X-RAY DIAGNOSTIC APPARATUS AND X-RAY DIAGNOSTIC SYSTEM

In one embodiment, an X-ray diagnostic apparatus can communicate with a controller configured to operate a catheter robot capable of moving an inserted device within the object and comprises a display and processing circuitry. The display is configured to display at least one fluoroscopic image of an object. The processing circuitry is configured to receive a control signal indicating a content of an operation on the catheter robot from the controller, acquire a plurality of fluoroscopic images of the object by irradiating the object with X-rays, control X-ray irradiation to the object, cause the display to display the plurality of fluoroscopic images to be sequentially acquired when the X-ray irradiation is performed, generate a plurality of reproduced images based on the plurality of fluoroscopic images acquired before a stop of the X-ray irradiation and cause the display to display the plurality of reproduced images when the X-ray irradiation is stopped.

CROSS-REFERENCE TO RELATED APPLICATION

This application is based upon and claims the benefit of priority from Japanese Patent Application No. 2023-089748 filed on May 31, 2023, the entire contents of which are incorporated herein by reference.

FIELD

Disclosed embodiments relate to an X-ray diagnostic apparatus and an X-ray diagnostic system.

BACKGROUND

A robotic catheter system assists a doctor in performing a catheterization such as PCI (Percutaneous Coronary Intervention), and such a robot for assisting the doctor in performing a medical procedure is hereinafter referred to as a “catheter robot”. For example, the catheter robot can insert a device such as a catheter into an object such as a patient and move the device within the object. When the doctor or another user operates a robot console installed near the X-ray diagnostic apparatus such as an X-ray angiography apparatus or installed at a remote location away from the X-ray diagnostic apparatus, the device inserted into the object, such as a catheter, can be moved by the catheter robot.

Normally, the catheter robot is operated at the same time as X-ray imaging using the X-ray diagnostic apparatus such as an X-ray angiography apparatus. For example, the X-ray diagnostic apparatus irradiates the object with X-rays to time-sequentially generate fluoroscopic images in real-time such that the doctor can observe the movement of the vascular system and the movement and current position of the catheter to be moved by the catheter robot. In such a case, there is a known technique that reduces the radiation exposure of the object and the doctor by lowering the X-ray frame rate in accordance with the movement of the catheter and the vascular system.

However, if the X-ray frame rate is lowered with respect to the organs having movements such as the heart, it becomes impossible to observe movement smoothly. Furthermore, even if the X-ray frame rate is lowered, since X-rays continues to be irradiated, the object and/or the doctor will continue to be exposed to radiation.

As compared with a usual catheterization directly performed by the doctor (i.e., manual surgical operation by the doctor), the doctor has difficulty operating the catheter robot intuitively. Thus conceivably, it takes more time for the doctor to check the current position of the tip of the catheter. Hence, even if the dose of X-ray irradiation is reduced during the time the doctor checks the current position of the tip of the catheter, the radiation exposure during the check period cannot necessarily be reduced.

DETAILED DESCRIPTION

Hereinbelow, embodiments of an X-ray diagnostic apparatus and an X-ray diagnostic system will be described in detail by referring to the accompanying drawings.

In one embodiment, an X-ray diagnostic apparatus can communicate with a controller configured to operate a catheter robot capable of inserting a device into an object and moving the device within the object and comprises a display and processing circuitry. The display is configured to be able to display at least one fluoroscopic image of an object. The processing circuitry is configured to receive a control signal indicating a content of an operation on the catheter robot from the controller, acquire a plurality of fluoroscopic images of the object by irradiating the object with X-rays, control X-ray irradiation to the object, cause the display to display the plurality of fluoroscopic images to be sequentially acquired when the X-ray irradiation is performed, generate a plurality of reproduced images based on the plurality of fluoroscopic images acquired before a stop of the X-ray irradiation and cause the display to display the plurality of reproduced images when the X-ray irradiation is stopped.

First Embodiment

FIG.1is a block diagram illustrating a configuration of an X-ray diagnostic system1that includes an X-ray diagnostic apparatus200according to the first embodiment.FIG.2Ais a perspective view illustrating an appearance of the X-ray diagnostic apparatus200according to the first embodiment.

As shown inFIG.1, the X-ray diagnostic system1includes a medical image processing apparatus100, the X-ray diagnostic apparatus200, and a robotic assistant apparatus6. These apparatuses are communicably connected to each other via a network2.

The X-ray diagnostic apparatus200includes a scanner210, a bed220, a controller230, and an image processing device240. The scanner210, the bed220, and the controller230are generally installed in an operating room (i.e., an examination room or a treatment room), and the image processing device240is installed in a control room adjacent to the operating room.

The scanner210includes an X-ray high-voltage generator211, an X-ray irradiator212, a table (i.e., a table for a catheterization)221, a C-arm214, an X-ray detector215, a C-arm drive mechanism231, and a bed drive mechanism232.

The X-ray irradiator212is provided at one end of the C-arm214. The X-ray irradiator212is provided so as to be able to rotate and move in an arc under the control of the controller230. The X-ray irradiator212includes an X-ray source216(for example, an X-ray tube) and an adjustable aperture217. The X-ray source216is supplied with high-voltage power from the X-ray high-voltage generator211, and generates X-rays in accordance with the conditions of the high-voltage power. The adjustable aperture217movably supports aperture blades made of an X-ray shielding material at an X-ray irradiation port of the X-ray source216.

The X-ray detector215is provided at the other end of the C-arm214so as to face the X-ray irradiator212. The X-ray detector215is provided so as to be able to rotate and move in an arc under the control of the controller230. The X-ray detector215includes an FPD (Flat Panel Detector)218and an ADC (Analog to Digital Converter)219.

The FPD218has a plurality of detection elements arranged in two dimensions. Between the respective detection elements of the FPD218, scanning lines and signal lines are arranged so as to be orthogonal to each other. Note that a grid may be provided on the front of the FPD218.

The ADC219converts projection data of time-sequential analog signals (i.e., video signal) outputted from the FPD218into digital signals, and outputs the digitalized time-sequential projection data to the image processing device240.

As shown inFIG.2A, the C-arm214disposes both the X-ray irradiator212and the X-ray detector215in such a manner that both face each other with an object P interposed in the middle of both. As shown inFIG.1, under the control of the controller230, the C-arm214integrally rotates both the X-ray irradiator212and the X-ray detector215and moves both in the arc direction of the C-arm214by the C-arm drive mechanism231. In the following, a description will be given of a case where the X-ray diagnostic apparatus200is provided with the C-arm214and this C-arm214integrally drives the X-ray irradiator212and the X-ray detector215.

The bed220is supported by the floor and supports the table221. Under the control of the controller230, the bed220can slide the table221(in the X-axis and Z-axis directions), lift and lower the table221(in the Y-axis direction), and roll the table221by the bed drive mechanism232. Although a description will be given of an under-tube type scanner210in which the X-ray irradiator212is disposed below the table221, the scanner210may be configured as an over-tube system in which the X-ray irradiator212is disposed above the table221.

The controller230includes a CPU (Central Processing Unit) and a memory (not shown). The controller230controls the driving of the X-ray irradiator212, the X-ray detector215, and the C-arm214of the scanner210as well as the driving of the bed220for positioning under the control of the image processing device240. The controller230also controls the operation of each of the X-ray irradiator212, the X-ray detector215, and the C-arm drive mechanism231for X-ray radiographic imaging and/or X-ray fluoroscopic imaging under the control of the image processing device240.

The image processing device240is configured based on a computer, and includes processing circuitry241, a memory242, an input interface243, a network interface244, and a display250.

The processing circuitry241is a circuit that controls the operation of the entirety of the X-ray diagnostic apparatus200, and controls the controller230by executing various programs read out from the memory242on the basis of an input from a user U via the input interface243and/or various data read out from the memory242. In addition, the processing circuitry241generates X-ray images such as a fluoroscopic image and a radiographic image of the object P on the basis of the signals acquired by the scanner210, and controls respective components such that the X-ray images for display stored in the memory242are displayed on the display250, for example.

The memory242stores: image data; various data such as diagnostic information and diagnostic protocols; and various programs for the control by the controller230, for image processing, and for display processing, for example. The memory242is achieved by an optical disk, a hard disk, and a semiconductor memory element such as a RAM (Random Access Memory) and a flash memory, for example.

The network interface244is an interface for communicating with various apparatuses connected to the network2by wire or wirelessly. For example, the X-ray diagnostic apparatus200can exchange various data and images with the medical image processing apparatus100and the robotic assistant apparatus6through the network interface244.

The input interface243includes: an input device that can be operated by the user U; and an input circuit that receives signals from the input device. The input device can be achieved by a mouse, a keyboard, a touchpad that performs input operations by touching an operation surface, a touchscreen in which a display screen and a touchpad are integrated, a non-contact input circuit using an optical sensor, and a voice input circuit, for example.

The display250displays a GUI (Graphical User Interface) for receiving an instruction from the user U through the input interface243and X-ray images generated by the image processing device240, for example. The display250also displays various messages and display information to notify the user U of the processing status and processing results of the X-ray diagnostic apparatus200. In addition, the display250may have a speaker and output audio. Further, the display250can display various support images and/or support information generated by the medical image processing apparatus100for supporting operations on the catheter4, as exemplified by data and images received from various apparatuses connected to the network2.

FIG.1shows the catheter4and a medical device40. In this specification, mainly, a thin medical device to be inserted into the body cavity of the object P or into a tubular tissue such as a blood vessel for treatment or diagnosis is referred to as the catheter4. The catheter4includes, for example, a thin tube constituting its main body, a guidewire for guiding the catheter4to the treatment target site, and the medical device40attached to the tip of the catheter4.

The medical device40is a part to be used for treatment at a predetermined target site after the catheter4is inserted into the body of the object P. Aspects of the medical device40include devices such as an occlusion device, a balloon, and a stent. As one case in the following description, the target site for treatment is assumed to be the heart and its surroundings.

The medical image processing apparatus100has the function of controlling the robotic assistant apparatus6. The robotic assistant apparatus6is an apparatus that can perform an operation of inserting the catheter4into the object P and moving the catheter4to the treatment target site of the object P. This operation is performed on the basis of user operations on a console60that is installed remotely from the X-ray diagnostic apparatus200. The robotic assistant apparatus6may be referred to as a robotic catheter system6or a catheter robot6. The console60of the robotic assistant apparatus6may be located at a remote location different from the operating room or may be located inside the operating room. The robotic assistant apparatus6is one example of a catheter robot.

FIG.2Bis a perspective view illustrating an appearance of the console60of the robotic assistant apparatus6. As shown inFIG.1andFIG.2B, the robotic assistant apparatus6includes the console60and a robot main-body67. The robot main-body67is disposed near the bed220, and can insert the catheter4into the object P and move the catheter4to the treatment target site within the object P.

The console60includes a display61, a controller62, a table63, and a foot switch64. The display61and the controller62are disposed on the table63, for example. The foot switch64is disposed under the table63, for example.

The display61displays information or patient-specific data to the user near the console60. For example, the display61displays X-ray images, CT images, hemodynamic data such as blood pressure and heart rate, and patient record information such as a medical history, age, and weight. In addition, the display61displays procedure-specific information such as duration of the procedure, a catheter position, a guidewire position, and volume of a delivered drug or a delivered contrast agent. The display61also displays information on the position of the catheter4.

The display61may display the same image as the image displayed on the display250of the X-ray diagnostic apparatus200(for example, a fluoroscopic image and a reproduced image described below).

The controller62is a device for operating the robotic assistant apparatus6that can insert the catheter4into the object P and move the catheter4within the object P. For example, the controller62can be configured to: advance, retreat, or rotate the catheter4; inflate or deflate a balloon installed on the catheter4; place and deploy a stent; inject a contrast medium into the catheter4; and inject a drug into the catheter4. The controller62can implement various other functions that may be part of a medical procedure based on the catheter4. In order to achieve this, the controller62may be configured to cause the robot main-body67to perform various tasks with the use of various percutaneous intervention devices that may be provided in the robot main-body67.

The controller62includes a touch screen621, a joystick622, and buttons623and624. The touch screen621displays one or more icons (not shown) related to the respective components of the controller62. For example, the joystick622is configured to advance, retract, or rotate various components and percutaneous devices including the catheter4. For example, corresponding to the direction and amount (angle) of the joystick622operated by the user U, the components and the percutaneous devices operate. The buttons623and624may include a button for selecting a reproduction speed of many frames of time-sequential images, for example.

The foot switch64is a switch that allows the user U to turn on or turn off X-ray irradiation with his/her foot. The foot switch64is one example of an operation switch. The foot switch64may be installed near the bed220. In this case, the switching operation of turning on or turning off the X-ray irradiation with the use of the foot switch64may be performed by another user other than the user U of the console60.

FIG.3is a block diagram illustrating a configuration of the medical image processing apparatus100according to the first embodiment. As shown inFIG.3, the medical image processing apparatus100is configured to be able to communicate with the X-ray diagnostic apparatus200and the robotic assistant apparatus6via the network2. The medical image processing apparatus100is configured as a computer such as a workstation and a personal computer. The medical image processing apparatus100provides the user U with images and information for supporting operations on the robotic assistant apparatus6.

The medical image processing apparatus100includes processing circuitry110, a memory120, an input interface130, a network interface140, and a display150. These components may be included in the image processing device240of the X-ray diagnostic apparatus200. In other words, the entire system of the first embodiment may be configured such that the X-ray diagnostic apparatus200includes the above-described components of the medical image processing apparatus100and these components implement the respective functions described below. In this case, the X-ray diagnostic apparatus200can communicate with the controller62.

The processing circuitry110has a special-purpose or general-purpose processor, and implements various functions described below through software processing by executing programs stored in the memory120. The processing circuitry110may include hardware such as an Application Specific Integration Circuit (ASIC) and a programmable logic device such as a Field Programmable Gate Array (FPGA). The various functions described below can also be achieved by hardware processing using these components. In addition, the processing circuitry110may achieve the various functions described below by combining software processing and hardware processing.

The processing circuitry110implements each of a signal reception function F01, an image acquisition function F02, an X-ray control function F03, a display control function F04, a cardiac signal acquisition function F05, and a respiration signal acquisition function F06.

The signal reception function F01includes a function to receive a control signal indicative of the operational detail by the user U on the robot main-body67from the controller62.

The image acquisition function F02includes a function to acquire fluoroscopic images of the object P by irradiating the object P with X-rays.

The X-ray control function F03controls X-ray irradiation to the object P. The X-ray control function F03includes a function to: perform the X-ray irradiation when the control signal indicates that the catheter4is moving inside the object P; and stop the X-ray irradiation when the control signal indicates that the catheter4is stopped inside the object P. The catheter4is one example of a device.

The display control function F04includes a function to time-sequentially display a plurality of fluoroscopic images acquired in real time on the display250while the X-ray irradiation is being performed. In the meantime, when the X-ray irradiation is stopped, the display control function F04includes a function to generate a plurality of reproduced images based on the plurality of fluoroscopic images acquired before a stop of the X-ray irradiation and display the plurality of reproduced images on the display250.

The cardiac signal acquisition function F05includes a function to acquire a cardiac signal (i.e., electrocardiogram) of the object P from an electrocardiogramat shown) attached to the object P. The cardiac signal is one example of electrocardiograma information.

The respiration signal acquisition function F06includes a function to acquire a respiration signal of the object P from a respiratory sensor (not shown) such as a microwave Doppler sensor. The respiration signal is one example of respiration information.

The memory25is composed of, for example, a hard disk, an optical disk, and a semiconductor memory element such as a flash memory and a RAM. The memory120stores various processing programs (including application programs and an operating system, for example) to be used by the processing circuitry110and data necessary for executing the programs. In addition, the memory120can store various data such as image data inputted via the input interface130and/or the network interface140.

The input interface130includes: an input device that can be operated by the user U; and an input circuit that receives signals from the input device. The input device can be achieved by a mouse, a keyboard, a touchpad that performs input operations by touching an operation surface, a touchscreen in which a display screen and a touchpad are integrated, a non-contact input circuit using an optical sensor, and a voice input circuit, for example.

The network interface140is an interface for communicating with various apparatuses connected to the network2by wire or wirelessly. For example, the medical image processing apparatus100can exchange various data with the X-ray diagnostic apparatus200and the robotic assistant apparatus6through the network interface140.

The display150provides movement support information on the catheter4generated by the medical image processing apparatus100to the user U. For example, the display150may be a large-size display device disposed at a position where it can be easily viewed by the user U. The display150may have a speaker so as to be able to output the movement support information in audio form. In addition to the data such as the movement support information generated by the processing circuitry110, the display150can also display data and images received from various apparatuses connected via the network2and various images generated by the medical image processing apparatus100for assisting the user U in operating the robotic assistant apparatus6, for example.

FIG.4is a flowchart illustrating the processing to be performed by the medical image processing apparatus100according to the first embodiment. This processing displays reproduced images or fluoroscopic images from X-ray fluoroscopic imaging for the user U, in accordance with the state of each switch. In the following, a description will be given of the processing in which the medical image processing apparatus100causes the display250of the image processing device240of the X-ray diagnostic apparatus200to display images. Note that the medical image processing apparatus100may cause the display150of the medical image processing apparatus100to display images or cause the display61provided on the console60of the robotic assistant apparatus6to display images.

FIG.5is a timing chart illustrating the operation of the medical image processing apparatus100or the X-ray diagnostic apparatus200according to the first embodiment for each of the plurality of periods Tn (n=1 to 6). In the timing chart ofFIG.5, the period during which the graph is at high level is the period during which X-ray irradiation to the object P is turned on and X-ray fluoroscopic imaging is performed. The period during which the graph is at low level is the period during which the X-ray irradiation to the object is turned off and X-ray fluoroscopic imaging is not performed.

In the period during which X-ray fluoroscopic imaging is performed, true (i.e., unprocessed) fluoroscopic images obtained by X-ray irradiation are time-sequentially displayed in real time. In the period during which X-ray fluoroscopic imaging is not performed, reproduced images (i.e., reproduced moving images) or a still image are generated from the stored fluoroscopic images and are displayed.

Hereinbelow, on the basis ofFIG.4andFIG.5, a description will be given of the processing in which the medical image processing apparatus100displays fluoroscopic images, reproduced images, and a still image.

In the step S1, the display control function F04of the medical image processing apparatus100causes the display250of the X-ray diagnostic apparatus200to display a still image. This display of the still image is referred to as LIH (Last Image Hold). In the LIH, the display control function F04displays the last frame image of the fluoroscopic images that are obtained from the most recent X-ray irradiation.

At the time of the step S1, it is assumed that the user U has not yet turned on the foot switch64configured as an X-ray fluoroscopic imaging switch and X-ray irradiation is not being performed. It is also assumed that the user U is not operating the controller62of the console60and the catheter4is stopped.

In the step S2, the processing circuitry110determines whether the foot switch64(i.e., the X-ray fluoroscopic imaging switch) is turned on or not. For example, when the user U depresses the foot switch64, the foot switch64is turned on. If the foot switch64is turned on (YES in the step S2), the processing circuitry110advances the processing to the step S3. If the foot switch64is not turned on (NO in the step S2), the processing circuitry110repeats the processing of the step S2. The period T1inFIG.5is the period from the start of displaying the still image in the step S1to the turn-on determination of the foot switch64in the step S2.

In the step S3, the processing circuitry110determines whether the catheter4is moving or not. Specifically, the image acquisition function F02receives the control signal indicating the operational detail of the robotic assistant apparatus6from the console60. The processing circuitry110determines whether the received control signal indicates that the catheter4is moving within the object P or not. If the catheter4is moving (YES in the step S3), the processing circuitry110advances the processing to the step S4. If the catheter4is not moving (NO in the step S3), the processing circuitry110repeats the processing of the step S3.

According to the flowchart inFIG.4, though the display of the still image by the step S1continues while the step S3is being repeated, processing different from this may be performed. For example, as shown inFIG.5, when the foot switch64is turned on, X-ray fluoroscopic imaging may be temporarily performed during the period T2equivalent to the length of one heartbeat of the object P so that reproduced images generated from the fluoroscopic images during this one heartbeat are displayed in the period T3from the end of this temporary X-ray fluoroscopic imaging until the operation switch of the catheter4is turned on, i.e., until moving of the catheter4is started or restarted.

In the step S4, if the foot switch64being the X-ray fluoroscopic imaging switch is turned on (YES in the step S2) and the control signal indicates that the catheter4is moving within the object P (YES in the step S3), the X-ray control function F03starts or resumes the X-ray irradiation to the object P. Since the X-ray irradiation is being performed, the display control function F04causes the display250to time-sequentially display the fluoroscopic images sequentially acquired by the image acquisition function F02on a real-time basis.

In the step S5, the processing circuitry110determines whether the catheter4is stopped or not. Specifically, the image acquisition function F02receives the control signal indicating the operational detail of the robotic assistant apparatus6from the console60. The processing circuitry110determines whether the control signal indicates that the catheter4is stopped within the object P or not. If the catheter4is stopped (YES in the step S5), the processing circuitry110advances the processing to the step S6. If the catheter4is not stopped (NO in the step S5), the processing circuitry110repeats the processing of the step S5.

In the step S6, the processing circuitry110continues X-ray fluoroscopic imaging for a period of at least one heartbeat (e.g., for a period of one heart beat) after the catheter4stops, stores the fluoroscopic images during this period, and then stops X-ray fluoroscopic imaging. For example, the X-ray control function F03continues the X-ray irradiation to the object P for a period corresponding to at least one heartbeat of the object P on the basis of the timing synchronized with the cardiac signal. The image acquisition function F02stores the fluoroscopic image data acquired during this period in the memory120. Afterward, the X-ray control function F03stops the X-ray irradiation. In other words, if the control signal indicates that the catheter4is stopped within the object P, the X-ray control function F03stops the X-ray irradiation regardless of whether the foot switch64is turned on or turned off.

The period T4inFIG.5is the period from the start/restart time of the X-ray irradiation by turning on the operation switch of the catheter4(i.e., by staring moving of the catheter4) until the stop time of the X-ray irradiation after the operation switch of the catheter4is turned off (i.e., the catheter4is stopped), and then X-ray fluoroscopic imaging continues only for the period of at least one heartbeat.

In the step S7, the display control function F04reads out the above-described plurality of fluoroscopic images for at least one heartbeat stored just before a stop of the X-ray irradiation from the memory120, generates reproduced images from the fluoroscopic images, and displays the reproduced images on the display250.

In the period during which the X-ray irradiation is stopped, the display control function F04repeatedly reproduces the stored plurality of fluoroscopic images for at least one heartbeat (for example, a plurality of fluoroscopic images for the span equivalent to one heartbeat) so as to display them on the display250. At this time, the display control function F04may finely adjust (e.g., change, shorten, or extend) the reproduction cycle of the reproduced images (i.e., reproduction time of one cycle of cardiac images) corresponding to the heartbeat cycle based on the cardiac signal that is acquired by the cardiac signal acquisition function F05(i.e., depending on the actual real-time heartbeat cycle of the object P). For example, the display control function F04may finely adjust the reproduction cycle of the reproduced images in such a manner that the reproduction cycle of the reproduced images matches the heartbeat cycle based on the cardiac signal.

The heartbeat cycle of the object P can vary between the period during which the fluoroscopic images are acquired by X-ray fluoroscopic imaging and the period during which the reproduced images are displayed. Thus, the display control function F04can make the heartbeat cycle of the reproduced images match the actual real-time heartbeat cycle of the object P by extending or shortening the display time-length of the reproduced images corresponding to the actual electrocardiogram waveform. For example, the display control function F04can adjust the cardiac cycle of the fluoroscopic images to be reproduced, by shortening or extending the frame cycle of the fluoroscopic images to be reproduced.

The display control function F04may display a mark indicating whether the image currently displayed on the display250is a reproduced image of a stored fluoroscopic image or a fluoroscopic image acquired in real time in such a manner that this mark is superimposed and displayed on the currently displayed image. Displaying such a mark can prevent the user U from being confused.

According to the processing in the steps S6and S7, the user U can check the position of the catheter4without performing X-ray irradiation. In other words, according to the processing in the steps S6and S7, while the object P is prevented from X-ray exposure, a sufficient time can be secured to determine whether the current position of the catheter4is at a proper position or not. In addition, deviation in the time axis between the reproduced images and the actual movement of the heart can be suppressed by synchronizing the display of the reproduced images with the cardiac signal.

The user U checks the position of the catheter4by observing the reproduced images, and then operates the joystick622or the other tool of the controller62to move the catheter4inside the blood vessel of the object P. At this time, X-ray fluoroscopic imaging is instantaneously restarted in conjunction with the control signal from the console60, and the fluoroscopic images are time-sequentially displayed in real time. In other words, if the catheter4starts moving inside the object P after a stop of the X-ray irradiation due to a stop of the catheter4inside the object P, the X-ray control function F03instantaneously restarts X-ray irradiation. This corresponds to the step S4in the case of restarting the X-ray irradiation.

In the step S8, the processing circuitry110determines whether the foot switch64being the X-ray fluoroscopic imaging switch is turned off or not. For example, when the user U releases the foot switch64, the foot switch64is turned off. If the foot switch64is turned off (YES in the step S8), the processing circuitry110advances the processing to the step S9. If the foot switch64is not turned off (NO in the step S8), the processing circuitry110returns the processing to the step S3.

In the period from the time at which the user U turns on the X-ray fluoroscopic imaging switch in the step S2until the time at which the user U turns off the X-ray fluoroscopic imaging switch in the step S8, there is no manual on/off control of X-ray fluoroscopic imaging and the on/off control of X-ray fluoroscopic imaging is performed in conjunction with the robotic assistant apparatus6. The period T5inFIG.5is the period from the time at which X-ray fluoroscopic imaging is turned off due to a stop of the catheter4until the time at which the foot switch64being the X-ray fluoroscopic imaging switch is turned off. During the period T5, the reproduced images for one heartbeat are repeatedly displayed on the display250or the display61, for example.

In the step S9, since the foot switch64has already been turned off by the user U, the X-ray control function F03completes the X-ray irradiation to the object P accordingly. The display control function F04stops displaying the reproduced images and switches the screen to display of a still image. This display of the still image is referred to as the LIH. In the LIH, the display control function F04displays the last frame image of the fluoroscopic images generated by the X-ray irradiation just before its end. The period T6is the period after the foot switch64being the X-ray fluoroscopic imaging switch is turned off, and is the period during which the still image is displayed.

According to the first embodiment, the X-ray irradiation to the object P can be suppressed to the minimum level without requiring any special operations by the user U. Further, by the electrocardiogram synchronous reproduction, natural reproduced images can be displayed without irradiating the object P with X-rays. This configuration can reduce the radiation exposure of the object P.

When the user U is a doctor, the user U needs time to check where the current catheter4is and to consider what operation to perform next while stopping the catheter4by operating the controller62. This check and consideration period is assumed to be longer for robot operation than for manual operation (manipulation). During this check and consideration period, X-ray exposure of the object P can be stopped according to the first embodiment.

Second Embodiment

The medical image processing apparatus100or the X-ray diagnostic apparatus200according to the second embodiment differs from the first embodiment in the acquisition time of the fluoroscopic images. In the first embodiment, X-ray fluoroscopic imaging is performed for a duration of at least one heartbeat of the object P in the case of generating the reproduced images. However, when the treatment site or the examination site of the object with the use of the catheter4is not the heart, the acquisition time of the fluoroscopic images is not limited to the above-described aspect. The time length of acquiring the fluoroscopic images may be a predetermined time, an acquisition time corresponding to one frame of image, or a time corresponding to one breath of the object P, for example.

When the time length of acquiring the fluoroscopic images is a predetermined time, the fluoroscopic images of an anatomical imaging site except the heart, such as the brain which is an immovable part and/or lower limbs may be acquired.

When the time length of acquiring the fluoroscopic images is the time of one breath, in the step S7ofFIG.4, the plurality of reproduced images are the plurality of fluoroscopic images for one breath of the object P and are acquired before a stop of X-ray irradiation. The display control function F04repeatedly reproduces the plurality of fluoroscopic images for one breath so as to display them on the display250in the period during which the X-ray irradiation is stopped. This configuration can store the fluoroscopic images for a time length suitable for an anatomical imaging site except the heart, such as the liver and the abdomen, and can generate and display the reproduced images suitable for the liver and/or the abdomen.

In addition, the display control function F04may adjust the reproduction cycle of the plurality of reproduced images corresponding to the respiration cycle based on the respiration signal that is acquired by the respiration signal acquisition function F06. The display control function F04may adjust the reproduction cycle of the plurality of reproduced images in such a manner that the reproduction cycle of the plurality of reproduced images matches the respiration cycle based on the respiration signal, for example.

Further, the image acquisition function F02may adjust the time length of acquiring the plurality of fluoroscopic images depending on a method of a surgical operation and an observation site. The observation site is one example of the target site of the object.

Third Embodiment

In the medical image processing apparatus100or the X-ray diagnostic apparatus200according to the third embodiment, reproduction speed of the reproduced images is different from the first embodiment and the second embodiment. The display control function F04may switch the reproduction speed of the images to the recording speed or a slow speed. In other words, the display control function F04may be able to arbitrarily adjust the reproduction speed of the plurality of reproduced images.

According to the third embodiment, the user U can view the reproduced images at a reproduction speed suitable for his/her eyes or at a reproduction speed suppressed as necessary. In addition, this configuration can meet the needs of the user U when it is preferred to carefully observe each reproduced image of the object P in terms of precise diagnosis or judgment.

Fourth Embodiment

The medical image processing apparatus100or the X-ray diagnostic apparatus200according to the fourth embodiment differs from the first to third embodiments in the content of the still image in the LIH display. In the step S9ofFIG.4, when the X-ray irradiation is completed by turning off the foot switch64by the user U, the display control function F04may select one frame image from the recorded frame images of one cardiac cycle and display the selected image as a still image on the display250. For example, the display control function F04may select one of: the fluoroscopic image most recently acquired by the image acquisition function F02; the reproduced image displayed on the display250at the time at which the X-ray irradiation is completed; and a reproduced image of an arbitrary heartbeat phase. The arbitrary heartbeat phase may be designated by the user U with the use of the controller62.

Fifth Embodiment

The medical image processing apparatus100or the X-ray diagnostic apparatus200according to the fifth embodiment differs from the first to the fourth embodiments in that the X-ray irradiation is performed and stopped in conjunction with another event other than the movement and stop of the catheter4. The X-ray diagnostic apparatus200may be able to further communicate with a driving apparatus, which drives a peripheral device except the console60or drives another medical apparatus except the X-ray diagnostic apparatus200. In this case, the signal reception function F01of the medical image processing apparatus100receives a driving signal indicating the content of the driving from the driving apparatus. If the driving signal indicates that the peripheral device or the other medical apparatus is being driven, the X-ray control function F03performs the X-ray irradiation to the object P. If the driving signal indicates that the peripheral device or the other medical apparatus is not being driven, the X-ray control function F03stops the X-ray irradiation.

For example, an injector configured to inject a contrast medium into the object P may be applied as the other peripheral device. In the case of injecting a contrast agent, the fluoroscopic images of the object P change sequentially (i.e., from image to image) due to the contrast agent, so the X-ray control function F03performs the X-ray irradiation to the object P. If the contrast agent is not injected, the fluoroscopic images of the object P do not change between these images, so the X-ray control function F03stops the X-ray irradiation to the object P.

In addition, the C-arm214and the bed220can be applied as the other peripheral devices. If the C-arm214rotates or moves in an arc or if the bed220slides, moves up and down, or rolls, the fluoroscopic images of the object P change sequentially (i.e., from image to image) due to change in the direction of X-ray irradiation or change in the target position, and thus, the X-ray control function F03performs the X-ray irradiation to the object P. If both the C-arm214and the bed220are stopped, the fluoroscopic images of the object P do not change between these images, and thus, the X-ray control function F03stops the X-ray irradiation to the object P.

Furthermore, an ultrasonic diagnostic apparatus may be applied as the other medical apparatus. If the ultrasonic diagnostic apparatus is being driven, the fluoroscopic images of the object P change sequentially (i.e., from image to image), and thus, the X-ray control function F03performs the X-ray irradiation to the object P. If the ultrasonic diagnostic apparatus is not being driven, the fluoroscopic images of the object P do not change between these images, and thus, the X-ray control function F03stops the X-ray irradiation to the object P.

Sixth Embodiment

The medical image processing apparatus100or the X-ray diagnostic apparatus200according to the sixth embodiment differs from the first to fifth embodiments in the function or configuration of the foot switch64that is an X-ray operation switch. For example, in the first and other embodiments, when the foot switch64is turned on, the X-ray irradiation is turned on under the condition that the catheter4is moving, and the X-ray irradiation is turned off when the catheter4is stopped. In other words, the foot switch64alone does not control on/off of the X-ray irradiation. Instead, the on/off of the X-ray irradiation is controlled by involving both the on/off state of the foot switch64and the moving/stopping state of the catheter4.

The sixth embodiment is configured to enable selection between a first function of controlling the X-ray irradiation by the foot switch64alone and a second function of controlling the X-ray irradiation by involving both the on/off state of the foot switch64and the moving/stopping state of the catheter4. In the sixth embodiment, a selection switch for this selection is further provided.

In addition, the X-ray diagnostic apparatus200may further include two operation switches composed of operation switches A and B, which turn on or turn off the X-ray irradiation in response to the user's operation. In this case, the operation switch A can independently switch on/off the X-ray irradiation regardless of whether the catheter4is moving or stopped. The operation switch B is configured to switch on/off the X-ray irradiation by involving both the on/off state of the operation switch B itself and the moving/stopping state of the catheter4, similarly to the operation switch in the first and other embodiments. The on/off of the X-ray irradiation based on the moving/stopping state of the catheter4is implemented by the X-ray control function F03. The operation switch A is one example of the first operation switch. The operation switch B is one example of the second operation switch.

Moreover, the X-ray diagnostic apparatus200may further include another switch for forcibly stopping the display of the reproduced images and forcibly restarting X-ray fluoroscopic imaging, aside from the above-described operation switches. In such a configuration, regardless of the operation of the catheter4, the user U can view the actual fluoroscopic images of the object P before operating the catheter4, for example.

According to at least one embodiment described above, exposure to X-rays in a period during which the user performs an operation to insert the device into the object can be reduced.