Re-photographing support device, program, and re-photographing support method

Abstract

To accurately determine the deviation of positioning of a joint.SOLUTION: According to a control unit of a console, a re-imaging support device determines first deviation of a predetermined area of a radiation image, determines second deviation of a predetermined area of the radiation image, and outputs re-imaging determination support information for supporting determination on whether or not to capture the radiation image again, on the basis of at least the determination of the first deviation and the determination of the second deviation.SELECTED DRAWING: Figure 6

Description

[Technical Field]

[0001] The present invention provides Re-photographing support device, program, and re-photographing support method Regarding. [Background technology]

[0002] In recent years, optimization of medical radiation exposure and dose management have become particularly important, and there is a demand for reducing the radiation dose when taking images using radiography equipment. In order to avoid unnecessary radiation exposure, it is necessary to find ways to minimize the number of retakes. In radiography, if the patient's posture is not appropriate, a deviation in the patient's positioning occurs during imaging, requiring re-imaging. While there are known techniques for determining whether or not to perform re-imaging by detecting deviations in the patient's positioning, there is a need for a more accurate method for determining deviations in positioning to avoid having to perform re-imaging multiple times.

[0003] As a technique for determining deviation in the positioning of a patient, a technique for determining deviation in the positioning of a joint has been known (see, for example, Patent Document 1). [Prior art documents] [Patent documents]

[0004] [Patent Document 1] Patent Publication No. 2021-097864 Summary of the Invention [Problem to be solved by the invention]

[0005] For example, when imaging the knee in a supine position, the degree of freedom of the joint is low. The positioning on the thigh side is difficult to change and change. For this reason, in the past, deviations in knee positioning were determined by determining deviations in positioning of one area on the lower leg side. Similarly, for example, when imaging the ankle in a supine position, the degree of freedom of the joint is low. The positioning on the lower leg side is difficult to change and change. For this reason, in the past, deviations in ankle positioning were determined by determining deviations in positioning of one area on the toe side.

[0006] On the other hand, because the elbow has a high degree of freedom of movement, positioning deviations at the elbow are likely to occur in both the forearm and upper arm directions. Therefore, even if positioning deviations in only one direction (the forearm or upper arm) are determined by determining positioning deviations in only one region, as in the past, it is not possible to accurately determine positioning deviations at the elbow.

[0007] Furthermore, even in the knee, ankle, and other joints, although the degree of freedom of the joints is low, there is a possibility that deviations in positioning may occur in both directions (for example, the thigh side and the lower leg side for the knee, and the lower leg side and the toe side for the ankle). Therefore, when determining deviations in positioning of joints such as the knee and ankle, determining deviations in positioning in only one direction by determining deviations in positioning in only one region does not allow for highly accurate determination of deviations in positioning.

[0008] An object of the present invention is to determine deviations in joint positioning with high accuracy. [Means for solving the problem]

[0009] In order to solve the above problems, the re-photographing support device of the present invention comprises: Radiography Positioning of joint areas A determination means for determining a deviation; an output unit that outputs re-photographing support information that supports re-photographing of the radiographic image based on at least the determination of the deviation; and The output means can output, as the rephotographing support information, information for changing the position of the part related to the deviation, together with information indicating that rephotographing is necessary.

[0010] Further, the re-photographing support device of the present invention comprises: At least a radiographic image and a Positioning of joint areas Information about the deviation of , a trained model trained as training data, and an acquisition means for acquiring a radiation image; an output means for outputting re-photographing support information for supporting re-photographing of the radiographic image based on the trained model and the radiographic image acquired by the acquisition means; and The output means can output, as the rephotographing support information, information for changing the position of the part related to the deviation, together with information indicating that rephotographing is necessary.

[0011] The program of the present invention also includes: Computer, Radiography Positioning of joint areas A determination means for determining the deviation; an output means for outputting re-photographing support information for supporting re-photographing of the radiographic image based on at least the determination of the deviation; It functions as The output means outputs, as the rephotographing support information, information for changing the position of the part related to the deviation, together with information indicating that rephotographing is necessary.

[0012] Further, the re-photographing support method of the present invention includes: Radiography Positioning of joint areas a determination step of determining a deviation; an output step of outputting re-photographing support information for supporting re-photographing of the radiographic image based on at least the determination of the deviation; Including, The output step outputs information indicating that re-imaging is necessary, as the re-imaging support information, information for changing the position of the part related to the deviation. [Effects of the Invention]

[0015] According to the present invention, deviations in joint positioning can be determined with high accuracy. [Brief explanation of the drawings]

[0016] [Figure 1] 1 is a block diagram illustrating an example of a radiation imaging system according to an embodiment of the present invention. [Figure 2] FIG. 2 is a diagram showing a schematic side view of an elbow joint. [Figure 3] FIG. 2 is a diagram showing a schematic front view of an elbow joint. [Figure 4] FIG. 1A is a diagram showing an example of a radiographic image used as training data for input data, and FIG. 1B is a diagram showing an example of a region map used as training data for output data. [Figure 5] FIG. 2 is a block diagram showing the functional configuration of the console of FIG. 1. [Figure 6] 6 is a flowchart showing the flow of a shooting control process executed by the control unit in FIG. 5. [Figure 7] FIG. 10 is a diagram showing a display example of re-photographing decision support information. [Figure 8] FIG. 10 is a diagram showing a display example of re-photographing support information. DETAILED DESCRIPTION OF THE INVENTION

[0017] Hereinafter, embodiments of the present invention will be described with reference to the drawings, but the technical scope of the present invention is not limited to the following embodiments and illustrated examples.

[0018] <1. Radiography System> First, the schematic configuration of a radiation imaging system (hereinafter referred to as system 100) according to this embodiment will be described. FIG. 1 is a block diagram illustrating a system 100 .

[0019] As shown in FIG. 1, the system 100 includes a radiation image capturing device (hereinafter referred to as a capturing device 1) and a console 2. The system 100 according to this embodiment further includes a radiation generating device (hereinafter referred to as a generating device 3), an image management device 4, and a learning device 5. The devices 1 to 5 are capable of communicating with each other via, for example, a communication network N (such as a local area network (LAN), a wide area network (WAN), or the Internet).

[0020] The system 100 may be installed in an imaging room, or may be configured to be movable (for example, a medical examination cart). Furthermore, the system 100 may be capable of communicating with a Hospital Information System (HIS), a Radiology Information System (RIS), and the like, which are not shown.

[0021] [1-1. Radiation Generator] The generating device 3 includes a generator 31 , an irradiation instruction switch 32 , and a radiation source 33 .

[0022] The generator 31 applies a voltage according to preset imaging conditions to a radiation source 33 (tube) based on the operation of an irradiation instruction switch 32 .

[0023] When a voltage is applied from the generator 31, the radiation source 33 generates radiation R (for example, X-rays) at a dose corresponding to the applied voltage.

[0024] The generating device 3 according to this embodiment is configured to generate radiation R in a manner that corresponds to the form of the radiation image to be generated (a still image, a dynamic image having a plurality of frames). In the case of a still image, radiation R is irradiated only once per depression of the irradiation instruction switch 32. In the case of dynamic images, each time the irradiation instruction switch 32 is pressed, the irradiation of pulsed radiation R is repeated multiple times per predetermined time (for example, 15 times per second), or the irradiation of radiation R is continued for a predetermined time.

[0025] [1-2. Radiation imaging device] The imaging device 1 generates digital data of a radiation image showing an imaging region of a subject. The imaging device 1 according to this embodiment is a portable FPD (Flat Panel Detector). Specifically, although not shown, the imaging device 1 according to this embodiment includes a sensor substrate on which imaging elements that generate charges according to the radiation dose when exposed to radiation R and switch elements that store and release the charges are arranged two-dimensionally (in a matrix), a scanning unit that switches each switch element on and off, a readout unit that reads out the amount of charge released from each pixel as a signal value, a control unit that controls each unit and generates a radiographic image from the multiple signal values ​​read out by the readout unit, and a communication unit that transmits data on the generated radiographic image and various signals to other devices (the console 2, the generator 3, the image management device 4, etc.) and receives various information and signals from other devices.

[0026] The imaging device 1 generates image data of a still image (hereinafter referred to as still image data) or image data of a dynamic image (hereinafter referred to as dynamic image data) by storing and releasing electric charges and reading out signal values ​​in synchronization with the timing at which radiation R is irradiated from the generating device 3. When still image data is generated, a radiation image is generated only once per depression of the irradiation instruction switch 32. When dynamic image data is generated, the generation of frames constituting a dynamic image is repeated multiple times per predetermined time (for example, 15 times per second) for each depression of the irradiation instruction switch 32.

[0027] The image capturing device 1 may be integrated with the generating device 3.

[0028] [1-3. Console] The console 2 sets various imaging conditions for at least one of the imaging device 1 and the generating device 3 . The console 2 is composed of a PC, a dedicated device, etc. The imaging conditions include, for example, conditions related to the subject S (imaged area, imaging direction, physique, etc.), conditions related to the irradiation of radiation R (tube voltage, tube current, irradiation time, current-time product (mAs value), etc.), and conditions related to image reading by the imaging device 1. The console 2 may set the imaging conditions automatically based on examination order information obtained from other systems (HIS, RIS, etc.), or may set them (manually) based on operations performed on the operation unit 25 by a user (e.g., a technician, etc.).

[0029] Moreover, the console 2 according to this embodiment also serves as a re-photographing decision support device and a re-photographing support device. That is, the console 2 has a function as a rephotographing decision support device that outputs rephotographing decision support information at the timing of determining whether or not to rephotograph (at the timing when it has not yet been decided whether or not to rephotograph), which supports the user in determining whether or not to rephotograph the radiographic image generated in the radiographing device 1. The console 2 also has a function as a rephotographing support device that outputs rephotographing support information at the timing of rephotographing (at the timing when it has been decided to rephotograph).

[0030] [1-4. Image management device] The image management device 4 manages the image data generated by the photographing device 1. The image management device 4 is a Picture Archiving and Communication System (hereinafter referred to as PACS), an image diagnosis workstation (hereinafter referred to as IWS), or the like.

[0031] [1-5. Learning Device] The learning device 5 is a device that learns a plurality of pieces of training data and generates a learned model M that is used when the console 2 performs a re-photographing decision support information generation process, which will be described later. The learning device 5 is configured with, for example, a CPU (Central Processing Unit), a memory unit, a communication unit, an operation unit, a display unit, etc., and the generation of a trained model M based on teacher data is realized through cooperation between the CPU and a program stored in the memory unit. The learning device 5 generates, for example, a plurality of types of trained models M according to the imaging region and imaging direction.

[0032] In this embodiment, the learning device 5 performs machine learning using a set of training data, a radiographic image of an imaged joint (for example, an elbow joint, a knee joint, an ankle joint, etc.), information on a first deviation in a predetermined region of the radiographic image, and information on a second deviation in a predetermined region of the radiographic image, to generate a trained model M (a trained model M that estimates (determines) information on the first deviation and information on the second deviation in the predetermined region from the input radiographic image). The machine learning method is not particularly limited, and for example, deep learning or the like can be used.

[0033] Here, in the present invention, deviation refers to deviation from a reference correct position or state. The reference correct position or state is, for example, a position or state in ideal positioning that is optimal for diagnosis. For example, in a radiographic image of the lateral surface of the elbow joint, ideal positioning results in the lateral edge of the trochlea 71 of the humerus and the capitellum edge 72 of the humerus (see FIG. 2) nearly overlapping (matching). A radiographic image in which the lateral edge of the trochlea 71 of the humerus and the capitellum edge 72 of the humerus do not overlap indicates deviation.

[0034] The predetermined area in the present invention is an area in which deviations (first deviation, second deviation) in a radiographic image are to be determined, and is an area determined based on the imaging part information. In this embodiment, this area is called a deviation area. The predetermined area in which the first deviation is to be determined is called the first deviation area, and the predetermined area in which the second deviation is to be determined is called the second deviation area. The first displacement region and the second displacement region are the same joint region. The same joint region may be, for example, a region of the same elbow joint. It may also be a region of the same ankle joint or a region of the same knee joint. For example, a first displacement region in a radiographic image of the lateral surface of an elbow joint may be a region on the medial side of the elbow surrounded by the lateral edge of the trochlea 71 of the humerus and the capitellum edge 72 of the humerus (the region indicated by low-density dots in FIG. 2 ), and a second displacement region may be a region on the lateral side of the elbow surrounded by the lateral edge of the trochlea 71 of the humerus and the capitellum edge 72 of the humerus (the region indicated by high-density dots in FIG. 2 ).

[0035] In the present invention, the first deviation may be, for example, a deviation in a first direction, and the second deviation may be, for example, a deviation in a second direction different from the first direction. For example, the first deviation in a predetermined region in a radiographic image of the lateral surface of the elbow joint may be a deviation in the forearm direction between the lateral edge 71 of the trochlea of ​​the humerus and the capitellum edge 72 of the humerus in the elbow joint region (shown by reference symbol 241k in FIG. 7), and the second deviation may be a deviation in the upper arm direction between the lateral edge 71 of the trochlea of ​​the humerus and the capitellum edge 72 of the humerus in the elbow joint region (shown by reference symbol 241j in FIG. 7).

[0036] An example of an index representing the first deviation is the amount of deviation in the first direction, and an example of an index representing the second deviation is the amount of deviation in the second direction. Here, the amount of deviation in the present invention refers to the amount by which the position of a specific part deviates from the reference position when ideal positioning is used as the reference. When the amount of deviation is zero, ideal positioning is achieved. For example, the amount of deviation in the first direction of a specific area in a radiographic image of the lateral surface of the elbow joint is the amount of deviation between the outer edge 71 of the trochlea of ​​the humerus and the capitellum edge 72 of the humerus toward the forearm (shown by reference symbol D1 in FIG. 2), and the amount of deviation in the second direction is the amount of deviation between the outer edge 71 of the trochlea of ​​the humerus and the capitellum edge 72 of the humerus toward the upper arm (shown by reference symbol D2 in FIG. 2).

[0037] Hereinafter, the generation of the trained model M in the training device 5 will be described using an example in which a radiographic image of the lateral surface of an elbow joint is input. Figure 2 is a schematic side view of the elbow joint, and Figure 3 is a schematic front view of the elbow joint. As described above, in a radiographic image of the lateral surface of the elbow joint, the ideal positioning state is when the lateral edge 71 of the trochlea of ​​the humerus and the capitellum edge 72 of the humerus are aligned. However, there are cases where the lateral edge 71 of the trochlea of ​​the humerus and the capitellum edge 72 do not match and are shifted in the forearm direction (toward the forearm) and / or the upper arm direction (toward the upper arm). In this embodiment, when the radiographic image is an image of the lateral surface of the elbow joint, the console 2 determines the shift between the lateral edge 71 of the trochlea of ​​the humerus and the capitellum edge 72 in the forearm direction as a first shift, and the shift between the lateral edge 71 of the trochlea of ​​the humerus and the capitellum edge 72 in the upper arm direction as a second shift, and generates re-photography decision support information and re-photography support information by determining the first shift and the second shift. The learning device 5 uses the captured radiographic image as input to generate a trained model M for acquiring information about the first shift and information about the second shift used in the console 2.

[0038] The learning device 5 receives one or more input data including at least a radiographic image, and output data that is information relating to the deviation of a predetermined region of the radiographic image (information relating to the first deviation and information relating to the second deviation), and by learning the set of input data and output data as training data, generates a trained model M that estimates the output data when input data with unknown output data is input. 4(a), the input data for the training data may include, for example, imaging site information (e.g., whether the image is of the elbow joint), left / right information, imaging conditions such as the dose at the time of imaging, image information such as pixel size, images of the affected area learned with an optical camera, etc. The more input data for the training data, the higher the estimation accuracy of the trained model M.

[0039] Examples of output data in the training data include a displacement area map (coordinate information of the displacement area) for each of the first and second displacements shown in FIG. 4(b), the amount of displacement, information for changing the position of the part related to the displacement (described in detail below), a rank for determining the degree of displacement, information on the presence or absence of an alert indicating the occurrence of a displacement, and coordinate information of the pulley shaft (73 in FIG. 2) used to determine the displacement. The displacement area map may be of an area that combines the first and second displacement areas. In this case, information separating the first and second displacement areas (such as information on the line segment (e.g., L3 in FIG. 2) separating the two or information indicating whether each coordinate of the displacement area belongs to the first or second displacement area) is also required. The displacement area map may also include information on whether the radiographic image is of the target (e.g., whether it is an image of the elbow or whether a joint is included, etc.). Furthermore, the output data may include information indicating the direction in which the irradiation center at the time of shooting deviates from the ideal position, so that the trained model M can output information indicating the direction in which the irradiation center at the time of shooting deviates from the ideal position (the accuracy of the position for each direction). The displacement area map and other information about the displacement are determined by experts (radiographers or physicians) for the radiological images.

[0040] In this embodiment, when a radiographic image of the lateral surface of an elbow joint is input, the learning device 5 generates a trained model M that outputs information on the first displacement area (displacement area map and information separating the first displacement area from the second displacement area) and information on the second displacement area (displacement area map and information separating the first displacement area from the second displacement area). The trained model M also outputs the coordinates of the pulley shaft 73. Here, the range of the displacement region (the combined region of the first and second displacement regions) in a radiographic image of the lateral side of the elbow joint can be, for example, the region surrounded by the outer edge of the trochlea 71 of the humerus, the capitellum edge 72 of the humerus, a line L1 drawn from the trochlear axis 73 in the direction of the uncinate fossa, and a line L2 drawn through the trochlear axis 73 in the longitudinal direction of the humerus 76 (toward the ulna 77), as shown in Figures 2 and 3. Of these, the region on the medial side of the elbow of line L3 drawn from the trochlear axis 73 to the end of the radius 75 (the region indicated by low-density dots in Figure 2) is the displacement region in the direction of the forearm (the first displacement region), and the region on the lateral side of the elbow (the region indicated by high-density dots in Figure 2) is the displacement region in the direction of the upper arm (the second displacement region). In this embodiment, the first and second deviations are determined based on the deviation between the outer edge of the trochlea 71 of the humerus and the capitellum edge 72 of the humerus, but this is not limited to this, and the first and second deviations may also be determined based on the deviation from ideal positioning between two other parts.

[0041] In addition to the above, the trained model M may also be one that, when a radiological image or the like is input, outputs at least one of the amount of deviation, information for changing the position of the part related to the deviation, a judgment rank of the degree of deviation, or whether or not an alert is issued.

[0042] <2. Console details> Next, the console 2 will be described in detail. FIG. 5 is a block diagram showing the functional configuration of the console 2, and FIG. 6 is a flowchart showing the processing flow in the console 2.

[0043] [2-1. Console Configuration] As shown in Figure 5, the console 2 is configured to include a control unit 21, a memory unit 22, a communication unit 23, a display unit 24, and an operation unit 25, and each unit 21 to 25 is electrically connected by a bus or the like.

[0044] The control unit 21 includes a CPU (Central Processing Unit), a RAM (Random Access Memory ), ROM (Read Only Memory), etc. The ROM stores various programs executed by the CPU and parameters required to execute the programs. The CPU reads out various programs stored in the ROM, loads them into the RAM, executes various processes in accordance with the loaded programs, and centrally controls the operations of each part of the console 2. The control unit 21 executes a shooting control process, which will be described later, and thereby functions as a first determination unit, a second determination unit, an output unit, and a decision unit.

[0045] The storage unit 22 is configured by a non-volatile memory, a hard disk, or the like. The storage unit 22 is capable of storing image data of radiographic images acquired from other devices (such as the imaging device 1 and the image management device 4).

[0046] Furthermore, the storage unit 22 according to this embodiment stores a plurality of trained models M. The plurality of trained models M includes, for example, a trained model M generated in the learning device 5. The storage unit 22 also stores a plurality of types of algorithms used when executing the re-photographing decision support information generation process, which will be described later. The memory unit 22 also stores, in association with the imaging area and imaging direction, information indicating the type of re-photographing decision support information generation process to be executed on the radiological image of the imaging area and imaging direction (e.g., algorithm name), and information indicating the type of trained model M used in the process (e.g., trained model name).

[0047] The storage unit 22 also stores test order information transmitted from the RIS or the like.

[0048] The communication unit 23 is composed of a communication module and the like. The communication unit 23 transmits and receives various signals and various data to and from other devices (the photographing device 1, the generating device 3, the image management device 4, and the learning device 5) connected by wire or wirelessly via the communication network N. The communication unit 23 functions as an acquisition unit.

[0049] The display unit 24 is configured by, for example, an LCD (Liquid Crystal Display), a CRT (Cathode Ray Tube), etc. The display unit 24 displays a radiation image or the like in accordance with an image signal received from the control unit 21.

[0050] The operation unit 25 includes a keyboard (cursor keys, numeric input keys, various function keys, etc.), a pointing device (mouse, etc.), a touch panel laminated on the surface of the display unit 24, etc. The operation unit 25 outputs a control signal to the control unit 21 in accordance with an operation performed by the user.

[0051] In addition, the console 2 may not be equipped with a display unit 24 or an operation unit 25, and may instead receive control signals from an input device provided separately from the console 2, for example, via a communication unit 23, or output image signals to a display device (monitor) provided separately from the console 2. Furthermore, if the other device (such as the image management device 4) has a display unit and an operation unit, it may be configured to receive control signals from the operation unit of the other device and output image signals to the display unit of the other device (the display unit and operation unit may be shared with the other device).

[0052] [2-2. Console Operation] Next, the operation of the console 2 will be described with reference to FIG. The console 2 executes the imaging control process shown in Fig. 6. The imaging control process is executed by the CPU of the control unit 21 in cooperation with a program stored in the ROM when, for example, examination order information is selected by the operation unit 25 from the examination list screen displayed on the display unit 24.

[0053] First, the control unit 21 causes the display unit 24 to display the examination screen 241 for the selected examination order information (step S1). The examination screen 241 (see, for example, FIG. 7) is provided with an imaging selection button 241a displaying the details of each imaging (such as imaging region and imaging direction) included in the examination order information, a setting area 241b for setting image reading conditions and image processing conditions for the selected imaging, an image display area 241c for displaying the captured radiographic image, a rejected image button 241d, an output button 241e, etc. At the stage of step S1, no radiographic image is yet displayed in the image display area 241c. Furthermore, re-imaging decision support information (denoted by symbols 241f to 241n), which will be described later, is not displayed.

[0054] When the imaging selection button 241a is pressed on the operation unit 25 to select the imaging to be performed (area to be imaged, imaging direction) (step S2), the control unit 21 sets the imaging conditions (image reading conditions, radiation irradiation conditions) in the imaging device 1 and the generator 3 (step S3). For example, the control unit 21 automatically sets the imaging conditions (image reading conditions, such as pixel size, image size, frame rate, etc.) in the imaging device 1 based on the imaging part, imaging direction, etc. of the pressed imaging selection button 241a, and also sets the imaging conditions (radiation irradiation conditions, such as tube voltage (kV), tube current (mA), irradiation time (ms), etc.) of the radiation source in the generator 3. Alternatively, the imaging conditions (image reading conditions) for imaging to be performed may be set in the imaging device 1 in accordance with the user's operation of the operation unit 25 on the examination screen 241. Furthermore, the radiation irradiation conditions may be set by the user from the operation panel of the generator 3.

[0055] After pressing the radiography selection button 241a and setting the radiography conditions, the user (technologist) positions the subject S between the radiation source 33 of the radiation generating device 3 and the radiography device 1. Here, positioning refers to, for example, how the patient is positioned during radiography. When the user operates the irradiation instruction switch 32, the radiation generator 3 irradiates the region of the subject S to be imaged with the radiation R. The imaging device 1 generates a radiographic image (still image, dynamic image) of the imaging region when it receives radiation R from the generator 3, and transmits the image data (still image data, dynamic image data) to the console 2.

[0056] When the image data of the radiation image is received (acquired) by the communication unit 23 (step S4), the control unit 21 displays a preview of the received radiation image in the image display area 241c of the examination screen 241 (step S5).

[0057] Next, the control unit 21 determines the type of rephotographing decision support information generation process to be applied to the received radiographic image based on the radiographic region and radiographic direction of the radiographic image (step S6). As described above, the memory unit 22 stores information indicating the type of re-shooting decision support information generation process to be executed on the radiographic image of the radiographic body part and the radiographic direction, in association with the radiographic body part and the radiographic direction. The control unit 21 determines the re-shooting decision support information generation process to be applied to the received radiographic image based on the radiographic body part and the radiographic direction. The re-photographing decision support information generation process to be applied to the received radiographic image may be determined when the radiography selection button 241a is pressed and the imaging region, imaging direction, etc. Alternatively, the control unit 21 may not automatically determine the process, but the user may select the process by operating the operation unit 25.

[0058] Next, the control unit 21 executes the determined re-photographing decision support information generation process (step S7).

[0059] In the re-photographing decision support information generation process, the control unit 21 first inputs the received radiographic image into one of the multiple trained models M stored in the memory unit 22 that corresponds to the imaging area and imaging direction of the received radiographic image, and generates re-photographing decision support information based on the information output from the trained model M. The re-photography decision support information is not particularly limited as long as it is information that supports the decision on whether or not to perform re-photography. For example, the re-photography decision support information includes information on a first deviation and information on a second deviation in a predetermined region of the radiographic image. The information on deviation includes, for example, at least one of information on the direction of deviation, information on the distance (amount of deviation) of deviation, information on the region of deviation, a judgment rank of the degree of deviation, and information for changing the position of a region related to the deviation. The information on the direction of deviation may include information on the angle of deviation.

[0060] The rephotography decision support information generation process will be described below by taking as an example a case where the received radiographic image is a radiographic image of the lateral surface of an elbow joint. First, the control unit 21 inputs the received radiographic image to the trained model M corresponding to the lateral surface of the elbow joint. When the radiographic image of the lateral surface of the elbow joint is input, the trained model M determines the first and second deviation regions of the input radiographic image based on the imaging site (here, the elbow joint), and also determines the coordinates of the pulley shaft 73, and outputs information on the first and second deviation regions (for example, the deviation region map shown in FIG. 4(b) or information distinguishing the first and second deviation regions) and information on the coordinates of the pulley shaft 73. The coordinates of the pulley shaft 73 may be determined by the control unit 21 through image processing.

[0061] Next, the control unit 21 generates re-photographing decision support information based on the information output from the trained model M as follows. First, the control unit 21 determines (measures) the amount of deviation of the elbow joint in the forearm direction (amount of deviation in the first direction) and the amount of deviation in the upper arm direction (amount of deviation in the second direction). For example, as shown in Fig. 2, in a region on the inside of the elbow of a line L3 drawn from the trochlear axis 73 to the end of the radius 75, when a line is drawn from the trochlear axis 73 in the direction of the radius, the control unit 21 determines the maximum width D1 at which the line intersects perpendicularly with the first deviation region (the region shown by low-density dots in Fig. 2) as the amount of deviation in the direction of the forearm. Also, in a region on the outside of the elbow of a line L3 drawn from the trochlear axis 73 to the end of the radius 75, when a line is drawn from the trochlear axis 73 in the direction of the ulna 77, the control unit 21 determines the maximum width D2 at which the line intersects perpendicularly with the second deviation region (the region shown by high-density dots in Fig. 2) as the amount of deviation in the direction of the upper arm.

[0062] The amount of deviation may be measured directly as described above, or indirectly. For example, the amount of deviation in the first direction and the amount of deviation in the second direction may be measured based on the width (e.g., maximum width) of the area surrounded by the capitellum edge 72 of the humerus and the medial edge 78 of the trochlea of ​​the humerus. In this case, a trained model M that outputs the area surrounded by the capitellum edge 72 of the humerus and the medial edge 78 of the trochlea of ​​the humerus using a radiographic image of the lateral surface of the elbow joint as input may be generated by the learning device 5 and stored in the storage unit 22, or the measurement area may be determined by image processing.

[0063] Next, the control unit 21 determines the rank of the degree of deviation (determination rank) based on the determined amount of deviation and a preset threshold value. For example, the control unit 21 classifies the result as "Rank A (Good)" when the amount of deviation in the forearm direction is less than a threshold TH1 (lowest possibility of imaging failure), "Rank B (Acceptable)" when the amount is equal to or greater than the threshold TH1 and less than a threshold TH2, and "Rank C (Retake)" when the amount is equal to or greater than the threshold TH2 (highest possibility of imaging failure). Furthermore, the control unit 21 classifies the result as "Rank A (Good)" when the amount of deviation in the upper arm direction is less than a threshold TH11 (lowest possibility of imaging failure), "Rank B (Acceptable)" when the amount is equal to or greater than the threshold TH11 and less than a threshold TH12, and "Rank C (Retake)" when the amount is equal to or greater than the threshold TH12 (highest possibility of imaging failure). The lower of the determination ranks for the forearm direction and the upper arm direction (Rank A > Rank B > Rank C) is used as the overall determination rank.

[0064] Furthermore, when the determination rank of the amount of deviation in the forearm direction is C, the control unit 21 generates information for changing the position of a first portion (here, for example, the lateral edge 71 of the trochlea of ​​the humerus or the capitellum edge 72 of the humerus) related to the first deviation (deviation in the forearm direction) based on the amount of deviation. When the determination rank of the amount of deviation in the upper arm direction is C, the control unit 21 generates information for changing the position of a second portion (here, the lateral edge 71 of the trochlea of ​​the humerus or the capitellum edge 72 of the humerus) related to the second deviation (deviation in the upper arm direction) based on the amount of deviation.

[0065] Here, the information for changing the position of the part related to the deviation is information indicating what, in which direction, and how much to move in order to move the part related to the deviation from its current position on the radiological image to the correct reference position.

[0066] For example, information for changing the position of a part related to the deviation may include information indicating the distance and direction (including the angle) to move the part from its current position to the correct reference position. For example, if the deviation in the upper arm direction is 2 cm, An example of information for changing the position of the part related to the misalignment is notification information such as "When retaking the image, move the outer edge of the trochlea of ​​the humerus upward by 2 cm."

[0067] In addition, if there is another object that can be moved from its current position to move the area related to the deviation on the radiographic image from its current position to a correct reference position, the distance and direction (including the angle) of movement of that object may be used as information for changing the position of the area related to the deviation. For example, if the part related to the deviation can be moved from its current position to a correct reference position by moving the position of the shoulder relative to the panel (imaging device 1) up by 2 cm, notification information such as "When reimaging, please raise the height of your shoulder relative to the panel (FPD) by 2 cm" may be generated as information for changing the position of the part related to the deviation. Also, if the part related to the deviation can be moved from its current position to a correct reference position by internally rotating the irradiation center of radiation source 33 by 5 degrees and abducting it by 2 degrees, notification information such as "When reimaging, please internally rotate the irradiation center by 5 degrees and abduct it by 2 degrees" may be generated as information for changing the position of the part related to the deviation.

[0068] Information for changing the position of the part related to the deviation can be generated, for example, by experimentally determining in advance the relationship between the direction and amount of deviation of the part related to the deviation, the object to be moved, and the distance and direction of movement of that object, creating a table or the like, and storing this in the memory unit 22. Ideally, the deviation should be zero, but if the deviation is within the range that is acceptable for diagnosis, there is no need to generate information for changing the position related to the deviation.

[0069] Furthermore, the control unit 21 creates a displacement area map by superimposing a predetermined color indicating that the displacement area is a displacement area on the displacement area of ​​the radiographic image, and also superimposes a marker on the position where the amount of displacement is measured.

[0070] When the generation of the re-photographing decision support information is completed, the control unit 21 outputs the generated re-photographing decision support information (step S8). For example, the control unit 21 displays the generated re-photographing decision support information on the display unit 24 (examination screen 241).

[0071] FIG. 7 is a diagram showing an example of an examination screen 241 on which a preview image of a radiographic image received from the radiographing apparatus 1 and rephotographing decision support information are displayed. As shown in Fig. 7, in step S8, a preview of the received radiographic image is displayed in the image display area 241c of the examination screen 241. Also, re-photographing decision support information is displayed. In Fig. 7, the re-photographing decision support information includes a judgment rank 241f, a deviation amount in a first direction 241h, a deviation amount in a second direction 241g, a deviation area map 241i, a measurement position of the deviation amount in the first direction 241k, a measurement position of the deviation amount in the second direction 241j, and information for changing the position of a region associated with the deviation (information for changing the position of a first region associated with the first deviation and information for changing the position of a second region associated with the second deviation) 241m. Also, if the judgment rank is C, an alert 241n indicating that re-photographing is necessary is displayed. It should be noted that the re-photographing decision support information may not be generated and displayed in its entirety, but may be generated and displayed in part only.

[0072] The user (photographer) checks the radiographic image and the re-photographing decision support information, and ultimately determines whether or not re-photographing is necessary. If it is determined that re-photographing is necessary, the user presses the rejected image button 241d. Here, the rejected image refers to attaching a label to the failed image when re-photographing due to a failed image capture so that it cannot be used for diagnosis.

[0073] The control unit 21 determines whether or not the rejected image button 241d has been pressed by the operation unit 25 to instruct re-photographing (step S9). When it is determined that the defective image button 241d has been pressed by the operation unit 25 and that a re-photograph has been instructed (step S9; YES), the control unit 21 associates a flag indicating that the radiographic image is a defective image, information such as the judgment rank, deviation area, deviation amount, part information, information on the technician in charge, etc. with the radiographic image that has been determined to require re-photography, and stores the associated information in the memory unit 22 (step S10). By storing and storing information such as the judgment rank, deviation area, deviation amount, part information, and information about the technician in charge, in association with radiographic images that are determined to require re-photography, this information can be used to educate future photographers.

[0074] Next, the control unit 21 outputs re-photographing support information (step S11). For example, the control unit 21 displays the re-photographing support information on the display unit 24 (examination screen 241). The re-photographing support information is not particularly limited as long as it is information that supports re-photographing. For example, among the information generated as the re-photographing decision support information, information for changing the position of a part related to a deviation is useful re-photographing support information. Furthermore, information on the direction of deviation, information on the distance (amount of deviation), information on the deviation area, etc. may also be used as the re-photographing support information. Furthermore, new information that has not been generated as the re-photographing decision support information may be generated and output as the re-photographing support information.

[0075] For example, when information indicating the direction of deviation of the irradiation center from the ideal position at the time of imaging is output from the trained model M (likelihood of each direction), a heat map 241p indicating the direction of deviation of the irradiation center may be generated and displayed as re-imaging support information, as shown in FIG. 8. In the heat map 241p shown in FIG. 8, the center of each of nine divided regions indicates the ideal position of the irradiation center, and among the directions of deviation of the irradiation center output from the trained model M, directions with higher likelihood are indicated with darker colors. FIG. 8 shows that the irradiation center at the time of imaging was externally rotated by about 5 degrees and internally rotated by about 2 degrees from the ideal position. Internal rotation / external rotation represents rotation in the left-right direction, and internal rotation / external rotation represents rotation in the up-down direction. Together with the heat map 242p, information indicating the direction and amount to which the irradiation center should be shifted may be displayed as information 241m for changing the position of a part related to the deviation. The heat map 241p may be generated and output as re-photographing decision support information.

[0076] The user refers to the displayed preview image of the radiation image and the re-photographing support information, resets the settings of the photographing conditions and readjusts the positioning, and then performs a re-photographing. In response to an operation on the operation unit 25 or reception of a radiological image by the communication unit 23, the control unit 21 returns to step S4 (S3) and repeatedly executes steps S4 (S3) to S8.

[0077] On the other hand, in step S9, if it is determined that the rejected image button 241d has not been pressed by the operation unit 25 (step S9; NO), the control unit 21 performs predetermined image processing on the radiographic image and displays it as a final image in the image display area 241c (step S12). When the user operates the image processing conditions in the setting area 241b, the control unit 21 performs image processing in accordance with the operation.

[0078] The control unit 21 determines whether or not the output button 241e has been pressed by the operation unit 25, and if it determines that the output button 241e has not been pressed (step S13; NO), the process returns to step S9. When it is determined that the output button 241e has been pressed by the operation unit 25 (step S13; YES), the control unit 21 associates a flag indicating that the radiographic image generated as the final image with a non-exposure error, body part information, information on the technician in charge, and the like, and stores the associated image in the storage unit 22. The control unit 21 also associates the patient information and examination information (examination ID, examination date, radiographic body part, radiographic direction, etc.) with the radiographic image generated as the final image and transmits the associated image to the image management device 4 via the communication unit 23 (step S14), and terminates the radiography control process.

[0079] As described above, the control unit 21 of the console 2 determines a first deviation in a predetermined area of ​​a radiographic image, determines a second deviation in a predetermined area of ​​the radiographic image, and outputs re-shooting decision support information that supports the decision on whether or not to re-shoot the radiographic image based on at least the first deviation determination and the second deviation determination. Therefore, it is possible to determine the deviation of the joint positioning with high accuracy, and to output effective re-photographing decision support information.

[0080] Furthermore, the control unit 21 outputs information relating to the first deviation and information relating to the second deviation as re-photographing decision support information. Therefore, it is possible to assist the radiographer in easily understanding what kind of deviation has occurred in a predetermined region of the radiographic image.

[0081] For example, the control unit 21 outputs, as the re-photographing decision support information, information for changing the position of a first part related to a first deviation and information for changing the position of a second part related to a second deviation. Therefore, it is possible to assist the photographer in easily understanding how to change the positions of the first and second regions to achieve correct positioning.

[0082] For example, control unit 21 outputs the movement distance of the first part as information for changing the position of the first part, and outputs the movement distance of the second part as information for changing the position of the second part. Therefore, it is possible to assist the photographer in easily understanding how much the positions of the first and second regions should be moved to achieve correct positioning.

[0083] Also, for example, the control unit 21 outputs the movement direction of the first part as information for changing the position of the first part, and outputs the movement direction of the second part as information for changing the position of the second part. Therefore, it is possible to assist the photographer in easily understanding in which direction the positions of the first and second regions should be moved to achieve correct positioning.

[0084] Furthermore, for example, the control unit 21 outputs re-photographing decision support information together with information indicating that re-photographing is necessary. Therefore, it is possible to assist the photographer in easily determining whether or not re-photographing is necessary.

[0085] Furthermore, the control unit 21 determines a first deviation in a predetermined region of the radiographic image, determines a second deviation in a predetermined region of the radiographic image, and outputs re-photographing support information that supports re-photographing of the radiographic image based on at least the determination of the first deviation and the determination of the second deviation. Therefore, it is possible to determine the deviation of the joint positioning with high accuracy, and to output effective re-photographing support information.

[0086] The console 2 also has a trained model M that has been trained using at least the radiographic image, information regarding a first deviation in a specified area of ​​the radiographic image, and information regarding a second deviation in a specified area of ​​the radiographic image as training data, and the control unit 21 outputs decision support information that supports the decision on whether or not to re-shoot the radiographic image based on the trained model M and the acquired radiographic image. Therefore, it is possible to determine the deviation of the joint positioning with high accuracy, and to output effective re-photographing decision support information.

[0087] Furthermore, the learning device 5 learns at least a radiographic image, information regarding a first deviation in a predetermined region of the radiographic image, and information regarding a second deviation in a predetermined region of the radiographic image as training data, and generates a trained model. Therefore, it is possible to generate a trained model that outputs information regarding the first deviation and information regarding the second deviation from an input radiographic image.

[0088] It goes without saying that the present invention is not limited to the above-described embodiments, and can be modified as appropriate within the scope of the present invention.

[0089] For example, in the above embodiment, the present invention has been described as being applied to support for determining whether or not to retake radiographs when capturing radiographic images of the lateral surface of an elbow joint. However, the present invention can also be applied to support for determining whether or not to retake radiographs when capturing radiographic images of other joints, such as a knee joint or an ankle joint.

[0090] Furthermore, in the above embodiment, the description has been given of extracting the misalignment area from the radiation image using machine learning, but the misalignment area may be extracted by image processing. Furthermore, not only the deviation area but also the re-photographing decision support information and the re-photographing support information may be generated by machine learning.

[0091] In the above embodiment, the functions of the re-photographing decision support device and the re-photographing support device of the present invention are mounted on the console 2. However, the functions of the re-photographing decision support device and the re-photographing support device may be mounted on a device separate from the console 2, or may be a dedicated device. In addition, the functions of the learning device 5 may be provided in the console 2.

[0092] In addition, in the above embodiment, the control unit 21 of the console 2 is described as displaying the re-photographing decision support information and the re-photographing support information on the display unit 24, but it may also be displayed on a display device separate from the console 2.

[0093] Furthermore, the re-photographing decision support information and the re-photographing support information may be outputted not only as a display but also as a sound by a sound output device (not shown).

[0094] The control unit 21 of the console 2 may also output the result of the deviation determination (information about the deviation), the radiographic image used for the deviation determination (generation of information about the deviation), threshold information, the type of algorithm, and other information to an external device so that the contents can be confirmed on the external device. Also, the deviation determination function itself (for example, a program for executing the above-mentioned re-photography determination support information generation process or the used trained model M) may be output to the external device so that the deviation can be determined by the external device.

[0095] Furthermore, for example, in the above description, examples have been disclosed in which a hard disk or a semiconductor nonvolatile memory is used as a computer-readable medium for the program according to the present invention, but the present invention is not limited to this example. Portable recording media such as CD-ROMs can also be used as other computer-readable media. Furthermore, carrier waves can also be used as a medium for providing data for the program according to the present invention via a communication line. [Explanation of symbols]

[0096] 100 Radiography System 1. Radiography equipment 2 Console 21 Control section 22 Memory section 23 Communications Department 24 Display 25 Control section 3. Radiation Generator 31 Generator 32 Irradiation instruction switch 33 Radiation source 4. Image management device 5 Learning Device 71 Lateral border of the trochlea of ​​the humerus 72 Capitellum of the humerus 73 Pulley shaft 75 Radius 76 Humerus 77 Ulna 78 Medial border of the trochlea of ​​the humerus N Communication Network R Radiation S Subject M trained models

Claims

1. a determining means for determining a positioning deviation of a joint region in a radiographic image; an output unit that outputs re-photographing support information that supports re-photographing of the radiographic image based on at least the determination of the deviation; and The output means is capable of outputting, as the rephotographing support information, information for changing the position of the part related to the deviation, together with information indicating that rephotographing is necessary.

2. the determining means determines a first deviation in positioning of the joint region of the radiographic image and a second deviation in positioning of the joint region of the radiographic image; 2. The re-photographing support device according to claim 1, wherein the output means is capable of outputting the re-photographing support information based on at least the first deviation determination and the second deviation determination.

3. the determining means determines a deviation in a first direction of positioning of the joint region of the radiographic image as the determination of the first deviation, and determines a deviation in a second direction of positioning of the joint region of the radiographic image as the determination of the second deviation; 3. The re-photographing support device according to claim 2, wherein the output means is capable of outputting the re-photographing support information based on the determination of the deviation in the first direction and the determination of the deviation in the second direction.

4. 3. The re-photographing support device according to claim 2, wherein the output means is capable of outputting, as the re-photographing support information, information for changing the position of a first portion associated with the first deviation and information for changing the position of a second portion associated with the second deviation.

5. The re-photographing support device according to claim 1 , wherein the output unit is capable of outputting the information indicating that re-photographing is necessary and the re-photographing support information on the same screen.

6. 2. The rephotographing support device according to claim 1, wherein the output means is capable of outputting, as the rephotographing support information, information for changing the position of the part related to the deviation with respect to the photographing device.

7. a trained model trained using at least a radiographic image and information relating to a positioning deviation of a joint region in the radiographic image as training data; an acquisition means for acquiring a radiation image; an output means for outputting re-photographing support information for supporting re-photographing of the radiographic image based on the trained model and the radiographic image acquired by the acquisition means; and The output means is capable of outputting, as the rephotographing support information, information for changing the position of the part related to the deviation, together with information indicating that rephotographing is necessary.

8. Computer, a determining means for determining a positioning deviation of a joint region in a radiographic image; an output means for outputting re-photographing support information for supporting re-photographing of the radiographic image based on at least the determination of the deviation; It functions as The output means is a program that outputs, as the rephotographing support information, information for changing the position of the part related to the deviation, together with information indicating that rephotographing is necessary.

9. the determining means determines a first deviation in positioning of the joint region of the radiographic image and a second deviation in positioning of the joint region of the radiographic image; The program according to claim 8 , wherein the output means outputs the re-photographing support information based on at least the first deviation determination and the second deviation determination.

10. the determining means determines a deviation in a first direction of positioning of the joint region of the radiographic image as the determination of the first deviation, and determines a deviation in a second direction of positioning of the joint region of the radiographic image as the determination of the second deviation; The program according to claim 9 , wherein the output means outputs the re-photographing support information based on the determination of the deviation in the first direction and the determination of the deviation in the second direction.

11. 10. The program according to claim 9, wherein the output means outputs, as the re-photographing support information, information for changing the position of a first part related to the first deviation and information for changing the position of a second part related to the second deviation.

12. 12. The program according to claim 8, wherein the output means outputs the information indicating that re-photographing is necessary and the re-photographing support information on the same screen.

13. The program according to claim 8 , wherein the output means outputs, as the re-photographing support information, information for changing the position of the part related to the deviation with respect to the photographing device.

14. a determining step of determining a positioning deviation of a joint region of a radiographic image; an output step of outputting re-photographing support information for supporting re-photographing of the radiographic image based on at least the determination of the deviation; Including, The output step outputs, as the rephotographing support information, information for changing the position of the part related to the deviation, together with information indicating that rephotographing is necessary.

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