# US 2022/0054862 A1 · Medical image processing device, storage medium, medical device, and treatment system > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2022/0054862 A1 - Document ID: US20220054862A1 - Status: Published application - Kind: A1 - Application number: 17/453,899 - Filed: 2021-11-08 - Published: 2022-02-24 - Earliest claimed: 2019-05-14 - Assignees: Toshiba Energy Systems & Solutions Corporation; National Institutes for Quantum Science and Technology - Applicants: Toshiba Energy Systems & Solutions Corporation; National Institutes for Quantum Science and Technology - Inventors: Ryusuke HIRAI; Yukinobu SAKATA; Akiyuki TANIZAWA; Keiko OKAYA; Shinichiro MORI - Web page: https://patentgrep.com/patent/US20220054862A1 ## CPC - A61N 5/1049: {for verifying the position of the patient with respect to the radiation beam} - A61B 6/00: Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment (instruments measuring radiation intensity for application in the field of nuclear medicine, e.g. in vivo counting, G01T1/161) - A61N 5/1067: {in real time, i.e. during treatment} - A61N 5/107: {in real time, i.e. during treatment} - G06T 1/00: General purpose image data processing - G06T 12/20: Inverse problem, i.e. transformations from projection space into object space - G06T 12/30: Image post-processing, e.g. metal artefact correction - A61N 2005/1062: {using virtual X-ray images, e.g. digitally reconstructed radiographs [DRR]} - G06T 2210/41: Medical - A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B) - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - G06T: IMAGE DATA PROCESSING OR GENERATION, IN GENERAL ## Abstract A medical image processing device of an embodiment includes a first image acquirer, a second image acquirer, a generator, and a calculator. The first image acquirer acquires a first fluoroscopic image of a patient. The second image acquirer acquires a second fluoroscopic image according to radiation with which the patient is irradiated at a time point different from a time point of acquisition of the first fluoroscopic image from a photography device that detects radiation with a detector and performs an imaging process. The generator generates a reconstructed image obtained by reproducing the second fluoroscopic image from the first fluoroscopic image virtually arranged in a three-dimensional space on the basis of an installation position of the detector in the three-dimensional space. The calculator obtains a suitable position on the first fluoroscopic image in the three-dimensional space on the basis of a degree of similarity between the second fluoroscopic image and the reconstructed image. The generator generates the reconstructed image which is for use in the calculator and has a range larger than a range corresponding to the second fluoroscopic image. ## Claims ### Claim 1 A medical image processing device comprising: a first image acquirer configured to acquire a first fluoroscopic image of a patient; a second image acquirer configured to acquire a second fluoroscopic image according to radiation with which the patient is irradiated at a time point different from a time point of acquisition of the first fluoroscopic image from a photography device that detects radiated radiation with a detector and performs an imaging process; a generator configured to generate a reconstructed image obtained by reproducing the second fluoroscopic image from the first fluoroscopic image virtually arranged in a three-dimensional space on the basis of an installation position of the detector in the three-dimensional space; and a calculator configured to obtain a suitable position on the first fluoroscopic image in the three-dimensional space on the basis of a degree of similarity between the second fluoroscopic image and the reconstructed image, wherein the generator generates the reconstructed image which is for use in the calculator and has a range larger than a range corresponding to the second fluoroscopic image. ### Claim 2 (depends on 1) The medical image processing device according to claim 1, wherein the reconstructed image generated to have the range larger than the range corresponding to the second fluoroscopic image among reconstructed images includes a target portion of the patient. ### Claim 3 (depends on 2) The medical image processing device according to claim 2, wherein the generator generates a first reconstructed image of the range larger than the range corresponding to the second fluoroscopic image among the reconstructed images and a second reconstructed image other than the first reconstructed image among the reconstructed images, and wherein the calculator includes a first calculator configured to obtain a first position where a degree of similarity between the target portion included in the first reconstructed image and the target portion included in the second fluoroscopic image is higher by virtually moving the first reconstructed image parallel with respect to the second reconstructed image, and a second calculator configured to obtain a second position where a degree of similarity between the target portion included in the second reconstructed image and the target portion included in the second fluoroscopic image is higher by causing the second reconstructed image to be virtually subjected to parallel and rotation movements with respect to the second reconstructed image on the basis of the first position obtained by the first calculator, and outputs the second position as the suitable position that is final. ### Claim 4 (depends on 3) The medical image processing device according to claim 3, wherein the calculator further includes an image range determiner configured to determine a range of the first reconstructed image, which is subsequently generated, on the basis of an amount of movement for virtually moving the first reconstructed image parallel with respect to the second reconstructed image when the first position is obtained. ### Claim 5 (depends on 3) The medical image processing device according to claim 3, wherein the generator generates the first reconstructed image corresponding to the detector that detects the radiation radiated from at least a first direction and the first reconstructed image corresponding to the detector that detects the radiation radiated from a second direction different from the first direction with respect to the patient and generates the second reconstructed image including information indicating the direction in which the detector detects the radiation. ### Claim 6 (depends on 5) The medical image processing device according to claim 5, wherein the first calculator obtains at least the first position using the first reconstructed image corresponding to one detector that detects the radiation radiated from one of the first direction and the second direction. ### Claim 7 (depends on 6) The medical image processing device according to claim 6, wherein the first calculator iterates a process of obtaining the first position using the first reconstructed image corresponding to the detector that detects the radiation radiated from one of the first direction and the second direction and a process of obtaining the first position where a degree of similarity between the target portion included in the first reconstructed image and the target portion included in the second fluoroscopic image is higher using the first reconstructed image corresponding to the detector that detects the radiation radiated from the other direction on the basis of the first position until the degree of similarity between the target portion included in the first reconstructed image and the target portion included in the second fluoroscopic image is within a prescribed range, and wherein the second calculator obtains the second position on the basis of the first position within the prescribed range. ### Claim 8 (depends on 7) The medical image processing device according to claim 7, wherein the generator generates the first reconstructed image corresponding to the other detector after the first calculator obtains the first position corresponding to one detector. ### Claim 9 (depends on 1) The medical image processing device according to claim 1, further comprising: a display controller configured to cause a display device to display the first fluoroscopic image and the second fluoroscopic image and cause the display device to further display information of the suitable position; and a receiver configured to receive an instruction for moving the suitable position within the three-dimensional space of the first fluoroscopic image. ### Claim 10 A computer-readable non-transitory storage medium storing a medical image processing program for causing a computer to function as a medical image processing device including: a first image acquirer configured to acquire a first fluoroscopic image of a patient; a second image acquirer configured to acquire a second fluoroscopic image according to radiation with which the patient is irradiated at a time point different from a time point of acquisition of the first fluoroscopic image from a photography device that detects radiated radiation with a detector and performs an imaging process; a generator configured to generate a reconstructed image obtained by reproducing the second fluoroscopic image from the first fluoroscopic image virtually arranged in a three-dimensional space on the basis of an installation position of the detector in the three-dimensional space; and a calculator configured to obtain a suitable position on the first fluoroscopic image in the three-dimensional space on the basis of a degree of similarity between the second fluoroscopic image and the reconstructed image, wherein the generator generates the reconstructed image which is for use in the calculator and has a range larger than a range corresponding to the second fluoroscopic image. ### Claim 11 (depends on 1) A medical device comprising: the medical image processing device according to claim 1; and the photography device including two detectors configured to detect the radiation with which the patient has been irradiated from different directions. ### Claim 12 (depends on 11) A treatment system comprising: the medical device according to claim 11; an irradiator configured to irradiate a treatment target portion of the patient with a treatment beam; an irradiation controller configured to control irradiation with the treatment beam; and a bed controller configured to cause a position of a bed on which the patient is fixed to be moved in association with the suitable position obtained in the medical device.