Medical image diagnostic apparatus, medical information processing system, and computer program product

A medical image diagnostic apparatus of an embodiment includes processing circuitry. The processing circuitry executes a scan based on a protocol designated by a user. The processing circuitry extracts a candidate protocol to be executed next to the protocol, based on protocol order information in which identification information that indicates each of a plurality of candidate protocols that can be executed starting from a specific protocol, and order information in which each candidate protocol is executed, are correlated with each other. The processing circuitry outputs the extracted candidate protocol.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is based upon and claims the benefit of priority from Japanese Patent Application No. 2020-169535, filed on Oct. 7, 2020; and Japanese Patent Application No. 2021-161445, filed on Sep. 30, 2021, the entire contents of which are incorporated herein by reference.

FIELD

Embodiments described herein relate generally to a medical image diagnostic apparatus, a medical information processing system, and a computer program product.

BACKGROUND

In the related art, in imaging using an X-ray computed tomography (CT) apparatus, a scan protocol (hereinafter, also simply referred to as a “protocol”) for collecting data according to an examination site and examination content is set. The protocol is set by selecting a protocol that is suitable for the examination site and the examination content from a plurality of protocols in which various conditions have been preset, and appropriately adjusting the preset conditions. Here, each protocol is classified according to, for example, age, adult/child, male/female, physiques such as weight and height, an examination purpose, and the like, and various conditions are preset, such as an imaging range of a positioning image (scanogram image) for setting the imaging range, an imaging angle of the scanogram image, a tube voltage and a tube current when imaging the positioning image, a scan method for main imaging (scan) for collecting data to be used for diagnosis, a scan position, a scan range, a tube voltage and a tube current when executing a scan, and a position and a range of image reconstruction.

In CT imaging, a scan may be executed using a specific protocol and then protocols for next imaging may be appropriately selected. For example, when a positioning scan such as “whole body scan” is executed as a first scan, a protocol for local imaging is selected as a second scan. Furthermore, when a scan called “Ca Score” for measuring an Agatston score is executed as the first scan, a protocol corresponding to the measured value (Agatston score) is selected as the second scan. In such a case, a user sequentially selects protocols for next imaging according to a result of the executed scan. Alternatively, the user generates in advance a plurality of protocols to be executed and a continuous protocol that strictly defines the order thereof, and performs imaging by using the continuous protocol.

DETAILED DESCRIPTION

A medical image diagnostic apparatus of an embodiment includes processing circuitry. The processing circuitry executes a scan on the basis of a protocol designated by a user. The processing circuitry extracts a candidate protocol to be executed next to the protocol, on the basis of protocol order information in which identification information which indicates each of a plurality of candidate protocols that can be executed starting from a specific protocol, and order information in which each candidate protocol is executed, are correlated with each other. The processing circuitry outputs the extracted candidate protocol.

Hereinafter, a medical image diagnostic apparatus, a medical information processing system, and a computer program product according to embodiments will be described with reference to the drawings. Note that embodiments are not limited to the following embodiments. Furthermore, content described in one embodiment can also be similarly applied to other embodiments in principle.

First Embodiment

FIG.1is a block diagram illustrating an example of a configuration of an X-ray CT apparatus according to a first embodiment. As illustrated inFIG.1, an X-ray CT apparatus1according to the first embodiment has a gantry device10, a couch device30, and a console device40. Note that inFIG.1, the gantry device10are drawn at two locations for convenience of illustration, but typically, one X-ray CT apparatus1includes one gantry device10.

Note that in the present embodiment, the longitudinal direction of a rotating shaft of a rotating frame13or a couchtop33of the couch device30in a non-tilted state is defined as a Z-axis direction. Furthermore, an axial direction orthogonal to the Z-axis direction and horizontal to a floor surface is defined as an X-axis direction. Furthermore, an axial direction orthogonal to the Z-axis direction and perpendicular to the floor surface is defined as a Y-axis direction.

The gantry device10has an X-ray tube11, an X-ray detector12, the rotating frame13, an X-ray high voltage device14, a control device15, a wedge16, a collimator17, and a data acquisition system (DAS)18.

The X-ray tube11is a vacuum tube that generates X-rays by emitting thermoelectrons toward an anode (target) from a cathode (filament) by the application of a high voltage from the X-ray high voltage device14. For example, an example of the X-ray tube11includes a rotating anode type X-ray tube that generates X-rays by emitting thermoelectrons to a rotating anode.

The wedge16is a filter for adjusting the dose of the X-rays emitted from the X-ray tube11. Specifically, the wedge16is a filter that attenuates the X-rays emitted from the X-ray tube11by allowing the X-rays to pass therethrough so that the X-rays emitted from the X-ray tube11to a subject P have a predetermined distribution. For example, the wedge16is a filter made of aluminum so as to have a predetermined target angle and a predetermined thickness. The wedge16may be called a wedge filter or a bow-tie filter.

The collimator17is a lead plate and the like for narrowing down the emission range of the X-rays having passed through the wedge16and forms a slit by a combination of a plurality of lead plates and the like. Note that the collimator17is also referred to as an X-ray diaphragm.

The X-ray detector12detects the X-rays emitted from the X-ray tube11and passed through the subject P, and outputs an electric signal corresponding to the dose of the X-rays to the DAS18. The X-ray detector12has, for example, a plurality of X-ray detection element arrays in which a plurality of X-ray detection elements are arranged in a channel direction along one arc centered on a focal point of the X-ray tube. The X-ray detector12has, for example, a structure in which the X-ray detection element arrays with the X-ray detection elements arranged in the channel direction are arranged in a slice direction (column direction and row direction).

Furthermore, the X-ray detector12is an indirect conversion type detector having, for example, a grid, a scintillator array, and an optical sensor array. The scintillator array has a plurality of scintillators, and each of the scintillators has a scintillator crystal that outputs light with a photon quantity corresponding to an incident X-ray dose. The grid has an X-ray shielding plate that is disposed on the surface of the scintillator array on an X-ray incident side and has a function of absorbing scattered X-rays. Note that the grid is also be referred to as a collimator (one-dimensional collimator or two-dimensional collimator). The optical sensor array has a function of converting light into an electric signal corresponding to the amount of light from the scintillator, and has, for example, an optical sensor such as a photomultiplier (PMT). Note that the X-ray detector12may be a direct conversion type detector having a semiconductor element that converts the incident X-rays into an electric signal. Furthermore, the X-ray detector12is an example of an X-ray detector.

The X-ray high voltage device14has an electric circuitry such as a transformer and a rectifier, and has a high voltage generation device having a function of generating a high voltage to be applied to the X-ray tube11and an X-ray control device that controls an output voltage corresponding to the X-rays emitted by the X-ray tube11. The high voltage generation device may be of a transformer type or an inverter type. Note that the X-ray high voltage device14may be provided on the rotating frame13to be described below, or may also be provided on a fixed frame (not illustrated) side of the gantry device10. Note that the fixed frame is a frame that rotatably supports the rotating frame13. Note that the X-ray high voltage device14is an example of an X-ray high voltage unit.

The DAS18has an amplifier that performs an amplification process on the electric signals output from each X-ray detector element of the X-ray detector12and an A/D converter that converts the electric signal to a digital signal, and generates detection data. The detection data generated by the DAS18is transferred to the console device40. Furthermore, the DAS18is an example of a data collection unit.

The rotating frame13is an annular frame that supports the X-ray tube11and the X-ray detector12so as to face each other and rotates the X-ray tube11and the X-ray detector12by the control device15to be described below. Note that the rotating frame13further includes the X-ray high voltage device14and the DAS18in addition to the X-ray tube11and the X-ray detector12, and supports the X-ray high voltage device14and the DAS18. Note that the detection data generated by the DAS18is transmitted by optical communication from a transmitter having a light emitting diode (LED) provided in the rotating frame to a receiver provided in a non-rotating part (for example, a fixed frame and not illustrated inFIG.1) of the gantry device and having a photodiode, and is transferred to the console device40. Note that the transmission method of the detection data from the rotating frame to the non-rotating part of the gantry device is not limited to the aforementioned optical communication, and may adopt any method as long as it is a non-contact type data transmission. Furthermore, the rotating frame13is an example of a rotating unit.

The control device15has processing circuitry having a CPU and the like, and a driving mechanism such as a motor and an actuator. The control device15has a function of receiving an input signal from an input interface43to be described below, which is attached to the console device40or the gantry device10, and controlling the operations of the gantry device10and the couch device30. For example, the control device15receives the input signal and performs control of rotating the rotating frame13, tilting the gantry device10, and operating the couch device30and the couchtop33. Note that the control of tilting the gantry device10is implemented by the control device15that rotates the rotating frame13around an axis parallel to the X-axis direction based on information on inclination angle (tilt angle) information input by the input interface attached to the gantry device10. Note that the control device15may be provided in the gantry device10or may also be provided in the console device40.

The couch device30is a device that places and moves the subject P to be scanned and includes a pedestal31, a couch driving device32, the couchtop33, and a support frame34. The pedestal31is a casing that supports the support frame34so as to be movable in a vertical direction. The couch driving device32includes processing circuitry having a CPU and the like and a driving mechanism such as a motor and an actuator, and controls the movement of the couchtop33and the support frame34. The couchtop33is a plate on which the subject P is placed and is provided on an upper surface of the support frame34. The support frame34is a member that supports the couchtop33so as to be movable in the long axis direction of the couchtop33, and moves up and down together with the couchtop33by the operation of the pedestal31.

The console device40has a memory41, a display42, the input interface43, and processing circuitry44. Although the console device40is described as a separate body from the gantry device10, the gantry device10may include the console device40or some of the respective components of the console device40.

The memory41is implemented by, for example, a semiconductor memory element such as a random access memory (RAM) and a flash memory, a hard disk, an optical disk, and the like. The memory41stores, for example, projection data and reconstructed image data. Furthermore, the memory41is an example of storage circuitry.

The display42displays various information. For example, the display42outputs a medical image (CT image) generated by the processing circuitry44, a graphical user interface (GUI) for receiving various operations from an operator, and the like. For example, the display42is a liquid crystal display or a cathode ray tube (CRT) display. Furthermore, the display42may be provided on the gantry device10. Furthermore, the display42may be of a desktop type, or may be composed of a tablet terminal and the like capable of wirelessly communicating with a body of the console device40. Furthermore, the display42is an example of a display unit.

The input interface43receives various input operations from the operator, converts the received input operations into electric signals, and outputs the electric signals to the processing circuitry44. For example, the input interface43receives, from the operator, collection conditions when collecting the projection data, reconstruction conditions when reconstructing the CT image, image processing conditions when generating a post-processing image from the CT image, and the like. For example, the input interface43is implemented by a mouse, a keyboard, a trackball, a switch, a button, a joystick, and the like. Furthermore, the input interface43may be provided on the gantry device10. Furthermore, the input interface43may be composed of a tablet terminal and the like capable of wirelessly communicating with the body of the console device40. Furthermore, the input interface43is an example of an input unit.

The processing circuitry44controls the overall operation of the X-ray CT apparatus1. For example, the processing circuitry44performs a system control function441, a pre-processing function442, a reconstruction processing function443, an image processing function444, a generation function445, an extraction function446, and an output control function447. Furthermore, the processing circuitry44is an example of a processing unit.

The system control function441controls various functions of the processing circuitry44on the basis of the input operations received from the operator via the input interface43. For example, the system control function441controls a data collection process in the gantry device10by controlling the operation of the gantry device10. Furthermore, the system control function441controls the operation of the gantry device10so that the data collection process is performed under imaging conditions designated by the operator. Furthermore, the system control function441is an example of a scan execution unit that executes a scan on the basis of a protocol designated by a user.

The pre-processing function442generates data obtained by performing pre-processing, such as logarithmic transformation processing, offset correction processing, inter-channel sensitivity correction processing, and beam hardening correction, on the detection data output from the DAS18. Note that data (detection data) before the pre-processing and data after the pre-processing may be collectively referred to as projection data. Furthermore, the pre-processing function442is an example of a pre-processing unit.

The reconstruction processing function443generates CT image data by performing reconstruction processing using a filtered back projection method, a successive approximation reconstruction method, and the like on projection data generated by the pre-processing function442. Furthermore, the reconstruction processing function443is an example of a reconstruction unit.

The image processing function444converts the CT image data generated by the reconstruction processing function443into tomographic image data or three-dimensional image data having an arbitrary section by a known method on the basis of the input operation received from the operator via the input interface43. Note that the reconstruction processing function443may directly generate the three-dimensional image data. Furthermore, the image processing function444is an example of an image processing unit.

The generation function445, the extraction function446, and the output control function447will be described below.

Here, in the CT imaging, a scan may be executed using a specific protocol, and then protocols for next imaging may be appropriately selected. For example, when a positioning scan such as “whole body scan” is executed as a first scan, a protocol for local imaging is selected as a second scan. Furthermore, when a scan called “Ca Score” for measuring an Agatston score is executed as the first scan, a protocol corresponding to the measured value (Agatston score) is selected as the second scan. In such a case, a user sequentially selects protocols for next imaging according to a result of the executed scan (first method). Alternatively, the user generates in advance a plurality of protocols to be executed and a composite protocol that strictly defines the order thereof, and performs imaging by using the composite protocol (second method).

Note that the composite protocol is information in which the protocols to be executed are arranged in order including various information (imaging conditions, reconstruction conditions, various parameters, and the like) included in the respective protocols. Therefore, the composite protocol strictly defines a protocol to be executed next to a certain protocol and does not include protocol options. Furthermore, since the composite protocol is integrated as “one protocol” including information included in all the protocols to be executed in order, various information included in the respective are all registered.

However, when the protocols for next imaging are sequentially selected (first method), the protocols for next imaging are selected from many options stored in the X-ray CT apparatus1according to a result of a previous scan. Therefore, inexperienced users (medical workers such as doctors and engineers) or users having a different field of specialization may take extra time to select an appropriate protocol.

Furthermore, when the composite protocol is used (second method), the work of selecting a protocol does not occur, but composite protocols corresponding to all options are individually generated, resulting in a significant increase in the number of protocols to be managed. Furthermore, when conditions of a scan that tends to be included in many composite protocols, such as a positioning scan, are partially changed, it is necessary to change a plurality of composite protocols including the conditions, resulting in a significant increase in the management load.

In this regard, the X-ray CT apparatus1according to the first embodiment performs the following processing in order to easily select an appropriate protocol. That is, the X-ray CT apparatus1executes a scan on the basis of a protocol designated by a user. Then, the X-ray CT apparatus1extracts a candidate protocol to be executed next to the protocol of the executed scan, on the basis of a workflow, in which identification information indicating each of a plurality of candidate protocols that can be executed starting from a specific protocol and selection conditions for selecting each candidate protocol are correlated with each other, and the result of the scan. Then, the X-ray CT apparatus1outputs the extracted candidate protocol.

Note that the workflow used in the present embodiment is information indicating options (choices) of a protocol that can be executed next to a specific protocol. Furthermore, since the workflow is information indicating the order and options of each protocol by the identification information of each protocol, the workflow does not basically include various information included in each protocol. Note that the workflow is an example of “branch information (protocol branch information)” indicating options (branches) from a specific protocol to a next protocol.

The X-ray CT apparatus1according to the first embodiment performs a generation process of generating a workflow and an extraction process of extracting a candidate protocol from the workflow. Hereinafter, the generation process and the extraction process will be described in order.

First, the generation process of generating a workflow will be described with reference toFIG.2.FIG.2is a flowchart illustrating a processing procedure of the generation process by the X-ray CT apparatus1according to the first embodiment.FIG.2will be described with reference toFIG.3A,FIG.3B,FIG.3C,FIG.3D,FIG.4A,FIG.4B,FIG.4C, andFIG.4D. Note that the following processing procedure is merely an example and is not limited to the processing procedure ofFIG.2. For example, the processing content and order can be appropriately changed as long as no contradiction exists in the processing content.

As illustrated inFIG.2, at step S101, the processing circuitry44of the X-ray CT apparatus1determines whether a processing timing is reached. For example, when an instruction for starting the generation process is received from a user, the processing circuitry44determines that the processing timing is reached (Yes at step S101) and starts the generation process ofFIG.2. Note that the processing circuitry44does not determine that the processing timing is reached (No at step S101) and does not start the generation process ofFIG.2until the instruction for starting the generation process is received from the user.

When it is determined that the processing timing is reached (Yes at step S101), the generation function445reads history information from the memory41at step S102. The history information is, for example, information including information (order information) indicating a protocol executed next to a specific protocol and the result of a scan by each protocol. Note that the order information includes identification information (protocol identification information) indicating the specific protocol and identification information indicating the protocol executed next to the specific protocol.

The history information will be described with reference toFIG.3A,FIG.3B,FIG.3C, andFIG.3D.FIG.3A,FIG.3B,FIG.3C, andFIG.3Dare diagrams for explaining the history information according to the first embodiment. Note that the history information illustrated inFIG.3A,FIG.3B,FIG.3C, andFIG.3Dis merely an example and is not limited to the content illustrated in the drawings.

FIG.3Aillustrates history H11, history H12, history H13, and history H14as history information related to case A “examination at the time of traffic accident”. InFIG.3A, “whole body scan” is identification information of a protocol for imaging the whole body of a subject. In the examination at the time of traffic accident, a damage site is roughly searched starting from the “whole body scan” and is specified by executing a detailed scan step by step while narrowing an imaging range.

The history H11includes order information indicating that protocols “whole body scan”, “protocol P11”, and “protocol P12” have been executed in order. Furthermore, the history H11includes information “damage to the abdomen” as a result of the “whole body scan”. Furthermore, the history H11includes information “damage to the stomach” as a result of the “protocol P11”. Note that the “protocol P11” is identification information of a protocol for scanning the abdomen, and the “protocol P12” is identification information of a protocol for scanning the stomach. Furthermore, the result of the finally executed protocol (protocol P12) may not be stored.

The history H12includes order information indicating that protocols “whole body scan”, “protocol P11”, and “protocol P13” have been executed in order. Furthermore, the history H12includes information “damage to the abdomen” as a result of the “whole body scan”. Furthermore, the history H12includes information “damage to the intestine” as a result of the “protocol P11”. Note that the “protocol P13” is identification information of a protocol for scanning the intestine.

The history H13includes order information indicating that protocols “whole body scan”, “protocol P14”, and “protocol P15” have been executed in order. Furthermore, the history H13includes information “damage to the head” as a result of the “whole body scan”. Furthermore, the history H13includes information “severe damage” as a result of the “protocol P14”. Note that the “severe damage” is, for example, information indicating that a specific part of the head is severely affected. The “protocol P14” is identification information of a protocol for scanning the head, and the “protocol P15” is identification information of a protocol for scanning the specific part of the head.

The history H14includes order information indicating that protocols “whole body scan” and of “protocol P16” have been executed in order. Furthermore, the history H14includes information “damage to the lung” as a result of the “whole body scan”. Note that the “protocol P16” is identification information of a protocol for scanning the lung.

FIG.3Billustrates history H21, history H22, and history H23as history information related to case B “calcification examination”. InFIG.3B, “Ca Score” is identification information of a protocol for measuring the calcification of coronary arteries that nourish the heart, and an index value such as “Agatston score” is calculated as a calcification index. In the calcification examination, the calcification of the coronary arteries is measured starting from the “Ca Score” and a next protocol is selected according to the measurement result. Note that “protocol P21”, “protocol P22”, and “protocol P23” are arbitrary protocols. The history H21includes order information indicating that protocols “Ca Score” and “protocol P21” have been executed in order. Furthermore, the history H21includes information “Agatston score 100” as a result of the “Ca Score”.

The history H22includes order information indicating that protocols “Ca Score” and “protocol P22” have been executed in order. Furthermore, the history H22includes information “Agatston score 150” as a result of the “Ca Score”.

The history H23includes order information indicating that protocols “Ca Score” and “protocol P23” have been executed in order. Furthermore, the history H23includes information “Agatston score 200” as a result of the “Ca Score”.

FIG.3Cillustrates history H31and history H32as history information related to case C “head examination”. InFIG.3C, “head positioning scan” is identification information of a protocol for confirming a damage site and a damage size in the head. In the head examination of the case C, the damage site and the damage size are specified starting from the “head positioning scan” and a next protocol is selected according to the result.

The history H31includes order information indicating that protocols “head positioning scan” and “protocol P31” have been executed in order. Furthermore, the history H31includes information “damage size 10 mm” as a result of the “head positioning scan”. Furthermore, the history H31includes information “slice thickness/interval 2 mm/1 mm” as a reconstruction condition for the “protocol P31”.

The history H32includes order information indicating that protocols “head positioning scan” and “protocol P32” have been executed in order. Furthermore, the history H32includes information “damage size 30 mm” as a result of the “head positioning scan”. Furthermore, the history H32includes information “slice thickness/interval 5 mm/5 mm” as a reconstruction condition for the “protocol P32”.

FIG.3Dillustrates history H41and history H42as history information related to case D “head examination”. InFIG.3D, “head positioning scan” is identification information of a protocol for confirming a damage site and a damage size in the head. In the head examination of the case D, the “head positioning scan” is used as a starting point and a next protocol is selected according to the result.

The history H41includes order information indicating that protocols “head positioning scan” and “protocol P41” have been executed in order. Furthermore, the history H41includes information “slice thickness/interval 5 mm/5 mm”, “average number of slices 70”, and “WL/WW 35/80 to 40/300” as reconstruction conditions for the “protocol P41”.

The history H42includes order information indicating that protocols “head positioning scan” and “protocol P42” have been executed in order. Furthermore, the history H42includes information “slice thickness/interval 2 mm/1 mm”, “average number of slices 350”, and “WL/WW 600/3200” as reconstruction conditions for the “protocol P42”.

In this way, the generation function445reads, for example, a plurality of history information having a common starting protocol from the memory41. Note that the history information is appropriately collected at the stage when a scan by each protocol has been executed, for example, and is stored in advance in a predetermined storage device (for example, the memory41and the like).

Note that the history information illustrated inFIG.3AtoFIG.3Dis merely an example and is not limited to the content illustrated in the drawings. For example, inFIG.3AtoFIG.3D, the cases, where a user designates in advance items (damage site, Agatston score, damage size, and the like) of the scan results to be used in a workflow generation process and stores only the designated items, have been described; however, embodiments are not limited thereto. For example, the memory41may store all recordable items among the scan results as history information.

Furthermore, the items (damage site, Agatston score, damage size, and the like) of the scan results illustrated inFIG.3AtoFIG.3Dmay be information output from an analysis application that automatically analyzes medical images and outputs various scan results, or Information (operation history information) input by a user.

Furthermore, in the examples ofFIG.3CandFIG.3D, the cases where the history information includes the reconstruction conditions have been described; however, embodiments are not limited thereto. For example, the history information may not include the reconstruction conditions. Since the reconstruction conditions for the respective protocols are stored in a predetermined storage device (for example, the memory41) as one of the items of the respective protocols, the reconstruction conditions can be achieved even though the reconstruction conditions are not included in the history information.

Referring not back to the description ofFIG.2, at step S103, the generation function445generates workflows on the basis of the history information. For example, the generation function445generates workflows by specifying the result of a scan before each protocol is executed and using the result of a specified scan as a selection condition for each protocol.

Workflows will be described with reference toFIG.4A,FIG.4B,FIG.4C, andFIG.4D.FIG.4A,FIG.4B,FIG.4C, andFIG.4Dare diagrams for explaining workflows according to the first embodiment. Note that the workflows illustrated inFIG.4A,FIG.4B,FIG.4C, andFIG.4Dare merely examples and are not limited to the content illustrated in the drawings.

For example, inFIG.4A, the generation function445generates a workflow W11on the basis of the history H11, the history H12, the history H13, and the history H14of the case A illustrated inFIG.3A. Specifically, the generation function445refers to the history H11, the history H12, the history H13, and the history H14, and specifies each identification information of the “protocol P11”, the “protocol P14”, and the “protocol P16” as protocols executed next to the “whole body scan”. Furthermore, the generation function445specifies the information “damage to the abdomen”, which is the result of the “whole body scan” before the “protocol P11” is executed, as a selection condition for the “protocol P11”. Furthermore, the generation function445specifies the information “damage to the head”, which is the result of the “whole body scan” before the “protocol P14” is executed, as a selection condition for the “protocol P14”. Furthermore, the generation function445specifies the information “damage to the lung”, which is the result of the “whole body scan” before the “protocol P16” is executed, as a selection condition for the “protocol P16”. Then, the generation function445generates the workflow W11by correlating the identification information, the order information, and the selection conditions for the respective protocols. Since a process of adding the “protocol P12”, the “protocol P13”, and the “protocol P15” to the workflow W11is the same as the process described above, description thereof will be omitted.

InFIG.4B, the generation function445generates a workflow W21on the basis of the history H21, the history H22, and the history H23of the case B illustrated inFIG.3B. Specifically, the generation function445refers to the history H21, the history H22, and the history H23, and specifies each identification information of the “protocol P21”, the “protocol P22”, and the “protocol P23” as protocols executed next to the “Ca Score”. Furthermore, the generation function445specifies the information “Agatston score 100”, which is the result of the “Ca Score” before the “protocol P21” is executed, as a selection condition for the “protocol P21”. Furthermore, the generation function445specifies the information “Agatston score 150”, which is the result of the “Ca Score” before the “protocol P22” is executed, as a selection condition for the “protocol P22”. Furthermore, the generation function445specifies the information “Agatston score 200”, which is the result of the “Ca Score” before the “protocol P23” is executed, as a selection condition for the “protocol P23”. Then, the generation function445generates the workflow W21by correlating the identification information, the order information, and the selection conditions for the respective protocols.

Note that when the selection condition includes an index value, a value matching the selection condition may not be obtained. Therefore, when the selection condition includes the index value, the numerical range of the selection condition may be set on the basis of the value of the scan result. For example, in the example ofFIG.4B, the selection condition for the “protocol P21” may be set to “less than Agatston score 125”, the selection condition for the “protocol P22” may be set to “Agatston score 125 or more” and less than Agatston score 175″, and the selection condition for the “protocol P23” may be set to “Agatston score 175 or more”.

Furthermore, inFIG.4C, the generation function445generates a workflow W31on the basis of the history H31and the history H32of the case C illustrated inFIG.3C. Specifically, the generation function445refers to the history H31and the history H32, and specifies each identification information of the “protocol P31” and the “protocol P32” as protocols executed next to the “head positioning scan”. Furthermore, the generation function445specifies the information “damage size 10 mm”, which is the result of the “head positioning scan” before the “protocol P31” is executed, as a selection condition for the “protocol P31”. Furthermore, the generation function445specifies the information “damage size 30 mm”, which is the result of the “head positioning scan” before the “protocol P32” is executed, as a selection condition for the “protocol P32”. Furthermore, the generation function445specifies the “slice thickness/interval 2 mm/1 mm” as a reconstruction condition for the “protocol P31”. Furthermore, the generation function445specifies the “slice thickness/interval 5 mm/5 mm” as a reconstruction condition for the “protocol P32”. Then, the generation function445generates the workflow W31by correlating the identification information, the order information, the selection conditions, and the reconstruction conditions for the respective protocols.

Furthermore, inFIG.4D, the generation function445generates a workflow W41on the basis of the history H41and the history H42of the case D illustrated inFIG.3D. Specifically, the generation function445refers to the history H41and the history H42, and specifies each identification information of the “protocol P41” and the “protocol P42” as protocols executed next to the “head positioning scan”. Furthermore, the generation function445specifies the “slice thickness/interval 5 mm/5 mm”, “average number of slices 70”, and “WL/WW 35/80 to 40/300” as reconstruction conditions for the “protocol P41”. Furthermore, the generation function445specifies the “slice thickness/interval 2 mm/1 mm”, “average number of slices 350”, and “WL/WW 600/3200” as reconstruction conditions for the “protocol P42”. Then, the generation function445generates the workflow W41by correlating the identification information, the order information, and the reconstruction conditions for the respective protocols. Note that in the example ofFIG.4D, the workflow W41does not include selection condition.

In this way, the generation function445generates the workflows, for example, on the basis of the history information read from the memory41. Note that the generation function445may not simultaneously generate the workflows W11, W21, W31, and W41illustrated inFIG.4AtoFIG.4D. For example, the generation function445can read a plurality of history information having a common starting protocol, and generate a workflow starting from the protocol by using the read history information.

Furthermore, in the examples ofFIG.4CandFIG.4D, the cases where the workflow includes the reconstruction conditions have been described; however, embodiments are not limited thereto. For example, the workflow may not include the reconstruction conditions. Since the reconstruction conditions of the respective protocols are stored in a predetermined storage device (for example, the memory41) as one of the items of the respective protocols, the reconstruction conditions can be achieved even though the reconstruction conditions are not included in the workflow.

Referring not back to the description ofFIG.2, at step S104, the output control function447stores the workflows in the memory41. For example, the output control function447stores the workflows W11, W21, W31, and W41generated by the generation function445in the memory41. Then, the processing circuitry44ends the generation process.

Next, the extraction process of extracting a candidate protocol from a workflow will be described with reference toFIG.5.FIG.5is a flowchart illustrating a processing procedure of the extraction process by the X-ray CT apparatus1according to the first embodiment.FIG.5will be described with reference toFIG.6A,FIG.6B,FIG.6C,FIG.6D,FIG.6E, andFIG.6F. Note that the following processing procedure is merely an example and is not limited to the processing procedure ofFIG.5. For example, the processing content and order can be appropriately changed within a range in which no contradiction exists in the processing content.

As illustrated inFIG.5, at step S201, the processing circuitry44of the X-ray CT apparatus1determines whether an examination has been started. For example, when the examination has been started (Yes at step S201), the processing circuitry44starts the process ofFIG.5. Note that the processing circuitry44does not start the process ofFIG.5until the examination is started (No at step S201).

When the examination has been started (Yes at step S201), the system control function441receives the designation of a protocol at step S202. For example, when a user designates the protocol “whole body scan”, the system control function441receives the designation of the protocol “whole body scan”.

Note that the number of protocols that are designated here is basically1, but a plurality of protocols may be designated. For example, a user designates information, which indicates two protocols “Ca Score” and “protocol P21” as protocols to be executed in the examination, and an order in which the “protocol P21” is executed after the “Ca Score”. With this, the system control function441receives the information, which indicates two protocols “Ca Score” and “protocol P21”, and order information in which the “protocol P21” is executed after the “Ca Score”.

Subsequently, at step S203, the system control function441executes a scan on the basis of the designated protocol. For example, when the “whole body scan” is designated, the system control function441executes the “whole body scan”. Furthermore, when a plurality of protocols are designated, the system control function441executes a scan of a first protocol (for example, “Ca Score”).

Then, at step S204, the extraction function446acquires a scan result. For example, the extraction function446acquires the scan result by inputting a medical image obtained by the scan into an analysis application.

For example, in the case of the case A, the extraction function446inputs a medical image obtained by the “whole body scan” into an analysis application for automatically specifying a damage part, thereby acquiring information on a damage part, such as “damage to the abdomen” and “damage to the intestine”, as a scan result.

Furthermore, in the case of the case B, the extraction function446inputs a medical image obtained by the “Ca Score” into an analysis application for automatically measuring an Agatston score, thereby acquiring a value, such as “Agatston score 100”, as a scan result.

Note that the type of the analysis application used here is preferably correlated with a prior scan protocol. For example, it is preferable to correlate an analysis application for automatically specifying a damage part with the “whole body scan”.

Furthermore, when there are a plurality of analysis applications correlated with a specific protocol, it is preferable to narrow down the analysis applications from information and the like related to an examination. For example, an analysis application for automatically specifying a damage part and an analysis application for detecting a tumor from a whole body image may be correlated with the “whole body scan”. Therefore, in the case of the case A (traffic accident), the extraction function446can selectively execute an analysis application for specifying a damage part, instead of detecting a tumor, by receiving an input indicating a “traffic accident” from a user.

Furthermore, in the above description, the case of using the analysis application has been described; however, embodiments are not limited thereto. For example, when the analysis application is not used, information on a damage part can also be acquired by the input of a user who has browsed a medical image obtained by the “whole body scan”.

Furthermore, for example, the extraction function446can also acquire, as a scan result, information on an operation performed by a user according to a result of a scan. For example, when a parameter is changed by the input of a user who has browsed a medical image obtained by a scan, the extraction function446can also acquire the operation history as a scan result.

Then, at step S205, the extraction function446reads a workflow corresponding to a protocol of the executed scan. For example, when the “whole body scan” is executed by the system control function441, the extraction function446reads, from the memory41, the workflow W11starting from the “whole body scan”. Furthermore, when the “Ca Score” is executed by the system control function441, the extraction function446reads, from the memory41, the workflow W21starting from the “Ca Score”.

Then, at step S206, the extraction function446extracts a candidate protocol on the basis of the workflow and the scan result. For example, the extraction function446reads a workflow starting from the protocol of the executed scan among the workflows stored in the memory41. Then, the extraction function446extracts the identification information of a candidate protocol corresponding to a selection condition corresponding to the result of the executed scan among a plurality of candidate protocols included in the read workflow. Then, the extraction function446outputs the identification information of the extracted candidate protocol to the output control function447.

The extraction process of the extraction function446will be described with reference toFIG.6A,FIG.6B,FIG.6C,FIG.6D,FIG.6E, andFIG.6F.FIG.6A,FIG.6B,FIG.6C,FIG.6D,FIG.6E, andFIG.6Fare diagrams for explaining the extraction process of the extraction function446according to the first embodiment. Note that the recommended workflows illustrated inFIG.6A,FIG.6B,FIG.6C,FIG.6D,FIG.6E, andFIG.6Fare merely examples and are not limited to the content illustrated in the drawings.

FIG.6Adescribes a case where the scan result “damage to the abdomen” is obtained in the “whole body scan” of the case A “examination at the time of traffic accident”. In such a case, the extraction function446reads the workflow W11(seeFIG.4A) starting from the “whole body scan” among the workflows stored in the memory41. Then, the extraction function446extracts the “protocol P11” with the scan result “damage to the abdomen” as a selection condition from among the three candidate protocols “protocol P11”, “protocol P14”, and “protocol P16” that can be executed next to the “whole body scan” in the workflow W11. Then, the extraction function446outputs the identification information “protocol P11” of the extracted candidate protocol to the output control function447as a recommended workflow R11.

Furthermore, inFIG.6A, when the “protocol P11” is further executed, the extraction function446extracts a candidate protocol, which can be executed next, on the basis of the scan result of the “protocol P11”. For example, a case where the scan result “damage to the intestine” is obtained in the “protocol P11” will be described. In such a case, the extraction function446extracts the “protocol P13” with the scan result “damage to the intestine” as a selection condition from among the two candidate protocols “protocol P12” and “protocol P13” that can be executed next to the “protocol P11” in the workflow W11. Then, the extraction function446outputs the identification information “protocol P13” of the extracted candidate protocol to the output control function447as the recommended workflow R11.

FIG.6Bdescribes a case where the scan results “damage to the abdomen” and “damage to the lung” are obtained in the “whole body scan” of the case A “examination at the time of traffic accident”. In such a case, the extraction function446reads the workflow W11(seeFIG.4A) starting from the “whole body scan” among the workflows stored in the memory41. Then, the extraction function446extracts the “protocol P11” with the scan result “damage to the abdomen” as a selection condition and the “protocol P16” with the scan result “damage to the lung” as a selection condition from among the three candidate protocols “protocol P11”, “protocol P14”, and “protocol P16” that can be executed next to the “whole body scan” in the workflow W11. Then, the extraction function446outputs the identification information “protocol P11” and “protocol P16” of the extracted candidate protocols to the output control function447as a recommended workflow R12.

In addition, inFIG.6B, when the “protocol P11” is further executed and the scan result “damage to the intestine” is obtained, the extraction function446extracts the “protocol P13” with the scan result “damage to the intestine” as a selection condition. Since this process is the same as the process described inFIG.6A, description thereof will be omitted.

FIG.6Cdescribes a case where the scan result “Agatston score 150” is obtained in the “Ca Score” of the case B “calcification examination”. In such a case, the extraction function446reads the workflow W21(seeFIG.4B) starting from the “Ca Score” among the workflows stored in the memory41. Then, the extraction function446extracts the “protocol P22” with the scan result “Agatston score 150” as a selection condition from among the three candidate protocols “protocol P21”, “protocol P22”, and “protocol P23” that can be executed next to the “Ca Score” in the workflow W21. Then, the extraction function446outputs the identification information “protocol P22” of the extracted candidate protocol to the output control function447as a recommended workflow R21.

FIG.6Ddescribes a case where it is preset at the start of examination that the “protocol P21” is executed after the “Ca Score” in the case B “calcification examination”. In such a case, when the scan result “Agatston score 150” is obtained, the extraction function446reads the workflow W21(seeFIG.4B) starting from the “Ca Score” among the workflows stored in the memory41. Then, the extraction function446extracts the “protocol P22” with the scan result “Agatston score 150” as a selection condition from among the three candidate protocols “protocol P21”, “protocol P22”, and “protocol P23” that can be executed next to the “Ca Score” in the workflow W21. Then, the extraction function446outputs the identification information “protocol P22” of the extracted candidate protocol to the output control function447as a recommended workflow R22.

Note that when the selection condition includes an index value, a value matching the selection condition may not be obtained. Therefore, when the selection condition includes the index value, a candidate protocol with a value close to the value of a scan result as a selection condition may be extracted. For example, when the obtained Agatston score is “190”, the extraction function446extracts the “protocol P23” because the selection condition “Agatston score 200” of the “protocol P23” is close to “190”.

FIG.6Edescribes a case where the scan result “damage size 10 mm” is obtained in the “head positioning scan” of the case C “head examination (with analysis application)”. In such a case, the extraction function446reads the workflow W31(seeFIG.4C) starting from the “head positioning scan” among the workflows stored in the memory41. Then, the extraction function446extracts the “protocol P31” with the scan result “damage size 10 mm” as a selection condition from among the two candidate protocols “protocol P31” and “protocol P32” that can be executed next to the “head positioning scan” in the workflow W31. Then, the extraction function446outputs the identification information “protocol P31” of the extracted candidate protocol to the output control function447as a recommended workflow R31.

FIG.6Fdescribes a case where it is set at the start of examination that the “protocol P41” with the reconstruction condition “WL/WW 35/80” is executed after the “head positioning scan” in the case D “head examination (with no analysis application)”. In such a case, the extraction function446reads the workflow W41(seeFIG.4D) starting from the “head positioning scan” among the workflows stored in the memory41. When no analysis application exists (or when no analysis application works), a user browses a medical image obtained by the “head positioning scan” and considers a next protocol from the conditions of a damage site and the like. As a result of the consideration, when the user changes the “WL/WW 35/80” to the “WL/WW 600/3200” in the reconstruction conditions for the “protocol P41” planned next, the extraction function446acquires the operation history (change history) as a scan result. Then, the extraction function446extracts the candidate protocol “protocol P42” including the scan result “WL/WW 600/3200” as a reconstruction condition from among the two candidate protocols “protocol P41” and “protocol P42” that can be executed next to the “head positioning scan” in the workflow W41. Then, the extraction function446outputs the identification information “protocol P42” of the extracted candidate protocol to the output control function447as a recommended workflow R41.

Note that inFIG.6F, when the “WL/WW 35/80” is changed to the “WL/WW 40/300”, the extraction function446determines that it is within the range of the reconstruction condition for the “protocol P41” and does not extract the “protocol P42”.

In this way, the extraction function446extracts candidate protocols on the basis of the workflows and the scan results. Then, the extraction function446outputs the identification information of the extracted candidate protocols to the output control function447.

Note that the aforementioned processing of the extraction function446is merely an example and embodiments are not limited thereto. For example, the content illustrated inFIG.6AtoFIG.6Fcan be arbitrarily changed as long as no contradiction exists in the processing content.

Then, at step S207, the output control function447displays the candidate protocols. For example, the output control function447allows the identification information of the candidate protocols extracted by the extraction function446to be displayed on the display42.

For example, the output control function447may display the candidate protocols in the formats of the recommended workflows illustrated inFIG.6AtoFIG.6F, or information arbitrarily selected from the illustrated recommended workflows. In the example ofFIG.6A, the output control function447may also display only the recommended protocol “protocol P11”. Furthermore, the output control function447may select arbitrary information from the “whole body scan” previously executed, the scan result “damage to the abdomen”, the selection condition “damage to the abdomen”, and the like, and display the selected information, in addition to the recommended protocol “protocol P11”.

Furthermore, in the example ofFIG.6D, it is preset at the start of examination that the “protocol P21” is executed after the “Ca Score”. In such a case, it is preferable that the output control function447highlights the “protocol P22” extracted by the extraction function446, in addition to the “protocol P21” set in advance. Examples of the highlighting include a case of writing the word “recommended”, a case of emphasizing the “protocol P22” by a display form such as a thick line and a marker, a case of relatively emphasizing the “protocol P21” by allowing the “protocol P21” to be discreet by a display form such as increasing the transmittance and applying shadows.

Furthermore, the output control function447may display the candidate protocols in the form of the workflows illustrated inFIG.4AtoFIG.4D. In such a case, the output control function447may display the selection conditions of candidate protocols not extracted by the extraction function446. With this, a user can understand the reason why the non-recommended candidate protocols have not been recommended. For example, in the workflow W11ofFIG.4A, when the “protocol P11” is extracted and the “protocol P14” and the “protocol P16” are not extracted, a user can understand that “no damage to the head and the lung” and understand that “sites, other than the abdomen, the head, and the lung, are not subjected to damage site analysis by an analysis application”.

Note that the output control function447can not only allow the workflows to be displayed on the display42, but also output the workflows in various forms. For example, the output control function447can transfer the workflows to an external apparatus, or store the workflows in any recording medium. Note that the workflows stored in any recording medium can be read by any medical image diagnosis apparatus.

Then, at step S208, the system control function441receives the selection of a protocol. For example, when the recommended workflow R12illustrated inFIG.6Bis displayed, a user performs an operation of selecting either the “protocol P11” or the “protocol P16”. The system control function441receives the candidate protocol selected by the user as a protocol to be executed next.

Note that a user may not select a protocol from the candidate protocols displayed by the output control function447. For example, when the recommended workflow R11illustrated inFIG.6Ais displayed, a user may not select the “protocol P11”. That is, the user can select any protocol from the protocols stored in the X-ray CT apparatus1.

Furthermore, the system control function441may not receive the selection of a protocol. For example, as illustrated inFIG.6A, when the number of candidate protocols extracted by the extraction function446is 1, the system control function441may automatically execute a candidate protocol without receiving a user's operation.

Then, at step S209, the system control function441executes a scan on the basis of the selected protocol. For example, when the “protocol P11” is selected, the system control function441executes the scan of the “protocol P11”.

Then, at step S210, the system control function441determines whether there is any other protocol to be executed. For example, inFIG.6B, the “protocol P11” has been executed, but the “protocol P16” may not be executed. In such a case, the system control function441determines that there is another protocol to be executed (Yes at step S210), proceeds to the process of step S208, and receives the selection of an unexecuted protocol.

Furthermore, when a plurality of candidate protocols exist after the protocol of the scan executed at step S209, the system control function441proceeds to step S204. For example, as illustrated inFIG.4A, two protocols “protocol P12” and “protocol P13” may exist after the “protocol P11”. In such a case, the system control function441executes the “protocol P11” and then proceeds to step S204. Then, the extraction function446acquires the scan result of the previously executed “protocol P11” (step S204), and performs the processes after step S205. Since the description of the processes after step S204is as described above, description thereof will be omitted.

Furthermore, when it is determined that there is no other protocol to be executed (No at step S210), the system control function441ends the procedure ofFIG.5.

As described above, in the X-ray CT apparatus1according to the first embodiment, the system control function441executes a scan on the basis of a protocol designated by a user. The extraction function446extracts a candidate protocol to be executed next to the protocol, on the basis of a workflow (branch information), in which identification information indicating each of a plurality of candidate protocols that can be executed starting from a specific protocol and selection conditions for selecting the respective protocols are correlated with each other, and the result of the scan. The output control function447outputs an extracted candidate protocol. Consequently, the X-ray CT apparatus1can easily select an appropriate protocol.

For example, in accordance with the X-ray CT apparatus1according to the first embodiment, a protocol recommended to be executed next is presented to a user on the basis of a workflow and a scan result. Therefore, the user does not have to select a protocol from all the protocols stored in the X-ray CT apparatus1, so that the workload can be reduced. Furthermore, even though the user is inexperienced or has a different field of specialization, the user can easily select an appropriate protocol.

Furthermore, a workflow is generated and registered separately from an existing protocol. Therefore, in the X-ray CT apparatus1, the number of protocols to be managed does not increase. Furthermore, the workflow defines the execution order and options of protocols, and does not basically include various information included in each protocol. Therefore, even when some of the conditions of a protocol such as a positioning scan are changed, if only conditions of a protocol to be changed are changed, even though the protocol is read from any workflow, information of the changed protocol is read. Consequently, the X-ray CT apparatus1can restrain an increase in the management load.

In the first embodiment, the “whole body scan”, the “Ca Score”, and the “head positioning scan” have been described as examples of a starting protocol; however, embodiments are not limited thereto. For example, the generation function445can generate a workflow starting from any kind of protocol.

Furthermore, in the first embodiment, the case where the extraction process is performed using a workflow has been described; however, embodiments are not limited thereto. An extraction process using no workflow will be described in a third embodiment.

First Modification of First Embodiment

In the first embodiment, the case where a candidate protocol that can be executed next is presented has been described; however, embodiments are not limited thereto. For example, when there is no need to change a protocol, the X-ray CT apparatus1can also present a change in a parameter.

For example, the extraction function446extracts a change target parameter on the basis of a workflow and a scan result. Then, the output control function447outputs the change target parameter.

The extraction process of the extraction function446according to the first modification of the first embodiment will be described with reference toFIG.7.FIG.7is a diagram for explaining the extraction process of the extraction function446according to the first modification of the first embodiment. Note that a workflow illustrated inFIG.7is merely an example and is not limited to content illustrated in the drawing.

In the example illustrated inFIG.7, it is set at the start of examination that the first “protocol P51” is executed after the “head positioning scan”. As a result of browsing a medical image obtained by the “head positioning scan” and considering a next protocol from the conditions of a damage site and the like, a user may change some of the reconstruction conditions for the “protocol P51” planned next. For example, when the user changes the “slice thickness/interval 5 mm/5 mm” to the “slice thickness/interval 3 mm/3 mm”, the extraction function446acquires this operation history (change history) as a scan result. Then, the extraction function446specifies the second “protocol P51” including the “slice thickness/interval 3 mm/3 mm” in the workflow W51. With this, the extraction function446determines that the user changes the first “protocol P51” to the second “protocol P51”, and extracts a change target parameter “average number of slices 100” that is changed in conjunction with the “slice thickness/interval 3 mm/3 mm”. Then, the extraction function446outputs the extracted “average number of slices 100” to the output control function447. Then, the output control function447allows the “average number of slices 100” extracted by the extraction function446to be displayed on the display42.

In this way, when some parameters are changed by user input, if there is no need to change a protocol, the X-ray CT apparatus1according to the first modification of the first embodiment can extract only a change target parameter and present the extracted parameter to a user.

Note thatFIG.7has described the case where one parameter is changed in conjunction with a parameter changed by a user has been described; however, embodiments are not limited thereto. For example, even when two parameters are changed in conjunction with a parameter changed by a user, the X-ray CT apparatus1may also present a change in a parameter. The number of interacting parameters when presenting a change in a parameter can be controlled by a threshold value. However, since an operation becomes more complicated as the number of parameters changed in conjunction with a parameter changed by a user increases, it is preferable to change a protocol.

Second Modification of First Embodiment

Furthermore, the X-ray CT apparatus1can acquire a workflow generated by an external apparatus and use the workflow for examination in the own apparatus (the X-ray CT apparatus1). Note that the external apparatus is a medical image diagnostic apparatus different from the own apparatus.

For example, in the X-ray CT apparatus1, the output control function447receives a workflow (hereinafter, referred to as an “external flow”) generated by an X-ray CT apparatus of another medical institution or facility, and stores the received external flow in the memory41.

Then, the X-ray CT apparatus1reads the external flow stored in the memory41and uses the read external flow for examination. For example, when the examination is started, the X-ray CT apparatus1performs the extraction process ofFIG.5. In the X-ray CT apparatus1, the extraction function446reads the external flow from the memory41and uses the read external flow for an extraction process. Since the extraction process using the external flow is the same as the extraction process using the workflow described above, description thereof will be omitted.

Second Embodiment

For example, the X-ray CT apparatus1can change a workflow. The second embodiment will describe a case where a workflow is changed.

FIG.8is a block diagram illustrating an example of a configuration of an X-ray CT apparatus1according to the second embodiment. As illustrated inFIG.8, in the X-ray CT apparatus1according to the second embodiment, the processing circuitry44further performs a change function448. Since the configuration of the X-ray CT apparatus1according to the second embodiment is the same as that of the X-ray CT apparatus1illustrated inFIG.1except that the processing circuitry44performs the change function448, description thereof will be omitted.

InFIG.8, the change function448changes a workflow on the basis of an instruction from a user. For example, the change function448reads a change target workflow from the memory41and allows the read workflow to be displayed on the display42. Then, the change function448receives a change operation for the workflow from the user on a display screen of the display42. Then, the change function448changes the workflow on the basis of the received change operation. Note that examples of the change operation may include addition, change, and deletion of a candidate protocol, and addition, change, and deletion of a selection condition. Note that the change function448is an example of a change unit.

The processing of the change function448according to the second embodiment will be described with reference toFIG.9AandFIG.9B.FIG.9AandFIG.9Bare diagrams for explaining the processing of the change function448according to the second embodiment.FIG.9Aillustrates a case where the workflow W21generated inFIG.4Bis changed. Furthermore,FIG.9Billustrates a case where a workflow is newly generated.

As illustrated inFIG.9A, the change function448allows a workflow edit screen to be displayed on the display42. On the workflow edit screen, the workflow W21is displayed as a workflow to be changed. Furthermore, on the workflow edit screen, “New+” is displayed at a display position of a protocol and a display position of a selection condition. By designating the display of the “New+”, a user can add a protocol and a selection condition at arbitrary positions.

Furthermore, by designating a registered candidate protocol and a selection condition on the workflow, the registered candidate protocol and the selection condition can be changed or deleted. For example, by designating the “protocol P21”, the user can change the designated protocol to another protocol. Furthermore, by designating the deletion of the selection condition “Agatston score 150”, the user can delete the designated selection condition.

As illustrated inFIG.9B, the change function448can newly generate a workflow. For example, by selecting the “New+” at the display position of a starting protocol and designating an arbitrary protocol, the user can register the arbitrary protocol as the starting point of the workflow. Furthermore, the user can newly add selection conditions and candidate protocols from the starting protocol.

In this way, the X-ray CT apparatus1according to the second embodiment can change a workflow. Note that the X-ray CT apparatus1according to the second embodiment can change not only a workflow generated by the own apparatus, but also an external workflow generated by an external apparatus in the same manner. For example, when an external workflow generated by an external apparatus (external facility and the like) is introduced into the own apparatus, it is preferable that the change function448changes the introduced external workflow according to the situation of the own apparatus.

First Modification of Second Embodiment

In the second embodiment, the case where a workflow is manually changed has been described; however, a workflow can also be automatically changed.

The change function448changes a workflow on the basis of history information and a workflow. For example, the change function448changes an external workflow generated by an external apparatus, on the basis of history information stored in the own apparatus.

The processing of the change function448according to the first modification of the second embodiment will be described with reference toFIG.10.FIG.10is a diagram for explaining the processing of the change function448according to the first modification of the second embodiment.

FIG.10describes a case where the workflow W21ofFIG.4Bis generated by an external apparatus and history H24exists as history information of the own apparatus. The history H24includes order information indicating that protocols “Ca Score” and “protocol P24” have been executed in order. Furthermore, the history H24includes information “Agatston score 170” as a result of the “Ca Score”. In such a case, the change function448specifies information “Agatston score 170”, which is the result of the “Ca Score” before the “protocol P24” is performed, as a selection condition for the “protocol P24”.

Then, the change function448adds the specified “protocol P24” to the workflow W21in correlation with the selection condition “Agatston score 170”, thereby changing the workflow W21to a workflow W22illustrated inFIG.10. Note that in the workflow W22, a region surrounded by a broken line is a newly added candidate protocol.

In this way, the X-ray CT apparatus1according to the first modification of the second embodiment can automatically change a workflow on the basis of history information and a workflow. The automatic change of the workflow is particularly useful when a workflow generated by an external apparatus (external facility and the like) is introduced into the own apparatus as illustrated inFIG.10.

Note thatFIG.10has described the case where an external workflow is changed has been described; however, embodiments are not limited thereto, and a workflow generated by the own apparatus can also be changed in the same manner. For example, when new history information is registered, the change function448changes a workflow generated by the own apparatus, on the basis of the new history information.

Second Modification of Second Embodiment

Furthermore, the X-ray CT apparatus1may present a workflow change plan instead of automatically changing a workflow.

For example, the change function448generates a workflow change plan on the basis of history information and a workflow. Then, when the change plan is approved by a user, the change function448changes a workflow on the basis of the change plan.

For example, the change function448allows the workflow W22illustrated in the lower figure ofFIG.10to be displayed on the display42as a change plan. In the workflow W22, it is preferable to highlight a portion changed from the workflow W21. A user browses the change plan of the workflow W22displayed on the display42and considers whether to adopt the change plan. When the user approves the change plan, the existing workflow W21is changed to the new workflow W22. Note that when the change plan is not approved, the change function448does not change the workflow.

Third Embodiment

In the above embodiments, the cases where the extraction process is performed using a workflow have been described; however, embodiments are not limited thereto. For example, the X-ray CT apparatus1can perform the extraction process by using history information.

That is, in the X-ray CT apparatus1according to the third embodiment, the system control function441performs a scan on the basis of a protocol selected by a user. The extraction function446extracts a candidate protocol, which is executed next, on the basis of history information, which includes information indicating a protocol executed next to a specific protocol and scan results by respective protocols, and the scan results. The output control function447outputs the extracted candidate protocol.

Since the configuration of the X-ray CT apparatus1according to the third embodiment is the same as that of the X-ray CT apparatus1illustrated inFIG.1, description thereof will be omitted.

An extraction process of extracting a candidate protocol from history information will be described with reference toFIG.11.FIG.11is a flowchart illustrating a processing procedure of the extraction process by the X-ray CT apparatus1according to the third embodiment. Note that the following processing procedure is merely an example and is not limited to the processing procedure ofFIG.11. For example, the processing content and order can be appropriately changed as long as no contradiction exists in the processing content.

Since processes of step S301to step S304in the extraction process illustrated inFIG.11are the same as those of step S201to step S204illustrated inFIG.5, description thereof will be omitted. Furthermore, since processes of step S307to step S310in the extraction process illustrated inFIG.11are the same as those of step S207to step S210illustrated inFIG.5, description thereof will be omitted.

In step S305ofFIG.11, the extraction function446reads history information corresponding to the protocol of the executed scan. For example, when “whole body scan” is performed by the system control function441, the extraction function446reads the history H11to the history H14illustrated inFIG.3Afrom the memory41as history information starting from the “whole body scan”.

Then, in step S306, the extraction function446extracts a candidate protocol on the basis of the history information and a result of the scan. For example, the extraction function446extracts, as a candidate protocol, a protocol executed according to the result of the executed scan among a plurality of protocols included in a plurality of history information read from the memory41.

As an example, a case where the scan result “damage to the abdomen” is obtained in the “whole body scan” of the case A “examination at the time of traffic accident” will be described. In such a case, the extraction function446reads the history H11to the history H14illustrated inFIG.3Afrom the memory41as history information starting from the “whole body scan”. Then, the extraction function446extracts the “protocol P11” executed according to the scan result “damage to the abdomen” from among the three protocols “protocol P11”, “protocol P14”, and “protocol P16” that can be executed next to the “whole body scan” in the history H11to the history H14. Then, the extraction function446outputs the identification information of the “protocol P11” to the output control function447as a candidate protocol.

In this way, the X-ray CT apparatus1according to the third embodiment can perform an extraction process by using history information.

Other Embodiments

Workflow without Branching

For example, in the aforementioned embodiment, the case where the workflow includes a branch has been described; however, the workflow does not necessarily include a branch. For example, the workflow may be protocol order information indicating the order of the protocols.

FIG.12is a diagram for explaining a workflow according to another embodiment.FIG.12is an example of a workflow generated on the basis of the history H11ofFIG.3A.

First, a generation process will be described. For example, a case where the history H11ofFIG.3Aexists and the history H12, the history H13, and the history H14ofFIG.3Ado not exist as the history information related to the case A “examination at the time of traffic accident” will be described. In such a case, the generation function445generates a workflow W61illustrated inFIG.12on the basis of the history H11.

Specifically, the generation function445refers to the history H11, specifies the identification information of the “protocol P11” as a protocol executed next to the “whole body scan”, and specifies the identification information of the “protocol P12” as a protocol executed next to the “protocol P11”. Then, the generation function445generates the workflow W61by correlating the identification information of each protocol with order information in which the protocols are executed. Since the workflow W61includes no branch, the workflow W61may not include a selection condition for selecting each protocol.

Next, an extraction process will be described. The extraction function446extracts a candidate protocol to be executed next to a protocol designated by a user, on the basis of protocol order information in which the identification information of each candidate protocol and the order information in which the candidate protocols are executed, are correlated with each other.

For example, when the workflow W61ofFIG.12exists and the “whole body scan” is designated by the user, the system control function441sends identification information of the designated “whole body scan” to the extraction function446. Then, the extraction function446reads the workflow W61starting from the designated “whole body scan” from the memory41. Then, the extraction function446extracts a candidate protocol from the read workflow W61. Specifically, the extraction function446extracts the identification information of the “protocol P11” as a candidate protocol to be executed next to the “whole body scan”. Furthermore, the extraction function446extracts the identification information of the “protocol P12” as a candidate protocol to be executed next to the “protocol P11”. Then, the extraction function446outputs the identification information of the extracted candidate protocol to the output control function447.

Then, the output control function447displays the candidate protocol. For example, the output control function447may individually (one by one) display the “protocol P11” and the “protocol P12”, or display two (all) candidate protocols while indicating the order of the “protocol P11” and the “protocol P12”, as protocols to be executed next.

In this way, the X-ray CT apparatus1can extract a candidate protocol to be executed next to a protocol designated by a user, on the basis of the protocol order information. In such a case, the extraction function446can extract a candidate protocol from the protocol order information without using a scan result (medical image analysis result).

Use of Patient Attribute Information

Furthermore, for example, the X-ray CT apparatus1can further use attribute information of a patient (subject). The attribute information is, for example, various information indicating the age, height, weight (degree of obesity), gender, and the like of the patient.

For example, the frequency of protocols used may vary depending on the age of a patient such as minors and the elderly. Furthermore, the frequency of protocols used may also vary depending on the height, weight, gender, and the like. Therefore, in the X-ray CT apparatus1, the generation function445generates a workflow on the basis of the attribute information of the subject (generation process). Furthermore, the extraction function446extracts a candidate protocol on the basis of the attribute information of the subject (extraction process).

First, the generation process using the attribute information will be described. For example, the generation function445reads history information corresponding to specific attribute information such as the age, height, weight, and gender of a patient from the memory41. Then, the generation function445generates a workflow on the basis of the history information corresponding to the specific attribute information.

As an example, among the histories H11to H14illustrated inFIG.3A, when the history H11, the history H13, and the history H14are history information of a minor and the history H12is not the history information of the minor, the generation function445reads three pieces of history information of the history H11, the history H13, and the history H14from the memory41. Then, the generation function445generates a workflow of the minor on the basis of the history H11, the history H13, and the history H14. The generated workflow of the minor is stored in, for example, the memory41. Note that the generation function445can generate a workflow on the basis of arbitrary attribute information, not limited to the “minor”.

Next, the extraction process using the attribute information will be described. For example, the extraction function446reads the workflow corresponding to the specific attribute information such as the age, height, weight, and gender of the patient from the memory41. Then, the extraction function446extracts a candidate protocol on the basis of the workflow corresponding to the specific attribute information.

As an example, a case where the subject is the minor will be described. In such a case, the extraction function446reads the workflow of the minor from the memory41. Then, the extraction function446extracts a candidate protocol on the basis of the workflow of the minor.

Note that the aforementioned process is merely an example and the embodiment is not limited thereto. For example, the age may be correlated with each candidate protocol of the workflow and a candidate protocol corresponding to the age may be recommended in a preferential manner. Furthermore, the degree of obesity (weight and the like) may be correlated with each candidate protocol of the workflow and a candidate protocol may be recommended in a preferential manner according to the degree of obesity.

Omission (Skip) of Candidate Protocol Corresponding to Specific Attribute Information

Furthermore, a specific candidate protocol can also be omitted (skipped) using the attribute information. That is, the extraction function446omits a candidate protocol corresponding to the attribute information of the subject.

For example, when the degree of obesity is above a certain level, the “Ca Score” is expected to be above a certain value. Therefore, in the recommended workflow R21ofFIG.6C, when the degree of obesity of the subject is above a certain level, the extraction function446omits a scan for measuring the “Ca Score” and extracts the “protocol P22”. With this, when the degree of obesity of the subject is above a certain level, the scan of the “Ca Score” is omitted and the scan of the “protocol P22” is recommended to a user.

Edition of Workflow

Furthermore, for example, when a plurality of processes included in each candidate protocol of a workflow are referred to and a common process exists, the workflow may be edited by moving the common process (overlapping process) to a candidate protocol in a previous stage or a subsequent stage, or deleting the common process (overlapping process).

First, the “movement of the common process” will be described. For example, the generation function445edits a workflow by moving a common process among a plurality of processes included in parallel candidate protocols to a candidate protocol in a previous stage or a subsequent stage of the candidate protocols. Note that the “processes” included in the candidate protocols correspond to, for example, a preparation scan, a reconstruction process, and the like.

FIG.13A,FIG.13B, andFIG.13Care diagrams for explaining the editing process of the generation function445according to another embodiment.FIG.13A,FIG.13B, andFIG.13Cillustrate a process when the workflow W11ofFIG.4Ais edited.

As illustrated inFIG.13A, the workflow W11may include a common process among the “protocol P11”, the “protocol P14”, and the “protocol P16” that are parallel candidate protocols. In the example ofFIG.13A, the “protocol P11” includes a process α1, a process β1, and a process γ1. Furthermore, the “protocol P14” includes the process α1, the process β1, and a process γ2. Furthermore, the “protocol P16” includes the process α1, the process β1, and a process γ3. In such a case, the process α1and the process β1are processes common to the “protocol P11”, the “protocol P14”, and the “protocol P16”.

Therefore, as illustrated inFIG.13B, the generation function445moves the process α1and the process β1, which are common processes inFIG.13A, to the candidate protocol “whole body scan” in the previous stage, and changes the “whole body scan” to a “whole body scan+α1+β1”. The “whole body scan+α1+β1” indicates that the whole body scan, the process α1, and the process β1are executed in order. As a consequence, the “protocol P11” is changed to a “protocol P11′” including the process γ1. Furthermore, the “protocol P14” is changed to a “protocol P14′” including the process γ2. Furthermore, the “protocol P16” is changed to a “protocol P16′” including the process γ3. With this, the workflow W11is edited to a simpler workflow W12.

Moreover, as illustrated inFIG.13C, the generation function445may also move the process γ1and the process γ2inFIG.13Bto the protocols in the subsequent stages, respectively. For example, the generation function445moves the process γ1to the candidate protocols of “protocol P12” and “protocol P13” in the subsequent stage, thereby changing the “protocol P12” and the “protocol P13” to a “γ1+protocol P12” and a “γ1+protocol P13”, respectively. The “γ1+protocol P12” indicates that the process γ1and the protocol P12are executed in order, and the “γ1+protocol P13” indicates that the process γ1and the protocol P13are executed in order. As a consequence, the “protocol P11′” and the “protocol P14′” inFIG.13Bare deleted. With this, the workflow W12is edited to a simpler workflow W13.

Next, the “deletion of the common process” will be described. For example, the generation function445edits a workflow by deleting a common process among a plurality of processes included in candidate protocols arranged before and after.

FIG.14AandFIG.14Bare diagrams for explaining an editing process of the generation function445according to another embodiment.FIG.14AandFIG.14Billustrate a process when the workflow W11ofFIG.4Ais edited.

As illustrated inFIG.14A, the workflow W11may include a common process among the candidate protocol “whole body scan” in the previous stage and the candidate protocols “protocol P11”, “protocol P14”, and “protocol P16” in the subsequent stage. In the example ofFIG.14A, the “whole body scan” includes the process α1and the process β1. Furthermore, the “protocol P11” includes the process α1, the process β1, and the process γ1. Furthermore, the “protocol P14” includes process α1, process β1, and process γ2. Furthermore, the “protocol P16” includes process α1, process β1, and process γ3. In such a case, the process α1and the process β1are processes common to the “whole body scan”, the “protocol P11”, the “protocol P14”, and the “protocol P16”.

Therefore, as illustrated inFIG.14B, the generation function445deletes the process α1and the process β1, which are common processes inFIG.14A, from the candidate protocols “protocol P11”, “protocol P14”, and “protocol P16” in the subsequent stages, respectively. As a consequence, the “protocol P11” is changed to a “protocol P11′” including the process γ1. Furthermore, the “protocol P14” is changed to a “protocol P14′” including the process γ2. Furthermore, the “protocol P16” is changed to a “protocol P16′” including the process γ3. With this, the workflow W11is edited to a simpler workflow W14.

Although not illustrated in the drawings, the generation function445may also move the process γ1and the process γ2inFIG.14Bto the protocols in the subsequent stages, respectively. For example, the generation function445moves the process γ1to the candidate protocols “protocol P12” and “protocol P13” in the subsequent stages, thereby changing the “protocol P12” and the “protocol P13” to a “γ1+protocol P12” and a “γ1+protocol P13”, respectively. As a consequence, the “protocol P11′” and the “protocol P14′” can be deleted as inFIG.13C.

Note that the contents described inFIG.13AtoFIG.13CandFIG.14AandFIG.14Bare merely examples and the embodiment is not limited thereto. For example, even when a common process exists among the “protocol P11”, the “protocol P12”, and the “protocol P13”, or even when a common process exists between the “protocol P14” and the “protocol P15”, the common process can be moved or deleted in the same manner.

In this way, the generation function445can reduce the number of processes included in a workflow and simplify the workflow by specifying a process common to protocols and moving or deleting the common process. As a consequence, the X-ray CT apparatus1can provide a simpler and easy-to-use workflow for engineers or doctors who actually take the lead in an examination.

Medical Information Processing System

Furthermore, for example, the processes according to the aforementioned embodiment can be provided as a server device (image processing server) on a network. The server device can provide, for example, an information processing service (cloud service) via the network.

For example, the server device performs an interpretation alert function. That is, the server device receives a medial image imaged by a medical image diagnostic apparatus such as an X-ray CT apparatus and performs an analysis process before interpretation. Then, the server device analyzes whether an urgent abnormality exists in the analysis process, and issues an alert in an interpretation request list (list of images waiting for interpretation) to increase the priority of interpretation when the abnormality is found. Similarly to the aforementioned “analysis application”, the “analysis process” detects a feature in an image as an “abnormality” by image analysis, or detects an “abnormality” by comparing an arbitrary parameter obtained from an image with a threshold value. That is, the interpretation alert function can generate information corresponding to the “scan result” described in the first embodiment, such as information on a damage site and the value of an Agatston score, by the analysis process.

The server device according to the present embodiment can perform at least one of the “generation process” of the workflow and the “extraction process” of the candidate protocol according to the aforementioned embodiment, in addition to the interpretation alert function.

FIG.15is a block diagram illustrating an example of a configuration of a medical information processing system according to another embodiment. As illustrated inFIG.15, for example, a server device100is installed in a service center that provides an information processing service. The server device100is connected to an operating terminal101. Furthermore, the server device100is connected to a plurality of client terminals103A,103B, . . . ,103N via a network102. Note that the server device100and the operating terminal101may also be connected via the network102. Furthermore, when the client terminals103A,103B, . . . ,103N are generally referred without distinction, they are described as a “client terminal103”. Furthermore, the medical information processing system includes the server device100and the client terminal103.

The operating terminal101is an information processing terminal used by a person (operator) who operates the server device100. For example, the operating terminal101includes an input device such as a mouse, a keyboard, and a touch panel for receiving various instructions and setting requests from the operator. Furthermore, the operating terminal101includes a display device for displaying an image or displaying a GUI used when the operator inputs various setting requests by using the input device. The operator can transmit various instructions and setting requests to the server device100or browse information inside the server device100by operating the operating terminal101. Furthermore, the network102is an arbitrary communication network such as the Internet, a wide area network (WAN), and a local area network (LAN).

The client terminal103is an information processing terminal operated by a user who uses an information processing service. The user is, for example, a medical worker such as a doctor and an engineer who work in a medical institution. For example, the client terminal103corresponds to an operating terminal of a medical image diagnostic apparatus such as a console device included in an X-ray CT apparatus. The client terminal103has a client function enabling use of the information processing service provided by the server device100. Note that the client function is pre-recorded in the client terminal103in the form of a computer program that can be executed by a computer. Furthermore, the client terminal103may be an information processing device such as a personal computer and a workstation connected to the medical image diagnostic apparatus.

The server device100includes a communication interface110, storage circuitry120, and processing circuitry130. The communication interface110, the storage circuitry120, and the processing circuitry130are communicably connected to one another.

The communication interface110is, for example, a network card or a network adapter. The communication interface110is connected to the network102to perform information communication between the server device100and an external device.

The storage circuitry120is, for example, a Not AND (NAND)-type flash memory or a hard disk drive (HDD), and stores therein various computer programs for displaying medical image data and GUI, and information to be used by the computer programs.

The processing circuitry130is an electronic device (processor) that controls the overall processing in the server device100. The processing circuitry130performs a generation function131, an extraction function132, and an output control function133. The processing functions performed by the processing circuitry130are recorded in the storage circuitry120in the form of computer programs that can be executed by a computer, for example. The processing circuitry130reads and executes the computer programs, thereby implementing the functions corresponding to the respective read computer programs. The generation function131, the extraction function132, and the output control function133can perform basically the same processing as the generation function445, the extraction function446, and the output control function447illustrated inFIG.1.

First, the “generation process” in the server device100will be described. For example, the storage circuitry120of the server device100stores therein history information. The history information is collected from the client terminals103. The timing at which the history information is collected is as follows, for example: the history information may be collected each time a scan is executed by each protocol, and may be collectively collected at the timing when the generation process is performed by the server device100.

Then, the generation function131performs the generation process of generating a workflow on the basis of the collected history information. Since the generation process is the same as the process illustrated inFIG.2, for example, description thereof will be omitted. Then, the output control function133stores the generated workflow in the storage circuitry120or a storage device (memory41or the like) of each client terminal103. For example, preferably, the workflow is stored in the storage circuitry120when the extraction process is performed by the server device100, and is stored in the storage device of each client terminal103when the extraction process is performed by each client terminal103.

Next, the “extraction process” in the server device100will be described. For example, each time a scan is executed, each client terminal103transmits (uploads) a medical image obtained by the scan to the server device100. Note that the transmission of the medical image may be automatically performed by each client terminal103, or may be manually performed (manually operated) by a user.

Then, the extraction function132performs the extraction process of extracting a candidate protocol on the basis of the workflow. The extraction process is basically the same as illustrated inFIG.5, for example, but by acquiring the processing result of the analysis process performed by the aforementioned interpretation alert function, a common process (overlapping process) can be omitted. That is, when the information corresponding to the scan result has been generated by the interpretation alert function of the server device100, the extraction function132acquires the information corresponding to the scan result from the interpretation alert function. With this, the extraction function132can omit a process corresponding to step S204ofFIG.5.

Then, the output control function133transmits (downloads) the extracted candidate protocol to each client terminal103. Specifically, the output control function133transmits the candidate protocol to the client terminal103that is a transmission source of the medical image.

In this way, the server device100can perform the workflow generation process and the candidate protocol extraction process in addition to the interpretation alert function. With this, a user of each client terminal103can easily select an appropriate protocol.

Note that the aforementioned process is merely examples and the embodiment is not limited thereto. For example, an arbitrary function of the interpretation alert function, the generation process, and the extraction process may be performed by the client terminal103or another external device. For example, the interpretation alert function and the generation process may be performed by the server device100, and the extraction process may be performed by the client terminal103(such as the console device of X-ray CT apparatus).

In addition to the aforementioned embodiments, various different embodiments may also be implemented.

Medical Image Diagnosis Apparatus

In the above embodiments, the cases where the processing according to the above embodiments is executed by the X-ray CT apparatus1have been described; however, embodiments are not limited thereto. The processing according to the above embodiments can also be performed by, for example, other medical image diagnosis apparatuses, such as magnetic resonance imaging (MRI) apparatuses and ultrasonic diagnostic apparatuses, as well as the X-ray CT apparatus1.

Furthermore, the respective components of the respective apparatuses illustrated in the drawings are functional conceptual ones and do not necessarily have to be physically configured as illustrated in the drawings. That is, specific forms of distribution and integration of the respective apparatuses are not limited to those illustrated in the drawings and all or some of the apparatuses can be configured to be distributed or integrated functionally or physically in any units depending on various loads, usage conditions, and the like. Moreover, all or any part of processing functions performed by the respective apparatuses can be implemented by a CPU and a computer program analyzed and executed by the CPU, or can be implemented as hardware by wired logic.

Furthermore, among the respective processes described in the aforementioned embodiments and modifications, all or some of the processes described as being automatically performed can also be manually performed, or all or some of the processes described as being manually performed can also be automatically performed by a known method. In addition, processing procedures, control procedures, specific names, and information including various data and parameters indicated in the aforementioned specification and the drawings can be modified in any manner unless otherwise specified.

Furthermore, the scanning method described in the aforementioned embodiments and modifications can be implemented by executing a scanning program prepared in advance on a computer such as a personal computer and a work station. The scanning program can be distributed via a network such as the Internet. Furthermore, the scanning program can also be executed by being recorded on a non-transitory recording medium such as a hard disk, a flexible disk (FD), a CD-ROM, a MO, and a DVD that can be read by a computer, and being read from the recording medium by the computer.

According to at least one embodiment described above, it is possible to easily select an appropriate protocol.