Medical reporting system, apparatus and method

A medical reporting system includes a display panel for displaying plural CT images. A ROI setting unit designates a region of interest in the CT images. A group setting unit sets a group of specific CT images having the region of interest among the CT images, to generate group information of the group. A report editor displays a note area for inputting a note related to the specific CT images. A memory stores a text location of the note area assigned to the group information, and stores location information of the region of interest in the specific CT images. Furthermore, a first terminal device has the report editor, the ROI setting unit and the group setting unit. A second terminal device communicates with the first terminal device on line. A reporting display panel displays at least the specific CT images and the note.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates to a medical reporting system, apparatus and method. More particularly, the present invention relates to a medical reporting system, apparatus and method in which a set of plural medical images can be handled for observation without error for high precision in the diagnosis.

2. Description Related to the Prior Art

In a hospital as medical facilities, various modality systems are utilized for diagnosis, including a CR (computed radiography) device, CT (computed tomography) device, MRI (magnetic resonance imaging) device, PET (positron emission tomography) device, and ultrasonic diagnosis device. To examine a patient, a doctor utilizes medical images obtained by modality systems to find symptoms of the patient in a precise manner.

The doctor of each of hospital departments requests a diagnostic radiologist as specialized doctor of an inspection department who reads the medical image for the purpose of diagnosis. The radiologist, after reading the medical image in response to the request, writes a medical report and sends it to the doctor of the specific hospital department. Then he or she makes a patient note by final observation of the patient in consideration of the medical report.

A medical image filing system has been recently proposed to raise efficiency in medical management. The medical images and progress notes are processed electronically, so image reading is carried out on line. For example, JP-A 2004-305289 discloses producing the medical report in the medical image filing system. Attribute information is added to a note area in the medical report for determining the medical image and a text location within the medical image. A portion of the medical image assigned with the note can be easily recognized.

In the medical examination, a region of interest of an organ, lesion or site within a body extends in a three dimensional manner. In general, a plurality of medical images are created for examination with the CT or MRI device.

In JP-A 2004-305289, however, manual operation is complicated typically if the region of interest appears in any of a plurality of medical images. The medical images are designated by one image, and the region of interest is designated by one region in the medical image, for the purpose of assignment of the progress note. Furthermore, there is no grouping of images of the region of interest being the same. There is no association of two or more regions of interest in the medical image. After the medical report is edited, there occurs a problem when the doctor wishes to refer to the medical report visually for diagnosis. Every one of the medical images must be observed according to comments in the medical report. There is no simultaneous observation of a plurality of medical images. There is no concentrated observation of the region of interest for a plurality of medical images. Precision in the diagnosis cannot be higher, because of limited efficiency in the observation of the medical images in an electronic manner.

SUMMARY OF THE INVENTION

In view of the foregoing problems, an object of the present invention is to provide a medical reporting system, apparatus and method in which a set of plural medical images can be handled for observation without error for high precision in the diagnosis.

In order to achieve the above and other objects and advantages of this invention, a medical reporting system includes a display panel for displaying plural medical images. A ROI setting unit designates a region of interest in the medical images A group setting unit sets a group of specific medical images having the region of interest among the plural medical images, to generate group information of the group. A report editor displays a note area for inputting a note related to the specific medical images. An assigning unit assigns a text location of the note area to location information of the region of interest in the specific medical images assigned to the group information, so as to store the text location and the location information.

The ROI setting unit extracts an abnormal shadow from data of the medical images, and the region of interest is a portion with the abnormal shadow.

Furthermore, there is a reporting display panel. A display control unit controls the reporting display panel according to the text location and the location information assigned to the group information, to display the specific medical images, the region of interest and the note.

Furthermore, an additional memory stores metadata assigned to the medical images and adapted to discernment. The report editor causes display of the metadata of the specific medical images in the note area among the medical images.

The display control unit displays the specific medical images according to the group information and the location information.

The display control unit enlarges or reduces the specific medical images simultaneously in the reporting display panel by display control.

In one preferred embodiment, the display control unit enlarges or reduces the specific medical images discretely from one another by display control.

Also, the display control unit moves the specific medical images simultaneously in a scroll manner.

In another preferred embodiment, the display control unit moves the specific medical images in a scroll manner discretely from one another by display control.

Furthermore, a first terminal device has the report editor, the ROI setting unit and the group setting unit. A second terminal device communicates with the first terminal device through a network. A reporting display panel is controlled by the second terminal device, for displaying at least the specific medical images and the note.

The plural medical images are tomographic images of a body.

Furthermore, a processor combines the tomographic images to reconstruct a 3D image.

Also, a medical reporting apparatus includes a display panel for displaying plural medical images. A ROI setting unit designates a region of interest in the medical images. A group setting unit sets a group of specific medical images having the region of interest among the plural medical images, to generate group information of the group. A report editor displays a note area for inputting a note related to the specific medical images. A memory stores a text location of the note area assigned to the group information, and for storing location information of the region of interest in the specific medical images assigned to the group information.

Also, a medical reporting method includes a display step of displaying plural medical images. In a ROI setting step, a region of interest in the medical images is designated. In a group setting step, a group of specific medical images having the region of interest is set among the plural medical images, to generate group information of the group. In an editing step, a note area is displayed for inputting a note related to the specific medical images. In an assigning step, a text location of the note area is assigned to the group information, and location information of the region of interest in the specific medical images is assigned to the group information.

In one preferred embodiment, a computer executable program for medical image filing is provided, and includes a display program code for displaying plural medical images. A ROI setting program code is for designating a region of interest in the medical images. A group setting program code is for setting a group of specific medical images having the region of interest among the plural medical images, to generate group information of the group. An editing program code is for displaying a note area for inputting a note related to the specific medical images. An assigning program code is for assigning a text location of the note area to the group information, and assigning location information of the region of interest in the specific medical images to the group information.

Also, a user interface for medical image filing is provided, and includes a screen area for displaying plural medical images. A ROI setting region designates a region of interest in the medical images. A group setting region sets a group of specific medical images having the region of interest among the plural medical images, to generate group information of the group. There is a note area for inputting a note related to the specific medical images. An assigning region assigns a text location of the note area to the group information, and assigning location information of the region of interest in the specific medical images to the group information.

In another preferred embodiment, a medical reporting system includes an image storage for storing information of plural medical images. A ROI memory stores information of a region of interest designated in the medical images. A group information memory stores group information generated by setting a group of specific medical images having the region of interest among the plural medical images. A note area memory stores information of a note area for inputting a note related to the specific medical images. A memory stores a text location of the note area assigned to the group information, and stores location information of the region of interest in the specific medical images.

Consequently, a set of plural medical images can be handled for observation without error for high precision in the diagnosis, because the group information can be checked to verify the specific medical images to be read, and the text location and location of the region of interest are assigned to a group of the specific medical images.

InFIG. 1, a hospital2of a large scale has specific hospital departments3, for example, internal, surgical and other departments, an inspection department4, and a medical reporting system5as medical network system for medical image filing. The inspection department4has an examination room6where a patient's body is examined to obtain medical images, and a reading room7where a doctor or radiologist reads medical images. Various modality systems9of high precision for medical use are installed in the examination room6, including CT (computed tomography) device, MRI (magnetic resonance imaging) device, CR (computed radiography) device and the like.

The medical reporting system5includes local terminal devices10, an image server11, a report server12, a report editing terminal device13for medical image filing, an LAN (local area network)14for communication between those devices.

The image server11has an image database (DB)16. The report server12has a report database (DB)17. An example of storage for the image database16and the report database17is a hard disk drive (HDD). After examination is requested in the inspection department4, medical images are created by each of the modality systems9. A case number (inspection ID) is assigned to the medical images from the modality systems9. Data of the medical images are transmitted through the LAN14to the image server11, and stored to the image database16. The report database17stores information of a report as a data file edited by the report editing terminal device13. The local terminal devices10are installed in the hospital departments3on the side of request of examination. A doctor utilizes one of the local terminal devices10to request the examination, to display a report, and for various purposes.

The report editing terminal device13is installed in the reading room7, and is constituted by any one of a personal computer, workstation and the like and a computer executable program set up therein for medical image filing. InFIG. 2, the report editing terminal device13includes a computer main unit18and a service console19. An input interface in the service console19includes a monitor display panel21, a mouse23, and a keyboard24. An editing screen area30as user interface for medical image filing appears on the monitor display panel21by the control of the report editing terminal device13according to transmitted data and other information.

The computer main unit18includes a CPU26, a working memory27, a hard disk drive (HDD)28and a communication interface29. The hard disk drive28is a well-known data storage device, and stores the operating system (OS), various programs, attribute information (inspection information) of medical images, and the like. Examples of the attribute information include information of case number, patient ID, patient's name, modality, inspection condition and the like. The working memory27is a temporary memory for use in executing a control program in the monitor display panel21. The communication interface29performs control of communication according to a communication protocol in the LAN14for transmitting and receiving data on line.

The CPU26controls various elements in the computer main unit18, and runs a computer executable program to edit a medical report. Thus, the CPU26includes elements of a report editor26a, a display control unit26b, a ROI setting unit26c, a group setting unit26dand an assigning unit26e.

InFIG. 6, the editing screen area30is displayed on the monitor display panel21, while the display control unit26boperates. The editing screen area30includes a region of a viewer31and a region of an editor32. The region of the viewer31displays medical images read from the image database16. In the examination of the CT, MRI or the like with plural images, all medical images from one time of the examination are displayed together. For example, six CT (computed tomography) images33a-33fas medical images are created by the CT device and displayed in the region of the viewer31at one time. The CT images33a-33fare obtained by consecutive slice of a patient's body on planes as a cross section. The CT image33ais assigned with metadata of No. 1 as created in the lowest position among the CT images33a-33f. The CT images33b-33fare assigned with metadata of Nos. 2-6, because created one after another upwards from the lowest position.

In the region of the editor32are indicated a patient note window36for a note or comment, attribute information37of the inspection, and a completion button38. The patient note window36has patient note areas36a,36band36cfor a note or comment of findings, features and the like according to observation. When a pointer of a mouse is positioned at each of the patient note areas36a-36c, a keyboard is manually operated to draft and input a note. For example, a diagnostic radiologist after reading the images inputs a note for the CT image33ato at least one of the patient note areas36a-36c. In the embodiment, a note for presence of a lesion in the CT images33c-33fof Nos. 3-6 is drafted and input to the patient note area36aas a finding. In response to the input, the assigning unit26eoperates for assigning the information of CT images with a text location of the note.

InFIG. 4, a flow chart is illustrated for a process in the report editing terminal device13with steps of inputting a note, assigning image information, and finally editing a report.

To edit a medical report in the report editing terminal device13, at first the service console19is manually operated to input a case number (inspection ID). The image server11is accessed to retrieve medical images from the image database16according to the case number. Also, attribute information (inspection information) assigned with the case number is read from the hard disk drive28. The report editing terminal device13displays the editing screen area30ofFIG. 3, so the radiologist creates a medical report by following instructions on the editing screen area30.

The radiologist after reading the CT images33a-33fon the region of the viewer31drafts and inputs a note at the patient note areas36a-36c, and then designates a region of interest (ROI)40where a lesion is present within each of the CT images33a-33f. To this end, a service console is operated to enter a signal for the designation. When he or she moves a cursor around a portion of the lesion by clicking the mouse23, the ROI setting unit26coperates to designate the region of interest40with a slightly larger range than the lesion pointed by a click. The region of interest40is indicated in a specific form distinct from the remaining portion of each of the CT images33a-33f, for example, with a different brightness, with a clear contour line, with a specific color, or in a filtered form.

Note that various known techniques can be used for designating the region of interest (ROI)40in medical images, for example, CAD (Computer Aided Diagnosis) system, in which abnormal shadows are automatically extracted from data of medical images, to designate portions of the abnormal shadows as the region of interest40.

For all the CT images33c-33fof Nos. 3-6, the region of interest (ROI)40is designated as illustrated inFIG. 5A. Then the group setting unit26dselectively designates the CT images33c-33fafter designation of the region of interest40, to produce group information as illustrated inFIG. 5B. In the embodiment, the group information is defined by a group of the CT images33c-33fof Nos. 3-6, and is stored in the working memory27. Note that frame lines41appear about CT images for clarifying the group setting of the CT images33c-33fof Nos. 3-6. The group will correspond to a data file later.

After the group setting, the CT image33eof No. 5 is selected among the CT images33c-33fof Nos. 3-6 in the group. The mouse23is operated for drag. A pointer of the mouse23is set near to the note in the patient note area36aand is operated for drop. Then the assigning unit26edesignates a text location45of the patient note area36aat the pointer. The text location45is stored in association with the group information and information of the position and size of the region of interest (ROI)40in the CT images33c-33faccording to the group information. Note that various modes of inputs can be used in place of the drag and drop of the mouse23, for example, an input of a short-cut key on the keyboard24or other predetermined mode with any of input devices. Then Nos. 3-6 of the CT images as metadata are indicated in the text location45and near to the note for easy recognition of the assignment in a visual manner.

Then the completion button38is clicked upon completion of inputting a note and assignment to the note. The report editor26aoperates in response to the click, to edit a medical report or a data file including the note and meta information assigned to the note. The medical report is stored in the report database17.

The medical report edited by the report editing terminal device13is read from the report database17, so as to display information of the note and images assigned with the note. In the embodiment, the local terminal device10as second terminal device operates to retrieve the medical report in a separate manner from the report editing terminal device13. However, the report editing terminal device13as a single device may edit and then retrieve a medical report.

In the embodiment, the local terminal device10retrieves and displays a medical report, for a doctor to view the report as a result of his or her request for the examination. InFIG. 7, the local terminal device10includes a processor51, a monitor display panel52as user interface, a keyboard53and a mouse54. A display control unit56and a communication interface57are provided in the processor51. A reporting screen area60as user interface is caused to appear on the monitor display panel52by the display control unit56according to the retrieval of the data file of the medical report.

It is possible in the local terminal device10to access the report server12through the LAN14by inputting the case number (inspection ID) for retrieving a medical report. Group information assigned to the note on the medical report, and location information related to the region of interest (ROI)40in medical images according to the group information, are read when the medical report is received. Data of the medical images are retrieved from the report database17. The monitor display panel52is caused to display the reporting screen area60as illustrated inFIG. 7upon receipt of the medical report and medical images. The reporting screen area60includes a patient note window61for a note or comment, a specific image area62, a cursor button63, and enlargement/reduction buttons64aand64b. The patient note window61includes patient note areas61a,61band61cfor a note or comment drafted on the editing screen area30. The specific image area62displays all medical images according to the group.

The patient note window61displays plural notes and Nos. 3-6 to denote the CT images33c-33fassigned with the text location45of the notes. When Nos. 3-6 are clicked, assignment is checked, and the CT images33c-33fof the group are displayed on the specific image area62. Those can be verified for their common body part. Also, location information related to the region of interest (ROI)40in the CT images33c-33fis read. The region of interest40is displayed in a visually distinct manner from the remaining portions.

When the CT images33c-33fare displayed in the specific image area62, the cursor button63is clicked, to move the images in each of the directions of the cursor button63in a scroll manner. Thus, the region of interest (ROI)40can be positioned at the center of each of the images. When the enlargement/reduction buttons64aand64bare clicked, the images are enlarged or reduced while displayed. The use of the cursor button63and the enlargement/reduction buttons64aand64bcan adjust the region of interest40as illustrated inFIG. 8for the position and size with reference to each of the CT images. Note that all of the CT images33c-33fin the specific image area62can be either enlarged or reduced at the same time, and can be moved in scroll at the same time. Otherwise, it is possible to designate at least one of the images in the specific image area62and to enlarge or reduce, or move the designated one of the images.

The operation of the embodiment is described now. The report editing terminal device13is operated to edit a medical report in which a text location within the patient note window36is assigned to group information and location information of the region of interest (ROI)40inside medical images. Information of the medical report is transmitted to the report server12. When the medical report of the data file is retrieved from the report server12and displayed, the location information related to the region of interest40in the medical images of the group is assigned to the medical report together with the group information. Thus, all the medical images can be displayed with the region of interest40of one patient and in a distinct manner for the region of interest40. As a doctor after the request for the examination can view all the medical images of the group with the region of interest40, the medical images are verified for their common body part. The precision in the diagnosis can be high. All the medical images according to the group can be displayed by use of the local terminal device10in an enlarged manner about a center defined at the region of interest40. Thus, the precision in the diagnosis can be still higher by the observation of the enlarged images.

In the embodiment, medical images are displayed in a two dimensional manner. In contrast, another preferred embodiment ofFIG. 9is based on a display method of three dimensional images by reconstruction of tomographic images obtained by a CT device or MRI device. On a reporting screen area71as user interface, a 3D image70is displayed. The display control unit56in the processor51of the local terminal device10includes a component for reconstruction of tomographic images to create a 3D image.

To display the 3D image70after reconstruction with the CT images33c-33fas illustrated inFIG. 9, a slice thickness used in the course of forming the CT images33c-33fis input initially. As a method of inputting the slice thickness, a service console of the local terminal device10can be operated. Also, information of the slice thickness can be previously assigned to the CT images33c-33f, and can be read.

A value of a slice thickness is used to reconstruct the CT images33c-33fin an overlaid manner on one another to display the CT images33c-33fon the reporting screen area71, to create the 3D image70. It is possible to use an actual value of the slice thickness, or to use a reference thickness as a product obtained by multiplying the slice thickness by a predetermined coefficient. Also for the region of interest (ROI)40included in the CT images33c-33f, images are reconstructed into a 3D image in the same processing. A 3D image portion70bof the region of interest40is displayed and overlapped with a 3D image portion70aof the entirety of the CT images. The 3D image portion70bof the region of interest40is displayed together with the 3D image portion70aof the entirety of the CT images for indication of an actual position relation according to the location information of the region of interest40assigned to the medical report. The region of interest40can be recognized visually in the three dimensional indication, to raise precision in the diagnosis.

In the above embodiment, the notes and medical images are displayed on a common display panel. However, it is possible to use a first display panel for displaying medical images and a second display panel for displaying a note of a medical report and the like.

In the above embodiment, the one text location in the patient note window36is assigned to group information and location information related to the region of interest (ROI)40of medical images according to the group information. However, plural locations in the patient note window36can be designated, and each of the locations in the patient note window36can be assigned to group information and location information related to the region of interest40of medical images according to the group information.

Also, medical images of the invention may be endoscopic images or the like other than tomographic images. Various well-known techniques in the DICOM (Digital Imaging and Communication in Medicine) in the field of the medical image filing may be used in combination with the present invention.