Medical image processing apparatus, X-ray diagnostic apparatus, and medical image processing program

Abstract

To easily grasp a position of a medical device inserted to a blood vessel.SOLUTION: A medical image processing apparatus according to an embodiment comprises an image acquisition unit, a device information acquisition unit, and a display control unit. The image acquisition unit acquires a two-dimensional X-ray image collected from a subject in which a medical device is inserted to a blood vessel and a three-dimensional blood vessel image including the blood vessel of the subject. The device information acquisition unit acquires position information on a three-dimensional space of the medical device. The display control unit determines a display mode of the three-dimensional blood vessel image on the basis of the position information and displays the three-dimensional blood vessel image and the two-dimensional X-ray image in an overlapping manner in the determined display mode.SELECTED DRAWING: Figure 1

Description

Technical Field

[0001] The embodiments disclosed in this specification and the like relate to a medical image processing apparatus, an X-ray diagnostic apparatus, and a medical image processing program.

Background Art

[0002] Various procedures for inserting a medical device into a blood vessel of a subject are known. Also, in performing such procedures, a technique for confirming the position of a medical device in a blood vessel using an X-ray image is known. However, even when referring to an X-ray image, it has sometimes been difficult to grasp the three-dimensional position and orientation of the medical device.

Prior Art Documents

Patent Documents

[0003]

Patent Document 1

Summary of the Invention

Problems to be Solved by the Invention

[0004] One of the problems to be solved by the embodiments disclosed in this specification and the like is to facilitate grasping the position of a medical device inserted into a blood vessel. However, the problems solved by the embodiments disclosed in this specification and the like are not limited to the above problem. The problems corresponding to the respective effects of each configuration shown in the embodiments described later can also be positioned as other problems solved by the embodiments disclosed in this specification and the like.

Means for Solving the Problems

[0005] The medical image processing apparatus according to the embodiment includes an image acquisition unit, a device information acquisition unit, and a display control unit. The image acquisition unit acquires a two-dimensional X-ray image collected from a subject with a medical device inserted into a blood vessel and a three-dimensional blood vessel image including the blood vessels of the subject. The device information acquisition unit acquires position information of the medical device in a three-dimensional space. The display control unit determines a display mode of the three-dimensional blood vessel image based on the position information, and superimposes and displays the three-dimensional blood vessel image and the two-dimensional X-ray image in the determined display mode.

Brief Description of Drawings

[0006]

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Embodiments for Carrying Out the Invention

[0007] Hereinafter, embodiments of a medical image processing apparatus, an X-ray diagnostic apparatus, and a medical image processing program will be described in detail with reference to the drawings.

[0008] (First Embodiment) In the first embodiment, a medical image processing system 1 including a medical image processing apparatus 30 will be described as an example. For example, as shown in FIG. 1, the medical image processing system 1 includes an X-ray diagnostic apparatus 10, an image storage apparatus 20, and a medical image processing apparatus 30. The X-ray diagnostic apparatus 10, the image storage apparatus 20, and the medical image processing apparatus 30 are connected via a network NW. Note that FIG. 1 is a block diagram showing an example of the configuration of the medical image processing system 1 according to the first embodiment.

[0009] The X-ray diagnostic apparatus 10 is an apparatus that collects X-ray images from a subject P. For example, the X-ray diagnostic apparatus 10 collects a two-dimensional X-ray image from a subject P with a medical device inserted into a blood vessel, and transmits the collected two-dimensional X-ray image to the image storage apparatus 20 or the medical image processing apparatus 30. Note that the X-ray diagnostic apparatus 10 will be described later.

[0010] The image storage apparatus 20 stores various medical images. For example, the image storage apparatus 20 stores a three-dimensional blood vessel image including the blood vessels of the subject P. For example, the image storage apparatus 20 stores, as a three-dimensional blood vessel image, a three-dimensional X-ray image collected from a subject P in a state where a contrast agent has been injected into the blood vessel. Note that the three-dimensional blood vessel image may be collected by the X-ray diagnostic apparatus 10 or may be collected by another apparatus. Also, for example, the image storage apparatus 20 stores a two-dimensional X-ray image collected from the subject P by the X-ray diagnostic apparatus 10. For example, the image storage apparatus 20 is realized by a computer device such as a server device.

[0011] The medical image processing device 30 executes various processes based on images acquired from the X-ray diagnostic device 10 or the image storage device 20. For example, as shown in FIG. 1, the medical image processing device 30 includes an input interface 31, a display 32, a memory 33, and a processing circuit 34.

[0012] The input interface 31 receives various input operations from the user, converts the received input operations into electrical signals, and outputs them to the processing circuit 34. For example, the input interface 31 is realized by a mouse, a keyboard, a trackball, a switch, a button, a joystick, a touch pad that performs an input operation by touching an operation surface, a touch screen in which a display screen and a touch pad are integrated, a non-contact input circuit using an optical sensor, a voice input circuit, or the like. Note that the input interface 31 may be configured by a tablet terminal or the like that can communicate wirelessly with the main body of the medical image processing device 30. Further, the input interface 31 may be a circuit that receives an input operation from the user by motion capture. For example, the input interface 31 can receive the body movement, the line of sight, etc. of the user as input operations by processing a signal acquired via a tracker or an image collected about the user. Further, the input interface 31 is not limited to only those provided with physical operation components such as a mouse and a keyboard. For example, an electrical signal processing circuit that receives an electrical signal corresponding to an input operation from an external input device provided separately from the medical image processing device 30 and outputs this electrical signal to the processing circuit 34 is also included in the examples of the input interface 31.

[0013] The display 32 displays various types of information. For example, the display 32 superimposes and displays a two-dimensional X-ray image collected by the X-ray diagnostic apparatus 10 and a three-dimensional vascular image under the control of the processing circuit 34. Also, for example, the display 32 displays a GUI (Graphical User Interface) for receiving various instructions, settings, etc. from the user via the input interface 31. For example, the display 32 is a liquid crystal display or a CRT (Cathode Ray Tube) display. The display 32 may be a desktop type, or may be configured as a tablet terminal or the like capable of wireless communication with the main body of the medical image processing apparatus 30. Also, for example, the display 32 may be a projector or the like. For example, the display 32 may be a projector that projects onto a screen, wall, floor, the body surface of the subject P, etc. As an example, the display 32 can also perform projection onto an arbitrary plane, object, space, etc. by projection mapping.

[0014] The memory 33 is realized by, for example, a semiconductor memory element such as a RAM (Random Access Memory), a flash memory, a hard disk, an optical disk, etc. For example, the memory 33 stores a program for the circuits included in the medical image processing apparatus 30 to realize their functions. Also, the memory 33 stores various images acquired from the X-ray diagnostic apparatus 10 or the image storage apparatus 20. Note that the memory 33 may be realized by a server group (cloud) connected to the medical image processing apparatus 30 via the network NW.

[0015] The processing circuit 34 controls the operation of the entire medical image processing apparatus 30 by executing a control function 34a, an image acquisition function 34b, a device information acquisition function 34c, a display control function 34d, and a transmission function 34e. Here, the image acquisition function 34b is an example of an image acquisition unit. Also, the device information acquisition function 34c is an example of a device information acquisition unit. Also, the display control function 34d is an example of a display control unit. Also, the transmission function 34e is an example of a transmission unit.

[0016] For example, the processing circuit 34 reads out and executes a program corresponding to the control function 34a from the memory 33, and controls various functions such as an image acquisition function 34b, a device information acquisition function 34c, a display control function 34d, and a transmission function 34e based on various input operations received from the user via the input interface 31.

[0017] Also, for example, the processing circuit 34 reads out and executes a program corresponding to the image acquisition function 34b from the memory 33, and acquires a two-dimensional X-ray image obtained from the subject P into whom a medical device has been inserted into the blood vessel and a three-dimensional blood vessel image including the blood vessels of the subject P. Also, for example, the processing circuit 34 reads out and executes a program corresponding to the device information acquisition function 34c from the memory 33, and acquires position information in the three-dimensional space of the medical device inserted into the blood vessel of the subject P. Also, for example, the processing circuit 34 reads out and executes a program corresponding to the display control function 34d from the memory 33, determines the display mode of the three-dimensional blood vessel image based on the position information acquired by the device information acquisition function 34c, and superimposes the three-dimensional blood vessel image and the two-dimensional X-ray image in the determined display mode and displays them on the display 32. Also, for example, the processing circuit 34 reads out and executes a program corresponding to the transmission function 34e from the memory 33, and transmits various data to the X-ray diagnostic apparatus 10. Note that the processing by the image acquisition function 34b, the device information acquisition function 34c, the display control function 34d, and the transmission function 34e will be described later.

[0018] Next, with reference to FIG. 2, the configuration of the X-ray diagnostic apparatus 10 will be described. FIG. 2 is a block diagram showing an example of the configuration of the X-ray diagnostic apparatus 10 according to the first embodiment. In the present embodiment, a case where the X-ray diagnostic apparatus 10 is a biplane X-ray diagnostic apparatus will be described as an example. For example, the X-ray diagnostic apparatus 10 includes an X-ray high voltage apparatus 101, a first X-ray tube 102a, a second X-ray tube 102b, a first X-ray collimator 103a, a second X-ray collimator 103b, a top plate 104, a first arm 105a, a second arm 105b, a first X-ray detector 106a, a second X-ray detector 106b, a memory 107, a display 108, an input interface 109, and a processing circuit 110.

[0019] The X-ray high voltage apparatus 101 supplies a high voltage to the first X-ray tube 102a and the second X-ray tube 102b under the control of the processing circuit 110. For example, the X-ray high voltage apparatus 101 has an electric circuit such as a transformer and a rectifier, and includes a high voltage generator that generates a high voltage to be applied to the first X-ray tube 102a and the second X-ray tube 102b, and an X-ray control apparatus that controls the output voltage according to the X-rays irradiated by the first X-ray tube 102a and the second X-ray tube 102b. The high voltage generator may be of a transformer type or an inverter type.

[0020] The first X-ray tube 102a and the second X-ray tube 102b are vacuum tubes each having a cathode (filament) that generates thermoelectrons and an anode (target) that generates X-rays upon receiving the collision of the thermoelectrons. The first X-ray tube 102a and the second X-ray tube 102b generate X-rays by irradiating thermoelectrons from the cathode toward the anode using the high voltage supplied from the X-ray high voltage apparatus 101.

[0021] The first X-ray collimator 103a and the second X-ray collimator 103b each have a collimator that narrows down the irradiation range of the X-rays and a filter that adjusts the X-rays.

[0022] The collimator in the first X-ray collimator 103a has, for example, four slidable aperture vanes. By sliding these aperture vanes, the X-rays generated by the first X-ray tube 102a are narrowed down and irradiated onto the subject P. Here, the aperture vanes are plate-like members made of, for example, lead and are provided near the X-ray irradiation port of the first X-ray tube 102a to adjust the irradiation range of the X-rays. Similarly, the collimator in the second X-ray collimator 103b narrows down the X-rays generated by the second X-ray tube 102b by sliding the aperture vanes and irradiates the subject P.

[0023] The filters in the first X-ray collimator 103a and the second X-ray collimator 103b change the quality of the X-rays transmitted depending on their material and thickness for the purpose of reducing the radiation dose to the subject P and improving the image quality of the X-ray image, reducing the soft X-ray component that is easily absorbed by the subject P, or reducing the high-energy component that causes a decrease in the contrast of the X-ray image data. Also, the filter changes the dose and irradiation range of the X-rays depending on its material, thickness, position, etc., and attenuates the X-rays so that the X-rays irradiated onto the subject P have a predetermined distribution.

[0024] For example, the first X-ray collimator 103a and the second X-ray collimator 103b have a drive mechanism such as a motor and an actuator, and control the irradiation of the X-rays by operating the drive mechanism under the control of a processing circuit 110 described later. For example, the first X-ray collimator 103a and the second X-ray collimator 103b adjust the opening degree of the aperture vanes of the collimator by applying a drive voltage to the drive mechanism according to the control signal received from the processing circuit 110, thereby controlling the irradiation range of the X-rays irradiated onto the subject P. Also, for example, the first X-ray collimator 103a and the second X-ray collimator 103b control the dose distribution of the X-rays irradiated onto the subject P by adjusting the position of the filter by applying a drive voltage to the drive mechanism according to the control signal received from the processing circuit 110.

[0025] The top plate 104 is a bed on which the subject P is placed and is arranged above a bed driving device (not shown). Note that the subject P is not included in the X-ray diagnostic apparatus 10. For example, the bed driving device has a driving mechanism such as a motor and an actuator, and controls the movement and inclination of the top plate 104 by operating the driving mechanism under the control of a processing circuit 110 described later. For example, the bed driving device adds a driving voltage to the driving mechanism according to a control signal received from the processing circuit 110 to move or incline the top plate 104.

[0026] The first X-ray detector 106a and the second X-ray detector 106b are, for example, X-ray flat panel detectors (FPDs) having detection elements arranged in a matrix. The first X-ray detector 106a detects X-rays irradiated from the first X-ray tube 102a and transmitted through the subject P, and outputs a detection signal corresponding to the detected X-ray dose to the processing circuit 110. Similarly, the second X-ray detector 106b detects X-rays irradiated from the second X-ray tube 102b and transmitted through the subject P, and outputs a detection signal corresponding to the detected X-ray dose to the processing circuit 110. Note that the first X-ray detector 106a and the second X-ray detector 106b may be indirect conversion type detectors having a grid, a scintillator array, and a photosensor array, or may be direct conversion type detectors having semiconductor elements that convert incident X-rays into electrical signals.

[0027] The first arm 105a holds the first X-ray tube 102a and the first X-ray detector 106a. Specifically, the first arm 105a holds the first X-ray tube 102a and the first X-ray detector 106a so as to face each other with the subject P therebetween. The first arm 105a is also called a C-arm or a C-shaped arm.

[0028] For example, the first arm 105a has a drive mechanism such as a motor and an actuator, and rotates or moves by operating the drive mechanism under the control of a processing circuit 110 described later. For example, the first arm 105a adds a drive voltage to the drive mechanism according to a control signal received from the processing circuit 110, thereby rotating and moving the first X-ray tube 102a and the first X-ray detector 106a with respect to the subject P, and controlling the imaging position and imaging angle.

[0029] Incidentally, hereinafter, among the components of the X-ray diagnostic apparatus 10, the first arm 105a and the components held by the first arm 105a are also referred to as the first imaging system. The first imaging system includes, for example, the first arm 105a, the first X-ray tube 102a, the first X-ray collimator 103a, and the first X-ray detector 106a. The imaging position and imaging angle in the first imaging system are controlled by the arrangement of the first arm 105a.

[0030] The second arm 105b holds the second X-ray tube 102b and the second X-ray detector 106b. Specifically, the second arm 105b holds the second X-ray tube 102b and the second X-ray detector 106b so as to face each other with the subject P therebetween. The second arm 105b is also called an Ω arm or an Ω-shaped arm.

[0031] For example, the second arm 105b has a drive mechanism such as a motor and an actuator, and rotates or moves by operating the drive mechanism under the control of a processing circuit 110 described later. For example, the second arm 105b adds a drive voltage to the drive mechanism according to a control signal received from the processing circuit 110, thereby rotating and moving the second X-ray tube 102b and the second X-ray detector 106b with respect to the subject P, and controlling the imaging position and imaging angle.

[0032] Incidentally, hereinafter, among the components of the X-ray diagnostic apparatus 10, the second arm 105b and the components held by the second arm 105b are also referred to as the second imaging system. The second imaging system includes, for example, the second arm 105b, the second X-ray tube 102b, the second X-ray collimator 103b, and the second X-ray detector 106b. The imaging position and imaging angle in the second imaging system are controlled by the arrangement of the second arm 105b.

[0033] The memory 107 is realized by, for example, semiconductor memory elements such as RAM and flash memory, hard disks, optical disks, etc. For example, the memory 107 receives and stores the X-ray images collected by the processing circuit 110. Also, the memory 107 stores programs corresponding to various functions that are read and executed by the processing circuit 110. Note that the memory 107 may be realized by a server group (cloud) connected to the X-ray diagnostic apparatus 10 via a network.

[0034] The display 108 displays various types of information. For example, the display 108 displays a GUI for receiving an operator's instruction under the control of the processing circuit 110. For example, the display 108 is a liquid crystal display or a CRT display. Note that the display 108 may be desktop type, or may be configured as a tablet terminal or the like capable of wireless communication with the processing circuit 110. Also, for example, the display 108 may be a projector or the like. For example, the display 108 may be a projector that projects onto a screen, wall, floor, the body surface of the subject P, etc. As an example, the display 108 can also perform projection onto an arbitrary plane, object, space, etc. by projection mapping.

[0035] The input interface 109 receives various input operations from the operator, converts the received input operations into electrical signals, and outputs them to the processing circuit 110. For example, the input interface 109 can be realized by a mouse, a keyboard, a trackball, a switch, a button, a joystick, a touch pad for performing input operations by touching the operation surface, a touch screen in which a display screen and a touch pad are integrated, a non-contact input circuit using an optical sensor, a voice input circuit, etc. Note that the input interface 109 may be composed of a tablet terminal or the like that can communicate wirelessly with the processing circuit 110. Also, the input interface 109 may be a circuit that receives input operations from the user by motion capture. For example, the input interface 109 can receive the user's body movements, line of sight, etc. as input operations by processing signals acquired via a tracker or images collected about the user. Also, the input interface 109 is not limited to those equipped with physical operation components such as a mouse and a keyboard. For example, an electrical signal processing circuit that receives an electrical signal corresponding to an input operation from an external input device provided separately from the X-ray diagnostic apparatus 10 and outputs this electrical signal to the processing circuit 110 is also included in the examples of the input interface 109.

[0036] The processing circuit 110 controls the operation of the entire X-ray diagnostic apparatus 10 by executing a control function 110a, a collection function 110b, a display control function 110c, and a transmission function 110d. Note that the collection function 110b is an example of a collection unit. Also, the display control function 110c is an example of a display control unit. Also, the transmission function 110d is an example of a transmission unit.

[0037] For example, the processing circuit 110 reads out and executes a program corresponding to the control function 110a from the memory 107, and controls various functions such as the collection function 110b, the display control function 110c, and the transmission function 110d based on various input operations received from the user via the input interface 109.

[0038] Also, for example, the processing circuit 110 reads and executes a program corresponding to the collection function 110b from the memory 107 to collect a two-dimensional X-ray image. For example, the collection function 110b controls the operation of the bed driving device to move or tilt the top plate 104. Also, the collection function 110b controls the X-ray high voltage device 101, the first imaging system, and the second imaging system to collect a two-dimensional X-ray image from the subject P placed on the top plate 104.

[0039] Here, the collection function 110b can control the first imaging system and the second imaging system respectively to collect a two-dimensional X-ray image for each imaging system. For example, the collection function 110b controls the X-ray high voltage device 101 and adjusts the voltage supplied to the first X-ray tube 102a to control the X-ray dose and on / off irradiated from the first X-ray tube 102a to the subject P. Also, the collection function 110b controls the operation of the first X-ray collimator 103a and adjusts the opening degree of the collimator blades to control the irradiation range of the X-rays irradiated to the subject P. Also, the collection function 110b controls the operation of the first X-ray collimator 103a and adjusts the position of the filter to control the dose distribution of the X-rays. Also, the collection function 110b controls the operation of the first arm 105a to control the arrangement of the first arm 105a. That is, the collection function 110b controls the operation of the first arm 105a to control the imaging position and imaging angle in the first imaging system. Also, the collection function 110b generates a two-dimensional X-ray image based on the detection signal received from the first X-ray detector 106a and stores the generated two-dimensional X-ray image in the memory 107.

[0040] Further, the acquisition function 110b controls the X-ray high-voltage device 101 and adjusts the voltage supplied to the second X-ray tube 102b, thereby controlling the X-ray dose and on / off irradiated from the second X-ray tube 102b to the subject P. Further, the acquisition function 110b controls the operation of the second X-ray collimator 103b and adjusts the opening degree of the collimator blades, thereby controlling the irradiation range of the X-rays irradiated to the subject P. Further, the acquisition function 110b controls the operation of the second X-ray collimator 103b and adjusts the position of the filter, thereby controlling the dose distribution of the X-rays. Further, the acquisition function 110b controls the operation of the second arm 105b, thereby controlling the arrangement of the second arm 105b. That is, the acquisition function 110b controls the operation of the second arm 105b, thereby controlling the imaging position and imaging angle in the second imaging system. Further, the acquisition function 110b generates a two-dimensional X-ray image based on the detection signal received from the second X-ray detector 106b and stores the generated two-dimensional X-ray image in the memory 107.

[0041] Note that the acquisition function 110b may perform various image processes on the generated two-dimensional X-ray image. For example, the acquisition function 110b performs noise reduction processing and scattered ray correction using an image processing filter on each of the two-dimensional X-ray image collected using the first imaging system and the two-dimensional X-ray image collected using the second imaging system.

[0042] Further, for example, the processing circuit 110 reads and executes a program corresponding to the display control function 110c from the memory 107, thereby displaying a GUI and an X-ray image on the display 108. Further, for example, the processing circuit 110 reads and executes a program corresponding to the transmitter function 110d from the memory 107, thereby transmitting the two-dimensional X-ray image collected by the acquisition function 110b to the image storage device 20 or the medical image processing device 30.

[0043] The medical image processing system 1 including the X-ray diagnostic apparatus 10, the image storage apparatus 20, and the medical image processing apparatus 30 has been described above. Under such a configuration, the medical image processing apparatus 30 in the medical image processing system 1 facilitates grasping the position of a medical device inserted into a blood vessel by the processing by the processing circuit 34. Hereinafter, the processing performed by the processing circuit 34 will be described in detail.

[0044] Prior to the start of the procedure for the subject P, the image acquisition function 34b first acquires a three-dimensional blood vessel image including the blood vessels of the subject P. For example, the image acquisition function 34b acquires a three-dimensional blood vessel image collected by performing rotational imaging on the subject P in the X-ray diagnostic apparatus 10.

[0045] For example, the collection function 110b collects a three-dimensional blood vessel image by rotational imaging using the first imaging system or the second imaging system. Further, the transmission function 110d transmits the collected three-dimensional blood vessel image to the image storage apparatus 20 for storage. Then, the image acquisition function 34b acquires the three-dimensional blood vessel image stored in the image storage apparatus 20 via the network NW. Alternatively, the image acquisition function 34b may directly acquire the three-dimensional blood vessel image from the X-ray diagnostic apparatus 10 without going through the image storage apparatus 20.

[0046] For example, the acquisition function 110b in the X-ray diagnostic apparatus 10 first retracts the second imaging system to a position where no contact (interference) occurs between the first imaging system and the second imaging system when performing rotational imaging using the first imaging system by moving the second arm 105b. Next, the acquisition function 110b rotates the first arm 105a to rotate and move the first X-ray tube 102a and the first X-ray detector 106a around the subject P while irradiating X-rays from the first X-ray tube 102a at a predetermined frame rate. Here, the acquisition function 110b irradiates the subject P with X-rays at the timing when a contrast agent is injected into the blood vessel of the subject P. Note that the injection of the contrast agent into the subject P may be performed by the acquisition function 110b by controlling an injector (not shown), or may be manually performed by a user such as a doctor. Further, the first X-ray detector 106a outputs a detection signal corresponding to the detected X-ray dose, and the acquisition function 110b generates a plurality of projection data based on the detection signal received from the first X-ray detector 106a. Hereinafter, the projection data collected from the subject P into which the contrast agent has been injected into the blood vessel is also referred to as a contrast image. That is, the acquisition function 110b collects a plurality of contrast images at a predetermined frame rate by performing rotational imaging. Then, the acquisition function 110b reconstructs a three-dimensional X-ray image from the plurality of collected contrast images. Such a three-dimensional X-ray image is an example of a three-dimensional blood vessel image including the blood vessels of the subject P.

[0047] As another example, the collection function 110b performs rotational imaging on the subject P in a state where no contrast agent has been injected into the blood vessel, and collects a plurality of projection data (hereinafter also referred to as a mask image) at a predetermined frame rate. Further, the collection function 110b performs rotational imaging on the subject P in a state where a contrast agent has been injected into the blood vessel, and collects a plurality of contrast images at a predetermined frame rate. Further, the collection function 110b performs difference processing between the plurality of mask images and the plurality of contrast images to generate a plurality of difference images. Then, the collection function 110b reconstructs a three-dimensional X-ray image from the plurality of difference images. Such a three-dimensional X-ray image is an image that contrasts the blood vessels of the subject P and removes background components such as bones and soft tissues, and is an example of a three-dimensional blood vessel image.

[0048] Alternatively, the collection function 110b reconstructs a three-dimensional X-ray image from the mask image, reconstructs a three-dimensional X-ray image from the contrast image, and further differentiates the two reconstructed three-dimensional X-ray images. The three-dimensional X-ray image generated by such differentiation is an image that contrasts the blood vessels of the subject P and removes background components such as bones and soft tissues, and is an example of a three-dimensional blood vessel image.

[0049] Although the case where a three-dimensional blood vessel image is collected by performing rotational imaging in the X-ray diagnostic apparatus 10 has been described, the embodiment is not limited to this. For example, the three-dimensional blood vessel image may be collected by performing rotational imaging in an X-ray diagnostic apparatus different from the X-ray diagnostic apparatus 10. Further, for example, the three-dimensional blood vessel image may be collected by a modality different from the X-ray diagnostic apparatus 10. As an example, the three-dimensional blood vessel image may be an X-ray CT image collected by an X-ray CT (Computed Tomography) apparatus, or may be an MR image collected by an MRI (Magnetic Resonance Imaging) apparatus.

[0050] When performing a procedure, the subject P is placed on the top plate 104 of the X-ray diagnostic apparatus 10. Also, a medical device is inserted into the blood vessel of the subject P. Here, examples of the medical device include a catheter, a guide wire, and various medical devices used according to the type of procedure.

[0051] For example, in cardiac PCI (Percutaneous Coronary Intervention), in addition to a catheter and a guide wire, a balloon for dilating a stenotic portion of a blood vessel and a stent to be placed in the stenotic portion of the blood vessel are inserted into the blood vessel of the subject P. That is, when cardiac PCI is performed, examples of the medical device include a balloon and a stent. Also, for example, in the treatment of mitral valve insufficiency, in addition to a catheter and a guide wire, a clip-shaped device for attaching to the tip of the mitral valve is inserted into the blood vessel of the subject P. That is, when the treatment of mitral valve insufficiency is performed, examples of the medical device include such a clip-shaped device.

[0052] The user operates the medical device inserted into the blood vessel of the subject P to perform the procedure. Here, the medical image processing apparatus 30 presents the two-dimensional X-ray image collected from the subject P by the X-ray diagnostic apparatus 10 to the user in order to support the procedure.

[0053] Hereinafter, a series of processes from collecting to displaying the two-dimensional X-ray image will be described with reference to FIG. 3. FIG. 3 is a diagram showing an example of the process according to the first embodiment. For example, the image acquisition function 34b in the medical image processing apparatus 30 first acquires the three-dimensional blood vessel image I1 shown in FIG. 3. The three-dimensional blood vessel image I1 is, for example, a three-dimensional X-ray image collected by the X-ray diagnostic apparatus 10. Alternatively, the three-dimensional blood vessel image I1 may be a three-dimensional X-ray image collected by another X-ray diagnostic apparatus other than the X-ray diagnostic apparatus 10, or may be a three-dimensional image collected by another modality such as an X-ray CT apparatus or an MRI apparatus.

[0054] Next, the collection function 110b in the X-ray diagnostic apparatus 10 collects an X-ray image I22 from the subject P placed on the top plate 104. The X-ray image I22 is a mask image and is a two-dimensional X-ray image collected before the medical device D1 is inserted into the blood vessel of the subject P. Further, the transmission function 110d transmits the X-ray image I22 to the medical image processing apparatus 30.

[0055] Next, the collection function 110b in the X-ray diagnostic apparatus 10 collects an X-ray image I21 from the subject P placed on the top plate 104. The X-ray image I21 is a two-dimensional X-ray image collected while the medical device D1 is inserted into the blood vessel of the subject P. In other words, the X-ray image I21 is a two-dimensional X-ray image collected while a procedure on the subject P is being performed. As shown in FIG. 3, in the X-ray image I21, in addition to background components such as bones and soft tissues, the medical device D1 inserted into the blood vessel of the subject P is depicted. Further, the transmission function 110d transmits the X-ray image I21 to the medical image processing apparatus 30.

[0056] In FIG. 3, as an example, the X-ray image I21 and the X-ray image I22 are described as being images on the F (Frontal) side. The collection function 110b may collect the X-ray image I21 and the X-ray image I22 using the first imaging system, or may collect the X-ray image I21 and the X-ray image I22 using the second imaging system.

[0057] The image acquisition function 34b acquires the X-ray image I21 and the X-ray image I22 from the X-ray diagnostic apparatus 10 via, for example, the network NW. Further, as shown in FIG. 3, the image acquisition function 34b performs differential processing between the X-ray image I21 and the X-ray image I22 to generate an X-ray image I23. The X-ray image I23 is a DSA (Digital Subtraction Angiography) image, and background components other than the medical device D1 are removed.

[0058] Next, the display control function 34d superimposes the three-dimensional vascular image I1 and the X-ray image I23 and displays them on the display 32. For example, as shown in FIG. 3, the display control function 34d first performs a rendering process on the three-dimensional vascular image I1 to generate a rendering image I11. Note that the type of rendering process is not particularly limited. For example, the display control function 34d executes a volume rendering process on the three-dimensional vascular image I1 along the X-ray irradiation direction when the X-ray images I21 and I22 are collected, and generates a rendering image I11. The three-dimensional vascular image I1 is an image in which the blood vessel B1 of the subject P is contrast-enhanced, and the blood vessel B1 is also contrast-enhanced in the rendering image I11 based on the three-dimensional vascular image I1. Then, the display control function 34d displays a superimposed image I31 obtained by superimposing the rendering image I11 and the X-ray image I23 on the display 32.

[0059] For example, the display control function 34d adjusts the transparency of the rendering image I11 and superimposes it on the X-ray image I23. Thereby, the user referring to the superimposed image I31 can visually recognize both the blood vessel B1 in the rendering image I11 and the medical device D1 in the X-ray image I23.

[0060] Here, while the procedure is being executed, the collection function 110b repeatedly collects the X-ray image I21 in FIG. 3. That is, the collection function 110b collects a plurality of time-series X-ray images I21. Further, the image acquisition function 34b sequentially generates the X-ray image I23 each time the X-ray image I21 is collected, and the display control function 34d sequentially generates the superimposed image I31 each time the X-ray image I23 is generated and displays it on the display 32. Thereby, the user can execute the procedure while confirming the current position of the medical device D1 with respect to the blood vessel B1.

[0061] However, depending on the target site of the procedure, the blood vessel B1 may be complexly distributed, and even when referring to the superimposed image I31, it may not be possible to determine in which blood vessel the medical device D1 is located. For example, as shown in FIG. 4, depending on the distribution of the blood vessel B1, a plurality of blood vessels may overlap each other and be displayed on the superimposed image I31. Here, when the medical device D1 further overlaps these plurality of blood vessels, it may not be possible to determine whether the medical device D1 is located in the blood vessel on the front side or the blood vessel on the back side. Note that FIG. 4 is a diagram showing an example of the blood vessel B1 and the medical device D1 according to the first embodiment.

[0062] Therefore, the medical image processing apparatus 30 acquires the position information of the medical device D1 in the three-dimensional space, determines the display mode of the three-dimensional blood vessel image I1 based on the position information, and superimposes the three-dimensional blood vessel image I1 and the X-ray image I23 in the determined display mode, thereby facilitating the grasping of the position of the medical device D1 inserted into the blood vessel. Hereinafter, this point will be described with reference to FIG. 5. FIG. 5 is a diagram showing an example of the process according to the first embodiment.

[0063] For example, the image acquisition function 34b first acquires the three-dimensional blood vessel image I1 shown in FIG. 5. The image acquisition function 34b also acquires the X-ray image I22 and the X-ray image I25, which are mask images. The image acquisition function 34b also acquires the X-ray image I21 and the X-ray image I24 collected from the subject P into which the medical device D1 has been inserted into the blood vessel. The transmitter function 110d transmits the X-ray image I21, the X-ray image I22, the X-ray image I24, and the X-ray image I25 to the medical image processing apparatus 30.

[0064] Here, as shown in FIG. 5, while the X-ray images I21 and I22 are images on the F side, the X-ray images I24 and I25 are images on the L (Lateral) side. For example, when collecting the X-ray images I21 and I22 using the first imaging system, the collection function 110b can collect the X-ray images I24 and I25 using the second imaging system. For example, the collection function 110b can collect the X-ray images I21 and I24 substantially simultaneously using the first imaging system and the second imaging system.

[0065] The image acquisition function 34b acquires the X-ray images I21 and I22, performs differential processing between the X-ray image I21 and the X-ray image I22, and generates the X-ray image I23. Similarly, the image acquisition function 34b acquires the X-ray images I24 and I25, performs differential processing between the X-ray image I24 and the X-ray image I25, and generates the X-ray image I26. The X-ray images I23 and I26 are DSA images, and background components other than the medical device D1 are removed.

[0066] Next, as shown in FIG. 5, the device information acquisition function 34c generates a three-dimensional X-ray image I27 based on the X-ray images I23 and I26. For example, the device information acquisition function 34c generates the three-dimensional X-ray image I27 by specifying the positions of the medical device D1 appearing in each of the X-ray images I23 and I26 in three-dimensional space based on the epipolar line.

[0067] Note that in FIG. 5, the description is made assuming that the three-dimensional X-ray image I27 is generated based on the X-ray images I23 and I26, but the embodiment is not limited thereto. For example, the device information acquisition function 34c may generate the three-dimensional X-ray image I27 by specifying the positions of the medical device D1 appearing in each of the X-ray images I21 and I24 in three-dimensional space based on the epipolar line. That is, the device information acquisition function 34c can generate the three-dimensional X-ray image I27 based on at least two two-dimensional X-ray images in which the medical device D1 is depicted and the imaging angles are different.

[0068] Next, the device information acquisition function 34c acquires the position information of the medical device D1 in the three-dimensional space based on the three-dimensional X-ray image I27. That is, the device information acquisition function 34c acquires the position information of the medical device D1 in the three-dimensional space based on the two-directional X-ray images collected using the biplane X-ray diagnostic apparatus 10. For example, the device information acquisition function 34c acquires the tip A1 of the medical device D1 as the position information of the medical device D1 in the three-dimensional space based on the three-dimensional X-ray image I27.

[0069] For example, the device information acquisition function 34c identifies the tip A1 of the medical device D1 in the three-dimensional blood vessel image I1 as the position information of the medical device D1 in the three-dimensional space. For example, when background components such as bones and soft tissues appear in the three-dimensional blood vessel image I1, the device information acquisition function 34c extracts a plurality of anatomical feature points from the three-dimensional blood vessel image I1. Also, the device information acquisition function 34c extracts a plurality of anatomical feature points from each of the X-ray image I21 and the X-ray image I24. Then, the device information acquisition function 34c aligns the subject P at the time of collection of the three-dimensional blood vessel image I1 with the subject P after being placed on the top plate 104 by comparing the plurality of anatomical feature points extracted from the three-dimensional blood vessel image I1 with the plurality of anatomical feature points extracted from the X-ray image I21 and the X-ray image I24. Thereby, the device information acquisition function 34c can align the three-dimensional X-ray image I27 with the three-dimensional blood vessel image I1 and identify the tip A1 of the medical device D1 in the three-dimensional blood vessel image I1.

[0070] When the three-dimensional vascular image I1 is a DSA image and the background component has been removed, the device information acquisition function 34c can acquire a plurality of contrast images collected for generating the three-dimensional vascular image I1, and extract a plurality of anatomical feature points from the three-dimensional image based on the acquired plurality of contrast images. Further, although the extraction of anatomical feature points from the X-ray image I21 and the X-ray image I24 has been described, the device information acquisition function 34c may extract a plurality of anatomical feature points from the X-ray image I22 and the X-ray image I25.

[0071] Next, the display control function 34d determines the display mode of the three-dimensional vascular image I1 based on the position information of the medical device D1 in the three-dimensional space. For example, the display control function 34d arranges a ring L1 colored so that the user can easily visually recognize it on the blood vessel at the portion of the three-dimensional vascular image I1 where the tip A1 of the medical device D1 is located. Hereinafter, the three-dimensional image with the ring L1 arranged on the three-dimensional vascular image I1 is also referred to as the three-dimensional vascular image I12.

[0072] For example, the display control function 34d identifies a plane that passes through the tip A1 and minimizes the cross-sectional area of the blood vessel B1 in the three-dimensional vascular image I1. Then, the display control function 34d arranges the ring L1 so as to overlap the contour of the blood vessel B1 in the identified plane to generate the three-dimensional vascular image I12. That is, the display control function 34d causes the ring L1 to be displayed on the blood vessel at the portion of the three-dimensional vascular image I1 where the tip A1 of the medical device D1 is located. Alternatively, the display control function 34d arranges the ring L1 outside or inside the contour of the blood vessel B1 in the identified plane to generate the three-dimensional vascular image I12. That is, the display control function 34d causes the ring L1 to be displayed around the portion of the three-dimensional vascular image I1 where the tip A1 of the medical device D1 is located.

[0073] As another example, the display control function 34d approximates a portion of a predetermined length from the tip A1 of the medical device D1 as a straight line, and specifies a plane that is orthogonal to the approximated straight line and passes through the tip A1. Then, the display control function 34d arranges the ring L1 so as to overlap the contour of the blood vessel B1 in the specified plane, and generates a three-dimensional blood vessel image I12. Alternatively, the display control function 34d arranges the ring L1 outside or inside the contour of the blood vessel B1 in the specified plane to generate a three-dimensional blood vessel image I12. That is, the display control function 34d acquires the angular information of the medical device D1 in the three-dimensional space in addition to the position information of the medical device D1 in the three-dimensional space, and arranges the ring L1 based on the position information and the angular information of the medical device D1.

[0074] Next, as shown in FIG. 5, the display control function 34d performs a rendering process on the three-dimensional blood vessel image I12 to generate a rendering image I13. Here, the three-dimensional blood vessel image I12 is an image in which the blood vessel B1 is imaged and the ring L1 is arranged. Therefore, the blood vessel B1 and the ring L1 are drawn in the rendering image I13 based on the three-dimensional blood vessel image I12. Then, the display control function 34d causes the display 32 to display a superimposed image I32 obtained by superimposing the rendering image I13 and the X-ray image I23.

[0075] Here, while the procedure is being executed, the collection function 110b repeatedly collects the X-ray image I21 and the X-ray image I24 in FIG. 5. That is, the collection function 110b collects a plurality of time-series X-ray images I21 and X-ray images I24. Further, the image acquisition function 34b sequentially generates the X-ray image I23 and the X-ray image I26 each time the X-ray image I21 and the X-ray image I24 are collected. Further, each time the X-ray image I23 and the X-ray image I26 are generated, the device information acquisition function 34c acquires the position information of the medical device D1 in the three-dimensional space.

[0076] In addition, each time the X-ray image I23 and the X-ray image I26 are generated, the display control function 34d determines the display mode of the three-dimensional blood vessel image I1 based on the position information acquired by the device information acquisition function 34c. For example, each time the X-ray image I23 and the X-ray image I26 are generated, the display control function 34d generates a three-dimensional blood vessel image I12 in which the ring L1 is arranged based on the position information acquired by the device information acquisition function 34c, generates a rendering image I13 based on the three-dimensional blood vessel image I12, generates a superimposed image I32 by superimposing the rendering image I13 and the X-ray image I23, and displays it on the display 32. Then, the user can perform the procedure while checking the current position of the medical device D1 with respect to the blood vessel B1 by referring to the superimposed image I32.

[0077] Here, the superimposed image I32 is an image that displays the ring L1 in addition to the blood vessel B1 and the medical device D1. Hereinafter, a display example of the superimposed image I32 will be described with reference to FIGS. 6A and 6B. FIGS. 6A and 6B are diagrams showing a display example according to the first embodiment. Note that FIG. 6B is a diagram in which the shape of the blood vessel B1 is simplified with respect to FIG. 6A. In FIGS. 6A and 6B, as an example of the ring L1, a ring L11 is shown.

[0078] By referring to the ring L11 shown in FIGS. 6A and 6B, the user can easily grasp the position of the medical device D1. In particular, as shown in FIG. 6B, even when a plurality of blood vessels overlap and are displayed on the superimposed image I32, the user can easily grasp in which blood vessel the medical device D1 is located by referring to the ring L11. Specifically, in the case shown in FIG. 6B, since the ring L11 is arranged with respect to the blood vessel on the back side, the user can easily grasp that the medical device D1 is located in the blood vessel on the back side.

[0079] Also, by referring to the ring L11 shown in FIGS. 6A and 6B, the user can also grasp the angle of the medical device D1. For example, in the case of FIG. 6A, since the ring L11 and the medical device D1 do not intersect, the user can intuitively understand that the medical device D1 is facing the back side. In particular, when the ring L1 is arranged based on the position information and angle information of the medical device D1, the display control function 34d can change and display the angle of the ring L11 according to the angle information, so that the user can grasp the angle of the medical device D1 more accurately.

[0080] Furthermore, by referring to the ring L1, the user can also grasp the movement of the medical device D1 in the depth direction. That is, when the medical device D1 is operated to move the tip position, although the movement in the vertical and horizontal directions is relatively easy to grasp, the movement in the depth direction is often difficult to grasp. In contrast, the medical image processing apparatus 30 enables the user to easily grasp the movement in the depth direction by displaying the ring L1. Hereinafter, a display example of the superimposed image I32 will be described with reference to FIGS. 7A and 7B. FIGS. 7A and 7B are diagrams showing a display example according to the first embodiment. Note that FIG. 7B is a diagram in which the shape of the blood vessel B1 is simplified with respect to FIG. 7A.

[0081] Figures 7A and 7B show the case where the user performs an operation of inserting the medical device D1 deeper, and the tip position of the medical device D1 moves from the tip A12 to the tip A13. Here, the display control function 34d displays the ring L12 when the tip position of the medical device D1 is the tip A12, and displays the ring L13 when the tip position of the medical device D1 is the tip A13. In FIG. 7A, the medical device D1 and the ring L12 when the tip position is the tip A12 are shown by solid lines, and the medical device D1 and the ring L13 when the tip position is the tip A13 are shown by broken lines. Also, in FIG. 7A, the rings L12 and L13 are shown on one image, but these are displayed sequentially. That is, the display control function 34d displays the ring L13 instead of the ring L12 after displaying the ring L12.

[0082] As shown in FIGS. 7A and 7B, by displaying the rings L12 and L13, the user can grasp whether the medical device D1 is facing the front side or the back side. For example, in the case of FIG. 7A, since the ring L12 is displayed so as to intersect the medical device D1, the user can intuitively understand that the medical device D1 is facing the front side. Further, when the tip position of the medical device D1 moves from the tip A12 to the tip A13 and the ring L13 is displayed, since the medical device D1 facing the front side moves in the tip direction, the user can intuitively understand that the medical device D1 has moved to the front side.

[0083] As shown in FIGS. 7A and 7B, there is a case where the ring L1 and the medical device D1 intersect. Here, the display control function 34d may display the ring L1 in front of the medical device D1, or may display the medical device D1 in front of the ring L1. When the ring L1 is displayed in front, since the positional relationship between the ring L1 and the medical device D1 can be intuitively understood, the user can more easily grasp the position of the medical device D1. On the other hand, when the medical device D1 is displayed in front, since the medical device D1 is not hidden by the ring L1, the user can visually recognize the overall shape of the medical device D1. The display control function 34d may accept a selection from the user as to which of the ring L1 and the medical device D1 is to be displayed in front. Also, during the procedure, the display control function 34d may appropriately switch which of the ring L1 and the medical device D1 is to be displayed in front according to a request from the user.

[0084] Also, in FIGS. 6A and 7A, the back side portion of the ring L1 (the portion that becomes the shadow of the blood vessel B1) is not shown, but as shown in FIGS. 6B and 7B, the back side portion of the ring L1 may also be displayed. For example, the display control function 34d displays the back side portion of the ring L1 in a color or transparency different from that of the front side portion. For example, the display control function 34d displays the back side portion of the ring L1 in a lighter color or higher transparency than the front side portion.

[0085] When moving the medical device D1 during the procedure, from the viewpoint of avoiding damage to the blood vessel B1, it is preferable that the tip A1 of the medical device D1 is located at the center of the blood vessel B1. Therefore, the display control function 34d may change the display according to whether the tip A1 of the medical device D1 is located at the center of the blood vessel B1 or near the wall surface of the blood vessel B1.

[0086] For example, as shown in FIG. 5, the device information acquisition function 34c acquires the tip A1 of the medical device D1 as the position information of the medical device D1 in the three-dimensional space based on the three-dimensional X-ray image I27. Further, the display control function 34d arranges the ring L1 with respect to the three-dimensional blood vessel image I1 based on the position information acquired by the device information acquisition function 34c, and calculates the distance from the tip A1 of the medical device D1 to the blood vessel wall surface. For example, the display control function 34d calculates the distance to the blood vessel wall surface along each of a plurality of straight lines passing through the tip A1, and identifies the direction in which the distance to the blood vessel wall surface is the shortest. Further, the display control function 34d identifies the distance to the blood vessel wall surface in the identified direction as the distance from the tip A1 of the medical device D1 to the blood vessel wall surface.

[0087] Then, the display control function 34d changes and displays the color of the ring L1 according to the distance from the tip A1 of the medical device D1 to the blood vessel wall surface. For example, when the distance from the tip A1 of the medical device D1 to the blood vessel wall surface is large, as shown in the left diagram of FIG. 8, it can be said that the tip A1 of the medical device D1 is located substantially at the center of the blood vessel B1. On the other hand, when the distance from the tip A1 of the medical device D1 to the blood vessel wall surface is small, as shown in the middle diagram of FIG. 8, it can be said that the tip A1 of the medical device D1 is located near the wall surface of the blood vessel B1. Therefore, the display control function 34d changes and displays the color of the ring L1 according to the distance from the tip A1 of the medical device D1 to the blood vessel wall surface, as shown in the left and middle diagrams of FIG. 8. Note that FIG. 8 is a diagram showing a display example according to the first embodiment.

[0088] In the left and middle diagrams of FIG. 8, the color of the entire ring L1 was described as changing. However, the display control function 34d may locally change the color of the ring L1. For example, as shown in the right diagram of FIG. 8, the display control function 34d changes and displays the color of each position of the ring L1 according to the distance from the tip A1 of the medical device D1 to the blood vessel wall surface. Thereby, the user can understand in which direction the medical device D1 should be moved to widen the distance between the medical device D1 and the blood vessel wall surface. Although the right diagram of FIG. 8 shows the case of displaying in three colors, the display control function 34d may display in two colors or may display in multi-gradations of four or more colors. Also, although the case where the distance from the tip A1 to the blood vessel wall surface is represented by color has been described, the embodiment is not limited to this. For example, the display control function 34d may represent the distance from the tip A1 to the blood vessel wall surface by changing the thickness, size, shape, etc. of the ring L1.

[0089] Also, heretofore, in the description of the display mode of the three-dimensional blood vessel image I1, the case where there is one device has been described. However, in an actual procedure, there may be a plurality of devices simultaneously. In such a case, the display control function 34d may simultaneously display a plurality of rings according to the number of devices. Alternatively, the display control function 34d may automatically narrow down the devices for which the ring is to be displayed to only the device of interest during operation even when there are a plurality of devices. Alternatively, the display control function 34d may allow the user to arbitrarily select the device for which the ring is to be displayed.

[0090] Also, although the arrangement and color of the ring L1 have been described as the display mode of the three-dimensional blood vessel image I1 so far, the embodiment is not limited to this. For example, the display control function 34d may color and display a figure with a shape other than a ring on the blood vessels in the portion of the three-dimensional blood vessel image I1 where the tip A1 of the medical device D1 is located, based on the position information of the medical device D1 in the three-dimensional space. Further, for example, the display control function 34d may change the color of the voxels corresponding to the blood vessels in the portion of the three-dimensional blood vessel image I1 where the tip A1 of the medical device D1 is located, based on the position information of the medical device D1 in the three-dimensional space. That is, the display control function 34d may color and display the blood vessels in the portion where the tip of the medical device D1 is located, either with or without using the ring L1.

[0091] Alternatively, the display control function 34d may color and display a figure with a shape other than a ring around the portion of the three-dimensional blood vessel image I1 where the tip A1 of the medical device D1 is located, based on the position information of the medical device D1 in the three-dimensional space. Further, for example, the display control function 34d may change the color of the voxels around the portion of the three-dimensional blood vessel image I1 where the tip A1 of the medical device D1 is located, based on the position information of the medical device D1 in the three-dimensional space. That is, the display control function 34d may color and display around the portion where the tip of the medical device D1 is located, either with or without using the ring L1.

[0092] Further, for example, the display control function 34d may change the transparency between the blood vessel in which the medical device D1 is located and other blood vessels based on the position information of the medical device D1 in the three-dimensional space of the three-dimensional blood vessel image I1. For example, in the case shown in FIG. 6B, the display control function 34d may increase the transparency of the front blood vessel and decrease the transparency of the back blood vessel in which the medical device D1 is located for display. For example, in the case shown in FIG. 6B, the display control function 34d may not display the front blood vessel. Thereby, the user can more easily grasp in which blood vessel the medical device D1 is located.

[0093] For example, the display control function 34d changes the transparency between the blood vessel in which the medical device D1 is located and other blood vessels, and color-codes and displays the blood vessel at the portion where the tip of the medical device D1 is located or the periphery of the portion where the tip of the medical device D1 is located. Alternatively, the display control function 34d changes the transparency between the blood vessel in which the medical device D1 is located and other blood vessels without color-coding and displaying the blood vessel at the portion where the tip of the medical device D1 is located or the periphery of the portion where the tip of the medical device D1 is located.

[0094] Next, an example of the processing procedure by the medical image processing apparatus 30 will be described with reference to FIG. 9. FIG. 9 is a flowchart for explaining a series of processes of the medical image processing apparatus 30 according to the first embodiment. Steps S101, S102, and S106 correspond to the image acquisition function 34b. Step S103 corresponds to the device information acquisition function 34c. Steps S104 and S105 correspond to the display control function 34d.

[0095] First, the processing circuit 34 acquires a three-dimensional blood vessel image I1 (step S101). Next, the processing circuit 34 acquires X-ray images in two directions (step S102). For example, the processing circuit 34 acquires the X-ray image I21 and the X-ray image I24 shown in FIG. 5. Next, the processing circuit 34 acquires the position information of the medical device D1 (step S103). For example, the processing circuit 34 acquires the position information of the medical device D1 based on the three-dimensional X-ray image I27 shown in FIG. 5.

[0096] Next, the processing circuit 34 determines the display mode of the three-dimensional blood vessel image I1 based on the position information of the medical device D1 (step S104). For example, the processing circuit 34 causes a colored ring L1 to be displayed around the blood vessel at the portion where the tip A1 of the medical device D1 is located or around the portion where the tip A1 is located in the three-dimensional blood vessel image I1 based on the position information of the medical device D1.

[0097] Next, the processing circuit 34 superimposes and displays the two-dimensional X-ray image collected from the subject P and the three-dimensional blood vessel image I1 in the determined display mode (step S105). For example, as shown in FIG. 5, the processing circuit 34 superimposes and displays the X-ray image I23, which is a DSA image on the F side, and the rendering image I13 generated based on the three-dimensional blood vessel image I1.

[0098] Here, the processing circuit 34 determines whether there is a next image (step S106). If there is a next image, the process returns to step S102 to acquire X-ray images in two directions again (affirmative in step S106). On the other hand, if there is no next image (negative in step S106), the processing circuit 34 ends the process.

[0099] As described above, according to the first embodiment, the image acquisition function 34b acquires a two-dimensional X-ray image collected from the subject P into whom the medical device D1 has been inserted into the blood vessel, and a three-dimensional blood vessel image I1 including the blood vessels of the subject P. Further, the device information acquisition function 34c acquires the position information of the medical device D1 in the three-dimensional space. Further, the display control function 34d determines the display mode of the three-dimensional blood vessel image I1 based on the position information of the medical device D1, and superimposes and displays the three-dimensional blood vessel image I1 and the two-dimensional X-ray image in the determined display mode. Therefore, the medical image processing apparatus 30 according to the first embodiment can easily grasp the position of the medical device D1 inserted into the blood vessel.

[0100] Also, as described above, according to the first embodiment, the image acquisition function 34b acquires a plurality of two-dimensional X-ray images in time series. Further, the device information acquisition function 34c acquires the position information of the medical device D1 in the three-dimensional space for each of the plurality of two-dimensional X-ray images in time series. Further, the display control function 34d determines the display mode for each of the plurality of two-dimensional X-ray images in time series. Further, the display control function 34d sequentially displays the plurality of two-dimensional X-ray images in time series, and superimposes and displays the three-dimensional blood vessel image I1 and the two-dimensional X-ray image in the determined display mode for each of the two-dimensional X-ray images. Therefore, the medical image processing apparatus 30 according to the first embodiment can easily grasp the current position of the medical device D1 inserted into the blood vessel. Further, the medical image processing apparatus 30 can easily grasp whether the medical device D1 operated by the user has moved deeper or closer to the user.

[0101] In addition, in FIG. 5, the display of the superimposed image I32 has been described, but the display control function 34d may further display various images. For example, the display control function 34d may display the X-ray image I26, which is the DSA image on the L side, on the display 32 in addition to the superimposed image I32. Similarly, the display control function 34d may further display images such as the X-ray image I21, the X-ray image I23, and the X-ray image I24.

[0102] Here, when displaying the superimposed image I32 as shown in FIG. 5, the degree of attention to the X-ray image on the L side is often lower than that on the F side. That is, although the X-ray images on the L side such as the X-ray image I24 and the X-ray image I26 are used when acquiring the position information of the medical device D1 in the three-dimensional space, they often do not become the objects that the user pays attention to. Therefore, the medical image processing apparatus 30 may perform control so as to reduce the exposure amount related to the collection of the X-ray images on the L side.

[0103] For example, based on the position information of the medical device D1 in the three-dimensional space acquired by the device information acquisition function 34c, the transmission function 34e transmits the X-ray irradiation conditions on the L side to the X-ray diagnostic apparatus 10. For example, the transmission function 34e sets the aperture of the collimator in the second X-ray shutter 103b so as to minimize the X-ray irradiation range on the condition that the medical device D1 is included in the X-ray irradiation range. Then, the transmission function 34e transmits the set aperture to the X-ray diagnostic apparatus 10. Also, for example, the transmission function 34e sets the tube current value in the second X-ray tube 102b so as to minimize the X-ray dose on the condition that the medical device D1 can be identified on the X-ray image. Further, the transmission function 34e may set the tube current conduction time (pulse width) in the second X-ray tube 102b. That is, since the X-ray dose per unit time can be controlled by PWM (Pulse Width Modulation) control, the transmission function 34e may set the tube current conduction time in the second X-ray tube 102b so as to minimize the X-ray dose on the condition that the medical device D1 can be identified on the X-ray image. Then, the transmission function 34e transmits the set tube current value and the tube current conduction time to the X-ray diagnostic apparatus 10.

[0104] Also, in FIG. 5, the case of displaying the superimposed image I32 obtained by superimposing the three-dimensional vascular image I1 and the X-ray image I23 which is the DSA image on the F side was described, but the embodiment is not limited thereto. For example, the display control function 34d may display a superimposed image of the three-dimensional vascular image I1 and the X-ray image I26 which is the DSA image on the L side instead of the X-ray image I23. In this case, the transmitter function 34e may transmit the X-ray irradiation conditions on the F side to the X-ray diagnostic apparatus 10 based on the position information of the medical device D1 in the three-dimensional space acquired by the device information acquisition function 34c. Alternatively, the display control function 34d may display both the superimposed image I32 of the three-dimensional vascular image I1 and the X-ray image I23 and the superimposed image of the three-dimensional vascular image I1 and the X-ray image I26.

[0105] Also, in FIG. 5, the case of superimposing and displaying the three-dimensional vascular image I1 and the DSA image was described, but the embodiment is not limited thereto. For example, the display control function 34d may superimpose and display the three-dimensional vascular image I1 and the X-ray image I21 or the X-ray image I24. In this case, in addition to the medical device D1, the blood vessel B1, and the ring L1, background components such as bones and soft tissues are also depicted in the superimposed image displayed on the display 32. Also, in this case, it may be unnecessary to collect the X-ray images I22 and I25 which are the mask images.

[0106] (Second Embodiment) Now, although the first embodiment has been described so far, it may be implemented in various different forms other than the above-described embodiment.

[0107] For example, in the above-described embodiment, the case of acquiring the position information of the medical device D1 in the three-dimensional space based on the X-ray images in two directions collected using the biplane X-ray diagnostic apparatus 10 has been described. However, the embodiment is not limited thereto. For example, the device information acquisition function 34c may acquire the position information of the medical device D1 in the three-dimensional space using a position sensor provided in the medical device D1. Further, the device information acquisition function 34c may acquire the device tip position from outside the blood vessel (including outside the body) using various sensors including a magnetic sensor.

[0108] Also, in the above-described embodiment, the case of determining the display mode of the three-dimensional blood vessel image I1 based on the position information of the medical device D1 in the three-dimensional space has been described. However, the embodiment is not limited thereto. For example, the display control function 34d may determine the display mode of the two-dimensional X-ray image based on the position information of the medical device D1 in the three-dimensional space. Hereinafter, this point will be described with reference to FIG. 10. FIG. 10 is a diagram showing an example of the process according to the second embodiment.

[0109] For example, the acquisition function 110b in the X-ray diagnostic apparatus 10 acquires the X-ray images I22 and I25 which are mask images. Further, the acquisition function 110b acquires the X-ray images I21' and I24' at the timing when the contrast agent is injected from the subject P with the medical device D1 inserted into the blood vessel. The X-ray image I21' is an X-ray image on the F side collected in a state where the medical device D1 is inserted into the blood vessel of the subject P in the same manner as the X-ray image I21, and is different in that the blood vessel B1 is further depicted. Also, the X-ray image I24' is an X-ray image on the L side collected in a state where the medical device D1 is inserted into the blood vessel of the subject P in the same manner as the X-ray image I24, and is different in that the blood vessel B1 is further depicted. Further, the image acquisition function 34b acquires the X-ray images I21', I22, I24', and I25 via the network NW.

[0110] Next, the image acquisition function 34b generates an X-ray image I23' by differentiating the X-ray image I21' and the X-ray image I22. Further, the image acquisition function 34b generates an X-ray image I26' by differentiating the X-ray image I24' and the X-ray image I25. The X-ray image I23' and the X-ray image I26' are DSA images, and background components other than the medical device D1 and the blood vessel B1 are removed.

[0111] Next, as shown in FIG. 5, the device information acquisition function 34c generates a three-dimensional X-ray image I27' based on the X-ray image I23' and the X-ray image I26'. For example, the device information acquisition function 34c generates the three-dimensional X-ray image I27' by specifying the positions of the medical device D1 and the blood vessel B1 that appear in each of the X-ray image I23' and the X-ray image I26' in a three-dimensional space based on an epipolar line.

[0112] Next, the device information acquisition function 34c acquires position information of the medical device D1 in a three-dimensional space based on the three-dimensional X-ray image I27'. For example, the device information acquisition function 34c acquires the tip A1 of the medical device D1 as position information of the medical device D1 in a three-dimensional space based on the three-dimensional X-ray image I27'.

[0113] Next, the display control function 34d determines a display mode of a two-dimensional X-ray image based on the position information of the medical device D1 in a three-dimensional space. In FIG. 10, as an example, the case of determining the display mode of the X-ray image I23' will be described. For example, the display control function 34d adds information regarding the position of the medical device D1 in the depth direction to the X-ray image I23' based on the position information of the medical device D1 in a three-dimensional space.

[0114] For example, the display control function 34d first identifies a blood vessel at a portion where the tip A1 of the medical device D1 is located in the X-ray image I23'. Since the three-dimensional X-ray image I27' is generated based on the X-ray image I23', when the position of the tip A1 is identified based on the three-dimensional X-ray image I27', the position of the tip A1 in the X-ray image I23' is already known.

[0115] Also, when a plurality of blood vessels overlap in the X-ray image I23', the display control function 34d can identify the blood vessel in the portion where the tip A1 of the medical device D1 is located based on, for example, the shape information of blood vessel B. Hereinafter, this point will be described for the case where blood vessel B11 and blood vessel B12 overlap in the X-ray image I23'.

[0116] For example, the display control function 34d first acquires the shape information of the blood vessel where the medical device D1 is located from the three-dimensional X-ray image I27'. For example, the display control function 34d replaces other blood vessels except the blood vessel where the medical device D1 is located in the three-dimensional X-ray image I27' with the background color, and performs volume rendering processing on the replaced three-dimensional X-ray image I27' to generate a volume rendering image. Another example is that the display control function 34d generates a MPR (Multi Planar Reconstruction) image including the blood vessel where the medical device D1 is located from the three-dimensional X-ray image I27'. Then, the display control function 34d acquires the shape information of the blood vessel where the medical device D1 is located based on rendering images such as the volume rendering image and the MPR image. For example, the display control function 34d acquires information such as the shape of the center line of the blood vessel on the rendering image and the thickness of the blood vessel at each position on the center line as the shape information of the blood vessel.

[0117] Next, the display control function 34d identifies in which of the blood vessels B11 and B12 in the X-ray image I23' the medical device D1 is located based on the shape information of the blood vessel acquired from the three-dimensional X-ray image I27'. For example, the display control function 34d calculates the shape information such as the shape of the center line of the blood vessel and the thickness of the blood vessel at each position on the center line for each of the blood vessels B11 and B12, and compares it with the shape information of the blood vessel acquired from the three-dimensional X-ray image I27' to identify in which of the blood vessels B11 and B12 the medical device D1 is located.

[0118] Then, the display control function 34d adds information regarding the position in the depth direction of the medical device to the blood vessels in the portion of the X-ray image I23' where the tip A1 of the medical device D1 is located. For example, as shown in FIG. 10, the display control function 34d causes the display 108 to display an X-ray image I33 in which a ring L2 is added to the blood vessels in the portion of the X-ray image I23' where the tip A1 of the medical device D1 is located. In the X-ray image I23', if it is specified that the blood vessel B11 and the blood vessel B12 overlap and the medical device D1 is located within the blood vessel B11, the display control function 34d adds the ring L2 only to the blood vessel B11.

[0119] Note that if it is possible to distinguish from the blood vessel B1, the color of the ring L2 is not particularly limited. For example, the display control function 34d may color and display the ring L2 in a predetermined color.

[0120] Another example is that the display control function 34d may obtain the position in the depth direction of the X-ray image I33 with respect to the tip A1 of the medical device D1, and change the color of the ring L2 according to the obtained position in the depth direction. For example, the display control function 34d sets the ring L2 as a mixed color of blue and red, and increases the ratio of blue as the tip A1 of the medical device D1 is located deeper, and increases the ratio of red as the tip A1 is located closer to the front. The display control function 34d can obtain the position in the depth direction of the X-ray image I33 of the tip A1 of the medical device D1 based on, for example, the three-dimensional X-ray image I27'. Thereby, the user can grasp the position in the depth direction of the medical device D1, and can also grasp whether the medical device D1 is moving deeper or closer to the front when the medical device D1 is operated.

[0121] Regarding the ring L2, various colorings similar to those of the ring L1 described above can be performed. For example, the display control function 34d may calculate the distance from the tip A1 of the medical device D1 to the blood vessel wall surface, and change the color of the ring L2 according to the calculated distance. Further, the display control function 34d may change and display the angle of the ring L2 based on the angle information of the medical device D1 in the three-dimensional space.

[0122] In FIG. 10, the ring L2 is shown as an example of information regarding the position of the medical device D1 in the depth direction, but the embodiment is not limited thereto. For example, the display control function 110c may display a figure having a shape other than a ring instead of the ring L2. Further, instead of displaying a figure such as a ring, the display control function 110c may change the values of some pixels in the X-ray image I23'.

[0123] In FIG. 10, the X-ray image I33 in which information regarding the position of the medical device D1 in the depth direction is added to the X-ray image I23' has been described, but the embodiment is not limited thereto. For example, the display control function 110c may display an X-ray image in which information regarding the position of the medical device D1 in the depth direction is added to the X-ray image I26'. Alternatively, the display control function 110c may display both the X-ray image I33 in which information regarding the position of the medical device D1 in the depth direction is added to the X-ray image I23' and the X-ray image in which information regarding the position of the medical device D1 in the depth direction is added to the X-ray image I26'.

[0124] In the above-described embodiment, the medical image processing apparatus 30 has been described as displaying various X-ray images. However, the embodiment is not limited to this. For example, the display of X-ray images may be performed by the X-ray diagnostic apparatus 10. For example, the transmitter function 110d in the medical image processing apparatus 30 transmits the superimposed image I32 shown in FIG. 5 and the X-ray image I33 shown in FIG. 10 to the X-ray diagnostic apparatus 10. Then, the display control function 110c in the X-ray diagnostic apparatus 10 causes the X-ray images such as the superimposed image I32 and the X-ray image I33 to be displayed on the display 108.

[0125] Alternatively, the generation process of the superimposed image I32, the X-ray image I33, etc. may be performed by the X-ray diagnostic apparatus 10. Hereinafter, this point will be described with reference to FIG. 11. FIG. 11 is a block diagram showing an example of the configuration of the X-ray diagnostic apparatus 10 according to the second embodiment. The X-ray diagnostic apparatus 10 shown in FIG. 11 has the same configuration as the X-ray diagnostic apparatus 10 shown in FIG. 2, and is different in that the processing circuit 110 further executes an image acquisition function 110e and a device information acquisition function 110f. The image acquisition function 110e has the same function as the image acquisition function 34b. Also, the device information acquisition function 110f has the same function as the device information acquisition function 34c. Further, the display control function 110c shown in FIG. 11 executes the same processing as the display control function 34d. Note that the image acquisition function 110e is an example of an image acquisition unit. Also, the device information acquisition function 110f is an example of a device information acquisition unit.

[0126] For example, first, the image acquisition function 110e acquires the three-dimensional vascular image I1 shown in FIG. 5. For example, the image acquisition function 110e acquires, as the three-dimensional vascular image I1, a three-dimensional X-ray image collected by an X-ray diagnostic apparatus different from the X-ray diagnostic apparatus 10, a CT image, an MR image, etc. via the network NW. Alternatively, the acquisition function 110b executes rotational imaging on the subject P and collects a three-dimensional X-ray image as the three-dimensional vascular image I1.

[0127] Next, the collection function 110b collects the X-ray images I22 and I25 shown in FIG. 5. Further, the collection function 110b collects the X-ray images I21 and I24. Also, the image acquisition function 110e generates an X-ray image I23 based on the X-ray images I21 and I22, and an X-ray image I26 based on the X-ray images I24 and I25. Further, the device information acquisition function 110f generates a three-dimensional X-ray image I27 based on the X-ray images I23 and I26, and acquires the position information of the medical device D1 in the three-dimensional space based on the three-dimensional X-ray image I27.

[0128] Next, the display control function 110c determines the display mode of the three-dimensional blood vessel image I1 based on the position information of the medical device D1 in the three-dimensional space. For example, as shown in FIG. 5, the display control function 110c generates a three-dimensional blood vessel image I12 with a ring L1 added to the blood vessels in the portion of the three-dimensional blood vessel image I1 where the tip A1 of the medical device D1 is located, and generates a rendering image I13 based on the three-dimensional blood vessel image I12. Then, the display control function 110c causes the display 108 to display a superimposed image I32 obtained by superimposing the rendering image I13 and the X-ray image I23.

[0129] As another example, the collection function 110b collects the X-ray images I22 and I25 shown in FIG. 10. Further, the collection function 110b collects the X-ray images I21' and I24'. Also, the image acquisition function 110e generates an X-ray image I23' based on the X-ray images I21' and I22, and an X-ray image I26' based on the X-ray images I24' and I25. Further, the device information acquisition function 110f generates a three-dimensional X-ray image I27' based on the X-ray images I23' and I26', and acquires the position information of the medical device D1 in the three-dimensional space based on the three-dimensional X-ray image I27'.

[0130] Next, based on the position information of the medical device D1 in the three-dimensional space, the display control function 110c adds information regarding the position in the depth direction of the medical device D1 to the two-dimensional X-ray image. For example, as shown in FIG. 10, the display control function 110c generates an X-ray image I33 in which a ring L2 colored the blood vessel at the portion where the tip A1 of the medical device D1 is located in the X-ray image I23' is added. Then, the display control function 110c causes the X-ray image I33 to be displayed on the display 108.

[0131] Also, in the above-described embodiment, the X-ray diagnostic apparatus 10 has been described as a biplane X-ray diagnostic apparatus, but the embodiment is not limited thereto. For example, when the X-ray diagnostic apparatus 10 is a single-plane X-ray diagnostic apparatus, the X-ray image I21 and the X-ray image I24 shown in FIG. 5 cannot be collected substantially simultaneously, and thus the three-dimensional X-ray image I27 cannot be generated. In such a case, the device information acquisition function 34c or the device information acquisition function 110f can acquire the position information of the medical device D1 in the three-dimensional space by using, for example, a position sensor provided in the medical device D1. Further, the device information acquisition function 34c or the device information acquisition function 110f can also acquire the position information of the medical device D1 in the three-dimensional space from outside the blood vessel (including outside the body) by a sensor such as a magnetic sensor.

[0132] The term "processor" used in the above description means, for example, a circuit such as a CPU (Central Processing Unit), a GPU (Graphics Processing Unit), an application specific integrated circuit (ASIC), or a programmable logic device (for example, a simple programmable logic device (SPLD), a complex programmable logic device (CPLD), and a field programmable gate array (FPGA)). When the processor is, for example, a CPU, the processor realizes its functions by reading and executing a program stored in a storage circuit. On the other hand, when the processor is, for example, an ASIC, instead of storing a program in a storage circuit, the function is directly incorporated as a logic circuit in the circuit of the processor. Note that each processor of the embodiments is not limited to being configured as a single circuit for each processor, and a plurality of independent circuits may be combined and configured as one processor to realize its functions. Further, a plurality of components in each figure may be integrated into one processor to realize its functions.

[0133] Each component of each device according to the above-described embodiments is conceptually functional and does not necessarily have to be physically configured as shown in the drawings. That is, the specific form of the distribution and integration of each device is not limited to that shown in the drawings, and all or part of them can be functionally or physically distributed and integrated in any unit according to various loads, usage situations, and the like. Further, each processing function performed by each device can be realized in whole or in any part by a CPU and a program analyzed and executed by the CPU, or can be realized as hardware by wired logic.

[0134] In addition, the medical image processing method described in the above-described embodiments can be realized by executing a pre-prepared medical image processing program on a computer such as a personal computer or a workstation. This medical image processing program can be distributed via a network such as the Internet. Further, this medical image processing program can be recorded on a non-transitory recording medium readable by a computer, such as a hard disk, a flexible disk (FD), a CD-ROM, an MO, or a DVD, and can also be executed by being read from the recording medium by the computer.

[0135] According to at least one of the embodiments described above, it is possible to facilitate grasping the position of a medical device inserted into a blood vessel.

[0136] Although several embodiments have been described, these embodiments are presented by way of example and are not intended to limit the scope of the invention. These embodiments can be implemented in various other forms, and various omissions, replacements, changes, and combinations of embodiments can be made without departing from the gist of the invention. These embodiments and their modifications are included in the scope and gist of the invention, and are also included in the invention described in the claims and its equivalent scope.

Explanation of Reference Numerals

[0137] 1 Medical image processing system 10 X-ray diagnostic apparatus 110 Processing circuit 110a Control function 110b Collection function 110c Display control function 110d Transmission function 110e Image acquisition function 110f Device information acquisition function 20 Image storage device 30 Medical image processing apparatus 34 Processing circuit 34a Control function 34b Image acquisition function 34c Device information acquisition function 34d Display control function 34e Transmission function

Claims

1. An image acquisition unit that acquires a first two-dimensional X-ray image collected from a subject with a medical device inserted into a blood vessel, a second two-dimensional X-ray image collected before the medical device is inserted into the blood vessel of the subject, and a three-dimensional blood vessel image including the blood vessel of the subject, and performs differential processing on the first two-dimensional X-ray image and the second two-dimensional X-ray image to generate a third two-dimensional X-ray image; A device information acquisition unit that acquires position information of the medical device in a three-dimensional space; A display control unit that determines a display mode of the three-dimensional blood vessel image based on the position information, and superimposes and displays the three-dimensional blood vessel image and the third two-dimensional X-ray image in the determined display mode; Comprising; The display control unit is a medical image processing apparatus that displays a colored ring around the blood vessel at the tip of the medical device in the three-dimensional blood vessel image or around the tip of the medical device in the three-dimensional blood vessel image based on the position information.

2. An image acquisition unit that acquires a first two-dimensional X-ray image collected from a subject with a medical device such as a catheter or a guide wire inserted into a blood vessel, a second two-dimensional X-ray image collected before the medical device is inserted into the blood vessel of the subject, and a three-dimensional blood vessel image including the blood vessel of the subject, and performs differential processing on the first two-dimensional X-ray image and the second two-dimensional X-ray image to generate a third two-dimensional X-ray image; A device information acquisition unit that acquires position information of the tip of the medical device in a three-dimensional space; A display control unit that determines a display mode of the three-dimensional blood vessel image based on the position information, and superimposes and displays the three-dimensional blood vessel image and the third two-dimensional X-ray image in the determined display mode; Comprising; The display control unit is a medical image processing apparatus that changes the color of pixels corresponding to the blood vessel at the tip of the medical device in the three-dimensional blood vessel image or the color of pixels in the three-dimensional blood vessel image around the tip of the medical device based on the position information.

3. The medical image processing apparatus according to claim 1 or 2, wherein the device information acquisition unit acquires the position information based on two-directional X-ray images collected using an X-ray diagnostic apparatus of a biplane.

4. Further comprising a transmission unit that transmits data to the X-ray diagnostic apparatus of the biplane. The image acquisition unit generates an X-ray image in a first direction among the X-ray images in the two directions as the third two-dimensional X-ray image. The display control unit determines a display mode of the three-dimensional blood vessel image based on the position information, and in the determined display mode, superimposes and displays the three-dimensional blood vessel image and the X-ray image in the first direction. The transmission unit transmits, to the biplane X-ray diagnostic apparatus, X-ray irradiation conditions used for collecting an X-ray image in a second direction among the X-ray images in the two directions based on the position information. The medical image processing apparatus according to claim 3.

5. The display control unit calculates a distance from the tip of the medical device to the blood vessel wall surface based on the position information, and changes and displays the color of the ring according to the distance. The medical image processing apparatus according to claim 1.

6. The device information acquisition unit further acquires angular information of the medical device in a three-dimensional space. The display control unit changes and displays the angle of the ring according to the angular information. The medical image processing apparatus according to claim 1 or 5.

7. The image acquisition unit generates a plurality of the third two-dimensional X-ray images in time series. The device information acquisition unit acquires the position information for each of the plurality of the third two-dimensional X-ray images in time series. The display control unit sequentially displays the plurality of the third two-dimensional X-ray images acquired by the image acquisition unit, and determines a display mode of the three-dimensional blood vessel image for each of the plurality of the third two-dimensional X-ray images based on the position information, and in the determined display mode, superimposes and displays the three-dimensional blood vessel image on the third two-dimensional X-ray image. The medical image processing apparatus according to any one of claims 1 to 6.

8. A first two-dimensional X-ray image in two directions including a blood vessel of the subject, collected from a subject in which a medical device such as a catheter or a guide wire is inserted into a blood vessel using a biplane X-ray diagnostic apparatus, and a second two-dimensional X-ray image in two directions collected before the medical device is inserted into the blood vessel of the subject are obtained, and an image acquisition unit that performs difference processing between the first two-dimensional X-ray image and the second two-dimensional X-ray image to generate a third two-dimensional X-ray image in two directions, A device information acquisition unit that acquires position information of the tip of the medical device in a three-dimensional space based on the third two-dimensional X-ray image in two directions. Based on the position information, information regarding the position in the depth direction of the medical device is added to at least one of the third two-dimensional X-ray images in the two directions, and a display control unit that displays the two-dimensional X-ray image with the added information is provided, The display control unit displays a colored ring around a blood vessel in a portion where the tip of the medical device is located in at least one of the third two-dimensional X-ray images in the two directions, or around a portion where the tip of the medical device is located in at least one of the third two-dimensional X-ray images in the two directions. A medical image processing apparatus

9. A first two-dimensional X-ray image in two directions including the blood vessels of the subject, collected from a subject in which a medical device that is a catheter or a guide wire is inserted into a blood vessel, using a biplane X-ray diagnostic apparatus, and the medical device in the blood vessels of the subject An image acquisition unit that acquires a second two-dimensional X-ray image in two directions collected before being inserted, and performs a difference process between the first two-dimensional X-ray image and the second two-dimensional X-ray image to generate a third two-dimensional X-ray image in two directions, A device information acquisition unit that acquires position information of the tip of the medical device in a three-dimensional space based on the third two-dimensional X-ray image in the two directions, Based on the position information, information regarding the position in the depth direction of the medical device is added to at least one of the third two-dimensional X-ray images in the two directions, and a display control unit that displays the two-dimensional X-ray image with the added information is provided, The display control unit changes the color of pixels corresponding to blood vessels in a portion where the tip of the medical device is located in at least one of the third two-dimensional X-ray images in the two directions, or the color of pixels in at least one of the third two-dimensional X-ray images in the two directions around a portion where the tip of the medical device is located. A medical image processing apparatus

10. A collection unit that collects a first two-dimensional X-ray image collected from a subject in which a medical device that is a catheter or a guide wire is inserted into a blood vessel, and a second two-dimensional X-ray image collected before the medical device is inserted into the blood vessel of the subject, An image acquisition unit that performs a difference process between the first two-dimensional X-ray image and the second two-dimensional X-ray image to generate a third two-dimensional X-ray image, A device information acquisition unit that acquires position information of the tip of the medical device in a three-dimensional space, A display control unit that determines a display mode of a three-dimensional blood vessel image including the blood vessels of the subject based on the position information, and superimposes and displays the three-dimensional blood vessel image and the third two-dimensional X-ray image in the determined display mode comprising The display control unit is an X-ray diagnostic apparatus that displays a colored ring on a blood vessel in a portion of the three-dimensional blood vessel image where the tip of the medical device is located, or around a portion of the three-dimensional blood vessel image where the tip of the medical device is located, based on the position information.

11. A collection unit that collects a first two-dimensional X-ray image collected from a subject in which a medical device such as a catheter or a guide wire is inserted into a blood vessel, and a second two-dimensional X-ray image collected before the medical device is inserted into the blood vessel of the subject An image acquisition unit that performs differential processing on the first two-dimensional X-ray image and the second two-dimensional X-ray image to generate a third two-dimensional X-ray image A device information acquisition unit that acquires position information of the tip of the medical device in three-dimensional space A display control unit that determines a display mode of a three-dimensional blood vessel image including the blood vessels of the subject based on the position information, and superimposes and displays the three-dimensional blood vessel image and the third two-dimensional X-ray image in the determined display mode comprising The display control unit is an X-ray diagnostic apparatus that changes the color of pixels corresponding to blood vessels in a portion of the three-dimensional blood vessel image where the tip of the medical device is located, or the color of pixels of the three-dimensional blood vessel image around the portion where the tip of the medical device is located, based on the position information.

12. Obtaining a first two-dimensional X-ray image collected from a subject in which a medical device such as a catheter or a guide wire is inserted into a blood vessel, a second two-dimensional X-ray image collected before the medical device is inserted into the blood vessel of the subject, and a three-dimensional blood vessel image including the blood vessels of the subject, performing differential processing on the first two-dimensional X-ray image and the second two-dimensional X-ray image to generate a third two-dimensional X-ray image Obtaining position information of the tip of the medical device in three-dimensional space Determining a display mode of the three-dimensional blood vessel image based on the position information, and superimposing and displaying the three-dimensional blood vessel image and the third two-dimensional X-ray image in the determined display mode A medical image processing program that causes a computer to execute each process In the step of superimposing and displaying the three-dimensional blood vessel image and the third two-dimensional X-ray image, based on the position information, a colored ring is displayed on the blood vessels in the portion of the three-dimensional blood vessel image where the tip of the medical device is located, or around the portion of the three-dimensional blood vessel image where the tip of the medical device is located. A medical image processing program.

13. A first two-dimensional X-ray image collected from a subject in which a medical device, which is a catheter or a guide wire, is inserted into a blood vessel, a second two-dimensional X-ray image collected before the medical device is inserted into the blood vessel of the subject, and a three-dimensional blood vessel image including the blood vessel of the subject are obtained, and differential processing is performed on the first two-dimensional X-ray image and the second two-dimensional X-ray image to generate a third two-dimensional X-ray image. Obtain the position information of the tip of the medical device in three-dimensional space. Determine the display mode of the three-dimensional blood vessel image based on the position information, and superimpose and display the three-dimensional blood vessel image and the third two-dimensional X-ray image in the determined display mode. A medical image processing program that causes a computer to execute each process. In the step of superimposing and displaying the three-dimensional blood vessel image and the third two-dimensional X-ray image, based on the position information, change the color of the pixels corresponding to the blood vessels in the portion of the three-dimensional blood vessel image where the tip of the medical device is located, or the color of the pixels of the three-dimensional blood vessel image around the portion where the tip of the medical device is located. A medical image processing program.

Images