This application is based upon and claims the benefit of priority from Japanese Patent Application No. 2017-045183, filed on Mar. 9, 2017; the entire contents of which are incorporated herein by reference.
Embodiments described herein relate generally to an image processing apparatus.
As an examination for analyzing a myocardial blood flow, myocardial perfusion is known. For example, in the myocardial perfusion, an X-ray computed tomography (CT) apparatus obtains a time-density curve (TDC) indicating a temporal change in a CT value of an aorta and a TDC indicating a temporal change in a CT value of a myocardium from X-ray CT images that are generated by capturing chronological images of a subject to which a contrast agent is administered. Then, by solving a transfer function or a compartment model using the TDC of the aorta as input and the TDC of the myocardium as output, a myocardial blood flow rate is calculated.
An image processing apparatus according to an embodiment includes processing circuitry. The processing circuitry is configured to acquire pieces of change information indicating temporal changes in computed tomography (CT) values of a myocardium and a right ventricular of a subject based on a plurality of chronologically consecutive images that are generated by an X-ray CT apparatus by scanning the subject to which a contrast agent is administered. The processing circuitry is configured to correct the piece of change information on the myocardium based on the piece of change information on the right ventricular.
Exemplary embodiments of an image processing apparatus will be described below with reference to the drawings. A medical information processing system including the image processing apparatus will be described below as an example. Possible embodiments are not limited to the embodiments described below. Contents described in one embodiment are similarly applicable to any other embodiment in principle.
The X-ray CT apparatus 2 reconstructs X-ray CT images based on projection data collected by scanning a subject. The X-ray CT apparatus 2 is connected to an electrocardiograph (not illustrated), and detects a cardiac cycle of a heart of the subject based on an electrocardiographic signal output from the electrocardiograph. For example, when imaging the heart, the X-ray CT apparatus 2 performs electrocardiogram-gated scan, in which imaging is performed in synchronization with the cardiac cycle of the heart using a contrast agent. More specifically, the X-ray CT apparatus 2 performs the electrocardiogram-gated scan on the whole heart of a subject to which a contrast agent is administered in the myocardial perfusion, and generates a plurality of chronologically consecutive X-ray CT images.
A lower diagram in
An upper diagram in
The X-ray CT apparatus 2 transmits the generated X-ray CT images to the medical image processing apparatus 10. When a medical image storage apparatus or the like is provided in the medical information processing system 1 for example, the X-ray CT apparatus 2 may transmit the generated X-ray CT image to the medical image storage apparatus.
The description returns to
The input interface 11 corresponds to, for example, a mouse, a keyboard, a button, a touch panel, or the like. The input interface 11 receives various setting requests from an operator, and appropriately transfers the received various setting requests to the processing circuitry 14.
The display 12 displays a graphical user interface (GUI) used by the operator to input various setting requests with the input interface 11, and displays a processing result obtained by the processing circuitry 14, or the like.
The memory 13 is, for example, a semiconductor memory device, such as a random access memory (RAM) or a flash memory, or a storage device, such as a hard disk or an optical disk. The memory 13 stores therein a control program, various kinds of data, or the like for causing the medical image processing apparatus 10 to perform various processes.
The processing circuitry 14 controls operation of the medical image processing apparatus 10. As illustrated in
The configurations of the apparatuses included in the medical information processing system 1 have been described above. In the medical information processing system 1 configured as above, the medical image processing apparatus 10 calculates a myocardial blood flow rate in myocardial perfusion. For example, the medical image processing apparatus 10 generates, from X-ray CT images generated by the X-ray CT apparatus 2, change information indicating a temporal change in a CT value of an aorta and change information indicating a temporal change in a CT value of a myocardium. In the following, a case will be described in which the medical image processing apparatus 10 generates, as the change information, a time-density curve (TDC) indicating a temporal change in the CT value, for convenience of explanation. The medical image processing apparatus 10 calculates a myocardial blood flow rate by solving a transfer function using the TDC of the aorta as input and the TDC of the myocardium as output, for example.
Incidentally, the TDC of the myocardium generated from the X-ray CT images may be influenced by an artifact from a right ventricular in some cases. For example, when the right ventricular and the left ventricular are deeply colored by administration of a contrast agent, and if only a signal of the myocardium is low, a signal of the myocardium between high signals of the right ventricular and the left ventricular increases. In this case, for example, the TDC of the myocardium has a local peak at the same timing as the TDC of the right ventricular.
In
In view of the foregoing situations, the medical image processing apparatus 10 according to the first embodiment corrects the TDC of the myocardium based on the TDC of the right ventricular. For example, the medical image processing apparatus 10 corrects the TDC of the myocardium in a predetermined period based on a time at which the CT value of the TDC of the right ventricular indicates a peak. This process is realized by the processing circuitry 14 of the medical image processing apparatus 10. The process performed by the processing circuitry 14 of the medical image processing apparatus 10 will be described in detail below.
Step S1 to Step S3 are steps corresponding to the acquisition function 14a. At these steps, the processing circuitry 14 calls a predetermined program corresponding to the acquisition function 14a from the memory 13 and executes the program, so that the acquisition function 14a is implemented.
At step S1, the acquisition function 14a acquires X-ray CT images of a heart, for example. For example, the acquisition function 14a acquires, from the X-ray CT apparatus 2, a plurality of chronologically consecutive images that are generated by the X-ray CT apparatus 2 by scanning a subject to which a contrast agent is administered. When X-ray CT images generated by the X-ray CT apparatus 2 are stored in the medical image storage apparatus, the acquisition function 14a may acquire X-ray CT images of the heart from the medical image storage apparatus.
At step S2, the acquisition function 14a receives setting of a region of interest (ROI). For example, the acquisition function 14a receives setting of an ROI in each of a right ventricular, a myocardium, and a supply site that supplies blood to the myocardium. The supply site that supplies blood to the myocardium is, for example, any of an aorta, a left ventricular, and a coronary artery. In other words, the supply site that supplies blood to the myocardium is a blood vessel, and is, for example, the aorta, a blood vessel of the left ventricular, and the coronary artery. In the following, a case will be described in which the supply site that supplies blood to the myocardium is the aorta.
An X-ray CT image illustrated in
The description returns to
Step S4 is a step corresponding to the determination function 14b. At this step, the processing circuitry 14 calls a predetermined program corresponding to the determination function 14b from the memory 13 and executes the program, so that the determination function 14b is implemented. At Step S4, the determination function 14b determines whether a correction process on the TDC of the myocardium is to be performed.
For example, the TDC of the myocardium generated from the X-ray CT images may be influenced by an artifact from the right ventricular in some cases. If there is an influence of the artifact from the right ventricular, it is desirable to perform a correction process on the TDC of the myocardium. Therefore, the determination function 14b determines whether a process of correcting the TDC of the myocardium is to be performed based on a time at which the CT value of the TDC of the right ventricular indicates a peak. More specifically, the determination function 14b determines that the process of correcting the TDC of the myocardium is to be performed when a time at which the CT value of the TDC of the right ventricular indicates a peak and a time at which the CT value of the TDC of the myocardium indicates a maximum value fall within a predetermined time range. In other words, the determination function 14b determines that the process of correcting the TDC of the myocardium is to be performed when the TDC of the myocardium has a local peak at the same timing as the TDC of the right ventricular or when the TDC of the myocardium has a local peak at around a peak of the TDC of the right ventricular.
Alternatively, for example, the determination function 14b may determine that the process of correcting the TDC of the myocardium is to be performed when the CT value of the TDC of the myocardium indicates a maximum value between the time at which the CT value of the TDC of the right ventricular indicates a peak and the time at which the CT value of the TDC of the supply site that supplies blood to the myocardium indicates a peak.
If it is determined that the correction process on the TDC of the myocardium is to be performed (Yes at Step S4), the determination function 14b proceeds to Step S5. In contrast, if it is not determined that the correction process on the TDC of the myocardium is to be performed (No at Step S4), the determination function 14b proceeds to Step S6. Step S5 and Step S6 are steps corresponding to the correction function 14c. At these steps, the processing circuitry 14 calls a predetermined program corresponding to the correction function 14c from the memory 13 and executes the program, so that the correction function 14c is implemented.
At step S5, the correction function 14c performs the correction process on the TDC of the myocardium. In other words, if the determination function 14b determines that the process of correcting the TDC of the myocardium is to be performed, tine correction function 14c corrects the TDC of the myocardium. Here, the correction function 14c corrects the TDC of the myocardium based on the TDC of the right ventricular. For example, the correction function 14c corrects the TDC of the myocardium based on the time at which the CT value of the TDC of the right ventricular indicates a peak.
The correction function 14c corrects the TDC 32 of the myocardium in the period from Tx to Ty by linear interpolation. In the example illustrated in
The correction process on the TDC of the myocardium performed by the correction function 14c will be described in detail below with reference to
As illustrated in
At Step S12, the correction function 14c identifies a fitting range. Step S12 is a process of identifying data for approximating a line for linear interpolation. The time Ty at which the TDC 31 of the aorta reaches the peak corresponds to the time at which the TDC 32 of the myocardium has the maximum slope. Further, a temporal change in the CT value at around the time at which the TDC 32 of the myocardium has the maximum slope is important in the myocardial perfusion. Therefore, the correction function 14c identifies data for approximating a line by using a temporal change in the CT value at around the time at which the TDC 32 of the myocardium has the maximum slope. For example, as illustrated in
The description returns to
At Step S14, the correction function 14c corrects the TDC of the myocardium using a base line and the approximated line 94. For example, the correction function 14c first identifies the base line. Here, the base line indicates a CT value obtained when a contrast agent is not present, and is, for example, an average of CT values at a few points from the first point of the TDC 32 of the myocardium. As one example, as illustrated in
The correction function 14c obtains an intersection 97 of an extended line of the base line 96 and an extended line of the approximated line 94. The correction function 14c corrects the TDC 32 of the myocardium such that the base line 96 and the intersection 97 are connected and the intersection 97 and the approximated line 94 are connected. In this manner, the correction function 14c corrects, by linear interpolation, the TDC 32 of the myocardium in a predetermined period (the period from Tx to Ty in
The description returns to
The CT values of the TDCs illustrated in
More specifically, as illustrated in
Step S7 is a step corresponding to the calculation function 14d. At this step, the processing circuitry 14 calls a predetermined program corresponding to the calculation function 14d from the memory 13 and executes the program, so that the calculation function 14d is implemented. At Step S7, the calculation function 14d calculates the myocardial blood flow rate. For example, the calculation function 14d calculates the myocardial blood flow rate by solving a transfer function using, as input, the TDC of the aorta that has been corrected by use of the base line at Step S6 and using, as output, the TDC of the myocardium that has been corrected by use of the base line at Step S6.
If it is determined that the correction process is to be performed at Step S4, the calculation function 14d calculates the myocardial blood flow rate by solving a transfer function using, as output, the TDC of the myocardium that has been corrected by use of the base line at Step S6 after the correction process at Step S5. After completion of Step S7, the processing circuitry 14 ends the process.
As described above, in the first embodiment, if the TDC of the myocardium is influenced by the artifact from the right ventricular, the medical image processing apparatus 10 generates a TDC of the myocardium for which the artifact from the right ventricular is corrected. For example, the medical image processing apparatus 10 corrects, by linear interpolation, the TDC of the myocardium in a predetermined period corresponding to a period including a time of the peak of the TDC of the right ventricular. Then, the medical image processing apparatus 10 calculates a myocardial blood flow rate using the TDC of the myocardium for which the artifact from the right ventricular is corrected. Consequently, according to the medical image processing apparatus 10 of the first embodiment, even when the TDC of the myocardium is influenced by the artifact from the right ventricular, it is possible to accurately calculate the myocardial blood flow rate.
In the first embodiment described above, a case has been described in which, as the process at Step S5 in
As illustrated in
At Step S22, the correction function 14c subtracts the TDC of the right ventricular subjected to the scaling from the TDC of the myocardium. For example, the correction function 14c performs a process of subtracting the TDC 51 obtained through the scaling process as illustrated in
If it is determined that a plurality of extreme values are present (Yes at Step S24), the correction function 14c proceeds to Step S22, and repeats the processes from Step S22 to Step S24 until it is not determined that a plurality of extreme values are present. In other words, the correction function 14c performs a scaling process such that a single extreme value is obtained when the TDC of the myocardium obtained through multiple times of the subtraction process is differentiated.
In contrast, if it is not determined that a plurality of extreme values are present (No at Step S24), the correction function 14c ends the process. For example, it is assumed that the correction function 14c performs, a total of n times, a process of subtracting the TDC 51 obtained through the scaling process from the TDC 32 of the myocardium obtained before the correction, and obtains a state in which a plurality of extreme values are not present. In this case, assuming that a TDC 510 illustrated in
As described above, in the modification of the first embodiment, when the TDC of the myocardium is influenced by the artifact from the right ventricular, the medical image processing apparatus 10 generates the TDC of the myocardium for which the artifact from the right ventricular is corrected. For example, the medical image processing apparatus 10 performs a scaling process on the TDC of the right ventricular in a certain period including the time of the peak, and subtracts the TDC obtained through the scaling process from the TDC of the myocardium to thereby correct the TDC of the myocardium. Then, the medical image processing apparatus 10 calculates the myocardial blood flow rate using the TDC of the myocardium for which the artifact from the right ventricular is corrected. Therefore, according to the medical image processing apparatus 10 of the modification of the first embodiment, even when the TDC of the myocardium is influenced by the artifact from the right ventricular, it is possible to accurately calculate the myocardial blood flow rate.
In the examples illustrated in
Possible embodiments are not limited to the embodiments described above.
In the embodiments described above, a case has been described in which the medical image processing apparatus 10 generates TDCs; however, possible embodiments are not limited to this example. For example, the X-ray CT apparatus 2 may generate TDCs. In this case, the X-ray CT apparatus 2 receives setting of ROIs in X-ray CT images, and generates TDCs indicating temporal changes in CT values in the set ROIs. The medical image processing apparatus 10 acquires the TDCs generated by the X-ray CT apparatus 2, and corrects the TDC of the myocardium based on the TDC of the right ventricular.
Further, in the embodiments described above, a case has been described in which the medical image processing apparatus 10 performs a process of correcting the TDC of the myocardium; however, possible embodiments are not limited to this example. For example, the X-ray CT apparatus 2 may perform the process of correcting the TDC of the myocardium.
Furthermore, in the embodiments described above, a case has been described in which a TDC is adopted as the change information indicating a temporal change in a CT value; however, possible embodiments are not limited to this example. For example, an expression form of the change information indicating a temporal change in the CT value can be arbitrarily changed as long as a time and the CT value are associated in the information.
In the embodiments described above, a case has been described in which the aorta is adopted as the supply site that supplies blood to the myocardium; however, possible embodiments are not limited to this example. For example, the supply site may be the left ventricular or the coronary artery.
The word “processor” used in the above description means, for example, a central processing unit (CPU), a graphics processing unit (GPU), or a circuit, such as an application specific integrated circuit (ASIC) and a programmable logic device (for example, a simple programmable logic device (SPLD), a complex programmable logic device (CPLD), and a field programmable gate array (FPGA)). The processor reads and executes programs stored in a memory to implement functions. The programs may be directly embedded in the circuit of the processor, instead of storing the programs in the memory. In this case, the processor reads and executes the programs embedded in the circuit to implement the functions. Each of the processors in the embodiment does not necessarily have to be configured as a single circuit. Alternatively, a plurality of independent circuits may be combined into a single processor that implements corresponding functions. Further, a plurality of components illustrated in
The components of the apparatuses illustrated in the drawings of the embodiment described above are merely conceptual, and need not be physically configured in the manner illustrated in the drawings. In other words, specific forms of distribution and integration of the apparatuses are not limited to those illustrated in the drawings, and all or part of the apparatuses may be functionally or physically distributed or integrated in arbitrary units depending on various loads or use conditions. Further, for each processing function performed by each apparatus, all or any part of the processing function may be implemented by a CPU and a program analyzed and executed by the CPU or may be implemented as hardware by wired logic.
Further, the control method explained in the embodiment described above may be implemented by causing a computer, such as a personal computer or a workstation, to execute a control program prepared in advance. The control program may be distributed via a network, such as the Internet. The control program may be stored in a computer-readable recording medium, such as a hard disk, a flexible disk (FD), a compact disc read only memory (CD-ROM), a magneto-optical disk (MO), or a digital versatile disk (DVD), and may be executed by the computer by being read from the recording medium.
According to at least one of the embodiments described above, it is possible to accurately calculate a myocardial blood flow rate.
While certain embodiments have been described, these embodiments have been presented by way of example only, and are not intended to limit the scope of the inventions. Indeed, the novel embodiments described herein may be embodied in a variety of other forms; furthermore, various omissions, substitutions and changes in the form of the embodiments described herein may be made without departing from the spirit of the inventions. The accompanying claims and their equivalents are intended to cover such forms or modifications as would fall within the scope and spirit of the inventions.
Number | Date | Country | Kind |
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2017-045183 | Mar 2017 | JP | national |