Patent Application
20070083396
1. Field of the Invention
The present invention relates to an image interpretation support system for supporting image interpretation performed by doctors after imaging of examination images (medical images) to be used for medical diagnoses by images.
2. Description of a Related Art
Recent years, along with the spread of medical digital image generation technologies such as CR (computed radiography), MRI (magnetic resonance imaging) and CT (computed tomography), medical images obtained by examinations have been electronically managed.
Generally, when an imaging examination is performed, interpretation is performed on generated images by an image interpretation doctor and an image interpretation report, in which an interpretation result and finding are written, is created before a specific diagnosis is made to a patient by a doctor in charge. Conventionally, even when digital image data is generated, medical images printed on photographic films are used at the time of image interpretation. On the other hand, with the development of high-definition monitors (viewers), medical images displayed on the monitors are also used for image interpretation.
By the way, when follow-up observation of a lesion part is performed, it is necessary for the image interpretation doctor to refer to examination images of the past plural examinations and image interpretation reports on those examinations. In this regard, it is desirable that changed portions in the past image interpretation results can be extracted because the change of an affected part as a target of the examination can be easily grasped.
As a related technology, Japanese Patent Application Publication JP-P2001-125995A discloses a medical report system including report information input means for inputting report information, management means for associating the report information inputted by the report information input means with version information representing the version number of the report information and managing them, and output means for outputting the version information associated and managed with the report information by the management means. Further, the medical report system includes difference information acquiring means for acquiring difference information representing a difference from the last report information at each input of the report information, and the management means updates the version information based on the difference information acquired by the difference information acquiring means. Furthermore, in the medical report system, the management means associates the difference information acquired by the difference information acquiring means with the report information and manages them.
Further, Japanese Patent Application Publication JP-P2005-160661A discloses an examination management system characterized by including executed information input means for inputting executed information including information on execution contents of medical act executed on an examination and information related to a report regarding the medical act, executed information storage means for storing the executed information inputted by the executed information input means, executed information acquiring means for acquiring the executed information related to the report from the executed information storage means by using the information indicating the same examination of the same patient as a key, report comparing means for mutually comparing the plurality of reports acquired by the executed information acquiring means, and report comparison result display means for displaying a result compared by the comparing means.
In JP-P2001-125995A, differences between the text information are managed, and when there is a difference, it is determined that the finding has been changed and the version number of report text is increased. However, according to the system, the finding and changes of affected parts determined from the finding cannot be easily grasped.
Further, according to the examination management system disclosed in the JP-P2005-160661A, when there is a change in diagnosis, the user can be informed of the examination result. However, in the examination management system, when there is no change in diagnosis and the progress of medical condition is observed, the progress of lesion part cannot be indicated.
The present invention has been achieved in view of the above-mentioned problems. A purpose of the present invention is to provide an image interpretation support system by which past image interpretation results on a certain examination as an object of follow-up observation can be easily grasped.
In order to achieve the purpose, an image interpretation support system according to one aspect of the present invention is an image interpretation support system for supporting creation of image interpretation reports based on medical images, which system comprises: (i) an image interpretation report server for storing a report database which accumulates difference information between past reports as image interpretation reports created in past on a same patient as that in this examination in association with the respective past reports; and (ii) an image interpretation report creating apparatus connected to the image interpretation report server directly or via a network, and the image interpretation report creating apparatus includes: follow-up observation examination determining means for determining whether or not this examination is an object of follow-up observation; report finding control means for creating, when this examination is an object of follow-up observation, an image interpretation report at this time by generating an image interpretation report creation screen by utilizing at least one past report and the difference information on the at least one past report accumulated in the report database to cause a display unit to display the image interpretation report creation screen and entering information in the image interpretation report creation screen according to a user's operation; changed portion extracting means for extracting a portion, which is changed between the image interpretation report creation screen in which the information is entered according to the user's operation and an image interpretation report creation screen generated by utilizing the at least one past report, to generate difference information; and report saving means for storing the difference information generated by the changed portion extracting means in association with the image interpretation report at this time and the at least one past report in the report database.
According to the present invention, the changed portions of the finding sentences among the plural image interpretation reports on the same patient as that of this examination are extracted and displayed, and therefore, it becomes easier for the user to grasp the past progress of the medical condition. By utilizing the past progress, the time required for creating the image interpretation report can be reduced, and the image interpretation report can be efficiently created.
Hereinafter, preferred embodiments of the present invention will be explained in detail by referring to the drawings. The same reference numerals are assigned to the same component elements and the explanation thereof will be omitted.
As shown in
The image interpretation report creating apparatus 1 is an apparatus for creating image interpretation reports under a user's operation (image interpretation doctor's operation) and characterized in that, when a certain examination as a target of image interpretation is an object of follow-up observation, a change in a lesion part is grasped by referring to the image interpretation reports on examinations made in the past, and thus, the creation efficiency of the image interpretation reports is improved. In the present application, for a certain examination, one or more interpretation report on the same type of examination made on the same part of the same patient is referred to as “past report”, the examination made immediately before the certain examination is referred to as “last examination”, the most recent report among the past reports, i.e., a past report on the last examination is referred to as “last report”, and further, a past report on the examination made immediately before the last examination is referred to as “second last report”.
As shown in
The input unit 110 is an input device such as a keyboard or a mouse. The user enters information of finding text and so on by using the input unit 110 in the finding entry screen 30 shown on the display unit 100 while observing the examination images displayed on the image display terminal 2, which will be described later.
The image display terminal 2 is a terminal device for displaying an examination image as a target of image interpretation and has a high-definition display. In
The image server 3 is, for example, a server for PACS (Picture Archiving and Communication System) for storing and managing image data acquired by the imaging modalities such as the CR apparatus 6a, the CT apparatus 6b and the MRI apparatus 6c. The image server 3 outputs desired image data to the image interpretation report creating apparatus 1 according to a request of the image interpretation report creating apparatus 1.
The image interpretation report server 4 includes a recording medium for storing a report database (DB) 4a. The report database 4a has accumulated report data representing image interpretation reports created in the past. The report data contains report ID, patient ID, name of patient, examination ID, text information (finding data) displayed as finding by the image interpretation doctor, and so on. Further, in the report database 4a, the report data on the same type of examination made on the same part of the same patient are managed in association with one another.
The text information representing finding is managed by identification tag information <FINDING> to </FINDING>. Further, the report difference information represents changed portions between the finding in the image interpretation report and the finding in the last image interpretation report thereof. The report difference information is also managed by identification tag information. That is, the changed sentence tag <CHANGED SENTENCE> to </CHANGED SENTENCE> is attached to the sentence changed from the last report (changed sentence), and the changed portion tag <CHANGED PORTION> to </CHANGED PORTION> is attached to the phrase changed in the sentence (changed portion). Alternatively, difference of information other than finding such as names of diagnoses of medical condition may be used as the report difference information.
In the report difference information of the report ID “000005” shown in
Referring to
The RIS 5 is a server for managing radiological examinations in the radiological department, and manages examination schedules, sends examination orders to the imaging modalities, and sends image interpretation orders (image interpretation requests) for examinations for which imaging has been finished, based on information such as the patient information, examination contents and so on inputted by using the input terminal. The image interpretation orders are stored in the image interpretation report server 4.
Next, a constitution and an operation of the image interpretation report creating apparatus will be explained by referring to
In the hard disk 131, software (program) for actuating the CPU 10 to perform processing is recorded. As the recording medium, not only the built-in hard disk 131, but also an external hard disk, a flexible disk, an MO, an MT, a RAM, a CD-ROM, a DVD-ROM or the like may be used.
Next, plural function blocks formed by the CPU 10 and software (program) will be explained. These function blocks includes a request information acquiring unit 11, an image data acquiring unit 12, an image data output unit 13, a follow-up observation examination determining unit 14, a last report determining unit 15, a report finding display unit 16, a report finding entry unit 17, a key image setting unit 18, a changed portion extracting unit 19, a report saving unit 20, a report progress list creating unit 21 and a report progress list display unit 22.
The request information acquiring unit 11 acquires image interpretation request information (also referred to as request information or order information) from the image interpretation report server 4 via the network. The request information contains information of examination ID, examination image ID, type of examination, name of patient, age and sex of patient, modality to be used, and examined part and so on. Alternatively, the request information acquiring unit 11 may acquire request information offline, or, when the image interpretation report creating apparatus is also connected to another system such as an HIS (hospital information system), the request information acquiring unit 11 may acquire request information from such a system via a network.
The image data acquiring unit 12 acquires image data for display on the image display terminal 2 from the image server 3 and outputs the data to the image data output unit 13 based on the request information. Further, the image data acquiring unit 12 outputs image data in a slice position to be used as a key image to the key image setting unit 18, which will be described later, according to the request therefrom. By the way, although the image interpretation report creating apparatus 1 acquires image data from the image server 3 online in the embodiment, the apparatus may acquire the image data offline from recording media such as DVD (digital versatile disk) or CD (compact disk).
The image data output unit 13 outputs the image data received from the image data acquiring unit 12 such that examination images are displayed on the image display terminal 2. In this regard, the image data output unit 13 sets a layout of the examination images such that plural slice images are located in plural areas 201 in the order of image number, for example.
The follow-up observation examination determining unit 14 determines whether or not an examination on which an image interpretation report is to be created is an examination as an object of follow-up observation. For example, in the case where it is determined that the same type of examination is performed within a predetermined period (e.g., within six months) on the same part of the same patient as a result of referring to the work list in the past, the examination is determined as being an object of follow-up observation. The period, within which an examination is determined as being an object of follow-up observation, may be designated by the user settings. Alternatively, in the case where an examination is clearly stated as an object of follow-up observation in the details of the request of examination and request information contains information representing that the examination is an object of follow-up observation, those examinations are also determined as being objects of follow-up observation.
Such determination may be performed at the time when the user selects an examination from the work list when performing image interpretation, at the time when new image data is stored in the image server, or at the time when request information is received from the RIS or the like.
When an examination on which an image interpretation report is to be created is determined as being an examination as an object of follow-up observation, the last report determining unit 15 determines the most recent image interpretation report (last report) on the same type of examination performed on the same part of the same patient as that in this examination from the report database 4a stored in the image interpretation report server 4.
A report finding control unit including the report finding display unit 16, the report finding entry unit 17 and the key image setting unit 18 creates the finding entry screen 30 to cause the display unit 100 to display it, and edits the text information representing finding based on the information inputted by the user and creates an image interpretation report.
The finding entry column 32 is an area where finding is entered by the image interpretation doctor. In order to create the finding entry column 32, the report finding display unit 16 first acquires information on the last report determined in the last report determining unit 15 from the report database 4a shown in
As the format set for the finding, for example, the changed sentences within the report difference information are indicated by boldface (sentences of “IN PLAIN CT, . . . APPEARS IN LIVER.”, “IN CONTRAST CT, . . . IN THE PERIPHERY.”, “CONCLUDED AS LIVER CANCER.”, “TUMOR APPEARS IN PANCREAS”, and “REEXAMINATION IS REQUIRED.”), and the changed portions in the sentences are underlined (the portions of “4 cm”, “DISTINCT”, “CONCLUDED AS LIVER CANCER.”, “TUMOR APPEARS IN PANCREAS.”, and “REEXAMINATION IS REQUIRED.”). Alternatively, the color of characters in the changed sentences and changed portions may be altered.
Thus displayed finding in the finding entry column 32 is used as a draft of the image interpretation report to be created at this time. The report finding entry unit 17 rewrites the draft according to the user's operation, and thereby, the finding in the image interpretation report at this time is created.
By the way, when the examination as a target of image interpretation is the first examination or not an object of follow-up observation, the report finding display unit 16 displays a blank finding entry column 32.
The diagnostic outcome entry column 33 is an area where a diagnosis by the image interpretation doctor is entered. The report finding entry unit 17 inputs text information representing the diagnostic outcome into the diagnostic outcome entry column 33 according to the user's operation.
The key image display column 34 is an area for displaying an image (key image) determined by the image interpretation doctor as being a key of image interpretation among a series of images obtained by one examination. At least one key image is set for one examination. As the key image, a slice image in which a lesion part is recognizably shown, a slice image in which an especially notable part is shown, or a slice image determined as being suitable for image interpretation is selected.
The key image setting unit 18 shown in
Further, the key image setting unit 18 may set a link between the key image displayed in the key image display column 34 and the examination images displayed on the image display terminal 2 (
When a save command of finding data is inputted or an end command of finding entry is inputted by the user, the changed portion extracting unit 19 generates report difference information by extracting changed portions between the text information of the finding in the last report and the text information of the finding in the image interpretation report created at this time (this report). For example, as shown in
Alternatively, the changed portion extracting unit 19 may save the edit operation history in the report finding entry unit 17 and extract the changed text information based on the edit operation history so as to generate report difference information.
Furthermore, the changed portion extracting unit 19 may extract, as report difference information, changed portions in request information, diagnostic information (e.g., information displayed in the diagnostic outcome entry column 33 shown in
When a save command of finding data is inputted or an end command of finding entry is inputted by the user, the report saving unit 20 generates report data representing this report containing the edited finding, associates the report difference information generated by the changed portion extracting unit 19, this report and the last report with one another, and stores them in the report database 4a (
Further, the report saving unit 20 does not save this report when the report difference information is not generated by the changed portion extracting unit 19 (i.e., when there is no changed portion). That is, the finding unedited from the draft is not saved.
When the examination as a target of image interpretation is determined as being an object of follow-up observation by the follow-up observation examination determining unit 14, the report progress list creating unit 21 creates a report progress list that indicates the progress of the examination based on the report database 4a shown in
In each progress information display column 42, report identification information 43 for identifying the image interpretation report created in the past (past report), examination date information 44, a report summary 45 as a summary of finding in the past report and a key image 46 are displayed.
The report progress list creating unit 21 shown in
Further, the report progress list creating unit 21 copies the key image stored in the report database 4a shown in
The report progress list display unit 22 allows the display unit 100 to display the report progress list created in the report progress list creating unit 21.
Further, as shown in
Next, the creation of image interpretation report utilizing the image interpretation support system according to the embodiment will be explained.
The image interpretation report creating apparatus 1 shown in
The user rewrites the draft displayed on the finding entry screen 30 while referring to the report progress list, and creates the finding at this time. Thus, since the draft is shown, even the image interpretation doctor inexperienced to finding entry can create the image interpretation report easily.
After finishing the finding entry, the user inputs a save command of the image interpretation report. Thereby, the difference information between the finding text at this time and the finding text at the previous time is extracted, associated with the image interpretation reports at this time and at the previous time, and stored in the format shown in
Next, an image interpretation support system according to the second embodiment of the present invention will be explained. The constitution of the image interpretation support system according to the embodiment is nearly the same as the constitution of the image interpretation support system according to the first embodiment (
As shown in
When a value relating to a medical condition is contained in the past report and/or report difference information, the graph display unit 23 allows the display unit 100 to display a graph showing an aged variation or change of the value relating to the medical condition in time sequence.
Next, the operation of the graph display unit 23 will be specifically explained.
When the report database 4a shown in
At this time, the graph display unit 23 determines whether or not the values relating to the medical condition are contained in the image interpretation reports and/or report difference information on the first to third examinations. Here, the value “1 cm to 2 cm” representing the diameter of the tumor is contained in the finding of the image interpretation report on the first examination, the value “3 cm” representing the diameter of the tumor is contained in the image interpretation report and the report difference information on the second examination, and the value “4 cm” representing the diameter of the tumor is contained in the image interpretation report and the report difference information on the third examination. In this case, the graph display unit 23 allows the display unit 100 to display a graph display screen 60 for displaying a line graph with the horizontal direction as the number of examinations and the vertical direction as the length (the diameter of tumor).
The graph display screen 60 may be displayed within the finding entry screen 30 as shown in
Further, when a save command of the image interpretation report on the fourth examination is inputted, the value on the medical condition (the diameter of the tumor) in the image interpretation report on the fourth examination may be additionally plotted in the graph.
Here, the case where each of the past reports and/or report difference information contains a value on one medical condition (a diameter of one tumor) has been described. However, in the case where each of the past reports and/or report difference information contains plural values on two or more medical conditions, two or more graph display screens may be displayed, or two or more line graphs may be displayed within one graph display screen. For example, when each of the past reports and/or report difference information contains diameters of two tumors, the series of the diameter of the first tumor and the series of the diameter of the second tumor may be distinguishably displayed by indicating the diameter of the first tumor by the first line type (solid line, blue line or the like) and the diameter of the second tumor by the second line type (dotted line, red line or the like) in one graph display screen as shown in
Further, when each of the past report and/or report difference information contains values on two or more medical conditions, the aged variation of the value on the medical condition selected by the user may be displayed. For example, when each of the past reports and/or report difference information contains diameters of two tumors, only the aged variation of one diameter of the tumor selected by the user may be displayed in a line graph.
Alternatively, the graph may be displayed only when the changed portion tag <CHANGED PORTION> to </CHANGED PORTION> is attached to the value on the medical condition in the past report difference information (
Here, the line graph is displayed within the graph display screen 60, however, other types of graphs (bar graph or the like) may be displayed. Alternatively, the change over age on the medical condition may be displayed not as a graph but as numerical values. For example, when the report database 4a shown in
As described above, according to the embodiment, when the value on the medical condition is contained in the past reports and/or report difference information, the user can visually recognize the series of the value on the medical condition, and easily grasp the change of the value on the medical condition. Thereby, it becomes easier to put the change of the value on the medical condition to good use in creating the image interpretation report on this examination.
| Number | Date | Country | Kind |
|---|---|---|---|
| 2005-280708 | Sep 2005 | JP | national |
| 2006-084951 | Mar 2006 | JP | national |
