Patent Description:
A procedure is known which performs treatment (expansion of a constriction of a blood vessel or the like), examination (imaging of an inside region of a blood vessel or the like), or the like by delivering a medical instrument to a site within a living body via the blood vessel (living body lumen) (see Patent Document <NUM>, for example).

The medical instrument is introduced from the outside of the living body via a site as an access point to the blood vessel (which site will hereinafter be an introduction site) into the blood vessel, and is delivered to a target site as a target of the procedure via a plurality of sites of the blood vessel. For example, in a case where a blood vessel of a lower limb is treated by using trans radial intervention (TRI), the medical instrument is introduced from a radial artery or the like into the blood vessel, and delivered to the target site of the lower limb via an aortic arch, an aorta (descending aorta), an iliac artery, and the like. TRI is a procedure that has recently been performed extensively because of a small burden on a patient or the like as compared with trans femoral intervention (TFI) that introduces a medical instrument from a femoral artery or the like.

There are a plurality of routes of blood vessels leading from the introduction site to the target site depending on the introduction site. An operator such as a doctor needs to select an appropriate route in consideration of the ease of delivery of a medical instrument at a time of delivery of the medical instrument, a burden on the patient, and the like. The ease of delivery of the medical instrument changes according to the magnitude of bending and curvature of sites of the blood vessel constituting a route, for example.

<CIT> discloses a method and corresponding system for calculating an optimum surgical trajectory or path for displacing a surgical instrument through the interior of the body of a patient. Upon obtaining a volumetric scan of a patient, such as a CT scan, the surgeon can identify and assign weight values indicating a preference on whether an anatomical area be utilized in plotting an optimum instrument trajectory. Upon providing a starting and destination point for a surgical instrument, an optimum surgical trajectory can be determined in essentially real time and graphically presented to the surgeon by superimposing the proposed trajectory upon the patient's volumetric scan. Furthermore, the system and method is interactive, allowing the surgeon to deviate from the proposed optimum path if desired and choose another path.

However, the magnitude of bending and curvature of sites of the blood vessel differs for each target patient. Before starting the above-described procedure, the operator needs to perform the work of checking the magnitude of bending and curvature of sites of the blood vessel or the like by visually recognizing an image of the inside of the living body of the target patient, and selecting an appropriate blood vessel route. The work greatly depends on many years of experience of the operator, and is a great burden on the operator.

In a case of performing treatment of the blood vessel of a lower limb or the like by using TRI, in particular, the number of sites of the blood vessel to be passed is increased as compared with TFI.

In the case of TFI, when a retrograde puncture is performed from an ipsilateral femoral artery, the femoral artery and an iliac artery as a target of treatment are reached, and when a crossover approach is performed from a contralateral femoral artery, an aortailiac bifurcation is passed from the femoral artery and an iliac artery, and an iliac artery or a femoral artery on an opposite side is reached.

On the other hand, in a case of performing treatment of a blood vessel of a lower limb or the like from TRI, at a time of insertion from a right radial artery, an aortic arch is generally passed from the right radial artery, a right brachial artery, a right axillary artery, a right subclavian artery, and a brachiocephalic artery. At a time of insertion from a left radial artery, the aortic arch is generally passed from the left radial artery, a left brachial artery, a left axillary artery, the right subclavian artery, and the brachiocephalic artery. After the aortic arch is reached, a thoracic aorta and an abdominal aorta (descending aorta) are passed, and the aortailiac bifurcation is reached.

Further reached to treat a lower limb artery are left or right one of common iliac arteries, external iliac arteries, internal iliac arteries, common femoral arteries, superficial femoral arteries, and deep femoral arteries, and further, as required, popliteal arteries, anterior tibial arteries, posterior tibial arteries, peroneal arteries, dorsalis pedis arteries, plantar arteries, and other arteries of the lower limbs, peripheral blood vessels connected thereto, and the like.

The magnitude of bending and curvature of sites of these blood vessels or the like differs greatly for each target patient depending on age, a medical history, and the like. Further, in TRI, the blood vessel of the introduction site is thin as compared with a brachial artery puncture and TFI, and the radial arteries are muscular arteries and thus tend to cause spasm (angiospasm). Therefore, in the case of performing treatment of the blood vessel of a lower limb or the like by using TRI, there is a particularly great burden of the work of selecting the route of an appropriate blood vessel as described above.

The present invention has been made in view of the above-described problems, and it is an object of the present invention to provide a route selection assistance system enabling easy selection of a route of a living body lumen for delivering a medical instrument to a site within a living body via the living body lumen, a recording medium on which a route selection assistance program is recorded, a route selection assistance method, and a diagnosis method.

The presently claimed invention is defined in the independent claims. Further developments of the herein claimed invention are described in the dependent claims.

According to the route selection assistance system, the recording medium on which the route selection assistance program is recorded, and the route selection assistance method in accordance with the present invention, the ranking assigning section assigns rankings to the plurality of routes extracted by the route extracting section by using route scores determined according to ease of delivery of the medical instrument at a time of delivery of the medical instrument and patient scores determined according to the magnitude of a burden imposed on the target patient. The output section then outputs the plurality of routes extracted by the route extracting section and the rankings assigned by the ranking assigning section. An operator such as a doctor can thereby select an appropriate route easily from among the plurality of routes of living body lumens through which the medical instrument can be delivered to the target site as a target of a procedure in consideration of the ease of delivery of the medical instrument at a time of delivery of the medical instrument and the magnitude of a burden imposed on the target patient. Hence, according to the route selection assistance system, the recording medium on which the route selection assistance program is recorded, and the route selection assistance method in accordance with the present invention, it is possible to easily select a route of a living body lumen for delivering the medical instrument to a site within the living body via the living body lumen.

Embodiments of the present invention will hereinafter be described with reference to the drawings. It is to be noted that the dimensional ratios in the drawings are exaggerated for the convenience of description, and may be different from actual ratios.

A route selection assistance system <NUM> according to the present embodiment is a route selection assistance system that assists in selecting a route RT of a blood vessel BV (corresponding to a living body lumen) for delivering a medical instrument to a site within a living body BD via the blood vessel BV.

<FIG> is a schematic diagram of assistance in explaining a device configuration of the route selection assistance system <NUM>. <FIG> is a block diagram of assistance in explaining a functional configuration of the route selection assistance system <NUM>. <FIG> are diagrams of assistance in explaining various functions of the route selection assistance system <NUM>.

A device configuration of the route selection assistance system <NUM> will be described.

Referring to <FIG>, the route selection assistance system <NUM> includes a computer main unit <NUM> and a display <NUM>. The computer main unit <NUM> is connected to an external server <NUM>.

The computer main unit <NUM> includes an arithmetic unit <NUM>, a storage device <NUM>, and a reading device <NUM>.

The arithmetic unit <NUM> performs operation on the basis of a program and data stored in the storage device <NUM>. The arithmetic unit <NUM> is formed by using a publicly known central processing unit (CPU).

The storage device <NUM> includes a memory circuit <NUM> and a hard disk drive <NUM>. The memory circuit <NUM> includes a read only memory (ROM) and a random access memory (RAM).

The storage device <NUM> stores a basic program such as an operating system, a route selection assistance program PR making the arithmetic unit <NUM> perform functions of the route selection assistance system <NUM>, and data processed by the route selection assistance program PR.

The reading device <NUM> reads information recorded on a computer readable recording medium MD. The computer readable recording medium MD is for example an optical disk such as a compact disk (CD)-ROM, or a digital video disk (DVD)-ROM, a universal serial bus (USB) memory, or a secure digital (SD) memory card. The reading device <NUM> is for example a CD-ROM drive, or a DVD-ROM drive.

The route selection assistance program PR is provided in a state of being recorded on the computer readable recording medium MD. The reading device <NUM> reads the route selection assistance program PR recorded on the computer readable recording medium MD. The route selection assistance program PR read by the reading device <NUM> is stored on the hard disk drive <NUM>.

The display <NUM> is connected to the computer main unit <NUM>. The display <NUM> transmits and receives information to and from the computer main unit <NUM>.

The display <NUM> includes a screen <NUM> that inputs and outputs information. The display <NUM> outputs information received from the computer main unit <NUM> on the screen <NUM>. The display <NUM> transmits information input via the screen <NUM> to the computer main unit <NUM>. The display <NUM> is formed by using a publicly known touch panel display.

The computer main unit <NUM> transmits and receives information to and from the external server <NUM>.

The computer main unit <NUM> and the external server <NUM> are connected to each other via a network. The kind of the network is not particularly limited. The network may be a network of a wired system using a local area network (LAN) cable or the like, or may be a network of a radio system using wireless fidelity (Wi-Fi) or the like.

A functional configuration of the route selection assistance system <NUM> will next be described.

Referring to <FIG>, the route selection assistance system <NUM> includes a receiving section <NUM>, an image obtaining section <NUM>, a route extracting section <NUM>, a ranking assigning section <NUM>, and an output section <NUM>.

Operation related to processing of the receiving section <NUM>, the image obtaining section <NUM>, the route extracting section <NUM>, the ranking assigning section <NUM>, and the output section <NUM> is performed by the arithmetic unit <NUM>. Data processed by the receiving section <NUM>, the image obtaining section <NUM>, the route extracting section <NUM>, the ranking assigning section <NUM>, and the output section <NUM> is stored in the storage device <NUM>.

Referring to <FIG>, the receiving section <NUM> receives an input of site information specifying a target site RG as a target of a procedure to be performed by delivering a medical instrument. The receiving section <NUM> receives the input of the site information via the display <NUM>.

The receiving section <NUM> displays one or a plurality of sites to be received as the target site RG as alternatives on the display <NUM>, and receives a selection of a displayed site.

Though not particularly limited, the target site RG is for example a left and a right common iliac artery, external iliac arteries, internal iliac arteries, common femoral arteries, superficial femoral arteries, deep femoral arteries, popliteal arteries, anterior tibial arteries, posterior tibial arteries, peroneal arteries, dorsalis pedis arteries, plantar arteries, and other arteries of lower limbs, or collateral circulations, peripheral blood vessels connected thereto.

The image obtaining section <NUM> obtains image information DT1 within the living body BD of a target patient as a target of a procedure to be performed by delivering a medical instrument.

Referring to <FIG> and <FIG>, the image information DT1 includes image data DT2 within the living body BD of the target patient which living body is photographed by a medical image photographing device. The image data DT2 of the living body BD is three-dimensional image data.

Though not particularly limited, the medical image photographing device is for example an X-ray computed tomography (CT) device or a magnetic resonance imaging (MRI) device.

Though not particularly limited, the data format of the image information DT1 is for example digital imaging and communication in medicine (DICOM).

The image information DT1 is stored in the external server <NUM>. The image obtaining section <NUM> obtains the image information DT1 from the external server <NUM> via the network.

The route extracting section <NUM> extracts a plurality of routes RT of blood vessels BV through which a medical instrument can be delivered to the target site RG on the basis of the image information DT1 obtained by the image obtaining section <NUM>. Though not particularly limited, the number of routes RT of blood vessels BV extracted by the route extracting section <NUM> is for example <NUM>, preferably <NUM>, more preferably <NUM>.

For each candidate for a site as an access point at a time of introduction of a medical instrument from the outside of the living body BD to a blood vessel BV (which site will hereinafter be an introduction site RS), the route extracting section <NUM> extracts the route RT of the blood vessel BV leading from the target site RG to the introduction site RS.

Though not particularly limited, candidates for the introduction site RS are for example a right radial artery, a right brachial artery, a right subclavian artery, a right carotid artery, a right femoral artery, a left radial artery, a left brachial artery, a left subclavian artery, a left carotid artery, and a left femoral artery. Candidates for the introduction site RS may also be a popliteal artery, an anterior tibial artery, a posterior tibial artery, a peroneal artery, a dorsalis pedis artery, a plantar artery, and other blood vessels of an ankle.

In addition, the radial artery may be a distal radial artery or a radial artery located in a snuff box.

Referring to <FIG>, the route extracting section <NUM> extracts the route RT of the blood vessel BV leading from the target site RG to the introduction site RS by using an introduction site list LS1 in which candidates for the introduction site RS are recorded. The introduction site list LS1 is stored in the external server <NUM>. The route extracting section <NUM> obtains the introduction site list LS1 from the external server <NUM> via the network. Details of processing in the route extracting section <NUM> will be described later.

Referring to <FIG>, the ranking assigning section <NUM> includes a route score calculating section <NUM> that calculates a route score SR determined according to ease of delivery of a medical instrument and a patient score calculating section <NUM> that calculates a patient score SP determined according to the magnitude of a burden imposed on the target patient.

The ranking assigning section <NUM> assigns rankings to the plurality of routes RT extracted by the route extracting section <NUM> by using the route score SR calculated by the route score calculating section <NUM> and the patient score SP calculated by the patient score calculating section <NUM>.

The ranking assigning section <NUM> assigns rankings to the plurality of routes RT extracted by the route extracting section <NUM> in increasing order of a product SR × SP of the route score SR calculated by the route score calculating section <NUM> and the patient score SP calculated by the patient score calculating section <NUM>.

The route score calculating section <NUM> calculates the route score SR on the basis of a length L of the route RT and a bending degree P of the route RT. The route score calculating section <NUM> calculates, as the route score SR, a product L × P of the length L of the route RT and the bending degree P of the route RT.

Referring to <FIG>, the route score calculating section <NUM> includes a center line deriving section <NUM> that calculates a center line CL of the route RT extracted by the route extracting section <NUM>, a route length calculating section <NUM> that calculates the length L of the route RT, and a bending degree calculating section <NUM> that calculates the bending degree P of the route RT.

Referring to <FIG>, the image data DT2 includes a boundary marker MK indicating a boundary between an inside region BVa1 of the blood vessel BV and an outside region BVa2 of the blood vessel BV. The center line deriving section <NUM> calculates a center of the blood vessel BV on the basis of the boundary marker MK included in the image data DT2, and derives the center line CL of the blood vessel BV by connecting centers of the blood vessel BV leading from the target site RG to the introduction site RS to each other. Incidentally, "a center of the blood vessel BV" refers to a center of a region enclosed by a blood vessel wall in a cross section of the blood vessel BV.

The route length calculating section <NUM> calculates the length of the center line CL calculated by the center line deriving section <NUM> as the length L of the route RT.

The bending degree calculating section <NUM> calculates the bending degree of the center line CL derived by the center line deriving section <NUM> as the bending degree P of the route RT. Incidentally, the "bending degree" is a sum total of the magnitude of bendings or curves calculated for respective parts bent or curved in the center line CL of the blood vessel BV. "The magnitude of bendings" is a curvature or the like.

The patient score calculating section <NUM> calculates the patient score SP by using an invasion degree of the route RT extracted by the route extracting section <NUM>.

The invasion degree is for example determined according to an amount of bleeding at a time of introduction of a medical instrument into the blood vessel BV via the introduction site RS, a time from an end of the procedure to the stopping of the bleeding, or the like. The invasion degree of the route RT whose introduction site RS is a radial artery, for example, is smaller than the invasion degree of the route RT whose introduction site RS is a femoral artery.

Referring to <FIG>, recorded in the introduction site list LS1 for each candidate for the introduction site RS is the invasion degree at a time of introduction of a medical instrument into the blood vessel BV via the corresponding introduction site RS.

The patient score calculating section <NUM> calculates the invasion degree of the route RT extracted by the route extracting section <NUM> by using the invasion degree recorded in the introduction site list LS1. The patient score calculating section <NUM> obtains the introduction site list LS1 from the external server <NUM> via the network.

Referring to <FIG>, the output section <NUM> outputs, to the display <NUM>, the plurality of routes RT extracted by the route extracting section <NUM>, the rankings assigned by the ranking assigning section <NUM>, the route score SR, and the patient score SP. The output section <NUM> outputs the plurality of routes RT extracted by the route extracting section <NUM> on the display <NUM> together with an image GR of the living body BD of the target patient.

The output section <NUM> displays the plurality of routes RT extracted by the route extracting section <NUM> in a route display region AR1 of the display <NUM>. The output section <NUM> displays an enlarged image of the plurality of routes RT extracted by the route extracting section <NUM> in a detailed display region AR2.

The receiving section <NUM> receives a selection of a route RT output to the display <NUM> by the output section <NUM>. In response to the selection of the route RT which selection is received by the receiving section <NUM>, the output section <NUM> displays, on the display <NUM>, one route RT of the plurality of routes RT extracted by the route extracting section <NUM>, a ranking corresponding to the one route RT, a route score SR, and a patient score SP.

Processing in the route extracting section <NUM> will next be explained in detail.

Referring to <FIG>, the image information DT1 includes divided image data DT3 obtained by dividing the image data DT2 into a plurality of pieces and supplementary information DT4 recorded as information about the divided image data DT3.

The divided image data DT3 is data generated by dividing the image data DT2 according to sites of the blood vessel BV. For example, the divided image data DT3 is data generated by dividing the image data DT2 for each site of a right subclavian artery, a brachiocephalic artery, an aortic arch, a thoracic aorta, an abdominal aorta, a left common iliac artery, a left external iliac artery, a left femoral artery, or the like. Divided images are identified by unique identifiers (hereinafter IDs).

Recorded as the supplementary information DT4 for each piece of divided image data DT3 are site information specifying a site of the blood vessel BV included in the corresponding divided image data DT3 and link information bidirectionally linking adjacent pieces of divided image data DT3 to each other.

Referring to <FIG>, the route extracting section <NUM> includes: a target site image specifying section <NUM> that specifies the ID of a piece of divided image data DT3 including the target site RG from among the plurality of pieces of divided image data DT3 included in the image information DT1; an introduction site image specifying section <NUM> that specifies the ID of a piece of divided image data DT3 including a candidate for the introduction site RS from among the plurality of pieces of divided image data DT3 included in the image information DT1; and a route searching section <NUM> that searches for the route RT of the blood vessel BV leading from the target site RG to the introduction site RS.

The target site image specifying section <NUM> specifies the ID of the piece of divided image data DT3 including the target site RG by using the site information received by the receiving section <NUM> and the site information included in the supplementary information DT4.

The introduction site image specifying section <NUM> specifies the ID of a piece of divided image data DT3 including a candidate for the introduction site RS by using the introduction site list LS1 and the site information included in the supplementary information DT4.

The route searching section <NUM> searches for the route RT of the blood vessel BV leading from the target site RG to the introduction site RS by using the ID of a divided image specified by the target site image specifying section <NUM>, the ID of a divided image specified by the introduction site image specifying section <NUM>, and the link information included in the supplementary information DT4.

Description will next be made of a method of assisting in selecting the route RT of the blood vessel BV (corresponding to a living body lumen) for delivering a medical instrument to a site within a living body via the living body lumen (which method will hereinafter be a route selection assistance method).

Referring to <FIG>, the route selection assistance method includes: step S1 of receiving an input of site information; step S2 of obtaining the image information DT1; step S3 of extracting the routes RT of blood vessels BV; step S4 of calculating route scores SR; step S5 of calculating patient scores SP; step S6 of assigning rankings to the extracted routes RT; and step S7 of outputting the extracted routes RT and the rankings.

Step S1 of receiving an input of site information receives the input of the site information specifying the target site RG as a target of a procedure performed by delivering a medical instrument. Step S1 of receiving the input of the site information is performed by the receiving section <NUM>.

Step S2 of obtaining the image information DT1 obtains the image information DT1 of the living body BD of the target patient as a target of a procedure performed by delivering a medical instrument. Step S2 of obtaining the image information DT1 is performed by the image obtaining section <NUM>.

Step S3 of extracting the routes RT of blood vessels BV extracts a plurality of routes RT of living body lumens through which a medical instrument can be delivered to the target site RG on the basis of the obtained image information DT1. Step S3 of extracting the routes RT of the blood vessels BV is performed by the route extracting section <NUM>.

Step S4 of calculating route scores SR calculates the route scores SR determined according to ease of delivery of a medical instrument at a time of delivery of the medical instrument via the routes RT. Step S4 of calculating the route scores SR is performed by the route score calculating section <NUM>.

Step S5 of calculating patient scores SP calculates the patient scores SP determined according to the magnitude of a burden imposed on the target patient. Step S5 of calculating the patient scores SP is performed by the patient score calculating section <NUM>.

Step S6 of assigning rankings assigns rankings to the plurality of extracted routes RT on the basis of the calculated route scores SR and the calculated patient scores SP. Step S6 of assigning the rankings is performed by the ranking assigning section <NUM>.

Outputting step S7 outputs, to the display <NUM>, the plurality of routes RT extracted in step S3 of extracting the routes RT of the blood vessels BV, the rankings assigned in step S6 of assigning the rankings, the route scores SR calculated in step S4 of calculating the route scores SR, and the patient scores SP calculated in step S5 of calculating the patient scores SP.

Outputting step S7 outputs, to the display <NUM>, the routes RT, the rankings, the route scores SR, and the patient scores SP in order to assist an operator such as a doctor in selecting the route RT of a blood vessel BV for delivering a medical instrument to the target site RG within the living body BD via the blood vessel BV.

Outputting step S7 outputs the plurality of routes RT extracted by the route extracting section <NUM> to the display <NUM> together with the image GR of the living body BD of the target patient.

Outputting step S7 is performed by the output section <NUM>.

Description will next be made of a method of diagnosing the route RT of a blood vessel BV for delivering a medical instrument to a site within the living body BD via the blood vessel BV (corresponding to a living body lumen) (which method will hereinafter be a diagnosis method).

The diagnosis method according to the present embodiment includes a step of diagnosing a route RT from the plurality of routes RT extracted in step S3 of extracting the routes RT of the blood vessels BV and the rankings assigned in step S6 of assigning the rankings in addition to steps S1 to S6 of the route selection assistance method described above.

The step of diagnosing a route RT diagnoses a route RT assigned a high ranking in step S6 of assigning the rankings as a more appropriate route RT as compared with a route RT having a low ranking from a viewpoint of the ease of delivering a medical instrument at a time of delivery of the medical instrument via the route RT and the magnitude of a burden imposed on the target patient.

Description will next be made of an example of usage of the route assistance system according to the present embodiment. In the following, description will be made by taking as an example a case where six sites of a right radial artery, a right brachial artery, a right femoral artery, a left radial artery, a left brachial artery, and a left femoral artery are recorded in the introduction site list LS1 (see <FIG>). In the following, description will be made by taking as an example a case where a left superficial femoral artery (SFA) is to be treated.

Referring to <FIG>, by operating the display <NUM>, an operator inputs a "left superficial femoral artery" as site information specifying the target site RG as a target of a procedure performed by delivering a medical instrument.

The image obtaining section <NUM> obtains the image information DT1 on the inside of the living body BD of the target patient as a target of a procedure performed by delivering a medical instrument from the external server <NUM> (see <FIG>) via the network.

The route extracting section <NUM> extracts six routes RT of blood vessels BV corresponding to six candidates for the introduction site RS, the six candidates being a right radial artery, a right brachial artery, a right femoral artery, a left radial artery, a left brachial artery, and a left femoral artery recorded in the introduction site list LS1 (see <FIG>).

For each of the six routes RT extracted by the route extracting section <NUM>, the route score calculating section <NUM> calculates a route score SR on the basis of the length L of the route RT and the bending degree P of the route RT. For each of the six routes RT extracted by the route extracting section <NUM>, the patient score calculating section <NUM> calculates a patient score SP by using an invasion degree.

In the present usage example, the route score SR is decreased in order of the route RT whose introduction site RS is a right radial artery (left radial artery), the route RT whose introduction site RS is a right brachial artery (left brachial artery), and the route RT whose introduction site RS is a right femoral artery (left femoral artery). In contrast to this, the patient score SP is decreased in order of the route RT whose introduction site RS is the right femoral artery (left femoral artery), the route RT whose introduction site RS is the right brachial artery (left brachial artery), and the route RT whose introduction site RS is the right radial artery (left radial artery).

In the present usage example, the product SR × SP of the route score SR and the patient score SP is decreased in order of the route RT whose introduction site RS is the right femoral artery (left femoral artery), the route RT whose introduction site RS is the right brachial artery (left radial artery), and the route RT whose introduction site RS is the right radial artery (left radial artery).

The ranking assigning section <NUM> assigns rankings to the plurality of routes RT extracted by the route extracting section <NUM> in increasing order of the product SR × SP of the route score SR calculated by the route score calculating section <NUM> and the patient score SP calculated by the patient score calculating section <NUM>.

The output section <NUM> outputs, to the display <NUM>, the plurality of routes RT extracted by the route extracting section <NUM>, the rankings assigned by the ranking assigning section <NUM>, and the route scores SR and the patient scores SP (see <FIG>).

The operator such as a doctor refers to the routes RT of the blood vessels BV, the rankings, and the route scores SR and the patient scores SP output to the display <NUM>, and thereby selects an appropriate route RT with consideration given to the ease of delivery of a medical instrument at a time of delivery of the medical instrument and the magnitude of a burden imposed on the target patient.

According to the route selection assistance system <NUM>, the recording medium MD on which the route selection assistance program PR is recorded, the route selection assistance method, and the diagnosis method in accordance with the present embodiment, the ranking assigning section <NUM> assigns rankings to the plurality of routes RT extracted by the route extracting section <NUM> by using the route scores SR determined according to the ease of delivery of a medical instrument at a time of delivery of the medical instrument and the patient scores SP determined according to the magnitude of a burden imposed on the target patient. The output section <NUM> then outputs the plurality of routes RT extracted by the route extracting section <NUM> and the rankings assigned by the ranking assigning section <NUM>. The operator such as a doctor can thereby select an appropriate route RT easily from among the plurality of routes RT of blood vessels BV through which a medical instrument can be delivered to the target site RG as a target of a procedure in consideration of the ease of delivery of the medical instrument at a time of the delivery of the medical instrument and the magnitude of a burden imposed on the target patient. Hence, according to the route selection assistance system <NUM>, the recording medium MD on which the route selection assistance program PR is recorded, and the route selection assistance method in accordance with the present invention, it is possible to easily select the route RT of a blood vessel BV for delivering a medical instrument to a site within the living body BD via the blood vessel BV. Such an effect is particularly remarkable in a case where the number of sites of the blood vessel BV which sites are to be passed is increased, that is, in a case where the blood vessel BV of a lower limb is treated by using TRI or the like.

In addition, according to the route selection assistance system <NUM>, the recording medium MD on which the route selection assistance program PR is recorded, the route selection assistance method, and the diagnosis method in accordance with the present embodiment, the route score calculating section <NUM> calculates a route score SR by using the length of a route RT and the bending degree P of the route RT. The ranking assigning section <NUM> can thereby evaluate the ease of delivery of a medical instrument at a time of delivery of the medical instrument more appropriately, and rank the routes RT. Therefore, the operator can easily select a more appropriate route RT from among the plurality of routes RT of the blood vessels BV through which a medical instrument can be delivered to the target site RG in consideration of the ease of delivery of the medical instrument at a time of delivery of the medical instrument. Such an effect is particularly remarkable in a case where an appropriate route RT is selected from among the plurality of routes RT including sites greatly differing in the magnitude of bending or curvature for each target patient, the sites being a right radial artery, a right brachial artery, a right axillary artery, a right subclavian artery, a right brachiocephalic artery, a left radial artery, a left brachial artery, a left axillary artery, a right subclavian artery, a brachiocephalic artery, an aortic arch, a thoracic aorta, an abdominal aorta (descending aorta), an aortailiac bifurcation, left or right one or both of common iliac arteries, external iliac arteries, internal iliac arteries, common femoral arteries, superficial femoral arteries, and deep femoral arteries, and further, as required, popliteal arteries, anterior tibial arteries, posterior tibial arteries, peroneal arteries, dorsalis pedis arteries, plantar arteries, collateral circulations, or the like.

In addition, according to the route selection assistance system <NUM>, the recording medium MD on which the route selection assistance program PR is recorded, the route selection assistance method, and the diagnosis method in accordance with the present embodiment, the patient score calculating section <NUM> calculates a patient score SP by using the invasion degree of a route RT. The ranking assigning section <NUM> can thereby evaluate the magnitude of a burden imposed on the target patient more appropriately, and rank the routes RT. Therefore, the operator can easily select a more appropriate route RT from among the plurality of routes RT of the blood vessels BV through which a medical instrument can be delivered to the target site RG in consideration of the magnitude of a burden imposed on the target patient.

Referring to <FIG>, a route selection assistance system <NUM> according to a present embodiment includes a medical instrument extracting section <NUM> that extracts a kind of medical instrument to be used for a procedure and a device extracting section <NUM> that extracts useable device candidates according to the kind of medical instrument extracted by the medical instrument extracting section <NUM>, in addition to the functional configuration of the route selection assistance system <NUM> according to the foregoing embodiment.

The route selection assistance system <NUM> according to the present embodiment will be described in the following. Incidentally, a device configuration of the route selection assistance system <NUM> according to the present embodiment is the same as the device configuration of the route selection assistance system <NUM> according to the foregoing embodiment. A functional configuration of the route selection assistance system <NUM> according to the present embodiment is the same as the functional configuration of the route selection assistance system <NUM> according to the foregoing embodiment except that the functional configuration of the route selection assistance system <NUM> according to the present embodiment further includes the medical instrument extracting section <NUM> and the device extracting section <NUM>. The same devices and functional blocks as in the route selection assistance system <NUM> according to the foregoing embodiment are identified by the same reference numerals, and description thereof will be omitted.

Referring to <FIG>, the receiving section <NUM> receives an input of procedure information specifying a kind of procedure to be performed by delivering a medical instrument to the target site RG via a blood vessel BV (corresponding to a living body lumen). The kinds of procedure is for example expansion or piercing of a constriction in the blood vessel BV, excavation of the constriction of the blood vessel BV, imaging of the inside region BVa1 of the blood vessel BV, or releasing of a drug within the blood vessel BV. Except for receiving an input of procedure information, functions of the receiving section <NUM> are the same as the functions of the receiving section <NUM> in the route assistance system according to the foregoing embodiment.

The medical instrument extracting section <NUM> extracts one or a plurality of kinds of medical instruments to be used for the kind of procedure specified by the procedure information. The kinds of medical instruments are for example an introducer sheath, a guide wire, an imaging catheter, a micro-catheter, an angiographic catheter, a guide wire support catheter, a guiding catheter, a balloon catheter, a balloon-expandable stent, a self-expandable stent, a drug releasing stent, a drug releasing balloon, a directional coronary atherectomy (DCA) catheter, a microdissection catheter, a laser ablation catheter, and a catheter for image diagnosis.

The catheter for image diagnosis is for example a catheter for obtaining an image by using an intravascular ultrasound diagnosis method (IVUS) or an optical coherence tomography diagnosis method (OCT).

The device extracting section <NUM> extracts a useable device candidate for each kind of medical instrument extracted by the medical instrument extracting section <NUM>. The device extracting section <NUM> extracts the useable device candidate on the basis of the presence or absence of stock of a device.

In a case where there are a plurality of useable device candidates, the device extracting section <NUM> extracts the plurality of device candidates within a range not exceeding an upper limit number. Though not particularly limited, the upper limit number is for example about <NUM> for each device.

In a case where there is no useable device, the number of device candidates extracted by the device extracting section <NUM> is zero.

Referring to <FIG>, the external server <NUM> stores a medical instrument list LS2 recording kinds of medical instruments to be used for each kind of procedure, a device list LS3 recording device candidates for each kind of medical instrument, and a device information list LS4 recording the presence or absence of stock of a device for each device candidate.

The device list LS3 records commercially available devices for each kind of medical instrument. The devices are identified by unique device identifiers. The unique device identifiers are for example the manufacturer name of a manufacturer selling devices, a model name, a pharmaceutical approval number, a product code, bar code data, a product name, and a lot number.

The device information list LS4 records the presence or absence of stock of devices in a facility in which the route selection assistance system <NUM> is used.

The medical instrument extracting section <NUM> extracts kinds of medical instruments by using the medical instrument list LS2. The device extracting section <NUM> extracts useable device candidates by using the device list LS3 and the device information list LS4.

The ranking assigning section <NUM> adjusts rankings assigned to the plurality of routes RT extracted by the route extracting section <NUM> on the basis of a result of the device extraction by the device extracting section <NUM>.

The ranking assigning section <NUM> decreases the ranking of a route RT for which no useable device is extracted in the device extracting section <NUM>.

Referring to <FIG>, the output section <NUM> outputs the device candidates extracted by the device extracting section <NUM> to the display <NUM> in addition to information output by the output section <NUM> of the route selection assistance system <NUM> according to the foregoing embodiment.

The output section <NUM> outputs, to the display <NUM>, the routes RT, the rankings, the route scores SR, and the patient scores SP in order to assist an operator such as a doctor in selecting a device to be used for a procedure performed by delivering a medical instrument to the target site RG within the living body BD via the blood vessel BV.

According to the route selection assistance system <NUM> in accordance with the present embodiment, the receiving section <NUM> receives an input of procedure information specifying a kind of procedure to be performed by delivering a medical instrument via the blood vessel BV. The route selection assistance system <NUM> according to the present embodiment includes the medical instrument extracting section <NUM> that extracts kinds of medical instruments to be used for the procedure specified by the procedure information and the device extracting section <NUM> that extracts useable device candidates for each kind of medical instrument extracted by the medical instrument extracting section <NUM>. The output section <NUM> then outputs a result of the extraction of the device candidates by the device extracting section <NUM>. Thus, the operator can more easily select a device to be used for a procedure performed by delivering a medical instrument via the blood vessel BV. Therefore, a burden on the operator at a time of performing a procedure by delivering a medical instrument via the blood vessel BV is reduced more.

In addition, according to the route selection assistance system <NUM>, the recording medium MD on which the route selection assistance program PR is recorded, and the route selection assistance method in accordance with the present embodiment, the ranking assigning section <NUM> adjusts the rankings assigned to the plurality of routes RT extracted by the route extracting section <NUM> on the basis of a result of extraction of device candidates by the device extracting section <NUM>. Thus, the operator can easily select a more appropriate route RT from among the plurality of routes RT of blood vessels BV through which a medical instrument can be delivered to the target site RG according to the useable device candidates.

In the foregoing first and second embodiments, the patient score calculating section <NUM> calculates the magnitude of a burden imposed on the target patient by using an invasion degree. However, the patient score calculating section <NUM> may also calculate a patient score SP using patient information recording characteristics of the target patient.

The patient information can be stored in the external server <NUM>. The patient score calculating section <NUM> obtains the patient information from the external server <NUM> via the network.

The patient information includes information about the anamnesis of the target patient. The information about the anamnesis of the target patient includes procedure history information recording history information about a procedure on the blood vessel BV. The procedure on the blood vessel BV is for example placement of a stent or a graft. The procedure history information includes information specifying a site of the blood vessel BV on which site the procedure is performed.

The patient score calculating section <NUM> calculates a patient score SP using the information about the anamnesis of the target patient. Using the procedure history information, the patient score calculating section <NUM> calculates that a patient score SP for a route RT including the blood vessel BV on which the procedure is performed is high as compared with a route RT not including the blood vessel BV on which the procedure is performed.

According to the route selection assistance system, the recording medium MD on which the route selection assistance program PR is recorded, and the route selection assistance method in accordance with the present modification, the patient score calculating section <NUM> calculates a patient score SP using information about the characteristics of the target patient. The ranking assigning section <NUM> can thereby evaluate the magnitude of a burden imposed on the target patient even more appropriately, and rank the routes RT. Therefore, the operator can easily select an even more appropriate route RT from among the plurality of routes RT of the blood vessels BV through which a medical instrument can be delivered to the target site RG in consideration of the magnitude of a burden imposed on the target patient.

In the foregoing first and second embodiments, the receiving section <NUM> displays one or a plurality of sites to be received as the target site RG as alternatives on the display <NUM>, and receives a selection of a displayed site.

Referring to <FIG>, for the site displayed on the display <NUM> as an alternative, the receiving section <NUM> may further receive a selection of a range of the site as a target of delivering a medical instrument. The operator such as a doctor can select the target site RG in a more detailed and accurate manner by selecting the range of the site as a target of delivering a medical instrument.

At this time, the receiving section <NUM> may display the image GR of the living body BD of the target patient on the display <NUM>, and display the range selected as the site as a target of delivering a medical instrument in the image GR by a distinguishable marker MK2.

In addition, referring to <FIG>, the receiving section <NUM> may display the image GR of the living body BD of the target patient on the display <NUM>, and receive a selection of the target site RG in the image GR. In this case, the operator such as a doctor can select the target site RG by tracing the target site RG by a finger or the like on the image GR displayed on the display <NUM>. Therefore, according to the route selection assistance system in accordance with the present modification, the selection of the target site RG is facilitated, and the selection of the target site RG can be made in a more detailed and accurate manner.

In the foregoing second embodiment, the device extracting section <NUM> extracts useable device candidates on the basis of the presence or absence of stock of devices.

The device extracting section <NUM> may further narrow down the useable device candidates extracted on the basis of the presence or absence of stock of devices by using characteristics of the devices.

For example, the device extracting section <NUM> may exclude a device whose device length is less than the length L of the route RT from the useable device candidates extracted on the basis of the presence or absence of stock of devices.

The route selection assistance system, the recording medium on which the route selection assistance program is recorded, and the route selection assistance method have been described above through embodiments and modifications thereof. However, the present invention is not limited to only configurations described in the embodiments, but can be changed as appropriate on the basis of the description of claims.

For example, in the foregoing embodiments and the modifications thereof, a blood vessel of a lower limb is illustrated as the target site. However, the target site is not particularly limited. For example, the target site may be a blood vessel in a brain, a heart, or the like. Further, in the foregoing embodiments and the modifications thereof, description has been made by taking as an example a case where the living body lumen is a blood vessel. However, the living body lumen is not limited to a blood vessel, but may be a vessel, a bile duct, an oviduct, a hepatic duct, a trachea, an esophagus, a urethra, or the like.

In addition, the patient score calculating section calculates a patient score using history information about a procedure on a blood vessel as information about the characteristics of the target patient. However, the patient score calculating section may calculate a patient score using information such as a tendency toward spasm (abnormal contraction of a blood vessel which contraction accompanies convulsion) because of a tendency toward tonus or an onset history of constriction, occlusion, or the like as the information about the characteristics of the target patient. In this case, the patient score calculating section calculates that the patient score of a route including a blood vessel site where there is an onset history of spasm or the like is high as compared with the patient score of a route not including a blood vessel site where there is an onset history of spasm or the like. In addition, the patient score calculating section may calculate a patient score by combining the information about the characteristics of the target patient and an invasion degree with each other.

In the foregoing embodiments and the modifications thereof, the output section outputs, to the display, the plurality of routes extracted by the route extracting section, the rankings assigned by the ranking assigning section, the route scores, and the patient scores. However, the output section may output the plurality of routes extracted by the route extracting section, the rankings assigned by the ranking assigning section, the route scores, and the patient scores as data to the external server. In this case, the route of a living body lumen can be expressed as a set of coordinates with the target site as an origin.

In addition, in the foregoing embodiments and the modifications thereof, the output section displays one of the plurality of routes extracted by the route extracting section on the display in response to a selection of the route which selection is received by the receiving section. However, the output section may simultaneously display the plurality of routes extracted by the route extracting section on the display. In this case, the output section may display the plurality of routes extracted by the route extracting section on the display in different colors.

In addition, in the foregoing embodiments and the modifications thereof, the image information includes image data and supplementary information. However, it suffices for the image information to include at least image data of the living body lumen of the target patient, and the supplementary information is not an essential requirement.

In addition, the image data does not have to include a boundary marker. Even in this case, the center line calculating section of the route score calculating section can derive the center line of the blood vessel on the basis of the image data by using a publicly known image processing technology or the like.

In addition, the image data does not need to be divided for each site of the living body lumen. Even when the image data is not divided for each site of the living body lumen, the route extracting section can extract the route of the living body lumen through which a medical instrument can be delivered to the target site by using a publicly known image processing technology or the like on the basis of the image data.

In addition, in the foregoing embodiments and the modifications thereof, the route selection assistance program recorded on the computer readable recording medium is read by the reading device and stored in the storage device, and thereby the route selection assistance system functions. However, the route selection assistance system may be provided in a state in which the route selection assistance program is stored in the storage device in advance. In addition, a part or all of the functions of the route selection assistance system may be implemented by a programmable circuit structure such as a field programmable gate array (FPGA). In this case, a part or the whole of the route selection assistance program is described in a hardware description language such as Verilog.

In addition, in the foregoing embodiments and the modifications thereof, the receiving section receives an input of site information or the like via the touch panel display. However, in the route selection assistance system, an input device is not limited to the touch panel display, but a publicly known input device can be used. For example, the route selection assistance system may include a mouse or a pen tablet as the input device in addition to a display that is not the touch panel display. The operator such as a doctor can input site information by operating the mouse or the pen tablet.

In addition, in the foregoing embodiments and the modifications thereof, the computer main unit and the display are configured as separate parts. However, the computer main unit and the display may be configured integrally with each other, or the display may be incorporated in the computer main unit.

In addition, in the foregoing embodiments and the modifications thereof, the image obtaining section obtains image information from the external server. However, the image obtaining section may be configured by using an image photographing device for medical use such as an X-ray CT device, or an MRI device.

Claim 1:
A route selection assistance system (<NUM>) for assisting in selecting a route (RT) of a living body lumen (BV) for delivering a medical instrument to a site within a living body (BD) via the living body lumen (BV) via an introduction site (RS), the route selection assistance system (<NUM>) comprising a computer main unit (<NUM>), the computer main unit (<NUM>) comprising:
a receiving section (<NUM>) configured to receive an input of site information specifying a target site (RG) within the living body (BD) as a target of delivering the medical instrument;
an image obtaining section (<NUM>) configured to obtain image information (DT1) on an inside of the living body (BD) of a target patient as the target of delivering the medical instrument; characterized by:
a route extracting section (<NUM>) configured to extract a plurality of routes (RT) of the living body lumen (BV), the plurality of routes (RT) allowing the medical instrument to be delivered to the target site (RG) on a basis of the image information (DT1) obtained by the image obtaining section (<NUM>);
a ranking assigning section (<NUM>) including a route score calculating section (<NUM>) configured to calculate route scores (SR) determined according to ease of delivery of the medical instrument at a time of delivery of the medical instrument via the routes (RT) and based on lengths of the routes (RT) and bending degrees (P) of the routes (RT), and a patient score calculating section (<NUM>) configured to calculate patient scores (SP) determined according to magnitude of a burden imposed on the target patient by using an invasion degree of the route (RT) extracted by the route extracting section (<NUM>), the ranking assigning section (<NUM>) assigning rankings to the plurality of routes (RT) extracted by the route extracting section (<NUM>) by using the route scores (SR) and the patient scores (SP); and
an output section (<NUM>) configured to output the plurality of routes (RT) extracted by the route extracting section (<NUM>) and the rankings assigned by the ranking assigning section (<NUM>).