JPH09117417A - Phthologic image telediagnosis system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To display and examine a tissue image necessary for pathologic examination and diagnosis as an animation image, middle quality still image and high quality still image on a monitor successively transferred from a hospital to a pathologist while talking with a hospital doctor and watching on the monitor, and to quickly transfer the results diagnosed to the hospital. SOLUTION: A tissue image taken by a camera 2 is converted to a middle quality analogue output and a high quality digital output by a down converter 3 and is transferred to a system controlling apparatus 4 and to a host machine 5, respectively. The system controlling apparatus 4 processes an animation image and a middle quality still image utilizing the middle quality analogue output, and at the same time, sends a high quality still image sent from the host machine 5 with a speech communication and processing to the receiver side. The receiver side displays the animation image, and the middle quality still image from the image data received by a system controlling apparatus 10 on a TV monitor 13 and the high quality still image on a monitor 12 through a host machine 11, respectively while performing speech communication and processing.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a remote image diagnosis based on an image of a microscope, an endoscope or the like, and more specifically, a pathologist and a hospital located apart from a hospital are connected to each other by a communication line. The tissue image below is transmitted to the pathologist side, and based on the tissue image displayed on the display of the terminal installed there, a pathologist performs a pathological examination / diagnosis, and in the course of the diagnosis, the hospital side The present invention relates to a pathological remote image diagnostic system which transmits a tissue image required for pathological examination / diagnosis one by one while interacting with each other and promptly transmits the diagnosis result to a hospital.

[0002]

2. Description of the Related Art In the field of medical treatment, for example, when a lesion is found by looking inside the body with an endoscope, a specialist makes a visual judgment. However, the lesion tissue must be examined microscopically to determine whether the lesion found is benign or malignant. A pathologist makes a pathological diagnosis by observing a pathological specimen made from the diseased tissue with a microscope. At present, because there is a shortage of pathologists, hospitals that do not have pathologists outsource the work related to pathological examination / diagnosis to external medical institutions. It is time-consuming to outsource the pathological examination / diagnosis, and it is not possible to respond promptly, especially when a new judgment of the lesion is needed during surgery. In order to solve such a situation, a pathological remote image diagnostic system has been proposed. Conventional methods include a method using a hi-vision monitor and a method for transferring a still image. As shown in Fig. 6, the hi-vision system connects the transmitter on the hospital side and the receiver on the pathologist side by using a satellite line or a dedicated optical fiber, transmits the tissue image taken by a high-quality camera, and displays it on a high-definition monitor. However, since it uses a dedicated line, communication costs and equipment are high. In the still image transfer method, as shown in FIG. 7, a tissue image taken by a medium-quality camera is taken out by a video cap, and a still image of the tissue is taken out, and the host machine (HO
(ST) image processing and transfer using ISDN or modem, host machine installed at specialist side (HOST)
The image is processed and displayed on the monitor, and it takes a long time to transfer the data, which is not suitable for quick diagnosis. In such a method, in order to find an important part remotely, there is no choice but to transfer a number of high-quality images depending on the size of a sample or to use a method with high communication cost such as high-definition. The purpose of the present invention is to display moving images, medium-quality still images, and high-quality still images of a tissue image necessary for pathological examination / diagnosis one by one while displaying them on a monitor while interacting between the hospital side and the pathologist. The purpose of the present invention is to provide a pathological remote image diagnostic system that promptly transmits the result judged by a pathologist while watching it to the hospital side.

[0003]

In order to achieve the above-mentioned object, the present invention according to claim 1 is a pathological remote image diagnostic system for performing based on an image obtained by a microscope, an endoscope or the like,
A moving image communication unit for transmitting an image as a moving image, a medium image quality still image communication unit for transmitting an image as a medium image quality still image, a high quality still image communication unit for transmitting an image as a high quality still image, and an image monitor And a display unit for displaying the medium-quality still image and / or the high-quality still image of the portion specified by the moving image on the receiving side. Another invention is characterized in that the above invention has the following configuration. (1) A means is provided for carrying out a dialogue between the sender and the receiver. (2) The display means is configured to display the patient information, the request form display area, the diagnosis / finding writing area, and the image display area on one screen. (3) The screen display area of the display means is composed of an image list display area for displaying all the captured images and an enlarged display area for enlarging and displaying the images designated in the image list display area. Further, the pathological remote image diagnosis method according to the invention of claim 5 is configured such that an image obtained by a microscope, an endoscope or the like is transferred as a moving image, and then a still image of a portion specified by the moving image is transferred. It is in.

[0004]

According to the structure of the first aspect of the present invention, the moving image transmitted by the moving image communication means is displayed on the monitor, and the lesioned part is hit in the moving image. The medium image quality still image transferred by the medium image quality still image communication unit for confirming the region is displayed to confirm the region. The high-quality still image transmitted by the high-quality still image communication means is finally confirmed and diagnosed. According to the configuration of claim 2, the hospital side and the pathologist side can interact in real time while looking at the transferred image, and the instruction to have the tissue image of the site necessary for pathological judgment transferred accurately and promptly. Therefore, it is possible to eliminate the transfer of the image of the part unnecessary for the pathological judgment. According to the configurations of claims 3 and 4, since all the information necessary for diagnosis is displayed on the screen at one time, the operation of switching the display screen is eliminated, and it can be easily used by a person unfamiliar with the computer. According to the configuration of claim 5, by observing a site using a moving image that can be transferred in real time, a wide range to a site of interest can be viewed in a short time, and a lesion site can be easily hit. It is possible to accurately make a request for a medium image still image and / or a high quality still image only for the part of interest in the instruction of the transferred image. According to the present invention, since the moving image can be sent in real time, the moving image of the site designated by the receiving side can be quickly sent, and the lesion site can be easily hit. Confirm the lesion site with medium-quality still images that can be sent relatively quickly.
Further, at the stage of making a final diagnosis, a high-quality still image is sent.
By thus sending the moving image, the medium-quality still image, and the high-quality still image in combination, the pathological diagnosis can be performed with the shortest communication time. In particular, communication cost for image transfer can be reduced by using ISN64.

[0005]

Embodiments of the present invention will be described below with reference to the drawings. The present invention enables transfer of a moving image until a lesion tissue (part) is found, a medium-quality still image for confirming the part, and a high-quality still image for making a final decision / diagnosis. The communication time is greatly shortened and the speed of the pathological examination / diagnosis is improved by carrying out the communication with the calling side and the receiving side. For this purpose, there are cases where a high-quality video camera (CCD × 3 with 900,000 pixels or more) is used and a medium-quality video camera (CCD × 3 with 400,000 images or less) is used.

FIG. 1 shows a hardware configuration of a pathological remote image diagnostic system on the transmitting side using a high quality camera. In the case of a high-quality camera, a pathological specimen of a lesion tissue observed with the microscope 1 or the like is photographed by a video camera or the like, and a video signal of the tissue image is downconverted by a down converter 3 to an N of 640 × 480 resolution.
Converts to medium-quality analog signals and high-quality digital signals such as TSC-compliant video signals. The medium image quality analog output from the down converter 3 is input to the video input terminal Vin of the system control device 4, and the high image quality digital output is input to the host machine (HOST) 5.

The system controller 4 takes in the high-quality digital output sent from the host machine 5 via the SCSI interface, and sends it to the receiving side installed on the pathologist side in the integrated digital communication network (ISDN). The medium image quality analog output is taken in via the video interface, and after being subjected to image processing such as compression of image data, it is transmitted to the receiving side by ISDN in the same manner as the high image quality digital output. The medium image quality analog output is displayed on the television (TV) monitor 6 connected to the video output terminal Vout.

The host machine 5 is a control means for executing a program for realizing the function of the present system, and is provided with a high resolution monitor 7, and performs processing necessary for image diagnosis based on an input operation on the monitor screen. . In capture mode, the high-quality digital output captured by the microscope camera is directly captured and displayed on the monitor screen. In response to a transfer command from the host machine 5, the system control device 4 causes the captured image data of the tissue image (moving image, middle image still image) and SCSI.
The high-quality still image data captured from the host machine side via the is transmitted to the receiving side. In order to request the transmission side and the reception side to transfer the histological image of the necessary site while mutually monitoring the diseased tissue photographed, or to give a specific instruction such as at which resolution the diseased tissue is imaged, Microphone,
A dialogue device such as a speaker is provided.

FIG. 2 shows the case where a medium image quality camera is used. Here, the configuration different from the system using the high image quality camera will be described in detail. Since the video signal of the medium image quality camera is an analog output, this analog output is input to the input terminal Vin of the system control device 4. The system control device 4 outputs the captured medium image quality image signal to the TV monitor through the video output terminal Vout to display a moving image. Further, the medium image quality image data is subjected to moving image processing (compression) by a moving image codec, and still image processing (compression) by a still image codec, and transferred by ISND.
The still image data before compression, which is taken in via the video interface 40, is stored in the frame memory 47, and the contents are transferred to the host machine 5 by SCSI. The host machine 5 displays a tissue image based on still image data on the high resolution monitor 7. When the receiving side requests a high-definition tissue image, the system control unit 4 causes the frame memory 4
7 contents (resolution 640 × 480 dots) are transferred by ISND.

FIG. 3 shows a communication system block. The communication system is the same for both high-quality cameras and systems using medium-quality cameras, so a system using high-quality cameras will be described here. In FIG. 3, on the transmitting side, image data of a tissue image photographed by a microscope camera (medium image quality camera, high image quality camera) is subjected to moving image processing by the system control device 10, and this moving image output is transmitted via ISDN. The moving image output of the tissue image and the voice output by the dialogue are captured by the system controller 10 on the receiving side. On the receiving side, the moving image output is taken into the host machine via the video interface and displayed on the TV monitor. Looking at the tissue image displayed on the TV monitor, the affected tissue is hit.
In this work, the camerawork is instructed by interacting between the sender and the receiver, and the tissue image requested by the receiver is transmitted. When the diseased tissue is hit, the transmission side requests transmission of a medium-quality still image or / and a high-quality still image of the relevant part. On the transmission side, necessary still image data is transmitted in response to the above-mentioned request for a still image. On the receiving side, a medium quality image is displayed on the TV monitor and a high quality image is displayed on the high resolution monitor attached to the host machine from the received still image data. Image diagnosis is performed by the tissue image acquired by the series of image transmission, and the result is output to the transmission side. With this system, switching between moving images, medium-quality images, and high-quality images can be done at any time by request from the receiving side.
The image of the tissue image necessary for diagnosis can be transmitted quickly.

Next, the function of the system controller will be described in detail. FIG. 4 shows a block diagram of the system controller. In this example, a high image quality camera requiring a down converter and a medium image quality camera not requiring a down converter can be switched and used.
In the case of a high-quality camera, when the high-quality digital output from the down converter is taken into the host machine, SCSI is selected on the host machine side (switch symbol in the figure), that is, switched to the down converter side. When transmitting a high quality digital signal taken in by the host machine, the SCSI in the system control unit is selected and transferred by ISDN via this SCSI. In the case of a medium image quality camera, the SCSI in the system control unit is selected, and the still image digital signal is captured or transferred via this SCSI.

The video interface 40 performs analog / digital conversion of image data, digital / analog conversion, format conversion, video capture, etc., and a high quality camera or a high quality camera via a down converter to an input terminal Vin for capturing image data. Video terminal Vout directly connected to the medium image quality camera and outputting image data
A TV monitor is connected to. The audio interface 41 performs analog / digital conversion, digital / analog conversion, format conversion, etc. of voice data.
A microphone is connected to the input terminal Ain for taking in the audio data, and a speaker is connected to Aout for outputting the audio data. The image data captured by the video interface 40 and the audio data captured by the audio interface 41 are encoded, passed through a communication line (ISN net 64 digital public line), and passed through the INS.
A codec 42, 4 for decoding the image data and audio data sent from the network interface 46.
3, 44 are provided.

The codec 42 converts the moving image data into, for example, H
261 is a moving image codec for performing image processing by a video encoding method, codec 43 is a still image codec for performing image processing by a still image encoding method such as JPEG, and codec 44 is an image processing by voice encoding such as G728. Is a voice codec. IS
The N64 network interface unit 46 is a subscriber line terminating device 60 (DSU: Digita Service Unit) of the INS net 64.
It has the function of connecting to The INS Net 64 is a digital public line that uses the same metallic cable as the analog telephone line, and has a B channel (speed 64 Kbp).
s) It has two lines and one D channel (speed 16 Kbps).

Between the respective codecs 42, 43, 44 and the INS64 network interface section 46, there is provided a media multiplexing / separating section 45 for carrying out a media multiplexing / separating process. The media multiplexer / separator 45 is INS64.
A function of separating the multiplexed B channel data (2 channels) sent from the network interface unit 46 into video, audio, and data as respective media data, and a video codec (moving image codec, still image codec), audio It has a function to multiplex the data sent from the codec, FAX, etc. Data such as FAX is directly connected to the media multiplexing / separating unit 45 from an external connection device. The frame memory 47 stores N frames of image data. The accumulated image data is displayed on the TV monitor via the video interface 40. The system control unit 48 controls the entire device. The interconnection procedure controller 49 controls the media multiplexer / separator 45. The network access control unit 50 controls the connection to the ISDN network.
The SCSI 51 comprises a SCSI interface section and a SCSI handler section.

Next, the transmission operation of moving images, medium-quality still images, and high-quality still images will be described. When diagnosis is started (when a high-quality camera is used), the tissue image taken by the high-quality camera is converted by the down converter into a medium-quality analog signal and a high-quality digital signal on the transmitting side. The high quality digital signal is captured by the host machine. The medium image quality analog signal is input to the video interface of the system control device, and is subjected to moving image codec (compression) to transfer moving image data by ISDN. At the request of the receiving side, the still image codec (compression) is performed and the medium image quality still image data or the high quality still image data from the host machine is transferred by ISDN.

When the diagnosis is started (when the medium image quality camera is used), the analog signal of the tissue image photographed by the medium image quality camera is input to the video interface of the system control device on the transmitting side, and the moving image codec (compression) is performed. And the moving image data is transferred by ISDN. At the request of the receiving side, the still image codec (compression) is performed and I
Transfer by SDN. The medium-quality still image data is stored in the frame memory and transferred to the host machine.
The host machine commands the system control unit of the system control device when there is a request for high-definition still image data from the receiving side, and the system control unit transfers the content of the frame memory by ISDN without compression.

Next, the monitor attached to the host machine will be described. FIG. 5 shows the screen structure of the monitor. In order to perform diagnosis more quickly, the screen is easy to operate, the necessary tissue image can be viewed as a whole, and the screen is configured so that the user can write while observing the site where the diagnosis / finding applies. Must be In order to satisfy such conditions, patient information, a request form display area, a diagnostic writing area, a finding writing area, an enlarged display area, and an image list display area are arranged on one screen. In the enlarged display area, the portions designated in the request document display area and the image list display area are enlarged and displayed. In particular, the contents such as images and characters displayed in the enlarged display area can be moved in the enlarged display area in the arrow direction by clicking the arrow of the enlarged display area moving key. For example, in the enlarged and displayed tissue image, when it is desired to observe the site of interest in more detail, the size can be displayed in a size that can be easily confirmed by operating the enlargement key. Further, in order to identify the position of the diseased tissue and compare it with the surrounding tissue, the tissue image can be reduced and displayed by operating the reduction key when observing a wide range of tissue. The image list display area is an area for displaying an image captured by the image input function. When this area is designated by the mouse, the image is displayed in the enlarged display area.

Explaining the procedure of the screen operation, the capture mode on the right side of the screen is selected and the chart number is designated. When new, press the new patient button and enter the chart number,
To add or change, select the chart No. by pressing the patient selection button or select from the chart list. Specify patient information from the keyboard and move to the item to be entered with the mouse cursor. When adjusting the image focus, first press the screen sample button to capture the entire image at half the resolution. When the screen focus adjustment (focus) button is pressed, the central part is continuously captured at a resolution of 1/1. Then, when the image input button is pressed, the cursor changes to a clock mark during the capture process and to an arrow mark when finished. This image focus adjustment and image input processing is repeated for the number of captured images.
Then press the request form input button and specify the request form file read by the scanner. Finally, pressing the transfer button sends the currently displayed patient data to the diagnostic system. The sent data is automatically saved in the storage.

The diagnostic procedure will be described. First, the diagnostic mode is selected, and the data of the patient to be diagnosed is selected from the patient selection or the chart list. Input diagnostic information by voice.
As a button for voice input operation, when the voice input button is pressed, an operation panel for voice input is displayed. This operation panel has a record button to start recording, a stop button to stop recording / playback, a pause button to pause recording / playback operation, a play button to play back recorded audio, and a save button to save voice recording. Is provided. To output the input voice, press the voice output button to display the voice output operation panel. This operation panel is also provided with buttons similar to those of the voice input operation panel. To enter a diagnosis / finding, move the cursor to the relevant area, click the cursor, and enter a sentence using the keyboard. When the diagnosis end button is pressed after the diagnosis is completed, * mark is displayed on the left side of the chart list. Select a result mode and select patient data referencing the results from the patient selection or chart list. Pressing the voice output button outputs the registered voice.

[Brief description of the drawings]

FIG. 1 is a system block diagram of a transmitting side when a high quality camera is used as an embodiment of the present invention.

FIG. 2 is a system block diagram of a transmitting side when a medium image quality camera is used as an embodiment of the present invention.

FIG. 3 is a diagram showing a communication diagram of the pathological remote image diagnostic system according to the present invention.

FIG. 4 is a block diagram of a system controller.

FIG. 5 is a diagram illustrating an example of a screen configuration.

FIG. 6 is an explanatory diagram of a conventional high-definition remote image diagnostic system.

FIG. 7 is an explanatory diagram of a conventional remote image diagnostic system using a still image transfer system.

[Explanation of symbols]

1 ... Microscope etc., 2 ... Video camera, 3 ... Down converter, 4, 10 ... System control device, 5, 11 ... Host machine, 6, 13 ... TV monitor, 7, 12 ... Monitor

 ─────────────────────────────────────────────────── ─── Continuation of the front page (72) Inventor Takeshi Oshima 3-35-18 Tomioka Nishi, Kanazawa-ku, Yokohama-shi, Kanagawa

Claims (5)

[Claims] 1. A pathological remote image diagnosis system based on an image obtained by a microscope, an endoscope, etc., and a moving image communication means for transmitting the image as a moving image, and transmitting the image as a medium-quality still image. And a high-quality still image communication unit for transmitting the image as a high-quality still image, and a display unit for monitoring the image, wherein the receiving side includes the medium-quality still image communication unit for displaying the image. A pathological remote image diagnostic system characterized in that it is configured to deliver high quality still images and / or high quality still images. 2. The pathological remote image diagnostic system according to claim 1, further comprising means for carrying out a dialogue between a transmitting side and a receiving side. 3. The display means includes patient information, a request form display area,
The pathological remote image diagnosis system according to claim 1, wherein the diagnosis / finding writing area and the image display area are configured to be displayed on one screen. 4. The screen display area of the display means is composed of an image list display area for displaying all the captured images and an enlarged display area for enlarging and displaying the images designated in the image list display area. The pathological remote image diagnostic system according to claim 3. 5. A pathological remote image diagnosis method characterized in that an image obtained by a microscope, an endoscope or the like is transferred as a moving image, and then a still image of a portion specified by the moving image is transferred.