阅读说明：本技术 路径选择支援系统、记录了路径选择支援程序的记录介质、路径选择支援方法及诊断方法 (Path selection support system, recording medium having path selection support program recorded thereon, path selection support method, and diagnosis method ) 是由 高桥治彦 于 2018-05-29 设计创作，主要内容包括：本申请发明的目的在于提供一种能够容易对用于将医疗器具经由生物体管腔运送到生物体内的部位的、生物体管腔的路径进行选择的路径选择支援系统、记录了路径选择支援程序的记录介质及路径选择支援方法。路径选择支援系统(1)具有：受理部(110),其受理对对象部位进行特定的部位信息的输入；图像获取部(120),其获取对象患者的生物体的图像信息；路径提取部(130),其基于图像信息,提取多条能够将医疗器具运送到对象部位的生物体管腔的路径；排位部(140),其使用根据运送医疗器具时的医疗器具的运送容易度而确定的路径分数和根据给对象患者造成的负担大小而确定的患者分数,对路径提取部提取出的多条路径排出位次；以及输出部(150),其输出路径提取部提取出的多条路径和排位部排出的位次。(An object of the present invention is to provide a route selection support system, a recording medium recording a route selection support program, and a route selection support method, which can easily select a route of a biological lumen for transporting a medical instrument to a site in a living body through the biological lumen. A route selection support system (1) comprises: a receiving unit (110) that receives input of specific part information for a target part; an image acquisition unit (120) that acquires image information of a living body of a target patient; a path extraction unit (130) that extracts a plurality of paths of a biological lumen that can carry a medical instrument to a target site, based on image information; an ejection unit (140) that ejects orders to the plurality of routes extracted by the route extraction unit, using a route score determined from the ease of transport of the medical instrument when the medical instrument is transported and a patient score determined from the magnitude of the load on the target patient; and an output unit (150) that outputs the plurality of routes extracted by the route extraction unit and the number of bits discharged by the discharge unit.)

1. A route selection support system that supports selection of a route of a biological lumen for transporting a medical instrument to a site in a living body through the biological lumen, the route selection support system comprising:

a reception unit that receives input of site information specifying a target site in the living body that is a target for transporting the medical instrument;

an image acquisition unit that acquires image information of the inside of the living body of a target patient to be a target for transporting the medical instrument;

a path extracting unit that extracts a plurality of paths that can transport the medical instrument to the lumen of the living body of the target site, based on the image information acquired by the image acquiring unit;

an order-ranking unit that has a route-score calculating unit that calculates a route score determined according to ease of transport of the medical instrument when the medical instrument is transported via the route, and a patient-score calculating unit that calculates a patient score determined according to a magnitude of a burden imposed on the target patient, and that ranks the plurality of routes extracted by the route-extracting unit using the route score and the patient score; and

and an output unit that outputs the plurality of routes extracted by the route extraction unit and the rank discharged by the ranking unit.

2. The routing support system according to claim 1,

the receiving unit receives an input of operation information specifying a type of an operation performed to transport the medical instrument to the target site through the biological lumen,

the route selection support system further includes:

a medical instrument extraction unit that extracts a type of the medical instrument used in the operation specified based on the operation information; and

an equipment extraction unit that extracts candidates of equipment that can be used for each type of the medical instrument extracted by the medical instrument extraction unit,

the output section outputs the extraction result of the candidate of the device extracted by the device extraction section.

3. The routing support system according to claim 2,

the ranking unit adjusts the rank of the plurality of routes extracted by the route extraction unit based on the extraction result of the candidates of the device extracted by the device extraction unit.

4. The path selection support system according to any one of claims 1 to 3,

the route score calculation unit calculates the length of the route and the degree of flexion of the route extracted by the route extraction unit based on the image information in the living body of the target patient, and calculates the route score using the calculated length of the route and the degree of flexion of the route.

5. The path selection support system according to any one of claims 1 to 4,

the patient score calculation unit calculates the degree of invasiveness of the route extracted by the route extraction unit, and calculates the patient score using the calculated degree of invasiveness of the route.

6. The path selection support system according to any one of claims 1 to 5,

the patient score calculating unit acquires patient information relating to a feature of the subject patient, and calculates the patient score based on the patient information.

7. A recording medium having a computer-readable recording medium on which a routing support program is recorded,

the path selection support program supports selection of a path of a biological lumen for transporting a medical instrument to a site in a living body through the biological lumen,

the routing support program causes a computer to execute:

receiving input of site information specifying a target site in the living body to be a target for transporting the medical instrument;

acquiring image information in the living body of a target patient to be a subject to which the medical instrument is delivered;

extracting a plurality of paths that can transport the medical instrument to the lumen of the living body of the target site based on the acquired image information;

calculating a path score determined according to the ease of transport of the medical instrument when the medical instrument is transported through the path, calculating a patient score determined according to the magnitude of a load imposed on the subject patient, and ranking the plurality of extracted paths using the calculated path score and the calculated patient score;

outputting the extracted plurality of paths and the drained bits.

8. A path selection support method for supporting selection of a path of a biological lumen for transporting a medical instrument to a site in a living body through the biological lumen, the path selection support method being characterized in that,

receiving input of site information specifying a target site in the living body to be a target for transporting the medical instrument;

acquiring image information in the living body of a target patient to be a subject to which the medical instrument is delivered;

extracting a plurality of paths that can transport the medical instrument to the lumen of the living body of the target site based on the acquired image information;

ranking the plurality of extracted paths using a path score determined based on ease of transport of the medical instrument when the medical instrument is transported via the path and a patient score determined based on a magnitude of a load imposed on the subject patient;

outputting the extracted plurality of paths and the drained bits.

9. A diagnostic method for diagnosing a path of a biological lumen for carrying a medical instrument to a site in a living body through the biological lumen, the diagnostic method being characterized in that,

receiving input of site information specifying a target site in the living body to be a target for transporting the medical instrument;

acquiring image information in the living body of a target patient to be a subject to which the medical instrument is delivered;

extracting a plurality of paths that can transport the medical instrument to the lumen of the living body of the target site based on the acquired image information;

ranking the plurality of extracted paths using a path score determined based on ease of transport of the medical instrument when the medical instrument is transported via the path and a patient score determined based on a magnitude of a load imposed on the subject patient;

and diagnosing the paths according to the extracted paths and the ranking of the discharge.

Technical Field

The present invention relates to a route selection support system, a recording medium on which a route selection support program is recorded, a route selection support method, and a diagnosis method for supporting selection of a route of a biological lumen for transporting a medical instrument to a site in a living body through the biological lumen.

Background

There is known an operation of delivering a medical instrument to a site in a living body via a blood vessel (a living body lumen) to perform a treatment (e.g., expansion of a stenosed portion of the blood vessel), an examination (e.g., imaging of an inner region of the blood vessel), and the like (for example, see patent document 1).

The medical instrument is introduced into a blood vessel from the outside of a living body through a site (hereinafter, referred to as an introduction site) that is an entry point into the blood vessel, and is transported to a target site that is a surgical target through a plurality of sites of the blood vessel. For example, when a blood vessel of a lower limb is treated by TRI (Trans Radial intervention), a medical instrument is introduced into the blood vessel from a Radial artery or the like and is carried to a target site of the lower limb via an aortic arch, an aorta (descending aorta), an iliac artery, or the like. TRI is a surgery which has been actively performed in recent years for such reasons as a smaller burden on a patient than TFI (Trans Femoral intervention) introduced into a medical instrument from a Femoral artery or the like.

The route of the blood vessel from the introduction site to the target site is multiple depending on the introduction site. The operator such as a doctor needs to select an appropriate route in consideration of the ease of transportation of the medical instrument when the medical instrument is transported, the load on the patient, and the like. The ease of transport of the medical instrument varies depending on, for example, the magnitude of flexion or bending of a portion of the blood vessel constituting the route.

Disclosure of Invention

However, the size of the flexion and bending of the blood vessel site differs for each subject patient. Before starting the above-described operation, the operator needs to perform an operation of selecting an appropriate blood vessel path by confirming the size of bending, or the like of a blood vessel portion by visually recognizing an image in the living body of the target patient. This operation is mostly dependent on many years of experience of the operator, and becomes a heavy burden for the operator.

In particular, when a treatment of a lower limb blood vessel is performed using TRI, the number of sites of the blood vessel to be passed through is larger than that of TFI.

In the case of TFI, when a retrograde puncture is performed from the ipsilateral femoral artery, when the femoral artery and the iliac artery of the treatment subject are reached from the contralateral femoral artery through a contralateral mountain climbing approach (crossover approach), the femoral artery and the iliac artery are branched from the aorta and then reach the iliac artery or the femoral artery on the opposite side.

On the other hand, when a lower limb blood vessel is treated by TRI, when the patient is inserted from the right radial artery, the patient usually passes through the aortic arch from the right radial artery, the right brachial artery, the right axillary artery, the right subclavian artery, and the brachiocephalic artery. When inserted from the left radial artery, it usually passes through the aortic arch from the left radial artery, the left brachial artery, the left axillary artery, the right subclavian artery, and the brachiocephalic artery. After reaching the aortic arch, the aortic branch is reached via the thoracic aorta and the abdominal aorta (descending aorta).

In order to treat the lower limb artery, the blood further reaches the common iliac artery, external iliac artery, internal iliac artery, common femoral artery, superficial femoral artery, and deep femoral artery on one of the right and left sides, and if necessary, reaches the lower limb artery such as popliteal artery, anterior tibial artery, posterior tibial artery, peroneal artery, dorsal foot artery, and plantar artery, and peripheral blood vessels connected to these arteries.

The size of the curve or bend of the blood vessel varies greatly depending on the age, medical history, and the like. In addition, in TRI, the blood vessel at the introduction site is thinner than in brachial artery puncture and TFI, and the radial artery is a muscular artery, so spasm (vasospasm) is likely to occur. Therefore, when a treatment of a blood vessel of a lower limb or the like is performed using TRI, there is a problem that the above-described work load for selecting an appropriate blood vessel route is particularly large.

The present invention has been made in view of the above-described problems, and an object thereof is to provide a route selection support system, a recording medium on which a route selection support program is recorded, a route selection support method, and a diagnostic method, which can easily select a route of a biological lumen for transporting a medical instrument to a site in a living body through the biological lumen.

A path selection support system according to the present invention for achieving the above object is a path selection support system that supports selection of a path of a living body lumen for transporting a medical instrument to a site in a living body via the living body lumen, the path selection support system including: a reception unit that receives input of site information specifying a target site in the living body that is a target for transporting the medical instrument; an image acquisition unit that acquires image information of the inside of the living body of a target patient to be a target for transporting the medical instrument; a path extracting unit that extracts a plurality of paths that can carry the medical instrument to the biological lumen of the target site, based on the image information acquired by the image acquiring unit; an order-giving unit that includes a route-score calculating unit that calculates a route score determined according to the ease of transportation of the medical instrument when the medical instrument is transported via the route, and a patient-score calculating unit that calculates a patient score determined according to the magnitude of a burden imposed on the target patient, and that gives an order to the plurality of routes extracted by the route extracting unit using the route score and the patient score; and an output unit that outputs the plurality of routes extracted by the route extraction unit and the rank discharged by the discharge unit.

A computer-readable recording medium recording a route selection support program for supporting selection of a route of a biological lumen for transporting a medical instrument to a site in a living body through the biological lumen is a computer-readable recording medium recording a route selection support program for causing a computer to execute: receiving input of site information specifying a target site in the living body to be a target for transporting the medical instrument; acquiring image information of the inside of the living body of a target patient to be a target for transporting the medical instrument; extracting a plurality of paths of the biological lumen that can transport the medical instrument to the target site based on the acquired image information; calculating a path score determined according to the ease of transport of the medical instrument when the medical instrument is transported via the path, calculating a patient score determined according to the magnitude of a burden imposed on the subject patient, and ranking the extracted plurality of paths using the calculated path score and the calculated patient score; and outputting the extracted plurality of paths and the discharged bit order.

A route selection support method according to the present invention for achieving the above object is a method for supporting selection of a route of a biological lumen for transporting a medical instrument to a site in a living body through the biological lumen, the method receiving input of site information specifying a target site in the living body which is a target for transporting the medical instrument; acquiring image information of the inside of the living body of a target patient to be a target for transporting the medical instrument; extracting a plurality of paths of the biological lumen that can transport the medical instrument to the target site based on the acquired image information; ranking the plurality of extracted paths using a path score determined based on ease of transport of the medical instrument when the medical instrument is transported via the path and a patient score determined based on a magnitude of a load imposed on the target patient; and outputting the extracted plurality of paths and the discharged bit order.

A diagnostic method according to the present invention for achieving the above object is a method of diagnosing a path of a living body lumen for transporting a medical instrument to a site in a living body via the living body lumen, the diagnostic method receiving input of site information specifying a target site in the living body which is a target for transporting the medical instrument; acquiring image information of the inside of the living body of a target patient to be a target for transporting the medical instrument; extracting a plurality of paths of the biological lumen that can transport the medical instrument to the target site based on the acquired image information; ranking the plurality of extracted paths using a path score determined based on ease of transport of the medical instrument when the medical instrument is transported via the path and a patient score determined based on a magnitude of a load imposed on the target patient; and diagnosing the paths according to the extracted paths and the discharged orders.

Effects of the invention

According to the route selection support system, the recording medium recording the route selection support program, the route selection support method, and the diagnosis method of the present invention, the ranking unit ranks the plurality of routes extracted by the route extraction unit using the route score determined according to the ease of transportation of the medical instrument when the medical instrument is transported and the patient score determined according to the magnitude of the load imposed on the subject patient. The output unit outputs the plurality of routes extracted by the route extraction unit and the number of bits discharged by the discharge unit. Thus, the operator such as a doctor can easily select an appropriate path from a plurality of paths that can carry the medical instrument to the biological lumen of the target site to be operated, taking into consideration the ease of carrying the medical instrument when carrying the medical instrument and the magnitude of the load on the target patient. Therefore, according to the route selection support system, the recording medium recording the route selection support program, the route selection support method, and the diagnostic method of the present invention, it is possible to easily select the route of the biological lumen for transporting the medical instrument to the site in the living body through the biological lumen.

Drawings

Fig. 1 is a schematic diagram showing the device configuration of a route selection support system according to embodiment 1.

Fig. 2 is a block diagram showing a functional configuration of the route selection support system according to embodiment 1.

Fig. 3 is a schematic diagram showing a screen of a display of the route selection support system according to embodiment 1.

Fig. 4 is a diagram schematically showing the data structure of the import location list.

Fig. 5 is a block diagram showing a functional configuration of a route score calculating unit in the route selection support system according to embodiment 1.

In fig. 6, (a) of fig. 6 is a diagram schematically showing an image of a living body of a target patient, and (B) of fig. 6 is an enlarged view of a region surrounded by a dashed line portion 6B in (a) of fig. 6.

In fig. 7, (a) of fig. 7 is a schematic view showing a screen of a display of the route selection support system according to embodiment 1, and (B) of fig. 7 is a schematic view showing a route display region of the screen.

In fig. 8, (a) in fig. 8 is a diagram schematically showing a data structure of image information, and (B) in fig. 8 is a diagram schematically showing a data structure of incidental information.

Fig. 9 is a block diagram showing a functional configuration of a route extracting unit of the route selection support system according to embodiment 1.

Fig. 10 is a flowchart for explaining a route selection support method according to embodiment 1.

Fig. 11 is a block diagram showing a functional configuration of a route selection support system according to embodiment 2.

Fig. 12 is a schematic view showing a screen of a display of the route selection support system according to embodiment 2.

In fig. 13, (a) in fig. 13 is a diagram schematically showing a data structure of a medical instrument list, (B) in fig. 13 is a diagram schematically showing a data structure of an apparatus list, and (C) in fig. 13 is a diagram schematically showing a data structure of an apparatus information list.

Fig. 14 is a schematic diagram showing a screen of a display of the route selection support system according to embodiment 2.

Fig. 15 (a) is a schematic view showing a screen of a display of the route selection support system according to the one embodiment of modification 2, and fig. 15 (B) is a schematic view showing a screen of a display of the route selection support system according to the other embodiment of modification 2.

Detailed Description

Embodiments of the present invention will be described below with reference to the drawings. In addition, the dimensional scale of the drawings may be exaggerated for convenience of explanation, and may be different from the actual scale.

(embodiment mode 1)

The route selection support system 1 of the present embodiment is a route selection support system that supports selection of a route RT of a blood vessel BV for transporting a medical instrument to a site in a living body BD via the blood vessel BV (corresponding to a living body lumen).

Fig. 1 is a schematic diagram for explaining the device configuration of the route selection support system 1, fig. 2 is a block diagram for explaining the functional configuration of the route selection support system 1, and fig. 3 to 9 are diagrams for explaining the respective functions of the route selection support system 1.

The apparatus configuration of the route selection support system 1 will be described.

Referring to fig. 1, a routing support system 1 includes a computer main body 10 and a display 20. The computer main body 10 is connected to an external server 30.

The computer main body 10 includes an arithmetic unit 50, a storage unit 60, and a reading unit 70.

The arithmetic device 50 performs arithmetic operations based on the programs and data stored in the storage device 60. The arithmetic Unit 50 is configured using a known CPU (Central Processing Unit).

The storage device 60 has a memory circuit 61 and a hard disk drive 65. The Memory circuit 61 includes a ROM (Read Only Memory) and a RAM (Random Access Memory).

The storage device 60 stores a basic program such as an operating system, and data processed by the routing support program PR and the routing support program PR for causing the arithmetic device 50 to execute the functions of the routing support system 1.

The reading device 70 reads information recorded in the computer-readable recording medium MD. The computer-readable recording medium MD is, for example, an optical disk such as a CD-ROM or DVD-ROM, a USB memory, an SD memory card, or the like. The reading device 70 is, for example, a CD-ROM drive, a DVD-ROM drive, or the like.

The path selection support program PR is provided in a state recorded in the computer-readable recording medium MD. The reading device 70 reads the path selection support program PR recorded in the computer-readable recording medium MD. The path selection support program PR read by the reading device 70 is stored in the hard disk drive 65.

The display 20 is connected to the computer main body 10. The display 20 transmits and receives information to and from the computer main body 10.

The display 20 includes a screen 21 for inputting and outputting information. The display 20 outputs information received from the computer main body 10 to the screen 21. The display 20 transmits information input via the screen 21 to the computer main body 10. The display 20 is configured using a known touch panel display.

The computer main body 10 transmits and receives information to and from the external server 30.

The computer main body 10 and the external server 30 are connected via a network. The type of network is not particularly limited, and may be a wired network using a LAN cable or the like, or a wireless network using Wi-Fi or the like.

Next, a functional configuration of the route selection support system 1 will be explained.

Referring to fig. 2, the routing support system 1 includes a reception unit 110, an image acquisition unit 120, a route extraction unit 130, an alignment unit 140, and an output unit 150.

The arithmetic operation relating to the processing of the reception unit 110, the image acquisition unit 120, the route extraction unit 130, the placement unit 140, and the output unit 150 is performed in the arithmetic device 50. The data processed by the reception unit 110, the image acquisition unit 120, the route extraction unit 130, the placement unit 140, and the output unit 150 is stored in the storage device 60.

Referring to fig. 3, the receiving unit 110 receives input of site information specifying a target site RG that is a target of a surgery performed by carrying a medical instrument. The receiving unit 110 receives input of the part information via the display 20.

The receiving unit 110 displays one or more parts received as the target part RG on the display 20 as options, and receives selection of the displayed parts.

The target site RG is not particularly limited, and may be, for example, the arteries of the lower extremities such as the left and right common iliac arteries, external iliac arteries, internal iliac arteries, common femoral arteries, superficial femoral arteries, deep femoral arteries, popliteal arteries, anterior tibial arteries, posterior tibial arteries, peroneal arteries, dorsal plantar arteries, or the collateral circulation, peripheral blood vessels connected to these arteries, or the like.

The image acquisition unit 120 acquires image information DT1 in the living body BD of the target patient to be subjected to the operation carried out by carrying the medical instrument.

Referring to fig. 6 a and 8 a, the image information DT1 includes image data DT2 of the living body BD of the target patient captured by the medical image capturing apparatus. The image data DT2 of the biological body BD is three-dimensional image data.

The medical Imaging device is not particularly limited, and may be, for example, an X-ray CT (Computed Tomography) device or an MRI (Magnetic Resonance Imaging) device.

The data format of the image information DT1 is not particularly limited, and is, for example, DICOM (Digital Imaging and Communication in Medicine).

The image information DT1 is stored in the external server 30. The image acquisition unit 120 acquires the image information DT1 from the external server 30 via the network.

The route extraction unit 130 extracts a plurality of routes RT that can carry a medical instrument to the blood vessel BV of the target region RG based on the image information DT1 acquired by the image acquisition unit 120. The number of the paths RT of the blood vessel BV extracted by the path extraction unit 130 is not particularly limited, and is, for example, 12, preferably 8, and more preferably 6.

The route extraction unit 130 extracts a route RT of the blood vessel BV from the target region RG to the introduction region RS for each candidate of a region (hereinafter referred to as an introduction region RS) that becomes an entry point when the medical instrument is introduced into the blood vessel BV from the outside of the living body BD.

The candidates for the introduction site RS are not particularly limited, and include, for example, the right radial artery, the right brachial artery, the right subclavian artery, the right carotid artery, the right femoral artery, the left radial artery, the left brachial artery, the left subclavian artery, the left carotid artery, and the left femoral artery. The candidate of the introduction site RS may be blood vessels of the ankle such as the popliteal artery, the anterior tibial artery, the posterior tibial artery, the peroneal artery, the dorsum pedis artery, and the plantar artery.

In addition, the radial artery may be a distal radial artery, a radial artery located in the snuff fossa.

Referring to fig. 4, the route extraction unit 130 extracts a route RT of the blood vessel BV from the target region RG to the introduction region RS by using the introduction region list LS1 in which the candidates of the introduction region RS are recorded. The import location list LS1 is stored in the external server 30. The route extraction unit 130 acquires the introduction location list LS1 from the external server 30 via the network. The details of the processing in the path extracting unit 130 will be described later.

Referring to fig. 2, the ranking part 140 has: a route score calculation unit 141 for calculating a route score SR determined according to the ease of transport of the medical instrument; and a patient score calculation unit 145 for calculating a patient score SP determined according to the magnitude of the burden imposed on the subject patient.

The ranking unit 140 ranks the plurality of routes RT extracted by the route extraction unit 130 using the route score SR calculated by the route score calculation unit 141 and the patient score SP calculated by the patient score calculation unit 145.

The ranking unit 140 ranks the plurality of routes RT extracted by the route extraction unit 130 in descending order of the product SR × SP of the route score SR calculated by the route score calculation unit 141 and the patient score SP calculated by the patient score calculation unit 145.

The route score calculation unit 141 calculates a route score SR based on the length L of the route RT and the degree of flexion P of the route RT. The path score calculation unit 141 calculates the product L × P of the length L of the path RT and the degree of curvature P of the path RT as a path score SR.

Referring to fig. 5, the route score calculation unit 141 includes: a center line deriving unit 142 for calculating the center line CL of the route RT extracted by the route extracting unit 130; a path length calculation unit 143 that calculates the length L of the path RT; and a curvature calculating unit 144 for calculating the curvature P of the path RT.

Referring to fig. 6 (B), the image data DT2 includes a boundary marker MK representing a boundary between the inner region BVa1 of the blood vessel BV and the outer region BVa2 of the blood vessel BV. The center line deriving unit 142 calculates the center of the blood vessel BV based on the boundary marker MK included in the image data DT2, and derives the center line CL of the blood vessel BV by connecting the centers of the blood vessel BV from the target region RG to the introduction region RS. Further, "the center of the blood vessel BV" means the center of a region surrounded by a blood vessel wall in a cross section of the blood vessel BV.

The path length calculation unit 143 calculates the length of the center line CL calculated by the center line derivation unit 142 as the length L of the path RT.

The degree of flexion calculator 144 calculates the degree of flexion of the center line CL derived by the center line derivation unit 142 as the degree of flexion P of the path RT. The "degree of flexion" is the sum of the magnitudes of the flexion or bending calculated for each flexion or bending portion in the center line CL of the blood vessel BV. The "magnitude of the buckling" is, for example, a curvature or the like.

The patient score calculation unit 145 calculates a patient score SP using the degree of invasiveness of the route RT extracted by the route extraction unit 130.

The degree of invasiveness is determined, for example, by the amount of bleeding when the medical device is introduced into the blood vessel BV via the introduction site RS and/or the time until bleeding stops after the end of the operation. For example, the degree of invasion of the path RT whose introduction site RS is a radial artery is smaller than the degree of invasion of the path RT whose introduction site RS is a femoral artery.

Referring to fig. 4, the introduction site list LS1 records the degree of invasiveness when a medical device is introduced into a blood vessel BV via a corresponding introduction site RS for each candidate of the introduction site RS.

The patient score calculation unit 145 calculates the degree of invasiveness of the route RT extracted by the route extraction unit 130 using the degree of invasiveness recorded in the introduction site list LS 1. The patient score calculation unit 145 acquires the introduction site list LS1 from the external server 30 via the network.

Referring to fig. 7 (a) and 7 (B), the output unit 150 outputs the plurality of routes RT extracted by the route extraction unit 130, the number of times of discharge by the discharge unit 140, the route score SR, and the patient score SP to the display 20. The output unit 150 outputs the plurality of paths RT extracted by the path extraction unit 130 to the display 20 together with the image GR of the living body BD of the target patient.

The output unit 150 displays the plurality of routes RT extracted by the route extraction unit 130 in the route display area AR1 of the display 20. The output unit 150 displays the enlarged images of the plurality of routes RT extracted by the route extraction unit 130 in the detailed display area AR 2.

The reception unit 110 receives selection of a path RT output to the display 20 by the output unit 150. The output unit 150 displays one of the plurality of paths RT extracted by the path extraction unit 130, and the rank, the path score SR, and the patient score SP corresponding to the one path RT on the display 20, based on the selection of the path RT received by the reception unit 110.

Next, the processing in the route extraction unit 130 will be described in detail.

Referring to fig. 8 (a) and 8 (B), the image information DT1 includes: divided image data DT3 obtained by dividing image data DT2 into a plurality of parts; and incidental information DT4 in which information related to the divided image data DT3 is recorded.

The segmented image data DT3 is generated by segmenting the image data DT2 in accordance with the region of the blood vessel BV. For example, the segmented image data DT3 is generated by segmenting the image data DT2 for each of the right subclavian artery, the brachiocephalic artery, the aortic arch, the thoracic aorta, the abdominal aorta, the left common iliac artery, the left external iliac artery, and the left femoral artery. The divided image is identified by a unique identifier (hereinafter referred to as an ID).

The incidental information DT4 records, for each of the divided image data DT3, region information for specifying a region of the blood vessel BV included in the corresponding divided image data DT3, and link information for linking the adjacent divided image data DT3 to each other in two directions.

Referring to fig. 9, the route extraction unit 130 includes: an object region image specifying unit 131 for specifying the ID of the divided image data DT3 including the object region RG from among the plurality of divided image data DT3 included in the image information DT 1; an introduction site image specifying unit 132 that specifies the ID of the divided image data DT3 including the candidate of the introduction site RS from among the plurality of divided image data DT3 included in the image information DT 1; and a route searching unit 133 for searching a route RT of the blood vessel BV from the target site RG to the introduction site RS.

The target site image specifying unit 131 specifies the ID of the divided image data DT3 including the target site RG using the site information received by the receiving unit 110 and the site information included in the incidental information DT 4.

The introduced portion image specifying unit 132 specifies the ID of the candidate divided image data DT3 including the introduced portion RS, using the portion information included in the introduced portion list LS1 and the incidental information DT 4.

The route searching unit 133 searches for the route RT of the blood vessel BV from the target site RG to the introduction site RS using the ID of the divided image specified by the target site image specifying unit 131, the ID of the divided image specified by the introduction site image specifying unit 132, and the link information included in the incidental information DT 4.

Next, a method for supporting selection of a route RT of a blood vessel BV (corresponding to a living body lumen) for transporting a medical instrument to a site in a living body through the living body lumen (hereinafter, referred to as a route selection support method) will be described.

Referring to fig. 10, the path selection support method includes: the method includes the steps of receiving an input of the site information S1, acquiring image information DT 1S 2, extracting a route RT of the blood vessel BV S3, calculating a route score SR S4, calculating a patient score SP S5, ranking the extracted route RT S6, and outputting the extracted route RT and the ranking S7.

In step S1, in which the input of the site information is received, the input of the site information specifying the target site RG that is the target of the operation performed by carrying the medical instrument is received. The reception unit 110 performs step S1 of receiving input of the part information.

In step S2 of acquiring the image information DT1, the image information DT1 of the living body BD of the target patient to be subjected to the operation carried out by carrying the medical instrument is acquired. The image obtaining unit 120 performs step S2 of obtaining the image information DT 1.

In step S3 of extracting the path RT of the blood vessel BV, a plurality of paths RT of the living body lumen capable of conveying the medical instrument to the target site RG are extracted based on the acquired image information DT 1. The step S3 of extracting the route RT of the blood vessel BV is performed by the route extraction unit 130.

In step S4, in which the route score SR is calculated, the route score SR determined according to the ease of transport of the medical instrument when the medical instrument is transported via the route RT is calculated. The path score calculation unit 141 performs step S4 of calculating the path score SR.

In step S5 of calculating the patient score SP, the patient score SP determined according to the magnitude of the burden imposed on the subject patient is calculated. The step S5 of calculating the patient score SP is performed by the patient score calculating unit 145.

In the ranking step S6, the extracted plurality of routes RT are ranked based on the calculated route score SR and the calculated patient score SP. The ejection order step S6 is performed by the ejection unit 140.

In the outputting step S7, the plurality of paths RT extracted in the step S3 of extracting the path RT of the blood vessel BV, the ranking ranked in the ranking-ranked step S6, the path score SR calculated in the step S4 of calculating the path score SR, and the patient score SP calculated in the step S5 of calculating the patient score SP are output to the display 20.

In the output step S7, the route RT, the rank, the route score SR, and the patient score SP are output to the display 20 in order to assist the operator such as a doctor to select the route RT of the blood vessel BV for transporting the medical instrument to the target site RG in the living body BD via the blood vessel BV.

In the output step S7, the plurality of paths RT extracted by the path extraction unit 130 are output to the display 20 together with the image GR of the living body BD of the target patient.

The output unit 150 performs step S7 of outputting.

Next, a method of diagnosing a route RT of a blood vessel BV for transporting a medical instrument to a site in a living body BD through the blood vessel BV (corresponding to a living body lumen) (hereinafter referred to as a diagnostic method) will be described.

The diagnosis method according to the present embodiment includes, in addition to the steps S1 to S6 of the route selection support method described above, a step of diagnosing the route RT based on the plurality of routes RT extracted in the step S3 of extracting the route RT of the blood vessel BV and the rank discharged in the rank discharging step S6.

In the step of diagnosing the route RT, the route RT of the highest rank discharged in the step S6 of discharging the rank is compared with the route RT of the next lowest rank, and the route RT is diagnosed to be more appropriate from the viewpoint of ease of transportation of the medical instrument when the medical instrument is transported via the route RT and the magnitude of the load imposed on the target patient.

Next, an example of use of the route support system according to the present embodiment will be described. Hereinafter, a case will be described as an example in which six sites, i.e., a right radial artery, a right brachial artery, a right femoral artery, a left radial artery, a left brachial artery, and a left femoral artery, are recorded in the introduction site list LS1 (see fig. 4). Hereinafter, the case of treating the left Superficial Femoral Artery (SFA) will be described as an example.

Referring to fig. 3, the operator inputs "the left superficial femoral artery" as the site information for specifying the target site RG to be subjected to the operation carried out by conveying the medical instrument by operating the display 20.

The image acquisition unit 120 acquires image information DT1 in the living body BD of the target patient to be subjected to the operation carried out by carrying the medical instrument from the external server 30 (see fig. 1) via the network.

The route extraction unit 130 extracts six routes RT of the blood vessel BV corresponding to the six candidates of the introduction site RS, which are the right radial artery, the right brachial artery, the right femoral artery, the left radial artery, the left brachial artery, and the left femoral artery, recorded in the introduction site list LS1 (see fig. 4).

The route score calculation unit 141 calculates the route score SR for each of the six routes RT extracted by the route extraction unit 130 based on the length L of the route RT and the degree of flexion P of the route RT. The patient score calculation unit 145 calculates the patient score SP using the degree of invasiveness for each of the six routes RT extracted by the route extraction unit 130.

In the present usage example, the route score SR decreases in the order of the route RT where the introduction site RS is the right radial artery (left radial artery), the route RT where the introduction site RS is the right brachial artery (left brachial artery), and the route RT where the introduction site RS is the right femoral artery (left femoral artery). In contrast, the patient score SP becomes smaller in the order of the path RT of the right femoral artery (left femoral artery) at the introduction site RS, the path RT of the right brachial artery (left brachial artery) at the introduction site RS, and the path RT of the right radial artery (left radial artery) at the introduction site RS.

In the present use example, the product SR × SP of the path score SR and the patient score SP becomes smaller in the order of the path RT of the introduction site RS as the right femoral artery (left femoral artery), the path RT of the introduction site RS as the right brachial artery (left radial artery), and the path RT of the introduction site RS as the right radial artery (left radial artery).

The ranking unit 140 ranks the plurality of routes RT extracted by the route extraction unit 130 in descending order of the product SR × SP of the route score SR calculated by the route score calculation unit 141 and the patient score SP calculated by the patient score calculation unit 145.

The output unit 150 outputs the plurality of routes RT extracted by the route extraction unit 130, the number of times of discharge by the discharge unit 140, the route score SR, and the patient score SP to the display 20 (see fig. 7 a and 7B).

The operator such as a doctor refers to the route RT, the rank, the route score SR, and the patient score SP of the blood vessel BV output to the display 20 to select an appropriate route RT in consideration of the ease of transportation of the medical instrument when the medical instrument is transported and the magnitude of the load imposed on the subject patient.

According to the route selection support system 1, the recording medium MD in which the route selection support program PR is recorded, the route selection support method, and the diagnosis method of the present embodiment, the placement unit 140 places orders on the plurality of routes RT extracted by the route extraction unit 130 using the route score SR determined according to the ease of transportation of the medical instrument when the medical instrument is transported and the patient score SP determined according to the magnitude of the load on the subject patient. The output unit 150 outputs the plurality of paths RT extracted by the path extraction unit 130 and the bit rank discharged by the discharge unit 140. Thus, the operator such as a doctor can easily select an appropriate path RT from among the plurality of paths RT of the blood vessel BV capable of transporting the medical instrument to the target site RG to be operated, in consideration of the ease of transporting the medical instrument and the magnitude of the load on the target patient when transporting the medical instrument. Therefore, according to the route selection support system 1, the recording medium MD on which the route selection support program PR is recorded, and the route selection support method of the present invention, it is possible to easily select the route RT of the blood vessel BV for transporting the medical instrument to the site in the living body BD via the blood vessel BV. This effect is particularly remarkable when the number of sites of the blood vessel BV is increased in the case of treating the blood vessel BV of the lower limb by using TRI.

In the route selection support system 1, the recording medium MD in which the route selection support program PR is recorded, the route selection support method, and the diagnosis method according to the present embodiment, the route score calculation unit 141 calculates the route score SR using the length of the route RT and the degree of flexion P of the route RT. Thus, the ranking unit 140 can more appropriately evaluate the ease of transportation of the medical instrument when the medical instrument is transported, and rank the route RT. Therefore, the operator can easily select a more appropriate route RT from among the plurality of routes RT that can carry the medical instrument to the blood vessel BV of the target site RG, in consideration of the ease of carrying the medical instrument when carrying the medical instrument. This effect is particularly remarkable when an appropriate path RT is selected from a plurality of paths RT including a portion of a subject patient that is greatly different in size in terms of flexion and bending, such as the right radial artery, the right brachial artery, the right axillary artery, the right subclavian artery, the right brachiocephalic artery, the left radial artery, the left brachial artery, the left axillary artery, the right subclavian artery, the brachiocephalic artery, the aortic arch, the thoracic aorta, the abdominal aorta (descending aorta), the aortic branch of the aorta, one or both of the left and right common iliac arteries, the external iliac artery, the internal iliac artery, the common femoral artery, the superficial femoral artery, and the deep femoral artery, and further, the popliteal artery, the anterior tibial artery, the posterior tibial artery, the peroneal artery, the dorsal aspect artery, and the plantar artery, or the.

Further, according to the route selection support system 1, the recording medium MD in which the route selection support program PR is recorded, the route selection support method, and the diagnosis method of the present embodiment, the patient score calculation unit 145 calculates the patient score SP using the degree of invasiveness of the route RT. Thus, the ranking unit 140 can more appropriately evaluate the magnitude of the burden imposed on the target patient and rank the route RT. Therefore, the operator can easily select a more appropriate route RT from among the plurality of routes RT that can carry the medical instrument to the blood vessel BV of the target site RG, in consideration of the magnitude of the burden imposed on the target patient.

(embodiment mode 2)

Referring to fig. 11, the route selection support system 200 according to the present embodiment includes, in addition to the functional configuration of the route selection support system 1 according to the above-described embodiment: a medical instrument extraction unit 160 for extracting the type of medical instrument used in the operation; and a device extraction unit 170 that extracts available device candidates according to the type of medical device extracted by the medical device extraction unit 160.

The following describes the route selection support system 200 according to the present embodiment. The configuration of the route selection support system 200 according to the present embodiment is the same as that of the route selection support system 1 according to the above-described embodiment. The functional configuration of the route selection support system 200 of the present embodiment is the same as the functional configuration of the route selection support system 1 of the above-described embodiment except that it further includes the medical instrument extraction unit 160 and the device extraction unit 170. The same devices and functional blocks as those of the route selection support system 1 of the above embodiment are denoted by the same reference numerals, and description thereof is omitted.

Referring to fig. 12, the receiving unit 110 receives input of operation information specifying the type of operation performed to transport a medical instrument to a target site RG through a blood vessel BV (corresponding to a living body lumen). The types of the operation include, for example, dilation and penetration of a narrowed portion of a blood vessel BV, excavation of the narrowed portion of the blood vessel BV, imaging of an inner region BVa1 of the blood vessel BV, and release of a drug into the blood vessel BV. The function of the receiving unit 110 is the same as that of the receiving unit 110 of the route support system according to the above-described embodiment except that the receiving unit receives the input of the surgical information.

The medical instrument extracting unit 160 extracts one or more types of medical instruments used in a type of surgery specified based on the surgical information. Examples of the types of medical instruments include guide sheaths, guide wires, contrast catheters, microcatheters, angiographic catheters, guide wire support catheters, guide catheters, balloon-expandable stents, self-expandable stents, drug-releasing balloons, DCA catheters (Directional Coronary Atherectomy), micro-dissection catheters, laser ablation catheters, and catheters for image diagnosis.

The catheter for image diagnosis is a catheter that acquires an image using intravascular ultrasound (IVUS) or Optical Coherence Tomography (OCT), for example.

The equipment extracting unit 170 extracts available equipment candidates for each type of medical instrument extracted by the medical instrument extracting unit 160. The device extraction unit 170 extracts candidates of devices that can be used based on the absence of the device stock.

In the case where there are a plurality of available device candidates, the device extraction unit 170 extracts the device candidates within a range not exceeding the upper limit number. The upper limit number is not particularly limited, and is, for example, about 10 for each facility.

When there is no available device, the number of device candidates extracted by the device extraction unit 170 is zero.

Referring to (a) to (C) of fig. 13, the external server 30 stores a medical instrument list LS2 in which the type of medical instrument used is recorded for each type of operation, an equipment list LS3 in which equipment candidates are recorded for each type of medical instrument, and an equipment information list LS4 in which the presence or absence of equipment inventory is recorded for each equipment candidate.

The device list LS3 records commercially available devices for each type of medical instrument. The device is identified based on the inherent device identifier. The inherent device identifier is, for example, a manufacturer name and a model name of a manufacturer that sells the device, a pharmaceutical approval document number, a product code, a barcode data, a product name, a lot number, or the like.

The device information list LS4 records the presence or absence of a device stock in a facility using the routing support system 200.

The medical instrument extraction unit 160 extracts the type of the medical instrument using the medical instrument list LS 2. The device extracting unit 170 extracts candidates of usable devices by using the device list LS3 and the device information list LS 4.

The ranking unit 140 adjusts the ranking of the plurality of routes RT extracted by the route extraction unit 130 based on the extraction result of the device extracted by the device extraction unit 170.

The placement unit 140 lowers the order of the path RT where the usable devices are not extracted by the device extraction unit 170.

Referring to fig. 14, the output unit 150 outputs the candidates of the facility extracted by the facility extraction unit 170 to the display 20 in addition to the information output by the output unit 150 of the route selection support system 1 according to the above-described embodiment.

In order to assist a surgeon such as a doctor in selecting a device used in a surgery in which a medical instrument is delivered to a target site RG in a living body BD via a blood vessel BV, the output unit 150 outputs a path RT, a rank, a path score SR, and a patient score SP to the display 20.

According to the route selection support system 200 of the present embodiment, the receiving unit 110 receives input of operation information specifying the type of operation performed by conveying a medical instrument through a blood vessel BV. The route selection support system 200 of the present embodiment includes: a medical instrument extraction unit 160 that extracts the type of medical instrument used in the operation specified based on the operation information; and a device extraction unit 170 that extracts candidates of devices that can be used for each type of medical device extracted by the medical device extraction unit 160. The output unit 150 outputs the extraction result of the device candidates extracted by the device extraction unit 170. This makes it easier for the operator to select a device to be used in a procedure to be performed by transporting a medical instrument through the blood vessel BV. Therefore, the burden on the operator when the medical instrument is transported via the blood vessel BV to perform the operation is further reduced.

Further, according to the route selection support system 200, the recording medium MD in which the route selection support program PR is recorded, and the route selection support method of the present embodiment, the placement unit 140 adjusts the number of times the plurality of routes RT extracted by the route extraction unit 130 are placed based on the extraction result of the device candidates extracted by the device extraction unit 170. Thus, the operator can easily select a more appropriate route RT from among the plurality of routes RT of the blood vessel BV which can carry the medical instrument to the target site RG, according to the candidates of the usable devices.

(modification 1)

In the above-described embodiments 1 and 2, the patient score calculation unit 145 calculates the magnitude of the burden imposed on the target patient using the degree of invasiveness. However, the patient score calculation unit 145 may calculate the patient score SP using patient information in which the characteristics of the target patient are recorded.

The patient information can be stored in the external server 30. The patient score calculating unit 145 acquires patient information from the external server 30 via the network.

The patient information includes information related to the past medical history of the subject patient. The information related to the past medical history of the subject patient includes operation history information in which history information of the operation on the blood vessel BV is recorded. The surgery for the blood vessel BV is, for example, stent, graft retention, etc. The operation history information includes information for specifying a site of the blood vessel BV on which the operation has been performed.

The patient score calculation unit 145 calculates a patient score SP using information on the past medical history of the subject patient. The patient score calculation unit 145 calculates the patient score SP for the path RT including the blood vessel BV subjected to the operation to be higher than the path RT not including the blood vessel BV subjected to the operation using the operation history information.

According to the route selection support system, the recording medium MD in which the route selection support program PR is recorded, and the route selection support method of the present modification, the patient score calculation unit 145 calculates the patient score SP using information on the characteristics of the subject patient. Thus, the ranking unit 140 can more appropriately evaluate the magnitude of the load imposed on the target patient and rank the route RT. Therefore, the operator can easily select a more appropriate route RT from among the plurality of routes RT that can carry the medical instrument to the blood vessel BV of the target site RG, in consideration of the magnitude of the burden imposed on the target patient.

(modification 2)

In the above-described embodiments 1 and 2, the receiving unit 110 displays one or more parts received as the target part RG on the display 20 as options, and receives selection of the displayed part.

Referring to fig. 15 (a), the reception unit 110 may further receive a selection of a range of a region to be a target for delivering a medical instrument, for a region displayed on the display 20 as an option. The operator such as a doctor can select the target region RG more precisely and accurately by selecting the range of the region to be the target for transporting the medical instrument.

At this time, the reception unit 110 may display an image GR of the living body BD of the target patient on the display 20, and display a range of the site selected as the target for transporting the medical instrument on the image GR with a recognizable marker MK 2.

Referring to fig. 15 (B), the receiving unit 110 may display an image GR of the living body BD of the target patient on the display 20, and receive a selection of the target site RG on the image GR. In this case, the operator such as a doctor can select the target region RG by tracing the target region RG with a finger or the like on the image GR displayed on the display 20. Therefore, according to the route selection support system of the present modification, the target portion RG can be easily selected, and the target portion RG can be accurately selected in more detail.

(modification 3)

In embodiment 2 described above, the device extracting unit 170 extracts candidates of devices that can be used based on the absence of the device inventory.

The device extracting unit 170 may further filter candidates of usable devices extracted based on the presence or absence of the stock of devices, using the characteristics of the devices.

For example, the device extracting unit 170 may remove a device whose length does not reach the length L of the route RT from the available device candidates extracted based on the absence of the stock of devices.

The above description has been made of the route selection support system, the recording medium on which the route selection support program is recorded, and the route selection support method according to the embodiments and the modified examples thereof, but the present invention is not limited to the configuration described in the embodiments, and can be appropriately modified based on the description of the claims.

For example, in the above-described embodiment and the modifications thereof, the blood vessel of the lower limb is exemplified as the target site, but the target site is not particularly limited. For example, the blood vessel may be a blood vessel in the brain, heart, or the like. In the above-described embodiment and the modifications thereof, the description has been given taking the living body lumen as a blood vessel as an example, but the living body lumen is not limited to a blood vessel, and may be a blood vessel, a bile duct, an oviduct, a hepatic duct, a trachea, an esophagus, a urethra, or the like.

The patient score calculating unit calculates the patient score using history information of the operation on the blood vessel as information related to the characteristics of the target patient. However, the patient score calculating unit may calculate the patient score by using, as the information relating to the characteristics of the target patient, information that is likely to cause spasm (abnormal contraction of blood vessels accompanied by spasm) due to stress, or the like, or a history of occurrence of stenosis, blockage, or the like. In this case, the patient score calculation unit calculates the patient score of a route including a blood vessel portion having a history of occurrence of spasm or the like to be higher than the patient score of a route not including a blood vessel portion having a history of occurrence of spasm or the like. The patient score calculating unit may calculate the patient score by combining information on the characteristics of the target patient and the degree of invasiveness.

In the above-described embodiment and the modifications thereof, the output unit outputs the plurality of routes extracted by the route extraction unit, the number of times of discharge by the discharge unit, the route score, and the patient score to the display. However, the output unit may output the plurality of routes extracted by the route extraction unit, the order of the orders discharged by the discharge unit, the route score, and the patient score as data to an external server. In this case, the path of the biological lumen can be expressed as a set of coordinates with the target site as the origin.

In the above-described embodiment and the modifications thereof, the output unit displays one of the plurality of routes extracted by the route extraction unit on the display in accordance with the selection of the route received by the reception unit. However, the output unit may display the plurality of routes extracted by the route extraction unit on the display at the same time. In this case, the output unit may display the plurality of paths extracted by the path extraction unit on the display in color.

In the above-described embodiment and the modifications thereof, the image information includes the image data and the accompanying information, but the image information only needs to include at least the image data of the living body lumen of the subject patient, and the accompanying information is not an essential element.

In addition, the image data may not include the boundary marker. In this case, the center line calculating unit of the path score calculating unit may derive the center line of the blood vessel based on the image data using a known image processing technique or the like.

In addition, the image data does not need to be divided for each part of the biological lumen. Even if the image data is not divided for each region of the biological lumen, the path extraction unit can extract a path of the biological lumen, which can transport the medical instrument to the target region, based on the image data, using a known image processing technique or the like.

In the above-described embodiment and the modifications thereof, the routing support program recorded in the computer-readable recording medium of the routing support system is read by the reading device and stored in the storage device to function. However, the routing support program of the routing support system may be provided in a state of being stored in the storage device in advance. A part or all of the functions of the path selection support system may be realized by a Programmable circuit structure such as an FPGA (Field Programmable gate array). In this case, a part or the whole of the routing support program is described in a hardware description language such as Verilog.

In the above-described embodiment and the modifications thereof, the receiving unit receives input of the part information and the like via the touch panel display. However, in the routing support system, the input device is not limited to the touch panel display, and a known input device can be used. For example, the route selection support system may include a mouse or a tablet as an input device, in addition to the display of the non-touch panel display. An operator such as a doctor can input the site information by operating a mouse or a tablet.

In the above-described embodiment and the modifications thereof, the computer main body and the display are separately configured, but the computer main body and the display may be integrally configured, or the display may be incorporated in the computer main body.

In the above-described embodiment and the modifications thereof, the image acquisition unit acquires image information from an external server. However, the image acquisition unit may be configured using a medical imaging apparatus such as an X-ray CT apparatus or an MRI apparatus.

The present application is based on japanese patent application No. 2017-110378, filed on 6/2/2017, the disclosure of which is incorporated by reference in its entirety.

Description of the reference numerals

1. 200 route selection support system,

10 a computer main body,

20 a display,

30 external servers,

50 arithmetic device,

60 a storage device,

70 a reading device,

110 receiving unit,

120 an image acquisition unit,

130 route extraction unit,

140 arranging and positioning parts,

141 route score calculating section,

145 patient score calculating part,

150 output part,

160 a medical instrument extraction part,

170 equipment extraction part,

BD organism,

BV blood vessel (lumen of living body),

DT1 image information,

An MD recording medium,

PR path selection support program,

RG target site,

The introduction site of RS,

The RT route,

SP patient score,

SR path fraction,

The length of the L path,

Degree of flexion of P-path