WO2013081042A1 - 医療システム - Google Patents
医療システム Download PDFInfo
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- WO2013081042A1 WO2013081042A1 PCT/JP2012/080885 JP2012080885W WO2013081042A1 WO 2013081042 A1 WO2013081042 A1 WO 2013081042A1 JP 2012080885 W JP2012080885 W JP 2012080885W WO 2013081042 A1 WO2013081042 A1 WO 2013081042A1
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Definitions
- the present invention relates to a medical system having a plurality of medical devices that perform predetermined diagnosis or treatment on a subject.
- a medical system having a plurality of medical devices that perform predetermined diagnosis or treatment on a subject is disclosed in, for example, Japanese Patent Application Laid-Open Nos. 2007-175231, 2005-87612, 2004-344390, and No. 2006-255395 and JP-A No. 2002-369787.
- the operating room includes various medical devices (radiography apparatus, radiation source, ultrasonic diagnostic apparatus, endoscope apparatus, etc. ) Is arranged narrowly.
- the operation part of these medical devices has a lower sterilization level than a surgical instrument used when a doctor (surgeon) performs an operation on a patient. Therefore, the doctor cannot directly operate the operation part of these medical devices.
- a doctor speaks to an engineer (radiologist, ultrasonic engineer, endoscopist) who operates a medical device while performing an operation on a patient.
- the operation of the medical device is instructed according to the progress of the operation.
- the technician if it is difficult for the technician to quickly and accurately operate the medical device as desired by the doctor, the doctor will feel very frustrated.
- the doctor or radiologist looks at the actual patient's situation and takes a picture.
- the conditions may be changed.
- the doctor or radiographer has the patient because the round-wheel is equipped with a console. After going to the place and positioning the patient, the camera returns to the console, and the imaging condition is changed by operating the console.
- the work load on the doctor or radiographer increases, and operations such as changing imaging conditions and positioning the subject can be performed quickly. Difficult to do.
- the present invention has been made to solve the above-described problems, and an object of the present invention is to provide a medical system that enables remote operation of a medical device by an operator including a doctor or an engineer.
- a medical system is portable to a plurality of medical devices that perform a predetermined diagnosis or treatment on a subject and the vicinity of the subject, and is operated by an operator. And a portable device capable of controlling each of the medical devices.
- the portable device includes a display unit capable of displaying the operation content for controlling each medical device, an operation unit that receives the operation of the operator based on the display content of the display unit, and the operator An operation control unit that limits medical devices that are controlled due to the operation of the operation unit, and a signal that corresponds to the operation content received by the operation unit is transmitted to the medical device that is limited by the operation control unit And a communication unit.
- the said medical device is controlled according to the said signal received from the said communication part.
- a signal corresponding to the operation content (command for controlling the medical device) is transmitted from the communication unit to the medical device to be operated.
- the medical device is controlled according to the received signal.
- a doctor performing an operation on a patient who is the subject in an operating room does not give a verbal instruction to an engineer of the medical device or more than a surgical instrument used by the doctor.
- the medical device can be controlled by remote operation by operating the operation unit of the portable device arranged at hand of the doctor.
- the portable device functions as a remote controller for each medical device, the doctor controls the desired medical device by operating the portable device at hand according to the progress of the operation.
- the remote operation of the medical device can be performed quickly and accurately.
- the operator of the portable device (the doctor, the radiographer) is positioning the subject in the vicinity of the subject.
- the shooting condition it becomes possible to change the shooting condition to an appropriate one according to the state of the subject by operating the portable device.
- the operator can remotely operate each medical device by operating the portable device.
- the operation control unit limits medical devices that are controlled due to the operation of the operation unit by the operator, the operator can respond according to the diagnosis or treatment content of the subject.
- the appropriate medical device can be operated reliably.
- the operation control unit enables the operation of the operation unit by the operator with respect to the medical device in use. It is preferable to invalidate the operation of the operation unit by the operator for other medical devices. Accordingly, the operator (doctor) can reliably remotely operate one medical device to be operated, and thus can reliably prevent the other medical device from being remotely operated by mistake. it can.
- the portable device further includes a touch panel including the display unit and the operation unit.
- the operation unit is displayed on the screen of the touch panel, shows the operation contents for each medical device and / or each medical device, and can be operated by the operator on each medical device. This is a simple operation image.
- the operation control unit enables the operator's operation on the operation image corresponding to the medical device in use, and controls the operator's operation on the operation image corresponding to the other medical device. It is preferable to disable it.
- the operation content for each medical device is displayed on the screen of the touch panel as the operation image (for example, a widget such as an icon or a text box), the operator operates the operation image, The medical device in use can be easily remotely operated. In addition, even if the operator operates an operation image corresponding to the other medical device that is not in use, the operation result becomes invalid, so that it is ensured that the other medical device is erroneously controlled. Can be prevented.
- the operation image for example, a widget such as an icon or a text box
- the touch panel operated by the operator since the touch panel operated by the operator has no irregularities on the surface, for example, if the surface of the touch panel is sterilized after surgery, the surface can be kept clean and prevent nosocomial infection. It is also possible to do.
- the operation image corresponding to the medical device in use is displayed larger than the operation image corresponding to the other medical device on the screen of the touch panel, the operator The operation image corresponding to the medical device inside can be easily operated.
- an end image for ending control of the medical device in use from the portable device is further displayed on the screen of the touch panel, and the operation is performed when the end image is operated by the operator. It is preferable that the control unit switches the operation of the operator with respect to the operation image corresponding to each medical device to an effective state. Thus, the operator can select the medical device to be used next by operating the end image.
- the operation control unit may operate the operation image corresponding to one medical device by the operator after the operation of the operator for the operation image corresponding to each medical device is switched to an effective state.
- the operation control unit may operate the operation image corresponding to one medical device by the operator after the operation of the operator for the operation image corresponding to each medical device is switched to an effective state.
- the portable device is preferably a tablet computer, a handheld computer, or a portable information terminal. With these portable devices, the portable device can be easily carried to the vicinity of the patient.
- the tablet computer does not have a keyboard or mouse and has no irregularities on the surface, for example, if the surface of the tablet computer is sterilized after surgery, the surface can be cleaned and nosocomial infections can be obtained. Can also be prevented.
- the portable device is preferably used in a state of being sealed in a sterilization bag.
- the sterilization bag may be a disposable transparent bag.
- the portable device further includes a transmission / reception setting unit that presets transmission / reception of signals by multi-access wireless communication between the communication unit and each medical device before controlling each medical device. Is preferred.
- the multiple access includes, for example, code division multiple access (CDMA), time division multiple access (TDMA), and frequency division multiple access (FDMA).
- CDMA code division multiple access
- TDMA time division multiple access
- FDMA frequency division multiple access
- the transmission / reception setting unit pre-allocates different channels (CDMA system: predetermined code, TDMA system: predetermined time slot, FDMA system: predetermined frequency range) to each medical device, and also assigns to each medical device.
- a command to be transmitted is selected in advance.
- the medical devices arranged in the operating room include a radiation source that irradiates the subject with radiation, a radiation imaging apparatus that converts the radiation transmitted through the subject into a radiation image, and the subject.
- An ultrasonic diagnostic apparatus that irradiates a desired part inside a specimen with ultrasonic waves and converts a reflected wave from the part into an ultrasonic image; and an ultrasonic diagnostic apparatus that is inserted into the specimen so as to be inside the specimen.
- the tube voltage of the radiation source, the tube current, the irradiation time of the radiation, and the like are the operation targets. Therefore, the operator (doctor) can remotely operate (set) these operation targets by operating the portable device at hand.
- the medical system further includes a control device that is disposed at a location away from the subject and controls the radiation source and the radiation imaging apparatus, and the communication unit includes the radiation imaging apparatus and the control apparatus. It suffices if signals can be transmitted and received by wireless communication.
- the portable device transmits a signal corresponding to the operation content of the operation unit by the operator from the communication unit to the control device. Accordingly, the radiation source and the radiation imaging apparatus may be controlled via the control device. Accordingly, the portable device can control the radiation source and the radiation imaging apparatus by causing the control device to function as a relay.
- the radiation source and the radiation imaging apparatus are controlled by transmitting the signal from the communication unit to the radiation imaging apparatus and transmitting the signal from the communication unit to the radiation source via the control device.
- the portable device directly controls the radiation imaging apparatus and controls the radiation source by causing the control apparatus to function as a relay.
- FIG. 1 is a perspective view of an operating room to which a medical system (radiation imaging system, medical image broadcasting system) according to the present embodiment is applied. It is a block diagram of the medical system of FIG. It is a block diagram of the portable apparatus which a doctor operates. It is a block diagram of a console. It is the perspective view which showed the state which a doctor operates the portable apparatus sealed by the sterilization bag.
- 6A and 6B are explanatory diagrams of the first characteristic function.
- 7A and 7B are explanatory diagrams of a second characteristic function.
- 8A and 8B are explanatory diagrams of a second characteristic function.
- 9A and 9B are explanatory diagrams of a second characteristic function.
- 10A and 10B are explanatory diagrams of a third characteristic function.
- 12A to 12C are flowcharts for explaining the first characteristic function. It is a flowchart for demonstrating a 2nd characteristic function. It is a flowchart for demonstrating a 3rd characteristic function. 15A and 15B are explanatory diagrams for describing a first modification of the present embodiment. It is a perspective view for demonstrating the 2nd modification of this embodiment. It is explanatory drawing for demonstrating the 3rd modification of this embodiment.
- a medical system (radiation imaging system, medical image broadcasting system) 10 according to the present embodiment is applied to an operating room 12 of a medical institution, for example, as shown in FIG.
- the medical system 10 according to the present embodiment can be applied to other than the operating room 12, but here, a case where it is applied to the operating room 12 will be described as an example.
- a patient (subject, subject) 16 lies on the operating table 14, and a doctor 18, who is a surgeon, performs treatment such as surgery on the patient 16.
- the operating room 12 is provided with a radiation output device 22 that irradiates the patient 16 with radiation 20.
- a radiation imaging device 24 such as a battery-driven electronic cassette is inserted between the patient 16 and the operating table 14. The radiation imaging apparatus 24 converts the radiation 20 that has passed through the patient 16 into a radiation image.
- an instrument table 26 on which various instruments used by the doctor 18 for surgery are placed, and a cradle 28 that is loaded with the radiation imaging apparatus 24 and performs a charging process is also arranged.
- an ultrasonic diagnostic apparatus (image capturing apparatus) 30 for irradiating a desired part inside the patient 16 with ultrasonic waves and converting a reflected wave from the part into an ultrasonic image is also disposed. Yes.
- an optical image of the inside of the patient 16 is taken by inserting a fiberscope into the inside of the patient 16, and further, an endoscope that performs a predetermined treatment inside the patient 16 as necessary.
- a mirror device (image photographing device) 32 is also arranged.
- the operating room 12 includes a camera (image capturing device) 34 that captures the entire or a part of the operating room 12 as a moving image (camera image), and various images (for example, radiographic images, ultrasonic images, optical images).
- a large display device 36 for displaying images and camera images is also provided.
- the camera 34 is supported in a state of being connected to an articulated arm 40 extending from the ceiling
- the radiation output device 22 is supported in a state of being connected to an articulated arm 42 extending from the ceiling
- the display device 36 is It is supported in a state of being connected to an articulated arm 44 extending from the ceiling.
- FIG. 1 the case where one camera 34 and one display device 36 are arranged in the operating room 12 is illustrated, but a plurality of cameras 34 and display devices 36 may be arranged. Of course.
- a mounting table 46 is disposed in the vicinity of the doctor 18 who performs an operation on the patient 16.
- a portable device such as a tablet computer (tablet PC), a handheld computer, or a personal digital assistant (PDA). 48 is placed on the mounting table 46.
- the portable device 48 can be carried to the mounting table 46 that is disposed slightly away from the patient 16 (distant from the patient 16 compared to the radiation imaging apparatus 24), and can be operated by the doctor 18 at hand.
- FIG. 1 shows a case of a tablet PC as an example.
- a console 52 as a control device for controlling the radiation output device 22 and the radiation imaging device 24 is disposed in the preparation room 50 adjacent to the operating room 12, and a radiologist 54 (hereinafter also referred to as a technician 54) is a doctor 18. Is operated, the console 52 is operated. In the present embodiment, for example, the console 52 is used in a state where it is disposed at a location farther than the patient 16 as compared with the portable device 48 as shown in FIG. Further, in the following description, an ultrasonic engineer who operates the ultrasonic diagnostic apparatus 30 in response to an instruction from the doctor 18, an endoscopic engineer who operates the endoscope apparatus 32 in response to an instruction from the doctor 18, and the engineer 54. May be described as follows.
- the radiation imaging apparatus 24 can transmit and receive signals by wireless communication with the portable device 48 via the antenna 56, and signal by wired communication with the console 52 via the optical fiber cable 58.
- Send and receive The portable device 48 can transmit and receive signals by wireless communication with other devices via the antenna 60.
- the ultrasonic diagnostic apparatus 30 can transmit and receive signals by wireless communication with the portable device 48 via the antenna 62, and the endoscope apparatus 32 wirelessly with the portable device 48 via the antenna 64. It is possible to send and receive signals by communication.
- the camera 34 can transmit and receive signals by wireless communication with the portable device 48 via the antenna 66.
- the console 52 can transmit and receive signals by wireless communication with the portable device 48 via the antenna 68.
- FIG. 1 illustrates the case where wireless communication is performed between devices in the operating room 12, but specifically, short-range wireless communication such as short-range wireless communication or wireless PAN (Personal Area Network). Wireless LAN (Local Area Network) may be used. Alternatively, signal transmission / reception may be performed by infrared communication.
- short-range wireless communication such as short-range wireless communication or wireless PAN (Personal Area Network).
- wireless PAN Personal Area Network
- Wireless LAN Local Area Network
- signal transmission / reception may be performed by infrared communication.
- the antenna 56 is included in a backup communication unit 78 as a backup for signal transmission / reception via the optical fiber cable 58.
- the radiation imaging apparatus 24 is a battery-driven electronic cassette, and includes a backup communication unit 78 including an antenna 56, a radiation conversion panel 80, a cassette control unit 82, a frame memory 84, an image storage unit 86, an information storage unit 88, and a linking process.
- the radiation conversion panel 80 detects the radiation 20 transmitted through the patient 16 and converts it into an electrical signal corresponding to the radiation image when the patient 20 is irradiated with the radiation 20 from the radiation output device 22.
- a radiation conversion panel 80 includes a direct conversion radiation conversion panel and an indirect conversion radiation conversion panel.
- the direct conversion type radiation conversion panel directly converts the radiation 20 into an electric signal by using a radiation conversion layer including a semiconductor made of amorphous selenium (a-Se) or the like.
- the indirect conversion type radiation conversion panel uses a scintillator made of CsI columnar crystals or a granular scintillator of GOS (Gd 2 O 2 S) to temporarily convert the radiation 20 into fluorescence and photoelectrically convert the fluorescence to a photodiode or the like. It is detected as an electrical signal by the element.
- the radiation conversion panel 80 has a structure in which a plurality of pixels for detecting the radiation 20 are arranged in a matrix, and an electrical signal corresponding to the radiation image is temporarily stored in each pixel as a charge.
- the radiation image is repeatedly applied by irradiating the patient 16 with the radiation 20 from the radiation output device 22 and converting the radiation 20 transmitted through the patient 16 into a radiation image on the radiation conversion panel 80.
- the cassette control unit 82 controls the radiation conversion panel 80 for each radiographic imaging (one irradiation of the radiation 20), and the pixels arranged in a matrix form.
- an electric signal (digital signal) corresponding to the read charge is temporarily stored in the frame memory 84 as a radiation image of one frame. Therefore, in the case of fluoroscopic imaging, the frame memory 84 sequentially stores one frame of radiation images for each imaging.
- the information storage unit 88 includes cassette ID information for specifying the radiation imaging apparatus 24, order information (subject information) for requesting fluoroscopic imaging of the patient 16, and imaging for causing the patient 16 to irradiate the radiation 20. Memorize the conditions.
- the order information is created by the doctor 18 in the radiology information system (RIS) 112 or the medical information system (HIS) 114 described later.
- RIS radiology information system
- HIS medical information system
- the imaging region and imaging method of the patient 16 are included.
- the imaging conditions are various conditions necessary for irradiating the imaging region of the patient 16 with the radiation 20 such as the tube voltage and tube current of the radiation source 106 and the irradiation time of the radiation 20.
- the linking processing unit 90 includes at least one frame of radiation image (digital image moving image) temporarily stored in the frame memory 84, and cassette ID information, order information, and imaging conditions stored in the information storage unit 88.
- the linked information (moving image, cassette ID information, order information, shooting conditions) is stored in the image storage unit 86. Since the moving image has a large capacity, the image storage unit 86 is preferably an auxiliary storage device such as a hard disk drive (HDD) or a memory card having a relatively large storage capacity.
- HDD hard disk drive
- the communication unit 94 transmits the linked information (moving image, cassette ID information, order information, photographing conditions) stored in the image storage unit 86 to the console 52 via the optical fiber cable 58.
- the communication unit 94 receives information (for example, order information and imaging conditions) and control signals (commands for controlling the radiation imaging apparatus 24) from the console 52 via the optical fiber cable 58.
- the backup communication unit 78 includes an antenna 56, a digital visual interface (DVI) 96, a signal processing unit (image processing unit) 98, and a communication unit (second communication unit) 100.
- DVI digital visual interface
- image processing unit image processing unit
- second communication unit second communication unit
- the signal processing unit 98 performs a process of converting a moving image (digital data) stored in the image storage unit 86 into a television broadcast signal (for example, an analog television broadcast signal). Further, the signal processing unit 98 performs a predetermined thinning process on the moving image stored in the image storage unit 86, thereby obtaining a thinned image having a smaller amount of information (with a reduced frame rate) than the moving image. It is also possible to generate.
- the DVI 96 is connected to a display device such as a display (not shown), and outputs a television broadcast signal (moving image processed for analog television broadcast) converted by the signal processing unit 98 to the display device.
- a display device such as a display (not shown)
- the communication unit 100 transmits a television broadcast signal or a thinned image to the portable device 48 by wireless communication via the antenna 56.
- the image storage unit 86 cassette ID information, order information, and shooting conditions are associated with the moving image. Therefore, the communication unit 100 associates the moving image for television broadcasting with the thinned image.
- Various attached information (cassette ID information, order information, and photographing conditions) is also transmitted to the portable device 48.
- the communication unit 100 functions as a backup for the communication unit 94. Therefore, when an abnormality has occurred in signal transmission / reception between the communication unit 94 and the console 52 via the optical fiber cable 58, a moving image as a normal radiation image stored in the image storage unit 86.
- the image and various types of information associated with the image may be transmitted to the portable device 48 by wireless communication.
- the radiation imaging apparatus 24 does not transmit a regular radiographic image or the like to the outside, but temporarily stores the regular radiographic image and various types of information in the image storage unit 86. For example, after the surgery is completed
- the normal radiographic image and various associated information may be transferred from the image storage unit 86 to the storage unit 104 or the console 52 of the controller 102 using an interface such as USB (Universal Serial Bus) (not shown). .
- USB Universal Serial Bus
- the battery 92 supplies power to each part of the radiation imaging apparatus 24.
- a controller 102 is interposed between the radiation imaging apparatus 24 and the console 52. That is, the optical fiber cable 58 includes an optical fiber cable 58 a that connects the radiation imaging apparatus 24 and the controller 102 by wire, and an optical fiber cable 58 b that connects the controller 102 and the console 52 by wire.
- the controller 102 transmits information (for example, order information and imaging conditions) and commands from the console 52 to the communication unit 94, and also associates each piece of information (moving image as a regular radiographic image, cassette ID information, order). Information, photographing conditions) is stored in the storage unit 104.
- the storage unit 104 is preferably an auxiliary storage device such as a memory card, similar to the image storage unit 86 described above.
- Each piece of linked information stored in the storage unit 104 is transmitted to the console 52 via the optical fiber cable 58b.
- the radiation output device 22 includes a radiation source 106 that outputs the radiation 20 and a control unit 108 that drives and controls the radiation source 106 in accordance with a control signal (command) from the console 52.
- the portable device 48 can receive various types of information associated with a radiation image (a regular radiation image, a thinned image, or a television broadcast image) acquired by the radiation imaging apparatus 24, and between the portable device 48 and the console 52.
- the signal can be transmitted and received by wireless communication.
- the portable device 48 receives the ultrasound image and the information related to the patient 16 associated with the ultrasound image by wireless communication from the ultrasound diagnostic apparatus 30.
- the portable device 48 receives the optical image and the information related to the patient 16 associated with the optical image from the endoscope device 32 by wireless communication.
- the portable device 48 also receives a camera image of the operating room 12 or the like from the camera 34 by wireless communication.
- the portable device 48 includes a camera image, an ultrasound image, information related to the patient 16 linked to the ultrasound image, an optical image, and information related to the patient 16 linked to the optical image.
- the radiographic image and various types of information associated with the radiographic image can be transmitted to the console 52. Therefore, the console 52 displays each moving image received through wireless communication and various information associated with it, a radiographic image received via the optical fiber cable 58, and various information associated with the radiographic image. 36 can be displayed.
- the console 52 is connected to the RIS 112, the HIS 114, and the medical image information system (PACS) 116 via the LAN 110 of the medical institution.
- the RIS 112 comprehensively manages radiographic images and other information handled in the radiology department in medical institutions.
- the HIS 114 comprehensively manages medical information in the hospital.
- the PACS 116 includes various medical devices (the radiation output device 22 and the radiation imaging device 24, the ultrasonic diagnostic device 30, and the endoscope device 32) in the medical system 10 and each piece of information (the above-described moving image and string) acquired by the camera 34.
- Various information attached can be received from the console 52 via the LAN 110 and managed centrally.
- the radiation imaging device 24, the ultrasound diagnostic device 30, and the endoscope device 32 as modalities are all devices that conform to the DICOM (Digital Imaging and Communication in Medicine) standard, and radiography.
- the device 24, the ultrasonic diagnostic device 30, and the endoscope device 32 are connected to the generated image data (radiation image, ultrasonic image, optical image) with incidental information defined by the DICOM standard or to the patient 16 to be linked.
- the information with the relevant information added is output as image information.
- the console 52 as a DICOM server transmits DICOM image information acquired from the radiation imaging apparatus 24, the ultrasonic diagnostic apparatus 30, and the endoscope apparatus 32 to the PACS 116 via the LAN 110.
- the console 52 performs DICOM conversion on the moving image acquired from the camera 34, and converts the converted moving image (DICOM standard image information) via the LAN 110.
- the portable device 48 and the console 52 have substantially the same configuration, the portable device 48 can also function as a DICOM server. Since the DICOM standard and DICOM conversion are known, detailed description thereof is omitted in this specification.
- the portable device 48 is directed to a predetermined area (for example, a waiting room, a conference room, an operating room 12, or a preparation room 50) in a medical institution, such as a camera image, an ultrasonic image, an optical image, or a radiographic image. It is also possible to distribute moving images and various types of information linked to these moving images in real time by terrestrial digital television broadcasting (area one-segment broadcasting in Japan).
- medical personnel other than the doctor 18 and the technician 54 carry the portable device 120a such as a mobile phone and a tablet PC, and the family of the patient 16 carries it.
- the portable device 120b such as a telephone or a tablet PC is possessed and each of the portable devices 120a and 120b includes antennas 122a and 122b capable of receiving digital terrestrial television broadcasting
- the portable devices 120a and 120b are within the predetermined area. If so, the moving image and the various information can be received.
- a display device 124 such as a display capable of displaying an image distributed in real time by digital terrestrial television broadcasting is disposed in the predetermined area, the moving image and the various information are received via an antenna 126. Is possible.
- FIG. 3 is a block diagram of the portable device 48 operated by the doctor 18, and FIG. 4 is a block diagram of the console 52.
- the portable device 48 and the console 52 have substantially the same components except for some components.
- the portable device 48 includes a communication unit (image broadcasting unit) 130, a control unit 132, an order information storage unit 134, an imaging condition storage unit 136, a switching processing unit 138, a transmission / reception setting unit 140, and an encryption process.
- the touch panel 150 includes a display unit 160 and an operation unit 162.
- the console 52 includes communication units 170 and 172, a control unit 174, an order information storage unit 176, an imaging condition storage unit 178, a switching processing unit 180, a transmission / reception setting unit 182 and an encryption processing unit 184.
- the communication unit 130 is connected to the communication unit 100 of the radiation imaging apparatus 24 in the operating room 12, the ultrasonic diagnostic apparatus 30, the endoscope apparatus 32, the camera 34, and the console via the antenna 60.
- the communication unit 170 transmits and receives signals by wireless communication. Further, the communication unit 130 performs digital terrestrial television broadcasting to a predetermined area in the medical institution via the antenna 60 and distributes a moving image and various types of associated information in real time.
- the control unit 132 controls each unit in the portable device 48.
- the order information storage unit 134 stores order information of the patient 16, and the imaging condition storage unit 136 stores imaging conditions for irradiating the patient 16 with the radiation 20.
- the switching processing unit 138 switches the device (master) that controls the radiation output device 22 and the radiation imaging device 24 to the portable device 48 or the console 52. That is, the portable device 48 and the console 52 are in a relationship of a master (main device) and a slave (secondary device) for controlling the radiation output device 22 and the radiation imaging device 24, and the switching processing unit 138
- the console 52 is switched to the master or slave.
- the master transmits a control signal (command) to the radiation output device 22 and the radiation imaging device 24 and directly controls the command, or transmits a command via a slave (with the slave functioning as a repeater). By doing so, the radiation output device 22 and the radiation imaging device 24 are controlled.
- the transmission / reception setting unit 140 includes the communication unit 130 of the portable device 48, the communication unit 100 of the radiation imaging apparatus 24, the communication unit 170 of the console 52, the camera 34, the ultrasonic diagnostic apparatus 30, and the endoscope before the start of fluoroscopic imaging.
- a channel for performing wireless communication with the device 32 through multiple access is set in advance.
- the transmission / reception setting unit 140 selects in advance the content of commands transmitted from the portable device 48 to the radiation output device 22, the radiation imaging device 24, the ultrasonic diagnostic device 30, the endoscope device 32, and the camera 34. These setting contents and selection contents are stored (managed) in the information management unit 152.
- multiple access examples include code division multiple access (CDMA), time division multiple access (TDMA), and frequency division multiple access (FDMA).
- the transmission / reception setting unit 140 transmits a predetermined channel (CDMA system: predetermined code, TDMA system: predetermined time slot, FDMA system: predetermined frequency range) to the radiation output device 22 (console 52 as a repeater), radiography.
- CDMA system predetermined code
- TDMA system predetermined time slot
- FDMA system predetermined frequency range
- a command to be transmitted to these devices is selected in advance while being assigned in advance to the device 24, the ultrasonic diagnostic device 30, the endoscope device 32, and the camera 34.
- the encryption processing unit 142 is configured to include cassette ID information, order information, and imaging conditions associated with the radiographic image, and an ultrasonic image.
- encryption processing using a public key or a secret key is performed on personal information or information regarded as the personal information, such as information related to the patient 16 associated with the optical image.
- the portable devices 120a and 120b and the display device 124 in the predetermined area can view public information or private keys (encryption keys) when they want to view various encrypted information (when they want to decrypt various kinds of information). Key) in advance (registration is required).
- the public key or the secret key is managed by the information management unit 152.
- pre-registration for example, a person who wants pre-registration (other medical personnel or the family of the patient 16) visits a nurse center of a medical institution, etc. What is necessary is just to acquire the encryption key for a decryption by performing the pre-registration process with respect to the portable devices 120a and 120b possessed by the applicant. In this case, since the nurse performs an authentication act on the applicant prior to pre-registration, it is possible to prevent a third party who is not involved in the operation of the patient 16 from performing pre-registration without permission.
- Pre-registration of the mobile devices 120a and 120b at the nurse center may be performed, for example, as described in (1) to (3) below.
- an electronic mail is transmitted from the portable devices 120a and 120b to the portable device 48.
- the mobile device 48 that has received the e-mail transmits a return e-mail attached with a decryption encryption key to the mobile devices 120a and 120b.
- the portable devices 120a and 120b can acquire the encryption key by receiving a reply e-mail. With the acquisition of the encryption key, pre-registration of the portable devices 120a and 120b with respect to the portable device 48 is completed.
- the mobile device 48 that has received an e-mail from the mobile devices 120a and 120b sends a reply e-mail attached with a two-dimensional barcode corresponding to the encryption key to the mobile device. It transmits to 120a, 120b.
- the portable devices 120a and 120b receive the return e-mail, the two-dimensional bar code is displayed on the screen.
- a decryption encryption key corresponding to the two-dimensional barcode can be acquired.
- the mobile device 48 that has received an e-mail from the mobile devices 120a and 120b sends a reply e-mail with a URL (Uniform Resource Locator) according to the encryption key. It transmits to portable device 120a, 120b.
- the portable devices 120a and 120b receive the reply e-mail, the contents of the e-mail are displayed on the screen.
- the decryption encryption key can be acquired from the URL.
- a device connected to a network such as a LAN is assigned a MAC (Media Access Control) address in advance, and the medical institution side pre-registers those who wish to pre-register (portable devices 120a and 120b). Since there is a possibility of grasping, the MAC addresses of these mobile devices 120a and 120b are registered in advance in the mobile device 48, and the decryption encryption key is stored in the mobile devices 120a and 120b in which the MAC addresses are registered from the mobile device 48. May be delivered.
- MAC Media Access Control
- the mobile devices 120 a and 120 b may receive the encryption key from the mobile device 48 instead of performing pre-registration with the mobile device 48.
- the mobile devices 120a and 120b may receive (download) the encryption key by performing wireless communication or infrared communication with the mobile device 48.
- the encryption key may be copied to a memory card or a USB memory, and the portable devices 120a and 120b may receive the encryption key from the memory card or the USB memory.
- the encryption key does not always have to be the same (fixed), and may be updated (changed) every time the portable device 48 performs terrestrial digital broadcasting, or one frame image is distributed. It may be updated every time.
- the mobile device 120a possessed by another medical staff acquires a public key or a secret key (encryption key) (the mobile device 120a performs pre-registration).
- a device that can remotely control the radiation output device 22, the radiation imaging device 24, the ultrasonic diagnostic device 30, the endoscope device 32, and the camera 34 is a portable device. 48 or console 52. That is, only the doctor 18 or the technician 54 has the authority to control the medical device by remote operation by operating the portable device 48 or the console 52.
- the image processing unit 144 performs predetermined image processing for displaying a moving image of a camera image, an ultrasonic image, an optical image, and a radiation image on the display unit 160.
- a moving image after image processing and various kinds of information associated with the moving image are stored in the image memory 146.
- the image processing unit 144 also performs processing for converting a moving image stored in the image memory 146 into a signal for terrestrial digital television broadcasting. Further, the image processing unit 144 also performs DICOM conversion on the above-described camera image.
- the display control unit 148 causes the display unit 160 of the touch panel 150 to display the moving image stored in the image memory 146 and various types of information associated with the moving image.
- the operation unit 162 is a widget (an operation image or an end image) such as an icon or a text box displayed on the display unit 160 of the touch panel 150, and is controlled by the doctor 18 operating the operation unit 162.
- the unit 132 performs various control processes. Further, due to the operation of the operation unit 162 by the doctor 18, the display control unit 148 controls the display unit 160 to display an image according to the operation content.
- the information management unit 152 manages the contents of the channel and command set by the transmission / reception setting unit 140 and the public key or secret key (encryption key) used for the encryption processing by the encryption processing unit 142 ( Remember.
- the operation control unit 154 is a medical device that performs a predetermined diagnosis or treatment on the patient 16, (1) the radiation output device 22 and the radiation imaging device 24, (2) the ultrasonic diagnostic device 30, and (3) endoscopy.
- the type of widget displayed on the display unit 160 is limited (limited) so that the doctor 18 can remotely control any one type of medical devices of the mirror device 32 via the operation unit 162. That is, since many medical devices are arranged narrowly in the operating room 12, in order to smoothly perform an operation on the patient 16, any one medical device is used without simultaneously using a plurality of medical devices. This is because it is preferable to use a device.
- the battery 156 supplies power to each unit in the portable device 48.
- console 52 will be described.
- components having the same names as those of the portable device 48 have substantially the same function.
- the console 52 and the portable device 48 can be switched to the master or the slave, when the console 52 is the master, it is necessary to exhibit the same function as the portable device 48 described above. Because.
- the communication unit 170 transmits and receives signals by wireless communication with the communication unit 130 of the portable device 48 via the antenna 68.
- the communication unit 170 causes the mobile device 48 to function as a repeater via the antenna 68, so that a moving image and various types of information associated with a predetermined area in the medical institution are real-time by digital terrestrial television broadcasting. It is also possible to distribute with.
- the communication unit 172 transmits and receives signals by wired communication with the control unit 108 of the radiation output device 22, the controller 102, the communication unit 94 of the radiation imaging apparatus 24, and the display device 36.
- the control unit 174 controls each unit in the console 52.
- the order information storage unit 176 stores order information
- the shooting condition storage unit 178 stores shooting conditions.
- the switching processing unit 180 switches the console 52 or the portable device 48 to a master or a slave.
- the transmission / reception setting unit 182 communicates with the communication unit 130 of the portable device 48, the communication unit 130 of the portable device 48, the communication unit 100 of the radiation imaging apparatus 24, the communication unit 170 of the console 52, A channel for performing wireless communication by multiple connection among the ultrasound diagnostic apparatus 30, the endoscope apparatus 32, and the camera 34 is set in advance.
- the transmission / reception setting unit 140 selects in advance the contents of commands transmitted from the console 52 to the radiation imaging apparatus 24, the radiation output apparatus 22, the ultrasonic diagnostic apparatus 30, the endoscope apparatus 32, and the camera 34. These setting contents and selection contents are stored (managed) in the information management unit 198.
- the encryption processing unit 184 When the digital terrestrial television broadcast is performed in real time from the communication unit 170 via the portable device 48 to the predetermined area, the encryption processing unit 184 performs a public key or a secret key on the personal information of the patient 16 described above. Encryption processing is performed using (encryption key).
- the public key or the secret key is stored in the information management unit 198.
- the image processing unit 186 performs predetermined image processing for displaying a moving image of a camera image, an ultrasonic image, an optical image, and a radiation image on the display unit 192.
- the image processing unit 144 also performs DICOM conversion on the camera image.
- the moving image after the image processing and various kinds of information associated with the moving image are stored in the image memory 188. Further, the image processing unit 186 performs processing for converting the moving image stored in the image memory 188 into a signal for digital terrestrial television broadcasting.
- the display control unit 190 causes the display unit 192 to display the moving image stored in the image memory 188 and various types of information associated with the moving image.
- the display control unit 190 can cause the display unit 192 to display the same content as the display content displayed on the display unit 160 of the touch panel 150 described above.
- the operation unit 194 of the console 52 is a keyboard or a mouse, and the doctor 18 or the engineer 54 operates the keyboard or mouse (operation unit 194) while viewing the display content of the display unit 192.
- the control unit 174 performs various control processes according to the operation content of the operation unit 194 by the doctor 18 or the technician 54. Further, due to the operation of the operation unit 194 by the doctor 18 or the engineer 54, the display control unit 190 controls the display unit 192 so as to display an image corresponding to the operation content.
- the information management unit 198 manages the contents of the channel and command set by the transmission / reception setting unit 182 and the public key or secret key (encryption key) used for the encryption processing by the encryption processing unit 184. (Remember.
- the operation control unit 199 is a medical device that performs a predetermined diagnosis or treatment on the patient 16, (1) the radiation output device 22 and the radiation imaging device 24, (2) the ultrasonic diagnostic device 30, and (3) internal vision.
- the type of widget displayed on the display unit 192 is limited (restricted) so that the doctor 18 or the technician 54 can remotely control any one type of medical device of the mirror device 32 via the operation unit 194. .
- the exposure switch 196 is an exposure button for starting the irradiation of the radiation 20.
- the control unit 174 synchronizes the start of the output of the radiation 20 from the radiation source 106 with the detection of the radiation 20 in the radiation conversion panel 80 and the conversion to the radiation image.
- a synchronous control signal for performing fluoroscopic imaging of the imaging region of the patient 16 is generated. Therefore, the console 52 transmits a command corresponding to the synchronization control signal to the control unit 108 and also transmits it to the radiation imaging apparatus 24 via the controller 102.
- FIG. 5 illustrates a state where the doctor 18 operates the portable device 48 of the tablet PC.
- the portable device 48 is used in a state of being sealed in the sterilization bag 200.
- a moving image 202 (radiation image) of the patient 16 and an icon 204 for the doctor 18 to operate are displayed on the display unit 160 of the touch panel 150.
- the first characteristic function is to change the imaging conditions that occur after the start of fluoroscopic imaging and to perform operations such as positioning of the patient 16 quickly and accurately, after the start of fluoroscopic imaging,
- the console 52 is switched to each slave.
- the second characteristic function is to allow the portable device 48 at hand to function as a remote controller for each medical device so that the doctor 18 in the operating room 12 can remotely control various medical devices.
- the third characteristic function is related to the patient 16 in the operating room 12 toward the family of the patient 16 and the medical staff (the portable devices 120a and 120b and the display device 124 possessed by the patient 16) in the predetermined area.
- a moving image or the like is distributed in real time by terrestrial digital television broadcasting.
- the switching processing unit 180 (see FIG. 4) of the console 52 performs the radiation output device 22 and the radiation imaging device 24 (see FIGS. 1 and 2).
- the console 52 is maintained at the console 52 and the portable device 48 is maintained as a slave. That is, when an instruction to start fluoroscopic imaging for the patient 16 is received verbally from the operating doctor 18, the technician 54 needs to operate the console 52 to perform operations such as setting imaging conditions. This is because the console 52 needs to be a master until the start.
- the switching processing unit 180 determines the relationship between the master and the slave before the start of fluoroscopic imaging.
- the switching processing unit 138 (see FIG. 3) of the portable device 48 may be notified from 170 by wireless communication. Thereby, the portable device 48 can recognize that it is a slave before the start of fluoroscopic imaging.
- the control unit 132 controls the radiation output device 22 and the radiation imaging device 24 based on the notification content so that the portable device 48 does not function as a master (due to the operation of the touch panel 150 by the doctor 18). Control each part in the portable device 48.
- the control unit 174 After the preparation for fluoroscopic imaging is completed, the control unit 174 generates a synchronization control signal due to the operation of the exposure switch 196 by the technician 54, and the radiation output device 22 and the radiographic imaging via the communication unit 172.
- the switching processing unit 180 determines that the fluoroscopic imaging has started, and switches the console 52 to the slave based on the determination result, and sets the portable device 48 to the master. Switch.
- the switching processing unit 180 notifies the switching processing unit 138 of the portable device 48 that the master has been switched by wireless communication from the communication unit 170. Accordingly, the mobile device 48 can recognize that the mobile device 48 has been switched to the master after the start of fluoroscopic imaging, and the control unit 132 can function as the master based on the notification content. Each part in the portable device 48 is controlled. As a result, the doctor 18 can control the radiation output apparatus 22 and the radiation imaging apparatus 24 by operating the portable device 48 at hand.
- the control unit 174 prevents the console 52 from functioning as a master (the console 52 causes the radiation output device 22 and the radiation imaging device 24 to be caused by the operation of the operation unit 194 by the engineer 54). Control each part in the console 52 so as not to control.
- FIG. 6A illustrates the display content of the display unit 160 of the touch panel 150 during fluoroscopic imaging.
- a moving image 210 of the patient 16 is displayed, and two icons 212 and 214 and a personal information display area 216 in which the name and ID of the patient 16 and imaging conditions are displayed are displayed.
- the icon 212 is an operation icon for temporarily stopping (interrupting) fluoroscopic imaging
- the icon 214 is an operation icon (ending icon) for ending fluoroscopic imaging.
- the moving image 210 is, for example, a radiographic image obtained by photographing the state of entry of the catheter 222 inserted into the blood vessel 220 of the patient 16, and the catheter 222 progresses in the blood vessel 220 aiming at the stenosis portion 224. .
- the display control unit 148 displays the icons 212 and 214 and the personal information display area 216 so as to avoid the display positions of the blood vessel 220, the catheter 222, and the stenosis portion 224.
- the display positions of the icons and the personal information display area are appropriately changed according to the content of the moving image displayed on the screen of the display unit 160.
- the doctor 18 may operate the icon 214 (the icon 214 may be touched). Due to the operation of the icon 214 by the doctor 18, the control unit 132 transmits a command instructing the radiography apparatus 24 (see FIGS. 1 and 2) to end fluoroscopic imaging by wireless communication via the communication unit 130. At the same time, the command is transmitted to the radiation output device 22 via the console 52. As a result, the control unit 108 stops the output of the radiation 20 from the radiation source 106 based on the received command.
- the switching processing unit 138 determines that the fluoroscopic imaging has ended, and determines the portable device 48 based on the determination result.
- the slave and console 52 are switched to the master. Further, the switching processing unit 138 notifies the switching processing unit 180 (see FIG. 4) of the console 52 by wireless communication from the communication unit 130 that the master has been switched.
- the console 52 can recognize that it has been switched to the master by the end of fluoroscopic imaging, and the engineer 54 can control the radiation output device 22 and the radiation imaging device 24 by operating the console 52. Become.
- the control unit 132 controls each part in the portable device 48 so that the portable device 48 does not function as a master.
- the doctor 18 resets the imaging conditions or the patient 16.
- the fluoroscopic imaging is temporarily stopped (interrupted), and the icon 212 indicating the pause of the fluoroscopic imaging is operated (touching the icon 212).
- control unit 132 transmits a command for instructing the temporary stop of the irradiation of the radiation 20 from the communication unit 130 to the radiation imaging apparatus 24 by wireless communication and also to the radiation output apparatus 22 through the console 52. Therefore, the control unit 108 interrupts the output of the radiation 20 from the radiation source 106 based on the received command.
- the switching processing unit 138 maintains the portable device 48 as a master even when fluoroscopic imaging is interrupted.
- FIG. 6B illustrates the display content of the display unit 160 in a time period when fluoroscopic imaging is interrupted.
- a moving image 210 is displayed on the screen of the display unit 160, and a personal information display area 216, an icon 226, and a text box display area 228 are displayed.
- the icon 226 is an operation icon for resuming the fluoroscopic imaging that has been interrupted.
- the text box display area 228 is a widget for changing the photographing conditions for fluoroscopic photography. That is, in the text box display area 228, a text box for changing the tube voltage and tube current of the radiation source 106 and the irradiation time of the radiation 20, which are imaging conditions, and “OK” for confirming the change contents of the text box. "Button and a" correction "button for correcting or canceling the changed contents.
- the doctor 18 may input a desired condition in each text box and press the “OK” button.
- the imaging conditions changed by the operation of the doctor 18 are stored in the imaging condition storage unit 136.
- the display control unit 148 controls the display unit 160 so that the shooting conditions displayed in the personal information display area 216 are switched to the changed contents.
- the technician 54 positions the patient 16, the imaging condition is not changed in the text box display area 228.
- the control unit 132 transmits a command for restarting the irradiation of the radiation 20 (based on the changed imaging condition) from the communication unit 130 to the radiation imaging apparatus 24 by wireless communication. And transmitted to the radiation output device 22 via the console 52. Accordingly, the control unit 108 restarts the output of the radiation 20 from the radiation source 106 (according to the changed imaging condition) based on the received command.
- the switching processing units 138 and 180 of the master device the portable device 48 or the console 52
- the switching processing units 138 and 180 of the slave can also perform switching processing.
- 6A and 6B is transmitted from the portable device 48 to the console 52 by wireless communication, or the doctor 18 operates the portable device 48 to change the changed imaging conditions from the portable device 48.
- the same display content as the display unit 160 of the touch panel 150 is displayed on the display unit 192 of the console 52, and the changed imaging condition is also stored in the imaging condition storage unit 178.
- the doctor 18 in order to perform a predetermined diagnosis or treatment on the patient 16, the doctor 18 operates the portable device 48 at hand so that the sterilization level is higher than the surgical instrument used by the doctor 18.
- the radiological output device 22 and the radiographic imaging device 24, the ultrasonic diagnostic device 30, or the various medical devices of the endoscopic device 32 that are low (the doctor 18 cannot directly operate) are controlled by remote control. .
- the transmission / reception setting unit 140 of the mobile device 48 includes the communication unit 130, each medical device, the camera 34, and the console 52.
- a predetermined channel is set for these devices, and the contents of commands transmitted from the portable device 48 to each device are selected in advance. The contents of these channels and commands are managed by the information management unit 152.
- FIGS. 7A to 9B illustrate a case where the doctor 18 (see FIGS. 1 and 5) controls each medical device by operating the touch panel 150 of the portable device 48 in order to perform a predetermined diagnosis or treatment on the patient 16.
- the display content of the display unit 160 is illustrated. These display contents are displayed on the display unit 160 by the display control unit 148 based on an instruction (notification) from the operation control unit 154 (see FIG. 3).
- FIG. 7A illustrates the display contents of the display unit 160 of the touch panel 150 when controlling the radiation output device 22 and the radiation imaging device 24 (see FIGS. 1 and 2) in order to acquire a radiation image of the patient 16. It is a thing.
- a moving image 210 On the screen of the display unit 160, a moving image 210, icons 212 and 214, and a personal information display area 216 are displayed, and three icons 230, 232, and 234 are also displayed.
- the icon 230 is an operation icon for changing the imaging conditions for fluoroscopic imaging.
- the icon 232 is a selection icon for the doctor 18 to select when controlling the ultrasonic diagnostic apparatus 30.
- the icon 234 is a selection icon for the doctor 18 to select when controlling the endoscope apparatus 32.
- the display content related to fluoroscopic imaging is displayed on the screen of the display unit 160.
- An icon 232 for selecting the ultrasonic diagnostic apparatus 30 and an icon 234 for selecting the endoscope apparatus 32 are displayed in broken lines so that they cannot be selected.
- the operation control unit 154 displays the icon of the icons 212, 214, and 230 that can be operated in FIG. 7A because the content of the diagnosis or treatment currently performed on the patient 16 is acquisition of the radiation image of the patient 16.
- the display control unit 148 displays the icons 232 and 234 in broken lines on the screen of the display unit 160 according to the notification content.
- the icons 212, 214, and 230 related to the radiation output device 22 and the radiation imaging device 24 to be controlled (operation objects) are displayed larger than the icons 232 and 234 that cannot be selected.
- the operation control unit 154 determines that the operation of the icon 230 of the doctor 18 is valid, and notifies the display control unit 148 of the determination result.
- the display control unit 148 causes the display unit 160 to display the display content of FIG. 6B according to the notification content. Thereby, the doctor 18 can change the imaging condition, and the radiation output device 22 and the radiation imaging device 24 can be controlled from the portable device 48.
- the operation control unit is operated when the icon 230 is operated without operating the icon 212 indicating that fluoroscopic imaging is paused. 154 notifies the control unit 132 of the determination result, and the control unit 132 interrupts the fluoroscopic imaging to the radiation imaging apparatus 24 and the console 52 (via the radiation output apparatus 22 via the communication unit 130) according to the notification content. A command for instructing is sent.
- the operation control unit 154 determines that the operation content by the doctor 18 is invalid, and notifies the display control unit 148 of the determination result.
- the display control unit 148 continues the screen display of FIG. 7A according to the notification content.
- the operation control unit 154 determines that the operation of the icon 230 of the doctor 18 is valid and determines that the operation is an instruction to end the fluoroscopic imaging, and these determination results Is notified to the display control unit 148 and the control unit 132.
- the control unit 132 transmits a command for instructing the end of fluoroscopic imaging to the radiographic imaging device 24 and the console 52 (via the radiation output device 22) via the communication unit 130 in accordance with the notification content, and fluoroscopic imaging. End.
- the display control unit 148 switches the display content of the display unit 160 from FIG. 7A to FIG. 7B according to the notification content.
- the display unit 160 displays a moving image 210, a personal information display area 216, and three icons 232 to 236.
- the two icons 232 and 234 are switched from the broken line display to the solid line display.
- the icon 236 is a selection icon for the doctor 18 to select when controlling the radiation output apparatus 22 and the radiation imaging apparatus 24.
- icons 232 to 236 corresponding to all the medical devices are displayed on the display unit 160 in a selectable manner. Is done. Therefore, if the doctor 18 operates the icon 232, the ultrasound diagnostic apparatus 30 can be controlled, if the icon 234 is operated, the endoscope apparatus 32 can be controlled, and if the icon 236 is operated, the radiation output apparatus 22 and The radiation imaging apparatus 24 can be controlled.
- the operation control unit 154 determines that the operation of the icon is valid, and next determines the medical device corresponding to the icon.
- the control unit 132 and the display control unit 148 are notified of the determination results.
- the control unit 132 notifies the medical device that control from the portable device 48 is performed via the communication unit 130 in accordance with the notification content.
- the display control part 148 switches the display content of the display part 160 to the display content according to the said medical device according to the said notification content.
- FIG. 8A illustrates the display contents of the display unit 160 of the touch panel 150 when the ultrasonic diagnostic apparatus 30 is controlled for the purpose of acquiring an ultrasonic image of the patient 16.
- the moving image 240 includes the organ 254 of the patient 16.
- the icon 242 is an operation icon for temporarily stopping (interrupting) the moving image shooting of the ultrasonic image
- the icon 244 is an operation icon for ending the moving image shooting.
- the name and ID of the patient 16 the maximum depth that can be measured by the ultrasonic diagnostic apparatus 30, the sound output, the ultrasonic frequency, and the ultrasonic wave that changes by controlling the ultrasonic pulse.
- An image display method normal or tissue harmonic imaging B mode, color Doppler, etc.
- 8A and 8B show a case where the name and ID of the patient 16 and the ultrasonic frequency are displayed in the personal information display area 246 as an example.
- the icon 248 is an operation icon for changing the shooting condition (for example, ultrasonic frequency) of the moving image shooting.
- the icon 250 is a selection icon for the doctor 18 to select when controlling the radiation output apparatus 22 and the radiation imaging apparatus 24, and the icon 252 is selected by the doctor 18 when controlling the endoscope apparatus 32. This is an icon for selection.
- FIG. 8A in order to control the ultrasound diagnostic apparatus 30 for the purpose of acquiring an ultrasound image of the patient 16, display contents related to the imaging of the ultrasound image are displayed on the screen of the display unit 160.
- the icons 250 and 252 are displayed in broken lines so that they cannot be selected.
- the operation control unit 154 displays icons that can be operated in FIG. 8A as the icons 242, 244, because the diagnosis or treatment currently performed on the patient 16 is acquisition of an ultrasound image of the patient 16.
- the display control unit 148 notifies the display control unit 148 of the limitation to 248, and the display control unit 148 displays the icons 250 and 252 in broken lines on the screen of the display unit 160 according to the notification content.
- the icons 242, 244 and 248 related to the ultrasonic diagnostic apparatus 30 to be operated are displayed larger than the icons 250 and 252 that cannot be selected.
- the operation control unit 154 determines that the operation of the icon 248 is valid, and notifies the display control unit 148 of the determination result.
- the display control unit 148 causes the display unit 160 to display display contents for changing the imaging conditions of the ultrasound diagnostic apparatus 30 according to the notification contents. Thereby, the doctor 18 can change the imaging conditions, and the ultrasonic diagnostic apparatus 30 can be controlled from the portable device 48.
- the operation is performed when the icon 248 is operated without operating the icon 242 indicating the pause of the video shooting.
- the control unit 154 notifies the control unit 132 of the determination result, and causes the ultrasound diagnostic apparatus 30 to transmit a command for instructing interruption of moving image shooting from the control unit 132 via the communication unit 130.
- the operation control unit 154 determines that the operation content by the doctor 18 is invalid and notifies the display control unit 148 of the determination result.
- the operation control unit 154 determines that the operation of the icon 244 of the doctor 18 is valid and determines that the operation is an instruction to end the video shooting, and the determination results thereof. Is notified to the display control unit 148 and the control unit 132. In accordance with the notification contents, the control unit 132 transmits a command for instructing the end of the moving image shooting to the ultrasonic diagnostic apparatus 30 via the communication unit 130 to end the moving image shooting.
- the display control unit 148 switches the display content of the display unit 160 from FIG. 8A to FIG. 8B according to the notification content.
- the display unit 160 displays a moving image 240, a personal information display area 246, and three icons 250, 252, and 256.
- the two icons 250 and 252 are switched from the broken line display to the solid line display.
- the icon 256 is a selection icon for the doctor 18 to select when controlling the ultrasonic diagnostic apparatus 30.
- the icons 160, 252 and 256 corresponding to all the medical devices are displayed on the display unit 160. Displayed as selectable. Therefore, when the doctor 18 operates any one of the icons, the operation control unit 154 controls the medical device corresponding to the operated icon next, and the display content corresponding to the medical device is displayed on the display unit 160. The control unit 132 and the display control unit 148 are controlled so as to be displayed.
- FIG. 9A illustrates the display content of the touch panel 150 when the endoscope apparatus 32 is controlled for the purpose of acquiring an optical image of the patient 16.
- the moving image 260 shows a state in which a tissue 280 such as a polyp is collected using a forceps 278 provided at the distal end portion of the fiberscope 276 inserted into the digestive organ 274 of the patient 16.
- the icon 262 is an operation icon for temporarily stopping (interrupting) the moving image shooting of the optical image
- the icon 264 is an operation icon for ending the moving image shooting.
- the icon 268 is an operation icon for changing the shooting conditions of the moving image shooting (for example, the pressure of air sent into the digestive organ 274, the magnification of the optical image).
- the icon 270 is a selection icon for selecting when controlling the radiation output apparatus 22 and the radiation imaging apparatus 24, and the icon 272 is a selection icon for selecting when controlling the ultrasonic diagnostic apparatus 30. is there.
- the display content related to moving image shooting of the optical image is displayed on the screen of the display unit 160.
- Icons 270 and 272 are displayed in broken lines so that they cannot be selected.
- the operation control unit 154 displays the icon of the icon that can be operated in FIG. 9A because the contents of the diagnosis or treatment currently performed on the patient 16 are acquisition of an optical image of the patient 16 and collection of the tissue 280. 262, 264, and 268 are notified to the display control unit 148, and the display control unit 148 displays the icons 270 and 272 in broken lines on the screen of the display unit 160 according to the notification content.
- the icons 262, 264, 268 related to the endoscope device 32 to be operated are displayed larger than the icons 270, 272 that cannot be selected.
- the operation control unit 154 determines that the operation of the icon 268 is valid, and notifies the display control unit 148 of the determination result.
- the display control unit 148 causes the display unit 160 to display display contents for changing the imaging conditions of the endoscope apparatus 32 in accordance with the notification contents. Thereby, the doctor 18 can change the imaging condition, and the endoscope apparatus 32 can be controlled from the portable device 48.
- the control unit 154 notifies the control unit 132 of the determination result, and causes the endoscope device 32 to transmit a command for instructing interruption of moving image shooting from the control unit 132 via the communication unit 130.
- 9A when the doctor 18 erroneously operates the icons 270 and 272, the operation control unit 154 determines that the operation content by the doctor 18 is invalid, and notifies the display control unit 148 of the determination result.
- the operation control unit 154 determines that the operation of the icon 264 of the doctor 18 is valid, determines that the operation is an instruction to end the video shooting, and the determination results thereof. Is notified to the display control unit 148 and the control unit 132. In accordance with the notification content, the control unit 132 transmits a command for instructing the end of the moving image shooting to the endoscope apparatus 32 via the communication unit 130 to end the moving image shooting.
- the display control unit 148 switches the display content of the display unit 160 from FIG. 9A to FIG. 9B according to the notification content.
- a moving image 260, a personal information display area 266, and three icons 270, 272, and 282 are displayed on the display unit 160.
- the two icons 270 and 272 are switched from the broken line display to the solid line display.
- the icon 282 is a selection icon for the doctor 18 to select when controlling the endoscope apparatus 32.
- the display unit 160 has icons 270, 272, and 282 corresponding to all the medical devices. Displayed as selectable. Therefore, when the doctor 18 operates any one of the icons, the operation control unit 154 controls the medical device corresponding to the operated icon next, and the display content corresponding to the medical device is displayed on the display unit 160. The control unit 132 and the display control unit 148 are controlled so as to be displayed.
- the control unit 132 since the signal can be transmitted and received by wireless communication between the portable device 48 and the console 52, the control unit 132 communicates the display content of the display unit 160 of the touch panel 150.
- the display control unit 190 of the console 52 can display the received display content on the display unit 192.
- the display control unit 190 of the console 52 can transmit the display content to the console 52 (see FIGS. 1, 2, and 4) by wireless communication.
- the console 52 includes a transmission / reception setting unit 140, a display control unit 148, an information management unit 152 and an operation control unit 154 that have the same functions as the transmission / reception setting unit 182, the display control unit 190, the information management unit 198, and the operation control unit 199. It is also possible to control each medical device in the operating room 12 by providing each and operating the operation unit 194 by the doctor 18 or the technician 54.
- the third characteristic function first, before an operation is performed on the patient 16 in the operating room 12, information management is performed on a public key or a secret key (encryption key) necessary for the encryption processing in the encryption processing unit 142.
- the encryption key is stored in the unit 152 and is also acquired in advance by the portable device 120a possessed by another medical person in the medical institution.
- the camera 34 captures an image of the entire operating room 12 (for example, an image obtained by bird's-eye view of the operating room 12) or a part of the operating room 12 (for example, a situation of surgery performed on the patient 16 by the doctor 18).
- a camera image is acquired, and the camera image is transmitted to the portable device 48 by wireless communication.
- the radiographic apparatus 24 starts to acquire a radiographic image of fluoroscopic imaging
- the radiographic apparatus 24 transmits the radiographic image to the portable device 48 by wireless communication or transmits the radiographic image to the portable device 48 via the optical fiber cable 58 and the console 52.
- the ultrasonic diagnostic apparatus 30 transmits the ultrasonic image to the portable device 48 by wireless communication.
- the endoscope apparatus 32 acquires an optical image
- the endoscope apparatus 32 transmits the optical image to the portable device 48 by wireless communication.
- these pieces of information are also transmitted from each device to the portable device 48.
- the encryption processing unit 142 of the portable device 48 receives the above-described moving image (camera image, radiation image, ultrasonic image, optical image) and associated information
- the encryption processing unit 142 performs processing on the associated information.
- the image processing unit 144 converts the moving image into a signal for terrestrial digital television broadcasting.
- the encrypted information and the moving image processed for terrestrial digital television broadcast are distributed in real time by terrestrial digital television broadcast from the communication unit 130 toward a predetermined area in the medical institution.
- FIG. 10A illustrates the display content displayed on the display unit 290a of the portable device 120a (see FIG. 2) possessed by a medical person in the predetermined area.
- FIG. 10B illustrates the display content displayed on the display unit 290b of the portable device 120b possessed by the family of the patient 16 in the predetermined area or the display unit 292 of the display device 124 arranged in the predetermined area. It is a thing.
- the portable device 120a possessed by the medical staff since the portable device 120a possessed by the medical staff has acquired the encryption key in advance, when receiving a moving image and various information encrypted by digital terrestrial television broadcasting, Information (information linked to a moving image) is decoded. Thereby, the moving image 210 is displayed on the screen of the display unit 290a, and the decrypted information can be displayed in the personal information display area 216.
- the portable device 120b and the display device 124 possessed by the family of the patient 16 have not acquired the encryption key, even if a moving image and various types of information encrypted by digital terrestrial television broadcasting are received, the encryption Therefore, only the moving image 210 is displayed on the screens of the display units 290b and 292.
- the control unit 132 can transmit the moving image and the video distributed by the terrestrial digital television broadcast.
- Various types of encrypted information may be transmitted from the communication unit 130 to the console 52 by wireless communication.
- the display control unit 190 of the console 52 performs a decryption process on the various encrypted information, and stores the decrypted information and the moving image. It can also be displayed on the display unit 192.
- the console 52 is provided with an encryption processing unit 184 and an image processing unit 186 having the same functions as the encryption processing unit 142 and the image processing unit 144, respectively, and information for terrestrial digital television broadcasting (moving images, encrypted images) If various types of information) are generated by the console 52 and the portable device 48 functions as a repeater, the digital terrestrial television broadcast can be distributed in real time from the console 52 to the predetermined area via the portable device 48. Become.
- FIG. 11 refers to the entire operation of the medical system 10 when the console 52 maintains the master from the start to the end of fluoroscopic imaging. Therefore, in FIG. 11, a case will be described in which fluoroscopic imaging starts or ends due to the engineer 54 operating the console 52 in response to an instruction from the doctor 18.
- FIGS. 11 to 14 a case will be described in which moving images and various types of information are distributed in real time from the portable device 48 to a predetermined area by terrestrial digital television broadcasting.
- step S ⁇ b> 1 of FIG. 11 communication settings between devices used in the medical system 10 are performed prior to surgery on the patient 16 (see FIGS. 1 and 2).
- the transmission / reception setting unit 140 (see FIG. 3) of the portable device 48 includes a communication unit 130 of the portable device 48, a communication unit 100 of the radiation imaging apparatus 24, a communication unit 170 of the console 52 (see FIG. 4), a camera. 34, the radiography apparatus 24, the ultrasonic diagnostic apparatus 30, the endoscopic apparatus 32, the camera 34, and the console 52 are used to perform wireless communication by multiple connection between the ultrasonic diagnostic apparatus 30 and the endoscopic apparatus 32. Assign a predetermined channel.
- the transmission / reception setting unit 140 also selects a command to be transmitted to these devices.
- the transmission / reception setting unit 140 notifies the portable device 120a possessed by another medical staff by a public key or a secret key (encryption key) used for the encryption processing by the encryption processing unit 142. , Pre-registration of the portable device 120a is performed.
- the allocated channel, the selected command, and the encryption key are managed by the information management unit 152.
- the camera 34 starts imaging in the operating room 12 in the next step S2.
- a moving image (camera image for at least one frame) of the operating room 12 photographed by the camera 34 is sequentially transmitted to the portable device 48 by wireless communication.
- the image processing unit 144 of the portable device 48 performs processing for converting the received camera image into a signal for terrestrial digital television broadcasting, and stores the processed camera image in the image memory 146.
- the control unit 132 starts distributing the camera image stored in the image memory 146 from the communication unit 130 to a predetermined area in real time by digital terrestrial television broadcasting.
- the portable devices 120a and 120b and the display device 124 in the predetermined area receive the camera images and display them on the display units 290a, 290b, and 292, respectively.
- other medical personnel and the family of the patient 16 can grasp the current state of the operating room 12 by viewing the display contents of the display units 290a, 290b, and 292.
- the portable device 48 broadcasts only the camera image of the operating room 12 and does not distribute the personal information of the patient 16, only the video of the operating room 12 is displayed on the display units 290a, 290b, and 292.
- camera images distributed in real time by digital terrestrial television broadcasting are also displayed on the display unit 160 of the portable device 48.
- the console 52 can also receive a camera image and display the camera image on the display unit 192 or the display device 36.
- the operation of the patient 16 by the doctor 18 is started.
- the camera 34 continues to shoot the operating room 12
- the camera image is distributed in real time by digital terrestrial television broadcasting, so that the operation pattern for the patient 16 in the operating room 12 can be changed to the portable devices 120a and 120b.
- the display units 290a and 290b are displayed on the display units 290a and 290b, the display unit 292 of the display device 124, the display unit 160 of the portable device 48, the display unit 192 of the console 52, and the display device 36, respectively.
- each of the mobile devices 120a and 120b and the display device 124 is only authorized to receive a camera image distributed from the mobile device 48 and display it on the display units 290a, 290b, and 292. Therefore, it is not possible to remotely control each medical device in the operating room 12 from the portable devices 120a and 120b and the display device 124 side via the portable device 48.
- the doctor 18 instructs the technician 54 to start fluoroscopic imaging verbally when it is determined that fluoroscopic imaging on the patient 16 is necessary.
- the engineer 54 operates the operation unit 194 of the console 52 in response to an instruction from the doctor 18.
- the control unit 174 acquires the order information from the RIS 112 or the HIS 114, and stores the acquired order information in the order information storage unit 176 (step S4).
- step S ⁇ b> 5 due to the operation of the operation unit 194 by the technician 54, the control unit 174 is based on the imaging region and imaging method of the patient 16 and the information of the radiation output device 22 and the radiation imaging device 24 included in the order information. Then, imaging conditions (tube voltage, tube current, irradiation time) for irradiating the imaging region of the patient 16 from the radiation source 106 of the radiation output device 22 are set, and the set imaging conditions and order information are imaged. Store in the condition storage unit 178.
- step S6 the technician 54 positions the imaging region of the patient 16 with respect to the radiation output device 22 and the radiation imaging device 24 after inserting the radiation imaging device 24 between the patient 16 and the operating table 14.
- control unit 108 of the radiation output device 22 requests the console 52 to transmit imaging conditions and the like, and the control unit 132 receives the imaging conditions based on the transmission request of the radiation output device 22 received via the communication unit 172.
- the imaging conditions stored in the storage unit 178 are transmitted to the control unit 108 via the communication unit 172.
- the cassette control unit 82 transmits order information and the like to the console 52 via the communication unit 94.
- the control unit 132 transmits the order information and the imaging conditions stored in the imaging condition storage unit 178 to the radiation imaging apparatus 24 via the communication unit 172 based on the transmission request of the cassette control unit 82 received via the communication unit 172.
- the cassette control unit 82 stores the order information and imaging conditions received via the communication unit 94 in the information storage unit 88.
- each pixel reaches a state where the radiation 20 can be converted into charges and stored.
- the control unit 132 when power is supplied from the battery 156 of the portable device 48 to each unit of the portable device 48, the control unit 132 also requests the console 52 to transmit order information and the like via the communication unit 130. Based on the transmission request of the control unit 132 received via the communication unit 170, the control unit 132 transmits the order information and the shooting conditions stored in the shooting condition storage unit 178 to the portable device 48 via the communication unit 170.
- the control unit 132 stores the order information received via the communication unit 130 in the order information storage unit 134 and also stores the order information and imaging conditions in the imaging condition storage unit 136.
- the control unit 174 synchronizes the start of the output of the radiation 20 from the radiation source 106 with the detection of the radiation 20 in the radiation conversion panel 80 and the conversion to the radiation image, whereby the imaging part of the patient 16 is detected.
- a synchronization control signal for executing radiography is generated.
- the control unit 174 transmits the generated synchronization control signal (command) to the radiation output device 22 via the communication unit 172, and transmits the communication unit 170 to the radiation imaging apparatus 24 and the portable device 48 by wireless communication.
- the control unit 108 of the radiation output device 22 receives the synchronization control signal, the radiation 20 having a predetermined dose is directed from the radiation source 106 toward the imaging region of the patient 16 for a predetermined irradiation time according to the imaging conditions. Irradiate (step S7).
- the radiation 20 passes through the imaging part of the patient 16 and reaches the radiation conversion panel 80 in the radiation imaging apparatus 24.
- the radiation 20 is directly converted into electric charges by the radiation conversion layer made of a-Se or the like and accumulated in each pixel.
- the radiation 20 is once converted into fluorescence by the scintillator, and the fluorescence is converted into electric charge and accumulated by the photoelectric conversion element of each pixel.
- the cassette control unit 82 receives the synchronization control signal via the communication unit 94, by supplying the control signal to the radiation conversion panel 80, the charge corresponding to the radiation image of the patient 16 accumulated in each pixel. Is read out as an electrical signal. That is, the cassette control unit 82 sequentially reads out the charges of the pixels arranged in a matrix for each line, and temporarily stores an electric signal corresponding to the read charges in the frame memory 84 as a radiation image for one frame (step S8).
- the association processing unit 90 associates the radiation image for one frame stored in the frame memory 84 with the cassette ID information, order information, and imaging conditions stored in the information storage unit 88.
- the linked radiation image, cassette ID information, order information, and imaging conditions are stored in the image storage unit 86 (step S10).
- step S11 the cassette control unit 82 transfers the radiographic image, cassette ID information, order information, and imaging conditions stored in the image storage unit 86 to the controller 102 via the communication unit 94 and the optical fiber cable 58a, and the signal.
- the data is output to the processing unit 98.
- the signal processing unit 98 performs a predetermined thinning process on the radiographic image to generate a thinned image
- the communication unit 100 wirelessly communicates the thinned image, cassette ID information, order information, and imaging conditions with the portable device 48. Send to.
- the control unit 132 displays the thinned image. Then, the associated various information is stored in the image memory 146, and the display control unit 148 causes the display unit 160 to display the thinned image and the associated various information stored in the image memory 146 (step S12). .
- the doctor 18 can immediately grasp the state of the imaging region of the patient 16 by looking at the display content of the display unit 160.
- the controller 102 stores the radiographic image received via the optical fiber cable 58a and various types of information (cassette ID information, order information, and imaging conditions) associated with the radiographic image in the storage unit 104, The data is transmitted to the console 52 via the fiber cable 58b.
- the control unit 174 of the console 52 receives the radiation image and the various types of information associated with each other via the communication unit 172, the control unit 174 stores the image in the image memory 188 and displays the information on the display unit 192 (step S12).
- the engineer 54 can grasp the state of the imaging region of the patient 16, the image quality of the radiation image, and the like by looking at the display content of the display unit 192.
- control unit 174 of the console 52 transfers the radiographic image stored in the image memory 188 and various associated information to the portable device 48 via the communication unit 170 by wireless communication.
- the control unit 132 images the received radiation image and various types of associated information.
- the display control unit 148 controls the display unit 160 so as to display the regular radiation image and various pieces of associated information instead of the thinned image and various pieces of associated information (step S12).
- the doctor 18 can grasp the detailed situation of the imaging region of the patient 16 and the image quality of the radiation image by looking at the display unit 160.
- the image processing unit 144 converts the radiographic image into a signal for digital terrestrial television broadcasting, while the encryption processing unit 142 uses the encryption key managed by the information management unit 152 to convert the radiographic image into a radiographic image. Encryption processing is performed on various types of linked information.
- the control unit 132 stores the radiographic image for digital terrestrial television broadcasting and various kinds of encrypted information in the image memory 146, and transmits the radiographic image from the communication unit 130 toward the predetermined area by digital terrestrial television broadcasting. And various encrypted information is distributed in real time. Note that the processing on the receiving side of the portable devices 120a and 120b and the display device 124 will be described in detail with reference to FIG.
- step S13 when the fluoroscopic imaging is continued (step S13: NO), the process returns to step S7, and the next radiation 20 is irradiated. Therefore, by repeating the processes of steps S7 to S13, a moving image (radiation images of a plurality of frames) of the imaging region of the patient 16 can be acquired.
- step S13 when the fluoroscopic imaging is terminated (step S13: YES), the doctor 18 instructs the technician 54 to end the fluoroscopic imaging verbally.
- the control unit 174 transmits a command for instructing the end of fluoroscopic imaging to the radiation output device 22 via the communication unit 172 and also via the communication unit 170.
- the command is transmitted to the radiation imaging apparatus 24 and the portable device 48 by wireless communication.
- the control unit 108 stops the output of the radiation 20 from the radiation source 106 based on the received command. Thereby, the distribution of the radiation image by the digital terrestrial television broadcast is completed.
- the technician 54 does not remove the radiation imaging apparatus 24 inserted between the patient 16 and the operating table 14, The current positioning state of the patient 16 is maintained.
- step S14 YES
- digital terrestrial television broadcasting is performed. Distribution of camera images is also terminated.
- step S20 of FIG. 12A immediately after the fluoroscopic imaging is started in step S7 of FIG. 11, the switching processing unit 180 (see FIG. 4) of the console 52 performs the radiation output device 22 and the radiation imaging device 24 (FIGS. 1 and 2).
- the master for controlling (see) is switched to the portable device 48, and the console 52 is switched to the slave.
- the switching processing unit 180 notifies the switching processing unit 138 (see FIG. 3) of the portable device 48 by wireless communication that the relationship between the master and the slave has been switched due to the start of fluoroscopic imaging. Therefore, the control unit 174 controls each part in the console 52 so that the engineer 54 does not operate even if the engineer 54 operates the operation unit 194 or the like (so that the operation by the engineer 54 becomes invalid).
- the control unit 132 controls each unit of the portable device 48 so that the doctor 18 can operate the portable device 48 based on the notification content. Therefore, after step S20, the medical system 10 performs the processing after step S8 in FIG.
- step S13 when the doctor 18 operates the icon 214 (see FIGS. 6A and 7A) or a command instructing the end of fluoroscopic imaging due to the operation of the icon 214 is performed by the radiation imaging apparatus 24 and
- step S21 of the next FIG. 12B the switching processing unit 138 of the master portable device 48 determines that the fluoroscopic imaging has ended, and the determination result is as follows. Based on this, the portable device 48 is switched to the slave and the console 52 is switched to the master. Next, the switching processing unit 138 notifies the switching processing unit 180 of the console 52 by wireless communication from the communication unit 130 that the relationship between the master and the slave has been switched due to the end of fluoroscopic imaging. Therefore, the control unit 132 controls each unit in the portable device 48 so that it does not operate even if the doctor 18 operates the operation unit 162 or the like (so that the operation by the doctor 18 becomes invalid).
- the control unit 174 controls each unit of the console 52 so that the engineer 54 can operate the console 52 based on the notification content.
- step S12 when a radiographic image is displayed on the display unit 192 or the like of the portable device 48 in step S12 and this radiographic image is a moving image that is difficult for the doctor 18 to see, the doctor 18 resets the imaging conditions and positions the patient 16. Therefore, it is decided to interrupt the fluoroscopic imaging, and the icon 212 is operated (step S22: YES).
- the switching processing unit 138 maintains the portable device 48 as a master (step S23).
- the control unit 132 of the portable device 48 transmits a command instructing to interrupt the irradiation of the radiation 20 from the communication unit 130 to the radiation imaging apparatus 24 by wireless communication, and also to the radiation output apparatus 22 via the console 52. Send. Therefore, the control unit 108 interrupts the output of the radiation 20 from the radiation source 106 based on the received command.
- the technician 54 positions the patient 16 according to an oral instruction from the doctor 18 (step S6), or the doctor 18 operates the operation unit 162 of the portable device 48.
- the photographing condition is reset by operating (step S5).
- the doctor 18 can also reset the order information by operating the operation unit 162 of the portable device 48 (step S4).
- the control unit 132 sends a command for instructing resumption of irradiation of the radiation 20 (including the imaging conditions after resetting) from the communication unit 130 by wireless communication. Since the data is transmitted to the radiation imaging apparatus 24 and transmitted to the radiation output apparatus 22 via the console 52, the control unit 108 starts from the radiation source 106 (reflecting the imaging conditions after resetting) based on the received command. The output of the radiation 20 can be resumed (step S7).
- step S31 if the doctor 18 (see FIGS. 1 and 5) wants to use a specific medical device, if the other medical device is currently in use (step S31: YES), the doctor 18
- the unit 162 icon 214 in FIGS. 6A and 7A, icon 244 in FIG. 8A, icon 264 in FIG. 9A is operated to end use of the other medical device (step S32).
- step S32 the control unit 132 of the portable device 48 transmits a command for ending the moving image capturing to the other medical device through wireless communication via the communication unit 130.
- the other medical device ends the shooting of the moving image according to the received command.
- FIGS. 7B, 8B, and 9B illustrate the display content of FIGS. 7B, 8B, and 9B.
- 7B illustrates the case where the use of the radiation output apparatus 22 and the radiation imaging apparatus 24 is terminated
- FIG. 8B illustrates the case where the use of the ultrasonic diagnostic apparatus 30 is terminated
- FIG. A case where the use of the mirror device 32 is terminated is illustrated.
- the operation control is performed.
- the unit 154 determines that the operation of the icon by the doctor 18 is valid, and notifies the control unit 132 and the display control unit 148 that the specific medical device has been selected.
- the control unit 132 notifies the specific medical device that the specific medical device has been selected as a control target from the communication unit 130 by wireless communication.
- the display control unit 148 causes the display unit 160 to display display contents for operating the specific medical device.
- the doctor 18 can operate the specific medical device by operating the operation unit 162.
- the operation control unit 154 determines that the operation of the icon by the doctor 18 is valid, and the operation content is displayed on the control unit 132 and the display.
- the control unit 148 is notified.
- the control unit 132 transmits a command corresponding to the notification content from the communication unit 130 to the specific medical device by wireless communication.
- the specific medical device acquires a moving image in accordance with the command, and transmits the acquired moving image to the portable device 48 by wireless communication. Accordingly, the mobile device 48 can display the received moving image on the display unit 160.
- the display control unit 148 controls the display unit 160 to display the display content corresponding to the notification content.
- step S35 when the use of the specific medical device is ended (step S35: YES), the doctor 18 moves the operation unit 162 (icons 214, 244, 264) in the same manner as in the above-described step S32.
- the operation of the specific medical device may be terminated by operating (Step S36). Accordingly, the control unit 132 transmits a command for ending the shooting of the moving image to the specific medical device via the communication unit 130 by wireless communication. As a result, the specific medical device ends the shooting of the moving image according to the received command.
- step S31 when the use of the other medical device is continued (step S31: NO), the processing in step S32 is not performed, and the processing after step S33 is performed on the other medical device. Good.
- steps S33 to S36 described above, if the phrase “specific medical device” is replaced with “other medical device”, the description is for the other medical device. The description of S33 to S36 is omitted.
- step S41 when the mobile device 120a in the predetermined area receives a moving image and various types of encrypted information, if it is the first reception (step S42: NO), the mobile device 120a receives an encryption key ( For example, a password input screen is displayed on the display unit 290a, and other medical personnel possessing the portable device 120a are preliminarily registered by acquiring the password, etc. (step S43: YES) , Prompt for a password.
- an encryption key For example, a password input screen is displayed on the display unit 290a, and other medical personnel possessing the portable device 120a are preliminarily registered by acquiring the password, etc.
- step S44 the other medical personnel operates the portable device 120a to input the password, and if the input password matches the password acquired in advance, the portable device 120a determines the encrypted information.
- Decoding processing is performed (step S45), and the moving image and the decoded information are displayed on the display unit 290a (step S46, FIG. 10A). Therefore, other medical personnel can grasp the moving image related to the patient 16 and the personal information (order information, imaging conditions, etc.) related to the patient 16 by looking at the display content of the display unit 290a.
- step S47 NO
- step S41 the portable device 120a is the second or subsequent reception.
- Step S42 YES
- the password input operation is omitted, and the processing of steps S45 and S46 is performed immediately.
- step S47 YES
- the portable device 120a repeats the processes of steps S41, S42, and S45 to S47.
- step S41 when the mobile device 120b and the display device 124 in the predetermined area receive moving images and various types of encrypted information (step S41), if the first reception (step S42: NO), the mobile device 120b and Since the display device 124 does not perform pre-registration by acquiring a password (step S43: NO), it cannot perform decryption processing on various encrypted information, and displays only moving images on the display units 290b and 292. (Step S48, FIG. 10B). Therefore, the family of the patient 16 can grasp the moving image related to the patient 16 by looking at the display contents of the display units 290b and 292.
- step S47 NO
- step S41 the terrestrial digital television broadcast is not finished (step S47: NO) and the next moving image and various encrypted information are received (step S41)
- step S42 the portable device 120b and the display device 124 Since it is reception (step S42: YES)
- step S48 the process of step S48 is continued.
- step S47 YES
- the portable device 120b and the display device 124 repeatedly perform the processes of steps S41, S42, S48, and S47.
- the device (master) that controls the radiation output device 22 and the radiation imaging device 24 is switched from the console 52 to the portable device 48. That is, the portable device 48 and the console 52 are in a master and slave relationship for controlling the radiation output device 22 and the radiation imaging device 24.
- the console 52 is a master and the portable device 48 is a slave.
- the console 52 is switched to a slave and the portable device 48 is switched to a master.
- the doctor 18 is disposed in the vicinity of the patient 16 (at the hand of the doctor 18) without instructing the technician 54 to verbally interrupt the fluoroscopic imaging and reset the imaging conditions of the fluoroscopic imaging.
- the portable device 48 that has been switched to the master, the imaging conditions can be reset quickly and accurately.
- the technician 54 may perform only the positioning of the patient 16 during the time period in which the fluoroscopic imaging is interrupted in response to the verbal instruction from the doctor 18 when the patient 16 moves. As a result, the work load on the engineer 54 is reduced, and the positioning can be performed quickly.
- the first characteristic function it is possible to quickly and accurately perform operations such as change of imaging conditions and positioning of the patient 16 that occur after the start of fluoroscopic imaging. It is possible to resume.
- the switching processing units 138 and 180 switch the master from the portable device 48 to the console 52, so that the engineer 54 operates the console 52 that has been switched to the master to perform imaging conditions for the next fluoroscopic imaging. Etc. can be set.
- the switching processing units 138 and 180 maintain the portable device 48 as a master even when fluoroscopic imaging is interrupted. Accordingly, the console 52 is maintained as a slave until the fluoroscopic imaging is completed.
- the radiation output device 22 and the radiation imaging device 24 are controlled due to the operation of the doctor 18 on the touch panel 150 of the portable device 48, and thus the doctor 18 uses the touch panel 150. It is possible to easily reset the shooting conditions by operating.
- the surface of the touch panel 150 is not uneven, if the surface of the touch panel 150 is sterilized after surgery, the surface can be kept clean and hospital infection can be prevented.
- the switching processing units 138 and 180 are provided in the portable device 48 and the console 52, and signals can be transmitted and received by wireless communication between the portable device 48 and the console 52, The master / slave switching process can be quickly performed. Further, when the portable device 48 is a master, the portable device 48 can control the radiation output device 22 and the radiation imaging device 24 by causing the console 52 to function as a relay.
- the radiation imaging apparatus 24 transmits and receives signals between the communication unit 94 and the console 52 through wired communication using the optical fiber cable 58, and signals between the communication unit 100 and the portable device 48 through wireless communication. Sending and receiving.
- the communication unit 94 transmits a normal radiographic image stored in the image storage unit 86 from the communication unit 94 to the console 52, and the communication unit 100 is generated by thinning out the radiographic image by the signal processing unit 98. The thinned image is transmitted to the portable device 48 by wireless communication.
- a moving image is transmitted from the radiation imaging apparatus 24 to the portable device 48 by wireless communication by generating a thinned image having a smaller data amount than the radiation image (the amount of information is reduced by reducing the frame rate). It becomes possible. As a result, the thinned image can be quickly displayed on the display unit 160 of the portable device 48.
- the radiographic image is displayed on the display unit 192 or the display device 36 of the console 52 and stored in the controller 102.
- the radiographic image can be stored in the unit 104.
- the console 52 when the console 52 is a master, the console 52 directly controls the radiation imaging apparatus 24 via the communication unit 94, while when the portable device 48 is a master, the portable device 48 includes a communication unit. It is also possible to directly control the radiation imaging apparatus 24 via 100.
- the radiation imaging apparatus 24 can be used.
- the image storage unit 86 a radiation image can be stored on the radiation imaging apparatus 24 side.
- the radiation imaging apparatus 24 can also transmit a regular radiation image to the console 52 via the portable device 48 by wireless communication.
- the console 52 causes the radiographic apparatus 24 to function as the relay device by causing the portable device 48 to function. It can also be controlled.
- a signal (command for controlling the medical device) corresponding to the operation content is operated from the communication unit 130 due to the operation of the operation unit 162 of the portable device 48 by the doctor 18.
- the medical device is transmitted to the target medical device, and the medical device is controlled according to the received signal.
- the doctor 18 performing an operation on the patient 16 in the operating room 12 does not give a verbal instruction to an operator of the medical device (for example, an engineer 54) or the surgical instrument used by the doctor 18 Even if it is not possible to directly operate a medical device having a lower sterilization level, it is possible to remotely control the medical device by operating the operation unit 162 of the portable device 48 arranged at hand of the doctor 18. .
- the portable device 48 functions as a remote controller for each medical device, the doctor 18 controls the desired medical device by operating the portable device 48 at hand according to the progress of the operation. Remote operation of the medical device can be performed quickly and accurately.
- the operation control unit 154 limits medical devices that are controlled due to the operation of the operation unit 162 by the doctor 18, so that the doctor 18 performs the diagnosis or treatment contents for the patient 16. It is possible to reliably operate an appropriate medical device according to the condition.
- the operation control unit 154 enables the operation of the operation unit 162 by the doctor 18 on the medical device in use and The operation of the operation unit 162 by the doctor 18 with respect to the medical device is invalidated. Thereby, since the doctor 18 can reliably operate one medical device to be operated remotely, it is possible to reliably prevent other medical devices from being remotely operated by mistake.
- the portable device 48 includes a touch panel 150 including a display unit 160 and an operation unit 162.
- the operation unit 162 is an icon that is displayed on the screen of the touch panel 150 and indicates the operation contents of each medical device and / or each medical device, and can be operated by the doctor 18 for each medical device. 204, 212, 214, 226, 230-236, 242, 244, 248-252, 256, 262, 264, 268, 270, 272, 282, and a text box display area 228.
- the operation control unit 154 validates the operation of the doctor 18 with respect to the icon or the like corresponding to the medical device in use, and invalidates the operation of the doctor 18 with respect to the icon or the like according to the other medical device.
- the doctor 18 since the operation content for each medical device is displayed as a widget such as an icon or a text box on the display unit 160 of the touch panel 150, the doctor 18 operates the widget to select the medical device in use. It can be easily remote-controlled. In addition, even if the doctor 18 operates a widget corresponding to another medical device that is not in use, the operation result is invalidated, so that it is possible to reliably prevent other medical devices from being erroneously controlled. it can.
- the doctor 18 can easily use the widget corresponding to the medical device being used. Can be operated.
- the operation control unit 154 switches the operation on the icons 232 to 236, 250, 252, 256, 270, 272, and 282 corresponding to each medical device to the valid state. Accordingly, the doctor 18 can select the medical device to be used next by operating the icons 232 to 236, 250, 252, 256, 270, 272, and 282.
- the operation control unit 154 displays an icon corresponding to one medical device. Is operated, it is determined that one medical device corresponding to the operated icon is a new medical device to be used, and a signal corresponding to the determination result is transmitted to the new medical device to be used via the communication unit 130. In addition to the transmission, the operation of the doctor 18 on the operation image corresponding to the other medical device is switched to the invalid state.
- the portable device 48 sets transmission / reception of signals by multi-access wireless communication between the communication unit 130 and each medical device in advance by the transmission / reception setting unit 140 before controlling each medical device.
- Signals by wireless communication between the communication unit 130 and one medical device within a limited frequency band for example, a band of 2.4 GHz to 2.56 GHz
- a limited frequency band for example, a band of 2.4 GHz to 2.56 GHz
- the portable device 48 transmits a signal corresponding to the operation content operated by the operation unit 162 from the communication unit 130 to the console 52 by wireless communication.
- the radiation output device 22 and the radiation imaging device 24 are controlled via the console 52.
- the portable device 48 can control the radiation output device 22 and the radiation imaging device 24 by causing the console 52 to function as a relay.
- the radiation output device 22 and the radiation imaging device 24 are controlled by transmitting a signal from the communication unit 130 to the radiation imaging apparatus 24 and transmitting a signal from the communication unit 130 to the radiation output device 22 via the console 52. May be. Even in this case, the portable device 48 can directly control the radiation imaging apparatus 24 and can control the radiation output apparatus 22 by causing the console 52 to function as a relay.
- a moving image related to diagnosis or treatment of the patient 16 is directed to a predetermined area in real time by digital terrestrial television broadcasting (in the case of Japan, area one segment broadcasting). Can be delivered.
- the camera 34 captures a moving image (camera image) of the operating room 12, and the radiographic apparatus 24, ultrasonic diagnosis.
- the device 30 and the endoscope device 32 capture a moving image (a radiographic image, an ultrasonic image, or an optical image related to diagnosis or treatment of the patient 16) inside the patient 16.
- the communication unit 130 of the portable device 48 possesses these moving images by the family of the patient 16 who is waiting in a predetermined area such as a waiting room in a medical institution, and has a reception function of terrestrial digital television broadcasting.
- Possessed by a portable device 120b such as a mobile phone, or other medical personnel (doctors, residents, medical students) in a predetermined area such as the operating room 12, the preparation room 50, or a conference room in the medical institution, and It can be distributed to a mobile device 120a such as a mobile phone having a reception function of terrestrial digital television broadcasting, or a display device 124 such as a display installed in the predetermined area.
- a mobile device 120a such as a mobile phone having a reception function of terrestrial digital television broadcasting, or a display device 124 such as a display installed in the predetermined area.
- the moving image can be relayed live to the family of the patient 16 and other medical personnel, and it is clear whether or not the operation on the patient 16 is being performed appropriately. If the family of the patient 16 and another medical person are in the same room, the family of the patient 16 is watching the moving image displayed on the display unit 290b of the portable device 120b or the display unit 292 of the display device 124. It is also possible to receive an explanation from other medical personnel as appropriate regarding the progress of the operation on the patient 16. Furthermore, other medical personnel can give appropriate advice to the doctor 18.
- the diagnosis or treatment status of the patient 16 in the operating room 12 is directed to the family of the patient 16 and other medical personnel in the predetermined area in real time. It becomes possible to broadcast on.
- the communication unit 130 of the portable device 48 directly receives a radiographic image from the radiation imaging apparatus 24 through wireless communication, or receives a radiographic image from the radiation imaging apparatus 24 through wireless communication via the optical fiber cable 58 and the console 52. Receive. In either case, the portable device 48 functions as a repeater for terrestrial digital television broadcasting.
- the mobile device 120a in the predetermined area performs decryption on the various encrypted information.
- the moving image and the information can be browsed, while the mobile device 120b and the display device 124 can browse only the moving image.
- only the other medical personnel can view the moving image and the various encrypted information that is personal information, while the family of the patient 16 can view only the moving image.
- the portable device 48 that performs digital terrestrial television broadcasting is disposed on the mounting table 46 slightly away from the patient 16, it is possible to suppress the influence of radio waves from the digital terrestrial television broadcasting on the patient 16. At the same time, it is possible to avoid the influence of the radio wave condition of the digital terrestrial television broadcast due to the presence of the patient 16.
- the portable device 48 is a tablet PC, a handheld computer or a PDA, the portable device 48 can be easily carried to the vicinity of the patient 16.
- tablet computers do not have a keyboard or mouse and have no irregularities on the surface, so if the surface of the tablet computer is sterilized after surgery, the surface can be cleaned and hospital infections can be prevented. Is also possible.
- the portable device 48 is used in a state of being sealed in the sterilization bag 200, and the doctor 18 operates the portable device 48 through the sterilization bag 200, so that the portable device 48 is kept clean. Can do. If the sterilization bag 200 is a disposable transparent bag, the portable device 48 can be sealed in a new sterilization bag 200 and repeatedly used without sterilizing the portable device 48.
- the medical system 10 according to the present embodiment is not limited to the above description, and the following configurations (first to third modifications) may be employed.
- the control unit 132 of the portable device 48 sets the radiation source 106 corresponding to the portion clicked by the doctor 18.
- the current position (height and plane position) and the position of the radiation source 106 such that the clicked portion becomes the center position of the screen are calculated, and the amount of movement of the radiation source 106 is calculated using each calculated position. calculate.
- control unit 132 transmits a control signal indicating the amount of movement of the radiation source 106 from the communication unit 130 to the control unit 108 of the radiation output device 22 via the console 52.
- control unit 108 receives the control signal from the control unit 132, the control unit 108 operates the articulated arm 42 according to the movement amount indicated by the control signal. Thereby, the position of the radiation source 106 is automatically adjusted to a position where the clicked portion becomes the center position of the screen.
- the control unit 108 When the control unit 108 receives the synchronization control signal in a state where the position of the radiation source 106 is adjusted in this way, the radiation source 106 directs the radiation 20 having a predetermined dose to the imaging region of the patient 16 according to the imaging conditions. Then, irradiation is performed for a predetermined irradiation time, and the next photographing is performed. Therefore, when the radiation conversion panel 80 converts the radiation 20 transmitted through the patient 16 into a radiation image, and the portable device 48 acquires the radiation image from the radiation imaging apparatus 24, the screen of the display unit 160 of the portable device 48 includes As shown in FIG. 16B, a radiation image (radiation image acquired by the next imaging) in which the clicked portion is the center position of the screen is displayed.
- the radiation image in which the clicked portion is the center position of the screen means that the position in the patient 16 corresponding to the clicked portion is the center position of the irradiation range of the radiation 20 from the radiation source 106 to the patient 16. It is the radiographic image obtained by irradiating the radiation 20 to. Therefore, in the first modification, the irradiation range (irradiation position and irradiation area) of the radiation 20 corresponding to the radiation image shown in FIG. 15A and the irradiation range (irradiation position and irradiation) of the radiation 20 corresponding to the radiation image shown in FIG. Are different from each other.
- the position of the radiation source 106 and the irradiation range of the radiation 20 are set so that the doctor 18 simply clicks the screen of the display unit 160 with a finger and the clicked portion becomes the center position of the screen. Since it is automatically adjusted and the next imaging is performed after the adjustment, when the radiation image acquired by the next imaging is displayed on the screen of the display unit 160, the clicked part is surely placed at the center position of the screen. Can be displayed.
- the doctor 18 or the technician 54 operates the operation unit 194 of the console 52 that is the master, so that the radiation source 106
- the position may be adjusted automatically.
- the position of the radiation source 106 and the irradiation range of the radiation 20 are automatically adjusted so that the clicked portion becomes the center position of the screen of the display unit 192
- the next imaging is performed after the adjustment.
- a radiographic image is acquired by the next imaging, a radiographic image in which the clicked portion is the center position of the screen can be displayed on the screen of the display unit 192.
- the portable device 48 delivers the radiation image to the portable devices 120a and 120b and the display device 124 by digital terrestrial television broadcasting in real time, the radiation image in which the clicked portion is the center position of the screen is carried. Of course, it is possible to display on the devices 120a and 120b and the display device 124.
- the doctor 18 clicks the screen of the display unit 160 with a finger so that the position of the radiation source 106 and the irradiation range of the radiation 20 can be automatically adjusted.
- the part to be clicked may be designated by the doctor 18 operating the icon 204 shown in FIG. 5 with a finger.
- part of the icon 204 is an arrow button and a decision button for scrolling the screen, and after clicking the decision button by operating the arrow button to determine the portion to be clicked, the icon 204 is clicked.
- the portion is designated, and the position adjustment of the radiation source 106 (adjustment of the irradiation range of the radiation 20) is started.
- the position of the radiation source 106 corresponding to the clicked part is automatically calculated on the portable device 48 or console 52 side, and the position of the radiation source 106 is automatically adjusted.
- the doctor 18 or the engineer 54 can manually adjust the position adjustment of the radiation source 106 in the next imaging using the portable device 48 or the console 52.
- the doctor 18 or the technician 54 operates the icon 204 of the portable device 48 or the operation unit 162 of the console 52 to input the position of the radiation source 106 including the height position and the irradiation range of the radiation 20.
- the portable device 48 or the console 52 transmits a control signal indicating the input position of the radiation source 106 and the irradiation range of the radiation 20 to the radiation output device 22.
- the control unit 108 of the radiation output device 22 adjusts the position of the radiation source 106 by operating the articulated arm 42 according to the received control signal, and narrows the irradiation range of the radiation 20 using a collimator (not shown).
- the position of the radiation source 106 is adjusted by the articulated arm 42, but the position adjustment method is not limited to this description.
- the radiation source 106 is attached to the tip of the articulated arm 42, the radiation source 106 is adjusted to a desired orientation by rotating the radiation source 106 about the axis of the articulated arm 42. Is also possible.
- the portable device 48 or the console 52 displays the display unit to the doctor 18 or the technician 54. It is desirable to notify (warn) that the position adjustment of the radiation source 106 is being performed by displaying screens 160 and 192 or by outputting sound from a speaker (not shown). This prevents the doctor 18 or the technician 54 from inadvertently contacting the radiation source 106 and the articulated arm 42 during position adjustment, and prevents the doctor 18 or the technician 54 from being inadvertently exposed in the next imaging. It can be avoided.
- the technician 54 or the doctor 18 moves the roundabout car 302 to the hospital room.
- the patient 16 is moved to 298 to perform a round-trip (for example, radiography using the radiation source 106 and the radiographic apparatus 24) for the patient 16.
- a round-trip for example, radiography using the radiation source 106 and the radiographic apparatus 24
- a loading port for loading the radiation imaging apparatus 24 is formed in the table unit 306. Inside the base unit 306, a cradle 28 for charging the radiation imaging apparatus 24 loaded in the loading port is provided.
- the portable device 48 can be charged by the cradle 28 if it is loaded into the loading slot. Further, a speaker 310 that outputs various kinds of information as sound is provided on the side of the base unit 306.
- a support column 312 is erected in front of the base unit 306, and the radiation output device 22 is attached to the tip of a support arm 314 that can be moved up and down along the support column 312.
- the radiation output device 22 can change the irradiation direction of the radiation 20 output from the radiation source 106 by, for example, rotating with respect to the distal end portion of the support arm 314.
- a camera 34 is attached to the outer periphery of the radiation output device 22.
- a collimator 316 that regulates the irradiation range of the radiation 20 is provided on the radiation output side of the radiation output device 22.
- the round wheel 302 moves the radiation output device 22, the radiation imaging device 24, the cradle 28, and the console 52 integrally (without separation) while the radiation imaging device 24 and the portable device 48 are loaded in the cradle 28.
- the round-trip wheel 302 can be moved according to the operation of the portable device 48 or the console 52 by the technician 54 or the doctor 18.
- the round-trip wheel 302 can communicate with the outside (RIS112, HIS114, PACS116) by wireless communication, it is not necessary to consider the routing of the wiring, and for the bed 300 (the patient 16 lying on the bed) It is possible to access from the side.
- the technician 54 or the doctor 18 holds the portable device 48.
- the case where radiation 20 is irradiated from the radiation source 106 toward the patient 16 by operating and controlling the radiation source 106 and the radiation imaging apparatus 24 by remote control is illustrated.
- the second modified example is different from the present embodiment and the first modified example shown in FIG. 1 in that the place where the patient 16 is located is a hospital room 298 and the console 52 can be moved by the roundabout wheel 302. . Therefore, even in the case of the second modification, the same effect can be obtained with respect to the configuration common to the present embodiment and the first modification.
- the portable device 48 or the console 52 by operating the portable device 48 or the console 52 and clicking on a desired location displayed on the screens of the display unit 160 and the display operation unit 308, radiation can be obtained.
- the position of the source 106 (the irradiation range of the radiation 20) is adjusted and the next imaging is performed at the adjusted position of the radiation source 106, the display unit 160 and the radiation image acquired by the next imaging are displayed.
- the clicked portion can be displayed at the center position of the screen of the display operation unit 308.
- the irradiation range of the radiation 20 by the collimator 316 may also be reduced.
- the position of the radiation source 106 and the irradiation range of the radiation 20 can be adjusted by moving the rounding wheel 302 itself in addition to the raising and lowering of the support arm 314 and the rotation of the radiation output device 22 with respect to the support arm 314.
- the position adjustment of the radiation source 106 and irradiation of the radiation 20 are performed on the engineer 54 or the doctor 18 by sound output from the speaker 310 or by screen display of the display unit 160 and the display operation unit 308 of the portable device 48. It is desirable to warn that range adjustments are being made. This prevents the technician 54 or the doctor 18 from inadvertently coming into contact with the radiation source 106 and the round wheel 302 being adjusted, and prevents the technician 54 or the doctor 18 from being inadvertently exposed in the next imaging. can do.
- the portable device 48 and the console 52 are in a master or slave relationship. Therefore, the roundabout vehicle 302 is used by the portable device 48 or the console 52 that functions as a master. Needless to say, overall control, change of photographing conditions, image processing for various images, and the like can be executed.
- the portable device 48 when at least the round-trip wheel 302 on which the console 52 is mounted and the technician 54 or the doctor 18 who owns the portable device 48 are separated from each other, the portable device 48 is switched to the master. That is, in the second modified example, the radiation output device 22, the radiation imaging device 24, the portable device 48, and the console 52 are mounted on the round-trip wheel 302 and transferred to the hospital room 298 where the patient 16 at the round-trip destination is located, and then the technician 54 Alternatively, when the doctor 18 takes out the portable device 48 from the round wheel 302 and moves to a position away from the round wheel 302 (when moved to a position where the console 52 cannot be operated immediately), the portable device 48 can be switched to the master. .
- the technician 54 or the doctor 18 holding the portable device 48 is away from the round-trip wheel 302 (to the patient 16) for positioning the patient 16 with respect to the radiation output device 22 and the radiation imaging device 24.
- the mobile device 48 is in a close position, the portable device 48 switches to the master.
- the technician 54 or the doctor 18 looks at the actual state of the patient 16 when the patient 16 is positioned, and operates the portable device 48 without returning to the round-trip wheel 302 even if the imaging condition is to be changed.
- the shooting conditions can be changed. That is, the technician 54 or the doctor 18 does not have to go back and forth between the patient 16 and the round-trip wheel 302 (the console 52) in order to change the imaging condition.
- the work load of the technician 54 or the doctor 18 is reduced, and operations such as changing the imaging conditions and positioning the patient 16 can be performed quickly.
- the portable device 48 may be switched to the master.
- the technician 54 or the doctor 18 can remotely operate the radiation source 106 and the radiation imaging apparatus 24 by operating the portable device 48.
- the portable device 48 and the radiation imaging apparatus 24 may be provided with a contact sensor (not shown).
- the contact sensor detects that the technician 54 or the doctor 18 has contacted the portable device 48, The portable device 48 switches to the master based on the detection result of the contact sensor.
- the contact sensor detects that the patient 16 has contacted the radiation imaging apparatus 24. Then, the radiation imaging apparatus 24 transmits the detection result of the contact sensor to the portable device 48. The portable device 48 switches to the master based on the received detection result of the contact sensor.
- the portable device 48 can reliably function as the master after the patient 16 is positioned.
- the portable device 48 may be made to always function as a master only during a round-trip within a medical institution.
- the technician 54 or the doctor 18 when the technician 54 or the doctor 18 always carries the portable device 48, for example, when the patient 16 positions the patient 16 or after the positioning, the technician 54 or the doctor 18 operates the icon 204 of the display unit 160, or the contact sensor. Due to this detection result, the portable device 48 may be switched to the master.
- the technician 54 or the doctor 18 inserts the radiation imaging apparatus 24 between the patient 16 and the bed 300 in order to perform radiation imaging on the patient 16, and carries it.
- the device 48 is operated.
- the round-trip wheel 302 is movable due to the operation of the portable device 48 by the technician 54 or the doctor 18. Therefore, in the case of the second modified example, the devices that the technician 54 or the doctor 18 contacts are at least the portable device 48 and the radiation imaging apparatus 24.
- the portable device 48 and the radiation imaging apparatus 24 are used in a state of being sealed in a contamination prevention bag (for example, the sterilization bag 200).
- the portable device 48 and the radiation imaging apparatus 24 are used in a state of being sealed in a pollution prevention bag. Therefore, after the round visit, the technician 54 discards the pollution prevention bag that seals the portable device 48 and the radiation imaging apparatus 24, and only performs the cleaning process on the portable device 48 and the radiation imaging apparatus 24. Thereby, the trouble of the washing process after the round can be greatly reduced.
- the technician 54 or the doctor 18 uses the roundabout wheel 302 to mount a device capable of attaching / detaching the anti-contamination bag to the round wheel 302 and perform radiography on the patient 16.
- the apparatus may automatically seal the radiation imaging apparatus 24 with a contamination prevention bag.
- the technician 54 or the doctor 18 can save the trouble of sealing the radiation imaging apparatus 24 and can use the radiation imaging apparatus 24 in a state of being sealed with the contamination prevention bag.
- the apparatus automatically breaks the pollution prevention bag and collects the pollution prevention bag.
- console 52 including the display operation unit 308 is configured to include a keyboard or the like, the surface has irregularities and it is not easy to attach or detach the anti-contamination bag. Also from this point, various effects can be easily obtained by sealing the portable device 48 with the anti-contamination bag and functioning as a master.
- the portable device 48 displays a list showing the list of patients 16 to be rounded on the screen of the display unit 160 in today's round. Also good. Thereby, the engineer 54 or the doctor 18 can grasp
- the portable device 48 functions as a master and has substantially the same function as the console 52.
- the technician 54 or the doctor 18 can easily change the order information (imaging conditions) stored in the order information storage unit 134 by operating the portable device 48 while observing the state of the patient 16 at the round-trip destination. Can do. That is, the portable device 48 also has a function as the RIS 112, and the control unit 132 updates the order information stored in the order information storage unit 134 to the changed order information.
- the control unit 132 transmits the changed order information from the communication unit 130 to the console 52 by wireless communication.
- the console 52 updates the order information stored in the order information storage unit 176 with the received order information. Therefore, radiation imaging for the patient 16 is performed based on the changed order information.
- the mobile device 48 selects an appropriate radiation imaging apparatus 24 based on the order information and displays it on the display unit 160. May be.
- the technician 54 or the doctor 18 can take out the appropriate radiation imaging apparatus 24 displayed on the display unit 160 from the round wheel 302 and insert it between the patient 16 and the bed 300.
- the frequency band of wireless communication between the portable device 48 and the console 52 and the frequency band of wireless communication between the radiation imaging apparatus 24 and the console 52 are: It is preferable to use different frequency bands.
- the portable device 48 functions as a master during the round (particularly before imaging), and only the technician 54 or the doctor 18 can see. It is preferable to display information necessary for imaging of the patient 16 only on the screen of the 48 display units 160. In this case, no information is displayed on the screen of the display operation unit 308 of the console 52 (the screen display of the display operation unit 308 is deleted). Thereby, it can prevent that the information regarding the patient 16 leaks to the said other patient.
- the engineer 54 or the doctor 18 When the engineer 54 or the doctor 18 does not look at the screen of the display unit 160, for example, the engineer 54 or the doctor 18 operates the icon 204 of the display unit 160 to delete the screen display, and Thus, it is also preferable to prevent information related to the patient 16 from being leaked so that the information related to the patient 16 cannot be seen instantaneously.
- the portable device 48 by causing the portable device 48 to function as a master, displays the captured radiation image of the patient 16 and the past radiation image of the patient 16 on the screen of the display unit 160. It is also possible to display them side by side. Thereby, for the patient 16 lying on the bed 300, both images can be compared to easily show the progress of the medical condition. That is, since the portable device 48 can access the PACS 116 via the console 52 and the LAN 110 that are DICOM servers, the portable device 48 acquires a past radiation image from the PACS 116 via the console 52, and displays the acquired past radiation image on the display unit 160. Can be displayed easily.
- the third modification of the present embodiment is a partial modification of the second modification (see FIG. 16).
- the patient 16 is lying on the bed 318 in the hospital room 298.
- a rail 322 is linearly provided on the ceiling 320 of the hospital room 298, and the base member 324 can travel along the rail 322.
- An articulated arm 326 is connected to the base member 324, and the radiation output device 22 is attached to the tip of the articulated arm 326.
- a camera 34 is attached to the outer periphery of the radiation output device 22.
- the base member 324 is provided with an antenna 328, and a drive mechanism (not shown) provided inside the base member 324 is driven by receiving a control signal from the portable device 48 by wireless communication. 324 travels along the rail 322 and operates the articulated arm 326.
- the third modification has substantially the same configuration as that of the second modification except that the radiation output device 22 is supported by the ceiling hanging method.
- the technician 54 or the doctor 18 operates the portable device 48 to change the position of the radiation source 106 and the irradiation range of the radiation 20. Then, a control signal instructing to change the position of the radiation source 106 and change the irradiation range of the radiation 20 is transmitted from the communication unit 130 of the portable device 48 to the antenna 328 by wireless communication.
- the drive mechanism is driven based on a control signal received by the antenna 328, causes the base member 324 to travel to a predetermined position along the rail 322, operates the articulated arm 326, and performs radiation of the radiation output device 22 ( The source 106) is adjusted to a predetermined height position and orientation.
- the radiation source 106 is changed to a desired position, the irradiation range of the radiation 20 is changed, and in the next imaging, the patient 16 is irradiated with the radiation 20 within the irradiation range from the changed position. be able to.
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Abstract
Description
本実施形態に係る医療システム(放射線撮影システム、医療画像放送システム)10は、図1に示すように、例えば、医療機関の手術室12に適用される。なお、後述するように、本実施形態に係る医療システム10は、手術室12以外にも適用可能であるが、ここでは、一例として、手術室12に適用した場合について説明する。
以上のように構成される本実施形態に係る医療システム10の特徴的な機能(第1~第3の特徴的な機能)について、図6A~図10Bを参照しながら説明する。
第1の特徴的な機能では、先ず、透視撮影が開始されるまで、コンソール52の切替処理部180(図4参照)は、放射線出力装置22及び放射線撮影装置24(図1及び図2参照)を制御するマスタをコンソール52に維持すると共に、携帯機器48をスレーブに維持する。すなわち、手術中の医師18から口頭で患者16に対する透視撮影の開始の指示を受けると、技師54は、コンソール52を操作して撮影条件の設定等の作業を行う必要があるため、透視撮影を開始するまでは、コンソール52をマスタにしておく必要があるからである。
第2の特徴的な機能では、患者16に対して所定の診断又は処置を行うために、医師18が手元の携帯機器48を操作することにより、医師18が使用する手術器具よりも滅菌レベルが低い(医師18が直接操作することのできない)放射線出力装置22及び放射線撮影装置24、超音波診断装置30、又は、内視鏡装置32の各種の医療機器を遠隔操作により制御するというものである。
第3の特徴的な機能では、先ず、手術室12で患者16に対する手術が行われる前に、暗号化処理部142での暗号化処理に必要な公開鍵又は秘密鍵(暗号キー)を情報管理部152に記憶させると共に、医療機関内の他の医療関係者が所持する携帯機器120aにも暗号キーを事前に取得させる。
次に、本実施形態に係る医療システム10の動作について説明する。
図11のステップS1において、患者16(図1及び図2参照)に対する手術に先立ち、医療システム10に用いられる各装置間の通信設定が行われる。
次に、図12A~図12Cを参照して、第1の特徴的な機能による動作を説明する。
次に、図13を参照して、第2の特徴的な機能による動作を説明する。
次に、図14を参照して、第3の特徴的な機能による動作を説明する。
以上説明したように、本実施形態に係る医療システム10によれば、第1~第3の特徴的な機能を有することにより、下記の効果が得られる。
第1の特徴的な機能によれば、透視撮影の開始後に、放射線出力装置22及び放射線撮影装置24を制御する装置(マスタ)を、コンソール52から携帯機器48に切り替える。すなわち、携帯機器48及びコンソール52は、放射線出力装置22及び放射線撮影装置24を制御するためのマスタ及びスレーブの関係にある。透視撮影の開始前は、コンソール52がマスタであると共に携帯機器48がスレーブであり、透視撮影の開始後に、コンソール52がスレーブ、携帯機器48がマスタにそれぞれ切り替わる。
第2の特徴的な機能によれば、医師18による携帯機器48の操作部162の操作に起因して、操作内容に応じた信号(医療機器を制御するためのコマンド)が通信部130から操作対象の医療機器に送信され、該医療機器は、受信した信号に従って制御される。これにより、手術室12で患者16に対して手術を行っている医師18は、医療機器の操作者(例えば、技師54)に口頭で指示しなくても、又は、医師18が使用する手術器具よりも滅菌レベルが低い医療機器を直接操作できなくても、該医師18の手元に配置された携帯機器48の操作部162を操作することにより、当該医療機器を遠隔操作で制御することができる。このように、携帯機器48が各医療機器に対するリモートコントローラとして機能するので、医師18は、手術の進行状況に応じて、手元の携帯機器48を操作して所望の医療機器を制御することにより、該医療機器の遠隔操作を迅速且つ的確に行うことが可能となる。
第3の特徴的な機能によれば、患者16の診断又は処置に関わる動画像を、所定領域内に向けて、地上デジタルテレビ放送(我が国の場合には、エリアワンセグメント放送)により、リアルタイムで配信することができる。
第1~第3の特徴的な機能では、携帯機器48がタブレットPC、ハンドヘルドコンピュータ又はPDAであるため、患者16の近傍にまで該携帯機器48を容易に持ち運ぶことが可能となる。
本実施形態に係る医療システム10は、上記の説明に限定されることはなく、下記の構成(第1~第3変形例)を採用することも可能である。
本実施形態の第1変形例は、図15Aに示すように、医師18が指で表示部192の画面上の所望箇所をクリックすることにより、クリックした部分が画面の中心に表示されるように患者16に対する次回の撮影が行われ、その後、図15Bに示すように、次回の撮影で取得された画像が表示部192の画面上に表示された際、クリックした部分が画面の中心に表示されるというものである。ここでは、一例として、図6Aと同様に、透視撮影の動画像を表示部192の画面に表示する場合について説明する。
これまでの説明は、手術室12内で医師18が患者16に対して手術を行う場合を前提として説明した。
本実施形態の第3変形例は、図17に示すように、第2変形例(図16参照)を一部改変したものである。
Claims (11)
- 被検体(16)に対して所定の診断又は処置を行う複数の医療機器(24、30、32、106)と、
前記被検体(16)の近傍まで持ち運び可能であり、操作者(18、54)の操作に起因して前記各医療機器(24、30、32、106)を制御可能な携帯機器(48)と、
を有し、
前記携帯機器(48)は、
前記各医療機器(24、30、32、106)を制御するための操作内容を表示可能な表示部(160)と、
前記表示部(160)の表示内容に基づく前記操作者(18、54)の操作を受け付ける操作部(162)と、
前記操作者(18、54)による前記操作部(162)の操作に起因して制御される医療機器(24、30、32、106)を限定する操作制御部(154)と、
前記操作制御部(154)で限定された医療機器(24、30、32、106)に対して、前記操作部(162)が受け付けた操作内容に応じた信号を送信する通信部(130)と、
を備え、
当該医療機器(24、30、32、106)は、前記通信部(130)から受信した前記信号に従って制御される
ことを特徴とする医療システム。 - 請求項1記載のシステム(10)において、
前記各医療機器(24、30、32、106)のうち、いずれか1つの医療機器が使用中である場合に、
前記操作制御部(154)は、前記使用中の医療機器に対する前記操作者(18、54)による前記操作部(162)の操作を有効にすると共に、他の医療機器に対する前記操作者(18、54)による前記操作部(162)の操作を無効にする
ことを特徴とする医療システム。 - 請求項2記載のシステム(10)において、
前記携帯機器(48)は、前記表示部(160)及び前記操作部(162)を含むタッチパネル(150)をさらに備え、
前記操作部(162)は、前記タッチパネル(150)の画面上に表示され、前記各医療機器(24、30、32、106)、及び/又は、該各医療機器(24、30、32、106)に対する操作内容を示し、且つ、前記各医療機器(24、30、32、106)に対する前記操作者(18、54)の操作が可能な操作用画像(204、212、214、226~236、242、244、248~252、256、262、264、268、270、272、282)であり、
前記操作制御部(154)は、前記使用中の医療機器に応じた操作用画像に対する前記操作者(18、54)の操作を有効にすると共に、前記他の医療機器に応じた操作用画像に対する前記操作者(18、54)の操作を無効にする
ことを特徴とする医療システム。 - 請求項3記載のシステム(10)において、
前記タッチパネル(150)の画面上において、前記使用中の医療機器に応じた操作用画像は、前記他の医療機器に応じた操作用画像よりも大きく表示される
ことを特徴とする医療システム。 - 請求項3又は4記載のシステム(10)において、
前記タッチパネル(150)の画面上には、前記携帯機器(48)から前記使用中の医療機器に対する制御を終了するための終了用画像(214、244、264)がさらに表示され、
前記操作者(18、54)により前記終了用画像(214、244、264)が操作された場合、前記操作制御部(154)は、前記各医療機器(24、30、32、106)に応じた操作用画像(204、212、214、226~236、242、244、248~252、256、262、264、268、270、272、282)に対する前記操作者(18、54)の操作を有効状態に切り替える
ことを特徴とする医療システム。 - 請求項5記載のシステム(10)において、
前記操作制御部(154)は、前記各医療機器(24、30、32、106)に応じた操作用画像(204、212、214、226~236、242、244、248~252、256、262、264、268、270、272、282)に対する前記操作者(18、54)の操作が有効状態に切り替わった後に、1つの医療機器に応じた操作用画像が前記操作者(18、54)により操作された場合、操作された操作用画像に応じた1つの医療機器を新たに使用する医療機器と判定すると共に、他の医療機器に応じた操作用画像に対する前記操作者(18、54)の操作を無効状態に切り替える
ことを特徴とする医療システム。 - 請求項1~6のいずれか1項に記載のシステム(10)において、
前記携帯機器(48)は、タブレットコンピュータ、ハンドヘルドコンピュータ又は携帯情報端末である
ことを特徴とする医療システム。 - 請求項1~7のいずれか1項に記載のシステム(10)において、
前記携帯機器(48)は、滅菌袋(200)に密封された状態で使用される
ことを特徴とする医療システム。 - 請求項1~8のいずれか1項に記載のシステム(10)において、
前記携帯機器(48)は、前記各医療機器(24、30、32、106)を制御する前に、前記通信部(130)と前記各医療機器(24、30、32、106)との間での多元接続の無線通信による信号の送受信を予め設定する送受信設定部(140)をさらに備える
ことを特徴とする医療システム。 - 請求項1~9のいずれか1項に記載のシステム(10)において、
前記各医療機器(24、30、32、106)は、
前記被検体(16)に放射線(20)を照射する放射線源(106)、及び、該被検体(16)を透過した前記放射線(20)を放射線画像に変換する放射線撮影装置(24)と、
前記被検体(16)の内部の所望の部位に超音波を照射し、該部位からの反射波を超音波画像に変換する超音波診断装置(30)と、
前記被検体(16)の内部に挿入されることによって前記被検体(16)の内部の光学画像を撮影する内視鏡装置(32)と、
である
ことを特徴とする医療システム。 - 請求項10記載のシステム(10)において、
前記被検体(16)から離間した場所(50)に配置され、前記放射線源(106)及び前記放射線撮影装置(24)を制御する制御装置(52)をさらに有し、
前記通信部(130)は、前記放射線撮影装置(24)及び前記制御装置(52)との間で無線通信による信号の送受信が可能であり、
前記放射線源(106)及び前記放射線撮影装置(24)が使用中である場合に、前記携帯機器(48)は、前記操作者(18、54)による前記操作部(162)に対する操作内容に応じた信号を、前記通信部(130)から前記制御装置(52)に送信することにより、前記制御装置(52)を介して前記放射線源(106)及び前記放射線撮影装置(24)を制御するか、あるいは、前記通信部(130)から前記放射線撮影装置(24)に前記信号を送信すると共に、前記通信部(130)から前記制御装置(52)を介して前記放射線源(106)に前記信号を送信することにより、前記放射線源(106)及び前記放射線撮影装置(24)を制御する
ことを特徴とする医療システム。
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CN103957800B (zh) | 2016-04-06 |
JPWO2013081042A1 (ja) | 2015-04-27 |
JP5823535B2 (ja) | 2015-11-25 |
US10667670B2 (en) | 2020-06-02 |
US20140276056A1 (en) | 2014-09-18 |
CN103957800A (zh) | 2014-07-30 |
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