Medical image processing apparatus and method, and radiotherapeutic apparatus

1. A medical image processing apparatus, comprising:

a reconstructed moving image obtainer;

a focus region identifier;

a first characteristics identifier;

a fluoroscopic moving image obtainer;

a second characteristics identifier;

a comparison selector;

a conversion parameter calculation unit; and

a focus region detector,

wherein the reconstructed moving image obtainer obtains a reconstructed moving image where at least one-period data of a three-dimensional moving image is reconstructed on a virtual plane from a set virtual viewpoint, the three-dimensional moving image being obtained by imaging an inside of a patient with designation of a region of a focus being displaced in synchronization with respiration,

the focus region identifier identifies a first focus region corresponding to the designated focus, in the reconstructed moving image,

the first characteristics identifier identifies, in the reconstructed moving image, two or more first characteristic regions defined by contours of internal body portions being displaced in synchronization with the respiration,

the fluoroscopic moving image obtainer obtains at least one-period data of a fluoroscopic moving image obtained by a medical fluoroscopic imager which fluoroscopically images the patient in conformity with the reconstructed moving image,

the second characteristics identifier identifies, in the fluoroscopic moving image, each of two or more second characteristics regions corresponding to the internal body portions,

the comparison selector compares a locus of displacement of each of the two or more first characteristic regions identified in the reconstructed moving image and a locus of displacement of each of the two or more second characteristics regions identified in the fluoroscopic moving image with respect to combinations having a coinciding internal body portion, and selects any one of the internal body portions where the locus of displacement most coincide with each other,

the conversion parameter calculation unit calculates a conversion parameter for converting the first characteristic region being displaced corresponding to the selected internal body portion into the first focus region being displaced in a same phase in the reconstructed moving image, and

the focus region detector detects a second focus region being displaced in the fluoroscopic moving image, based on the conversion parameter and the second characteristics region being displaced corresponding to the selected internal body portion.

2. The medical image processing apparatus according to claim 1 , further comprising:

a renderer; and

a first trigger signal output,

wherein the renderer renders the second focus region in the fluoroscopic moving image, and

the first trigger signal output outputs a first trigger signal at a timing when the second focus region rendered in the fluoroscopic moving image transmitted in real time from the medical fluoroscopic imager is displaced to a designated irradiation target.

3. The medical image processing apparatus according to claim 1 , further comprising:

a reference region setter;

a template extractor; and

a second trigger signal output,

wherein the reference region setter sets a reference region that includes at least a part of a range where the second focus region detected in the fluoroscopic moving image is being displaced in synchronization with the respiration,

the template extractor extracts the reference region that is periodically varying in synchronization with the respiration, as a plurality of templates for different phases, and

the second trigger signal output outputs a second trigger signal at a timing when the reference region periodically varying in the fluoroscopic moving image transmitted in real time from the medical fluoroscopic imager coincides with any one of the templates that is designated from among the templates.

4. The medical image processing apparatus according to claim 1 , further comprising:

a reference region setter;

a template extractor; and

a third trigger signal output,

wherein the reference region setter sets a reference region that includes at least a part of a range where the second focus region detected in the fluoroscopic moving image is being displaced in synchronization with the respiration,

the template extractor extracts the reference region that is periodically varying in synchronization with the respiration, as a plurality of templates for different phases, and

the third trigger signal output outputs a third trigger signal at a timing when the focus region detected based on the fluoroscopic moving image transmitted in real time from the focus region detector and a position of the focus recorded in a designated template are in a predetermined range, and the detected focus region is displaced to the irradiation target.

5. A radiotherapeutic apparatus, comprising:

a bed movement adjuster;

an imaging controller; and

an irradiation controller,

wherein the bed movement adjuster moves a bed onto which a patient is fixed, and adjusts a beam aim of a beam irradiation port so as to coincide with an irradiation target preliminarily designated on a locus of the focus being displaced,

the imaging controller controls the medical fluoroscopic imager that generates the fluoroscopic moving image in which the patient is fluoroscopically captured, and transmits the fluoroscopic moving image to the fluoroscopic moving image obtainer of the medical image processing apparatus according to claim 2 , and

the irradiation controller performs irradiation with a therapeutic beam from the beam irradiation port at a timing of receiving the trigger signal output from the medical image processing apparatus according to claim 2 .

6. A medical image processing method, comprising:

obtaining a reconstructed moving image where at least one-period data of a three-dimensional moving image is reconstructed on a virtual plane from a set virtual viewpoint, the three-dimensional moving image being obtained by imaging an inside of a patient with designation of a region of a focus being displaced in synchronization with respiration;

identifying a first focus region corresponding to the designated focus, in the reconstructed moving image;

identifying, in the reconstructed moving image, two or more first characteristic regions defined by contours of internal body portions being displaced in synchronization with the respiration;

obtaining at least one-period data of a fluoroscopic moving image obtained by a medical fluoroscopic imager which fluoroscopically images the patient in conformity with the reconstructed moving image;

identifying, in the fluoroscopic moving image, each of the two or more second characteristics regions corresponding to the internal body portions;

comparing a locus of displacement of each of the two or more first characteristic regions identified in the reconstructed moving image and a locus of displacement of each of the two or more second characteristics regions identified in the fluoroscopic moving image with respect to combinations having a coinciding internal body portion, and selecting any one of the internal body portions where the locus of displacement most coincide with each other,

calculating a conversion parameter for converting the first characteristic region being displaced corresponding to the selected internal body portion into the first focus region being displaced in a same phase in the reconstructed moving image; and

detecting a second focus region being displaced in the fluoroscopic moving image, based on the conversion parameter and the second characteristics region being displaced corresponding to the selected internal body portion.

7. A medical image processing apparatus, comprising:

circuitry configured to

obtain a reconstructed moving image where at least one-period data of a three-dimensional moving image is reconstructed on a virtual plane from a set virtual viewpoint, the three-dimensional moving image being obtained by imaging an inside of a patient with designation of a region of a focus being displaced in synchronization with respiration,

identify a first focus region corresponding to the designated focus, in the reconstructed moving image,

identify, in the reconstructed moving image, two or more first characteristic regions defined by contours of internal body portions being displaced in synchronization with the respiration,

obtain at least one-period data of a fluoroscopic moving image obtained by a medical fluoroscopic imager which fluoroscopically images the patient in conformity with the reconstructed moving image,

identify, in the fluoroscopic moving image, each of two or more second characteristics regions corresponding to the internal body portions,

compare a locus of displacement of each of the two or more first characteristic regions identified in the reconstructed moving image and a locus of displacement of each of the two or more second characteristics regions identified in the fluoroscopic moving image with respect to combinations having a coinciding internal body portion, and select any one of the internal body portions where the locus of displacement most coincide with each other,

calculate a conversion parameter for converting the first characteristic region being displaced corresponding to the selected internal body portion into the first focus region being displaced in a same phase in the reconstructed moving image, and

detect a second focus region being displaced in the fluoroscopic moving image, based on the conversion parameter and the second characteristics region being displaced corresponding to the selected internal body portion.