X-ray diagnostic equipment

Abstract

To assist in changing the posture of the subject during fluoroscopy using contrast agents. [Solution] The X-ray diagnostic apparatus according to the embodiment comprises a top plate, an X-ray tube, an X-ray detector, an image generation unit, and a support unit. A subject who has been administered a contrast agent and an effervescent agent is placed on the top plate. The X-ray tube irradiates the subject with X-rays. The X-ray detector detects the X-rays irradiated from the X-ray tube and transmitted through the subject. The image generation unit generates an X-ray image of the subject based on the output of the X-ray detector. The support unit assists in changing the posture of the subject.

Description

Technical Field

[0005] , , ,

[0001] The embodiments disclosed in this specification and the drawings relate to an X-ray diagnostic apparatus.

Background Art

[0002] In conventional gastrointestinal contrast examinations, for example, X-ray fluoroscopic imaging is performed on a subject administered with barium, and the barium is thinly adhered to the gastric wall by changing or rotating the position of the subject to observe the surface state of the gastric wall. In this type of barium examination, the amount of barium adhering to the gastric wall may be insufficient or excessive depending on the body shape of the subject, the change in position, the rotation method, etc. In this case, an operator such as a doctor or a technician visually recognizes the X-ray image and gives instructions to the subject to change or rotate the position, thereby eliminating the insufficiency or excess of the barium amount and performing X-ray imaging. Note that the barium examination using an X-ray diagnostic apparatus is not limited to the upper gastrointestinal tract such as the esophagus, stomach, and duodenum, but is also similarly performed on the large intestine and the like.

[0003] In such a gastrointestinal contrast examination, it is necessary to make the contrast agent adhere to the entire mucosa of the patient's internal organs, and the patient rotates the body many times on the tabletop. Then, the operator checks the image and gives detailed position instructions to the patient. The patient needs to take various further poses on the tabletop according to the operator's instructions.

Prior Art Documents

Patent Documents

[0004]

Patent Document 1

Summary of the Invention

Problems to be Solved by the Invention

[0005] One of the problems that the embodiments disclosed herein and in the drawings aim to solve is to assist in changing the posture of a subject during X-ray imaging using a contrast agent. 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]

[0006] The X-ray diagnostic apparatus according to the embodiment comprises a top plate, an X-ray tube, an X-ray detector, an image generation unit, and a support unit. A subject administered with a contrast agent and an effervescent agent is placed on the top plate. The X-ray tube irradiates the subject with X-rays. The X-ray detector detects the X-rays irradiated from the X-ray tube and transmitted through the subject. The image generation unit generates an X-ray image of the subject based on the output of the X-ray detector. The support unit assists in changing the posture of the subject. [Brief explanation of the drawing]

[0007] [Figure 1] Figure 1 shows an example of the configuration of an X-ray diagnostic apparatus according to an embodiment. [Figure 2] Figure 2 is a perspective view showing an example of the configuration of a fluoroscopy table according to the embodiment. [Figure 3] Figure 3 is a side view of a fluoroscopy table in a horizontal position. [Figure 4] Figure 4 is a side view of a fluoroscopy table in a foot-lowering, oblique position. [Figure 5] Figure 5 is a side view of a fluoroscopy table in a head-down, oblique position. [Figure 6] Figure 6 is a flowchart illustrating the procedure for an examination using the X-ray diagnostic apparatus according to this embodiment. [Figure 7] Figure 7 is a side view showing the subject rotating from the state shown in Figure 2. [Figure 8] Figure 8 is a flowchart illustrating the procedure for examination in a head-down, oblique position. [Figure 9]Figure 9 is a side view showing the fluoroscopy table tilted from the state shown in Figure 2 to a head-down oblique position. [Modes for carrying out the invention]

[0008] The X-ray diagnostic apparatus according to each embodiment will be described below with reference to the drawings. In the following description, components having substantially the same function and configuration will be denoted by the same reference numerals, thereby omitting redundant descriptions.

[0009] <First Embodiment> Figure 1 is a block diagram showing an example of the configuration of the X-ray diagnostic apparatus 1 according to the first embodiment, and Figure 2 is a schematic diagram showing an example of the external appearance of the X-ray diagnostic apparatus 1. The X-ray diagnostic apparatus 1 is an examination device that performs X-ray fluoroscopic imaging on a subject P to which a contrast agent has been administered, and performs gastrointestinal contrast imaging. The subject P is, for example, a patient, a subject of an examination, a person undergoing a health checkup, etc. In the following description, an example using barium as the contrast agent is described, but it is not limited to this. For example, a water-soluble iodine contrast agent may be used as the contrast agent. The X-ray diagnostic apparatus 1 may also be called an X-ray TV device.

[0010] Barium examinations are performed according to a predetermined workflow. The workflow is data that records a series of procedures in a gastrointestinal contrast examination of subject P. The workflow is recorded in advance, for example, when the X-ray diagnostic device 1 is installed. For example, in a barium examination of the stomach, the timing of subject P's rotation, subject P's imaging position, and the part of the stomach to be imaged are standardized according to the standard imaging method. The imaging positions for the standard imaging method, for example in the 8-position method, include supine front view, supine first oblique view, supine second oblique view, prone front view (lower anterior wall, head lowered), prone first oblique view (upper anterior wall), right lateral decubitus (upper stomach), supine second oblique view (splitting), and standing first oblique view (upper stomach). The workflow specifies the rotational movement to adhere the barium to the inner wall of the stomach before imaging, the order of imaging positions, and the imaging conditions for each imaging position. The imaging position for the standard imaging method is not limited to the 8-position method; other methods, such as the 12-position method, may also be used. In any case, in the X-ray diagnostic device 1, during the barium examination process, if the barium adhesion to the stomach area is good at each predetermined imaging position, the operator will take an X-ray image. The operator may be, for example, a doctor or technician.

[0011] The X-ray diagnostic apparatus 1 comprises a fluoroscopy table 2, a drive unit 13, an output unit 16, and a console device 20. The fluoroscopy table 2 includes an X-ray tube 3, an irradiation range limiter 5, an X-ray detector 7, a movement support mechanism 9, a rotation support mechanism 11, and a tabletop 14 that supports the subject P. The fluoroscopy table 2 performs actions such as tilting, oblique insertion, and compression. The fluoroscopy table 2 also performs vertical movement of the imaging system, which is composed of the X-ray tube 3, the irradiation range limiter 5, and the X-ray detector 7. The fluoroscopy table 2 may also be called a bed. In gastrointestinal contrast radiography, the subject P, to whom contrast agent and effervescent agent have been administered, is placed on the tabletop 14.

[0012] The X-ray tube 3 is connected to a high-voltage generator (not shown). The high-voltage generator generates the tube current supplied to the X-ray tube 3 and the tube voltage applied to the X-ray tube. The high-voltage generator supplies the X-ray tube 3 with a tube current suitable for X-ray imaging and X-ray fluoroscopy, respectively, and applies the X-ray tube 3 with a tube voltage suitable for X-ray imaging and X-ray fluoroscopy, respectively. Specifically, the high-voltage generator generates the tube voltage and tube current according to the X-ray imaging conditions under the control of the control function 251 described later.

[0013] The X-ray tube 3 generates X-rays from the X-ray focal point (hereinafter referred to as the tube focal point) based on the tube current supplied from the high-voltage generator and the tube voltage applied by the high-voltage generator. The generated X-rays are emitted from the X-ray emission window of the X-ray tube 3. For example, in the case of gastrointestinal contrast imaging, the X-ray tube 3 irradiates the subject P, who has been administered the contrast agent and effervescent agent, with X-rays.

[0014] The irradiation range limiter 5 is located on the front of the X-ray tube 3, between the X-ray tube 3 and the X-ray detector 7. Specifically, the irradiation range limiter 5 is located on the front of the X-ray emission window in the X-ray tube 3. The irradiation range limiter 5 is also called an X-ray movable diaphragm. The irradiation range limiter 5 limits the X-ray irradiation range so that the X-rays generated by the X-ray tube 3 do not irradiate areas other than the area desired by the operator. For example, the irradiation range limiter 5 limits the irradiation range by moving the diaphragm blades according to the irradiation range limiting instruction input via the input interface 22.

[0015] Specifically, the irradiation range limiter 5 has multiple aperture blades. Each of the multiple aperture blades is made of lead to shield the X-rays generated by the X-ray tube 3. The irradiation range limiter 5 may also have multiple filters (hereinafter referred to as additional filters) inserted into the X-ray irradiation field for the purpose of reducing the radiation dose to the subject P and improving image quality. Additional filters are also called X-ray filters, filter plates, beam filters, beam quality filters, or beam spectrogram filters.

[0016] The X-ray detector 7 detects X-rays generated from the X-ray tube 3 and transmitted through the subject P. The X-ray detector 7 is, for example, a flat panel detector (FPD). The X-ray detector 7 has a plurality of semiconductor detection elements. The semiconductor detection elements are of a direct conversion type and an indirect conversion type. The direct conversion type is a format that directly converts incident X-rays into electrical signals. The indirect conversion type is a format that converts incident X-rays into light using a phosphor and then converts that light into an electrical signal.

[0017] The electrical signals generated by the plurality of semiconductor detection elements upon the incidence of X-rays are output to an analog-to-digital converter (hereinafter referred to as an A / D converter), not shown. The A / D converter converts the electrical signals into digital data. The A / D converter outputs the digital data to a preprocessing unit, not shown. The preprocessing unit transfers the preprocessed digital data to the console device 20. Note that an image intensifier or the like may be used as the X-ray detector 7.

[0018] The movement support mechanism 9 supports the imaging system constituted by the X-ray tube 3, the irradiation range limiter 5, and the X-ray detector 7 so as to be movable with respect to the top plate 14. Specifically, the movement support mechanism 9 supports each of the X-ray tube 3, the irradiation range limiter 5, and the X-ray detector 7 so as to be movable along the long axis direction (X-axis direction in FIG. 1) of the top plate 14 under the control by a control function 251 described later. For example, when a shooting method such as a long shooting for moving the imaging system to shoot the subject P is input via the input interface 22, the movement support mechanism 9 moves the imaging system along the X-axis direction with respect to the top plate 14 according to the shooting timing in the input shooting method. Also, when there is no need to move the imaging system, the movement support mechanism 9 fixes the imaging system with respect to the top plate 14.

[0019] The rotation support mechanism 11 supports the movement support mechanism 9 and the top plate 14 so as to be rotatable (tiltable) about a rotation axis R1 along the width direction of the top plate 14. The rotation support mechanism 11 rotates the imaging system (X-ray tube 3, irradiation range limiter 5, and X-ray detector 7) or the top plate 14 around the rotation axis R1 according to an instruction from an operator via the input interface 22.

[0020] Here, the longitudinal direction of the top plate 14 in a state where the top plate 14 is arranged horizontally is defined as the X-axis direction. Also, the width direction (lateral direction) of the top plate 14 is defined as the Y-axis direction. The Y-axis direction is a direction orthogonal to the X-axis direction among the horizontal directions. Further, a direction substantially parallel to the vertical direction is defined as the Z-axis direction. The Z-axis direction is orthogonal to the X-axis direction and the Y-axis direction. The rotation axis R1 of the fluoroscopic examination table 2 is provided parallel to the Y-axis direction. Also, the top plate 14 is provided with a head placement portion 141 on which the head of the subject P is placed and a foot placement portion 142 on which the feet of the subject P are placed. The head placement portion 141 and the foot placement portion 142 are provided at opposite ends in the longitudinal direction of the top plate 14.

[0021] Hereinafter, the angle of the top plate 14 with respect to the horizontal direction is referred to as the tilt angle of the top plate 14. As shown in FIG. 3, when the top plate 14 is horizontal, the tilt angle of the top plate 14 is 0°, and the subject P supported by the top plate 14 is in a horizontal posture. Also, as shown in FIG. 4, in a state where the top plate 14 is tilted so that the foot placement portion 142 of the top plate 14 is positioned below the head placement portion 141 (hereinafter referred to as the inclined position state with the feet lower), the subject P is in a posture where the feet are positioned below the head (hereinafter referred to as the posture with the feet lower). Also, as shown in FIG. 5, in a state where the top plate 14 is tilted so that the head placement portion 141 of the top plate 14 is positioned below the foot placement portion 142 (hereinafter referred to as the inclined position state with the head lower), the subject P is in a posture where the head is positioned below the feet (hereinafter referred to as the posture with the head lower). As shown in FIGS. 4 and 5, in the inclined position states with the feet lower and the head lower, the tilt angle α of the top plate 14 is a value greater than 0.

[0022] The drive unit 13 drives the moving support mechanism 9, the rotating support mechanism 11, and the tabletop 14 under the control of the console device 20. Specifically, the drive unit 13 rotates the rotating support mechanism 11 around its axis of rotation according to the control signal from the console device 20. As a result, each component, such as the tabletop 14, rotates around its axis of rotation. For example, if an instruction to tilt the tabletop 14 is input via the input interface 22, the drive unit 13 drives the rotating support mechanism 11 to rotate the fluoroscopy table 2 so that the tabletop 14 is at a predetermined tilt angle. The drive unit 13 also drives the moving support mechanism 9 according to the operator's instructions via the console device 20 to move the imaging system (X-ray tube 3, irradiation range limiter 5, and X-ray detector 7) along the X-axis. Furthermore, the drive unit 13 moves the tabletop 14 by driving it under the control of the console device 20. For example, the drive unit 13 slides the top plate 14 in the X-axis and Y-axis directions based on control signals from the console device 20.

[0023] Furthermore, the movable support mechanism 9 and the rotating support mechanism 11 may support the imaging system (X-ray tube 3, irradiation range limiter 5, and X-ray detector 7) and the top plate 14 so as to be movable along the three orthogonal axes (X-axis, Y-axis, and Z-axis) shown in Figure 1. For example, the movable support mechanism 9 supports the X-ray tube 3, irradiation range limiter 5, and X-ray detector 7, etc., so as to be able to change the distance between the focal point of X-ray generation in the X-ray tube and the X-ray detector 7 (source image distance (hereinafter referred to as SID)).

[0024] As shown in Figures 2 and 3, a rotating body 30 is attached to the foot rest portion 142 of the top plate 14. The rotating body 30 is attached to the top plate 14 via a rotating body drive mechanism 31 and a rotating body holding mechanism 34. The rotating body holding mechanism 34 is fixed to the top plate 14 and supports the rotating body drive mechanism 31. The rotating body drive mechanism 31 is fixed to the rotating body holding mechanism 34 and supports the rotating body 30. The rotating body 30 is a disc-shaped member with a rotation axis R2 at its center. The diameter of the rotating body 30 is formed to be larger than, for example, the feet of the subject P. The rotating body 30 is positioned, for example, in the center in the width direction (Y-axis direction). The rotation axis R2 of the rotating body 30 is preferably positioned at the height where the center of gravity of the subject P placed on the top plate 14 is located, for example, in the center in the width direction (Y-axis direction). The size and installation position of the rotating body 30 should be set, for example, based on the general body shape and foot size of the subject P. Furthermore, the rotating body 30 is not limited to a disc shape; any structure that can rotate while the feet of the subject P are fixed is acceptable.

[0025] The rotating body 30 includes a fixing member 32 for securing the feet of the subject P. The fixing member 32 is, for example, a belt or band capable of binding (restraining) the feet of the subject P.

[0026] The rotating body drive mechanism 31 supports the rotating body 30 so that it can rotate around a rotation axis R2 that is aligned with the longitudinal direction of the top plate 14. That is, the rotating body 30 is fixed to the top plate 14 via the rotating body drive mechanism 31 in a state that allows it to rotate around the longitudinal axis of the top plate 14. The rotating body drive mechanism 31 is connected to the console device 20 and, under the control of the console device 20, drives the rotating body 30, thereby applying a rotational driving force (torque) to the rotating body 30 to rotate it. Specifically, the drive unit 13 drives the rotating body drive mechanism 31 according to a control signal from the console device 20, and applies a driving force to rotate the rotating body 30 in a predetermined rotational direction. The rotating body drive mechanism 31 is, for example, a servo motor.

[0027] Thus, the rotating body 30 is a fixing part that can secure the feet of the subject P, and rotates relative to the top plate 14 about the longitudinal direction of the top plate 14 while the feet of the subject P are fixed, thereby supporting the rotation of the subject P. The rotating body 30 is an example of a support unit that assists in changing the posture of the subject P.

[0028] Furthermore, as shown in Figures 2 and 3, a shoulder support 33 is attached to the head rest portion 141 of the tabletop 14 to support the subject P's shoulders from below in a head-down oblique position. The shoulder support 33 may also be called a shoulder rest. For example, one shoulder support 33 is provided at the positions where the subject P's right and left shoulders are rested. The shoulder support 33 comprises a cylindrical fixing portion 331 fixed to the tabletop 14 and a contact portion 332 protruding from the inside of the fixing portion 331 toward the foot rest portion 142. The contact portion 332 is a rod-shaped member extending along the longitudinal direction of the tabletop 14, and a pad is attached to the end of the contact portion 332 toward the foot rest portion 142 to contact the subject P's shoulder. The contact portion 332 is inserted into the fixing portion 331 and connected to an extension / retraction drive mechanism (not shown) inside the fixing portion 331.

[0029] The telescopic drive mechanism is connected to the console device 20 and extends and retracts the shoulder support 33 under the control of the console device 20. Specifically, the telescopic drive mechanism moves the contact portion 332 along the longitudinal direction of the tabletop 14 according to the control signal from the console device 20, thereby extending and retracting the shoulder support 33.

[0030] The output unit 16 is equipped with a speaker and a display, and outputs instructions to the subject P as audio or display output under the control of the console device 20.

[0031] Returning to Figure 1, the console device 20 includes a memory 21, an input interface 22, a display 23, a communication interface 24, and a processing circuit 25.

[0032] Memory 21 is a storage device such as ROM (Read Only Memory), RAM (Random Access Memory), HDD (Hard Disk Drive), SSD (Solid State Drive), and integrated circuit storage device that stores various types of information. Memory 21 may also be a drive device that reads and writes various types of information to and from portable storage media such as CD-ROM drives, DVD drives, and flash memory. Note that memory 21 does not necessarily have to be implemented by a single storage device. For example, memory 21 may be implemented by multiple storage devices. Furthermore, memory 21 may be located in another computer connected to the X-ray diagnostic device 1 via a network.

[0033] Memory 21 stores various programs, such as the processing program for the X-ray diagnostic device 1, as well as various data, such as information used for processing, data during processing, and data after processing. This processing program may, for example, be pre-stored in memory 21. Alternatively, it may be stored and distributed on a non-transient, computer-readable storage medium, and then read from the non-transient, computer-readable storage medium and installed in memory 21. Examples of the various data include images and fluoroscopic images from the current and past examinations. Hereinafter, images and fluoroscopic images will be collectively referred to as X-ray images and examination images. Past examination images are acquired from an image server via a network by the processing circuit 25 and stored in memory 21.

[0034] The input interface 22 receives various input operations from an operator, such as a medical professional represented by a technician or doctor, and converts the received input operations into electrical signals which are then output to the processing circuit 25. In this embodiment, the input interface 22 is connected to input devices such as a microphone, mouse, keyboard, trackball, switch, button, joystick, touchpad, and touch panel, where instructions are input by touching the operating surface. Alternatively, the input device connected to the input interface may be an input device provided on another computer connected via a network or the like.

[0035] The display 23 displays various information according to instructions from the processing circuit 25. For example, the display 23 displays an X-ray image generated and processed by the image processing function 252. The display 23 may also display an input screen for inputting X-ray imaging conditions, X-ray fluoroscopy conditions, SID, etc. For example, the display 23 may display a GUI (Graphical User Interface) to accept various operations from the user (operator such as a doctor or technician). The display 23 can be any display as appropriate, such as a CRT (Cathode Ray Tube) display, liquid crystal display, organic EL display, LED display, and plasma display. Note that the X-ray diagnostic device 1 may not include the display 23, and the GUI may be displayed on an external display, or the GUI may be displayed via a projector or the like.

[0036] The communication interface 24 is, for example, an interface to a network and an external storage device (not shown). Data such as X-ray images obtained by the X-ray diagnostic device 1 can be transferred to other devices via the communication interface 24 and the network.

[0037] The processing circuit 25 controls the operation of the entire X-ray diagnostic apparatus 1 in accordance with the electrical signals of input operations output from the input interface 22. For example, the processing circuit 25 has a processor such as a CPU, MPU, or GPU (Graphics Processing Unit) and memory such as ROM or RAM as hardware resources. The processing circuit 25 executes control functions 251, image processing functions 252, instruction generation functions 253, adhesion determination functions 254, rotation support functions 255, tilt support functions 256, disease determination functions 257, etc., using a processor that executes a program loaded into memory 21. The above functions are not limited to being realized by a single processing circuit. Multiple independent processors may be combined to form a processing circuit, and each processor may execute a program to realize the above functions. Furthermore, the division of each function described below is for convenience and can be changed as appropriate. This is because even if one function is responsible for a process that another function is responsible for, the processing circuit 25 will still execute that process. The fact that the division of each function can be changed is also true for the following embodiments and modifications.

[0038] The control function 251 causes the processing circuit 25 to temporarily store information such as command signals from the operator input through the input interface 22 and various initial setting conditions, and then transmit this information to each function of the processing circuit 25.

[0039] Furthermore, the control function 251 allows the processing circuit 25 to control the drive unit 13 using, for example, information regarding the driving of the movable support mechanism 9 and the rotating support mechanism 11 input from the input interface 22. For example, the control function 251 controls the rotation of the top plate 14, the sliding of the top plate 14, and the movement of the image system. The control function 251 also controls the X-ray irradiation range using, for example, information regarding the driving of the irradiation range limiter 5 input from the input interface 22.

[0040] Furthermore, the control function 251 allows the processing circuit 25 to read information such as various initial setting conditions and control imaging conditions such as tube voltage, tube current, and irradiation time in the high-voltage generator. The imaging conditions may include the product of tube current and irradiation time (mAs).

[0041] The image processing function 252 enables the processing circuit 25 to generate an X-ray image of the subject P based on the output from the X-ray detector 7. For example, the image processing function 252 collects fluoroscopic and radiographic images based on the output from the X-ray detector 7, performs various image processing for display, and displays the X-ray images of the subject P, such as the fluoroscopic and radiographic images, on the display 23. The image processing function 252 can also fix the fluoroscopic image, which is a moving image, and display the resulting still image, the current X-ray image, on the display 23. Alternatively, the image processing function 252 may read past examination images corresponding to the current X-ray image from the memory 21 and display the current X-ray image and past examination images in parallel on the display 23. The processing circuit 25 that implements the image processing function 252 is an example of an image generation unit.

[0042] The instruction generation function 253 allows the processing circuit 25 to read a pre-stored workflow, automatically generate instructions to be notified to the operator and subject P during the inspection based on that workflow, and notify the operator and subject P of the generated instructions. The processing circuit 25 that implements the instruction generation function 253 is an example of an instruction generation unit. Furthermore, the processing circuit 25 that implements the instruction generation function 253 is an example of a support unit that assists in changing the posture of the subject P by notifying them of the generated instructions.

[0043] The instruction generation function 253 enables the processing circuit 25 to generate instructions for the operator and the subject P based on the procedures recorded in the workflow. Methods for notifying the generated instructions include, for example, outputting voice instructions to the subject P from a speaker provided as an output unit 16, or displaying text instructions on the display 23. The generated instructions may be notified directly to the subject P without the operator's intervention, or indirectly to the subject P through the operator. Furthermore, a combination of display and speaker notification may be used.

[0044] The adhesion determination function 254 allows the processing circuit 25 to determine the adhesion status of the contrast agent based on the X-ray image. For example, the processing circuit 25 analyzes the adhesion status of the contrast agent using the fluoroscopic image and identifies areas where the contrast agent has not adhered. For example, a trained machine learning model that has been trained to accept fluoroscopic image input and output areas where the contrast agent has not adhered is used to determine the adhesion status of the contrast agent. In this case, the processing circuit 25 identifies areas where the contrast agent has not adhered by inputting the fluoroscopic image generated in the current examination to the trained machine learning model. Furthermore, the adhesion determination function 254 allows the processing circuit 25 to determine the actions of the subject P to ensure that the contrast agent is adhered without excess or deficiency, generate instructions to prompt the determined actions, and notify the operator and the subject P of the generated instructions, thereby supporting changes in the subject P's posture. The processing circuit 25 that implements the adhesion determination function 254 is an example of a support unit that assists in changing the posture of the subject P.

[0045] The rotation support function 255 allows the processing circuit 25 to support the rotational movement of the subject P by controlling the rotation of the rotating body 30. The processing circuit 25 that implements the rotation support function 255 is an example of a support unit that assists in changing the posture of the subject P. The processing circuit 25 assists the rotation of the subject P, for example, when applying contrast agent to the inner wall of the digestive tract or when changing the imaging posture. Specifically, in the rotation support function 255, the processing circuit 25 assists the rotational movement of the subject P by rotating the rotating body 30. In this case, the processing circuit 25 applies a rotational driving force to the rotating body 30 in the direction in which the subject P is to be rotated, and rotates the rotating body 30 together with the rotation of the subject P. The processing circuit 25 also stops applying the rotational driving force when the rotating body 30 has rotated to a predetermined inclination angle.

[0046] The tilt support function 256 enables the processing circuit 25 to assist in changing the posture of the subject P when taking images in a head-down oblique position. The processing circuit 25, which implements the tilt support function 256, is an example of a support unit that assists in changing the posture of the subject P. The head-down oblique position is used to take images after moving the contrast agent towards the head of the subject P. Conventionally, the operator would adjust the tilt angle of the tabletop 14 while observing the movement of the barium in the fluoroscopic image. However, if the operator is inexperienced, they may tilt the tabletop 14 more than necessary, unnecessarily increasing the burden on the subject P.

[0047] In the tilt support function 256, the processing circuit 25 calculates the minimum necessary tilt angle of the tabletop 14 in a head-down, strabismic state based on the fluoroscopic image. To calculate the tilt angle of the tabletop 14, a pre-trained machine learning model is used, which has been trained to accept fluoroscopic image input and output the minimum necessary tilt angle considering the degree of contrast agent adhesion and viscosity in the fluoroscopic image. In this case, the processing circuit 25 determines the tilt angle of the tabletop 14 in a head-down, strabismic state by inputting the fluoroscopic image generated in the current examination to the pre-trained machine learning model.

[0048] Thus, in the tilt support function 256, the processing circuit 25 assists in changing the posture of the subject P by controlling the tilt angle in the oblique state to the minimum necessary tilt angle. Furthermore, in the tilt support function 256, when the top plate 14 changes to an oblique state with the head lowered, the processing circuit 25 extends the shoulder support 33 toward the shoulders of the subject P and brings the shoulder support 33 into contact with the shoulders of the subject P, thereby assisting in changing the posture of the subject P. The processing circuit 25 in the tilt support function 256 is an example of a support control unit.

[0049] The processing circuit 25 uses the disease detection function 257 to extract areas suspected of being diseased from the fluoroscopic image. For example, a trained machine learning model that has learned from past cases can be used to extract areas suspected of being diseased. In this case, for example, a trained machine learning model that has been trained to accept fluoroscopic image input and output areas suspected of being diseased is used. The processing circuit 25 identifies areas suspected of being diseased by inputting the fluoroscopic image generated in the current examination to the trained machine learning model. As a result, for example, if there is an area with irregularities or shading similar to an area where a disease was found in the past, that area is extracted as an area suspected of being diseased.

[0050] Furthermore, the processing circuit 25, using the disease determination function 257, determines appropriate imaging conditions for additional imaging targeting the area suspected of having a disease, generates instructions for performing additional imaging according to those conditions, and notifies the operator and subject P of the generated instructions, thereby supporting the subject P's posture changes during additional imaging. The processing circuit 25, which implements the disease determination function 257, is an example of a support unit that assists in the subject P's posture changes. In addition, a machine learning model may be used to determine appropriate imaging conditions for additional imaging and generate instructions for performing additional imaging.

[0051] Next, the operation of the X-ray diagnostic apparatus 1 according to this embodiment will be described. The following explanation uses the case of performing a barium examination of the stomach on a patient as an example. Figure 6 is a flowchart of an example of the procedure for a barium examination performed using X-ray diagnostic equipment 1. Note that the procedure described below is merely an example, and each process may be modified as much as possible. Furthermore, depending on the embodiment, steps in the procedure described below may be omitted, replaced, or added as appropriate.

[0052] When performing a barium examination, the processing circuit 25 first reads a pre-recorded workflow from the memory 21 using the instruction generation function 253 (step S101).

[0053] Next, the processing circuit 25, using the instruction generation function 253, generates an instruction to place the patient on the fluoroscopy table 2 according to the examination procedure shown in the workflow, and notifies the patient. The operator then places the patient, who has been administered barium and effervescent agent, on the tabletop 14. At this time, the processing circuit 25 generates an instruction to fix the patient's feet and notifies the operator (step S102). The operator, upon receiving the instruction, fixes the patient's feet to the rotating body 30.

[0054] Next, the processing circuit 25, using the instruction generation function 253, generates an instruction to rotate the patient in order to adhere the barium to the stomach wall, and notifies the patient (step S103). For example, the processing circuit 25 generates a voice message saying, "Turn to the right three times," and notifies the patient. At this time, the processing circuit 25, using the rotation support function 255, applies a rotational driving force to the rotating body 30 in the same direction as the patient is to be rotated (step S104). The patient, receiving the force of the rotating body 30 attempting to rotate, rotates on the tabletop 14 in the direction that the rotating body 30 is attempting to rotate, as shown in Figure 7. When the patient and the rotating body 30 have rotated a predetermined number of times, the processing circuit 25 stops applying rotational driving force to the rotating body 30, and stops the rotation of the rotating body 30 and the patient. For example, the patient rotates clockwise three times with the instruction from the device and the assistance of the rotating body 30. In this case, the patient rotates in accordance with the rotation of the rotating body 30, to which their feet are fixed, and can rotate with minimal force, using the movement of the rotating body 30 as a guide. Therefore, the rotating body 30 assists the patient's rotation, allowing the patient to smoothly perform the instructed change of posture.

[0055] Next, the processing circuit 25 performs X-ray fluoroscopy imaging of the patient in response to the operation of the input interface 22, using the control function 251 and the image processing function 252. At this time, the X-ray tube 3 irradiates the patient, who has been administered barium and an effervescent agent, with X-rays. The X-ray detector 7 detects the X-rays irradiated from the X-ray tube 3 and transmitted through the patient. Based on the output of the X-ray detector 7, the processing circuit 25 generates an X-ray image of the patient and displays the generated X-ray image as a video on the display 23.

[0056] Subsequently, the processing circuit 25 inputs the fluoroscopic image into a machine learning model using the adhesion determination function 254 to identify areas where barium has not been applied, thereby determining the state of barium adhesion in the stomach (step S105), and notifies the operator of the determination result.

[0057] If there are areas where barium has not adhered, the processing circuit 25 determines that the barium has not covered the entire mucous membrane and that barium adhesion is not complete (step S106-No), and notifies the operator via screen display or voice that barium adhesion is not complete. The operator then instructs the patient to rotate left or right and performs the operation of raising or lowering the top plate 14. The processing circuit 25 repeats the process described in steps S102-S104 until it can confirm that the barium has covered the mucous membrane of the stomach wall. If there are no areas where barium has not adhered, the processing circuit 25 determines that the barium has covered the entire mucous membrane and that barium adhesion is complete (step S106-Yes), and notifies the operator via screen display or voice that barium adhesion is complete.

[0058] Once the barium has adhered, the processing circuit 25 generates instructions to perform imaging in eight different positions according to the standard imaging method, following the procedures defined in the workflow, and sequentially notifies the operator. Subsequently, the processing circuit 25 sequentially performs imaging in response to the operator's operation of the input interface 22 (step S107). At this time, the processing circuit 25 determines the next position to be performed based on the workflow and fluoroscopic images, generates instructions to change the imaging posture to the next position, and notifies the patient of the generated instructions. At this time, the processing circuit 25 assists in changing the patient's posture by rotating the rotating body 30 in the direction in which the patient is to be rotated.

[0059] For example, as shown in Figure 7, when taking a picture with the patient facing 90° to the left, the processing circuit 25 generates an audio instruction, "Turn to the left and lie on your side," notifies the patient of the generated audio instruction, and applies a leftward rotational driving force to the rotating body 30. The patient receives the force that causes the rotating body 30 to rotate to the left and rotates to the left along with the rotating body 30. The processing circuit 25 calculates the rotation angle of the rotating body 30 over time, and based on the fact that the rotating body 30 has rotated to 90°, it stops applying the rotational driving force to the rotating body 30, stopping the rotation of the rotating body 30 and the patient. In this way, the patient can rotate with minimal force by rotating in accordance with the rotation of the rotating body 30, which has its feet fixed, using the movement of the rotating body 30 as a guide. Therefore, the rotating body 30 assists the patient's rotation, allowing the patient to smoothly perform the instructed posture change.

[0060] Furthermore, when taking images in a head-down oblique position, the processing circuit 25 assists in changing the patient's posture when the tabletop 14 is changed to an oblique position. Figure 8 is a flowchart showing an example of the procedure when taking images in a head-down oblique position as shown in Figure 5 during the processing of step S107.

[0061] First, the processing circuit 25 inputs the perspective image into a machine learning model using the tilt support function 256 to determine the minimum necessary tilt angle of the tabletop 14 (step S201).

[0062] Next, the processing circuit 25 uses the instruction generation function 253 to generate an audio instruction prompting the rotation of the tabletop 14 and notifies the operator of the generated audio instruction. The processing circuit 25 also generates an audio instruction to the patient to change their posture in response to the tilting of the tabletop 14 in response to the operation of the input interface 22 (step S202). For example, the processing circuit 25 generates and notifies the patient of the audio instruction, "Please lie on your back. Your head will be upside down, so please hold firmly to the handrail on the side." If imaging is to be performed in a supine position, the audio instruction, "Please lie face down. Your head will be upside down, so please hold firmly to the handrail on the side," may also be notified.

[0063] Furthermore, the processing circuit 25 rotates the tabletop 14 around the rotation axis R1 using the tilt support function 256. The processing circuit 25 controls the tilt of the tabletop 14 so that it becomes the tilt angle determined in step S201 (step S203) using the tilt support function 256. In a head-down oblique position, the patient grasps a handrail (not shown) with their hands to prevent moving downward on the tilted tabletop 14. This puts a strain on the patient's arms. By minimizing the tilt of the tabletop 14, the strain on the patient's arms to maintain the head-down posture is reduced. In addition, since the patient's feet are fixed to the rotating body 30, the strain on the patient's arms to maintain the head-down posture is further reduced.

[0064] Furthermore, the processing circuit 25 tilts the tabletop 14 using the tilt support function 256, and at the same time extends the shoulder support 33 toward the patient's shoulders, as shown in Figure 9 (step S204). As a result, the patient assumes a head-down position, and both of the patient's shoulders are supported from below by the contact portion 332 of the shoulder support 33. With the patient supported by the shoulder support 33, the burden on the patient's arms to maintain the head-down position is further reduced. After that, the imaging is performed (step S205).

[0065] Returning to Figure 6, in step S107, once fluoroscopic imaging in each posture defined in the workflow is completed, the processing circuit 25 uses the disease determination function 257 to make a determination regarding the suspicion of disease using the fluoroscopic images generated in the current examination (step S108). At this time, the processing circuit 25 inputs the fluoroscopic images generated in the current examination into a machine learning model that has learned the characteristics of areas where diseases were found in past examinations, and detects areas where disease is suspected. For example, areas where irregularities or shadows are detected in the stomach wall are detected as areas where disease is suspected.

[0066] If an area suspected of having a disease is detected (step S109-Yes), the processing circuit 25 uses the disease determination function 257 to perform additional imaging to determine whether or not a disease is present in the suspected area (step S110). At this time, the processing circuit 25 determines the appropriate imaging direction and angle to determine whether or not a disease is present, and notifies the operator of the determined imaging conditions.

[0067] On the other hand, if no areas suspected of being diseased are detected (step S109-No), the series of tests ends. At this time, the processing circuit 25 generates an audio instruction to terminate the tests and notifies the operator or patient.

[0068] Next, the effects of the X-ray diagnostic apparatus 1 according to this embodiment will be described. The X-ray diagnostic apparatus 1 of this embodiment includes a top plate 14 on which a subject P administered with a contrast agent and an effervescent agent is placed, an X-ray tube 3 that irradiates the subject P with X-rays, an X-ray detector 7 that detects the X-rays irradiated from the X-ray tube 3 and transmitted through the subject P, a processing circuit 25 that generates an X-ray image of the subject P based on the output of the X-ray detector 7, and a rotating body 30. The X-ray image is, for example, a fluoroscopic image or a radiographic image.

[0069] The rotating body 30 is attached to the top plate 14 on which the subject P is placed, and is a fixing part that secures the feet of the subject P. With the feet of the subject P fixed, the rotating body 30 rotates relative to the top plate 14 about a rotation axis R2 that is along the longitudinal direction of the top plate 14. The rotation axis R2 of the rotating body 30 is positioned, for example, at the center of gravity of the subject P. The processing circuit 25 rotates the rotating body 30 when the subject P is rotated by the rotation support function 255. For example, the processing circuit 25 applies a rotational driving force to the rotating body 30 in the same direction as the rotation direction of the subject P, and stops applying the rotational driving force when the rotating body 30 has rotated to a predetermined rotation angle.

[0070] With the above configuration, the X-ray diagnostic apparatus 1 of this embodiment can assist in changing the posture of the subject P by rotating the rotating body 30, to which the subject P's feet are fixed, in the same direction as the desired direction of rotation of the subject P. For example, by rotating in accordance with the rotation direction of the rotating body 30, the subject P can rotate without confusion about the direction of rotation, using the movement of the rotating body 30 as a guide. This reduces stress on the subject P and prevents the examination time from becoming longer. Furthermore, by utilizing the rotational force of the rotating body 30 for the rotation of the subject P, the burden on the subject P during rotation can be reduced. In addition, since the subject P can be easily brought into the correct posture, the examination time can be shortened and the burden on the subject P can be reduced. In other words, by rotating the rotating body 30 when the subject P changes posture, the posture change of the subject P can be assisted.

[0071] Furthermore, the processing circuit 25, using the tilt support function 256, determines the tilt angle of the tabletop 14 in a head-down oblique position based on the X-ray image, and controls the movement of the tabletop 14 based on the determined tilt angle. For example, the processing circuit 25 uses a pre-trained machine learning model, which has been trained to output the minimum necessary tilt angle considering the degree of adhesion and viscosity of the contrast agent in the fluoroscopic image, to determine the minimum tilt angle required to move the contrast agent to the imaging site on the head side of the subject P. With the above configuration, the tilt angle of the tabletop 14 can be kept to the minimum necessary in a head-down oblique position, thereby reducing the burden on the subject P's arms to maintain the posture.

[0072] Furthermore, by tilting the top plate 14 while the subject P's feet are fixed to the rotating body 30, the burden on the subject P's arms to maintain posture can be further reduced. In addition, by extending the shoulder support 33 toward the subject P's shoulders when the top plate 14 changes to a head-down oblique position, the subject P's shoulders are supported from below by the shoulder support 33, further reducing the burden on the subject P's arms to maintain posture.

[0073] Furthermore, the processing circuit 25 extracts areas suspected of being diseased from X-ray images using the disease determination function 257. For example, by using a pre-trained machine learning model that has learned from past cases, image data in which diseases were found in past imaging can be used as samples to identify areas suspected of being diseased, and additional imaging can be performed on the areas suspected of being diseased, thereby reducing the chances of missing a disease.

[0074] Furthermore, the processing circuit 25, using the instruction generation function 253, generates instructions for operating the equipment and the subject P in accordance with the examination workflow, and notifies the operator and subject P of the generated instructions. This configuration eliminates the need for operator judgment, allowing the examination to proceed according to the instructions generated by image analysis, thus enabling accurate and consistent examinations regardless of the operator's skill level. In other words, because the processing circuit 25 generates instructions from the fluoroscopic image rather than the operator giving instructions from the fluoroscopic image, barium examinations can proceed smoothly even if the operator's skill level is low. This also helps to avoid re-examinations, suppress extensions of examination time, and reduce radiation exposure.

[0075] According to at least one embodiment described above, it is possible to assist in changing the posture of a subject during fluoroscopy using a contrast agent.

[0076] In the above description, the term "processor" refers to circuits such as CPUs, GPUs, or Application Specific Integrated Circuits (ASICs), programmable logic devices (e.g., Simple Programmable Logic Devices (SPLDs), Complex Programmable Logic Devices (CPLDs), and Field Programmable Gate Arrays (FPGAs)). The processor implements its functions by reading and executing programs stored in memory circuits. Alternatively, instead of storing programs in memory circuits, the processor may be configured to directly incorporate programs into its circuits. In this case, the processor implements its functions by reading and executing programs incorporated into the circuits. Furthermore, instead of executing a program, the processor may implement functions corresponding to the program through a combination of logic circuits. 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 implement its functions. Moreover, multiple components may be integrated into a single processor to implement its functions.

[0077] While several embodiments 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 a variety of other forms, and various omissions, substitutions, modifications, and combinations of embodiments are possible 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]

[0078] 1...X-ray diagnostic equipment 2…Fluoroscopy table 3...X-ray tube 5… Irradiation range limiter 7...X-ray detector 9...Movement support mechanism 11…Rotation support mechanism 13…Drive unit 14… Tabletop 141...Head mounting section 142... Footrest section 16…Output section 20…Console device 21…Memory 22…Input Interface 23…Display 24…Communication Interface 25… Processing circuit 251... Control function 252…Image processing function 253…Instruction generation function 254... Adhesion detection function 255... Rotation support function 256…Tilt support function 257…Disease diagnosis function 30…Rotational body 31…Rotating body drive mechanism 32… Fixing member 33...Shoulder support 331…Fixed part 332... Contact area 34…Rotating body holding mechanism R1, R2... Rotation axis

Claims

1. A table on which the subject who has been administered the contrast agent and effervescent agent is placed, An X-ray tube for irradiating the subject with X-rays, An X-ray detector that detects X-rays irradiated from the X-ray tube and transmitted through the subject, An image generation unit that generates an X-ray image of the subject based on the output of the X-ray detector, A support unit that assists in changing the posture of the subject, An X-ray diagnostic device equipped with [specific features / features].

2. The support unit is attached to the top plate on which the subject is placed and includes a fixing part for fixing the feet of the subject. The X-ray diagnostic apparatus according to claim 1.

3. The fixing part rotates relative to the top plate about the longitudinal direction of the top plate while fixing the feet of the subject, The support unit further includes a rotation control unit that rotates the fixing unit when the subject is rotated. The X-ray diagnostic apparatus according to claim 2.

4. The rotation control unit applies a rotational driving force to the fixed part in the same direction as the rotation direction of the object being tested. The X-ray diagnostic apparatus according to claim 3.

5. The rotation control unit stops applying the rotational driving force based on the fact that the fixed part has rotated to a predetermined rotation angle. The X-ray diagnostic apparatus according to claim 4.

6. The rotation axis of the fixed part is positioned at the center of gravity of the subject. The X-ray diagnostic apparatus according to claim 3.

7. The support unit determines the inclination angle of the top plate in a head-down oblique position based on the X-ray image. The X-ray diagnostic apparatus according to claim 1.

8. The support unit comprises a shoulder support attached to the tabletop and supporting the subject's shoulders from below in a head-down, oblique position, and a support control unit that brings the shoulder support into contact with the subject's shoulders when the tabletop is tilted in a head-down, oblique position. The X-ray diagnostic apparatus according to claim 1.

9. The support unit detects areas suspected of being diseased based on the X-ray image and performs additional imaging targeting the detected areas. The X-ray diagnostic apparatus according to claim 1.

10. The support unit determines the degree of adhesion of the contrast agent based on the X-ray image and generates instructions to ensure that the contrast agent is applied without excess or deficiency. The X-ray diagnostic apparatus according to claim 1.

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