WO2017179091A1 - Système de thérapie par faisceau de particules - Google Patents

Système de thérapie par faisceau de particules Download PDF

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Publication number
WO2017179091A1
WO2017179091A1 PCT/JP2016/061678 JP2016061678W WO2017179091A1 WO 2017179091 A1 WO2017179091 A1 WO 2017179091A1 JP 2016061678 W JP2016061678 W JP 2016061678W WO 2017179091 A1 WO2017179091 A1 WO 2017179091A1
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WO
WIPO (PCT)
Prior art keywords
particle beam
period
ray imaging
body surface
frame rate
Prior art date
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Ceased
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PCT/JP2016/061678
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English (en)
Japanese (ja)
Inventor
裕介 坂本
奈津子 大塚
卓紀 角尾
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Mitsubishi Electric Corp
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Mitsubishi Electric Corp
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Publication date
Application filed by Mitsubishi Electric Corp filed Critical Mitsubishi Electric Corp
Priority to JP2018511549A priority Critical patent/JP6582128B2/ja
Priority to PCT/JP2016/061678 priority patent/WO2017179091A1/fr
Priority to TW105129755A priority patent/TWI635884B/zh
Publication of WO2017179091A1 publication Critical patent/WO2017179091A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy

Definitions

  • the present invention relates to a particle beam therapy system using image guidance based on an X-ray image.
  • IGRT Image Guided Radiation
  • X-ray image is used to accurately irradiate the affected area with radiation for treatment while confirming the position of the affected area with an image such as an X-ray image. Therapy
  • Patent Document 1 image-guided radiation therapy
  • the patient will be exposed to X-rays for image acquisition in addition to therapeutic radiation. It is desirable that this exposure be as low as possible.
  • the frequency of imaging with imaging X-rays particularly in the case of an irradiation target in a range that moves due to patient respiration, such as the lungs and liver It is possible to grasp the organ position in real time the higher, the trade-off is that the exposure dose also increases.
  • particle beam therapy for irradiating the affected organs with a beam of carbon ions or protons, that is, a particle beam
  • particle accelerators are used to generate particle beams that are bundles of high energy charged particles. Many of these accelerators have a configuration in which the irradiated particle beam cannot be continuously generated.
  • an IGRT using an X-ray image includes a region including a moving part due to patient respiration, it is desired to grasp an organ position in real time while reducing the X-ray exposure as much as possible.
  • An object of the present invention is to reduce the exposure dose by X-ray imaging without impairing the accuracy of organ position determination by X-ray imaging in the particle beam therapy system.
  • the particle beam therapy system of the present invention includes a particle beam generator that generates a particle beam that irradiates an affected area of a patient who is an irradiation object, an irradiation nozzle that irradiates the irradiation object with a particle beam generated by the particle beam generator, Analyzing an X-ray image captured by an X-ray imaging device, an apparatus control device that controls a particle beam generation device and an irradiation nozzle, an X-ray imaging device that irradiates an irradiation target with X-rays to capture an X-ray image And an X-ray image analysis organ position estimation device for estimating the position of an organ having an affected part of a patient, and the device control apparatus has preset the position of the organ estimated by the X-ray image analysis organ position estimation device
  • the particle beam therapy system that controls a particle beam generator and an irradiation nozzle to irradiate a target with a particle beam when in a range position, the particle
  • FIG. 1 is a block diagram conceptually showing the structure of an example of a particle beam therapy system according to Embodiment 1 of the present invention.
  • a particle beam 2 emitted as a high-energy charged particle beam from an accelerator 1 that accelerates charged particles passes through a vacuum duct 3 that is a particle beam transport path and is transported to an irradiation nozzle 4 provided downstream of the vacuum duct 3. Is done.
  • a bending electromagnet for changing the traveling direction of the particle beam 2 is provided at a portion where the vacuum duct 3 is bent, but is omitted in FIG.
  • the particle beam 2 is scanned in a two-dimensional direction perpendicular to the traveling direction of the particle beam 2 by a scanning electromagnet provided in the irradiation nozzle 4.
  • the scanned particle beam 2a is irradiated to the affected part 60 of the patient 6 as an irradiation target placed on the treatment table.
  • Various irradiation parameters at the time of irradiation are set by the treatment planning device 10, and parameters of each device of the accelerator 1 and the irradiation nozzle 4 for irradiation with the irradiation parameters are transmitted to the device control device 21.
  • a command is output to each device such as the irradiation nozzle 4.
  • X-rays constituted by X-ray tubes 51a and 51b and flat panel detectors (FPD) 52a and 52b.
  • An imaging device 50 is installed. X-rays emitted from the X-ray tube 51a are detected by the FPD 52a, and X-rays emitted from the X-ray tube 51b are detected by the FPD 52b.
  • the X-ray tubes 51a and 51b and the FPDs 52a and 52b are controlled by the X-ray imaging control / image information acquisition device 22 to acquire X-ray image information.
  • the irradiation dose to be irradiated to the affected part 60 is determined.
  • the irradiation dose is determined as a three-dimensional distribution matched to the shape of the affected part 60, that is, an irradiation dose distribution.
  • the treatment planning apparatus 10 can determine irradiation parameters that are a set of various parameters of the accelerator 1 and the irradiation nozzle 4 for giving the irradiation dose distribution to the affected part 60.
  • the set of irradiation parameters cannot be uniquely determined by the intensity of the particle beam or the beam diameter. For this reason, an irradiation parameter that a user such as a doctor considers appropriate is determined.
  • the particle beam irradiation to the affected area 60 is performed once a day and in several tens of times.
  • a preset patient isocenter in the image of the affected part 60 of the patient 6 acquired by the X-ray imaging control / image information acquisition device 22 is the isocenter of the device determined by the irradiation nozzle 4.
  • the position of the patient on the treatment table is positioned by controlling the position of the treatment table.
  • each device is controlled via the device control device 21 according to predetermined parameters of the accelerator 1 and the irradiation nozzle 4, and the affected part 60 is irradiated with the particle beam.
  • the image analysis / organ position estimation device 23 analyzes the X-ray image acquired by the X-ray imaging control / image information acquisition device 22 in real time, and the position of the affected part 60 falls within a predetermined range.
  • the device controller 21 is instructed to irradiate the particle beam only at certain times.
  • the specific range generally refers to the position of the organ having the affected part 60 in the respiratory phase at which, for example, the moving speed of the affected part 60 becomes small at the time of planning a treatment (doctor, radiologist or medical physicist ).
  • the accelerator 1 is a synchrotron
  • the particle beam accumulated in the ring of the synchrotron is decelerated and discarded, a new particle beam is generated again by the ion source, and accelerated to the next energy, and the synchrotron
  • the particle beam accumulated in the ring of the ring is to the next energy, but in the former case, the latter accelerates and decelerates until the next acceleration is completed. Until the adjustment is completed, the particle beam cannot be emitted to the affected part 60 of the patient 6 to be irradiated.
  • the accelerator 1 When the accelerator 1 is a cyclotron, energy is not changed by the accelerator 1, and an energy absorber called a degrader is inserted in the particle beam transport path or in the irradiation nozzle, and the energy is adjusted by adjusting the thickness of the degrader. do. Also in this case, the particle beam cannot be emitted to the affected part 60 of the patient 6 to be irradiated while the degrader is operating. Thus, in the particle beam therapy system including the accelerator, the particle beam transport path, and the irradiation nozzle, the particle beam cannot be emitted for a period during which the particle beam can be emitted to the affected part 60 of the patient 6 to be irradiated for some reason. There is often a period.
  • the time when the particle beam therapy system is in a period in which the particle beam can be emitted from the irradiation target is referred to as being in a state where the treatment beam can be emitted.
  • a period during which the particle beam can be emitted from the irradiation target is referred to as a treatment beam extraction enabled period
  • a period during which the particle beam cannot be output is referred to as a treatment beam extraction disabled period.
  • FIG. 2 shows an example of a time chart of treatment beam irradiation in IGRT irradiation by the particle beam treatment system of the present invention.
  • the particle beam therapy system has a period during which the particle beam can be emitted (treatment beam extraction is possible on, treatment beam emission is possible period) and a period during which the particle beam is not available (treatment beam emission is off, treatment beam emission is not possible period). Exists.
  • the X-ray imaging period is synchronized with the treatment beam extraction period, and X-ray imaging is performed only during the treatment beam extraction period.
  • one X-ray imaging is instantaneous, and the imaging is repeated at a preset frame rate (imaging frequency), for example, 7.5 to 30 fps (frame per second).
  • a preset frame rate for example, 7.5 to 30 fps (frame per second).
  • a period in which X-ray imaging is performed at a preset frame rate is expressed as an X-ray imaging on period (X-ray imaging period).
  • the X-ray imaging control / image information acquisition device 22 acquires an X-ray image at a preset frame rate during X-ray imaging on, analyzes the acquired image by the image analysis / organ position estimation device 23, and The current position of the organ having the affected part 60 is estimated.
  • a treatment beam irradiation signal is sent to the device control apparatus 21.
  • the device controller 21 controls devices such as the accelerator 1 and the irradiation nozzle 4 so that the affected part 60 is irradiated with the particle beam only when the irradiation signal is received.
  • X-ray imaging is performed only when the treatment beam extraction is enabled, and the frame rate is set to 0 so that X-ray imaging is not performed during other periods.
  • the image analysis / organ position estimation device 23 may lose sight of the organ position.
  • the frame rate is lowered and the imaging frequency is lowered than the frame rate (also referred to as the first frame rate) of the X-ray imaging period.
  • X-ray imaging is preferably performed.
  • the imaging frame rate of X-ray imaging is reduced in the period during which treatment beam extraction is not possible (including the case where the frame rate is 0, that is, when imaging is not performed) than the period during which treatment beam extraction is possible.
  • the patient exposure dose by X-rays can be reduced, and the organ position is always confirmed by X-ray imaging during a period when the treatment beam can be emitted. Therefore, it is possible to irradiate the treatment beam with high positional accuracy.
  • FIG. FIG. 4 is an example of a time chart of treatment beam irradiation of the particle beam therapy system according to the second embodiment.
  • the X-ray image analysis / organ position estimation apparatus 23 estimates the organ position and determines whether or not the treatment beam can be irradiated until it is actually started or stopped. There is a delay.
  • the start time and end time of the X-ray imaging period are set earlier than the start time and end time of the treatment beam extraction possible period.
  • the treatment beam can be irradiated from the beginning of the treatment beam extraction period. It becomes possible. Moreover, useless X-ray irradiation can be reduced by setting the end time of the X-ray imaging period earlier.
  • FIG. FIG. 5 is a block diagram showing the configuration of the particle beam therapy system according to the third embodiment of the present invention.
  • a body surface position detector 53 that detects the body surface position of the patient 6 without using X-rays is provided.
  • the body surface position detector 53 can acquire position information on the body surface of the abdomen of the patient 6 in real time by means such as an infrared sensor.
  • FIG. 6 shows a time chart of treatment beam irradiation in the third embodiment.
  • the position of the body surface is within a specific range determined in advance, it is expressed as body surface position on, and this period is set as an X-ray imaging period, and X-ray imaging is performed only during this period. Is done.
  • X-ray imaging may be performed at a predetermined first frame rate during the X-ray imaging period, and X-ray imaging may be performed at a frame rate lower than the first frame rate during a period other than the X-ray imaging period.
  • the image analysis / organ position estimation device 23 analyzes the captured X-ray image and estimates the current position of the organ having the affected part 60.
  • a treatment beam irradiation signal is sent to the device control apparatus 21.
  • the particle beam generating apparatus 30 can emit the treatment beam only when the treatment beam emission is enabled, as a result, both the organ position on which X-ray imaging was performed and the treatment beam emission enabled on are simultaneously satisfied. Only when will the treatment beam be irradiated.
  • the above-mentioned specific range for determining the body surface position on corresponds to the range for determining whether or not treatment beam irradiation is possible based on the organ position of the X-ray image, and is determined by the practitioner.
  • the practitioner uses the body surface position detector 53, the X-ray imaging control / image information acquisition device 22, and the image analysis / organ position estimation device 23 equivalent to those used for treatment at the time of patient diagnosis. It is desirable to know in advance the correlation between the body surface position acquired by the detector 53 and the organ position having the affected part 60 in the body estimated by X-ray imaging.
  • an appropriate margin is set when determining the range for determining the body surface position on, and X It is desirable to set a wider range than the range for determining whether or not treatment beam irradiation is possible based on the organ position of the line image.
  • the correlation between the body surface position and the organ position in the body is not completely reproducible, but in many cases it is expected to have a certain degree of reproducibility. Since the X-ray imaging is not performed when the organ position having the position is not within a specific range, it can be expected that the exposure dose of the patient due to the X-ray is reduced.
  • the operation shown in FIG. 7 by performing X-ray imaging only when the treatment beam can be emitted and the body surface position is within a predetermined range determined in advance, the operation shown in FIG. It can be expected to reduce the patient's exposure dose by X-rays.
  • the time set as the start time and end time of the treatment beam extraction allowance may be set earlier than the start time and end time of the actual treatment beam extraction enable period. Good.
  • the frame rate is lower than the X-ray imaging period in the X-ray imaging off period in FIG. 7, that is, in a period other than the X-ray imaging period.
  • X-ray imaging may be performed.
  • the X-ray imaging may be performed at a lower frame rate than the X-ray imaging period in the X-ray imaging off period in FIG.
  • the particle beam therapy system is capable of emitting a treatment beam that can emit a particle beam to the affected area of the patient, and the patient.
  • a treatment beam extraction impossible period during which the particle beam cannot be emitted from the affected area, and the X-ray imaging period is a period including at least a part of the treatment beam emission possible period.
  • FIG. 9 is an example of a time chart of treatment beam irradiation of the particle beam therapy system according to the fourth embodiment.
  • the fourth embodiment is an embodiment of a particle beam therapy system in which the particle beam generator 30 including the accelerator 1 can continuously generate a particle beam that can be irradiated to a patient.
  • the configuration of the particle beam therapy system is the same as the configuration shown in FIG.
  • the particle beam therapy system according to the fourth embodiment irradiates the entire affected area 60 of the patient 6 without changing the energy of the particle beam generated from the particle beam generator 30 using, for example, a bolus, so-called broad irradiation. Applicable to law.
  • the position of the body surface is within a predetermined range, it is expressed as body surface position on, and X-ray imaging is performed at a preset frame rate (also referred to as a first frame rate) during this period. .
  • the imaging frame rate for X-ray imaging is reduced below the first frame rate.
  • the imaging frame rate in this case is 0, that is, includes the case where X-ray imaging is not performed.
  • the image analysis / organ position estimation device 23 analyzes the captured X-ray image and estimates the current position of the organ having the affected part 60. When the current position of the organ is within a predetermined irradiation range, a treatment beam irradiation signal is sent to the device control apparatus 21.
  • the specific range for the determination of the body surface position on corresponds to the range for determining whether the treatment beam can be irradiated based on the organ position of the X-ray image, Determined by the practitioner.
  • the practitioner uses the body surface position detector 53, the X-ray imaging control / image information acquisition device 22, and the image analysis / organ position estimation device 23 equivalent to those used for treatment at the time of patient diagnosis. It is desirable to know in advance the correlation between the body surface position of the patient 6 acquired by the detector 53 and the organ position having the affected part 60 estimated by X-ray imaging in the patient 6 body.
  • an appropriate margin is set when determining the range for determining the body surface position on, and X It is desirable to set a wider range than the range for determining whether or not treatment beam irradiation is possible based on the organ position of the line image.
  • the correlation between the body surface position and the organ position in the body is not completely reproducible, but in many cases it is expected to have some reproducibility. For this reason, in the fourth embodiment, when the position of the internal organ having the affected part 60 is clearly not within a specific range, the frequency of X-ray imaging is reduced or X-ray imaging is not performed. Therefore, even in a particle beam therapy system that can continuously generate a particle beam that can be irradiated to a patient, it can be expected to reduce the patient's exposure dose due to X-rays.
  • the treatment planning device 10, the device control device 21, the X-ray imaging control / image information acquisition device 22, and the image analysis / organ position estimation device 23 are each a processor 11 as shown in FIG. It is realized by a general computer including a memory 12, an input interface 13 such as a keyboard and a touch panel, a display 14 as an output interface, and the like.
  • the treatment planning device 10, the device control device 21, the X-ray imaging control / image information acquisition device 22, and the image analysis / organ position estimation device 23 may all be configured by a single computer.
  • the treatment planning device 10 and the device control device 21 are configured by a single computer, and the X-ray imaging control / image information acquisition device 22 and the image analysis / organ position estimation device 23 are configured by a single computer. Any computer configuration may be used.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Pathology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Radiation-Therapy Devices (AREA)

Abstract

La présente invention concerne un système de thérapie par faisceau de particules qui comprend : un dispositif de génération de faisceau de particules (30) qui génère un faisceau de particules avec lequel une partie affectée d'un patient à irradier est irradiée ; et un dispositif d'imagerie à rayons X (50) qui émet un rayon X vers le sujet qui est irradié et capture une image radiographique. Ce système de thérapie par faisceau de particules a une période d'émission de faisceau de thérapie pendant laquelle le faisceau de particules peut être émis vers le sujet étant irradié, et une période de non-émission de faisceau de thérapie pendant laquelle le faisceau de particules ne peut pas être émis vers le sujet étant irradié. Le dispositif d'imagerie à rayons X (50) utilise une première fréquence de trame pour la fréquence de trame d'imagerie de l'image radiographique du sujet étant irradié dans une période d'imagerie à rayons X qui est une période qui comprend au moins une partie de la période d'émission de faisceau thérapeutique, et utilise, dans des périodes autres que la période d'imagerie à rayons X, une fréquence de trame d'imagerie qui est inférieure à la première fréquence de trame.
PCT/JP2016/061678 2016-04-11 2016-04-11 Système de thérapie par faisceau de particules Ceased WO2017179091A1 (fr)

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JP2018511549A JP6582128B2 (ja) 2016-04-11 2016-04-11 粒子線治療システム
PCT/JP2016/061678 WO2017179091A1 (fr) 2016-04-11 2016-04-11 Système de thérapie par faisceau de particules
TW105129755A TWI635884B (zh) 2016-04-11 2016-09-13 粒子線治療系統

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN108014427A (zh) * 2017-12-11 2018-05-11 苏州雷泰医疗科技有限公司 一种变能装置及变能加速器治疗装置及其控制方法

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH10328318A (ja) * 1997-05-29 1998-12-15 Hitachi Medical Corp 放射線治療システム
JP2010154874A (ja) * 2008-12-26 2010-07-15 Hitachi Ltd 放射線治療システム
JP2012501792A (ja) * 2008-09-12 2012-01-26 アキュレイ インコーポレイテッド ターゲットの動きに基づくｘ線像形成の制御
JP2013111406A (ja) * 2011-11-30 2013-06-10 Hitachi Ltd 荷電粒子照射システムおよび荷電粒子照射方法
WO2014010073A1 (fr) * 2012-07-13 2014-01-16 三菱電機株式会社 Appareil de positionnement des rayons x, procédé de positionnement des rayons x, et procédé d'imagerie d'une image d'intérêt

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH10328318A (ja) * 1997-05-29 1998-12-15 Hitachi Medical Corp 放射線治療システム
JP2012501792A (ja) * 2008-09-12 2012-01-26 アキュレイ インコーポレイテッド ターゲットの動きに基づくｘ線像形成の制御
JP2010154874A (ja) * 2008-12-26 2010-07-15 Hitachi Ltd 放射線治療システム
JP2013111406A (ja) * 2011-11-30 2013-06-10 Hitachi Ltd 荷電粒子照射システムおよび荷電粒子照射方法
WO2014010073A1 (fr) * 2012-07-13 2014-01-16 三菱電機株式会社 Appareil de positionnement des rayons x, procédé de positionnement des rayons x, et procédé d'imagerie d'une image d'intérêt

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN108014427A (zh) * 2017-12-11 2018-05-11 苏州雷泰医疗科技有限公司 一种变能装置及变能加速器治疗装置及其控制方法
CN108014427B (zh) * 2017-12-11 2025-05-27 北京雷泰腾飞医疗科技有限公司 一种变能装置及变能加速器治疗装置及其控制方法

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TWI635884B (zh) 2018-09-21
JPWO2017179091A1 (ja) 2018-09-27
JP6582128B2 (ja) 2019-09-25

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