EVALUATION APPARATUS, EVALUATION METHOD, AND EVALUATION PROGRAM
20170245820 · 2017-08-31
Assignee
Inventors
Cpc classification
A61B5/7221
HUMAN NECESSITIES
A61B5/055
HUMAN NECESSITIES
A61B5/1076
HUMAN NECESSITIES
A61B2576/00
HUMAN NECESSITIES
A61B5/7264
HUMAN NECESSITIES
A61B6/5217
HUMAN NECESSITIES
G16H50/30
PHYSICS
A61B2034/105
HUMAN NECESSITIES
A61B5/1075
HUMAN NECESSITIES
A61B34/10
HUMAN NECESSITIES
International classification
A61B6/00
HUMAN NECESSITIES
A61B34/10
HUMAN NECESSITIES
Abstract
A first extracting unit extracts at least one portion of a region of a target structure that includes lumen structures having branches from a three dimensional image of the target structure. A second extracting unit extracts the lumen structures from the at least one portion of the region of the target region. An index value calculating unit calculates an index value that represents the uniformity of the distribution of the lumen structures within the at least one portion of the region of the target structure, based on the at least one portion of the region of the target structure and the extracted lumen structures. Further, a quantifying unit quantifies the degree of reliability of the image quality of the at least one portion of the region of the target structure.
Claims
1. An evaluating apparatus comprising: a first extracting unit configured to extract at least one portion of a region of a target structure from a three dimensional image of the target structure which includes lumen structures having branches; a second extracting unit configured to extract the lumen structures from the at least one portion of the region of the target structure; and an index value calculating unit configured to calculate an index value that represents the uniformity of the distribution of the lumen structures within the at least one portion of the region of the target structure, based on the at least one portion of the region of the target structure and the extracted lumen structures.
2. An evaluating apparatus as defined in claim 1, wherein: the index calculating unit calculates the index value from regions other than a lesion region within the at least one portion of the region of the target structure, in the case that a lesion region is present within the at least one portion of the region of the target structure.
3. An evaluating apparatus as defined in claim 1, further comprising: a quantifying unit configured to quantify at least one of the degree of reliability of the image quality of the at least one portion of the region of the target structure, the degree of reliability of the extraction results for the at least one portion of the region of the target structure, and the degree of reliability of the extraction results for the lumen structures, based on the index value.
4. An evaluating apparatus as defined in claim 1, wherein: if the at least one portion of the region of the target structure is a portion of a region determined within the target structure, the index value calculating unit calculates an index value that represents the distribution of lumen structures within the portion of the region; and the evaluating apparatus further comprises: a quantifying unit configured to quantify the degree of reliability for the determined portion of the region within the target structure.
5. An evaluating apparatus as defined in claim 3, wherein: if the at least one portion of the region of the target structure is a portion of a region determined within the target structure, the index value calculating unit calculates an index value that represents the distribution of lumen structures within the portion of the region; and the quantifying unit quantifies the degree of reliability for the determined portion of the region within the target structure.
6. An evaluating apparatus as defined in claim 3, wherein: the quantifying unit refers to a reliability map that defines relationships between index values and degree of reliability, to quantify the degree of reliability.
7. An evaluating apparatus as defined in claim 6, wherein: the reliability map defines the relationships between index values and degree of reliability, according to an allowable degree of error with respect to the at least one portion of the region of the target structure.
8. An evaluating apparatus as defined in claim 1, wherein: the index calculating unit calculates the shortest distance from each point within the at least one region of the region of the target structure to the lumen structures, and calculates the index values based on the shortest distances.
9. An evaluating apparatus as defined in claim 8, wherein: the index value calculating unit calculates the index values based on a statistical value related to the shortest distances.
10. An evaluating apparatus as defined in claim 1, wherein: the index value calculating unit calculates the index value based on the percentage of the volume occupied by the lumen structures within the at least one portion of the region of the target structure.
11. An evaluating apparatus as defined in claim 1, wherein: the index value calculating unit calculates a threshold value to discriminate lumen structures and structures other than lumen structures with respect to the at least one portion of the region of the target structure, calculates the average value of pixel values within the at least one portion of the region of the target structure, and calculates the index value based on the difference between the threshold value and the average value.
12. An evaluating apparatus as defined in claim 1, wherein: the index value calculating unit calculates the index value based on the number of branches of the lumen structure within the at least one portion of the region of the target structure.
13. An evaluating method, comprising: extracting at least one portion of a region of a target structure from a three dimensional image of the target structure which includes lumen structures having branches; extracting the lumen structures from the at least one portion of the region of the target structure; and calculating an index value that represents the uniformity of the distribution of the lumen structures within the at least one portion of the region of the target structure, based on the at least one portion of the region of the target structure and the extracted lumen structures.
14. A non-transitory recording medium having an evaluating program recorded therein, the evaluating program causing a computer to execute the procedures of: extracting at least one portion of a region of a target structure from a three dimensional image of the target structure which includes lumen structures having branches; extracting the lumen structures from the at least one portion of the region of the target structure; and calculating an index value that represents the uniformity of the distribution of the lumen structures within the at least one portion of the region of the target structure, based on the at least one portion of the region of the target structure and the extracted lumen structures.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0038]
[0039]
[0040]
[0041]
[0042]
[0043]
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[0045]
[0046]
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0047] Hereinafter, an embodiment of the present disclosure will be described with reference to the attached drawings.
[0048] The three dimensional image obtaining apparatus 2 images a portion of a subject 7 which is a target of surgery, to generate a three dimensional image V0 that represents the portion of the subject 7. Specific examples of the three dimensional image obtaining apparatus 2 include a CT apparatus, an MRI apparatus, and a PET (Positron Emission Tomography) apparatus. The three dimensional image V0 which is generated by the three dimensional image obtaining apparatus 2 is transmitted to the image storage server 3 and stored therein. Note that in the present embodiment, the portion of the subject 7 which is the target of surgery is the liver, the three dimensional image obtaining apparatus 2 is a CT apparatus, and a three dimensional image V0 of the abdomen of the subject 7 is generated. Note that the liver, which is a target of surgery, is a target structure. In addition, the portal veins which are included in the liver are lumen structures.
[0049] The image storage server 3 is a computer that stores and manages various types of data, and is equipped with a large capacity external memory device and database management software. The image storage server 3 communicates with the other components of the system via a wired or a wireless network 4, to transmit image data and the like. Specifically, image data such as the three dimensional image V0 which is generated by the three dimensional image obtaining apparatus 2 are obtained via the network, then stored within a recording medium such as the large capacity external memory device and managed. Note that the storage format of image data and communications among each component of the system are based on a protocol such as the DICOM (Digital Imaging and Communication in Medicine) protocol.
[0050] The evaluating apparatus 1 is a single computer in which a evaluating program of the present disclosure is installed. The computer may be a work station or a personal computer which is directly operated by a physician who performs diagnosis, or may be a server computer connected to the work station or the personal computer via a network. The evaluating program is recorded on recording media such as a DVD (Digital Versatile Disc) and a CD-ROM (Compact Dick Read Only Memory) which are distributed, and installed onto the tablet terminal from the recording medium. Alternatively, the evaluating program is stored in a recording device of a server computer connected to a network or in a network storage, in a state accessible from the exterior, downloaded to the tablet terminal according to a request, then installed therein.
[0051]
[0052] The storage 13 has recorded therein various types of data, including the three dimensional image V0 which is obtained from the image storage server 3 via the network 4, index values and the like which are generated by processes performed by the evaluating apparatus 1 as will be described later, and data necessary for the processes.
[0053] In addition, the evaluating program is stored in the memory 12. The evaluating program defines an image obtaining process that obtains the three dimensional image V0 obtained by the three dimensional image obtaining apparatus 2; a first extracting process that extracts at least one portion of a region of the liver from the three dimensional image V0; a second extracting process that extracts the portal veins, which are lumen structures, from the at least one portion of the region of the liver; an index value calculating process that calculates an index value that represents the degree of uniformity in the distribution of the portal veins within the at least one portion of the region of the liver, based on the portal veins which are extracted from the at least one portion of the region of the liver; and a quantifying process that quantifies at least one of the degree of reliability of the image quality of the at least one portion of the region of the liver, the degree of reliability of the extraction results for the at least one portion of the liver, and the degree of reliability of the extraction results for the portal veins.
[0054] The computer functions as an image obtaining unit 21, a first extracting unit 22, a second extracting unit 23, an index value calculating unit 24, and a quantifying unit 25, by the CPU executing the above processes according to the program. Note that the evaluating apparatus 1 may be equipped with a plurality of processors that execute each of the image obtaining process, the first extracting process, the second extracting process, the index value calculating process, and the quantifying process, respectively.
[0055] The image obtaining section 21 obtains the three dimensional image V0 from the image storage server. The image obtaining section 21 may obtain the three dimensional image V0 from the storage 13, if the three dimensional image V0 is already recorded in the storage 13.
[0056] The first extracting unit 22 extracts a liver, which is the target structure, from the three dimensional image V0. In the present embodiment, the extracting unit 22 extracts the entire region of the liver form the three dimensional image V0. Any method, such as a method in which a range of CT values for the liver within the three dimensional image V0 is estimated, a threshold value process is executed employing these values, ad a morphology filter is applied to a region extracted by the threshold value process, may be employed to extract the liver. Alternatively, a method in which a plurality of liver phase images which are obtained in temporal series is employed to extract an imaged pattern of the liver region, and the liver region is extracted employing the imaged pattern, as disclosed in “Method for Automatically Extracting Liver Region from Multiple CT Images of the Abdomen at Multiple Temporal Phases by Applying Non Rigid Registration”, Journal of the Academy of Computer Assisted Image Diagnosis, Vol. 7, No. 4-1, June 2003. As a further alternative, the level set method as disclosed in “A Liver Level Set (LLS) Algorithm for Extracting Liver's Volume Containing Disconnected Regions Automatically”, IJCSNS International Journal of Computer Science and Network Security, Vol. 8, No. 12, December 2008 and “Development and Evaluation of Liver Region Extracting Methods that Employ the Level Set Method”, Journal of the Academy of Computer Assisted Image Diagnosis, Vol. 7, No. 4-2, June 2003 may be employed. Note that as a still further alternative, a user may extract a liver region from the three dimensional image V0 by manual operations.
[0057] The second extracting unit 23 extracts portal veins from the liver which is extracted by the first extracting unit. Examples of methods for extracting the portal veins include a method in which position data and major axis directions of a plurality of candidate points that represent a target structure constituted by linear structures are calculated, and the plurality of candidate points are reconstructed such that they are connected to each other by employing a cost function having variables based on the calculated position data and major axis directions as disclosed in Japanese Unexamined Patent Publication No. 2010-220742 and a method that automatically discriminates and extracts blood vessels as disclosed in Japanese Unexamined Patent Publication No. 2011-212314. Alternatively, the histogram analysis may be administered on the pixel values (CT values) of the liver which is extracted by the first extracting unit 22, a threshold value may be calculated to discriminate portal veins and other structures, and the portal veins may be extracted employing the calculated threshold value. Note that as a further alternative, a user may extract the portal veins by manual operations.
[0058] The index value calculating unit 24 calculates an index value that represents the degree of uniformity of the distribution of the portal veins within the liver, based on the extracted liver and portal veins. In the present embodiment, a distance image of the liver is generated employing the portal veins, and the index value is calculated based on a statistical value related to the distance values through the entirety of the liver. Specifically, the index value calculating unit 24 calculates the shortest distances from the portal veins at each point within the liver, and calculates the inverse of the statistical value as the index value. The statistical value may be at least one of the average value, the maximum value, and the standard deviation of the shortest distances. Hereinafter, calculation of the index value will be described.
[0059]
[0060] Here, as illustrated in
[0061] Meanwhile, in the present embodiment, the index value calculating unit 24 extracts the cores of the extracted portal veins, determines the dominated regions of the portal veins in units of branches, and calculates the inverse of the statistical value related to the shortest distances from each point within a dominated region to the portal veins for each of the dominated regions.
[0062] Note that the index value calculating unit 24 may calculate the ratio of the volume of the extracted portal veins to the volume of the extracted liver as the index value. In this case, the index value will become greater as the degree of uniformity of the distribution of the portal veins within the liver is higher. In addition, the ratio of the volume of the extracted portal veins to the volume of the extracted liver as the index value in the case that the index value is calculated for each of a plurality of dominated regions as well.
[0063] As another alternative, the index value calculating unit 24 may calculate the index value based on the difference between the threshold value, which is calculated by the second extracting unit 23 to discriminate the portal veins and other regions when extracting the portal veins by histogram analysis, and the average value of pixel values within the entirety of the liver. In this case, the threshold value will become closer to the average value of the pixel values within the entirety of the liver as the degree of uniformity of the distribution of the portal veins within the liver is higher. Therefore, the difference will become smaller in the case that the portal veins are uniformly distributed within the liver, and will become greater in cases that not all of the portal veins are extracted or the like. For this reason, the index value calculating unit 24 calculates the inverse of the calculated difference as the index value such that the index value becomes greater as the degree of uniformity of the distribution of the portal veins within the liver is higher. In addition, the difference between the threshold value and the average value which is employed for histogram analysis may be employed as the index value in the case that index values are calculated for each of a plurality of dominated regions as well.
[0064] As a further alternative, the index value calculating unit 24 may calculate the index value based on the number of branching positions in the portal veins within the liver. In this case, if the portal veins are uniformly distributed within the liver, the number of branching positions will be great, and the number of branching positions will be small in the case that not all of the portal veins are extracted or the like. For this reason, the index value calculating unit 24 calculates the number of branching positions itself as the index value. In addition, the number of branching positions may be employed as the index value in the case that index values are calculated for each of a plurality of dominated regions as well.
[0065] Note that it is preferable for the index value calculating unit 24 to calculate the index value from regions other than a lesion region within the liver, in the case that a lesion is present within the liver. In this case, a lesion region may be specified by receiving input from a user, or specified by employing a known CAD (Computer Aided Diagnosis) technique. In this case, the evaluating apparatus of the present embodiment will be equipped with an additional means configured to extract a lesion. In the case that a lesion region is present, it is difficult for portal veins to be distributed within the lesion region, and therefore the portal veins will not be extracted. For this reason, the index value can be accurately calculated without being influenced by the lesion region, by calculating the index value from regions other than the lesion region. Note that in the present embodiment, the index value is calculated without excluding the lesion region in the case that index values are calculated for each of a plurality of dominated regions in order to quantify the degree of reliability of the extraction results of the portal veins, as will be described later.
[0066] The quantifying unit 25 quantifies at least one of the degree of reliability of the image quality of the liver, the degree of reliability of the extraction results for the liver, and the degree of reliability of the extraction results for the portal veins, based on the index value. In the present embodiment, all of the degree of reliability of the image quality of the liver, the degree of reliability of the extraction results for the liver, and the degree of reliability of the extraction results for the portal veins are quantified. First, quantification of the degree of reliability of the image quality of the liver will be described.
[0067] The quantifying unit 25 quantifies the degree of reliability employing a reliability map, which is prepared in advance and stored in the storage 13.
[0068] Here, the degree of reliability of the image quality of the liver represents to what degree of reliability the image quality of the liver exhibits for utilization as an image for diagnosis or surgical planning. If the image quality of the liver, that is, the image quality of the three dimensional image V0, is favorable, the liver and the portal veins can be accurately extracted. As a result, the portal veins will be uniformly distributed within the liver, and therefore the index value will become greater. Conversely, if the image quality of the three dimensional image V0 is poor, the liver and the portal veins will not be accurately extracted. As a result, the portal veins will not be uniformly distributed within the liver, and therefore the index value will become smaller. Note that the allowable degree of error is set by a physician who is a user, and is set according to a degree of error desired by the user. For example, in the case that stringent requirements regarding errors are desired with respect to the image quality, the allowable degree of error is set to be smaller, and in the case that it is not necessary for requirements regarding errors to be as stringent, the allowable degree of error is set to be greater. The allowable degree of error is input via the input unit 15.
[0069]
[0070] Here, reliability maps 40 that quantify the degree of reliability of the extraction results of the liver and the degree of reliability of the extraction results of the portal veins are prepared and stored in the storage 13, in addition to the reliability map that quantifies the degree of reliability of the image quality of the liver. In the case that the quantifying unit 25 calculates the degree of reliability of the extraction results of the liver, the reliability map for calculating the degree of reliability of the extraction results of the liver is referred to, to calculate the degree of reliability of the extraction results of the liver. The calculated degree of reliability of the extraction results of the liver is displayed on the display 14 in the same manner as the degree of reliability of the image quality of the liver.
[0071] Note that a user may view the degrees of reliability of the image quality and the extraction results of the liver which are displayed on the display 14, to judge whether the image quality of the liver as well as three dimensional image V0 are favorable. In addition, the user may view the degrees of reliability of the image quality and the extraction results of the liver which are displayed on the display 14 to judge whether the algorithm for extracting the liver is favorable. In the case that the user determines that the algorithm for extracting the liver is not favorable, measures such as reobtaining an image may be taken in the case that the cause is the image quality. Meanwhile, in the case that the cause is in the algorithm for extracting the liver, measures, such as changing the parameters of the algorithm and re-extracting the liver by manual operations may be taken. Note that in the present embodiment, lesion regions are excluded when quantifying the degrees of reliability of the image quality and the extraction results of the liver. Therefore, the user may perform the aforementioned judgments without taking the influence of lesions into consideration. In the case that the user determines that the image quality of the liver is not favorable, measures such as reobtaining an image may be taken.
[0072] Meanwhile, with respect to the degree of reliability of the extraction results of the portal veins, the quantifying unit 25 may quantify the degree of reliability by normalizing the index values, which are calculated by the index value calculating unit 24 for each of a plurality of dominated regions, by a predetermined value. In this case, the predetermined value may be a standard index value within the liver and a range of index values. Note that the predetermined value is input via the input unit 15 and is stored in the storage 13.
[0073] Here, in the case that the index value is calculated based on a statistical value, as well as in the case that the index value is calculated based on a histogram, the index value does not depend on the number of branching positions up to dominated regions or the distance from the root of the portal vein to the dominated regions. In contrast, in the case that the index value is the ratio of the volume of the portal veins with respect to the volume of the liver, the index value for each dominated region depends on the distance from the root of the portal vein to the dominated regions. In this case, it is preferable for the predetermined value for normalizing the index values to be set such that they change according to the distances from the root of the portal vein to the dominated regions. Note that the distances from the root of the portal vein to the dominated regions may be normalized by the length of the portal veins from the root of the portal vein to the dominated region farthest from the root, the volume of the entirety of the liver, or the length of the longest portion of the liver, and employed to normalize the index values. Here, the distance from the edge of the left lobe to the edge of the right love of the liver as viewed from the front may be employed as the length of the longest portion of the liver.
[0074] The quantifying unit 25 displays the degrees of reliability which are quantified in these manners on the display 14.
[0075] A user may view the degrees of reliability of the extraction results for the portal veins which are displayed on the display 14, to judge whether the algorithm for extracting the portal veins is favorable. Note that in the present embodiment, lesion regions are not excluded when quantifying the degrees of reliability of the extraction results for the portal veins. Therefore, the possibility of the presence of lesion regions can also be judged by viewing the degrees of reliability of the extraction results for the portal veins which are displayed on the display 14. Particularly in the case that a lesion region is extracted and a user is aware of the position thereof, the position of the lesion can be confirmed. As a result, the degrees of reliability of the extraction results for the portal veins can be judged without considering the influence of lesions. In the case that the user judges that the algorithm for extracting the portal veins is not favorable, measures such as reobtaining an image may be taken in the case that the cause is considered to be the image quality. Meanwhile, in the case that the cause is in the algorithm for extracting the portal veins, measures, such as changing the parameters of the algorithm and re-extracting the portal veins by manual operations may be taken.
[0076] Further, the user may view the degrees of reliability of the extraction results for the portal veins which are displayed on the display 14, to determine a dominated region to be ultimately surgically excised. For example, in the case that the position of a lsoin is known, a dominated region that includes the lesion is determined to be the dominated region to be excised. In the case that the position of a lesion is not known, a dominated region, in which the degree of reliability of the extraction result for the portal vein is low, is determined to be the dominated region to be excised. The quantifying unit 25 refers to an index value of the determined dominated region, an allowable degree of error, and a reliability map for dominated regions, to quantify a degree of reliability for the determined dominated region. In this case, the index value may be the index value which is calculated by the index value calculating unit 24 for each dominated region when quantifying the degrees of reliability of the extraction results for the portal veins. Note that the index value calculating unit 24 may recalculate an index value for the dominated region which is determined to be excised, and the quantifying unit 25 may quantify a degree of reliability employing the recalculated index value. The quantifying unit 25 displays the quantified degree of reliability on the display 14.
[0077] The user may view the degree of reliability for the dominated region to determine whether the dominated region to be excised is appropriate. In the case that the degree of reliability for the dominated region is low, the user may reset the dominated region to be excised. Thereafter, the index value calculating unit 24 may recalculate an index value for the dominated region which is determined to be excised again, and the quantifying unit 25 may quantify a degree of reliability employing the recalculated index value.
[0078] Next, the processes which are performed by the present embodiment will be described.
[0079] As described above, present the embodiment calculates the index value that represents the uniformity of the distribution of the portal veins within the liver or the index values that represent the uniformity of the distribution of the portal veins within dominated regions of the liver. Therefore, the degree of reliability of the image quality of the liver, the degree of reliability of the extraction results of the liver, the degree of reliability of the extraction results of the portal veins, and the degree of reliability of the dominated region can be accurately quantified, based on the index values.
[0080] Note the embodiment described above quantifies the degree of reliability of the image quality of the liver, the degree of reliability of the extraction results of the liver, the degree of reliability of the extraction results of the portal veins, and the degree of reliability of the dominated region. However, only one or two of the above degrees of reliability may be quantified.
[0081] In addition, the degree of reliability of the extraction results for the portal veins is quantified in the embodiment described above. However, the evaluating apparatus of the present disclosure may be configured to display only the index values which are calculated for each of the dominated regions on the display 14, as illustrated in
[0082] In addition, in the embodiment described above, the legion region is excluded when calculating the degrees of reliability of the image quality and the extraction results of the liver. Alternatively, the degrees of reliability of the image quality and the extraction results of the liver may be calculated without excluding the lesion region. In this case, the possibility of the presence of a lesion can be evaluated in addition to the degrees of reliability of the image quality and the extraction results of the liver.
[0083] In addition, in the embodiment described above, the lesion region is not excluded when calculating the degree of reliability of the extraction results for the portal veins. Alternatively, the lesion region may be excluded when calculating the degree of reliability of the extraction results for the portal veins. In this case, the degree of reliability of the extraction results for the portal veins may be calculated without evaluating the possibility of the presence of a lesion.
[0084] In addition, in the embodiment described above, the three dimensional image V0 may be employed to determine a dominated region to be excised, and the degree of reliability of the dominated region may be quantified only for the dominated region which is determined to be excised.
[0085] In addition, in the embodiment described above, the target structure and the lumen structure are the liver and the portal vein. However, the present disclosure is not limited to such a configuration. The present displeasure may evaluate degrees of reliability for target structures in which lumen structures are uniformly distributed. Examples of such target structures and lumen structures include a lung and bronchial tubes, as well as a brain and blood vessels within the brain.
[0086] The operative effects of the present embodiment will be described below.
[0087] In the case that a lesion region is present within at least one portion of a region of a target structure, calculating the index value after extracting the lesion region from the at least one portion of the region of the target structure enables the legion region to be excluded. Therefore, the index value can be calculated accurately, without being influenced by the presence of a lesion.
[0088] At least one of the degree of reliability of the image quality, the degree of reliability of the extraction results of the at least one portion of the region of the target structure, and the degree of reliability of the extraction results of the lumen structures is quantified based on the index values. Thereby, these degrees of reliability can be obtained.
[0089] Quantifying the degrees of reliability by referring to the reliability maps that define the relationships among index values and degrees of reliability enables the degrees of reliability to be quantified easily.