment. [Figure 14] FIG. 14 is a schematic diagram for explaining the form of notification by the screen display in the fourth modification of one embodiment. [Figure 15] FIG. 15 is a schematic diagram for explaining the form of notification by the screen display in the fourth modification of one embodiment. [Figure 16] FIG. 16 is a schematic diagram for explaining the form of notification by the screen display in the fourth modification of one embodiment. [Figure 17] FIG. 17 is a schematic diagram for explaining the reaction time to vibration in the fifth modification of one embodiment. [Figure 18] FIG. 18 is a schematic diagram for explaining the width of the recommended timing in the sixth modification of one embodiment. [Figure 19]FIG. 19 is a schematic diagram for explaining the recommended timing in the seventh modification of an embodiment. [Figure 20] FIG. 20 is a schematic diagram for explaining the width of the recommended timing in the seventh modification of an embodiment. [Figure 21] FIG. 21 is a block diagram showing the configuration of a system including an X-ray diagnostic apparatus and an electrocardiograph according to the eighth modification of an embodiment. [Figure 22] FIG. 22 is a flowchart for explaining the operation in the eighth modification of an embodiment. BEST MODE FOR CARRYING OUT THE INVENTION

[0009] Hereinafter, each embodiment will be described with reference to the drawings.

[0010] <First Embodiment> FIG. 1 is a block diagram showing the configuration of a system including an X-ray diagnostic apparatus and an electrocardiograph according to the first embodiment. This system includes an X-ray diagnostic apparatus 1 and an electrocardiograph 40 that can communicate with each other. Further, in this system, the X-ray diagnostic apparatus 1 may be capable of controlling the vibration device 83.

[0011] Here, the X-ray diagnostic apparatus 1 includes an imaging apparatus 10, an electrocardiograph 40, a bed apparatus 50, a console apparatus 70, a speaker 81, and a monitor 82. The imaging apparatus 10 includes a high-voltage generator 11, an X-ray tube 12, an X-ray detector 13, a C-arm 14, a state detector 141, and a C-arm driving device 142.

[0012] The high-voltage generator 11 generates a high voltage to be applied between the anode and the cathode in order to accelerate thermoelectrons generated from the cathode of the X-ray tube 12, and outputs the high voltage to the X-ray tube 12.

[0013] The X-ray tube 12 irradiates the subject P with X-rays. The X-ray tube 12 includes an X-ray aperture having a function of limiting the irradiation field of the X-rays or attenuating the X-rays for a part of the irradiation field.

[0014] The X-ray tube 12 generates X-rays. Specifically, the X-ray tube 12 is a vacuum tube that holds a cathode that generates thermionic electrons and an anode that receives thermionic electrons flying from the cathode and generates X-rays. For example, there is a rotating anode type X-ray tube 12 that generates X-rays by irradiating a rotating anode with thermionic electrons. The X-ray tube 12 is connected to a high-voltage generator 11 via a high-voltage cable. A tube voltage is applied between the cathode and the anode by the high-voltage generator 11. The application of the tube voltage causes thermionic electrons to fly from the cathode to the anode. A tube current flows as thermionic electrons fly from the cathode to the anode. The application of high voltage from the high-voltage generator 11 and the supply of filament current cause thermionic electrons to fly from the cathode to the anode, and X-rays are generated when the thermionic electrons collide with the anode.

[0015] The X-ray diaphragm is located between the X-ray tube 12 and the X-ray detector 13 and generally includes diaphragm blades, an additional filter, and a compensation filter. The X-ray diaphragm shields X-rays outside the aperture area, thereby focusing the X-rays generated by the X-ray tube 12 so that they are irradiated only to the region of interest of the subject P. For example, the X-ray diaphragm has diaphragm blades made of four lead plates, and by sliding these blades, the area to be shielded by the X-rays can be adjusted to any size. The diaphragm blades of the X-ray diaphragm are driven by a drive device (not shown) according to the region of interest input by the operator through the input interface 73. In addition, an additional filter for adjusting the total filtration of X-rays can be inserted through a slit in the X-ray diaphragm. Furthermore, a lead mask and a compensation filter used during X-ray examination can be inserted through an accessory slot in the X-ray diaphragm. The compensation filter may include an ROI (Region of Interest) filter that has the function of attenuating or reducing the amount of irradiated X-rays.

[0016] The X-ray detector 13 detects X-rays that have passed through the subject P. Such an X-ray detector 13 can be either one that directly converts X-rays into electric charge, or one that converts them into light first and then into electric charge. While the former is used as an example here, the latter is also acceptable. Specifically, the X-ray detector 13 comprises, for example, a flat panel detector (FPD) that converts and stores the X-rays that have passed through the subject P into electric charge, and a gate driver that generates drive pulses to read out the charge stored in the FPD. The FPD is constructed by arranging minute detection elements two-dimensionally in the column and line directions. Each detection element includes a photoelectric film that senses X-rays and generates charge according to the amount of incident X-rays, a charge storage capacitor that stores the charge generated in the photoelectric film, and a thin-film transistor (TFT) that outputs the charge stored in the charge storage capacitor at predetermined timings. The stored charge is sequentially read out by drive pulses supplied by the gate driver.

[0017] The X-ray detector 13 is followed by a projection data generation circuit and a projection data storage circuit (not shown). The projection data generation circuit includes a charge-voltage converter that converts charges read in parallel from the FPD in row or column units into voltages, an A / D converter that converts the output of the charge-voltage converter into a digital signal, and a parallel-serial converter that converts the digitally converted parallel signal into a time-series serial signal. The projection data generation circuit supplies this serial signal as time-series projection data to the projection data storage circuit. The projection data storage circuit sequentially stores the time-series projection data supplied from the projection data generation circuit to generate two-dimensional projection data. This two-dimensional projection data is stored in the memory 71.

[0018] The C-arm 14 holds the X-ray tube 12 and the X-ray detector 13 facing each other with the subject P and the top plate 53 in between, thereby enabling X-ray imaging of the subject P on the top plate 53 from various directions. Here, the term "X-ray imaging" is used as a broader concept encompassing the terms "fluoroscopy" or "imaging," which obtain multiple time-series X-ray images (moving images) by irradiating with low-dose X-rays, and the term "photography," which obtains multiple time-series X-ray images (moving images) or still X-ray images by irradiating with high-dose X-rays. Generally, X-ray images obtained by fluoroscopy are not saved, while X-ray images obtained by photography are saved. However, this is not limited to this. For example, X-ray images (low-dose moving images) obtained by low-rate (fps) fluoroscopy or imaging may be saved in the memory 71. Alternatively, X-ray images (high-dose still images) obtained by low-rate (fps) photography may be saved in the memory 71. In this specification, the X-ray irradiation rate is expressed in units of fps (frames per second), but pps (pulses per second) may also be used. Furthermore, the following description uses a ceiling-mounted C-arm as an example, but is not limited to this; for example, a floor-standing C-arm may also be used.

[0019] Specifically, the C-arm 14 is movable along the long axis and short axis of the top plate 53. The C-arm 14 is also supported by a support arm via a holding part. The support arm has a substantially arc shape and its base end is attached to a moving mechanism on a rail provided on the ceiling. The C-arm 14 is held by the holding part so as to be rotatable about an axis in the X direction that is perpendicular to both the Y direction perpendicular to the top plate 53 and the Z direction along the long axis of the top plate 53. The C-arm 14 also has a substantially arc shape around the Z axis and is held by the holding part so as to be slidable along the substantially arc shape. That is, the C-arm 14 can perform a sliding motion with the Z axis as the center of rotation. In addition, the C-arm 14 can perform a rotational motion around the X axis with respect to the holding part (hereinafter referred to as the "main rotational motion"), and the combination of sliding and this rotation makes it possible to observe X-ray images from various angles. Furthermore, the C-arm 14 can also rotate around the Y-axis, which allows the rotation axis of the sliding motion described above to be in the X-direction. The imaging axis passing through the X-ray focus of the X-ray tube 12 and the center of the detection surface of the X-ray detector 13 is designed to intersect the rotation axis of the sliding motion and the rotation axis of the main rotation motion at a single point. This intersection point is generally called the isocenter. The isocenter does not displace even when the C-arm 14 performs the sliding motion or main rotation motion described above. Therefore, when the area of ​​interest is located at the isocenter, it becomes easier to observe the area of ​​interest in the moving image of the medical image obtained by the sliding motion or main rotation motion of the C-arm 14.

[0020] Such a C-arm 14 is equipped with a support arm below the rail and multiple power sources at appropriate locations to realize movement related to the X-axis, Y-axis, and Z-axis. These power sources constitute a C-arm drive unit 142. The C-arm drive unit 142 reads drive signals from the drive control function 742 and causes the C-arm 14 to slide, rotate, and move linearly. Furthermore, each C-arm 14 is equipped with a state detector 141 that detects information about its angle, attitude, and position. The state detector 141 consists of, for example, a potentiometer that detects the rotation angle and the amount of movement, or an encoder which is a position detection sensor. As the encoder, for example, so-called absolute encoders such as magnetic, brush, or photoelectric types can be used. In addition, various types of position detection mechanisms can be used as appropriate for the state detector 141, such as a rotary encoder that outputs rotational displacement as a digital signal or a linear encoder that outputs linear displacement as a digital signal.

[0021] The electrocardiograph 40 acquires heart rate information from the subject P. For example, the electrocardiograph 40 acquires heart rate information, including the electrocardiogram (ECG) waveform and time information, of the subject P via electrodes (not shown) attached to the subject P. The electrocardiograph 40 outputs the acquired heart rate information to the processing circuit 74 and memory 71 of the console device 70. Note that the electrocardiograph 40 is not mandatory and may be omitted or not used. For example, if electrocardiogram-synchronized irradiation is not performed, the electrocardiograph 40 can be omitted.

[0022] The examination bed device 50 is a device for placing and moving the subject P, and comprises a base 51, an examination bed drive device 52, a top plate 53, a support frame 54, and a foot switch 55.

[0023] The base 51 is a housing that is installed on the floor and supports the support frame 54 so that it can move vertically (in the Y direction).

[0024] The bed drive unit 52 is housed within the casing of the bed device 50 and includes a motor or actuator that moves the top plate 53 on which the subject P is placed in the longitudinal direction (Z direction) of the top plate 53. The bed drive unit 52 reads a drive signal from the drive control function 742 and moves the top plate 53 horizontally or vertically relative to the floor surface.

[0025] The top plate 53 is provided on the upper surface of the support frame 54 and is a plate on which the subject P is placed.

[0026] The support frame 54 movably supports the top plate 53 on which the subject P is placed. More specifically, the support frame 54 is provided on the upper part of the base 51 and supports the top plate 53 so that it can slide along its longitudinal direction.

[0027] The foot switch 55 is a switch located on the floor and outputs a command signal to the input interface 73 of the console device 70 to switch the start and end of X-ray irradiation at a constant rate, in response to the operation of the user, who is the operator. The foot switch 55 is an example of an operating unit.

[0028] The console device 70 includes a memory 71, a display 72, an input interface 73, a processing circuit 74, and a network interface 76. The console device 70 may also be called an operating console.

[0029] The memory 71 comprises a memory unit that records electrical information, such as ROM (Read Only Memory), RAM (Random Access Memory), HDD (Hard Disk Drive), and image memory, as well as peripheral circuits such as a memory controller and memory interface associated with the memory unit. The memory 71 stores, for example, a program executed by the processing circuit 74, detection data (projection data) received from the X-ray detector 13, medical images generated by the processing circuit 74, electrocardiogram waveforms, display screens, data used for processing by the processing circuit 74, various tables, data during processing, and data after processing. Examples of medical images include live X-ray images. Furthermore, the medical images are not limited to X-ray images of the cardiac region with coronary arteries; medical images of any part with blood vessels into which the device is inserted can be used as appropriate.

[0030] A live image is an X-ray image obtained by fluoroscopy while inserting any device such as a catheter, guidewire, balloon, or stent into the treatment site of a patient during a procedure. The X-rays irradiated from the X-ray tube 12 change their intensity significantly as they pass through the device and enter the X-ray detector 13. Therefore, the live image will include the device inserted into the patient in addition to the background such as the patient's bone. Such live images are generated and displayed in real time. Here, the term "real time" does not strictly mean the process of generating and displaying the image at the moment it is captured, but rather that it is generated and displayed sequentially by the processing circuit 74 and the display 72.

[0031] The program enables, for example, a computer to implement an acquisition function for acquiring the timing of X-ray irradiation to a subject, a generation function for generating timing information related to the operation of a device inserted into the subject based on the acquired X-ray irradiation timing, and a notification function for notifying the timing of said operation based on the generated timing information. To elaborate, such a program may be one that is pre-installed on a computer from a network or a non-transient computer-readable storage medium M1, and enables the computer to implement each function of the X-ray diagnostic apparatus 1. In this specification, each function of the X-ray diagnostic apparatus 1 may be implemented by a computer implemented method or a timing notification method. Memory 71 is an example of a storage unit.

[0032] The display 72 consists of a display unit that displays various information such as medical images, an internal circuit that supplies display signals to the display unit, and peripheral circuits such as connectors and cables that connect the display unit and the internal circuit. The internal circuit generates display data by superimposing supplementary information such as subject information and projection data generation conditions onto image data supplied from the processing circuit 74, and then performs D / A conversion and TV format conversion on the obtained display data to display it on the display unit. For example, the display 72 outputs medical images generated by the processing circuit 74, or a GUI (Graphical User Interface) for receiving various operations from the operator. For example, the display 72 is a liquid crystal display or a CRT (Cathode Ray Tube) display. Also, the display 72 is just one example of a display unit. Furthermore, the display 72 may be a desktop type, or it may be composed of a tablet terminal that can wirelessly communicate with the console device 70. The display 72 is just one example of a display unit.

[0033] The input interface 73 performs tasks such as inputting subject information, setting X-ray conditions, and inputting various command signals. Subject information includes, for example, subject ID, subject name, date of birth, age, weight, sex, and examination site. Subject information may also include the subject's height. The input interface 73 can be implemented by, for example, a trackball for instructing the movement of the C-arm 14 and setting the region of interest (ROI), switches, buttons, a mouse, a keyboard, a touchpad for input operations by touching the operating surface, and a touch panel display that integrates a display screen and a touchpad. The input interface 73 is connected to the processing circuit 74, which converts the input operations received from the operator into electrical signals and outputs them to the processing circuit 74. The input interface 73 may also consist of a tablet terminal or the like that can communicate wirelessly with the console device 70. Furthermore, in this specification, the input interface 73 is not limited to those equipped with physical operating components such as a mouse or keyboard. For example, an electrical signal processing circuit that receives an electrical signal corresponding to an input operation from an external input device such as a foot switch 55, which is provided separately from the device, and outputs this electrical signal to a processing circuit 74, is also included as an example of an input interface 73. An input interface 73 is an example of an operating unit. The button shown as an example of an input interface 73 is an example of a button on a control console.

[0034] The processing circuit 74 is a processor that implements system control functions 741, drive control functions 742, shooting control functions 743, image processing functions 744, acquisition functions 745, generation functions 746, notification functions 747, and display control functions 748 corresponding to the program by calling and executing the program in the memory 71. In Figure 1, it is explained that the system control functions 741, drive control functions 742, shooting control functions 743, image processing functions 744, acquisition functions 745, generation functions 746, notification functions 747, and display control functions 748 are implemented by a single processing circuit 74. However, it is also possible to configure a processing circuit by combining multiple independent processors, with each processor implementing each function by executing a program. Furthermore, the system control function 741, drive control function 742, shooting control function 743, image processing function 744, acquisition function 745, generation function 746, notification function 747, and display control function 748 may also be called the system control circuit, drive control circuit, shooting control circuit, image processing circuit, acquisition circuit, generation circuit, notification circuit, and display control circuit, respectively, and may be implemented as individual hardware circuits.

[0035] The system control function 741, for example, stores information such as command signals from the operator input through the input interface 73 and various initial setting conditions, and then transmits this information to each processing function of the processing circuit 74.

[0036] The drive control function 742 controls the C-arm drive unit 142 and the bed drive unit 52 using information regarding the driving of the C-arm 14 and the tabletop 53 input from the input interface 73. For example, the drive control function 742 controls the movement and rotation of the imaging device 10, and the movement and tilt of the bed device 50.

[0037] The imaging control function 743 reads, for example, command signals from the operator input from the foot switch 55 or information from the system control function 741, and controls X-ray conditions such as tube voltage, tube current, and irradiation time in the high-voltage generator 11, as well as X-ray imaging with control of X-ray irradiation. The terms "X-ray imaging" and "X-ray irradiation" are concepts that include low-dose fluoroscopy or imaging and high-dose imaging, as described above. In the following, the imaging control function 743 controls low-dose fluoroscopy or imaging when assisting the user in operating the device, but is not limited to this. X-ray conditions may include the product of tube current and irradiation time (mAS). The imaging control function 743 may acquire heart rate information of the subject P from the electrocardiograph 40 and control X-ray irradiation to the subject P based on said heart rate information. For example, the control of X-ray irradiation may include a process of calculating the X-ray irradiation timing based on heart rate information received from the electrocardiograph 40 and sending a control signal to the high-voltage generator 11 to perform X-ray irradiation at the X-ray irradiation timing. Such electrocardiogram-gated irradiation based on heart rate information is preferable from the viewpoint of being able to acquire images of a specific cardiac phase even if the RR interval changes, by calculating the X-ray irradiation timing so as to irradiate in phase in conjunction with heart rate variability, based on the immediately preceding RR interval. When images of a specific cardiac phase can be acquired, for example, the angle of the guidewire tip to the CTO lesion can be accurately confirmed, which has the advantage of enabling safer procedures. However, electrocardiogram-gated irradiation may calculate the X-ray irradiation timing in conjunction with heart rate variability based on a preset RR interval, not limited to the immediately preceding RR interval. Alternatively, electrocardiogram-gated irradiation may calculate the X-ray irradiation timing in conjunction with heart rate variability based on the RR interval measured again at regular intervals. Furthermore, the imaging control function 743 may send the calculated X-ray irradiation timing to the acquisition function 745. The shooting control function 743 is an example of a control unit.

[0038] The image processing function 744 performs image processing, such as filtering, on projection data in memory 71 to generate X-ray image data, and stores the X-ray image data in memory 71. Examples of X-ray image data generated from projection data include medical image data such as live images.

[0039] The acquisition function 745 acquires the timing of X-ray irradiation to the subject P. For example, the acquisition function 745 may acquire the X-ray irradiation timing from the imaging control function 743. The acquisition function 745 is an example of an acquisition unit.

[0040] The generation function 746 generates timing information regarding the operation of the device inserted into the subject P based on the acquired X-ray irradiation timing. The timing information may include, for example, recommended timings for operation or non-recommended timings for operation. For example, the generation function 746 may calculate a recommended timing different from the X-ray irradiation timing and generate timing information indicating that recommended timing.

[0041] Here, devices such as catheters, guidewires, rotablators, diamondbacks, balloons, or stents can be used as appropriate to improve vascular occlusion or stenosis. Examples of occluded or stenotic blood vessels include any blood vessels throughout the body, such as those in the heart, brain, hands, and feet. Specifically, when electrocardiogram-gated irradiation is used, any blood vessel in the cardiac region can be used as an example. When electrocardiogram-gated irradiation is not used, any blood vessel outside the cardiac region can be used as an example.

[0042] In the case of electrocardiogram-gated irradiation, the generation function 746 may, for example, further acquire heart rate information of subject P and calculate the recommended timing so that it differs from the QRS duration indicated by the heart rate information. Alternatively, the generation function 746 may, for example, further acquire heart rate information of the subject and calculate the recommended timing so that it falls within either the first recommended time from the end of the S wave to the peak of the T wave, or the second recommended time from the end of the T wave to the beginning of the Q wave, as indicated by the heart rate information. The generation function 746 is an example of a generation unit.

[0043] The notification function 747 notifies the timing of the operation based on the generated timing information. The notification function 747 may also obtain the reaction time between notifying the timing of the operation and the user operating the device, and notify the timing of the operation at a point calculated by going back from the recommended timing according to the reaction time. This point in time calculated by going back from the recommended timing may be called the notification timing. The notification function 747 is an example of a notification unit.

[0044] The display control function 748 controls the display of display data, such as medical image data in memory 71, on the display 72. For example, the display control function 748 reads a signal from the system control function 741, retrieves desired medical image data from memory 71, and controls its display on the display 72. The display control function 748 may also be controlled by the notification function 747 to control the display on the display 72 to notify the timing of an operation. The display control function 748 is an example of a display control unit.

[0045] The network interface 76 is a circuit for connecting the console device 70 to a network and communicating with other devices such as the vibration device 83. For example, a network interface card (NIC) can be used as the network interface 76. In the following description, the fact that the network interface 76 is involved in communication with other devices will be omitted.

[0046] Speaker 81 is an audio output device located in the examination room housing the bed device 50. Speaker 81 is controlled by the processing circuit 74 to output an audio notification sound to indicate the timing for operating the device. However, speaker 81 does not necessarily have to be used for timing notification. For example, if monitor 82 or vibration device 83 notifies the timing, speaker 81 does not need to notify the timing.

[0047] Monitor 82 is a larger display than the display 72 of the console device 70 and is positioned so that it can be seen from near the patient bed device 50. Monitor 82 is controlled by the processing circuit 74 to display information on its screen. For example, while a live image, such as an X-ray image, is being displayed, Monitor 82 displays information to notify the timing for operating the device. Note that Monitor 82 may also be called a display. Furthermore, Monitor 82 does not necessarily have to be used for timing notification. For example, if the speaker 81 or vibration device 83 notifies the timing, Monitor 82 does not need to notify the timing.

[0048] The vibration device 83 is a device that is carried or worn by the user operating the device and is capable of vibrating by a piezoelectric element or an eccentric motor. For example, the vibration device 83 is controlled by the processing circuit 74 and vibrates to notify the user of the timing to operate the device. The vibration device 83 is not limited to a device dedicated to vibration, but may be integrated into a device carried or worn by the user. For example, the vibration device 83 may be installed in a smartphone or dosimeter carried by the user, or in a wearable device worn by the user. Wearable devices to which the vibration device 83 is installed include, for example, watch-type, wristband-type, glasses-type, ring-type, clothing-type, and shoe-type devices, which can be used as appropriate. In the case of glasses-type devices, for example, smart glasses such as AR (augmented reality) glasses can be used. In the case of AR glasses, instead of notification by vibration, notification by screen display, such as a flashing display at the edge of the field of view, may be used. Note that the vibration device 83 does not necessarily have to be used for timing notification. For example, if the speaker 81 or monitor 82 notifies the timing, the vibration device 83 may be omitted.

[0049] Next, the operation of the X-ray diagnostic apparatus and system configured as described above will be explained using the flowchart in Figure 2 and the schematic diagram in Figure 3. The following explanation will use the case of electrocardiogram-gated irradiation as an example, but is not limited to this.

[0050] First, the processing circuit 74 of the X-ray diagnostic device 1 controls the imaging device 10 to start low-rate X-ray fluoroscopy imaging in response to the user's operation of the input interface 73. At this time, the processing circuit 74 intermittently irradiates the cardiac region of subject P with X-rays based on the heart rate information of subject P received from the electrocardiograph 40. Through this electrocardiogram-gated irradiation, intermittently generated X-ray images are obtained as a stop-motion video. These X-ray images are displayed on the display 72 and monitor 82 by the processing circuit 74. In this state, the user inserts the device into subject P while viewing the monitor 82. After that, step ST10 is started.

[0051] In step ST10, the processing circuit 74 acquires the X-ray irradiation timing from the imaging control function 743 using the acquisition function 745.

[0052] After step ST10, in step ST20, the processing circuit 74 generates timing information regarding the operation of the device inserted into the subject P based on the acquired X-ray irradiation timing using the generation function 746. For example, the processing circuit 74 calculates a recommended timing that is different from the X-ray irradiation timing and is based on the heart rate information of the subject P. Here, the recommended timing may be, for example, a timing that satisfies the following conditions (i) and (ii). Alternatively, the recommended timing may be a timing that satisfies condition (i) and condition (iii). Note that if condition (iii) is satisfied, condition (ii), which is automatically satisfied, can be omitted. Also, condition (iii) may be replaced with condition (iv) or (v). Furthermore, if it is not electrocardiogram-gated irradiation, only condition (i) needs to be satisfied.

[0053] (i) The timing is different from the X-ray irradiation timing. In other words, the recommended timing can be any timing different from the X-ray irradiation timing. In Figure 3, for example, if the PQ time from the beginning of the P wave to the beginning of the Q wave is the X-ray irradiation timing, then the timing in condition (i) is any timing within the RR interval between consecutive R waves, excluding the PQ time. However, the X-ray irradiation timing is not limited to the PQ time. For example, the X-ray irradiation timing may be between the end of the U wave and the beginning of the P wave. Specifically, for example, if the RR interval is 100%, the X-ray irradiation timing may be 60-70% after the R wave. Note that if the device is operated at the X-ray irradiation timing, the motion blur of the device in the X-ray image will increase. Taking this into consideration, condition (i) indicates a timing in which the motion blur of the device in the X-ray image is minimized.

[0054] (ii) The timing is different from the time in the subject P's heart cycle when the heart rate is relatively large, as indicated by the heart rate information. For example, it is different from the QRS duration indicated by the heart rate information. The QRS duration is the time from the beginning of the Q wave to the end of the S wave, and includes the R wave and its fluctuations before and after. In other words, the recommended timing that satisfies condition (ii) is a timing that avoids the QRS duration when heart rate variability is large. Condition (ii) is preferable to satisfy when it is necessary to apply the tip of the guidewire perpendicular to the occlusion, such as in a procedure to penetrate a CTO (chronic total occlusion) lesion. Also, condition (ii) may not necessarily be satisfied from the standpoint of procedure safety, such as when the guidewire passes through a healthy blood vessel before reaching the lesion, or when applying the guidewire to a lesion that is not a CTO. However, it is desirable to satisfy condition (ii) not only for the safety of the procedure, but also from the standpoint of collecting X-ray images with minimal device motion blur and making them available for image processing such as device extraction as appropriate.

[0055] (iii) A timing that includes a period in the subject P's heart cycle in which the cardiac activity is relatively small, as indicated by the heart rate information. Condition (iii) may be carried out, for example, by condition (iv) or (v).

[0056] (iv) The timing is included in the first recommended time interval, which is the period from the end of the S wave to the peak of the T wave as indicated by the heart rate information. The first recommended time interval can also be rephrased as the time that includes the ST segment and the first half of the T wave. The first recommended time interval is the period in the heart cycle during which heart rate variability is relatively small. In other words, the recommended timing that satisfies condition (iv) is the time in the heart cycle during which heart rate variability is relatively small.

[0057] (v) This timing is included in the second recommended time, which is the period from the end of the T wave to the beginning of the Q wave as indicated by the heart rate information. This second recommended time includes the PQ interval mentioned above. The second recommended time is a resting period with smaller heart rate variability than the first recommended time. For this reason, the second recommended time is a period suitable for both device operation and X-ray irradiation. In other words, the recommended timing that satisfies condition (v) is a timing with smaller heart rate variability than condition (iv).

[0058] In any case, the processing circuit 74 generates timing information indicating the recommended timing.

[0059] After step ST20, in step ST30, the processing circuit 74 notifies the user of the timing of the operation based on the timing information. For example, the processing circuit 74 notifies the user of the timing of the operation via the speaker 81, monitor 82, or vibration device 83. In any case, the user can know the timing of the operation without taking their eyes off the monitor 82, whether via the speaker 81, monitor 82, or vibration device 83.

[0060] After step ST30, in step ST40, the device is operated for a short time by the user who has been notified of the timing of the operation.

[0061] After step ST40, in step ST50, the processing circuit 74 controls the imaging device 10 to irradiate the subject P with X-rays based on the X-ray irradiation timing.

[0062] After step ST50, in step ST60, the processing circuit 74 generates an X-ray image as a live image based on the output of the X-ray detector that detected the X-rays transmitted through the subject P. Then, the processing circuit 74 displays this X-ray image on the monitor 82 and the display 72.

[0063] After step ST60, in step ST70, the processing circuit 74 determines whether or not an instruction to end imaging has been received. If not, it returns to step ST10 and continues processing in steps ST10 to ST70. If, as a result of the determination, an instruction to end imaging has been received, the processing is terminated.

[0064] As described above, according to one embodiment, the processing circuit 74 of the X-ray diagnostic apparatus 1 acquires the timing of X-ray irradiation to the subject P. Based on the acquired X-ray irradiation timing, the processing circuit 74 generates timing information regarding the operation of a device inserted into the subject P. Based on the generated timing information, the processing circuit 74 notifies the timing of the operation. In this way, by notifying the timing of the operation according to the timing information based on the X-ray irradiation timing, it is possible to notify the timing of device operation more appropriately.

[0065] To elaborate, the notification sound for X-ray irradiation timing (hereinafter referred to as "X-ray irradiation sound") from a typical X-ray diagnostic device is not aligned with the irradiation timing. For example, in the case of high-dose imaging, the X-ray irradiation sound is emitted, but the X-ray irradiation sound and the irradiation timing do not strictly coincide. Also, in the case of low-dose fluoroscopy, the X-ray irradiation sound may not be emitted. In the case of fluoroscopy, if fluoroscopy acquisition is set in advance, the melody of the X-ray irradiation sound will play during X-ray irradiation, but it is unrelated to the irradiation timing. Furthermore, according to the standards, a sound must be emitted at the start and end of fluoroscopy. In addition, the notification sound for heartbeats from a typical electrocardiograph is not associated with the X-ray irradiation timing. Moreover, typical X-ray diagnostic devices predict the trend of heart rate variability and RR interval based on past electrocardiogram information when performing electrocardiogram-gated irradiation, and then irradiate accordingly. In other words, the optimal timing for device operation and the timing of the system's sound do not coincide (there is no correlation).

[0066] In contrast, according to one embodiment, as described above, the timing of the operation can be notified more appropriately by a configuration that notifies the timing of the operation according to timing information based on the X-ray irradiation timing. According to such an embodiment, for example, when outputting a notification sound from speaker 81, the optimal timing for the device operation and the timing of the system sound can be matched (they are correlated).

[0067] Furthermore, according to one embodiment, it is possible to achieve a safer procedure for the patient, and it is expected that this will lead to improved surgical outcomes and a reduction in procedure time. In addition, it is possible to collect X-ray images with reduced motion blur indicating device shake, thereby improving the visibility of the device. Moreover, because there is less device shake, there is no need for additional X-ray irradiation, thus reducing the radiation exposure of the patient. Furthermore, by avoiding the collection of X-ray images with significant device motion blur, the procedure can proceed more smoothly, and the radiation dose during the procedure can be reduced. In addition, by obtaining X-ray images with less device motion blur, it is possible to provide better X-ray images for user image observation and to collect X-ray images suitable for subsequent image processing (object detection, object recognition, AI (artificial intelligence), etc.).

[0068] Furthermore, according to one embodiment, the timing information indicates a recommended timing for performing an operation, or a deprecated timing for not performing an operation. In the former case, the user can perform the device operation at a more appropriate time by operating the device according to the notified timing. In the latter case, the user can perform the device operation at a more appropriate time by ending the device operation according to the notified timing. Therefore, the timing at which to perform or end an operation can be recommended can be notified according to the user's preference.

[0069] Furthermore, according to one embodiment, the processing circuit 74 calculates a recommended timing different from the X-ray irradiation timing and generates timing information indicating the recommended timing. In this case, by notifying the user of the time when X-rays are not irradiated as the recommended timing for device operation, it is possible to assist the user in operating the device to avoid the X-ray irradiation timing. However, the processing circuit 74 may also designate the X-ray irradiation timing as a non-recommended timing and generate timing information indicating the non-recommended timing. Even with such modifications, the user can be made aware of the timing for device operation.

[0070] Furthermore, according to one embodiment, the processing circuit 74 may further acquire heart rate information of the subject P and calculate a recommended timing that differs from the time in the subject's heart cycle when the heart rate information indicates that the heart movement is relatively large. In this case, for example, device operation can be performed at a recommended timing that differs from the QRS time when heart rate variability is large.

[0071] Furthermore, according to one embodiment, the processing circuit 74 may further acquire heart rate information of the subject P and calculate a recommended timing that includes a period in the subject P's heart cycle in which the heart rate movement is relatively small, as indicated by the heart rate information. In this case, the device operation can be performed at the recommended timing that is included in the period of small heart rate variability.

[0072] Furthermore, according to one embodiment, the processing circuit 74 may further acquire heart rate information of the subject P and calculate a recommended timing that falls within either a first recommended time from the end of the S wave to the peak of the T wave, or a second recommended time from the end of the T wave to the beginning of the Q wave. In this case, device operation can be performed at a recommended timing that falls within a period of small heart rate variability.

[0073] Furthermore, according to one embodiment, the processing circuit 74 acquires heart rate information of the subject P from the electrocardiograph and controls X-ray irradiation to the subject P based on the heart rate information. This enables electrocardiogram-synchronized irradiation.

[0074] (Various variations) Next, various modifications of one embodiment will be described. In the following description, parts identical to those in the previously mentioned drawings are denoted by the same reference numerals, and their detailed descriptions are omitted. The description will mainly focus on the differences.

[0075] (First variation) In one embodiment, the user operated the device when the timing of the operation was notified. In contrast, the first modified version of the embodiment performs calibration (adjustment) of the notification timing. Specifically, as shown in Figure 4, this calibration takes into account the delay time (response detection time) between the console device 70 and the user operation, from the viewpoint of wanting to operate the device at a time when X-ray irradiation is not occurring more reliably. For example, the processing circuit 74 of the console device 70 calculates the time t based on the output of the electrocardiograph 40. x The X-ray irradiation timing is calculated so that the X-ray tube 12 will then irradiate with X-rays. After that, the processing circuit 74 notifies the user of the timing of the operation, and a signal corresponding to the user operation is input with a delay time t in The signal is then input to the processing circuit 74. In this operation, the notification response time (reference code "?") from the notification by the processing circuit 74 to the user operation, and the input delay time t from the user operation until the signal is input to the processing circuit 74, are used. in The sum of these two values ​​represents the delay time. Note that the notification response time varies depending on whether the processing circuit 74 uses speaker 81, monitor 82, or vibration device 83 to notify the user of the timing of the operation, and also varies depending on the laboratory environment and the individual user. In the first modified example, the case in which speaker 81 is used will be described.

[0076] When using speaker 81, as shown in Figure 5, the notification response time "?" in Figure 4 is the sum of the 0th delay time t0, the 1st delay time t1, and the 2nd delay time t2. The 0th delay time t0 is the time from when speaker 81 outputs a notification sound in response to the output of the processing circuit 74 in the console device 70. The 1st delay time t1 is the time from when the user detects the notification sound output by speaker 81. The 2nd delay time t2 is the time from when the notification sound is detected until the user takes action. Of the notification response time, the delay time corresponding to the user's response (hereinafter referred to as the response time) is the sum of the 1st delay time t1 and the 2nd delay time t2. The response time (t1+t2) is a user-specific time that differs from user to user, so it is desirable to measure it for each user in advance. However, measuring the response time is not mandatory. For example, the response time may be a time estimated from experience. Furthermore, the response time can be measured at the time of system installation, immediately before the start of catheter treatment, or during catheter treatment. However, from the perspective of shortening surgical time, it is preferable to measure reaction time during system installation. Since the measurement of reaction time is related to the user who is performing the surgery, it can be performed even during system installation when the subject P is not present.

[0077] Furthermore, of the total delay time, the delay time corresponding to the system's signal processing (hereinafter referred to as the system delay time) is the 0th delay time t0 and the input delay time t in This is the sum of the system delay time (t0 + t). in ) is approximately a constant time, regardless of the user.

[0078] The total delay time is calculated as the system delay time (t0 + t in This is the sum of the system delay time and the user's reaction time (t1+t2). Hereafter, the total delay time will be referred to as the reaction detection time Td. The system delay time and reaction time can be measured at any time: when the system is installed, immediately before the start of catheter treatment, or during catheter treatment. However, from the viewpoint of shortening the surgical time, it is preferable to perform these measurements when the system is installed.

[0079] In other words, the first modification is a form in which the timing of notification is adjusted taking into account the reaction detection time Td. Specifically, the notification function 747 of the processing circuit 74 acquires in advance the reaction time (t1+t2) from the time the user is notified of the timing of the operation until the user operates the control unit, and adjusts the timing of notification based on the timing information and the reaction time. As for the acquisition method, for example, a method can be used in which a notification sound is output from the speaker 81 at a regular rate, and the reaction time (t1+t2) is measured by having the user perform an input operation from the control unit in accordance with the detection of the notification sound. To add to this, the reaction detection time Td (=t0+t1+t2+t) from the time the processing circuit 74 outputs a notification until the input operation is accepted is... in ) is measured, and the known system delay time (t0 + t) is taken from the reaction detection time Td. in The reaction time (t1+t2) is obtained by subtracting ). This is the same for other variations such as screen display and vibration detection. As the operating unit used to measure the reaction time, for example, a foot switch 55 or a button on the control console (input interface 73 of the console device 70) can be used as appropriate. However, the operating unit is not limited to these, and for example, the touch panel of the input interface 73, a mouse, or a microphone (voice input) may be used. Alternatively, a simulation tool capable of simulating the device insertion operation may be used as the operating unit. The operating units listed here are also applicable to each of the following variations. The notification function 747 may acquire the reaction time (t1+t2) from the time the timing of the operation is notified until the user operates the device in advance, and notify the timing of the operation at a point in time that is backdated from the recommended timing according to the reaction time. The notification function 747 may also adjust the timing of the notification according to the position of the user operating the device. For example, in the case of speaker 81, the response time differs depending on the placement of speaker 81 in the examination room and the user's position in the examination room. Therefore, the timing of notification is adjusted according to the user's position. In this case, it is necessary to obtain the response time for each user's position in advance.

[0080] In addition, when the notification function 747 notifies the timing of an operation with a notification sound from the speaker 81, it uses the recommended timing or the notification timing considering the delay time. The notification timing is the timing that precedes the recommended timing by the reaction detection time Td. Note that the recommended timing may vary depending on the rate of X-ray irradiation and may have a certain length. For example, when the rate of X-ray irradiation is low, the recommended timing may have a longer time width because the time to avoid the X-ray irradiation timing increases. Accordingly, the notification function 747 may output a notification sound, for example, at the start timing, end timing, or both of the recommended timing. At this time, the notification sounds for each of the start timing and the end timing may be the same sound or different sounds. Note that the notification sound at the end timing of the recommended timing also functions as the notification sound at the start timing of the non-recommended timing where the operation is not recommended. Similarly, the notification sound at the start timing of the recommended timing also functions as the notification sound at the end timing of the non-recommended timing. Also, the notification function 747 may continue to sound the notification sound during the recommended time of the device operation. Further, the notification function 747 may make the notification sound easier to hear by relatively lowering other system volumes during the period of outputting the notification sound.

[0081] Other configurations are the same as those in the embodiment.

[0082] Next, the operation of the first modified example configured as described above will be described using the flowchart of FIG. 6 and the schematic diagrams of FIGS. 7 and 8. In the following description, it is assumed that the system delay time (t0 + t in ) and the user's reaction time (t1 + t2) have been acquired in advance and set in the memory 71.

[0083] Now, as described above, steps ST10 to ST20 are executed, and timing information based on the X-ray irradiation timing is generated. For example, in step ST20, a recommended timing different from the X-ray irradiation timing acquired in step ST10 is calculated, and timing information indicating the recommended timing is generated.

[0084] After step ST20 is completed, step ST30 is executed. Step ST30 includes steps ST31 to ST34, as shown in Figure 6.

[0085] In step ST31, the processing circuit 74 receives heart rate information from the electrocardiograph 40 and, based on the electrocardiogram waveform and its R wave detection signal included in the heart rate information, obtains the RR interval (T_RR) as shown in Figure 7. The RR interval (T_RR) is the time interval between consecutive R waves and corresponds to the heart cycle, which is the time of one heartbeat. For example, if the heart rate is 60 [bpm], the RR interval is 1 [s]. The X-ray irradiation rate is, for example, 1 [fps]. In this case, one X-ray irradiation is performed for each heartbeat. Note that in Figure 7, the RR interval (T_RR) is represented as 100%, and other times are represented as percentages of the RR interval. To clarify, in Figure 7, the first R wave of the RR interval (T_RR) is set to 0%, and the second R wave is set to 100%, and the time position between them is represented as a percentage.

[0086] Furthermore, the X-ray irradiation timing is calculated as a timing delayed by a delay time T_DL from the immediately preceding R wave. For example, the X-ray irradiation timing is calculated as a percentage of the RR interval (100%) corresponding to a heart rate of 60 set in "Base (bps)" in Figure 8, using the delay time T_DL set in "Delay (%)" (e.g., 78%). In other words, the X-ray irradiation timing is calculated as a timing delayed by a delay time T_DL of 78% from the immediately preceding R wave.

[0087] Furthermore, the recommended timing is calculated as a different timing from the X-ray irradiation timing. For example, the recommended timing is calculated as T_DL-n (e.g., 48%), which precedes the delay time T_DL indicating the X-ray irradiation timing by an operation time n (e.g., 30%). Here, the operation time n[%] is the time the user operates the device as a percentage of the RR interval (100%). If not expressed as a percentage, the operation time[s] is the time (duration) the user operates the device.

[0088] After step ST31, in step ST32, the processing circuit 74 performs the RR interval t rr Based on the reaction time (t1+t2)[s], the reaction detection time (Td)[%] is calculated. In this example, the system delay time (t0+t in Using [s] as well, the reaction detection time (Td) is calculated as shown in equation (1). However, the reaction detection time (Td) only needs to include at least the reaction time (t1+t2), so it does not necessarily have to include the system delay time (t0+t in It is not necessary to include ).

[0089] Td=(t0+t1+t2+t in ) / T rr ×100 ···(1) The reaction time (t1+t2) may be obtained by pre-setting a value measured for each user, or by pre-setting an estimated value. Alternatively, the reaction time (t1+t2) may be obtained in advance for each user's standing position, so that the reaction time (t1+t2) corresponding to the user's standing position during the procedure can be used.

[0090] After step ST32, in step ST33, the processing circuit 74 calculates the notification timing (T3) as the point in time that is set back from the recommended timing (T_DL-n) according to the reaction detection time (Td). Specifically, as shown in equation (2), the processing circuit 74 calculates the notification timing (T3) by setting the recommended timing (T_DL-n) ahead by the reaction detection time (Td).

[0091] T3 = (T_DL - n) - Td ... (2) After step ST33, in step ST34, the processing circuit 74 notifies the timing of the operation based on the notification timing.

[0092] Step ST30 is completed by executing steps ST31 to ST34.

[0093] After step ST30 is completed, steps ST40 to ST70 are executed as described above. Similarly, steps ST10 to ST70 are repeatedly executed until imaging is complete.

[0094] Accordingly, according to the first modified embodiment, the processing circuit 74 acquires in advance the reaction time from the notification of the timing of the operation until the user operates the device, and notifies the user of the timing of the operation at a point that is set back from the recommended timing according to the reaction time. Therefore, in addition to the effects described above, by configuring the system to notify the user of the timing of the operation at a point that is set back from the recommended timing considering the reaction time, it is possible to prevent or reduce the notification of the recommended timing at a time when the user cannot react in time. Furthermore, by configuring the notification timing to precede by the reaction time, it is possible to secure the device operation time according to the recommended timing, so that the procedure time per heartbeat can be extended compared to the first embodiment, and the surgical time can be shortened.

[0095] Furthermore, according to the first modified example, the processing circuit 74 may acquire in advance the reaction time from the time it notifies the user of the timing of the operation until it operates the control unit, and adjust the timing of the notification based on the timing information and the reaction time. In this case, in addition to the effects described above, by adjusting the timing of the notification to the user while taking into account the user's unique reaction time, the timing of the notification can be optimized for each user.

[0096] Furthermore, according to the first modification, the operating unit may be a foot switch 55 or a button on the input interface 73. In this case, by using an operating unit such as a foot switch instead of a device to be operated, the user's reaction time can be obtained.

[0097] Furthermore, according to the first modification, the processing circuit 74 may adjust the timing of notification according to the position of the user operating the device. In this case, for example, the timing of notification can be adjusted based on the reaction time corresponding to the standing position of the user performing the procedure, thus enabling notification at an even more appropriate timing.

[0098] (Second variation) In the first modification, X-rays are emitted with each heartbeat, and when the heart rate is 60 [bpm], the X-ray emission rate is 1 [fps]. In contrast, the second modification changes the X-ray emission rate to an arbitrary rate such as 0.5 [fps] or 0.25 [fps]. For example, when the X-ray emission rate is 0.5 [fps], as shown in Figure 9, there is an X-ray emission timing every two heartbeats, and the timing for notifying the timing of the operation (notification timing in the figure) occurs at each RR interval.

[0099] Figure 10 is a table showing an example of the RR interval (T_RR), X-ray irradiation timing (T_DL), operation time (n), recommended timing (T_DL-n), and notification timing (T_DL-n-Td) for each X-ray irradiation rate. Note that the X-ray irradiation rates are not limited to those shown in Figure 10.

[0100] In Figure 10, when the X-ray irradiation rate is 1 [fps], the RR interval (T_RR), X-ray irradiation timing (T_DL), operation time (n), recommended timing (T_DL-n), and notification timing (T_DL-n-Td) for one irradiation are the same as in the first modified example.

[0101] When the X-ray irradiation rate is 0.5 [fps], the values ​​of the RR interval (T_RR) and X-ray irradiation timing (T_DL) per irradiation are increased by 100% compared to the first modified example. The values ​​of the operation time (n) and recommended timing (T_DL-n) are the same as in the first modified example, or they are the same as in the first modified example but increased by 100%. The value of the notification timing (T_DL-n-Td) is a slightly modified value (25) of the value in the first modified example (28), or it is the modified value increased by 100% (125). In other words, the notification timing (T_DL-n-Td) may be a slightly irregular value, unlike the operation time and recommended timing, because the reaction detection time Td for each X-ray irradiation rate differs depending on the user (U1).

[0102] When the X-ray irradiation rate is 0.25 [fps], the values ​​of the RR interval (T_RR) and X-ray irradiation timing (T_DL) per irradiation are increased by 300% compared to the first modified example. The values ​​of the operation time (n), recommended timing (T_DL-n), and notification timing (T_DL-n-Td) are the same as in the first modified example, or they are increased by 100%, 200%, and 300% compared to the same values ​​in the first modified example.

[0103] The other components are the same as in the first modification.

[0104] According to the second modification described above, even if the X-ray irradiation rate is changed, the same effects as the first modification can be obtained by using a configuration that uses the RR interval (T_RR), X-ray irradiation timing (T_DL), operation time (n), recommended timing (T_DL-n), and notification timing (T_DL-n-Td) corresponding to the changed X-ray irradiation rate. Furthermore, according to the second modification, the notification timing can be individually calibrated (adjusted) depending on the X-ray irradiation rate. For example, different correction values ​​can be used for the notification timing for X-ray irradiation rates of 1 fps, 0.5 fps, and 0.25 fps, respectively. Therefore, even if the optimal notification timing changes depending on the X-ray irradiation rate, a notification timing corresponding to the X-ray irradiation rate can be used.

[0105] (Third variation) The second modification involved changing the X-ray irradiation rate. In contrast, the third modification uses the same X-ray irradiation rate (1 fps) as the first modification, but changes the notification timing (T_DL-n-Td). For example, as shown in Figure 11, a notification timing of every three heartbeats (T_DL-n-Td) is used. Accordingly, the notification function 747 of the processing circuit 74 notifies the timing of the operation every three heartbeats. Note that the notification timing is not limited to every three heartbeats; any frequency such as every two heartbeats or every five heartbeats can be used as appropriate. The frequency of the notification timing can be set in advance by operating the input interface 73.

[0106] The other components are the same as in the first modification.

[0107] According to the third modification described above, in addition to the effects of the first modification, the frequency of notifications regarding the timing of operations can be changed. To elaborate, according to the third modification, the user can adjust the timing at which the device can be operated (start and stop timing). For example, the notification timing can be flexibly adjusted to the user's preference, not limited to notifying the user every heartbeat, but every two heartbeats, every three heartbeats, every five heartbeats, etc. In other words, the user can adjust how many seconds before X-ray irradiation the notification should be made to make operation easier for them at both the start and stop timings.

[0108] (Fourth variation) In the first modification, the processing circuit 74 used a speaker 81 to notify the user of the timing of the operation. In contrast, in the fourth modification, as shown in Figure 12, the processing circuit 74 uses a monitor 82 to notify the user of the timing of the operation. In Figure 12, the 0th delay time t0 is the time until the monitor 82 displays a notification in response to the display control of the processing circuit 74 in the console device 70. The 1st delay time t1 is the time until the user sees the notification displayed by the monitor 82. The 2nd delay time t2 is the time t2 from seeing the notification to the user's operation. The user's reaction time is the sum of the 1st delay time t1 and the 2nd delay time t2, as in the first modification. The reaction time (t1+t2) is preferably measured in advance for each user, as in the first modification. As for the measurement method, a method can be used in which the display of the monitor 82 is changed regularly at a constant rate, and the user is asked to perform an input operation from the control unit in accordance with the visual recognition of the change in the display, thereby determining the reaction time (t1+t2). Similarly, measuring reaction time is not essential. Reaction time can be estimated based on experience, as mentioned above.

[0109] Here, when the timing of the operation is notified from the monitor 82, the following methods (a) to (d) can be used as appropriate, as shown in Figures 13 to 16. Note that the monitor 82 shown on the left side of Figures 13 to 15 does not notify the timing, but displays a text area 82a indicating imaging conditions, etc., and a live image 82b.

[0110] Method (a), as shown on the right side of Figure 13, involves displaying a frame 82c that notifies the timing around the outer edge of the live image 82b during steps ST30 to ST40. The frame 82c can be either white or black if the monitor 82 displays a monochrome screen. If the monitor 82 displays a color screen, any color can be used for the frame 82c. This causes the frame 82c to blink in conjunction with the timing of the operation.

[0111] Method (b), as shown on the right side of Figure 14, involves applying a background color to the character area 82a in steps ST30 to ST40 to indicate the timing. If the monitor 82 displays a monochrome screen, the background color of the character area 82a may be inverted to black and white. If the monitor 82 displays a color screen, any color can be used for the background color of the character area 82a. As a result, the character area 82a on the monitor 82 flashes in conjunction with the timing of the operation.

[0112] Method (c) is a method in which a timing indicator mark 82d is superimposed on the live image 82b in steps ST30 to ST40, as shown on the right side of Figure 15. Preferably, the mark 82d is superimposed on one of the four corners of the live image 82b so as not to interfere with the observation of the device in the live image 82b.

[0113] Method (d) is a method of superimposing a timing lane 82e, which includes the recommended timing, X-ray irradiation timing, and electrocardiogram waveform, onto the live image 82b, as shown in Figure 16. Preferably, the timing lane 82e is superimposed on one of the four corners of the live image 82b so as not to interfere with the observation of the device within the live image 82b. The timing lane 82e is, for example, centered around the current time, with the area to the left of the current time designated as the past region and the area to the right of the current time designated as the future region. In the past region of the timing lane 82e, the recommended timing and X-ray irradiation timing are superimposed on the electrocardiogram waveform based on heart rate information, and the display is updated to flow from the current time to the left. In the future region of the timing lane 82e, there is no electrocardiogram waveform, and the recommended timing and X-ray irradiation timing are displayed, and the display is updated to flow from the right to the current time. That is, the timing lane 82e is updated to flow from right to left, and the recommended timing overlaps with the current time, thereby notifying the user of the recommended timing for device operation. Additionally, timing lane 82e notifies of undesirable timings for device operation when the X-ray irradiation timing coincides with the current time.

[0114] The other components are the same as in the first modification.

[0115] According to the fourth modified configuration as described above, when the processing circuit 74 notifies the timing of an operation, it displays a frame 82c, a character area 82a, a mark 82d, or a timing lane 82e on the monitor 82 to notify the timing of the operation. In this way, the timing of the operation is notified to the user by using the monitor 82, and the same effect as the first modified configuration using the speaker 81 can be obtained.

[0116] (Fifth variation) In the first modified example, the processing circuit 74 used a speaker 81 to notify the user of the timing of the operation. In contrast, in the fifth modified example, as shown in Figure 13, the processing circuit 74 uses a vibration device 83 to notify the user of the timing of the operation. In Figure 13, the 0th delay time t0 is the time from when the vibration device 83 vibrates in response to the output signal of the processing circuit 74 in the console device 70 until it indicates the notification by vibration. The 1st delay time t1 is the time from when the vibration device 83 is detected by the user until it is detected by the user. The 2nd delay time t2 is the time from when the vibration is detected until the user performs an operation. The user's reaction time is the sum of the 1st delay time t1 and the 2nd delay time t2, as in the first modified example. The reaction time (t1+t2) is preferably measured in advance for each user, as in the first modified example. As for the measurement method, a method can be used in which the vibration device 83 is vibrated regularly at a constant rate, and the user performs an input operation from the control unit in accordance with the detection of the vibration, thereby determining the reaction time (t1+t2). Similarly, measuring reaction time is not essential. Reaction time can be estimated based on experience, as mentioned above.

[0117] Here, as described above, the vibration device 83 is carried or worn by the user operating the device, and vibrates in response to control from the processing circuit 74 to notify the user of the timing to operate the device.

[0118] The other components are the same as in the first modification.

[0119] According to the fifth modified example configured as described above, when the processing circuit 74 notifies the timing of an operation, it vibrates the vibration device 83 to notify the timing of the operation. In this way, by using the vibration device 83, the timing of the operation is notified to the user, and the same effect as the first modified example using the speaker 81 can be obtained.

[0120] (Sixth variation) In the first modification, as shown in Figure 7, the recommended timing was a single time position within the RR interval, and there was no time width for the recommended timing. In contrast, in the sixth modification, as shown in Figure 18, the recommended timing has a time width within the RR interval. That is, the recommended timing in the sixth modification is a fixed period, for example, it indicates a time width for which the operation is recommended.

[0121] Accordingly, instead of the single operation time n mentioned above, we use a first operation time n1 and a second operation time n2. The first operation time n1 is a parameter related to the end of the recommended timing. The second operation time n2 is a parameter related to the start of the recommended timing.

[0122] For example, the end of the recommended timing is calculated by time T_DL-n1 (e.g., 48%), which precedes the delay time T_DL (e.g., 78%) by the first operation time n1 (e.g., 30%). Similarly, the start of the recommended timing is calculated by time T_DL-n2 (e.g., 38%), which precedes the delay time T_DL (e.g., 78%) by the second operation time n2 (e.g., 40%). In this example, the recommended timing is from 38% to 48% when the RR interval is 100%. It is calculated as a certain period of time that occupies a specific time position.

[0123] Accordingly, the notification function 747 of the processing circuit 74 notifies at least one of the following: the start timing of the recommended timing, which is a fixed period; the intermediate timing, which is the midpoint of the fixed period; and the end timing of the recommended timing. Note that the notification of the start timing of the recommended timing also functions as a notification of the end timing of the non-recommended timing. Similarly, the notification of the end timing of the recommended timing also functions as a notification of the start timing of the non-recommended timing.

[0124] Furthermore, when obtaining notification timing by considering reaction time from recommended timings over a certain period, the notification timing (T3) may be calculated by shifting the timing within the range between the start timing and the median of the recommended timing forward by the reaction detection time (Td). The timing within this range may, for example, be the start timing of the recommended timing, or the median timing of the recommended period. Alternatively, the notification timing (T3) may be calculated by shifting the timing forward by the reaction detection time (Td) from the end timing of the recommended timing.

[0125] The other components are the same as in the first modification.

[0126] According to the sixth modification described above, the configuration in which the recommended timing is a fixed period allows for notification of the timing of the operation as a longer time window, in addition to the effects of the first modification. This helps the user perform longer device operations at the timing of the operation. For example, the user can increase the amount of device movement or slow down the device movement speed to perform more precise treatment.

[0127] Furthermore, according to the sixth modification, the recommended timing is a fixed period, and the processing circuit 74 notifies at least one of the following: the start timing of the recommended timing, the intermediate timing which is the midpoint of the fixed period, and the end timing of the recommended timing. This makes it possible to notify the timing of operations at various points in time within the recommended timing of a fixed period, such as the start timing, intermediate timing, and end timing.

[0128] (Seventh variation) In the first modified example, as shown in Figure 7, the recommended timing was calculated based on the X-ray irradiation timing. In contrast, in the seventh modified example, as shown in Figure 19, the recommended timing is calculated as the median value Tc of the RR interval T_RR. That is, the generation function 746 of the processing circuit 74 calculates the recommended timing from the RR interval T_RR without using the X-ray irradiation timing. However, in this case, the delay time T_DL is predetermined so that the X-ray irradiation timing is different from the median value Tc of the RR interval T_RR. Furthermore, this recommended timing may have a time width, as shown in Figure 20. For example, when the time width is n, the recommended timing is calculated as the median value Tc ± n / 2 of the RR interval T_RR. For example, when n=6, the recommended timing is calculated as 47~53% (=50±3[%]), as shown in Figure 20. The time width (n) can be set to any value using the input interface 73. Furthermore, when obtaining the notification timing by working backward from a recommended timing with a time range, the notification timing (T3) may be calculated by shifting the timing within the range between the start timing and the median of the time range forward by the response detection time (Td), as described above.

[0129] The other components are the same as in the first modification.

[0130] According to the seventh modification described above, the processing circuit 74 calculates the recommended timing from the RR interval without using the X-ray irradiation timing, thereby reducing the calculation load of the recommended timing in addition to the effects of the first modification. Furthermore, if the recommended timing has a time width, in addition to the effects of the first modification, the timing of the operation can be notified as a time width.

[0131] In the eighth modification, the recommended timing is set to the median value Tc of the RR interval T_RR, but this is not limited to this. For example, the recommended timing may be set to the median value of the interval between X-ray irradiation timings. In this case, the processing circuit 74 can calculate a delay time of 38% corresponding to the recommended timing by subtracting 50% from the 78% delay time T_DL corresponding to the X-ray irradiation timing. Even with this modification, the same effect as the seventh modification can be obtained. Furthermore, the same effect as the seventh modification can be obtained even when the recommended timing has a time width.

[0132] (Variation 8) In one embodiment and each of its modifications, the timing of the operation was notified to the user operating the device near the patient bed 50. In contrast, in the eighth modification, instead of the user and the vibration device 83 carried by the user, a catheter manipulation robot 90 and a robot operation terminal 91 are provided, as shown in Figure 21. The catheter manipulation robot 90, the robot operation terminal 91 and the X-ray diagnostic device 1 are connected to each other so as to be able to communicate via a network.

[0133] Here, the catheter manipulation robot 90 is positioned near the patient bed 50 and is a medical robot that manipulates devices such as catheters and guidewires used in catheter treatment, controlled from the robot operation terminal 91. Furthermore, the catheter manipulation robot 90 can stop operating devices while they are being irradiated with X-rays, controlled from the X-ray diagnostic device 1. Note that the catheter manipulation robot 90 is an example of a device manipulation robot.

[0134] The robot operation terminal 91 is located away from the catheter operation robot 90 and controls the operation of the device by the catheter operation robot 90 in response to user input. The robot operation terminal 91 may also output the timing of device operation to the user when notified by the X-ray diagnostic device 1. For example, the robot operation terminal 91 can output the notified timing to the user using a display output (not shown) and / or a notification sound output (speaker). The display of the robot operation terminal 91 displays a live image similar to that of the monitor 82, as it is viewed by the user remotely operating the device via the catheter operation robot 90 through the operation of the robot operation terminal 91.

[0135] Accordingly, in addition to the functions described above, the notification function 747 of the processing circuit 74 may discourage operation of the device during X-ray irradiation by notifying the catheter operation robot 90 that operates the device of the timing of the operation. For example, the notification function 747 may control the catheter operation robot 90 to stop operating the device during X-ray irradiation based on the acquired X-ray irradiation timing. Specifically, for example, the notification function 747 may output a trigger signal to the catheter operation robot 90 to stop operating the device during X-ray irradiation. In this case, the notification function 747 outputs the trigger signal at a timing that precedes the X-ray irradiation timing by a predetermined delay time of the catheter operation robot 90. The delay time of the catheter operation robot 90 here refers to the difference between the timing of the output of the trigger signal by the notification function 747 and the timing at which the catheter operation robot 90 can stop the device operation triggered by the trigger signal. Alternatively, for example, the notification function 747 may output an enable signal to the catheter operation robot 90 that allows operation of the device when X-ray irradiation is not occurring. In addition to the functions described above, the notification function 747 may also notify the robot operation terminal 91 of the timing of the operation. Furthermore, while notification function 747 stops operation of the device during X-ray irradiation when it is discouraged, it is not limited to this, and may also allow device operation at a speed (low speed) at which the tip of the device is clearly visible without blurring during X-ray irradiation.

[0136] The other configurations are the same as in one embodiment and each of its modifications.

[0137] With the above configuration, as shown in Figure 22, steps ST10 to ST20 are executed as described above, and timing information based on the X-ray irradiation timing is generated. For example, in step ST20, a recommended timing different from the X-ray irradiation timing obtained in step ST10 is calculated, and timing information indicating this recommended timing is generated.

[0138] After step ST20, in step ST30A, the processing circuit 74 notifies the user of the timing of the operation based on the timing information. For example, the processing circuit 74 notifies the user of the timing of the operation via the display and / or speaker of the robot operation terminal 91. Thereafter, the catheter operation robot 90 operates the device in response to the user's operation of the robot operation terminal 91.

[0139] After step ST30A, in step ST31A, the processing circuit 74 outputs a trigger signal to the catheter manipulation robot 90 to stop the operation of the device while it is being irradiated with X-rays. Note that the output of the trigger signal is just one example of notifying the timing of the operation. Alternatively, the electrocardiograph 40 may output the trigger signal to the catheter manipulation robot 90.

[0140] After step ST31A, in step ST40A, the catheter manipulation robot 90 stops operating the device while it is being irradiated with X-rays, based on the trigger signal. For example, the catheter manipulation robot 90 stops operating the device immediately before the timing of X-ray irradiation, based on the trigger signal.

[0141] After step ST40A, in step ST50, the processing circuit 74 controls the imaging device 10 to irradiate the subject P with X-rays based on the X-ray irradiation timing.

[0142] After step ST50, in step ST60, the processing circuit 74 generates an X-ray image as a live image based on the output of the X-ray detector that detected the X-rays transmitted through the subject P. Then, the processing circuit 74 displays this X-ray image on the display of the robot operation terminal 91, the monitor 82 in the examination room, and the display 72 of the console device 70.

[0143] After step ST60, in step ST70, the processing circuit 74 determines whether or not an instruction to end imaging has been received. If not, it returns to step ST10 and continues processing in steps ST10 to ST70. If, as a result of the determination, an instruction to end imaging has been received, the processing is terminated.

[0144] According to the eighth modification described above, even if the catheter manipulation robot 90 operates the device in response to the user's operation of the robot operation terminal 91, the same effects as in the first embodiment and each of the modifications can be obtained. For example, even when remotely operated using the catheter manipulation robot 90, a clear X-ray image without device blur is displayed, thus reducing the burden on the user.

[0145] Furthermore, according to the eighth modification, if the timing of operation is notified to the catheter manipulation robot 90, thereby discouraging operation of the device during X-ray irradiation, the device will not be operated even if the user operates the robot operation terminal 91 during X-ray irradiation. Therefore, in addition to the effects described above, it is possible to more reliably avoid acquiring X-ray images with significant motion blur from the device.

[0146] In the eighth modification, the timing of the operation is notified to the robot operation terminal 91 and a trigger signal to stop the operation is output to the catheter operation robot 90, but this is not limited to this. For example, the notification and the trigger signal may be integrated, and the trigger signal to stop the operation may be used as timing information indicating a non-recommended timing when operation is not recommended for the catheter operation robot 90. In this case, the processing circuit 74 notifies the catheter operation robot 90 of the timing of the operation by outputting a trigger signal to stop the operation to the catheter operation robot 90. Even with this modification, the same effect as the eighth modification can be obtained. Similarly, the enable signal to permit the operation may be used as timing information indicating a recommended timing when operation is recommended. In this case, the processing circuit 74 notifies the catheter operation robot 90 of the timing of the operation by outputting an enable signal to permit the operation to the catheter operation robot 90. Even with this modification, the same effect as the eighth modification can be obtained.

[0147] Furthermore, while the eighth modification and its variations use a trigger signal to stop the operation of the device, the device is not limited to this; a trigger signal that performs the operation of the device at a slow speed may also be used. Even with such modifications, the same effects as the eighth modification and its variations can be obtained.

[0148] According to at least one embodiment and its variations described above, the timing of device operation can be notified more appropriately.

[0149] In the above description, the term "processor" refers to circuits such as a CPU (Central Processing Unit), a GPU (Graphics Processing Unit), an Application Specific Integrated Circuit (ASIC), a programmable logic device (e.g., a Simple Programmable Logic Device (SPLD), a Complex Programmable Logic Device (CPLD), and a Field Programmable Gate Array (FPGA)). The processor functions by reading and executing a program stored in a memory circuit. Alternatively, instead of storing the program in a memory circuit, the program may be directly embedded within the processor's circuitry. In this case, the processor functions by reading and executing the program embedded within the circuitry. In this embodiment, each processor is not limited to being configured as a single circuit; multiple independent circuits may be combined to form a single processor and realize its functions. Furthermore, multiple components shown in Figure 1 or Figure 21 may be integrated into a single processor to realize its functions.

[0150] While several embodiments of the present invention have been described, these embodiments are presented as examples only and are not intended to limit the scope of the invention. These embodiments can be implemented in various other forms, and various omissions, substitutions, and modifications can be made without departing from the spirit of the invention. These embodiments and their variations are included in the scope and spirit of the invention, as well as in the claims and their equivalents. [Explanation of Symbols]

[0151] 1. X-ray diagnostic equipment 10 Imaging device 11. High-voltage generator 12 X-ray tube 13 X-ray detector 14 C-arm 141 State detector 142 C-arm drive unit 40. Electrocardiograph 50 Bed equipment 51 Base 52 Bed drive mechanism 53 Top plate 54 Support frame 55 Footswitch 70 Console device 71 memory 72 displays 73 Input Interfaces 74 Processing Circuits 741 System control function 742 Drive control function 743 Shooting control function 744 Image processing functions 745 Acquisition function 746 Generation function 747 Notification function 748 Display control function 76 Network Interfaces 81 speakers 82 monitors 83 Vibration Devices 90 Catheter Manipulation Robot 91 Robot operation terminal

Claims

1. An acquisition unit that acquires the timing of X-ray irradiation to the subject, A generation unit generates timing information related to the operation of a device inserted into the subject based on the acquired X-ray irradiation timing, A notification unit that notifies the timing of the operation based on the timing information generated above, An X-ray diagnostic device equipped with [specific features / features].

2. The X-ray diagnostic apparatus according to claim 1, wherein the timing information is information indicating a recommended timing for recommending the operation or a non-recommended timing for not recommending the operation.

3. The X-ray diagnostic apparatus according to claim 2, wherein the generation unit calculates a recommended timing different from the X-ray irradiation timing and generates timing information indicating the recommended timing.

4. The X-ray diagnostic apparatus according to claim 3, wherein the notification unit acquires in advance the reaction time from the time it notifies the timing of the operation until the user operates the device, and notifies the timing of the operation at a point in time that is retroactive to the recommended timing according to the reaction time.

5. The aforementioned recommended timing is a certain period of time. The X-ray diagnostic apparatus according to claim 3, wherein the notification unit notifies at least one of the start timing of the recommended timing, the midpoint timing which is the median of the certain period, and the end timing of the recommended timing.

6. The X-ray diagnostic apparatus according to claim 3, wherein the generation unit further acquires heart rate information of the subject and calculates the recommended timing such that it differs from the time in the subject's heart cycle in which the heart rate information indicates that the heart movement is relatively large.

7. The X-ray diagnostic apparatus according to claim 3, wherein the generation unit further acquires heart rate information of the subject and calculates the recommended timing such that the heart rate information indicates that the heart movement of the heart is relatively small during the subject's heart cycle.

8. The X-ray diagnostic apparatus according to claim 3, wherein the generation unit further acquires heart rate information of the subject and calculates the recommended timing so that it falls within either a first recommended time from the end of the S wave to the peak of the T wave indicated by the heart rate information, or a second recommended time from the end of the T wave to the beginning of the Q wave.

9. The X-ray diagnostic apparatus according to claim 1, wherein the notification unit adjusts the timing of the notification according to the position of the user operating the device.

10. The X-ray diagnostic apparatus according to claim 1, wherein the notification unit acquires in advance the reaction time from the time it notifies the user of the timing of the operation until the user operates the operation unit, and adjusts the timing of the notification based on the timing information and the reaction time.

11. The X-ray diagnostic apparatus according to claim 10, wherein the operating unit is a foot switch or a button on the control console.

12. The X-ray diagnostic apparatus according to claim 1, wherein the notification unit discourages operation of the device during X-ray irradiation by notifying the device operation robot that operates the device of the timing of the operation.

13. An X-ray diagnostic apparatus according to any one of claims 1 to 12, comprising: a control unit that acquires heart rate information of the subject from an electrocardiograph and controls the irradiation of X-rays to the subject based on the heart rate information.

14. The X-ray diagnostic apparatus according to claim 13, An electrocardiograph that acquires heart rate information from the subject, A system equipped with this feature.

15. On the computer, Acquisition function to obtain the timing of X-ray irradiation to the subject. A generation function that generates timing information related to the operation of a device inserted into the subject based on the acquired X-ray irradiation timing, and A notification function that notifies the timing of the operation based on the timing information generated above, A program to achieve this.

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