WO2018072920A1 - Support de patient et dispositif de traitement de patient - Google Patents

Support de patient et dispositif de traitement de patient Download PDF

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Publication number
WO2018072920A1
WO2018072920A1 PCT/EP2017/072056 EP2017072056W WO2018072920A1 WO 2018072920 A1 WO2018072920 A1 WO 2018072920A1 EP 2017072056 W EP2017072056 W EP 2017072056W WO 2018072920 A1 WO2018072920 A1 WO 2018072920A1
Authority
WO
WIPO (PCT)
Prior art keywords
arm
axis
base
patient
table top
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/EP2017/072056
Other languages
German (de)
English (en)
Inventor
Alexander Krämer
Wolfgang Neuber
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.)
Siemens Healthcare GmbH
Original Assignee
Siemens Healthcare GmbH
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Siemens Healthcare GmbH filed Critical Siemens Healthcare GmbH
Publication of WO2018072920A1 publication Critical patent/WO2018072920A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • 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
    • A61N5/1048—Monitoring, verifying, controlling systems and methods
    • A61N5/1049—Monitoring, verifying, controlling systems and methods for verifying the position of the patient with respect to the radiation beam
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/04—Positioning of patients; Tiltable beds or the like
    • A61B6/0407—Supports, e.g. tables or beds, for the body or parts of the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/04—Positioning of patients; Tiltable beds or the like
    • A61B6/0487—Motor-assisted positioning
    • 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
    • A61N5/1048—Monitoring, verifying, controlling systems and methods
    • A61N5/1049—Monitoring, verifying, controlling systems and methods for verifying the position of the patient with respect to the radiation beam
    • A61N2005/1063—Monitoring, verifying, controlling systems and methods for verifying the position of the patient with respect to the radiation beam maintaining the position when the patient is moved from an imaging to a therapy system

Definitions

  • the invention relates to a patient bed for a radiation therapy system having an isocenter comprising a table top for patients extended along a central longitudinal axis and a positioning device for positioning the table top. Furthermore, the invention relates to a patient tenmakerss adopted with a corresponding patient bed.
  • patient beds For storage of patients during a medical examination and / or a medical treatment, so-called patient beds, also called medical tables or patient tables, are used. These often have not only ei ⁇ ne table top or couch for patients, but also a positioning or an adjustment mechanism, by means of which or by means of the table top or the couch and thus a resting thereon Pa ⁇ tient positioned and / / or are alignable.
  • the positioning device is designed as a multi-axis robotic arm and as described in DE 10 2008 019 114 A1. Proceeding from this, the object of the invention is to specify an advantageously designed patient couch or a patient care unit designed in front of a partially arranged patient with a patient couch. This object is achieved by a Patien ⁇ tenliege with the features of claim 1 and by a patient care device with the features of claim 11. Preferred developments are contained in the gurbezo ⁇ based claims. The advantages and preferred embodiments cited with regard to patient couches can also be transferred to the patient care facility and vice versa.
  • a corresponding patient support is formed for a Strah ⁇ lentherapiestrom and typi cally ⁇ is accordingly used in conjunction with a radiation therapy system.
  • the patient bed is preferably arranged in a fixed relative position to the radiation therapy system, wherein the patient bed is in particular positioned and aligned relative to the isocenter of the radiation therapy system. That relative alignment and positioning is typi ⁇ cally fixed and is fixed below. This allows a relatively accurate and reproducible positio ⁇ discrimination and orientation of a patient using the patient table relative to the radiation therapy system, which is usually not only desired for the Be ⁇ treatment of a patient by means of the radiation therapy system, but absolutely necessary borrowed is.
  • the patient bed in this case has a table top for the location ⁇ tion, edition or recording of patients and a positioning device for positioning and alignment of the table top.
  • Part of the positioning device is a vertically extending lifting arm as a linear unit for a lifting movement (axis 4) of the table top in the vertical direction, wherein the table top via a tilting device for tilting the table top (axis 5 and / or axis 5) on that lifting arm is stored.
  • the base side on the lifting arm which extends in the horizontal direction base arm is further mounted, this is a vertically-rich ⁇ ended and, in particular extending through the isocenter or is mounted rotatably near the isocenter passing base rotational axis (axis 1).
  • the vertical direction is considered to be a direction which, to a good approximation, is parallel to the direction of gravitational acceleration or acting gravitational force, and accordingly a direction is to be regarded as a horizontal direction which, in a good approximation, is perpendicular to the direction of gravitational acceleration or Direction of gravitational force is aligned.
  • a thus configured patient support a patient and thus a to be irradiated volume pre ⁇ zie can be aligned relative to the radiation therapy system, and more particularly to the isocenter of the radiation therapy system and Be ⁇ may proceed relative thereto during the irradiation of the volume by the radiation therapy system, which in turn is a very precise spatial dose distribution in the volume can be realized.
  • the basic axis of rotation is preferably realized as a fixed or space-fixed axis of rotation, that is to say as an axis of rotation which is arranged quasi immovably in an examination and / or treatment space.
  • the radiation therapy system and with it the
  • the base arm is rotatably mounted about the base axis of rotation
  • the base arm according to a variant of a part of a rotary joint or attached to a corresponding hinge fastened, for example, at the bottom of the examination ⁇ and / or treatment room and / or partially embedded in this
  • That hinge is example ⁇ realized as flat turntable, as in manufacturing conventional patient beds or radiotherapy loungers is common.
  • Um ⁇ armor in existing examination and / or treatment rooms is possible by the existing patient bed is replaced by a ne described here.
  • the base arm is guided by means of a curved guide, thus in particular by means of a nikbo ⁇ genförmigen guide which is concentric po- sitioned to the base axis of rotation and rotatable thus about the base pivot axis.
  • a correspondingly formed guide is then as ⁇ derum preferably located at the bottom of the examination and / or treatmen ⁇ lung space, fixed and / or embedded in the corresponding ⁇ the ground and for example as a rail or track system.
  • the aforementioned tilting device serves for tilting the table top out of a horizontal orientation, wherein the tilting device is preferably designed for this purpose such that the table top is rotatably mounted about its central longitudinal axis (axis 6) or an axis parallel thereto.
  • the tilting device allows a rotation of the table about a tilt axis (axis 5) which is perpendicular to the central longitudinal axis of the table top ⁇ directed.
  • tilting is typically referred to as a "pitch" movement.
  • the tilting device is designed as a biaxial joint, so that the table top around the central longitudinal axis or a parallel axis on the one hand and about the tilting axis on the other hand is rotatable.
  • the tilting device is positioned laterally on the lifting arm and the table top is thus mounted on the lifting arm.
  • the base arm itself is designed according to a variant as a telescopic arm with an inner axis of rotation facing the inner part of the arm and with a remote from the base axis of rotation outer arm.
  • the outer partial arm can then be moved in the direction of the central longitudinal axis (axis 2 *) of the base arm relative to the inner partial arm.
  • the base arm as articulated arm or
  • an inner partial arm of the base arm facing the base rotational axis is connected via a pivot joint to an outer partial arm of the base arm facing away from the base rotational axis.
  • the corresponding rotary joint is preferably designed such that the associated axis of rotation (axis 2) is aligned in the vertical direction, so that the two arms of the base ⁇ arms move substantially exclusively in a horizontal plane.
  • the lifting arm is connected via a pivot joint with the base arm, in particular such that the lifting arm about its Hubarml jossachse (axis 3) is rotatably mounted.
  • the previously described embodiments of the patient bed are advantageously used not only together with a radiation therapy system, but also together with an imaging system or imaging unit, such as a computer tomograph, wherein the entspre ⁇ -reaching radiation therapy system, the imaging system and the patient couch typically together a patient care Form training device, which is usually arranged in a examination and / or treatment room.
  • an imaging system or imaging unit such as a computer tomograph
  • fixed relative positions for the radiation therapy system, the imaging system and the patien ⁇ tenliege are usually predetermined in such a manner that the table top of the patient couch of the radiation therapy system for Schmge ⁇ removal plant and from the imaging system for radiation ⁇ therapy system is movable.
  • the radiation therapy system and / or the imaging system has a type
  • the patient couch is preferably designed for use in radiation therapy with high-energy photon radiation, which exits, for example, from a linear accelerator gantry which rotates about an isocenter. This is then preferably the kinematics of the positioning device adapted.
  • the kinematics are preferably fastened to the floor and have a first horizontal axis of rotation, the basic axis of rotation, which is arranged vertically below the isocenter or in its vicinity. It follows in the direction of movement radially to the base axis of rotation a telescopic linear axis, which forms the base arm.
  • a horizontal articulated arm is used as the base arm for the radial adjustment. At the end of the radial movement axis follows an axis of rotation in the horizontal plane with a vertical axis arranged thereon, the lifting arm.
  • This linear axis carries, for example, a two-axis Ge ⁇ steering with the tabletop attached to the table in the longitudinal direction (pitch) and transverse direction (roll) can be tilted.
  • the positioning device presented here has significant advantages over known robots or robot arms for patient positioning.
  • Isocenter of the radiation therapy system for example, the linear accelerator gantry
  • a symmetrical working area in particular to the left and to the right of the linear accelerator gantry.
  • all the necessary positions for the irradiation of a patient are easily accessible.
  • a CT scanner for imaging in parallel or 90 degrees rotated orientation can be achieved very well with the table top.
  • the movement axes of kinematics correlate with the necessary degrees of freedom of movement for the positioning of the tabletop (rotation, radial movement, vertical movement). Therefore, the motion sequence for operators is much more predictable than conventional industrial robots with serial joint kinematics.
  • FIG. 1 shows a perspective view of a first exemplary a patient bed with a drive out ⁇ NEN telescopic arm
  • FIG. 2 shows a perspective view of the first embodiment of the patient bed with partially retracted telescopic arm
  • 3 shows a perspective view of a second embodiment of the patient bed with an extended articulated arm
  • FIG. 4 shows a perspective view of the second embodiment of the patient bed with angled
  • FIG. 5 shows a plan view of a patient care device with a radiation therapy system, an imaging system and a patient couch in a first arrangement
  • FIG. 6 shows a plan view of the patient care device with the radiation therapy system, the imaging system and the patient bed in a second arrangement.
  • the patient couch 2 is designed for a Strahlenthe ⁇ rapiestrom 4 and, accordingly, typically as used together with a radiation therapy system. 4
  • a corresponding radiation therapy system 4 is typi cally ⁇ located at a fixed position in an examination and / or treatment chamber 6 and for example fixed to the floor of the examination and / or treatment chamber 6 therefor.
  • the patient bed 2 is also arranged at a fixed position in the examination and / or treatment room 6 and thereby positioned and aligned in a predefined manner to the isocenter 8 of the radiation therapy system 4.
  • a patient can then be positioned and aligned relative to the isocenter 8 by means of the patient couch 2 and, if necessary, during the irradiation by the patient Radiation therapy system 4 relative to the isocenter method, so that a volume to be irradiated in the patient can be irradiated with a planned spatial dose distribution.
  • the patient is positioned on a table top 12 of the Pa ⁇ tientenliege 2 10 and fixed in case of need, so that it is movable relative to the isocenter 8 by a relative movement of the tabletop 12th
  • the table top 12 is connected via a tilting device 14 with a lifting arm 18 extending in the vertical direction 16, to which in turn a base arm 22 extending in the horizontal direction 20 is fastened on the bottom side.
  • Those tilting device 14 is in this case designed such that the table top 12 is rotatably supported on the one hand about the central longitudinal axis 24 of the table top 12 and on the other hand rotatably mounted about a tilt axis 26 which is aligned perpendicular to the central ⁇ longitudinal axis 24 and positioned on the base arm 22.
  • the tilting device 14 and with it also the table top 12 in the vertical direction 16 along the base arm 22 and thus parallel to the Hubarmlashesachse 28 movable and mounted laterally on the lifting arm 18.
  • the lifting arm 18 itself is in turn rotatably mounted about the Hubarmlticiansachse 28 and connected thereto via a rotary joint with the base arm 22.
  • the base arm 22 is further formed as a telescopic arm and has an inner Ren, the isocenter 8 facing arm 30 and an outer, facing away from the isocenter 8 sub-arm 32. At that outer arm 32 then the lifting arm 18 is mounted, whereby this is movable in the longitudinal direction 34 of the base arm 22.
  • FIG 2 in which the patient table is reproduced from FIG 1 2, ⁇ of all recently in a situation in which the telescopic base arm is designed as 22 is only partially extended, in the Al so that the outer part of arm 32 approximately half in the inner part of arm 30 of the base arm 22 rests.
  • FIG 3 An alternative embodiment of the patient bed 2 is shown in FIG 3 and FIG 4.
  • the base arm 22 As
  • the outer, remote from the isocenter 8 part of arm 32 is connected via a rotary joint 36 with the inner, the isocenter 8 facing arm.
  • the rotational axis 38 of the swivel joint is aligned in direction 16 verti- Kaier 36, so that the two partial arms 30, 32 of the base arm 22 always lie in a horizontal plane and rich ⁇ ended move exclusively in this plane.
  • the base arm 22 is rotatably mounted about a base axis of rotation 40 which extends in the vertical direction 16 and extends through the isocenter 8.
  • ⁇ for the base arm 2 is guided in the embodiment along a rail 42 movable.
  • rail 32 is left in the bottom of the examination and / or treatment space 6 and has a circular arc shape which is positioned concentrically to the base axis of rotation 40.
  • the base arm 22 For a rotation of the base arm 22 about the base axis of rotation 40 then the base arm 22, the inner, the isocenter 8 facing the partial arm 30 projects radially with its central longitudinal axis of the circular arc shape of the rail 42, along the rail 42.
  • an imaging system 44 is also arranged in the examination and / or treatment space 6 in the exemplary embodiment, and likewise with a fixed relative position to the patient
  • both the radiation therapy system 4 and the imaging system 44 have a kind of gantry or bay, in which the table top 12 of the patient couch 2 has to be at least partially moved in to the corresponding one Device to use.
  • the special design of the patient support 2 it is possible 12 out down the table quasi from the gantry or the bay of the Strahlentherapieanla ⁇ ge 4 and hineinzuvon and in the gantry or the bay of the imaging system 44 reversed so that both plants, the radiation therapy system 4 and the imaging system 44, without having to move a patient 10 relative to the tabletop 12.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Medical Informatics (AREA)
  • Biomedical Technology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Veterinary Medicine (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Public Health (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Molecular Biology (AREA)
  • Surgery (AREA)
  • Physics & Mathematics (AREA)
  • High Energy & Nuclear Physics (AREA)
  • Biophysics (AREA)
  • Optics & Photonics (AREA)
  • Accommodation For Nursing Or Treatment Tables (AREA)
  • Radiation-Therapy Devices (AREA)

Abstract

L'invention concerne un support de patient (2) pour une installation de radiothérapie (4) comprenant un isocentre (8), présentant un plateau (12) pour patients (10) s'étendant le long d'un axe longitudinal central (24), ainsi qu'un dispositif de positionnement pour le positionnement du plateau (12), le dispositif de positionnement présentant un bras de levage (18) s'étendant dans la direction verticale (16) en tant qu'unité linéaire pour un mouvement de levage du plateau (12), qui est relié côté inférieur à un bras de base (22) s'étendant dans la direction horizontale (20), le bras de base (22) étant disposé de manière à tourner autour d'un axe de rotation de base (40) orienté verticalement et passant par l'isocentre (8). Le dispositif de positionnement présente un dispositif de basculement (14) pour le basculement du plateau (12) et le plateau (12) est monté sur le bras de levage (18) par l'intermédiaire du dispositif de basculement (14).
PCT/EP2017/072056 2016-10-17 2017-09-04 Support de patient et dispositif de traitement de patient Ceased WO2018072920A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102016220268.5 2016-10-17
DE102016220268.5A DE102016220268B4 (de) 2016-10-17 2016-10-17 Patientenliege und Patientenversorgungseinrichtung

Publications (1)

Publication Number Publication Date
WO2018072920A1 true WO2018072920A1 (fr) 2018-04-26

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PCT/EP2017/072056 Ceased WO2018072920A1 (fr) 2016-10-17 2017-09-04 Support de patient et dispositif de traitement de patient

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DE (1) DE102016220268B4 (fr)
WO (1) WO2018072920A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109758681A (zh) * 2019-03-07 2019-05-17 贾清丽 一种用于肿瘤科医疗临床的放射定位装置
CN116392152A (zh) * 2021-12-29 2023-07-07 西门子医疗有限公司 医学成像系统的图像记录装置、升降柱和成套系统

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102024111762A1 (de) 2024-04-26 2025-10-30 Schaeffler Technologies AG & Co. KG Patientenliege mit einem Aktuator

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19920008A1 (de) * 1999-05-03 2000-12-07 Siemens Ag Operations-Diagnose-Einrichtung mit einer Lagerungsvorrichtung für ein Behandlungs- und/oder Untersucherungsobjekt
EP1362617A1 (fr) * 2002-05-13 2003-11-19 Siemens Aktiengesellschaft Dispositif réglable de positionnement de patient pour une système de radiotherapie
US20040098804A1 (en) * 2002-11-26 2004-05-27 Muthuvelan Varadharajulu Grouted tilting patient positioning table for vascular applications
US20050234327A1 (en) * 2004-04-06 2005-10-20 Saracen Michael J Robotic arm for patient positioning assembly
DE102008019114A1 (de) 2008-04-16 2009-10-22 Siemens Aktiengesellschaft Medizinische Anlage und Verfahren zum Docken einer Positioniervorrichtung an ein Shuttle
EP2523011A1 (fr) * 2011-05-09 2012-11-14 Imris Inc. Bobine rf rm à réseau à commande de phase non visible dans une image à rayons x
EP2774537A1 (fr) * 2013-03-08 2014-09-10 Imris Inc. Alignement de patient dans une radiothérapie guidée par IRM
EP3061496A1 (fr) * 2015-02-24 2016-08-31 Ion Beam Applications S.A. Dispositif de support et de positionnement d'un patient dans un équipement médical

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN102872541A (zh) * 2012-09-29 2013-01-16 苏州雷泰医疗科技有限公司 一种放射治疗床装置
EP2883567A1 (fr) * 2013-12-11 2015-06-17 Buck Engineering & Consulting GmbH Dispositif de positionnement de patient et procédé de positionnement d'un patient sur un dispositif d'irradiation au moyen d'un dispositif de positionnement de patient
CN105534676B (zh) * 2016-03-01 2018-12-07 陈刚 一种机器人治疗椅

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19920008A1 (de) * 1999-05-03 2000-12-07 Siemens Ag Operations-Diagnose-Einrichtung mit einer Lagerungsvorrichtung für ein Behandlungs- und/oder Untersucherungsobjekt
EP1362617A1 (fr) * 2002-05-13 2003-11-19 Siemens Aktiengesellschaft Dispositif réglable de positionnement de patient pour une système de radiotherapie
US20040098804A1 (en) * 2002-11-26 2004-05-27 Muthuvelan Varadharajulu Grouted tilting patient positioning table for vascular applications
US20050234327A1 (en) * 2004-04-06 2005-10-20 Saracen Michael J Robotic arm for patient positioning assembly
DE102008019114A1 (de) 2008-04-16 2009-10-22 Siemens Aktiengesellschaft Medizinische Anlage und Verfahren zum Docken einer Positioniervorrichtung an ein Shuttle
EP2523011A1 (fr) * 2011-05-09 2012-11-14 Imris Inc. Bobine rf rm à réseau à commande de phase non visible dans une image à rayons x
EP2774537A1 (fr) * 2013-03-08 2014-09-10 Imris Inc. Alignement de patient dans une radiothérapie guidée par IRM
EP3061496A1 (fr) * 2015-02-24 2016-08-31 Ion Beam Applications S.A. Dispositif de support et de positionnement d'un patient dans un équipement médical

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109758681A (zh) * 2019-03-07 2019-05-17 贾清丽 一种用于肿瘤科医疗临床的放射定位装置
CN116392152A (zh) * 2021-12-29 2023-07-07 西门子医疗有限公司 医学成像系统的图像记录装置、升降柱和成套系统

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DE102016220268A1 (de) 2018-04-19

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