1 EP O 487 11 O B1 2
Des_ription [OOO9] The same CAD algorithm which is included in
the CAD system is applied to the image data regardless
[OOO1] The present invention relates to a computer- of the type of the image. For example, the same CAD
aided diagnosis system for medical use, which outputs algorithm is applied to a conventional X-ray radiograph
computer-aided diagnosis data for medical images us- 5 of chest as well as a CT image. Therefore, an unexpect-
ing a computer. ed CAD result is obtained thus lowering the ability of di-
[OOO2] Recently, a computer-aided diagnosis system agnosis.
(hereinafter referred to as a CAD system) for medical [OO1 O] The CAD system includes only one CAD algo-
use has been developed in which the features of medi- rithm for a given disease. Therefore, it is not possible to
cal image data are determined and computer-aided di- 1O obtain a plurality of CAD data for a plurality of diseases.
agnosis data (hereinafter referred to as CAD data) for Therefore, if ten diseases are to be detected from one
assisting a doctor are obtained by using a computer. It image based on the CAD data, the image data must be
is, however, cumbersome for a doctorto operate a com- input to ten CAD systems and ten CAD data must be
puter to obtain the CAD data during the diagnosis, re- output. This increases the time and labor for the CAD
sulting in an adverse effect on a reading operation of 15 operation.
image in terms of both time and labor. Further, the con- [OO11] A time for merely reading the image without
ventional CAD system itself cannot provide a high pre- outputting the CAD data is about three minutes. A time
cision CAD data required for the diagnosis. from requesting a kind of CAD operation to output the
[OOO3] Examples of such CAD system are disclosed CAD data is about two minutes. If the CAD operation is
in US-A-4,851 ,984 and US-A-4,839,8O7. The CAD sys- 2O performed during the reading, it takes a long time for
tem described in the above US-Patents comprises reading and a difficulty occurs for the reading.
means for inputting a medical image, means for analyz- [OO12] The CAD data includes many items, e.g., the
ing the medical image using a predetermined CAD al- position, type, and degree of the abnormality. In the con-
gorithm, and means for displaying an analysis result. ventional CAD system, all the items of data are output,
[OOO4] The doctor refers to the output of the CAD sys- 25 thereby the output becomes complicate.
tem at the time of reading of the medical image to pre- [OO13] The CAD system does not store the CAD re-
vent an oversight of a shadow image of the abnormal sult, therefore, if the CAD operation is requested for the
portion. image which has been once analyzed, the same CAD
[OOO5] To obtain the CAD data, the following proceed- operation is repeated thus wasting the time.
ings are required. Locations of one type of abnormal 3O [OO14] Meanwhile, a picture archiving communication
shadow images, e.g., an abnormal shadow image of the system (hereinafter referred to as a PACS) for transfer-
interstitial lung disease, are detected on a conventional ring, storing, and displaying the medical images has
X-ray radiograph and the result of the detection is out- been developed. In the PACS, digital medical image da-
put. Therefore, the medical image on the X-ray film is ta archived by modalities including a digitizer and at-
digitized. A rib, an object of the analysis, is identified in 35 tribute data thereof are transferred via a network and
the medical image. A region of interest (hereinafter re- are stored in a large capacity recording means such as
ferred to as a ROl) is set on the medical image, as de- an optical disk device. Desired data are retrieved by us-
scribed in the US-A-4,851 ,984. The data in the ROl is ing a data base system. The image data is transferred
frequency-analyzed to extract the amount of physical to a workstation via the network and is displayed. How-
texture ofthe image. The shadow image is classified into 4O ever, the prior PACS does not perform a CAD operation.
groups based on the amount of physical texture. A dis- [OO15] EP-A-O 366 O76 discloses a PACS system
play device displays the digital image and the type, de- wherein image data and image addition data are stored
gree, and position of the shadow image in an overlap- in a data base. The PACS comprises medical diagnosis
ping manner. apparatuses which are coupled to work stations via in-
[OOO6] The reading operation by the doctor is to draft 45 terface units and a star coupler. The system generates
the reading report. Before drafting the report, the doctor an unread examination list and a read examination list
refers to the CAD data to prevent an oversight of a shad- which are transferred to the work stations at the time of
ow image. a reading operation wherein the list data of the read ex-
[OOO7] If the doctor needs the CAD data, the above amination list is arranged in accordance with a desired
proceedings must be performed. That is, the medical im- 5O priority order.
age must be digitized before the CAD system starts to [OO16] Shimadzu Review, Japan, July 1 99O, Vol. 47,
operate. The digitized image is analyzed by the compu- No. 2, pages 1 63 to 1 68; M. Andoh et al_. ''Shimadzu Al-
ter using the above proceedings and the analysis result PACS SAIPACS'' discloses a PACS system wherein the
is output to an attached display device. The doctor con- workstations are arranged to perform a computer-aided
tinues the reading of the image after watching the CAD 55 diagnosis and a computer-aided diagnostic reporting,
result. by using artificial intelligence technique.
[OOO8] The above described CAD system has follow- [OO17] It is an object of the present invention to pro-
ing drawbacks. vide a system for analyzing a medical image using a
2
3 EP O 487 11 O B1 4
computer-aided diagnosis algorithm, for medical use, Fig. 1 9 is a block diagram schematically showing
which outputs computer-aided diagnosis data with high an algorithm for obtaining the amount of textures in
precision by a simple operation having no adverse effect the ROl;
on diagnosis made by doctors. Fig. 2O is a flow chart schematically showing an al-
[OO18] This object is achieved by the features men- 5 gorithm for determining based on the amount of tex-
tioned in independent claim 1 . tures whether the ROl is normal or abnormal;
[OO19] Some preferred implementations are defined Fig. 21 is a block diagram performing the operation
in the subclaims. shown in Fig. 2O;
[OO2O] The present invention thus also provides a pic- Fig. 22 shows an example of the data format of a
ture archiving communication system incorporating the 1O CAD result;
computer-aided diagnosis system for medical use and Fig. 23 is a view showing a practical example of the
having a high diagnosis precision. CAD result data;
[OO21] This invention can be more fully understood Fig. 24 is a perspective view showing a touch panel
from the following detailed description when taken in as an example of an input device of the workstation;
conjunction with the accompanying drawings, in which_. 15 Fig. 25 is a view showing a display example of the
touch panel;
Fig. 1 is a block diagram showing the arrangement Fig. 26 is a view for explaining an example of a
of afirst embodiment of a computer-aided diagnosis schematic naming of abnormal positions;
system for medical use according to the present in- Fig. 27 shows a relationship between locations and
vention_, 2O coordinates of the abnormal positions_,
Fig. 2 shows items of examination data; Fig. 28 shows a table for explaining an example of
Fig. 3 shows a practical example of the examination detailed naming of the abnormal positions;
data for a conventional X-ray radiograph of chest; Fig. 29 shows an example of a text sentence dis-
Fig. 4 is a block diagram showing the arrangement play;
of a film digitizer shown in Fig. 1 _, 25 Fig. 3O shows an example of marker display_,
Fig. 5 shows items of relevant data; Fig. 31 shows an example of detailed CAD display
Fig. 6 shows a practical example of the relevant da- using the marker shown in Fig. 3O;
ta; Fig. 32 shows another example of the marker dis-
Fig. 7 is a view for defining an imaging direction in play;
the conventional X-ray radiography; 3O Fig. 33 shows an ROC curve display as an optional
Fig. 8 is a block diagram showing the arrangement CAD output;
of a data base shown in Fig. 1 ; Fig. 34 shows the data format of a CAD result;
Fig. 9 shows an examination directory included in a Fig. 35 shows a practical example ofthe CAD result;
data retrieving device shown in Fig. 8; Fig. 36 is a blockdiagram showing the arrangement
Fig. 1 O shows the relationship between a doctor ID 35 of a CAD processor included in a second embodi-
and a requesting doctor ID which is used when the ment of a computer-aided diagnosis system for
image is transferred to a workstation at the time of medical use according to the present invention;
reading; Fig. 37 is a blockdiagram showing the arrangement
Fig. 1 1 shows an operation for transferring the im- of a sound output device as a main part of a third
ages which has been examined to the workstation 4O embodiment of the present invention;
at the time of reading; Figs. 38A and 38B show examples of a menu win-
Fig. 1 2 is a block diagram showing the arrangement dow display according to a seventh embodiment of
of the workstation shown in Fig. 1 ; the present invention;
Fig. 1 3 shows an example of the images displayed Fig. 39 is a blockdiagram showing the arrangement
on the workstation in the _ACS at the time of diag- 45 of a computer-aided diagnosis system according to
nosis of the conventional X-ray radiograph; an eleventh embodiment of the present invention;
Fig. 1 4 shows a CRT image display control table for Figs. 4OA to 4OE show modifications of marker dis-
managing the display of the workstation; play according to a twelfth embodiment;
Fig. 1 5 shows a table registering the relationship Figs. 41 A to 41 F show other modifications of the
between the name of a CAD algorithm and associ- 5O marker display according to the twelfth embodi-
ated attribute data ofthe image which is applied with ment;
the CAD algorithm; Figs. 42A and 42B show still another modifications
Fig. 1 6 is aviewshowing a practical example of ROl of the marker display according to the twelfth em-
setting in lungs; bodiment; and
Fig. 1 7 is a block diagram schematically showing 55 Fig. 43 shows an example of a table formed of
an algorithm for automatically setting an ROl; names of algorithms stored in a memory in a sev-
Fig. 1 8 is a detailed blockdiagram for explaining the enteenth embodiment of the present invention.
diagram of Fig. 1 6; 3
5 EP O 487 11 O B1 6
[OO22] A preferred embodiment of a computer-aided ray film by the film digitizer 1 8. The image data, for ex-
diagnosis system for medical use according to the ample, consists of an array of data obtained by dividing
present invention will now be described with reference the X-ray film into a matrix of 1 ,O24 X 1 ,O24 pixels and
to the accompanying drawings. Though it is possible to representing the density of each pixel by a digital
embody the CAD system as a stand-alone system, an 5 number of 1 O-bit.
embodiment of the CAD system incorporated into the [OO27] Fig. 4 shows the arrangement of the film digi-
PACS will be described. Fig. 1 is a block diagram show- tizer 1 8. The film digitizer 1 8 comprises a controller 4O,
ing the first embodiment constructed on the basis of the an input device 42, a display device 43, a read-only
PACS. In general, the PACS is a system for performing memoy (ROM) 44, an examination/relevant data stor-
storage and transferring of various types of digital image 1O ing device 46, an image data storing device 48, a sem-
data produced in a single or a plurality of hospitals, and iconductor memory 5O, afilm density detector 52, a cen-
is formed of an image data source 1 O (hereinafter re- tral processing unit (CPU) 54, and a network interface
ferred to as a modality), a data base 1 2, a workstation (l/F) 56. Of these components, the controller 4O, the in-
1 4 as a display unit, and a network 1 6 for connecting put device 42, the display device 43, the ROM 44, the
these components. 15 examination/relevant data storing device 46, the image
[OO23] The modality 1 O includesvarious diagnosis de- data storing device 48, the semiconductor memory 5O,
vices for generating medical digital images, such as a the film density detector 52, the CPU 54, and the net-
film digitizer 1 8 for digitizing an image of an X-ray film work l/F 56 are connected to a control bus line 58. The
obtained by an X-ray radiography apparatus, an angi- ROM 44, the image data storing device 48, the semi-
ography imaging apparatus 2O, a computed tomogra- 2O conductor memoy 5O, the film density detector 52, and
phy (CT) scanner 22, a magnetic resonance imaging the network l/F 56 are connected to an image bus line
(MRl) system 24, a nuclear medicine diagnosis appara- 6O. The network l/F 56 is connected to the network 1 6.
tus 26, an ultrasound diagnosis apparatus 28, and an [OO28] The film density detector 52 divides an X-ray
electric endoscope 3O. radiograph into a matrix of 1 ,O24 X 1 ,O24 pixels. The
[OO24] An examination ordering system 32 is also 25 density detector 52 scans each pixel with a laser beam
connected to the network 1 6 via a gateway 34. The ex- and measures the intensity of transmitted light to obtain
amination ordering system 32 supplies examination da- the density of the pixel, thereby forming an intensity dis-
ta indicating details of examination on individual patients tribution of the transmitted light of the X-ray radiograph.
to the network 1 6. In this manner, the PACS performs This intensity distribution is converted into digital inten-
control of data on the basis of correspondence between 3O sity data, and the data is supplied to the data storing
image data obtained by examination by the modality 1 O device 48through the image bus 6O and is storedtherein
and attribute data (including examination data, relevant as the image data. At the same time, examination data,
data, and amend and/or update data forthese data sup- together with relevant data, is stored in the examination/
plied from the workstation 1 4 and the data base 1 2). It relevant data storing device 46. At this time, the display
is noted that the number of each of the modalities 1 O, 35 device 43 displays a prompt message for urging a tech-
the data base 2, and the workstation 1 4 is not limited to nician to input an imaging direction of radiograph if the
that of the above arrangement but can be increased or imaging direction is not input. When the text character
decreased as needed. denoting the imaging direction is input from the input de-
[OO25] Fig. 2 shows an example of items of examina- vice 42 such as a keyboard, this data is written in the
tion data input by the examination ordering system 32 4O column of the imaging direction of relevant data (Fig. 5)
and supplied to the network 1 6. An examination l D stored in the storing device 46.
number is issued every time examination is performed. [OO29] Fig. 6 shows a practical example of the rele-
In the examination ordering system 32, such examina- vant data. The imaging direction of radiograph is de-
tion data is input by a doctor or a person in charge at fined, as shown in Fig. 7, such that when X-rays radiated
the sta_ of examination, and atechnician ofthe modality 45 from the back of a patient are detected on an X-ray film
executes examination on a patient upon receiving the placed in front of the patient, the resulting image is re-
examination request, thus obtaining image data. Each ferred to as a front image. Similarly, a right-side (left-
frame of the image data is associated with the relevant side) image is defined as an image obtained when X-
data. An example of the relevant data is shown in Fig. 5. rays radiated from the left (right) side of the patient are
[OO26] When, for example, radiographic examination 5O detected on a X-ray film placed on the right (left) side of
using a conventional X-ray radiography apparatus is the patient. When digitizing of one frame of the X-ray
necessary, examination data as shown in Fig. 3 is input radiograph is completed, the image data and the corre-
from the examination ordering system 32. A radiograph- sponding relevant data are associated with each other
ic technician of the conventional X-ray radiography ap- by means of the image l D number. The examination da-
paratus (not shown) takes conventional X-ray radio- 55 ta and the corresponding relevant data are associated
graphs according to the input examination data. In the with each other by means ofthe examination l D number.
case of a conventional X-ray radiograph, digital image The image data, the corresponding examination data,
data can be obtained by digitizing the image of the X- and the corresponding relevant data are supplied to the
4
7 EP O 487 11 O B1 8
network 1 6 via the network l/F 56 and transferred to the 1 4 ON, the workstation 1 4 is set ready for receiving an
data base 1 2 or the workstation 1 4 as data flowing image reading request. This is the same procedure as
through the network 1 6. the log in operation in the conventional computer sys-
[OO3O] Fig. 8 shows the arrangement of the data base tem. At this time, the workstation 1 4 sends a transfer
1 2. The data base 1 2 comprises a CPU 62, a ROM 64, 5 request for images of a patient as an object to be image-
a semiconductor memoy 66, a controller 68, a data re- read to the data base 1 2 on the basis of the examination
trieving device (including an examination directory) 7O, ID input by the doctor or the examination l D which is
a data compression circuit 71 , an image data storing de- registered in association with the doctor ID as shown in
vice 72, and a network interface (l/F) 74. Of these com- Fig. 1 O. If the patient has been examined, the worksta-
ponents, the CPU 62, the ROM 64, the semiconductor 1O tion 1 4 may send a transfer request for images which
memory 66, the controller 68, the data retrieving device have been read or viewed but are necessay to be re-
7O, the data compression circuit 71 , the image data stor- ferred as well as images which is not read or viewed.
ing device 72, and the network l/F 74 are connected to The necessary images are retrieved by means of, for
a control bus line 76. The ROM 64, the semiconductor example, the data base 1 2. All the examination l Ds re-
memory 66, the data compression circuit 71 , the image 15 lating to the patient l D and the necessary image data
data storing device 72, and the network l/F 74 are con- are determined using a logical procedure, for example,
nected to an image bus line 78. The network l/F 74 is as shown in Fig. 1 1 . The examination l Ds having the
connected to the network 1 6. same patient and the same modality are retrieved to
[OO31] The image data, the corresponding examina- make a list of the examination l Ds. Alternately, the ex-
tion data, and the corresponding relevant data, which 2O amination lDs having the same patient and the same
are flowing through the network 1 6, are input to the data object are retrieved to make a list of the examination
base 1 2 via the network l/F 74, and stored in the image IDs. The examination l Ds in one of the above two lists
data storing device 72. If necessary, these data, partic- which has a high priority are sorted in the reverse chron-
ularly the image data is temporarily stored in the semi- ological order.
conductor memoy 66 as a buffer memory. In this case, 25 [OO35] The data base 1 2 selects images in units of ex-
afterthe amount ofthe data is compressed to 1/2 or 1/1 O aminations to be transferred by using the examination
by the data compression circuit 71 , the data is stored in ID as a retrieval key. The selected image data in units
the image data storing device 72. The examination data of examinations orthe compressed image data if the da-
and the relevant data are registered in the examination ta is read outfrom the storing deice 72, the relevant data,
directory of the data retrieving device 7O to retrieve de- 3O and the examination data in units of examinations are
sired examination data and relevant data using an ex- transferred to the network 1 6 via the network interface
amination l D and read out items of data. 74, and in turn to the workstation 1 4 sequentially.
[OO32] Fig. 9 shows an example of data contained in [OO36] A section for performing a CAD will be de-
the examination directory of the data retrieving device scribed below. The CAD is to obtain CAD data, for ex-
7O of the data base 1 2. Referring to Fig. 9, reference 35 ample, denoting a position of an abnormality in the im-
symbol N denotes the number of images obtained in one age, by processing image data using a computer. In this
examination. The examination directory is formed of ex- embodiment, for example, the workstation 1 4 serves as
amination data (Fig. 2), address data for storing the a section for obtaining the CAD data.
reading report, amount of data of the reading report, and [OO37] Fig. 1 2 shows the arrangement of the worksta-
N number of image data included in the examination. 4O tion 1 4. The workstation 1 4 comprises an input device
Each of the image data is formed of address data for 8O, an output device 82, an alarm generator 83, a hard
storing the relevant data, amount of data of the relevant disk interface (HD l/F) 84, a semiconductor memory 86,
data, address data for storing the image data, amount a CPU 88, a timer 9O, a ROM 92, a network interface
of image data, and first CAD result to n-th CAD result. (LAN l/F) 94, a plurality of image memories 1 OO, a plu-
The CAD result is formed of a CAD ID number and ad- 45 rality of CRT displays 1 O2, a hard disk unit (HD) 1 O6,
dress data for storing the CAD result. and a data expansion circuit 1 O8. Of these components,
[OO33] Next, an image reading operation performed the input device 8O, the output device 82, the alarm gen-
by a doctor for the digital images whose attribute data erator 83, the HD l/F 84, the semiconductor memoy 86,
are stored in the data base 1 2 as described above will the CPU 88, the timer 9O, the ROM 92, the LAN l/F 94,
be described. ln hospitals, the image reading is per- 5O and the data expansion circuit 1 O8 are connected to a
formed to obtain a diagnosis result from medical imag- control bus line 96. The output device 82, the alarm gen-
es. The image reading in the PACS is that images are erator 83, the HD l/F 84, the semiconductor memoy 86,
displayed on a display device such as a CRT of the the ROM 92, and the LAN l/F 94 are connected to a high
workstation 1 4 and a doctor makes a diagnosis from the speed bus line 98. The LAN l/F 94 is connected to the
displayed images or X-ray film obtained in the conven- 55 network 1 6.
tional X-ray radiography examination. [OO38] The image memories 1 OO are provided in one-
[OO34] When a doctor for image reading inputs his or to-one correspondence with one or more (in this case,
her l D number with the power source of the workstation four) CRT displays 1 O2. Each of the image memories
5
9 EP O 487 11 O B1 1 O
1 OO has two or three overlay screens (plane memories) is a conventional radiograph, the examination object is
and is connected tothe output device 82. An output from a chest, the imaging direction is a front, and the result
the image memory 1 OO is displayed on the correspond- of CAD is nothing. If the CAD algorithm is not applied to
ing CRT display 1 O2. The HD unit 1 O6 is connected to the image data, nothing is stored in the item of the result
the HD l/F 84. In the workstation 1 4, the image data input 5 of CAD. If other than nothing is stored in the item of the
via the LAN l/F 94 in the form of the compressed image result of CAD, it means that the CAD algorithm is used
data, the corresponding relevant data, and the exami- forthe image data. Therefore, since the examination da-
nation data in units of examinations are stored in the HD ta (Fig. 2) and the relevant data (Fig. 6) are already read
unit 1 O6. out into the semiconductor memory 86, the items of mo-
[OO39] In order to perform an image reading, a doctor 1O dality and examination object are extracted from the ex-
selects an image and the attribute data and the image amination data, and the items of imaging direction and
is displayed on the CRT display 1 O2 via the output de- result of CAD are extracted from the relevant data.
vice 82. The image to be displayed is selected among These items are compared with items for each algorithm
the images forone examination using the image ID input stored in the table shown in Fig. 1 5. The table of Fig. 1 5
by the doctor. lf the compressed image data is read out 15 is read out from the ROM 92 and is stored in the semi-
from the HD unit 1 O6, the compressed data is expanded conductor memoy 86. If they are equal to each other,
by the data expansion circuit 1 O8 and then stored in the the image is determined to be an object to which the
semiconductor memoy 86. The relevant data and the CAD algorithm is to be applied. Therefore, an arithmetic
examination data are also stored in the semiconductor operation of the CAD algorithm corresponding tothe im-
memory 86. The image data is read out from the semi- 2O age data is started.
conductor memoy 86 and is displayed on the CRT dis- [OO44] First, the image data determined to be an ob-
play 1 O2 to be read or viewed by the doctor. For exam- ject to which the CAD algorithm is to be applied is read
ple, when an object to be image-read is a conventional out into the semiconductor memory 86. The CPU 88 ex-
X-ray radiograph, front and side images are usually dis- ecutes the CAD algorithm stored in the ROM 92 and
played. When the patient has been examined, both non- 25 stores the result of CAD in the semiconductor memoy
read and past images (other than the non-read image; 86. The CPU 88 issues a serial number for the CAD l D
reference image) are usually displayed to perform com- and writes the CAD l D for retrieving the result of CAD
parative image reading. in the item of the result of CAD in the relevant data (Fig.
[OO4O] The manner in which the images are displayed 6) stored in the semiconductor memoy 86. The CPU 88
on the CRTs is registered in a CRT image display control 3O also writes the address storing the result of CAD in the
table as shown in Fig. 1 4. The table is formed by asso- relevant data. The default data of the address of the re-
ciating the examination l D and the image ID with the se- sult of CAD is text data denoting nothing. When the op-
rial number of the CRTs. The table is stored in the sem- eration for one CAD algorithm is ended, it is determined
iconductor memory 86. whether the next CAD algorithm can be applied to the
[OO41] The image data which are sequentially trans- 35 image data.
ferred to the workstation 1 4 from the data base 1 2 are [OO45] The examples of the CAD algorithm written in
sequentially processed with a predetermined CAD algo- the ROM 92 are as follows. A CAD algorithm for detect-
rithm. ing a micro calcification in mammography is disclosed
[OO42] A timing at which the CAD operation is started in Unexamined Japanese Patent Application No.
will be described below. After image data, examination 4O 2-1 52443. A CAD algorithm for measuring the size of
data, and relevant data of one patient are transferred to the heart and lung is disclosed in United States Patent
the HD unit 1 O6 of the workstation 1 4, the examination Application No. 275,72O (filed November 23, 1 988). A
data and relevant data are read out sequentially from CAD algorithm for detecting an interstitial lung disease
the HD unit 1 O6 to the semiconductor memoy 86 by the is formed of the following algorithms_.
CPU 88. 45
[OO43] Since the CAD operation is performed in which #1 _. An algorithm (which is schematically shown in
one of a plurality of different CAD algorithms suitable for Fig. 1 7, and illustrated in detail in Fig. 1 8) for setting
the image data is selected, the ROM 92 includes a table ROls (symbolized by C] in Fig. 1 6) for the CAD al-
indicating the name of a CAD algorithm and the items gorithm for one frame of the image data.
of the attribute data of the image data capable of being 5O #2_. An algorithm (which is schematically shown in
applied with the CAD algorithm, as shown in Fig. 1 5. Fig. 1 9) for calculating a physical amount of texture
The items of the attribute data of the image data to be (which is an index indicating the magnitude and the
analyzed and corresponding items of the attribute data length of period of a density variation in a texture
of each CAD algorithm included in the table shown in pattern) in the ROl.
Fig. 1 5 are compared with each other to determine 55 #3_. An algorithm (the flow chart of which is shown
whether or not the CAD algorithm can be applied to the in Fig. 2O, and the arrangement in Fig. 21 ) for ap-
image data. For example, a CAD algorithm for an inter- plying athreshold to the calculated physical amount
stitial lung disease is performed only when the modality of texture to determine abnormality or normality of
6
1 1 EP O 487 11 O B1 1 2
the ROl. ton (CAD button shown in Fig. 25) for requesting an out-
put of a result of CAD is prepared (displayed) on the
[OO46] Of these algorithms, the algorithms #1 and #2 touch panel. Detecting depression on this CAD button
are described in USP 4,851 ,984, and therefore a de- on the touch panel is a trigger for requesting the CAD
tailed description thereof will be omitted. In addition, 5 result output.
since the algorithms #3 is described in USP 4,839,8O7, [OO51] Since the CAD result can be output in various
a detailed description thereof will be omitted. modes, the mode of outputting the CAD result is deter-
[OO47] The results of the CAD algorithm and the clas- mined next. The CPU 88 reads out the relevant data
sification of the normality are temporarily stored in the (Fig. 6) corresponding to the examination ID and image
semiconductor memory 86. The detailed description for 1O ID included in the CRT image display control table (Fig.
the case of the interstitial lung disease will be described. 1 4). Further, the CPU 88 reads out the CAD result l D
It is to be noted that ''diffuse'' is determined for those and CAD result address from this relevant data, thereby
classified to be abnormal (i.e., those determined to be reading out or retrieves the result of CAD (Fig. 22).
clustered abnormal ROls in the flowchart shown in Fig. [OO52] An example of CAD result output is described
2O) because of the presence of clusters (grouped ab- 15 below. The CPU 88 starts the program in the ROM 92
normal ROls), and ''local'' is determined for abnormali- and outputs a CAD result (Fig. 23) relating to the abnor-
ties other than these; they are called patterns of abnor- mality to a corresponding output device according to the
mality. The pattern of abnormality is included as one pattern of the abnormality. In this program, the item of
item in the result of CAD of Fig. 22, and the type of pat- data denoting the pattern of abnormality is extracted
tern is written in this item as text characters, e.g., denot- 2O from the result of CAD (Fig. 23) relating to the abnor-
ing local. Fig. 23 shows a practical example of the result mality and stored in the semiconductor memory 86. If
of CAD in the case of an abnormal ROl. Here, a TPF the pattern of abnormality is a diffused pattern, a text
represents a true positive fraction and an FPF repre- sentence generator is activated in orderto output an ab-
sents afalse positivefraction. failure. The l D ofthe result normality alarm in the form of a text sentence. If the pat-
of CAD and the address of this CAD result data in the 25 tern of abnormality indicates local, the alarm (marker)
semiconductor memoy 86 are additionally written as generator 83 is activated in orderto indicate the location
items in the relevant data (Fig. 5). When the result of of abnormality by means of a marker.
CAD is stored in the data base 1 2, the l D and address [OO53] In this case, the text sentence represents the
are registered in the examination directoy as shown in location of abnormality on an image by means of words,
Fig. 9. The above operation is performed plural times if 3O thereby making an alarm. For this purpose, as shown in
plural CAD algorithms can be applied to the image data. Fig. 26, a screen of the display is equally divided into
If plural results of CAD and addresses are obtained, all six regions in advance, and a name is assigned to each
the plural l Ds and addresses are stored in the examina- region. A table (Fig. 27) showing a correspondence be-
tion directory. tween the names and the x, y coordinates of the regions
[OO48] The CAD result is output in response to appli- 35 is stored in the ROM 92. The right and left is defined as
cation of an output request trigger. Therefore, while im- viewed from the patient. The CPU 88 starts the program
age reading is performed (a conventional X-ray radio- in the ROM 92. In this program, the x, y coordinates of
graph of a chest is read or viewed in case of interstitial the location of the abnormal ROl is extracted from the
Iung disease detection CAD), various commands in- CAD result and an expression of abnormality is read out
cluding this output request must be input from the input 4O from the table shown in Fig. 28 and stored in the ROM
device 8O of the workstation 1 4. In this embodiment, the 92 in accordance with the location of the abnormality.
description of the input device 8O will be given by using The readout expression data is stored in the semicon-
a touch panel type device. It is also possible to use a ductor memoy 86 to be inserted into the text sentence.
general device, such as a keyboard as the input device If plural CAD results are obtained, the above operation
8O. 45 is repeated for the number of the CAD results. The text
[OO49] Fig. 24 shows an example of the input device sentence is, for example, ''interstitial lung disease, _
8O. This touch panel comprises a command display 1 1 O (PICTURE) abnormal.'' In this case, the expression of
on which the names of commands is displayed, a panel the underlined portion changes in accordance with an
1 1 2 on which the command display 1 1 O is arranged, and abnormal portion. Subsequently, character string data
a transparent sensor board 11 4 located on the com- 5O of the te_ sentence is converted into dot patterns in
mand display 1 1 O. When a position corresponding to the units of characters. Thereafter, with reference to the
name of a command is selectively touched with a finger, CRT image display control table (Fig. 1 4), one text line
the sensor board 1 1 4 senses the touched portion. (white) is provided in the uppermost stage of an image
[OO5O] When, for example, several command buttons memoy 1 OO (overlay screen) corresponding to the CRT
are displayed on the output device, an operator can rec- 55 displaying the image, and dot patterns of black charac-
ognize a command display through the sensor board ters are stored in the text line of the image memoy 1 OO,
1 1 4. The operator selects a command by touching the as shown in Fig. 29.
sensor board 1 1 4, thus executing the command. A but- [OO54] The marker is a means for representing the lo-
7
1 3 EP O 487 11 O B1 1 4
cation of abnormality on an image by using an arrow. played, a trigger for requesting an output of the CAD
The CPU 88 of the workstation 1 4 starts the program in detailed result is generated.
the ROM 92 and reads out the location of abnormality [OO58] The output of the CAD detailed result will be
from the CAD result data (Fig. 22), thus forming the described below. It is assumed that the text sentence is
shape of a marker as shown in Fig. 29, based on a font 5 already formed and stored in the form of black charac-
pattern of the ROM 92. In this case, although d (diagonal ters on a white background as shown in Fig. 29 in the
of the square) -- 1 .5 cm is preferable, d is not limited to image memoy 1 OO (overlay screen). The CPU 88 starts
this value but can be changed freely. The screen is di- the program in the ROM 92 to read out the CAD result
vided into right and left portions as viewed from the op- data (Fig. 22) from the semiconductor memory 86. The
erator. If the location (the center of ROl indicated by a 1O CPU 88 forms an arrow marker for data having abnor-
symbol X) of abnormality is present on the right side of mality independently of the pattern of the abnormality.
the screen, the arrow shown in Fig. 3O is converted di- The marker indicates the location of the abnormality on
rectly into a bit pattern. If, by contrast, the location is an image by means of an arrow.
present on the left side, the arrow of Fig. 3O is inverted [OO59] The CPU 88 reads out the location of the ab-
symmetrically about a longitudinal line (alternate long 15 normality and forms the shape of the marker as shown
and short dashed line in Fig. 3O) including the center of in Fig. 31 , based on the font pattern in the ROM 92. At
ROl, i.e., in a mirrorlike manner and the resulting mirror this time, the screen is divided into right and left portions.
image of the arrow as indicated by a broken line in Fig. If the abnormality location is present on the right side
3O is converted into a bit pattern. viewed from the operator, the arrow of Fig. 31 is con-
[OO55] In addition, the bit pattern data is written in a 2O verted directly into a bit pattern. If, on the other hand,
Iocation corresponding to the position of abnormality in the abnormality location is present on the left side, the
the image memory 1 OO (overlay memory) correspond- arrow of Fig. 31 is mirrorlike-inverted symmetrically
ing to the CRT displaying the image. If a plural CAD re- about a longitudinal line (alternate long and short
sults are obtained, the above operation is repeated until dashed line in Fig. 31 ) including the location of the ab-
all the CAD results are read out and written intothe over- 25 normality, and the resultant mirrorlike arrowas indicated
Iay memory. The data in the image memory 1 OO (overlay by a broken line in Fig. 31 is converted into a bit pattern.
memory) is displayed on the CRT overlapped with the In addition, the type (e.g., nodular) and the degree (e.
image data. The display color of the bit pattern data of g., 75OXo) of the abnormality are read out from the CAD
the marker is switched between black and white in syn- result dataand are converted intoa bit pattern, as shown
chronism with the timer 9O. Thus, the effect of alarming 3O in Fig. 31 . Unlike the bit pattern of the arrow, the bit pat-
of the marker is enhanced. It is noted that the period of tern of characters of the type and degree is not mirror-
switching is 2Hz. like-inverted regardless of whether the abnormality lo-
[OO56] At this time, though all the CAD results are si- cation is present on the right side or the left side.
multaneously displayed on the CRT, some of them may [OO6O] This bit pattern data is written in a location cor-
be selectively displayed. The names of buttons dis- 35 responding to the position of the abnormality in the im-
played on the touch panel are changed in accordance age memoy 1 OO (overlay screen) corresponding to the
with the needs of the operator. For example, the names CRT 1 O2 displaying the image. As a result, the arrow
of the buttons are changed in accordance with the CAD marker associated with the characters indicating the
algorithm now applying to the image data. A label ''l D'', type and the degree of the abnormality (Fig. 31 ) is dis-
''MC'', and ''BH'' are provided for buttons in case of an 4O played, together with the text sentence shown in Fig. 29,
interstitial lung disease detection CAD, micro calcifica- on the screen.
tion detection CAD, and heart size measuring CAD. [OO61] The data in the image memory 1 OO (overlay
When a CAD algorithm is selected, the CAD result cor- screen) is displayed overlapped on the examination im-
responding to the algorithm is written in the overlay age. At this time, the color of the data display on the
memory and the other results are deleted from the over- 45 overlay screen is switched between black and white in
Iay memoy. synchronism with the timer 9O. The period of switching
[OO57] Another mode of CAD result output will be de- is 2Hz.
scribed in which the CAD result has a hierarchical struc- [OO62] An example of an option output of the CAD de-
ture. That is, a summary of the CAD result is output first tailed result will be described below. As in the case of
by means of, e.g., the text sentence and the marker as 5O the triggerforthe detailed output, a button for requesting
described above, and then details are output. For this a detailed option output of the CAD result is displayed
purpose, a button for requesting a CAD detail output is on the input device (touch panel) 8O of the workstation
prepared on the input device (touch panel) 8O (Fig, 25) 1 4 as a trigger for the option output. When depression
of the workstation 1 4. In other words, the names of but- on the CAD detailed option output button on the touch
tons on the touch panel are changed in accordance with 55 panel is sensed while the detailed output is performed,
the application used by an operator. When depression the triggerfor requesting the CAD detailed option output
on the CAD detail output button on the touch panel is is attained.
sensed while the text sentence and the marker are dis- [OO63] It is supposed that the text sentence is already
8
1 5 EP O 487 11 O B1 1 6
formed and stored in the form of black characters on a read if the button is depressed.
white background as shown in Fig. 29 in the image [OO68] A command for requesting the end of the CAD
memory 1 OO (overlay screen). The CPU 88 starts the output can also be applied from the input device 8O of
program in the ROM 92 to read out the CAD result data touch panel type.
(Fig. 22) from the semiconductor memory 86 and forms 5 [OO69] It is to be noted that the CAD data is preferably
an arrow marker for data having abnormality independ- stored even when its output (display) is stopped. The
ently of the pattern of the abnormality. This marker rep- CAD result is added to the updated relevant data, as
resents the location of the abnormality on the image by shown in Fig. 34, and supplied to the data base 1 2 to
means of an arrow. be stored therein. In the data base 1 2, all the CAD l Ds
[OO64] The CPU 88 reads out the location of the ab- 1O and CAD result addresses in the relevant data are
normality and forms an arrow marker and a square ROl stored in the examination directoy (Fig. 9). In a subse-
marker, as shown in Fig. 32, based on the font pattern quent image reading, if an image transfer request is sup-
of the ROM 92. Here, the screen is divided into right and plied to the data base 1 2, the image data and the cor-
Ieft portions. If the abnormality location is present on the responding examination and relevant data are trans-
right side, the arrowandthe ROl of Fig. 32 are converted 15 ferred by the network 1 6 and stored in the semiconduc-
directly into bit patterns. If the location is present on the tor memory 86 of the workstation 1 4. At the same time,
Ieft side, the arrow of Fig. 32 is inverted in a mirrorlike the CAD result l D is read out and all the CAD results are
manner, and the resulting arrow indicated by a broken retrieved based on the CAD IDs. In this case, as shown
line in Fig. 32 and the ROl are converted into bit pat- in Fig. 35, the address of the CAD result written in the
terns. This bit pattern data is written in the location cor- 2O relevant data is conve_ed into the address on the sem-
responding to the position of the abnormality in the im- iconductor memory 86 and is stored in the relevant data.
age memory 1 OO (overlay screen) corresponding to the [OO7O] According to this embodiment as has been de-
CRT displaying the image in the CRT display image con- scribed above, the following effects can be obtained.
trol table (Fig. 1 2). That is, in addition to a medical image, CAD data con-
[OO65] The data in the image memoy 1 OO (overlay 25 cerning the image is also displayed. Therefore, an erro-
screen) is displayed overlapped on the examination im- neous diagnosis due to an oversight of a disease can
age. At this time, the color of the data display on the be prevented in medical image diagnosis, thus increas-
overlay screen is switched between black and white in ing diagnosis precision. Labors can be reduced in a di-
synchronism with the timer 9O. The period of switching agnosis operation performed by a doctor (operator). In
is 2Hz. 3O medical image diagnosis, particularly in an image read-
[OO66] Another example of the option output will be ing operation, an erroneous diagnosis caused by an
described. When anotheroption output is requested, the oversight of a disease can be prevented to improve di-
CPU 88 starts a given program in the ROM 92 to read agnosis precision. Since the CAD data is obtained by
out ROC (Receiver Operator Curve) data included in the analyzing medical images using a computer, objective
CAD result from the semiconductor memory 86, thus 35 and quantitative results can be obtained. Therefore, it is
forming an ROC curve. As shown in Fig. 33, the ROC possible to prevent an erroneous diagnosis which is a
curve is one of examples for indicting the ability of CAD result of subjective determination by a human being,
and is so formed as to be fitted in a portion below and and consequently diagnosis precision can be increased.
to the right of the image. In the ROC curve, the abscissa In medical image diagnosis, a doctor who is not an ex-
denotes the FPF and the ordinate denotes the TPF. The 4O pert of an image of interest sometimes cannot make a
ROC curve is converted into a bit pattern. The bit pattern satisfactory diagnosis. According to the present inven-
data is written in the image memory 1 OO (overlay tion, diagnosis precision can be improved also in this
screen) corresponding tothe CRT displaying the image. case.
The data in the image memoy (overlay memory) 1 OO is [OO71] As the CAD data, the position, the type, or the
displayed on the CRT overlapped with the examination 45 degree of abnormality is displayed, so that the abnor-
image. mality can be readily recognized. As a result, an erro-
[OO67] An example of a request trigger for ending the neous diagnosis caused by an oversight of a disease
output of the CAD result will be described below. When can be prevented to improve diagnosis precision.
the image reading of a conventional X-ray radiograph of [OO72] Arithmetic operation calculating the CAD data
a chest is pe_ormed and the image and the CAD result 5O is started by a computer before an output request for the
are displayed on a CRT screen, the trigger for ending CAD data is generated. Therefore, it is possible to short-
the CAD result output is automatically generated upon en a time from generating the output request to display-
stopping the image display in order to display another ing the CAD data.
image. When the output is ended, the image display is [OO73] When several algorithms for obtaining CAD
continued, and only the display on the overlay screen is 55 data are available, an inappropriate processing is per-
turned off. Further, the touch panel may include a button formed for an image data of interest unless the image
for providing the command representing the end of the data is correctly assigned to the algorithm, and errone-
image reading and the relevant data is updated as being ous CAD data results. According to this embodiment,
9
1 7 EP O 487 11 O B1 1 8
however, since a suitable algorithm is selected for each [OO8O] Plural CAD algorithms are stored in the system
image, output of erroneous CAD data can be prevented and an optimum one is automatically selected based on
to increase diagnosis precision. the relevant data of the object image data. Therefore, it
[OO74] Since the CAD result is stored in the data base is possible to reduce the labors of the doctor for select-
1 2, an image which is diagnosed once need not be an- 5 ing the suitable algorithm, inputting the respective im-
alyzed again. age data, and outputting the respective CAD data.
[OO75] A CAD algorithm is determined for each diag- [OO81] The computerstarts an arithmetic operation for
nosis of interest, and the algorithms are selectively ex- calculating the CAD data before an output request for
ecuted in accordance with each object. Therefore, it is the CAD data is generated. Therefore, it is possible to
possible to prevent a production of CAD data which may 1O shorten a time from generating the output requestto dis-
cause an erroneous diagnosis in the case when an un- playing the CAD data.
suitable algorithm is applied to an object. Further, the [OO82] The numerical data denoting the CAD result in-
attribute data includes the modality, the examining ob- cludes many items. If all the data are output, the output
ject, and the imaging direction, and an algorithm is ex- becomes complicate. According to the first embodi-
ecuted when these items of the attribute data coincide 15 ment, the CAD data are stored in the form of a table and
with those of an object image of the algorithm. There- only desired data is output by retrieving the data from
fore, an unsuitable algorithm is not applied to the image. the table using the retrieval key corresponding to the de-
[OO76] An alarming means which strongly attracts at- sired condition. Therefore, the CAD result can be output
tention of the doctor is used as a means for alarming in a simple form.
abnormality. Therefore, an erroneous diagnosis due to 2O [OO83] The attribute data includes an item of data de-
an oversight can be prevented to increase diagnosis noting whether or not the image data has been read or
precision. An optimal alarming means is selected to at- viewed. Based on this attribute data, the CAD result of
tract attention in accordance with the type of abnormal- the image data which has been read or viewed is not
ity. Therefore, it is possible to prevent an erroneous di- output. Therefore, it is possible to prevent a confusion
agnosis caused by an oversight, thus improving diagno- 25 in which the CAD result different from the reading report
sis precision. By flickering the alarm display, the alarm- is output. Based on this attribute data, only the image
ing means strongly attracts attention to prevent an erro- data which has not been read or viewed is analyzed us-
neous diagnosis resulting from an oversight, thus im- ing the CAD algorithm. Therefore, a time from generat-
proving diagnosis precision. ing the output request to displaying the CAD data be-
[OO77] The CAD data is hierarchically constructed 3O comes shorterthan that in the case of all the image data
and output gradually from its summay to details. There- are analyzed. Further, the attribute data includes an item
fore, a large number of different types of CAD data are of data representing the CAD result and the image data
not simultaneously displayed to cause a cumbersome which has been analyzed is not analyzed again. There-
operation. Thus, an erroneous diagnosis can be pre- fore, it is possible to further shorten a time from gener-
vented to increase diagnosis precision. For example, 35 ating the output request to displaying the CAD data.
the position of abnormality alone is output first as the [OO84] Other embodiments of the present invention
CAD data. If the abnormality cannot be clearly deter- will be described below.
mined, a doctor freely makes output requests for, e.g., [OO85] A second embodiment comprises, in addition
the degree, the type, and the pattern of the abnormality, to the workstation 1 4 for displaying the image as shown
thus avoiding a cumbersome operation to increase di- 4O in Fig. 1 2, a workstation 1 4a having a CAD processor
agnosis precision. In this case, a usable command (but- 1 2O as shown in Fig. 36. This workstation 1 4a for ob-
ton) is prepared for each level (hierarchical level) of con- taining CAD data is different from the workstation 1 4 in
tents at which the CAD data is output. Since a user need that a controller 9Oa is provided in place of the timer 9O.
only select a command of interest from the prepared In terms of an operation, the second embodiment is dif-
commands, a labor for selecting from a large number of 45 ferent from the first embodiment in a timing at which a
commands is reduced. CAD arithmetic operation is started.
[OO78] Before application of the CAD algorithm to a [OO86] In the second embodiment, when image data,
given image data, it is determined whether the CAD al- examination data, and relevant data of one patient are
gorithm can be applied to the image data based on the transferred to the HD unit 1 O6 of the workstation 1 4a,
attribute data of the image data and only the algorithm 5O the examination data and the relevant data are read out
which is determined to be able to apply to the image sequentially from the HD unit 1 O6 into the semiconduc-
data is applied to the image data. Therefore, it is possi- tor memoy 86 by the CPU 88. The ROM 92 stores the
ble to prevent lowering the quality and precision of di- table denoting the relationship between the name of the
agnosis due to the output of the erroneous CAD data. CAD algorithm and the attribute data of the image data
[OO79] The CAD system according to the present in- 55 which can be adapted to the CAD algorithm as shown
vention is described as being incorporated into the in Fig. 1 5. Therefore, since the examination data (Fig.
PACS. However, it is possible to realize a stand-alone 2) and the relevant data (Fig. 6) are already read out
type CAD system according to the present invention. intothe semiconductor memoy 86, the modality and the
1 O
1 9 EP O 487 11 O B1 2O
examining object are read out from the examination da- abnormality indicates ''diffuse'', a statement formed as
ta, and the imaging direction is read out from the rele- a text sentence is automatically read. The text sentence
vant data. These read out items of data are stored in the is, for example, ''interstitial lung disease, (PICTURE)
semiconductor memoy 86. These items of data are _I abnormal.'' The expression in the underlined por-
compared with the attribute data of the image stored in 5 tion changes in accordance with an abnormal portion.
the table (Fig. 1 5) of the ROM 92. Next, the CPU 88 activates a program in the ROM 1 22
[OO87] Ifthese items are coincide with those of a given and converts character string data in the text sentence
CAD algorithm, e.g., interstitial lung disease detection into a voice sound. ''Interstitial lung disease, (PICTURE)
CAD, this image is determined to be an image to which _I abnormal'' is stated by generating three groups of
the interstitial lung disease detection CAD algorithm can 1O words, interstitial lung disease, (PICTURE), and ab-
be applied, and the operation of the CAD is started. At normal. Since the expression in the underlined portion
this time, the CPU 88 in the workstation 1 4a designates changes in accordance with an abnormal portion as de-
activation of the CAD processor 1 2O (Fig. 36), and sup- scribed above, a sound data base 1 24 is also provided
plies input datatothe processor 1 2O. The input data giv- to generate words for this purpose.
en to the CAD processor 1 2O includes the image data, 15 [OO91] According to the third embodiment as de-
the examination data, and the relevant data. The CAD scribed above, in specifying the position of abnormality
processor 1 2O has its own CPU, and by means of the by means of a sentence or a sound, words representing
CPU it executes the CAD operation and outputs a CAD a position are used to make it easy to recognize the ab-
result. The CAD result is temporarily stored in the mem- normality. Therefore, an oversight of a disease and con-
ory as data having the format shown in Fig. 22. ln addi- 2O sequently an erroneous diagnosis can be prevented to
tion, the l D and the address of the CAD result data are lead to an increase in diagnosis precision.
additionally written in the relevant data (Fig. 6). [OO92] As afourth embodiment, an embodiment of au-
[OO88] As described above, according to the second tomatically outputting a CAD result will be explained.
embodiment, since the display and the CAD arithmetic The arrangement of a workstation of the fourth embod-
operation are separately pe_ormed at different worksta- 25 iment is identical to that of the first embodiment shown
tions 1 4 and 1 4a, a processing time for the CAD can be in Fig. 1 2. In the fourth embodiment, however, even if
shortened. That is, if a CAD processing is performed at no CAD result request is present during image reading
devices such as the modality 1 O, the workstation 1 4, and of a conventional X-ray radiograph of chest, the result
the data base 1 2, a long processing time is required for is automatically displayed.
they share a single CPU. However, since the CAD proc- 3O [OO93] For this purpose, each time an image is dis-
essor 1 2O has a CPU 88 for a processing purpose only, played, the CPU 88 refers tothe CRT image display con-
the processing time is shortened. trol table (Fig. 1 4) and checks whetherthe l D ofthe CAD
[OO89] A third embodiment is different from the first result is included in the relevant data of the displayed
embodiment in that a CAD result is output as a sound. image, i.e., whether nothing is stored in the CAD result
For this purpose, a workstation of this embodiment has 35 ID, and in this manner checks whetherthe displayed im-
a sound generator as shown in Fig. 37 in addition to the age is an object of the CAD. If the CPU 88 determines
arrangement shown in Fig. 1 O. The CPU 88 of the work- that the displayed image is an object of the CAD, it
station 1 4 reads out relevant data using the CRT image measures a predetermined time from the start of image
display control table (Fig. 1 4). The CPU 88 also reads display by means ofthe timer 9O, and automatically gen-
out CAD results (Fig. 22) by reading out the CAD result 4O erates a trigger for requesting a CAD result output when
address from the relevant data. When the CAD result is the predetermined time has elapsed. This predeter-
to be output, the CPU 88 starts a program in the ROM mined time can be arbitrarily changed.
92 and assigns the CAD result having abnormality to a [OO94] In this manner, the output request for the CAD
corresponding output device in accordance with the pat- data can be omitted, and this results in a reduction in
tern of the abnormality. ln this program, the CAD results 45 labors. ln addition, if the CAD data is output immediately
and the classification of the CAD result are read out from after an image is displayed, an operator or doctor may
the semiconductor memory 86, and, if the type of abnor- have a preconceived knowledge. Therefore, CAD data
mality indicates ''diffuse'', a text sentence generator is is output when a certain time has elapsed after an image
activated in order to output an abnormality alarm in the is displayed. As a consequence, an erroneous diagno-
form of a text sentence. lf the type of abnormality indi- 5O sis due to an oversight is prevented to improve diagno-
cates ''local'', a marker generator and the sound gener- sis precision.
ator shown in Fig. 37 are activated in order to indicate [OO95] A fifth embodiment as another example of au-
the position of the abnormality by means of a marker tomatically outputting the CAD result will be described.
and a sound. Here, the arrangement of a workstation of this embodi-
[OO9O] When the CAD operation result is read out 55 ment is also the same as that shown in Fig. 1 2. First,
from the semiconductor memoy 86, if the pattern of ab- each time an image is displayed, the CPU 88 refers to
normality indicates ''local'', a sound of ''abnormality the CRT image display control table (Fig. 1 4) and
present'' is simply generated. If, however, the pattern of checks whether the ID of the CAD result is included in
21 EP O 487 11 O B1 22
the relevant data of the displayed image, i.e., whether present invention, so a seventh embodiment relating to
nothing is stored in the CAD result ID, and in this manner a modification of the input device will be described be-
checks whether the displayed image is an object of the low. During image reading of a conventional radiograph
CAD. If the CPU 88 determines that the displayed image of a chest, when an icon displayed on a CRT screen is
is an object of the CAD, it measures a number of times 5 designated (clicked) by a pointing device such as a
(the number of applications of the CAD algorithm) at mouse, a menu window as shown in Fig. 38A appears
which the image is displayed from the start of the image at a corner, in this case, the upper right corner of the
reading for the patient and writes the number of times screen. It is to be noted that this menu window shows
into the relevant data (Fig. 6). The number of times is only buttons which can be used by an operator at the
initially set to zero and increased by one every time the 1O time of click. If it is electrically sensed that a CAD button
image is displayed. The CPU 88 automatically gener- in the menu window on the screen is designated by the
ates a trigger for requesting a CAD result output when pointing device, a trigger for requesting a CAD result
the number of times reaches a predetermined time output is generated.
which can be arbitrarily set. [O1 OO] Similarly, when the icon displayed on the CRT
[OO96] In this manner, since an output request for 15 screen is designated (clicked) by the pointing device
CAD data can be omitted, labors can be reduced. In ad- such as a mouse, as shown in Fig. 38B, while the CAD
dition, if CAD data is output immediately after an image output is performed, the menu window emerges. If a but-
is displayed, an operator or doctor may have a preoc- ton for requesting a CAD detail result output in the menu
cupied knowledge. Therefore, CAD data is not output window is designated, a trigger for requesting the CAD
when an image is displayed for the first time and image 2O detail result output is generated. When the icon dis-
reading is performed but output when the image is dis- played on the CRT screen is designated (clicked) by the
played for a predetermined time or the image display is pointing device such as a mouse while the CAD output
switched. The result is that an erroneous diagnosis is performed, the menu window appears. If a button for
caused by an oversight is prevented to improve diagno- requesting an option output in the menu window is des-
sis precision. 25 ignated, a trigger for requesting an option output is gen-
[OO97] The fourth and fifth embodiments are embod- erated. When the icon displayed on the CRT screen is
iments automatically outputting a CAD result. Next, a designated (clicked) by the pointing device such as a
sixth embodiment of automatically ending outputting of mouse while the CAD output is performed, the menu
a CAD result will be described. The arrangement of a window emerges. If a button for requesting a CAD diag-
workstation ofthis embodiment is identical tothat shown 3O nosis level output in the menu window is designated, a
in Fig. 1 2. When, for example, image reading of a con- trigger for requesting the CAD diagnosis level output is
ventional radiograph of a chest is performed, a display generated. When the icon displayed on the CRT screen
of the CAD result is automatically stopped even if no is designated (clicked) by the pointing device such as a
CAD result request is present. For this purpose, each mouse while the CAD output is performed, the menu
time an image is displayed, the CPU 88 refers to the 35 window appears. If a button for requesting a CAD result
CRT image display control table (Fig. 1 4) and checks output end in the menu window is designated, a trigger
whether the l D of the CAD result is included in the rele- for requesting the CAD detail output end is generated.
vant data of the displayed image, i.e., whether nothing Upon the end of outputting, overlay screens are turned
is stored in the CAD result l D, and in this manner checks off.
whether the displayed image is an object of the CAD. If 4O [O1 O1] According to this embodiment as described
the CPU 88 determines that the displayed image is an above, a menu window including buttons having com-
object of the CAD, it measures a predetermined time mand names is displayed on the CRT screen. By des-
from the start of image display by means of the timer 9O, ignating a command with by means of a pointing device
and automatically generates a trigger for requesting the such as a mouse, a command for outputting CAD data
end of the CAD result output when the predetermined 45 can be input. ln addition, since the menu window is not
time has elapsed. This predetermined time can be arbi- constantly displayed but can be selectively displayed,
trarily changed. Upon the end of outputting, the CPU 88 an operator (doctor) can display commands only when
turns off all overlay screens displayed on CRTs. he or she needs them. Therefore, an annoyance caused
[OO98] According to this embodiment, since an output by frequent changes in commands displayed can be re-
end request for CAD data can be omitted, labors are 5O duced. ln this case, a usable menu is prepared for each
reduced. In addition, CAD data remaining on an image level (hierarchical level) of the contents of CAD data to
for a long time makes it difficult for an operator or doctor be output. Therefore, since a user need only select a
to observe details of an image. As in this embodiment, menu of interest from the prepared menus, a labor of
however, by automatically ending display of CAD data selecting from a large number of menus is reduced.
after the data has been displayed for a predetermined 55 [O1 O2] An eighth embodiment concerned with color-
time, an erroneous diagnosis is prevented to increase ing of a marker and a text sentence will be described
diagnosis precision. below. The arrangement of a workstation is the same as
[OO99] Various commands must be input in the that shown in Fig. 1 2. With reference to the CRT image
12
23 EP O 487 11 O B1 24
display control table (Fig. 1 4), an overlay screen corre- shortened.
sponding to a CRT not having ''nothing'' in the ID of the [O1 O7] In a tenth embodiment, a timing at which an
CAD result of relevant data of a displayed image is over- arithmetic operation of a CAD is started is when all the
Iaid on the examination image displayed on the CRT. At image data of one patient is transferred to the data base
this time, the data displayed on the overlay screen is 5 1 2. At this time, the CPU 88 reads out examination data
flickered in an arbitrary color, such as red, while being and relevant data sequentially from the HD unit 1 O6 into
synchronized by the timer 9O. The period of flickering is the semiconductor memory 86. In order to refer to the
2 Hz. table (Fig. 1 5) of CAD algorithms and corresponding at-
[O1 O3] According to the eighth embodiment, it is pos- tribute data, the modality and the examination object are
sible to strongly attract attention because of the color of 1O read out from the examination data (Fig. 2) and the im-
the alarm display. As a result, an erroneous diagnosis aging direction and the CAD result ID address are read
caused by an oversight can be prevented to conse- out from the relevant data (Fig. 6). These readout items
quently increase diagnosis precision. This effect can be of data are stored in the semiconductor memory 86.
further enhanced by flickering the alarm display. These items of data are compared with the attribute data
[O1 O4] A ninth embodiment in which a CAD arithmetic 15 of the image stored in the table (Fig. 1 5) of the ROM 92.
operation is started by the modality, such as a film dig- If these items are coincide with those of a given CAD
itizer 1 8 (Fig. 4) will be described. The arrangement of algorithm, this image is determined to be an image to
a workstation is identical to that shown in Fig. 1 2. In this which the given CAD algorithm can be applied, and the
embodiment, when the film digitizer 1 8 digitizes all the operation of the CAD is started.
image data for one patient and inputs the imaging direc- 2O [O1 O8] Upon the start of the CAD operation, image da-
tion, the CPU 88 reads out examination data and rele- ta determined to be an object of the CAD is read out into
vant data sequentiallyfrom the HD unit 1 O6 intothe sem- the semiconductor memory 86. The CPU 88 executes
iconductor memory 86. In order to referto the table (Fig. a CAD operation program written in the ROM 92 and
1 5) of CAD algorithms and corresponding attribute data, stores the result in the semiconductor memoy 86. The
the modality and the examination object are read out 25 CPU 88 transfers, as data flowing through the network
from the examination data (Fig. 2) and the imaging di- 1 6, the image data, the relevant data, the CAD result,
rection and the CAD result ID address are read out from and the examination data (for each examination) to the
the relevant data (Fig. 6). These readout items of data data base 1 2 via the LAN l/F 94. As shown in Fig. 34,
are stored in the semiconductor memory 86. These the data base 1 2 handles the CAD result data as a part
items of data are compared with the attribute data of the 3O of the relevant data.
image stored in the table (Fig. 1 5) of the ROM 92. If [O1 O9] When data is transferred to the workstation 1 4
these items are coincide with those of a given CAD al- during image reading, thetransferred data istemporarily
gorithm, this image is determined to be an image to stored in the HD unit 1 O6. However, the CAD result is
which the given CAD algorithm can be applied, and the read out from the HD unit 1 O6 into the semiconductor
operation of the CAD is started. 35 memoy 86 upon reception of a CAD output request as
[O1 O5] Upon the start ofthe CAD operation, image da- a trigger. In this case, the workstation 1 4 does not per-
ta determined to be an object of the CAD is read out into form any operation associated with the CAD but simply
the semiconductor memory 86. The CPU 88 executes displays the CAD result. Whenever an image is dis-
a CAD operation program written in the ROM 92 and played on the image display device (workstation), the
stores the result in the semiconductor memory 86. The 4O CAD result for the displayed image is stored in the sem-
CPU 88 transfers, as data flowing through the network iconductor memory 86. Therefore, a time from genera-
1 6, the image data, the relevant data, the CAD result, tion of an output request to display the CAD result is
and the examination data (for each examination) to the shortened.
data base 1 2 via the LAN l/F 94. As shown in Fig. 34, [O11 O] Fig. 39 is a blockdiagram showingthe arrange-
the data base 1 2 handles the CAD result data as a part 45 ment of an eleventh embodiment. ln the eleventh em-
of the relevant data. bodiment, a CAD processor 1 4a as shown in Fig. 36 is
[O1 O6] When data is transferred to the workstation 1 4 connected to the arrangement of the PACS shown in
during image reading, the transferred data istemporarily Fig. 1 . When a request of starting a CAD operation is
stored in the HD unit 1 O6. However, the CAD result is generated in the workstation 1 4, the CAD processor 1 4a
read out from the HD unit 1 O6 into the semiconductor 5O is used to perform only the CAD operation at a high
memory 86 upon reception of a CAD output request as speed. Therefore, the workstation 1 4 transfers data re-
a trigger. In this case, the workstation 1 4 does not per- quired forthe CAD operation to the CAD processor 1 4a,
form any operation associated with the CAD but simply and only the result is returned to the workstation 1 4.
displays the CAD result. Whenever an image is dis- [O111] A timing at which the CAD operation is started
played on the image display device (workstation), the 55 is similar to that in the tenth embodiment. However, un-
CAD result for the displayed image is stored in the sem- like in the tenth embodiment, the CAD operation is per-
iconductor memoy 86. Therefore, a time from genera- formed by the CAD processor 1 4a. The workstation 1 4
tion of an output request to display the CAD result is supplies the image data, the examination data, and the
13
25 EP O 487 11 O B1 26
relevant data to the CAD processor 1 4a via the network [O11 7] According to the thirteenth embodiment, only
1 6. As shown in Fig. 36, the CAD processor 1 4a has its necessary CAD results are selectively displayed during
own CPU, and by means ofthe CPU it executes the CAD the reading of the images displayed on the CRTs of the
operation and outputs the CAD result. The result of the workstation, therefore, the display is not complicate due
CAD operation is transferred as result data having the 5 to the omission of display of unnecessary CAD result.
format shown in Fig. 22 to the workstation 1 4 via the [O11 8] A fourteenth embodiment which is a modifica-
network 1 6. As shown in Fig. 34, the workstation 1 4 or tion of the thirteenth embodiment will be descried. In this
the data base 1 2 handles the CAD result as a part of the embodiment, when the image ID of the CRT display con-
relevant data. trol table is updated upon changing the image to be dis-
[O112] When data is transferred to the workstation 1 4 1O played, the CAD result address is read out from the rel-
during image reading, the transferred data istemporarily evant data of the new image and the CAD result is writ-
stored in the HD unit 1 O6. The CAD result, however, is ten intothe overlay memory, thereby displaying the CAD
read out from the HD unit 1 O6 into the semiconductor result overlapped on the image. That is, when the image
memory 86 upon reception of an output request for the ID is designated, the CAD result is automatically dis-
CAD as a trigger. ln this case, the workstation 1 4 does 15 played regardless of whether or not the image has been
not perform any operation associated with the CAD but read. If no CAD result address is stored (nothing is
simply displays the result. stored in the CAD result ID), the same operation as the
[O113] Processing executed by devices such as the first embodiment is performed from application of a suit-
modality, the workstation, and the data base takes a able CAD algorithm tothe image datato writing the CAD
long processing time for they share a CPU. ln this em- 2O result address into the table. When the depression of
bodiment, however, since the processor having a CPU the CAD display button for a reference image (an image
for a processing purpose only executes the processing, other than the image which has been read), the l Ds of
a processing time can be shortened. the images displayed on the CRTs are read out from the
[O114] As a twelfth embodiment, an embodiment con- CRT display control table (Fig. 1 4) and it is determined
cerned with a modification of a marker will be described 25 whether or not the image has been read. lf the image
below. Figs. 4OA to 4OE show modifications of a marker has been read, the CAD result address is read out from
for pointing the ROl, and Figs. 41 A to 41 F show modi- the relevant data and the CAD result is written into the
fications of a marker for surrounding the ROl. Pointing overlay memoy, thereby displaying the CAD result
the ROl includes a case in which the direction of an ar- overlapped on the image. For all the CRTs, this opera-
row points the center of the ROl as shown in Fig. 42A 3O tion is performed. It is to be noted that all the data in the
and a case in which it points a position other than the overlay memory are deleted before the CAD result is
center as shown in Fig. 42B. written into the memoy.
[O115] According to this embodiment, an alarming [O11 9] According tothe fourteenth embodiment, since
means which strongly attracts attention is used in order the CAD result is automatically output upon changing
to alarm abnormality. Therefore, an oversight and there- 35 the image to be displayed, labors for instructing the CAD
fore an erroneous diagnosis can be prevented, and this result output. It is possible to make a comparison diag-
results in an improvement in diagnosis precision. nosis with reference to the reference image which has
[O116] A thirteenth embodiment in which an on/off of been read, thereby improving the diagnosis precision.
the CAD result display is controlled for each of the CRTs [O12O] Afifteenth embodiment as a modification of the
will be described. The touch panel includes plural CAD 4O thirteenth embodiment will be described. Thetouch pan-
result display buttons provided for the respective CRTs. el includes a single CAD result display button provided
In order to display only the CAD result on the CRT #1 , for all the CRTs. When the depression of the display but-
it is necessaryto depress the CAD result display buttons ton is detected, the l Ds of the images displayed on the
for the CRT #1 . When the depression of that button is CRTs are read out from the CRT display control table
detected, the ID of the image displayed on the CRT #1 45 (Fig. 1 4). The CAD result addresses for all the images
is read out from the CRT display control table (Fig. 1 4). are read out from the relevant data and the CAD result
The CAD result address is read out from the relevant data are written into the overlay memories for all the
data of the image and the CAD result data is written into CRTs, thereby displaying the CAD results overlapped
the overlay memory for the CRT #1 , thereby displaying on the images. The CAD results are automatically dis-
the CAD result overlapped on the image. As described 5O played regardless of whether or not the images have
above, the operation of this embodiment is the same as been read. If no CAD result address is stored (nothing
that of the first embodiment except that the image l D is is stored in the CAD result l D), the same operation as
read out from the CRT display control table. If no CAD the first embodiment is performed from application of a
result address is stored (nothing is stored in the CAD suitable CAD algorithm to the image data to writing the
result l D), the same operation as the first embodiment 55 CAD result address into the table.
is performed from application of a suitable CAD algo- [O121] According to the fifteenth embodiment, since it
rithm tothe image datato writing the CAD result address is possible to make a comparison diagnosis with refer-
into the table. encetothe reference image which has been read, there-
14
27 EP O 487 11 O B1 28
by improving the diagnosis precision. When the CAD re- diagnosis system for medical use, which outputs com-
sult display is desired, it is sufficient to touch only one puter-aided diagnosis data with a high precision by a
button so that the operation is simple. simple operation having no adverse effect on diagnosis
[O122] A sixteenth embodiment which is a further made by doctors and a picture archiving communication
modification of the thirteenth embodiment will be de- 5 system incorporating the computer-aided diagnosis
scribed. The touch panel includes a CAD result display system for medical use and having a high diagnosis pre-
button forthe image which has not been read and a CAD cision.
result display button for the reference image (an image
other than the image which has not been read). When
the depression of the CAD result display button for the 1O Claims
image which has not been read is detected, the IDs of
the images displayed on the CRTs are read out from the 1 . A system for analyzing a medical image (1 4) using
CRT display control table (Fig. 1 4). It is determined a computer-aided diagnosis algorithm, comprising_.
whether or not the image has not been read based on
the relevant data of the image. If the image is detected 15 interface means (84, 94) for loading a medical
as being not read, the CAD result address is read out image as digital data;
from the relevant data of the image and the CAD result means (86) for storing said medical image data
data is written into the overlay memory. All the data in wherein said medical image data comprise at-
the overlay memoy are deleted before the CAD result tribute image data comprising information relat-
is written into the memory. When the depression of the 2O ed to the type of medical image which can be
CAD result display button for the reference image is de- analyzed by computer aided diagnosis
tected, the l Ds of the images displayed on the CRTs are algorithms ;
read out from the CRT display control table (Fig. 1 4). It algorithm storing means (92) for storing a plu-
is determined whether or not the image has not been rality of said computer-aided diagnosis algo-
read based on the relevant data of the image. lf the im- 25 rithms for detecting different types of abnormal
age is detected as being not read, the CAD result ad- portions in the medical image;
dress is read out from the relevant data of the image means (88) foranalyzingthe medical image da-
and the CAD result data is written into the overlay mem- ta using one of said plurality of computer-aided
ory. All the data in the overlay memoy are deleted be- diagnosis algorithms to detect abnormal por-
fore the CAD result is written into the memory. If no CAD 3O tions in said medical image ; and
result address is stored (nothing is stored in the CAD means for displaying an analysis result of said
result l D), the same operation as the first embodiment analyzing means, characterized in that said in-
is performed from application of a suitable CAD algo- terface means (84, 94) further comprise means
rithm tothe image datato writing the CAD result address to input said attribute image data of the medical
into the table. 35 image as digital data;
[O123] According to the sixteenth embodiment, since said analyzing means comprises_.
it is possible to make a comparison diagnosis with ref- means (92) for storing for each of said plurality
erence to the reference image which has been read, of computer aided diagnosis algorithms at-
thereby improving the diagnosis precision. When the tribute data defining the type of medical image
CAD result display is desired, it is sufficient totouch only 4O which can be analyzed by the computer-aided
one button so that the operation is simple. diagnosis algorithm;
[O124] A seventeenth embodiment will be described. means (88) for selecting, based on said at-
Though the above description, a suitable CAD algorithm tribute data stored in said storing means and
is selected by the computer using the attribute data, in said attribute image data of the medical image
this embodiment, the doctor designates the name of the 45 to be analyzed, an optimum computer aided di-
CAD algorithm. Before reading of the image, the doctor agnosis algorithm suitable to analyse said med-
selects one or more CAD algorithms as well as inputting ical image and
the examination l D. The names of the selected algo- wherein said analyzing means analyzes said
rithms are arranged in the form of the table as shown in medical image data using said optimum com-
Fig. 43. When the image is input to the workstation, the 5O puter-aided diagnosis algorithm selected by
CAD algorithms in the table are sequentially applied to said selecting means.
the images. The other operation is the same as the first
embodiment. 2. Asystem according to claim 1 , characterized byfur-
[O125] According to the seventeenth embodiment, ther comprising_.
only a desired CAD result is selectively displayed and 55
the display becomes simple. a network (1 6) connected to said interface
[O126] As has been described above, according tothe means
present invention, there is provided a computer-aided data base means (1 2) connected to said net-
15
29 EP O 487 1 1 O B1 3O
work for storing the medical image data, an Patentansprü_he
analysis result data of said analyzing means,
and association data indicating the relationship 1 . System zum Analysieren eines medizinischen Bilds
between the medical image data and the ana- (1 4) unter Verwendung eines computerunterstütz-
Iyzing result data; and 5 ten Diagnosealgorithmus, mit
means for writing said analysis result data and
said association data into said data base einer Schnittstelleneinrichtung (84, 94) zum La-
means via said network by means of said inter- den eines medizinischen Bilds in Form von di-
face means. gitalen Daten;
1O einer Einrichtung (86) zum Speichern der me-
3. A system according to claim 1 or 2, characterized dizinischen Bilddaten, wobei die medizinischen
in that a plurality of modalities are connected to said Bilddaten Attributbilddaten enthalten, die mit
network. dem Typ des medizinischen, mittels der com-
puterunterstützten Diagnosealgorithmen ana-
4. A system according to claim 2, characterized by fur- 15 lysierbaren Bilds zusammenhängende lnfor-
ther comprising_. mationen aufweisen;
einer Algorithmusspeichereinrichtung (92) zum
means (8O) for inputting retrieval data to re- Speichern einer Mehrzahl der computerunter-
trieve desired analysis result data stored in said stützten Diagnosealgorithmen zum Erfassen
data base means (1 2) ; and 2O von unterschiedlichen Arten von abnormalen
means for reading out the analysis result data Abschnitten in dem medizinischen Bild;
from said data base means (1 2) in accordance einer Einrichtung (88) zum Analysieren der me-
with said retrieval data. dizinischen Bilddaten unter Verwendung eines
aus der Mehrzahl von computerunterstützten
5. A system according to claim 1 or 2 wherein said at- 25 Diagnosealgorithmen, um hierdurch einen ab-
tribute image data further comprise information de- normalen Abschnitt in dem medizinischen Bild
noting whether or not a medical image has been zu erfassen; und
viewed by a doctor, characterized by further com- einer Einrichtung zum Anzeigen eines von der
prising_. Analysiereinrichtung gewonnenen Analyseer-
means for selectively extracting one of a first 3O gebnisses, dadurch gekennzeichnet, daß die
plurality of medical images which have been viewed Schnittstelleneinrichtung (84, 94) weiterhin ei-
by a doctor and one of second plurality of medical ne Eingabeeinrichtung zum Eingeben der Attri-
images which have not been viewed by a doctor butbilddaten des medizinischen Bilds in Form
based on said attribute image data, and character- von digitalen Daten umfaßt, und
ized in that said analyzing means analyzes said 35 daß die Analysiereinrichtung eine Einrichtung
medical images extracted by said extracting means (92) zum Speichern von Attributdaten, die den
using said optimum selected computer-aided diag- Typ des medizinischen Bilds definieren, das
nosis algorithm. durch den computerunterstützten Diagnoseal-
gorithmus analysiert werden kann, und zwar für
6. A system according to claim 2, characterized in that 4O jeden aus der Mehrzahl von computerunter-
said attribute image data further comprise informa- stützten Diagnosealgorithmen; und eine Ein-
tion denoting whether or not the medical image has richtung (88) zum Auswählen eines optimalen
been analyzed by said analyzing means. computerunterstützten Diagnosealgorithmus,
der zum Analysieren des medizinischen Bilds
_. A system according to claim 6, characterized in that 45 geeignet ist, auf der Basis der in der Speicher-
said analyzing means analyzes a medical image einrichtung gespeicherten Attributdaten und
which has been viewed by a doctor but has not been der Attributbilddaten des medizinischen, zu
analyzed by said analyzing means. analysierenden Bilds; wobei die Analysierein-
richtung die medizinischen Bilddaten unter Ver-
8. A system according to anyone of claims 5 to _, char- 5O wendung des optimalen computerunterstütz-
acterized by further comprising display means (82, ten Diagnosealgorithmus analysiert, der durch
1 OO, 1 O2) for displaying the medical image which die Wähleinrichtung ausgewählt worden ist.
has not been viewed by a doctor without the analy-
sis result of said analyzing means and displaying 2. System nach Anspruch 1 , dadurch gekennzeichnet,
the medical image which has been viewed by a doc- 55 daß es weiterhin aufweist_. ein Netzwerk (1 6) das
tor with the analysis result. mit der Schnittstelle verbunden ist;
eine Datenbankeinrichtung (1 2), die mit dem
1 6
31 EP O 487 1 1 O B1 32
Netzwerkverbunden ist und zum Speichern der richtung (82, 1 OO, 1 O2) zum Anzeigen des medizi-
medizinischen Bilddaten, von von der Analy- nischen Bilds, das noch nicht durch einen Arzt be-
siereinrichtung gebildeten Analyseergebnisda- trachtet worden ist, ohne das Analyseergebnis der
ten, und von Assoziationsdaten dient, die die Analysiereinrichtung, und zum Anzeigen eines me-
Beziehung zwischen den medizinischen Bild- 5 dizinischen Bilds, das von einem Arzt betrachtet
daten und den Analyseergebnisdaten ange- worden ist, zusammen mit dem Analyseergebnis
ben_, und aufweist.
eine Einrichtung zum Einschreiben der Analy-
seergebnisdaten und der Assoziationsdaten in
die Datenbankeinrichtung über das Netzwerk 1O Revendi_ations
mit Hilfe der Schnittstelleneinrichtung. 1 . Système pour analyser une image médicale (1 4) en
3. System nach Anspruch 1 oder 2, dadurch gekenn- utilisant un algorithme de diagnostic assisté par or-
zeichnet, daß eine Mehrzahl von Modalitäten mit dinateur, comprenant _.
dem Netzwerk verbunden sind. 15 des moyens formant interface (84, 94) pour
4. System nach Anspruch 2, dadurch gekennzeichnet, fournir une image médicale sous forme de don-
daß es weiterhin eine Einrichtung (8O) zum Einge- nées numériques ;
ben von Wiedergewinnungsdaten für die Wiederge-
winnung von gewünschten Analyseergebnisdaten, 2O des moyens de stockage (86) pour stocker les-
die in der Datenbankeinrichtung (1 2) gespeichert dites données d'image médicale, lesdites don-
sind; und eine Einrichtung zum Auslesen der Ana- nées d'image médicale comprenant des don-
Iyseergebnisdaten aus der Datenbankeinrichtung nées d'attribut d'image comprenant des infor-
(1 2) in Abhängigkeit von den Wiedergewinnungs- mations concernant le type des images médi-
daten enthält. 25 cales qui peuvent être analysées par des algo-
rithmes de diagnostic assistés par ordinateur ;
5. System nach Anspruch 1 oder 2, bei dem die Attri-
butbilddaten weiterhin Informationen umfassen, die des moyens de stockage d'algorithmes (92)
angeben, ob ein medizinisches Bild durch einen pour stocker une pluralité desdits algorithmes
Arzt betrachtet worden ist oder nicht, dadurch ge- 3O de diagnostic assistés par ordinateur et desti-
kennzeichnet, daß es weiterhin eine Einrichtung nés à détecter des types différents de parties
zum selektiven Herausgreifen eines aus einer er- anormales dans l'image médicale ;
sten Mehrzahl von medizinischen Bildern, die von
einem Arzt betrachtet worden sind, und/oder eines des moyens d'analyse (88) pour analyser les
aus einer zweiten Mehrzahl von medizinischen Bil- 35 données d'image médicale en utilisant l'un des-
dern aufweist, die nicht durch einen Arzt betrachtet dits algorithmes de diagnostic parmi la pluralité
worden sind, wobei das Herausgreifen aus der Ba- d'algorithmes de diagnostic assistés par ordi-
sis der Attributbilddaten erfolgt, sowie dadurch ge- nateur afin de détecter des parties anormales
kennzeichnet, daß die Analysiereinrichtung die me- dans ladite image médicale ; et
dizinischen Bilder, die durch die Einrichtung zum 4O
Herausgreifen herausgegriffen worden sind, unter des moyens pour afficher un résultat d'analyse
Verwendung des optimalen, ausgewählten, compu- desdits moyens d'analyse,
terunterstützten Diagnosealgorithmus analysiert. caractérisé en ce que
6. System nach Anspruch 2, dadurch gekennzeichnet, 45
daß die Attributdaten weiterhin Informationen um- lesdits moyens formant interface (84, 94) com-
fassen, die angeben, ob das medizinische Bild prennent en outre des moyens pour entrer les-
durch die Analysiereinrichtung analysiert worden ist dites données d'attribut d'image de l'image mé-
oder nicht. dicale sous forme de données numériques ;
5O
7. System nach Anspruch 6, dadurch gekennzeichnet, lesdits moyens d'analyse comprennent _.
daß die Analysiereinrichtung ein medizinisches Bild
analysiert, das durch einen Arzt betrachtet worden - des moyens (92) pour stocker, pour chacun
ist, jedoch noch nicht durch die Analysiereinrich- desdits algorithmes de diagnostic parmi ladite
tung analysiert worden ist. 55 pluralité d'algorithmes de diagnostic assistés
par ordinateur, des données d'attribut définis-
8. System nach einem der Ansprüche 5 bis 7, dadurch sant le type d'images médicales qui peuvent
gekennzeichnet, daß es weiterhin eine Anzeigeein- être analysées par l'algorithme de diagnostic
1 7
33 EP O 487 1 1 O B1 34
assisté par ordinateur ; en outre _.
des moyens pour extraire sélectivement une image
- des moyens de sélection (88) pour choisir, en médicale d'une première pluralité d'images médica-
se basant sur lesdites données d'attribut stoc- les qui ont été revues par un médecin, et une image
kées dans lesdits moyens de stockage et sur 5 médicale parmi une deuxième pluralité d'images
Iesdites données d'attribut d'image de l'image médicales qui n'ont pas été revues par un médecin,
médicale à analyser, l'algorithme de diagnostic en se basant sur lesdites données d'attributs d'ima-
assisté par ordinateur optimum qui convient ges, et caractérisé en ce que lesdits moyens d'ana-
pour l'analyse de ladite image médicale, et Iyse analysent lesdites images médicales extraites
dans lequel 1O par lesdits moyens d'extraction en utilisant ledit al-
gorithme de diagnostic optimum choisi parmi ladite
Iesdits moyens d'analyse analysent lesdites don- pluralité d'algorithmes de diagnostic assistés par
nées d'image médicale en utilisant ledit algorithme ordinateur.
de diagnostic assisté par ordinateur optimum choisi
par lesdits moyens de sélection. 15 6. Système selon la revendication 2, caractérisé en ce
que lesdites données d'attributs d'images compren-
2. Système selon l'une de la revendication 1 , caracté- nent en outre des informations indiquant si l'image
risé en ce qu'il comprend en outre _. médicale a été analysée ou non par lesdits moyens
d'analyse.
un réseau (1 6) connecté auxdits moyens for- 2O
mant interface ; 7. Système selon la revendication 6, caractérisé en ce
que lesdits moyens d'analyse analysent une image
une base de données (1 2) connectée audit ré- médicale qui a été revue par un médecin mais qui
seau et destinée à stocker les données d'ima- n'a pas été analysée par lesdits moyens d'analyse.
ges médicales, ainsi que des données de ré- 25
sultats d'analyses desdits moyens d'analyse et 8. Système selon l'une quelconque des revendica-
des données d'association indiquant la relation tions 5 à 7, caractérisée en ce qu'il comprend en
entre les données d'images médicales et les outre des moyens d'affichage (82, 1 OO, 1 O2) pour
données de résultats d'analyses ; et afficher l'image médicale qui n'a pas été revue par
3O un médecin, sans les résultats d'analyses desdits
des moyens d'écriture, pour écrire lesdites don- moyens d'analyse, et pour afficher l'image médicale
nées de résultats d'analyses et lesdites don- qui a été revue par un médecin, avec les résultats
nées d'association dans ladite base de don- d'analyses.
nées via ledit réseau à l'aide desdits moyens
formant inte_ace. 35
3. Système selon l'une ou l'autre des revendications
1 et 2, caractérisé en ce qu'une pluralité de moda-
lités sont connectées audit réseau. 4O
4. Système selon la revendication 2, caractérisé en ce
qu'il comprend en outre_.
des moyens d'entrée (8O) pour entrer des don-
nées de recherche afin de rechercher des don- 45
nées de résultats d'analyses désirées stockées
dans ladite base de données (1 2) ; et
des moyens de lecture pour lire les données de
résultats d'analyses depuis ladite base de don- 5O
nées (1 2) en accord avec lesdites données de
recherche.
5. Système selon l'une ou l'autre des revendications
1 et 2, dans lequel lesdites données d'attributs 55
d'images comprennent en outre des informations
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par un médecin, caractérisé en ce qu'il comprend 1 8
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