Patent Publication Number: US-2005143641-A1

Title: Medical information processing system

Description:
CROSS-REFERENCE TO RELATED APPLICATION  
      This application is based upon and claims the benefit of priority from the prior Japanese Patent Application No. 2003-431381, filed Dec. 25, 2004, the entire contents of which are incorporated herein by reference.  
     BACKGROUND OF THE INVENTION  
      1. Field of the Invention  
      The present invention is related to a medical information processing system for displaying a plurality of medical images acquired by imaging the same object.  
      2. Description of the Related Art  
      In imaging apparatus known such as CT (computerized tomographic) and MRI (magnetic resonance imaging), file names and date of formation information of their medical images have been applied independently. Viewers such as a DICOM viewer can display these medical images, and can rearrange the display sequence of these medical images in ascending or descending order based upon the file names and the image date of formation information.  
      Since doctors try to find slight differences of these medical images such as tomographic images and identify diseased portions by visually comparing them, the displaying sequence of these medical images is important.  
      However, even if medical images taken by imaging apparatus, such as CT or MRI, are arranged based on the order of file names and/or date of formation information of image files, these medical images are not always displayed in such a sequence that adjacent images resemble each other.  
      For example, in the field of brain surgeries, a total number of tomographic images may exceed 200 in one case. Therefore, if medical images are arranged in a disorderly fashion irrespective of resemblance, a long time is required to find and retrieve necessary medical images.  
     BRIEF SUMMARY OF THE INVENTION  
      A medical information processing system of the present invention, belonging to such a system for displaying a plurality of medical images taken from the same object, identifies features of the each medical image based on additional information added to each medical image and determines the sequence of displaying these images based on the result of the identification.  
      Preferably, the additional information contains at least one of patient relative information and information indicative of an image formation condition. If the display sequence of the medical images is determined by employing the patient relative information and the image formation condition, then there are larger possibilities that medical images having high resemblance are displayed and positioned close to each other. Examples of the patient relative information and the image formation condition includes, but is not limited to, an inclination of either a gantry or a detector of an image formation apparatus, and a slice position in a case that a medical image corresponds to a tomographic image.  
      When such medical images that inclinations of either the gantry or the detectors of the image formation apparatus are equal or similar to each other are arrayed, since imaging angles of these arrayed medical images are resembled to each other, there are larger possibilities that the resembling medical images are displayed and positioned close to each other. In the same meaning, when such medical images that slice positions thereof are equal or similar to each other are arrayed, since medical images of the same or similar portions are arrayed, there are larger possibilities that the resembling medical images are displayed and positioned close to each other.  
      The present invention is effective in such a case that medical images acquired by plural sorts of medical image formation apparatus are displayed by employing one viewer.  
      There are many opportunities that titles of medical images are named in relation to names of patients and IDs of patients, or numerically named by using sequence numbers. Therefore, there are many cases that even modalities are different from each other, titles of medical images are resembled to each other. As a consequence, in particular, the present invention is useful in the case that a plural of medical image formation apparatus give similar names to images they take and discrimination of these images is difficult based on their names. However, this invention does not always require the existence of the plural sorts of medical image formation apparatus, but the present invention may be alternatively applied to such a case that a plurality of medical images formed by one or one sort of medical image formation apparatus are displayed.  
      As previously explained, when the arranging sequence of the medical images is determined on the viewer side based upon the additional information, a degree of freedom and independence for applying file names is increased.  
      Preferably, additional information is positioned in front of a medical image in a medical image data file. When such a file configuration is employed, only the additional information may be read without reading a medical image having a large amount of data. As a result, an access speed for determining a display sequence may be increased.  
      In the same logic, it is also possible to store the additional information and the main body of the medical image data separately from each other to increase the access speed.  
      Preferably, a portion for storing the additional information is divided into a plurality of data items. In this data structure, plural sorts of additional information can be stored, and thus a variation for determining display sequence of the medical images is increased.  
      In the present invention, the display sequence of medical images is determined based upon the patient relative information and/or the image formation condition of the object under examination thereof, and the medical images are displayed in accordance with the determined display sequence. As a consequence, the medical images that are resembled to each other may be readily displayed and positioned close to each other.  
      The present invention is useful for a diagnostic operation, for instance, a doctor visually compares slight differences between respective medical images with each other so as to specify a shape of a diseased portion. 
    
    
     BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS  
      These and other features, aspects, and advantages of the apparatus and methods of the present invention will become better understood with regard to the following description, appended claims, and accompanying drawings where:  
       FIG. 1  is a structural diagram for representing an arrangement of a medical information processing system according to an embodiment of the present invention;  
       FIG. 2  is a block diagram for schematically showing an arrangement of a controller of  FIG. 1 ;  
       FIG. 3  is a first diagram for explaining display sequence of medical reference images which are displayed in a reference image display area on a display screen of a display apparatus of  FIG. 1 ;  
       FIG. 4  is a second diagram for explaining display sequence of medical reference images which are displayed in the reference image display area on the display screen of the display apparatus of  FIG. 1 ;  
       FIG. 5  is a first diagram for explaining a relationship in the sequence between patient relative information contained in the medical reference image of  FIG. 3  and/or image formation conditions, and the medical reference images;  
       FIG. 6  is a second diagram for explaining a relationship in the sequence between patient relative information contained in the medical reference image of  FIG. 3  and/or image formation conditions, and the medical reference images;  
       FIG. 7  is a diagram for explaining a structure of a data file which contains the patient relative information and/or the information indicative of the image formation conditions of  FIG. 3 ;  
       FIG. 8  is a flow chart for describing a flow of a display sequence determining process of the medical reference images executed by a CPU of  FIG. 2 ;  
       FIG. 9  is a diagram for explaining a structure of a modification of the data file which contains the patient relative information and/or the information indicative of the image formation conditions of  FIG. 7 ; and  
       FIG. 10  is a block diagram for schematically indicating an arrangement of a modification of the controller of  FIG. 1 . 
    
    
     DETAILED DESCRIPTION OF THE INVENTION  
      Preferred embodiments of the invention will be described below with reference to the accompanying drawings.  
       FIGS. 1-10  are related to an embodiment of the present invention.  
      As represented in  FIG. 1 , in the medical information processing system of this embodiment, a display apparatus  1  is connected to a controller  2  with a cable  3 . The controller  2  contains an operation apparatus  4  such as a keyboard, or a mouse, which controls displaying function. The cable  3  such as a VGA cable conveys image signals.  
       FIG. 2  indicates an internal arrangement of the above-described controller  2 . The controller  2  is equipped with an operation information I/F (interface)  43 , a HDD (hard disk drive)  41  and/or a memory  42 , and a CPU (central processing unit)  40 . The operation information I/F  43  acquires operation information from the operation apparatus  4 . The HDD  41  and/or the memory  42  correspond to an image storage unit for storing image data. The CPU  40  corresponds to an operating device functioning as an image characteristic identifying unit and a display control unit. The image characteristic identifying unit identifies characteristics of medical images based on such information as patient relative information and/or image formation conditions of an object under examination, which corresponds to additional information included in or otherwise associated with the images. The CPU  40  determines sequence of display based upon the additional information. The controller  2  further contains a graphic controller  44 , while the graphic controller  44  reads out an image stored in the HDD  41  and/or the memory  42 , and then, displays the read image on the display apparatus  1 .  
      As indicated in  FIG. 3 , a display screen  11  of the display apparatus  1  has a medical image display area  50 , a thumbnail display area  51 , and a reference image display area  52 .  
      On the display screen  11  of the display apparatus  1 , for instance, a medical moving image  50   a  acquired at a medical examination with an endoscope is displayed in the medical image display area  50 . The data of the medical moving image  50   a  has been stored in the HDD  41  and/or the memory  42 . Thumbnail images  51   a  are displayed in the thumbnail display area  51 . The thumbnail images  51   a  are constituted from a plurality of still images such as frame of interest in the medical moving image  50   a.    
      Also, at least one medical reference image (X-ray image, ultrasonic image, CT image, MRI image etc.)  52   a  of a patient corresponding to an examination subject is displayed in the reference image display area  52 , while the data of the medical reference image  52   a  has been stored in the HDD  41  and/or the memory  42 .  
      In a display control for the medical reference image  52   a  displayed in the reference image display area  52 , the patient relative information and/or the image formation conditions of the patient corresponding to the examination subject are evaluated by the CPU  40  so as to determine sequence of displays, and thus, the medical reference images  52   a  are displayed in such a sequence different from that of  FIG. 3 .  FIG. 4  shows an example in which the medical reference image  52   a  is displayed in sequence different from that of  FIG. 3 .  
       FIG. 5  shows a portion of information items that are added to the medical reference image  52   a  displayed in the reference image display area  52 . The information items contain a file name, image formation date/time, an inclination of a gantry/detector, and a slice position.  FIG. 5  shows an example that the medical reference images  52   a  are arranged according to the order of the file names. This image arrangement corresponds to the display manner of  FIG. 3 .  
      Similarly,  FIG. 6  shows a display sequence of the medical reference images  52   a  in such a case that the gantry/detector inclination and the slice position are set as references and the medical reference images  52   a  are rearranged in an ascent order thereof. This image arrangement manner corresponds to the display manner of  FIG. 4 .  
      In the embodiment, a term of “gantry/detector inclination” implies detection data of a detector which detects an inclination of a gantry on which a patient is laid when an imaging operation is carried out for taking an X-ray image, an ultrasonic image, a CT image, an MRI image, and the like. Also, a term of “slice position” corresponds to section slice positional information in a CT image and MRI image.  
       FIG. 7  indicates a file structure of a data file  90  of the medical image. At least, one piece of the information such as image formation date/time, and gantry/detector inclinations has been stored in “i”-th storage portions  91 -i of patient information/image formation conditions of the data file  90 . It should be noted that symbol “i” can take one value between 1 to “n.” 
      In this data file  90 , a file-identifying portion  91  indicative of a head of the file is present. This data file  90  represents that the file identifying portion  91  is positioned at the head portion of this data file  90 ; the “i”-th storage portions  92 -i for patient information and/or image formation conditions succeed the file identifying portion  91 ; a data portion  93  into which image information such as an organ, CT, and MRI is stored, succeeds the “i”-th storage portions  92 -i; and an EOF (End of File)  94  indicates an end of the data file  90 .  
      Next, operations of the medical information processing system according to this embodiment will be described. The HDD  41  and/or the memory  42  contained inside the controller  2  has stored therein the image data such as the medical moving image  50   a  and the medical reference images  52   a,  while this controller  2  is connected to the display apparatus  1  with the cable  3  such as the VGA cable for carrying the picture signals. The CPU  40  identifies one or more characteristics of the images based the patient relative information and/or the image formation condition, which are the additional information added to the medical reference image  52   a.    
      As indicated in  FIG. 3 , the display screen  11  displays thereon the images which are constituted by the medical image display area  50 , the thumbnail display area  51 , and the reference image display area  52 . More specifically, at least one of the medical reference image  52   a  which have been stored in the HDD  41  and/or the memory  42  is arranged to be displayed in the reference image display area  52 .  
      In the case that the medical reference images  52   a  are displayed randomly in the reference image display area  52 , as shown in  FIG. 3 , the medical reference images  52   a  are displayed irrespective of resemblance characteristics thereof and relative relationships therebetween. On the other hand, as shown in  FIG. 4 , the CPU  40  determines sequence of displays based upon at least one of the patient relative information and/or the image formation conditions of the object attached to the images, and the graphic controller  44  reads out the images which have been stored in the HDD  41  and/or the memory  42 , and then, the medical reference images  52   a  are displayed in the reference image display area  52  in accordance with the sequence determined by the CPU  40 .  
      In another way, for instance, as shown in  FIG. 5 , in the case that the medical reference images  52   a  are arranged in accordance with their file names, different kind of medical reference images  52   a  may be mixed with each other. On the other hand, as represented in  FIG. 6 , the CPU  40  rearranges these medical reference images  52   a  by using the gantry/detector inclination and the slice position as the reference. Therefore a doctor can readily and visually compare the medical reference images  52   a  with each other, and the doctor can notice a slight difference between resembling images so as to specify a pathological change.  
      A rearranging process for the medical reference images  52   a  is executed as indicated in the flow chart of  FIG. 8 . That is, in a step S 1  of the flow chart, the CPU  40  reads subject image data. In a step S 2 , which is an identifying process of an image characteristic, the CPU  40  identifies the patient information and/or image formation conditions of the object under examination, which are added to the medical reference image  52   a.    
      At step S 3 , the CPU  40  determines whether or not the rearranging process is carried out based upon the identified information. In the case that the rearranging process is not carried out (S 3 -No), the CPU  40  displays the medical reference images  52   a  in the original display sequence in a display process of step S 5 . In the case that the rearranging process is carried out (S 3 -Yes), the CPU  40  determines display sequence in a display sequence determining process of the step S 4 . Thereafter, in the display process of the step S 5 , the CPU  40  displays the medical reference images  52   a  in accordance with the display sequence determined in the display sequence determining process of the step S 4 .  
      As indicated in  FIG. 7 , the data file  90  contains at least one of the patient relative information and image formation condition storage portions  92 -i. The rearranging process is carried out by the CPU  40  based upon the patient relative information and/or the image formation condition of the object under examination, which have been identified.  
      As an alternative data configuration, shown in  FIG. 9 , the “i”-th storage portions  92   a -i (“i” corresponds one of 1 to n) for patient relative information and/or image formation conditions may be separated from a file identifying portion  91   a,  a data portion  93   a,  and an EOF  94   a.  In such a case, the “i”-th storage portions  92   a -i for patient relative information and/or image formation condition may be related to the other part of the data structure in the controller  2 , and such relations may be retained in the controller  2 . In  FIG. 9 , the “i”-th storage portions  92   a -i for patient information and/or image formation conditions are managed on the side of the operating system as such the “i”-th storage portions  92   a -i have been stored with relations to such data which is commenced by the file identifying portion  91   a.    
      Generally speaking, the data portion  93   a  of the data file  90  has a large data capacity. More specifically, in the case that there are large numbers of images stored in the data portion  93   a  of the data file  90 , a heavy workload is given in order to process these images by the CPU  40 . Therefore, in the example shown in  FIG. 9 , by separately storing the “i”-th storage portions  92 -i for patient information/image formation conditions, the CPU  40  can quickly determine display sequence without reading the whole part of data but just reading the separated portion of it.  
      It should also be noted that as shown in  FIG. 10 , an input I/F  45  for inputting the medical reference images  52   a  may be alternatively provided within the controller  2 . In this alternative case, in the controller  2 , an image input signal which is entered via the input I/F  45  from an external source is processed by the graphic controller  44  and displayed on the display apparatus  1 . Further, the medical reference images  52   a  derived from the external source are stored in the HDD  41  and/or the memory  42 . Therefore, the medical reference images  52   a  that have been entered from the external source may be alternatively stored and displayed.  
      In the embodiment, the medical information processing system analyzes the patient relative information and/or the image formation conditions of the object under examination, and identifies the characteristics of the corresponding images based thereon, and determines the sequence of the displays based upon the identification result, and then, displays the medical reference images in accordance with the determined display sequence. As a consequence, even in such a case that when the display sequence is determined by identifying the image names and the image forming dates/times and such of the display sequence gives poor resemblance between neighboring images, this system of the embodiment can rearrange display sequence with more resemblance. When the medical images are arranged by identifying, for instance, the inclinations of either the gantries or the detectors of the image formation apparatus that are identical or similar to each other, then there are larger possibilities that the resembling medical images are to be displayed and positioned close to each other. As a result, while the doctor visually compares these medical images with each other, the doctor can readily diagnose these medical images, for instance, can easily specify shapes of diseased portions. Also, the doctor can retrieve the necessary medical reference images in a higher efficiency.  
      Also, by arranging medical images where the inclinations of either the gantry or the detector of the image formation apparatus are equal or resembled to each other without depending upon the formation day/times, medical practitioners can enjoy easy grasping of the pathological changing portion of the same patient in the lapse of time after the medical operation.  
      Furthermore, when data of elapsed time after the medical operation is added to in the image data, by rearranging the pictures in ascending or descending order from the operation time, the medical practitioners can readily realize the recovering processes.  
      When medical history information such as the treatment times and the dosage times is contained as the additional information, the medical images can be rearranged in either ascending order or descending order based on such information. As a result, the recovery effect achieved by the dosage/treatment can be grasped, at the same time, some side effects or complications incurred on another organ by the treatment or dosage can be detected.  
      In curing of adiposis, the U.S.A has a large number of patients thereof, therefore, patient weight-related information such as weight, Body Mass Index, body fat amount can be used as the additional information. In such a case, the medical images can be arranged in either ascending order or descending order based upon the patient weight-related information. Such a display sequence may be useful to grasp increases/decreases in a particular amount and an organ fat amount, and to diagnose the risk of diabetes, hypertension, hyperlipemia, and the like.  
      When age information is contained as the additional information, the medical images can be arranged in a time sequential manner even in such a case that a modality&#39;s machine time is erroneously set and the medical images taken by the modality have incorrect time information.  
      In addition, the above-explained rearranging methods based upon the additional information may be effectively applied not only to the image comparing/investigating operation for the same patient, but also to the image comparing/investigating operations with another patient.  
      While there has been shown and described what is considered to be preferred embodiments of the invention, it will, of course, be understood that various modifications and changes in form or detail could readily be made without departing from the spirit of the invention. It is therefore intended that the invention be not limited to the exact forms described and illustrated, but should be constructed to cover all modifications that may fall within the scope of the appended claims.