WO2019215800A1 - Dispositif et système d'assistance therapeutique - Google Patents

Dispositif et système d'assistance therapeutique Download PDF

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Publication number
WO2019215800A1
WO2019215800A1 PCT/JP2018/017675 JP2018017675W WO2019215800A1 WO 2019215800 A1 WO2019215800 A1 WO 2019215800A1 JP 2018017675 W JP2018017675 W JP 2018017675W WO 2019215800 A1 WO2019215800 A1 WO 2019215800A1
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fluorescence
image
fluorescent
visible light
unit
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PCT/JP2018/017675
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English (en)
Japanese (ja)
Inventor
紘之 妻鳥
石川　亮宏
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株式会社島津製作所
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Priority to PCT/JP2018/017675 priority Critical patent/WO2019215800A1/fr
Publication of WO2019215800A1 publication Critical patent/WO2019215800A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements

Definitions

  • the present invention relates to a treatment support apparatus and a treatment support system, and more particularly, to a treatment support apparatus and a treatment support system for imaging a subject at the time of treatment and providing treatment support.
  • JP 2012-023492 A a subject including a fluorescent agent is irradiated with excitation light, and excited by the excitation light to capture a fluorescence image based on the fluorescence generated from the fluorescent agent to provide treatment support.
  • a treatment support apparatus is disclosed.
  • the surgical site to which the first fluorescent agent and the second fluorescent agent are administered is irradiated with the first excitation light to generate the first fluorescent agent generated from the first fluorescent agent.
  • a configuration is disclosed in which a first fluorescence image based on the second fluorescence image is captured, a second excitation light is irradiated, and a second fluorescence image based on the second fluorescence generated from the second fluorescent agent is captured.
  • the fluorescent agent is an agent that emits fluorescence of a predetermined wavelength when irradiated with excitation light of a predetermined wavelength.
  • the first excitation light and the second excitation light are excitation lights for exciting the first fluorescent agent and the second fluorescent agent, respectively, and have different wavelength bands.
  • indocyanine green hereinafter referred to as ICG
  • ICG is administered to a subject and treatment is performed by visualizing the part to be excised by irradiating with excitation light.
  • a fluorescent agent for purposes other than simply visualizing the part to be excised.
  • a method of using such a fluorescent agent is disclosed in, for example, Japanese Patent Application Laid-Open No. 2017-071654.
  • JP-A-2017-071654 a drug that binds a substance that emits fluorescence by absorbing excitation light and an antibody that selectively binds to cancer cells is administered to a subject, and a fluorescence image is displayed.
  • a method of killing cancer cells by irradiating with excitation light after specifying the position of the cancer cells by the fluorescence displayed on is disclosed.
  • IRDye 700Dx (hereinafter referred to as IR700) is used as a fluorescent agent. Note that the fluorescence emitted from IR700 and the fluorescence emitted from ICG have different wavelength bands.
  • IR700 and ICG have different distributions in the surgical site due to differences in biochemical characteristics
  • fluorescence emitted from ICG on the fluorescence image Is different from the display mode (reflection) of the fluorescence emitted from IR700. Therefore, in order to accurately perform follow-up after cancer treatment by the method disclosed in Japanese Patent Application Laid-Open No. 2017-071654, the treatment support device disclosed in Japanese Patent Application Laid-Open No. 2012-023492 is used.
  • a method is conceivable. That is, it is conceivable that the surgical site to which IR700 and ICG are administered is confirmed in different display modes by administering ICG to the subject in addition to IR700.
  • 2012-023492 has a problem in that it is not possible to confirm the surgical site to which IR700 and ICG are administered in different display modes.
  • IR700 and ICG are administered in different display modes.
  • not only the combination of ICG and IR700, but using two fluorescent agents having different biochemical characteristics by displaying two fluorescent images having different display modes, the surgical site to which the fluorescent agent has been administered is displayed. It may be necessary to check with different display modes.
  • the present invention has been made to solve the above-described problems, and one object of the present invention is an operation in which a fluorescent agent is administered when imaging a subject at the time of treatment and performing treatment support. It is to provide a treatment support apparatus and a treatment support system capable of confirming a part in different display modes.
  • a treatment support apparatus for imaging a subject at the time of treatment and performing treatment support, wherein the first fluorescence administered to the subject is provided.
  • a first fluorescence emitted from the drug and a detection unit that detects a second fluorescence emitted from the second fluorescent drug administered to the subject and having a wavelength band different from the first fluorescence, and detected by the detection unit Based on the first fluorescence and the second fluorescence, respectively, an image generation unit that generates the first fluorescence image and the second fluorescence image, and both the first fluorescence image and the second fluorescence image generated by the image generation unit And an image output unit that outputs to the display unit.
  • a second fluorescence image based on the second fluorescence emitted from the second fluorescence agent having a different wavelength band from the first fluorescence emitted from the agent can be imaged.
  • the image output unit can output both the first fluorescent image and the second fluorescent image to the display unit. Accordingly, both the first fluorescent image and the second fluorescent image having different display modes are obtained based on the first fluorescence and the second fluorescence emitted from the first fluorescent agent and the second fluorescent agent having different biochemical characteristics, respectively. It can be displayed on the display unit. As a result, it is possible to confirm the surgical site to which the fluorescent agent is administered in different display modes when imaging the subject at the time of treatment and providing treatment support.
  • the detection unit further detects visible light
  • the image generation unit generates a visible light image based on the visible light detected by the detection unit
  • the output unit is configured to output the first fluorescent image, the second fluorescent image, and the visible light image so that the display unit simultaneously displays the first fluorescent image, the second fluorescent image, and the visible light image.
  • region around the part in which the 1st fluorescence in a 1st fluorescence image and the 2nd fluorescence in a 2nd fluorescence image are reflected can be observed with a visible light image.
  • the surgical site to which the first fluorescent drug and the second fluorescent drug are administered can be observed together with the surrounding area, so that the surgical site to which the fluorescent drug is administered can be easily confirmed in different display modes. be able to.
  • the image output unit causes the display unit to display the first fluorescent image, the second fluorescent image, and the visible light so as to overlap each other. It is configured to output an image. If comprised in this way, the produced
  • the image output unit causes the display unit to superimpose and display the first fluorescent image and the visible light image, and superimposes the second fluorescent image and the visible light image.
  • the first fluorescence image, the second fluorescence image, and the visible light image are output so as to be displayed. If comprised in this way, while being able to grasp
  • the state of the portion where the first fluorescent agent is present as compared with the case where the first fluorescent image and the second fluorescent image are superimposed, The state of the portion where the fluorescent agent is present can be easily confirmed individually. Therefore, it is particularly useful when it is desired to distinguish and confirm the portion where the first fluorescent agent is concentrated and the portion where the second fluorescent agent is concentrated.
  • the detection unit includes a first fluorescence detector that detects the first fluorescence and a second fluorescence detector that detects the second fluorescence, and the first fluorescence. And an optical member for separating the second fluorescence and guiding them to the first fluorescence detector and the second fluorescence detector, respectively.
  • the first fluorescence image and the second fluorescence image can be easily generated as separate images that can be observed separately, not an image in which the first fluorescence and the second fluorescence are mixed. Further, the first fluorescence and the second fluorescence can be easily guided to the first fluorescence detector and the second fluorescence detector, respectively, by the optical member.
  • the detection unit includes a first fluorescence detection filter for extracting the first fluorescence and a second fluorescence detection filter for extracting the second fluorescence.
  • the first fluorescence and the second fluorescence having different wavelength bands can be easily obtained by the first fluorescence detection filter and the second fluorescence detection filter provided for the first fluorescence and the second fluorescence, respectively. It can be extracted separately.
  • the first fluorescence image and the second fluorescence image can be easily generated as separate images that can be observed separately, not an image in which the first fluorescence and the second fluorescence are mixed.
  • it is not necessary to provide a dedicated fluorescence detector for each of the first fluorescence and the second fluorescence and it is not necessary to provide an optical member for separating the first fluorescence and the second fluorescence. It can be simplified.
  • the treatment support apparatus preferably further includes a light source unit including a first excitation light source that irradiates a first excitation light for exciting the first fluorescent drug administered to the subject.
  • a light source unit including a first excitation light source that irradiates a first excitation light for exciting the first fluorescent drug administered to the subject.
  • the light source unit has a second excitation light source that has a wavelength band different from that of the first excitation light and that emits the second excitation light for exciting the second fluorescent agent administered to the subject.
  • medical agent can be easily excited with the 2nd excitation light irradiated from a 2nd excitation light source, it is easily 2nd from the 2nd fluorescence chemical
  • the first fluorescent image based on the first fluorescence and the second fluorescent image based on the second fluorescence can be easily obtained without separately providing a light source for exciting the first fluorescent agent and the second fluorescent agent other than the treatment support apparatus. Can be generated.
  • the light source unit includes the first excitation light source and the second excitation light source
  • a plurality of first excitation light sources and a plurality of second excitation light sources are provided, and a plurality of first excitation light sources and a plurality of second excitation light sources are provided.
  • the light sources are arranged in a ring and at substantially equal intervals. If comprised in this way, since it can suppress that bias arises in the 1st excitation light and 2nd excitation light with which a subject is irradiated, it detects in the 1st fluorescence detected by a detection part, and 2nd fluorescence. Generation of unevenness can be suppressed.
  • the way the first fluorescence and the second fluorescence are reflected can be made uniform, so that the portion where the first fluorescence agent and the second fluorescence agent are present is accurately reflected. It can be suppressed from disappearing.
  • the detection unit has a wavelength band different from that of the first fluorescence and the second fluorescence, and the third fluorescence emitted from the third fluorescent agent administered to the subject.
  • the image generation unit generates a third fluorescence image based on the third fluorescence detected by the detection unit, and the image output unit uses the display unit to generate the first fluorescence generated by the image generation unit.
  • the first fluorescent image, the second fluorescent image, and the third fluorescent image are output so that the image, the second fluorescent image, and the third fluorescent image are all displayed.
  • the first fluorescent image, the second fluorescent image, and the third fluorescent image that are different from each other can be displayed on the display unit.
  • a treatment support system is a treatment support system for imaging a subject at the time of treatment and providing treatment support, wherein the treatment support system is administered to a subject.
  • an image generation unit that generates a first fluorescence image and a second fluorescence image, respectively, and a treatment support device, and a first generated by the image generation unit
  • a display device that displays both the fluorescent image and the second fluorescent image.
  • the first fluorescence image based on the first fluorescence emitted from the first fluorescent agent and the first fluorescence agent emitted from the first fluorescent agent are used by the treatment support apparatus as described above.
  • the second fluorescence image based on the second fluorescence emitted from the second fluorescent agent having a different wavelength band from the one fluorescence can be imaged.
  • a display apparatus can display both the 1st fluorescence image and the 2nd fluorescence image imaged by the treatment assistance apparatus. Accordingly, both the first fluorescent image and the second fluorescent image having different display modes are obtained based on the first fluorescence and the second fluorescence emitted from the first fluorescent agent and the second fluorescent agent having different biochemical characteristics, respectively. It can be displayed on a display device. As a result, it is possible to confirm the surgical site to which the fluorescent agent is administered in different display modes when imaging the subject at the time of treatment and providing treatment support.
  • FIG. 1 is a perspective view of a treatment support apparatus and a treatment support system according to a first embodiment of the present invention. It is the block diagram which showed the outline of the treatment assistance apparatus and treatment assistance system by 1st Embodiment of this invention. It is the schematic of the imaging part of the treatment assistance apparatus by 1st Embodiment of this invention. It is the block diagram which showed the outline inside the imaging part of the treatment assistance apparatus by 1st Embodiment of this invention. It is the figure which showed a mode that the visible light image, the fluorescence image, and those synthesized images were displayed on the display apparatus of the treatment assistance system by 1st Embodiment of this invention.
  • the treatment support system is an apparatus for capturing an image of the subject P during treatment and performing treatment support.
  • the display device 900 is an example of the “display unit” in the claims.
  • the treatment support apparatus 100 includes an imaging unit 10 for imaging a subject P, a main body unit 20 including a control unit 21 (see FIG. 2), and the like. And an arm portion 30 that connects the portion 10 and the main body portion 20.
  • the treatment support apparatus 100 is configured to irradiate the fluorescent agent administered to the subject P with the excitation light Ex and detect and image the fluorescence Lx emitted when the fluorescent agent is excited by the excitation light Ex. Device.
  • the treatment support apparatus 100 is configured to be able to display an image captured by the imaging unit 10 on the display device 900.
  • the imaging unit 10 is configured to correspond to the wavelength bands of ICG and IR700 having different absorption spectra and emission spectra as fluorescent agents to be administered to the subject P.
  • ICG is a drug containing a substance that emits fluorescence Lx by absorbing excitation light Ex.
  • ICG is a drug that is administered to the subject P and used to visualize the surgical site Pa during surgery by irradiating the excitation light Ex.
  • IR700 is a drug in which a substance that emits fluorescence Lx by absorbing excitation light Ex and an antibody that selectively binds to cancer cells M are combined.
  • IR700 is a drug used for near-infrared photoimmunotherapy (NIR-PIT) that is administered to a subject P and kills cancer cells M (see FIG. 5) by irradiating with excitation light
  • ICG and IR700 are examples of “first fluorescent agent” and “second fluorescent agent” in the claims.
  • the imaging unit 10 includes a light source unit 50 for irradiating visible light Vis and excitation light Ex, an optical system 60 for separating visible light Vis and fluorescence Lx, visible light Vis and And a detection unit 70 for detecting the fluorescence Lx.
  • the light source unit 50 includes an excitation light source 51 that generates excitation light Ex1 for exciting the ICG, an excitation light source 52 that generates excitation light Ex2 for exciting the IR 700, a visible light source 54 that generates visible light Vis, It has.
  • the excitation light Ex1 and the excitation light Ex2 are examples of “first excitation light” and “second excitation light” in the claims.
  • the excitation light source 51 and the excitation light source 52 are examples of the “first excitation light source” and the “second excitation light source” in the claims, respectively.
  • the excitation light source 51, the excitation light source 52, and the visible light source 54 include, for example, a light emitting diode (LED) as a light source.
  • the excitation light source 51 and the excitation light source 52 are configured to generate excitation light Ex1 and excitation light Ex2 having different wavelengths so as to correspond to ICG and IR 700 having absorption spectra different from each other.
  • the excitation light Ex1 and the excitation light Ex2 are near infrared light having peak wavelengths of 760 mm and 700 mm, respectively.
  • the excitation light Ex2 is excitation light Ex (confirmation light) for confirming a portion to which IR700 is administered, and its irradiation intensity is lower than that of excitation light Ex (treatment light) for treating cancer.
  • the visible light source 54 is configured to generate white light including a plurality of (all) wavelengths in the visible region, for example, as the visible light Vis.
  • the visible light Vis is not limited to white light, and may be configured to include only a specific wavelength in the visible region.
  • a plurality (four each) of excitation light sources 51, excitation light sources 52, and visible light sources 54 are provided.
  • the plurality of (four) excitation light sources 51, the plurality (four) excitation light sources 52, and the plurality (four) visible light sources 54 are respectively annular and substantially equal in the light source unit 50. They are arranged side by side.
  • the four excitation light sources 51, the four excitation light sources 52, and the four visible light sources 54 are arranged in a ring shape so as to surround the periphery of the optical system 60.
  • the excitation light source 51, the excitation light source 52, and the visible light source 54 are arrange
  • the excitation light source 51, the excitation light source 52, and the visible light source 54 are in the state arrange
  • the light source unit 50 receives the excitation light Ex 1, the excitation light Ex 2, and the visible light Vis emitted from the excitation light source 51, the excitation light source 52, and the visible light source 54, respectively. It is configured to irradiate P.
  • ICG and IR700 are administered to the subject P, when the surgical site Pa in which ICG and IR700 are present is irradiated with excitation light Ex1 and excitation light Ex2, ICG and IR700 are excited, thereby causing ICG and IR700.
  • fluorescence Lx1 and fluorescence Lx2 having emission spectra (wavelength bands) different from each other are emitted.
  • the visible light Vis irradiated to the subject P is reflected by the subject P.
  • the fluorescence Lx1 and the fluorescence Lx2 have different peak wavelengths from the excitation light Ex1 and the excitation light Ex2, respectively.
  • the fluorescence Lx1 and the fluorescence Lx2 are examples of “first fluorescence” and “second fluorescence” in the claims, respectively.
  • the optical system 60 is separated by a zoom lens 61 for focusing, a prism 62 for separating visible light Vis and fluorescence Lx (fluorescence Lx1, fluorescence Lx2) reflected from the subject P, and the prism 62. And a prism 63 for separating the fluorescence Lx (fluorescence Lx1, fluorescence Lx2) into fluorescence Lx1 and fluorescence Lx2.
  • the zoom lens 61, the prism 62, and the prism 63 are arranged in this order along the optical axis L direction.
  • the prism 63 is an example of the “optical member” in the claims.
  • the zoom lens 61 is configured to be able to reciprocate in the direction of the optical axis L by a lens moving mechanism (not shown) for focusing.
  • the prism 62 separates the visible light Vis and fluorescence Lx (fluorescence Lx1, fluorescence Lx2) reflected from the subject P and passed through the zoom lens 61, and converts the visible light Vis and fluorescence Lx (fluorescence Lx1, fluorescence Lx2) into Each is configured to be guided to the visible light detector 74 and the prism 63.
  • the prism 63 is configured to separate the fluorescence Lx (fluorescence Lx1, fluorescence Lx2) that has passed through the prism 62 and guide the fluorescence Lx1 and fluorescence Lx2 to the fluorescence detector 71 and the fluorescence detector 72, respectively.
  • the detection unit 70 includes a fluorescence detector 71 for detecting fluorescence Lx1, a fluorescence detector 72 for detecting fluorescence Lx2, and a visible light detector 74 for detecting visible light Vis. .
  • the visible light detector 74 is configured to detect visible light Vis guided to the prism 62.
  • the fluorescence detector 71 and the fluorescence detector 72 are configured to detect fluorescence Lx1 and fluorescence Lx2 guided to the prism 63, respectively.
  • the fluorescence detector 71 and the fluorescence detector 72 are examples of the “first fluorescence detector” and the “second fluorescence detector” in the claims, respectively.
  • the fluorescence detector 71, the fluorescence detector 72, and the visible light detector 74 are each composed of an image sensor (imaging device) using, for example, a CMOS (complementary metal oxide semiconductor) or a CCD (charge coupled device).
  • image sensors that can detect light in a range including the wavelength bands of the fluorescence Lx1 and the fluorescence Lx2, respectively, are used.
  • the visible light detector 74 an imaging device capable of detecting light in a range including the wavelength band of the visible light Vis is used.
  • an imaging element capable of capturing a visible light image 84 see FIG. 5) as a color image is used.
  • the visible light Vis and the fluorescence Lx reflected from the subject P and simultaneously passing through the zoom lens 61 are separated by the optical system 60, and the fluorescence detector 71, the fluorescence detector 72, and the visible light are separated.
  • the detector 74 is configured to detect the fluorescence Lx1, the fluorescence Lx2, and the visible light Vis almost simultaneously.
  • the main body unit 20 includes a control unit 21 for controlling various configurations of the treatment support apparatus 100, an image generation unit 22 that generates an image based on a signal detected by the detection unit 70, A storage unit 23 that stores an image generated by the image generation unit 22 and an image output unit 24 that outputs the image generated by the image generation unit 22 to the display device 900 are provided.
  • the main unit 20 includes a personal computer (PC) including a control unit 21, an image generation unit 22, a storage unit 23, an image output unit 24, and the like, and is provided with wheels so that the treatment support apparatus 100 can be moved. It is configured as a trolley.
  • PC personal computer
  • the control unit 21 is a computer including a CPU (Central Processing Unit), a ROM (Read Only Memory), a RAM (Random Access Memory), and the like.
  • CPU Central Processing Unit
  • ROM Read Only Memory
  • RAM Random Access Memory
  • the image generation unit 22 is a computer including a processor such as a GPU (Graphics Processing Unit) or an FPGA (Field-Programmable Gate Array) configured for image processing. Based on the detection signals sent from the fluorescence detector 71, the fluorescence detector 72, and the visible light detector 74, the image generation unit 22, respectively, has a fluorescence image 81 (see FIG. 5) and a fluorescence image 82 (see FIG. 5). The visible light image 84 (see FIG. 5) can be generated.
  • a processor such as a GPU (Graphics Processing Unit) or an FPGA (Field-Programmable Gate Array) configured for image processing.
  • the image generation unit 22 Based on the detection signals sent from the fluorescence detector 71, the fluorescence detector 72, and the visible light detector 74, the image generation unit 22, respectively, has a fluorescence image 81 (see FIG. 5) and a fluorescence image 82 (see FIG. 5).
  • the visible light image 84 (see FIG. 5) can
  • the storage unit 23 includes, for example, a nonvolatile memory or a hard disk drive (HDD).
  • the storage unit 23 stores a program used for the processing of the control unit 21 and can store images (fluorescence image 81, fluorescence image 82, and visible light image 84) generated by the image generation unit 22 and the like. It is configured.
  • the storage unit 23 stores the image generated by the image generation unit 22 together with a time stamp such as an imaging date and time.
  • the image output unit 24 is an interface for connecting the treatment support apparatus 100 to the display apparatus 900.
  • the image output unit 24 is connected to the display device 900 by a video interface such as HDMI (registered trademark), for example.
  • the image output unit 24 is configured to output the images (fluorescent image 81, fluorescent image 82, and visible light image 84) generated by the image generating unit 22 to the display device 900.
  • the display device 900 is configured to display the output image 800 output by the image output unit 24 on the screen.
  • the arm unit 30 connects the main body unit 20 and the imaging unit 10 via a plurality of arms and a plurality of hinges.
  • the arm unit 30 is configured to be able to change the relative position of the imaging unit 10 with respect to the main body unit 20.
  • the display device 900 displays the images (fluorescence image 81, fluorescence image 82, and visible light image 84) generated by the image generation unit 22 and output by the image output unit 24.
  • the display device 900 is configured by, for example, a liquid crystal display, an organic EL display, an inorganic EL display, or the like.
  • 5 and 6 show an example in which the surgical site Pa affected by cancer is imaged and displayed on the display device 900.
  • the fluorescence image 81 and the fluorescence image 82 show the cancer cells M administered with ICG and IR700, respectively. Since ICG and IR700 have different distributions in the surgical site Pa due to differences in biochemical characteristics, the fluorescence image 81 and the fluorescence image 82 show the cancer cells M in different display modes. Further, in the visible light image 84, the periphery of the cancer cell M to which ICG and IR700 are administered is reflected. In FIGS. 5 and 6, for convenience of explanation, in the fluorescent image 81 and the fluorescent image 82, the cancer cells M are indicated by a solid line in which the inside is filled with diagonal lines and a thick solid line in which the inside is white, respectively. Yes.
  • the contours of the cancer cells M reflected in the fluorescence image 81 and the fluorescence image 82 are shown to be substantially the same, the cancer cells M reflected in the fluorescence image 81 and the fluorescence image 82 by ICG and IR 700, respectively, are shown.
  • the shapes may be different from each other.
  • the image output unit 24 is configured to be able to output both the fluorescent image 81 and the fluorescent image 82 to the display device 900. Furthermore, in the first embodiment, the image output unit 24 causes the display device 900 to simultaneously display the fluorescent image 81, the fluorescent image 82, and the visible light image 84, so that the fluorescent image 81, the fluorescent image 82, and the visible light image are displayed. 84 can be output. Specifically, as shown in FIGS. 5 and 6, the treatment support system can display the fluorescent image 81, the fluorescent image 82, and the visible light image 84 side by side on the screen of the display device 900 at the same time. It is configured. In FIG.
  • the fluorescent image 81, the fluorescent image 82, and the visible light image 84 are displayed side by side in the vertical direction on the left side on the screen of the display device 900.
  • the fluorescence image 81, the fluorescence image 82, and the visible light image 84 are displayed side by side on the upper side on the screen of the display device 900.
  • the image output unit 24 causes the display device 900 to display the fluorescence image 81, the fluorescence image 82, and the visible image 84 so that the fluorescence image 81, the fluorescence image 82, and the visible light image 84 are superimposed.
  • the optical image 84 can be output.
  • the treatment support system 1100 is configured to be able to display on the display device 900 a composite image 85 in which a fluorescent image 81, a fluorescent image 82, and a visible light image 84 are superimposed.
  • the composite image 85 is displayed on the right side on the screen of the display device 900.
  • the image output unit 24 superimposes and displays the fluorescent image 81 and the visible light image 84 on the display device 900 and superimposes and displays the fluorescent image 82 and the visible light image 84.
  • the fluorescent image 81, the fluorescent image 82, and the visible light image 84 can be output.
  • the treatment support system 1100 includes a composite image 86 in which the fluorescent image 81 and the visible light image 84 are superimposed, and a composite in which the fluorescent image 82 and the visible light image 84 are superimposed.
  • the image 87 can be displayed on the display device 900.
  • the composite image 86 and the composite image 87 are displayed side by side in the left-right direction on the lower side on the screen of the display device 900.
  • the treatment support system 1100 determines whether to display the composite image 85 as shown in FIG. 5 or whether to display the composite image 86 and the composite image 87 as shown in FIG. It can be set for the control unit 21 by the unit.
  • the treatment support apparatus 100 includes the fluorescence image 81 based on the fluorescence Lx1 emitted from the ICG and the fluorescence Lx1 emitted from the ICG by the detection unit 70 and the image generation unit 22.
  • the image output unit 24 can output both the fluorescent image 81 and the fluorescent image 82 to the display device 900.
  • both the fluorescent image 81 and the fluorescent image 82 having different display modes can be displayed on the display device 900 based on the fluorescence Lx1 and the fluorescence Lx2 emitted from the ICG and the IR 700 having different biochemical characteristics.
  • the surgical site Pa to which ICG and IR700 are administered can be confirmed in different display modes. It can be suppressed from occurring.
  • the detection unit 70 detects the visible light Vis
  • the image generation unit 22 generates the visible light image 84 based on the visible light Vis detected by the detection unit 70.
  • the image output unit 24 generates the fluorescent image 81, the fluorescent image 82, and the visible light image 84 so that the fluorescent image 81, the fluorescent image 82, and the visible light image 84 are simultaneously displayed on the display device 900.
  • the region around the portion where the fluorescence Lx1 in the fluorescence image 81 and the fluorescence Lx2 in the fluorescence image 82 are reflected can be observed with the visible light image 84.
  • the surgical site Pa to which ICG and IR700 are administered can be observed together with the surrounding area, so that the surgical site Pa to which ICG and IR700 are administered can be easily confirmed in different display modes. .
  • the image output unit 24 causes the display device 900 to display the fluorescent image 81, the fluorescent image 82, and the visible light image 84 so as to overlap each other.
  • the fluorescent image 82 and the visible light image 84 are output.
  • the generated fluorescence image 81, the fluorescence image 82, and the visible light image 84 are displayed so as to be superimposed, so that the fluorescence image 81, the fluorescence image 82, and the visible light image 84 are individually displayed without being superimposed.
  • the mutual positional relationship between the portion where the ICG exists and the portion where the IR 700 exists can be accurately grasped.
  • the image output unit 24 causes the display device 900 to display the fluorescent image 81 and the visible light image 84 so as to overlap each other, and the fluorescent image 82 and the visible light image 84.
  • the image output unit 24 is configured to output a fluorescent image 81, a fluorescent image 82, and a visible light image 84.
  • the state of the portion where the ICG exists and the state of the portion where the IR 700 exist are compared with the case where the fluorescent image 81 and the fluorescent image 82 are superimposed. It can be easily confirmed individually. Therefore, it is particularly useful when it is desired to distinguish and confirm the part where ICG concentrates and the part where IR700 concentrates.
  • the detection unit 70 includes the fluorescence detector 71 that detects the fluorescence Lx1 and the fluorescence detector 72 that detects the fluorescence Lx2, and the treatment support system 1100 includes the fluorescence detector 71.
  • a prism 63 is provided for separating Lx1 and fluorescence Lx2 and guiding them to the fluorescence detector 71 and the fluorescence detector 72, respectively. Accordingly, the fluorescence Lx1 and the fluorescence Lx2 having different wavelength bands can be easily and separately detected by the fluorescence detector 71 and the fluorescence detector 72 provided exclusively for the fluorescence Lx1 and the fluorescence Lx2, respectively.
  • the fluorescence image 81 and the fluorescence image 82 can be easily generated as separate images that can be observed separately, rather than an image in which the fluorescence Lx1 and the fluorescence Lx2 are mixed. Further, the fluorescence Lx1 and the fluorescence Lx2 can be easily guided to the fluorescence detector 71 and the fluorescence detector 72 by the prism 63, respectively.
  • the treatment support apparatus 100 includes the light source unit 50 including the excitation light source 51 that irradiates the excitation light Ex1 for exciting the ICG administered to the subject P.
  • the fluorescence Lx1 can be easily generated from the ICG administered to the subject P.
  • the fluorescence image 81 based on the fluorescence Lx1 can be easily generated without separately providing a light source for exciting the ICG other than the treatment support apparatus 100.
  • the light source unit 50 has an excitation light source that has a wavelength band different from that of the excitation light Ex1 and emits the fluorescence Lx2 for exciting the IR 700 administered to the subject P. 52.
  • the fluorescence Lx2 can be easily generated from the IR 700 administered to the subject P.
  • the fluorescence image 81 based on the fluorescence Lx1 and the fluorescence image 82 based on the fluorescence Lx2 can be easily generated without separately providing a light source for exciting the ICG and the IR 700 other than the treatment support apparatus 100.
  • a plurality of excitation light sources 51 and a plurality of excitation light sources 52 are provided, and the plurality of excitation light sources 51 and the plurality of excitation light sources 52 are respectively annular in the light source unit 50. Arranged at approximately equal intervals. Thereby, since it is possible to suppress the occurrence of bias in the excitation light Ex1 and the excitation light Ex2 irradiated to the subject P, it is possible to suppress the occurrence of detection unevenness in the fluorescence Lx1 and the fluorescence Lx2 detected by the detection unit 70. can do.
  • the way in which the fluorescence Lx1 and the fluorescence Lx2 are reflected can be made uniform, so that it is possible to prevent the portion where the ICG and IR700 are present from being accurately reflected.
  • the filter member 90 for extracting the fluorescence Lx1 and the fluorescence Lx2 is provided.
  • the example comprised so that it may be provided is demonstrated.
  • the same reference numerals are assigned to the same components as those in the first embodiment.
  • the treatment support apparatus 200 included in the treatment support system 1200 of the second embodiment includes an imaging unit 210 for imaging the subject P as shown in FIG.
  • the imaging unit 210 includes an optical system 260 for separating visible light Vis and fluorescence Lx, and a detection unit 270 for detecting visible light Vis and fluorescence Lx.
  • the optical system 260 includes a zoom lens 61 and a prism 62.
  • the fluorescence Lx fluorescence Lx1, fluorescence Lx2
  • the prism 63 for separating the fluorescence Lx1 and the fluorescence Lx2 is not included.
  • the detection unit 270 includes a visible light detector 74, a filter member 90 for separating the fluorescence Lx1 and the fluorescence Lx2, and a fluorescence detector 271 for detecting the fluorescence Lx1 and the fluorescence Lx2.
  • the fluorescence detector 271 is an example of “first fluorescence detector” and “second fluorescence detector” in the claims.
  • the filter member 90 includes a fluorescence detection filter 91 that extracts fluorescence Lx1, and a fluorescence detection filter 92 that extracts fluorescence Lx2.
  • the fluorescence detection filter 91 and the fluorescence detection filter 92 are configured to pass light in a range including the wavelength bands of the fluorescence Lx1 and the fluorescence Lx2, respectively.
  • the fluorescence detection filter 91 and the fluorescence detection filter 92 are alternately arranged on the filter member 90 in the horizontal direction and the vertical direction.
  • the fluorescence detection filter 91 and the fluorescence detection filter 92 are examples of the “first fluorescence detection filter” and the “second fluorescence detection filter” in the claims, respectively.
  • the fluorescence detection filter 92 is configured to remove light having a wavelength equal to or less than a predetermined wavelength in the wavelength band of the fluorescence Lx2 emitted from the IR 700. Specifically, the fluorescence detection filter 92 overlaps the wavelength band of light in the wavelength band of the fluorescence Lx2 with light such as room illumination in a space (such as an operating room) where the treatment support apparatus 200 is installed (predetermined). It is configured to remove light having a wavelength less than or equal to the wavelength of.
  • the fluorescence detection filter 92 is configured as a long-pass filter that removes light having a predetermined wavelength or less from light in the wavelength band of the fluorescence Lx2 and transmits only light having a wavelength longer than the predetermined wavelength.
  • the fluorescence Lx1 emitted from the ICG has a longer wavelength than the fluorescence Lx2 emitted from the IR700 and is longer than the wavelength band of light such as indoor lighting (the wavelength bands hardly overlap). There is little influence by.
  • the fluorescence detection filter 91 is configured to transmit all the light in the wavelength band of the fluorescence Lx1 emitted from the ICG.
  • the indoor lighting includes fluorescent lights, white light bulbs, LED lights, emergency lights, monitors, light that is lit by medical equipment, and the like.
  • the fluorescence detector 271 is configured to detect fluorescence Lx1 and fluorescence Lx2 separated by the filter member 90.
  • the fluorescence detector 271 includes a portion where the fluorescence Lx1 is detected by passing through the fluorescence detection filter 91 and a fluorescence detection filter 92 so as to correspond to the arrangement of the fluorescence detection filter 91 and the fluorescence detection filter 92. And the portion where the fluorescence Lx2 is detected.
  • the fluorescence image 81 and the fluorescence image 82 are generated based on the fluorescence Lx1 and the fluorescence Lx2 that have passed through the fluorescence detection filter 91 and the fluorescence detection filter 92, respectively.
  • the detection unit 270 includes the fluorescence detection filter 91 that extracts the fluorescence Lx1 and the fluorescence detection filter 92 that extracts the fluorescence Lx2. Accordingly, the fluorescence Lx1 and the fluorescence Lx2 having different wavelength bands can be easily extracted separately by the fluorescence detection filter 91 and the fluorescence detection filter 92 provided for the fluorescence Lx1 and the fluorescence Lx2, respectively. As a result, the fluorescence image 81 and the fluorescence image 82 can be easily generated as separate images that can be observed separately, rather than an image in which the fluorescence Lx1 and the fluorescence Lx2 are mixed.
  • the detection unit 270a includes a filter member 90a.
  • the filter member 90a includes a fluorescence detection filter 91a that extracts fluorescence Lx1, and a fluorescence detection filter 92a that extracts fluorescence Lx2.
  • the fluorescence detection filter 91a and the fluorescence detection filter 92a are configured to be switchable at a position between the prism 62 and the fluorescence detector 271.
  • the fluorescence detection filter 91a and the fluorescence detection filter 92a are examples of the “first fluorescence detection filter” and the “second fluorescence detection filter” in the claims, respectively.
  • the filter member 90a transmits only the fluorescence Lx1 out of the fluorescence Lx1 and the fluorescence Lx2 guided from the prism 62 in a state where the fluorescence detection filter 91a is disposed between the prism 62 and the fluorescence detector 271.
  • the filter member 90a transmits only the fluorescence Lx2 out of the fluorescence Lx1 and the fluorescence Lx2 guided from the prism 62 in a state where the fluorescence detection filter 92a is disposed between the prism 62 and the fluorescence detector 271.
  • the fluorescence detector 271 detects either the fluorescence Lx1 or the fluorescence Lx2.
  • the fluorescence detector 271 is configured to vary the readout timing of the detection signal. That is, in the treatment support apparatus 200, the fluorescence image 81 is based on the fluorescence Lx1 detected by the fluorescence detector 271 at the timing when the fluorescence detection filter 91a is disposed between the prism 62 and the fluorescence detector 271. Generated. Further, a fluorescence image 82 is generated based on the fluorescence Lx2 detected by the fluorescence detector 271 at the timing when the fluorescence detection filter 92a is disposed between the prism 62 and the fluorescence detector 271.
  • the detection unit 270a can be switched between the fluorescence detection filter 91a and the fluorescence detection filter 92a at a position between the prism 62 and the fluorescence detector 271.
  • the fluorescence detection filter for the fluorescence Lx1 and the fluorescence detection filter for the fluorescence Lx2 are easily provided without creating a fine structure as in the case where they are alternately arranged in the horizontal direction and the vertical direction. Can do.
  • the third embodiment differs from the first and second embodiments in which two fluorescent images having different display modes are displayed by using two fluorescent agents, unlike the first and second embodiments.
  • An example in which all three fluorescent images having different display modes are displayed by using two fluorescent agents will be described.
  • the same reference numerals are assigned to the same components as those in the first and second embodiments.
  • the treatment support apparatus 300 included in the treatment support system 1300 according to the third embodiment includes an imaging unit 310 and a main body unit 320 including an image generation unit 322 and the like.
  • the fluorescent agent administered to the subject P is configured to correspond to ICG, IR700 and 5-ala having different absorption spectra and emission spectra.
  • 5-ala is a fluorescent agent that is selectively metabolized to a tumor and used for tumor identification, photodynamic therapy, and the like.
  • 5-ala is an example of the “third fluorescent agent” in the claims.
  • the imaging unit 310 includes a light source unit 350 for irradiating visible light Vis and excitation light Ex, an optical system 360 for separating visible light Vis and fluorescence Lx, and for detecting visible light Vis and fluorescence Lx.
  • a detection unit 370 for detecting visible light Vis and fluorescence Lx.
  • the light source unit 350 includes an excitation light source 53 that generates excitation light Ex3 for exciting 5-ala.
  • the excitation light source 53 includes, for example, a light emitting diode (LED) as a light source.
  • the excitation light Ex3 has a peak wavelength different from that of the excitation light Ex1 and the excitation light Ex2.
  • the excitation light Ex3 is near ultraviolet light having a peak wavelength of 400 mm.
  • the excitation light Ex3 is excitation light Ex (confirmation light) for confirming a portion to which 5-ala has been administered, and the irradiation intensity compared to the excitation light Ex (treatment light) for treating cancer. Is configured to be low.
  • a plurality of (three in each) excitation light sources 51, excitation light sources 52, excitation light sources 53, and visible light sources 54 are provided.
  • a plurality of (three) excitation light sources 51, a plurality (three) excitation light sources 52, a plurality (three) excitation light sources 53, and a plurality (three) visible light sources 54 are light sources.
  • the part 50 it arrange
  • the three excitation light sources 51, the three excitation light sources 52, the three excitation light sources 53, and the three visible light sources 54 are arranged in an annular shape so as to surround the periphery of the optical system 360.
  • the excitation light source 51, the excitation light source 52, the excitation light source 53, and the visible light source 54 are arranged at substantially equal intervals so that the order of the excitation light source 51, the excitation light source 52, the excitation light source 53, and the visible light source 54 is repeated.
  • the excitation light source 51, the excitation light source 52, the excitation light source 53, and the visible light source 54 are in a state of being arranged at substantially equal intervals in the light source unit 350, respectively.
  • the subject P is configured to irradiate.
  • 5-ala is administered to the subject P
  • the excitation light Ex3 is irradiated to the surgical site Pa where 5-ala is present
  • 5-ala is excited, so that fluorescence Lx3 is emitted from 5-ala. Is emitted.
  • the fluorescence Lx3 has a different peak wavelength from the fluorescence Lx1 and the fluorescence Lx2.
  • the fluorescence Lx3 is an example of “third fluorescence” in the claims.
  • the optical system 360 includes a zoom lens 61, a prism 362, a prism 363, and a prism 64. As shown in FIG. 12, the zoom lens 61, the prism 362, the prism 363, and the prism 64 are arranged in this order along the optical axis L direction.
  • the prism 363 is an example of the “optical member” in the claims.
  • the prism 362 separates the visible light Vis and fluorescence Lx (fluorescence Lx1, fluorescence Lx2, fluorescence Lx3) reflected from the subject P, and converts the visible light Vis and fluorescence Lx (fluorescence Lx1, fluorescence Lx2, fluorescence Lx3).
  • the prism 362 separates the visible light Vis and fluorescence Lx (fluorescence Lx1, fluorescence Lx2, fluorescence Lx3) reflected from the subject P, and converts the visible light Vis and fluorescence Lx (fluorescence Lx1, fluorescence Lx2, fluorescence Lx3).
  • the prism 363 separates the fluorescence Lx (Lx1, fluorescence Lx2, fluorescence Lx3) separated by the prism 362 into fluorescence Lx1, fluorescence Lx2, and fluorescence Lx3, and converts the fluorescence Lx1, fluorescence Lx2, and fluorescence Lx3 into Each is configured to be guided to a fluorescence detector 71 and a prism 64.
  • the prism 64 separates the fluorescence Lx2 and the fluorescence Lx3 separated by the prism 363 into the fluorescence Lx2 and the fluorescence Lx3, and guides the fluorescence Lx2 and the fluorescence Lx3 to the fluorescence detector 72 and the fluorescence detector 73, respectively. It is configured.
  • the detection unit 370 includes a fluorescence detector 71, a fluorescence detector 72, a fluorescence detector 73, and a visible light detector 74.
  • the visible light detector 74 is configured to detect visible light Vis guided to the prism 362.
  • the fluorescence detector 71 is configured to detect the fluorescence Lx1 guided to the prism 63.
  • the fluorescence detector 72 and the fluorescence detector 73 are configured to detect fluorescence Lx2 and fluorescence Lx3 guided to the prism 64, respectively.
  • an imaging device capable of detecting light in a range including the wavelength band of the fluorescence Lx3 is used.
  • the main body unit 320 includes an image generation unit 322 that generates an image based on the signal detected by the detection unit 370, and an image output unit 324 that outputs the image generated by the image generation unit 322 to the display device 900. Yes.
  • the image generation unit 322 Based on the detection signals sent from the fluorescence detector 71, the fluorescence detector 72, the fluorescence detector 73, and the visible light detector 74, the image generation unit 322, respectively, has a fluorescence image 81, a fluorescence image 82, and a fluorescence image 83 ( 13) and a visible light image 84 can be generated.
  • the image output unit 324 is an interface for connecting the treatment support apparatus 300 to the display apparatus 900.
  • the image output unit 324 is configured to output the images (fluorescence image 81, fluorescence image 82, fluorescence image 83, and visible light image 84) generated by the image generation unit 322 to the display device 900.
  • the display device 900 is an image generated by the image generation unit 322 and output by the image output unit 324 (fluorescence image 81, fluorescence image 82, fluorescence image 83, and visible light image 84). Can be displayed.
  • the fluorescence image 81, the fluorescence image 82, and the fluorescence image 83 show the cancer cells M administered with ICG, IR700, and 5-ala, respectively. Since ICG, IR700, and 5-ala have different distributions in the surgical site due to differences in biochemical characteristics, the fluorescence image 81, the fluorescence image 82, and the fluorescence image 83 are reflected in different display modes of the cancer cells M. It is out.
  • the fluorescent image 83 the cancer cell M is indicated by a solid line whose inside is filled with dots.
  • the contours of the cancer cells M reflected in the fluorescence image 81, the fluorescence image 82, and the fluorescence image 83 are shown to be substantially the same, but the fluorescence image 81, the fluorescence image 82, and the ICG, IR700, and 5-ala are shown.
  • the shapes of the cancer cells M reflected in the fluorescent images 83 may be different from each other.
  • the image output unit 324 is configured to be able to output any of the fluorescent image 81, the fluorescent image 82, and the fluorescent image 83 to the display device 900. Furthermore, in the treatment support apparatus 300, the image output unit 324 causes the display device 900 to display the fluorescence image 81, the fluorescence image 82, the fluorescence image 83, and the visible light image 84 at the same time. The fluorescent image 83 and the visible light image 84 can be output. Specifically, as illustrated in FIGS. 13 and 14, the treatment support system 1300 displays the fluorescent image 81, the fluorescent image 82, the fluorescent image 83, and the visible light image 84 side by side on the screen of the display device 900 at the same time. It is possible to make it.
  • the fluorescent image 81, the fluorescent image 82, the fluorescent image 83, and the visible light image 84 are displayed side by side in the vertical direction on the left side on the screen of the display device 900.
  • the fluorescent image 81, the fluorescent image 82, the fluorescent image 83, and the visible light image 84 are displayed side by side in the left-right direction on the upper side on the screen of the display device 900.
  • the image output unit 324 causes the display device 900 to display the fluorescence image 81, the fluorescence image 82, the fluorescence image 83, and the visible light image 84 so as to overlap each other.
  • An image 82, a fluorescence image 83, and a visible light image 84 can be output.
  • the treatment support system 1300 causes the display device 900 to display a composite image 385 in which the fluorescence image 81, the fluorescence image 82, the fluorescence image 83, and the visible light image 84 are superimposed. Is configured to be possible.
  • the composite image 385 is displayed on the right side on the screen of the display device 900.
  • the image output unit 324 causes the display device 900 to display the fluorescent image 81 and the visible light image 84 in a superimposed manner, and displays the fluorescent image 82 and the visible light image 84 in a superimposed manner.
  • the fluorescent image 81, the fluorescent image 82, the fluorescent image 83, and the visible light image 84, which are displayed by superimposing the fluorescent image 83 and the visible light image 84, are configured to be output.
  • the treatment support system 1300 includes a composite image 86 in which the fluorescent image 81 and the visible light image 84 are superimposed, and a composite in which the fluorescent image 82 and the visible light image 84 are superimposed.
  • An image 87 and a composite image 88 obtained by superimposing the fluorescent image 83 and the visible light image 84 can be displayed on the display device 900.
  • the composite image 86, the composite image 87, and the composite image 88 are displayed side by side in the left-right direction on the lower side on the screen of the display device 900.
  • the remaining configuration of the third embodiment is the same as that of the first and second embodiments.
  • the detection unit 370 has a wavelength band different from the fluorescence Lx1 and the fluorescence Lx2, and detects the fluorescence Lx3 emitted from 5-ala administered to the subject P.
  • the generation unit 322 generates a fluorescence image 83 based on the fluorescence Lx3 detected by the detection unit 370, and the image output unit 324 uses the display device 900 to generate the fluorescence image 81 and the fluorescence image generated by the image generation unit 322.
  • the fluorescent image 81, the fluorescent image 82, and the fluorescent image 83 are configured to be output so that both the 82 and the fluorescent image 83 are displayed.
  • fluorescence images 81, fluorescence images 82, and fluorescence images 83 having different display modes are obtained. Both can be displayed on the display device 900.
  • fluorescence images 81, fluorescence images 82, and fluorescence images 83 having different display modes are obtained. Both can be displayed on the display device 900.
  • both two fluorescent images having different display modes are displayed. Compared with the case where both are displayed, since the surgical site Pa to which the fluorescent agent has been administered can be confirmed in more types of display modes, for example, the occurrence of oversight of cancer cells M can be further suppressed. it can.
  • the excitation light source 51, the excitation light source 52, and the visible light source 54 are each shown in an example in which four each are arranged in an annular shape at approximately equal intervals.
  • the present invention is not limited to this.
  • the excitation light source 51, the excitation light source 52, and the visible light source 54 may be arranged in a non-annular form, in an unequal interval, or in any number in the light source unit 50. Good.
  • the numbers of the excitation light source 51, the excitation light source 52, and the visible light source 54 may be different from each other. The same applies to the light source unit 350 shown in the third embodiment.
  • the fluorescent image 81, the fluorescent image 82, and the visible light image 84 are displayed side by side on the left side, and the composite image 85 is displayed on the right side.
  • An example is shown.
  • the fluorescent image 81, the fluorescent image 82, and the visible light image 84 are displayed side by side on the upper side in the horizontal direction, and the composite image 86 and the composite image 87 are arranged on the lower side in the horizontal direction.
  • the present invention is not limited to this.
  • the fluorescent image 81, the fluorescent image 82, the visible light image 84, the composite image 85, the composite image 86, and the composite image 87 may be displayed side by side on the display device 900.
  • only one of the fluorescent image 81, the fluorescent image 82, and the visible light image 84, the composite image 85, the composite image 86, and the composite image 87 may be displayed.
  • the fluorescence detection filter 91 and the fluorescence detection filter 92 are alternately arranged on the filter member 90 in the horizontal direction and the vertical direction. Not limited.
  • the fluorescence detection filter 91 and the fluorescence detection filter 92 may be irregularly arranged on the filter member 90 in either the left-right direction or the up-down direction, or in either the left-right direction or the up-down direction. May be arranged irregularly.
  • the fluorescence detection filter 92 removes light having a predetermined wavelength or less from light in the wavelength band of the fluorescence Lx2, and transmits only light having a wavelength longer than the predetermined wavelength.
  • the fluorescence detection filter 92 may be configured to transmit all the light in the wavelength band of the fluorescence Lx2.
  • the fluorescence detection filter 91 removes light having a predetermined wavelength or less from light in the wavelength band of the fluorescence Lx1, and transmits only light having a wavelength longer than the predetermined wavelength. You may comprise.
  • the optical unit is not provided with a prism for separating fluorescence having different wavelength bands, and a plurality of fluorescence Lx is provided in the detection unit.
  • a plurality (three) of fluorescence detection filters for extracting may be provided.
  • the detection unit need only have one fluorescence detector in order to detect a plurality of types (three types) of fluorescence Lx.
  • the visible light Vis and the fluorescence Lx reflected from the subject P and simultaneously passing through the zoom lens 61 are separated by the optical system 60 to obtain the fluorescence detector 71 and the fluorescence detector.
  • 72 and visible light detector 74 are shown as being configured to detect fluorescence Lx1, fluorescence Lx2 and visible light Vis almost simultaneously, respectively, but the present invention is not limited to this.
  • the detection timing of the fluorescence Lx1, the fluorescence Lx2, and the visible light Vis by the fluorescence detector 71, the fluorescence detector 72, and the visible light detector 74 may be different from each other. In that case, the detection of the fluorescence Lx1, the fluorescence Lx2, and the visible light Vis by the fluorescence detector 71, the fluorescence detector 72, and the visible light detector 74 may be switched.
  • the visible light source 54 is provided in the first to third embodiments, but the present invention is not limited to this.
  • a visible light source may be provided in addition to the light source unit 50 (350), or a visible light source separate from the treatment support apparatus 100 (200, 300) may be used.
  • the treatment support apparatus 100 irradiates the fluorescent agent administered to the subject P with the excitation light Ex (Ex1, Ex2, Ex3) that is confirmation light.
  • Ex excitation light
  • Ex3, Ex2, Ex3 confirmation light
  • an example is shown in which the fluorescence Lx (Lx1, Lx2, Lx3) emitted when the fluorescent agent is excited by the excitation light Ex (Ex1, Ex2, Ex3) is detected and imaged.
  • the present invention is not limited to this.
  • the treatment support apparatus irradiates the fluorescent drug administered to the subject P with excitation light Ex (treatment light) irradiated from a light source other than the treatment support apparatus for treating cancer
  • treatment light is, for example, for exciting excitation light Ex, 5-ala having a wavelength band substantially equal to the excitation light Ex1 for exciting the IR 700 and having a higher irradiation intensity than the excitation light Ex1.
  • the excitation light Ex has a wavelength band substantially equal to that of the excitation light Ex3 and has a higher irradiation intensity than the excitation light Ex3.
  • the excitation light source 51 (excitation light source 52) is provided has been described.
  • the present invention is not limited to this.
  • the excitation light source 51 (excitation light source 52) may be provided in addition to the light source unit 50 (350), or the treatment support apparatus 100 (200, 300) may be provided without providing the excitation light source 51 (excitation light source 52).
  • An excitation light source that is separate from the treatment support apparatus 100 (200, 300) may be used.
  • only either the excitation light source 51 or the excitation light source 52 may be provided separately from the treatment support apparatus 100 (200, 300).
  • the fluorescent image 81, 82 and 83 and the visible light image 84 are displayed on the display device 900, but the present invention is not limited to this. In the present invention, only the fluorescent image may be displayed on the display device 900.
  • an example is shown in which an image captured by the imaging unit 10 (210, 310) is displayed on the display device 900, but the present invention is not limited to this.
  • you may comprise so that a treatment assistance apparatus may be equipped with the display part which displays the image imaged by the imaging part.
  • fluorescence may be emitted from different sites for each fluorescent agent.
  • one fluorescent agent may emit fluorescence from cancer cells, and another fluorescent agent may emit fluorescence from around the cancer cells.
  • the surgical site Pa of the subject is a cancer cell M
  • the present invention is not limited to this.
  • the fluorescent agent is used to visualize other objects than cancer by fluorescence.
  • the present invention is not limited to this.
  • any drug may be used as long as it emits fluorescence when irradiated with excitation light and has different biochemical characteristics.
  • Excitation light source (first excitation light source) 52 Excitation light source (second excitation light source) 63, 363 Prism (optical member) 70, 270, 270a, 370 Detector 71 Fluorescence detector (first fluorescence detector) 72 Fluorescence detector (second fluorescence detector) 81 Fluorescence image (first fluorescence image) 82 Fluorescence image (second fluorescence image) 83 Fluorescence image (3rd fluorescence image) 84 Visible light image 91, 91a Fluorescence detection filter (first fluorescence detection filter) 92, 92a Fluorescence detection filter (second fluorescence detection filter) 100, 200, 300 Treatment support device 271 Fluorescence detector (first fluorescence detector, second fluorescence detector) 900 Display device (display unit) 1100, 1200, 1300 Treatment support system Ex1 Excitation light (first excitation light) Ex2 excitation light (second excitation light) Lx1 fluorescence (first fluorescence

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  • Life Sciences & Earth Sciences (AREA)
  • Medical Informatics (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Pathology (AREA)
  • Molecular Biology (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
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  • Veterinary Medicine (AREA)
  • Endoscopes (AREA)
  • Investigating, Analyzing Materials By Fluorescence Or Luminescence (AREA)

Abstract

Selon l'invention, un dispositif (100, 200, 300) d'assistance thérapeutique comporte une unité (24, 324) de sortie d'image, laquelle émet en sortie en direction d'une unité d'affichage (900) à la fois une première image fluorescente (81) basée sur un premier rayonnement fluorescent (Lx1) généré par un premier agent fluorescent et une deuxième image fluorescente (82) basée sur un deuxième rayonnement fluorescent (Lx2) généré par un deuxième agent fluorescent, la zone de longueur d'onde de ce deuxième rayonnement fluorescent étant différente de la zone de longueur d'onde du premier rayonnement fluorescent généré par le premier agent fluorescent.
PCT/JP2018/017675 2018-05-07 2018-05-07 Dispositif et système d'assistance therapeutique WO2019215800A1 (fr)

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102020117579A1 (de) 2020-07-03 2022-01-05 Hoya Corporation Endoskopisches Beleuchtungssystem für ein Fluoreszenzmittel
WO2022038806A1 (fr) * 2020-08-19 2022-02-24 株式会社島津製作所 Système d'assistance thérapeutique et dispositif d'assistance thérapeutique

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2005319115A (ja) * 2004-05-10 2005-11-17 Pentax Corp 蛍光観察内視鏡装置
JP2016214507A (ja) * 2015-05-19 2016-12-22 株式会社島津製作所 イメージング装置
WO2018003169A1 (fr) * 2016-06-30 2018-01-04 株式会社島津製作所 Dispositif d'imagerie

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2005319115A (ja) * 2004-05-10 2005-11-17 Pentax Corp 蛍光観察内視鏡装置
JP2016214507A (ja) * 2015-05-19 2016-12-22 株式会社島津製作所 イメージング装置
WO2018003169A1 (fr) * 2016-06-30 2018-01-04 株式会社島津製作所 Dispositif d'imagerie

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102020117579A1 (de) 2020-07-03 2022-01-05 Hoya Corporation Endoskopisches Beleuchtungssystem für ein Fluoreszenzmittel
WO2022038806A1 (fr) * 2020-08-19 2022-02-24 株式会社島津製作所 Système d'assistance thérapeutique et dispositif d'assistance thérapeutique

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