JP2018134421A - Infrared imaging device - Google Patents

Abstract

An infrared light imaging apparatus capable of easily recognizing an affected area even when a time after injection of a fluorescent dye has elapsed. An infrared imaging apparatus includes a main body 10 including an input unit 11 such as a touch panel, an illumination / imaging unit 12 movably supported by an arm 13, a pair of display units 14 and 15, and a patient. And a treatment table 16 on which 17 is placed. The illumination / photographing unit 12 includes a camera capable of detecting infrared and visible light, an infrared light source disposed on the outer periphery of the camera, and a visible light source disposed on the outer periphery of the infrared light source. The display unit 14 displays the current fusion image near the affected part of the patient 17 as a moving image, and the display unit 15 displays the past fusion image near the affected part of the patient 17 as a still image. [Selection] Figure 1

Description

  The present invention relates to an infrared imaging apparatus for displaying an infrared image of a subject on a display unit.

  In recent years, a technique called near-infrared fluorescence imaging has been used for surgery. In this near-infrared fluorescence imaging, indocyanine green (ICG) as a fluorescent dye is injected into the affected area. When this indocyanine green is irradiated with excitation light of 750 to 810 nm (nanometer), indocyanine green emits fluorescence in the infrared region having a peak at 845 nm. The fluorescence is photographed with a camera capable of detecting infrared light, and the image is displayed on a display unit such as a liquid crystal display panel. According to this near-infrared fluorescence imaging, it is possible to observe blood vessels, lymph vessels, and the like existing at a depth of about 20 mm from the body surface.

  Patent Document 1 discloses a near-infrared fluorescence intensity distribution image obtained by irradiating an indocyanine green excitation light to a living organ to which indocyanine green is administered, and indocyanine green administration. Compared with the cancer lesion distribution image obtained by applying X-rays, nuclear magnetic resonance or ultrasound to the previous test organ, it is detected by the intensity distribution image of near-infrared fluorescence, A data collection method is disclosed in which data of a region that is not detected in a cancer lesion distribution image is collected as cancer secondary lesion region data.

International Publication No. 2009/139466

  For example, when performing breast cancer surgery in breast surgery, it is necessary to specify the position of the sentinel lymph node. This sentinel lymph node is the lymph node that cancer cells reach first on the lymph flow. If cancer cells are not found in the sentinel lymph node, it can be determined that there is no breast cancer metastasis in the lymph node.

  By the way, indocyanine green used for near-infrared fluorescence imaging has a small molecular weight and high fluidity in lymphatic vessels, and thus has a characteristic of diffusing in a short time. For this reason, after indocyanine green administration, when time passes, the whole lymphatic vessel will fluoresce and it will become difficult to specify which lymph node is a sentinel lymph node. Such a problem that it becomes difficult to specify the affected part with the passage of time is a problem that generally occurs when performing not only breast cancer surgery but also other near-infrared fluorescence imaging.

  The present invention has been made to solve the above-described problem, and provides an infrared light imaging apparatus capable of easily recognizing an affected area even when a time after injection of a fluorescent dye has elapsed. With the goal.

  According to a first aspect of the present invention, an infrared light source for irradiating an infrared ray for exciting a fluorescent dye injected into a subject toward the subject, a visible light source for irradiating visible light toward the subject, and an infrared ray A camera capable of detecting infrared light and visible light for photographing infrared light generated from the fluorescent dye and visible light reflected from the surface of the subject, and the camera photographed by the camera A fusion unit that creates a fusion image by fusing an infrared image and a visible image of a subject, an image storage unit that stores an infrared image of the subject captured by the camera, and an image storage unit Of the stored infrared image, a fusion image created based on an infrared image capable of recognizing a specific portion of the subject after the fluorescent dye is injected into the subject, and a currently captured image An image that simultaneously displays on the display unit one of the fusion images created by fusing the visible image or the currently captured visible image and the currently captured infrared image in the fusion unit. And a processing unit.

  According to the first invention, a fusion image created based on an infrared image capable of recognizing a specific portion of the subject after the fluorescent dye is injected into the subject among the infrared images stored in the image storage unit; Display either the currently captured visible image or the fusion image created by fusing the currently captured visible image and the currently captured infrared image in the fusion section. By doing so, it is possible to easily recognize the specific portion of the subject even when the time after the injection of the fluorescent dye has elapsed.

1 is a schematic diagram of an infrared imaging apparatus according to the present invention. 2 is a perspective view of an illumination / photographing unit 12. FIG. It is a block diagram which shows the main control systems of the infrared light imaging device which concerns on this invention. 6 is a schematic diagram showing images displayed on display units 14 and 15. FIG. 6 is a schematic diagram showing images displayed on display units 14 and 15. FIG. 6 is a schematic diagram showing images displayed on display units 14 and 15. FIG. 6 is a schematic diagram showing images displayed on display units 14 and 15. FIG. 6 is a schematic diagram showing images displayed on display units 14 and 15. FIG.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings. FIG. 1 is a schematic diagram of an infrared imaging apparatus according to the present invention.

  The infrared imaging apparatus includes an input unit 11 such as a touch panel, a main body 10 including a control unit 30 and the like described later, an illumination / photographing unit 12 supported movably by an arm 13, a liquid crystal display panel, and the like A pair of display units 14 and 15 and a treatment table 16 on which a patient 17 is placed. The illumination / imaging unit 12 is not limited to the one supported by the arm 13, and may be carried by the surgeon in hand.

  FIG. 2 is a perspective view of the illumination / imaging unit 12 described above.

  The illumination / photographing unit 12 includes a camera 21 capable of detecting infrared and visible light, an infrared light source 22 disposed on the outer periphery of the camera 21, and a visible light disposed on the outer periphery of the infrared light source 22. A light source 23. Note that when only an infrared image is displayed, the visible light source 23 may not be provided.

  FIG. 3 is a block diagram showing a main control system of the infrared imaging apparatus according to the present invention.

  This infrared imaging device is composed of a CPU that executes logical operations, a ROM that stores operation programs necessary for controlling the device, a RAM that temporarily stores data during control, and the like, and controls the entire device. The control unit 30 is provided. As will be described later, the control unit 30 includes an image processing unit 31 having a fusion unit 32. The control unit 30 is connected to the input unit 11 and the display units 14 and 15 described above. The control unit 30 is connected to an illumination / photographing unit 12 including a camera 21, an infrared light source 22, and a visible light source 23. Further, the control unit 30 is also connected to an image storage unit 33 that stores an image taken by the camera 21. The image storage unit 33 includes an infrared image storage unit 34 that stores an infrared image and a visible image storage unit 35 that stores a visible image. Instead of the infrared image storage unit 34 and the visible image storage unit 35, a fusion image storage unit that stores an image obtained by fusing the visible image and the infrared image may be provided.

  Hereinafter, an operation when performing a surgical operation using the infrared imaging apparatus according to the present invention will be described. In the following description, a case where breast cancer surgery is performed on the patient 17 will be described.

  When performing an operation for breast cancer using the infrared imaging apparatus according to the present invention, indocyanine green is injected into the breast of the patient 17 who is supine on the treatment table 16 by injection. Thereafter, the infrared light source 22 emits infrared light and the visible light source 23 emits visible light toward the subject including the affected part. In addition, as infrared rays, near infrared light of 750 to 850 nm that acts as excitation light for indocyanine green to emit fluorescence is employed. Thereby, indocyanine green generates fluorescence in the infrared region having a peak at 845 nm.

  Then, the vicinity of the affected part of the patient 17 is photographed by the camera 21. The camera 21 can detect infrared light and visible light. The infrared image and the visible image captured by the camera 21 are sent to the image processing unit 31 shown in FIG. The image processing unit 31 converts the infrared image and the visible image into image data that can be displayed on the display units 14 and 15. The infrared image data is stored in the infrared image storage unit 34 in the image storage unit 33. The visible image data is stored in the visible image storage unit 35 of the image storage unit 33.

  The fusion unit 32 in the image processing unit 31 uses the infrared image data and the visible image data to create a fusion image obtained by fusing the visible image and the infrared image. The image processing unit 31 selectively displays an infrared image, a visible image, and a fusion image on the display units 14 and 15.

  4 to 8 are schematic diagrams showing images displayed on the display units 14 and 15.

  FIG. 4 shows a first embodiment of the present invention. In this embodiment, the display unit 14 displays a current fusion image near the affected part of the patient 17 as a moving image, and the display unit 15 displays a past fusion image near the affected part of the patient 17 as a still image. It is displayed. That is, the image processing unit 31 takes in an infrared image and a visible image captured by the camera 21, fuses them in the fusion unit 32, and displays the current fusion image near the affected part of the patient 17 as a moving image on the display unit 14. indicate. Further, the image processing unit 31 reads the past infrared image stored in the infrared image storage unit 34 and the past visible image stored in the visible image storage unit 35, and fuses them in the fusion unit 32, so that the patient 17 A past fusion image in the vicinity of the affected area is displayed on the display unit 14 as a still image. If a past fusion image is stored in the fusion image storage unit, the past fusion image may be read from the fusion image storage unit and displayed on the display unit 14.

  As shown in FIG. 4, lymphatic vessels 41 and 42 are displayed in the fusion image of the moving image displayed on the display unit 14 by fluorescence generated from indocyanine green. In addition, the code | symbol 51 in FIG. 4 is the mark described on the body surface of the patient 17 for surgery. As shown in FIG. 4, the lymphatic vessel 42 has a plurality of lymph nodes 42a, 42b, and 42c. Among these, the lymph node 42a to which the lymph reaches first from the breast is the sentinel lymph node.

  In the operation of breast cancer, it is necessary to specify the sentinel lymph node 42a. However, indocyanine green has a small molecular weight and high fluidity in the lymphatic vessel 42, and thus has a characteristic of diffusing in a short time. For this reason, when time passes after administration of indocyanine green, the entire lymph vessel 42 fluoresces, and it is specified where the sentinel lymph node 42a is located in the lymph vessel 42 or which lymph node is the sentinel lymph node 42a. It becomes difficult.

  For this reason, the past fusion image near the affected part of the patient 17 is displayed on the display unit 15 as a still image. The past fusion image in the vicinity of the affected part of the patient 17 is stored, for example, together with the time when the actual photographing is performed and the time after indocyanine green is injected. Alternatively, the operator or operator adds a time stamp to the fusion image while checking the fusion image of the moving image displayed on the display unit 14. Then, using these times and time stamps, the image at the time when the indocyanine green flowing through the lymph vessel 42 reaches the sentinel lymph node 42a, which is the first lymph node, is specified, and the fusion image at this time is taken as a still image. Is displayed on the display unit 15. Thereby, the position of the sentinel lymph node 42a can be easily specified.

  The surgeon identifies the sentinel lymph node 42a that cannot be seen by viewing the patient 17 by checking the current fusion image displayed on the display unit 14, and performs the removal operation. At this time, it is possible to identify which fluorescent portion is the sentinel lymph node 42 a based on the past still image fusion image displayed on the display unit 15. The removed sentinel lymph node 42a is pathologically examined. If there is no cancer metastasis in the sentinel lymph node 42a, the operation is completed only by removing the breast cancer. On the other hand, when there is cancer metastasis in the sentinel lymph node 42a, an operation for removing the entire lymphatic vessel is performed.

  As described above, according to the infrared imaging apparatus of the present invention, the current fusion image in the vicinity of the affected area of the patient 17 is displayed on the display unit 14 as a moving image, and the past in the vicinity of the affected area of the patient 17 is displayed on the display unit 15. Since the fusion image is displayed as a still image, the position of the sentinel lymph node 42a can be easily specified during the operation, and the operation for removing the sentinel lymph node 42a can be appropriately performed.

  In the embodiment shown in FIG. 4, the current infrared image and the visible image are displayed on the display unit 14 as a fusion image in a fused state, and are displayed on the display unit 15. The past infrared image and the visible image are displayed as a still image by the fusion image in a fused state. However, you may make it display an infrared image or a visible image on the display parts 14 and 15. FIG. Hereinafter, such an embodiment will be described.

  FIG. 5 shows a second embodiment of the present invention. In this embodiment, the display unit 14 displays a current fusion image near the affected part of the patient 17 as a moving image, and the display unit 15 displays a past infrared image near the affected part of the patient 17 as a still image. Is displayed. Also in such an embodiment, the position of the sentinel lymph node 42a can be easily specified during the operation, and the operation for removing the sentinel lymph node 42a can be appropriately performed.

  FIG. 6 shows a third embodiment of the present invention. In this embodiment, the display unit 14 displays a current visible image near the affected part of the patient 17 as a moving image, and the display unit 15 displays a past infrared image near the affected part of the patient 17 as a still image. Is displayed. In such an embodiment, the relationship between the actual patient 17 and the visible image displayed on the display unit 14 can be easily recognized in association with the visible image.

  FIG. 7 shows a fourth embodiment of the present invention. In this embodiment, the display unit 14 displays a current infrared image near the affected part of the patient 17 as a moving image, and the display unit 15 displays a past infrared image near the affected part of the patient 17 as a still image. Displayed on the screen. In such an embodiment, it is possible to more easily identify the sentinel lymph node 42a from the plurality of lymph nodes 42a, 42b, 42c by comparing the infrared images with each other.

  FIG. 8 shows a fifth embodiment of the present invention. In this embodiment, the current fusion image near the affected area of the patient 17 is displayed as a moving image on the display unit 14, and a plurality of past infrared images 61 near the affected area of the patient 17 are displayed on the display unit 15. , 62, 63, 64 are still images that are simultaneously reduced and displayed in a state of being arranged over time. In such an embodiment, the sentinel lymph node 42a can be easily identified by comparing a plurality of past infrared images 61, 62, 63, 64.

  That is, in any of the embodiments shown in FIGS. 5 to 8, as in the embodiment shown in FIG. 4, the position of the sentinel lymph node 42a can be easily identified during the operation. It is possible to appropriately perform the extraction operation.

  In the embodiment described above, a moving image is displayed on the display unit 14 and a still image is displayed on the display unit 15. However, a moving image and a still image may be selectively displayed as necessary. The display unit 14 may display a current infrared image near the affected part of the patient 17 as a moving image, and the display unit 15 may display a past fusion image near the affected part of the patient 17 as a still image. . Further, the display unit 14 may display a current visible image near the affected part of the patient 17 as a moving image, and the display unit 15 may display a past fusion image near the affected part of the patient 17 as a still image. Also, all of the infrared image, visible image, and fusion image may be displayed simultaneously.

  In the above-described embodiment, an infrared image, a visible image, and a fusion image are selectively displayed on the pair of display units 14 and 15, but a relatively large single display unit is used. A plurality of images may be divided and displayed on the display unit, or three or more display units are used, and an infrared image, a visible image, and a fusion image are selected for these display units. You may make it display automatically.

  In the above-described embodiment, near infrared light of 750 to 850 nm is used as infrared light acting as excitation light, but other infrared light may be used.

  Furthermore, although the case where indocyanine green was used as a fluorescent dye was described in the above-described embodiment, other fluorescent dyes may be used. For example, the present invention may be applied to a case where a tumor site is fluorescently displayed using 5-aminolevulinic acid (5-ALA).

  In the above embodiment, for the sake of convenience of explanation, the case where an affected part is imaged has been described as an example. However, blood flow observation of a normal part can be performed using the present invention. Therefore, the subject is defined by collectively referring to the affected part and the normal part photographed by the present invention.

DESCRIPTION OF SYMBOLS 10 Main body 11 Input part 12 Illumination and imaging | photography part 13 Arm 14 Display part 15 Display part 16 Treatment table 17 Patient 21 Camera 22 Infrared light source 23 Visible light source 30 Control part 31 Image processing part 32 Fusion part 33 Image storage part 34 Infrared image Storage unit 35 Visible image storage unit

Claims (1)

An infrared light source for irradiating the subject with infrared rays for exciting the fluorescent dye injected into the subject;
A visible light source that emits visible light toward the subject;
A camera capable of detecting infrared light and visible light for photographing infrared light generated from the fluorescent dye by irradiation with infrared light and visible light reflected on the subject surface;
A fusion unit that creates a fusion image by fusing an infrared image and a visible image of the subject photographed by the camera;
An image storage unit for storing an infrared image of the subject photographed by the camera;
A fusion image created based on an infrared image capable of recognizing a specific portion of the subject after the fluorescent dye is injected into the subject among the infrared images stored in the image storage unit, and currently captured An image processing unit that causes a display unit to simultaneously display any one of fusion images created by fusing a visible image or a currently captured visible image and a currently captured infrared image in the fusion unit. When,
An infrared imaging apparatus comprising:

Images