WO2020132958A1 - Procédé et appareil de positionnement, et système de radiothérapie - Google Patents

Procédé et appareil de positionnement, et système de radiothérapie Download PDF

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Publication number
WO2020132958A1
WO2020132958A1 PCT/CN2018/123964 CN2018123964W WO2020132958A1 WO 2020132958 A1 WO2020132958 A1 WO 2020132958A1 CN 2018123964 W CN2018123964 W CN 2018123964W WO 2020132958 A1 WO2020132958 A1 WO 2020132958A1
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Prior art keywords
initial
relative distance
treatment bed
angle
image
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English (en)
Chinese (zh)
Inventor
李金升
付凯强
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Our United Corp
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Our United Corp
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Priority to CN201880014414.6A priority Critical patent/CN111615365B/zh
Priority to PCT/CN2018/123964 priority patent/WO2020132958A1/fr
Publication of WO2020132958A1 publication Critical patent/WO2020132958A1/fr
Priority to US17/359,398 priority patent/US12109438B2/en
Anticipated expiration legal-status Critical
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    • 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
    • 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 invention relates to the technical field of radiotherapy, in particular to a positioning method, device and radiotherapy system.
  • an image guidance system (Image Guiding System, IGS) can be used to accurately position the patient under image guidance.
  • IGS image guidance system
  • DRR digitally reconstructed radiographic
  • CT computerized tomography
  • the information is used for image registration to determine the positioning deviation.
  • the patient can be accurately positioned by adjusting the position of the treatment bed.
  • the isocenter of the device based on the relative positional relationship between the imaging point and the isocenter of the device (that is, the beam focus of the ray source), and the relative positional relationship between the preset filming point and the target point in the CT reconstructed image
  • the relative position relationship between the point and the target point, and finally the position of the treatment bed can be adjusted according to the relative position relationship between the isocenter of the device and the target point, so that the target point of the affected part is aligned with the isocenter of the device for the purpose of Radiation Therapy.
  • the patient’s posture is generally adjusted by adjusting the gamma angle of the radiation therapy system, so that the treatment The beam can avoid sensitive parts.
  • the gamma angle may refer to the angle between the support surface of the gamma angle adjusting device at the bottom of the patient and the vertical surface for supporting the patient.
  • the gamma angle is fixed at 90 degrees. If the gamma angle is adjusted during the course of radiotherapy, the accuracy of the IGS system when positioning according to the reconstructed image of the CT image will be significantly lower, seriously affecting the effect of radiotherapy.
  • the invention provides a positioning method, device and radiation therapy system, which can solve the problem of low accuracy of the positioning method in the related art.
  • the technical solution is as follows:
  • a positioning method includes:
  • the first relative position, and the second relative position calculate the treatment when the target point coincides with the isocenter of the device at the gamma angle to be treated
  • the second coordinate of the bed
  • the position of the treatment bed is adjusted according to the second coordinate.
  • the method before acquiring the first coordinates of the treatment bed, the method further includes:
  • the IGS image being an image generated by the image guidance system
  • the image registration of the reconstructed image and the IGS image is performed by adjusting the position of the treatment bed, so that the preset filming point coincides with the imaging point.
  • the method further includes:
  • the rotation angle including a first rotation around a first axis extending in the width direction of the treatment bed Angle, a second angle of rotation about a second axis extending in the longitudinal direction of the treatment bed, and a third angle of rotation about a third axis extending in the height direction of the treatment bed;
  • the second coordinate of the treatment bed includes:
  • the corrected first relative position and the second relative position when the target point coincides with the isocenter of the device under the gamma angle to be treated, the The second coordinate of the treatment bed.
  • the determining the first relative position of the target point of the affected part and the imaging point according to the gamma angle to be treated includes:
  • the initial relative position including: a first initial relative distance of the target point and the imaging point in the width direction of the treatment bed , A second initial relative distance in the length direction of the treatment bed, and a third initial relative distance in the height direction of the treatment bed;
  • the first relative position of the target point and the imaging point is calculated according to the gamma angle to be treated, the first initial relative distance, the target distance, and the initial gamma angle.
  • the determining the initial gamma angle according to the second initial relative distance and the third initial relative distance includes:
  • the initial gamma angle is 90 degrees
  • the initial gamma angle is negative 90 degrees
  • the initial gamma angle is the sum of the arc tangent of the ratio of the third initial relative distance to the second initial relative distance and 180 degrees.
  • the first relative position includes: at the gamma angle to be treated, a first relative distance between the target point and the imaging point in the width direction of the treatment bed, at the A second relative distance in the length direction of the treatment bed, and a third relative distance in the height direction of the treatment bed;
  • the calculating the first relative position of the target point and the imaging point according to the gamma angle to be treated, the first initial relative distance, the target distance, and the initial gamma angle includes:
  • the product of the target distance and the cosine value of the first angle is determined as the second relative distance, the first angle is the initial gamma angle added to 90 degrees, and then combined with the gamma to be treated The angle obtained by subtracting the horns;
  • the product of the target distance and the sine value of the first angle is determined as the third relative distance.
  • the target point and the isocenter of the device are calculated under the gamma angle to be treated
  • the second coordinate of the treatment bed includes:
  • the first coordinate is added to the second relative position, and then subtracted from the first relative position to obtain the second coordinate of the treatment bed.
  • a positioning device in a second aspect, includes:
  • the first acquisition module is used to acquire the gamma angle to be treated
  • the second acquisition module is used to acquire the first coordinates of the treatment bed, where the first coordinates are the coordinates of the treatment bed when the preset filming point coincides with the imaging point of the image guidance system IGS;
  • a first determining module configured to determine the first relative position of the target point of the affected part and the imaging point according to the gamma angle to be treated
  • a third acquiring module configured to acquire a second relative position of the imaging point and the isocenter of the device
  • the calculation module is used to calculate the target point coincides with the isocenter of the device under the gamma angle to be treated according to the first coordinate, the first relative position and the second relative position Time, the second coordinate of the treatment bed;
  • the first adjustment module is used to adjust the position of the treatment bed according to the second coordinate.
  • the device further includes:
  • a fourth acquiring module configured to acquire a reconstructed image of the gamma angle to be treated before acquiring the first coordinates of the treatment bed, the reconstructed image being an image reconstructed according to the electronic image of the affected part acquired in advance;
  • a fifth acquisition module configured to acquire an IGS image of the affected part under the gamma angle to be treated, the IGS image being an image generated by the image guidance system;
  • the second adjustment module is used to perform image registration of the reconstructed image and the IGS image by adjusting the position of the treatment bed, so that the preset filming point coincides with the imaging point.
  • the device further includes:
  • a second determining module configured to determine when the preset filming point coincides with the imaging point after performing image registration of the reconstructed image and the IGS image by adjusting the position of the treatment bed A rotation angle of the target point about a rotation axis, the rotation angle including a first angle of rotation about a first axis extending in a width direction of the treatment bed, and a rotation about a second axis extending in a length direction of the treatment bed A second angle of rotation, and a third angle of rotation about a third axis extending in the height direction of the treatment bed;
  • a correction module configured to correct the first relative position according to the rotation angle
  • the calculation module is used to:
  • the corrected first relative position and the second relative position when the target point coincides with the isocenter of the device under the gamma angle to be treated, the The second coordinate of the treatment bed.
  • the first determining module includes:
  • the first calculation submodule is configured to calculate the target distance between the target point and the imaging point in a first plane according to the second initial relative distance and the third initial relative distance, the first plane is A plane on which the first axis extending along the length of the treatment bed and the second axis extending along the height of the treatment bed are located;
  • a determination submodule configured to determine an initial gamma angle according to the second initial relative distance and the third initial relative distance
  • a second calculation submodule configured to calculate the first point of the target point and the imaging point according to the gamma angle to be treated, the first initial relative distance, the target distance and the initial gamma angle A relative position.
  • the determination submodule is used to:
  • the initial gamma angle is 90 degrees
  • the initial gamma angle is negative 90 degrees
  • the initial gamma angle is the sum of the arc tangent of the ratio of the third initial relative distance to the second initial relative distance and 180 degrees.
  • the first relative position includes: at the gamma angle to be treated, a first relative distance between the target point and the imaging point in the width direction of the treatment bed, at the A second relative distance in the length direction of the treatment bed, and a third relative distance in the height direction of the treatment bed;
  • the second calculation submodule is used to:
  • the product of the target distance and the cosine value of the first angle is determined as the second relative distance, the first angle is the initial gamma angle added to 90 degrees, and then combined with the gamma to be treated The angle obtained by subtracting the horns;
  • the product of the target distance and the sine value of the first angle is determined as the third relative distance.
  • calculation module is used to:
  • the first coordinate is added to the second relative position, and then subtracted from the first relative position to obtain the second coordinate of the treatment bed.
  • a positioning device in a third aspect, includes:
  • a processor and a memory stores instructions, and the instructions are loaded and executed by the processor to implement the positioning method according to the first aspect.
  • a storage medium in which instructions are stored in the storage medium, and when the storage medium runs on a processing component, the processing component is caused to execute the positioning method as described in the first aspect.
  • the radiation therapy system includes the positioning device according to the second aspect.
  • the embodiments of the present invention provide a positioning method, device, and radiotherapy system.
  • the method can be based on the first coordinates of the treatment bed obtained when the preset filming point coincides with the imaging point, the first relative position of the target point of the affected part and the imaging point, and the second relative position of the imaging point and the center point of the device and the like Calculate the second coordinate of the treatment bed when the target point coincides with the isocenter of the device at the gamma angle to be treated, and adjust the position of the treatment bed according to the second coordinate. Therefore, when the gamma angle is adjusted during the radiotherapy process, the second coordinate of the treatment bed can be calculated accurately when the target point coincides with the isocenter of the device under the adjusted gamma angle. Improve the alignment accuracy of the target point and the isocenter of the device at different gamma angles, which can improve the accuracy of radiotherapy.
  • FIG. 1 is a schematic structural diagram of a radiation therapy system provided by an embodiment of the present invention.
  • FIG. 2 is a front view of a radiotherapy system including two sets of image acquisition components provided by an embodiment of the present invention
  • FIG. 3 is a flowchart of a positioning method provided by an embodiment of the present invention.
  • FIG. 5 is a schematic diagram of a CT reconstructed image including a target point and a preset filming point, which is provided by an embodiment of the present invention
  • FIG. 6 is a flowchart of a method for determining a first relative position of a target point of an affected part and an imaging point according to an embodiment of the present invention
  • FIG. 7 is a schematic structural diagram of a gamma angle adjustment device according to an embodiment of the present invention.
  • FIG. 8 is a side view of a gamma angle adjustment device provided by an embodiment of the present invention.
  • FIG. 9 is a side view of another gamma angle adjustment device provided by an embodiment of the present invention.
  • FIG. 10 is a block diagram of a positioning device provided by an embodiment of the present invention.
  • FIG. 11 is a block diagram of another positioning device provided by an embodiment of the present invention.
  • FIG. 12 is a block diagram of a first determination module provided by an embodiment of the present invention.
  • FIG. 1 is a schematic structural diagram of a radiation therapy system provided by an embodiment of the present invention.
  • the radiotherapy system may include an image guidance system 01, a host computer 02, a treatment bed 03, and a treatment rack 04.
  • the host computer 02 may establish a communication connection with the image guidance system 01 and the treatment bed 03.
  • the host computer 02 may be a control device in a treatment control system
  • the image guidance system 01 may be an IGS system.
  • the IGS system 01 may include one or more sets of image acquisition components, and each set of image acquisition components may include a relatively arranged detector 011 and a bulb 012 (FIG. 1 only shows a relatively arranged set of detector 011 and a bulb. 012), the bulb 012 can emit radiation (for example, X-rays), the detector 011 can be a flat panel detector, and the detector 011 can receive the radiation emitted by the bulb 012.
  • the IGS system 01 can generate an IGS image based on the radiation received by each detector 011.
  • the relatively arranged detector 011 and bulb 012 can be rotated to multiple positions and produce IGS images at multiple positions, respectively.
  • the rays emitted by the bulb 012 in the multiple sets of image acquisition components in the IGS system 01 may intersect at one point , This point is the imaging point A1 of the IGS system.
  • FIG. 2 shows a front view of a radiation therapy system including two sets of image acquisition components.
  • each group of image acquisition components includes a detector 011 and a bulb 012 that are relatively disposed.
  • the rays emitted by the bulb 012 in the two groups of image acquisition components all intersect at a point A1, which is the imaging point.
  • the treatment rack 04 may be provided with multiple radiation sources 041, and the multiple radiation sources 041 may all be gamma radiation sources (that is, the multiple radiation sources 041 may all emit gamma radiation), or It may also be all X-ray sources (that is, the multiple ray sources 041 may all emit X-rays).
  • the treatment beams emitted by the plurality of radiation sources 041 may intersect at a point, which is the beam focus (which may also be referred to as the isocenter of the device) A2.
  • a CT scan is usually performed on the patient to obtain a CT image of the affected part, and a CT reconstructed image is obtained based on the CT image.
  • the embodiments of the present invention take CT as an example for illustration.
  • the treating physician can formulate a treatment plan for the affected part based on the size, shape and surrounding tissue of the affected part tumor displayed in the CT reconstructed image, and input the treatment plan to the host computer 02. After that, the host computer 02 can drive the treatment bed 03 to move the affected part of the patient to the imaging area of the IGS system 01 to acquire images.
  • the preset filming point in the CT reconstructed image that is, a predetermined fixed point in the CT reconstructed image
  • the IGS system 01 The relative position of the imaging point A1.
  • the host computer 02 can adjust the position of the treatment bed 03 so that the preset filming point coincides with the imaging point A1 of the IGS system 01.
  • the host computer 02 can determine the target point A3 and the relative positional relationship between the preset point in the CT reconstructed image and the target point A3 according to the relative position relationship between the isocenter A2 of the device and the imaging point A1 The positional relationship between the isocenter A2 of the device, and adjust the position of the treatment bed 03 according to the positional relationship, so that the target point A3 is aligned with the isocenter A2 of the device, so as to realize the positioning of the patient.
  • the treating physician can adjust the patient's position through the gamma angle adjustment device 031 and so on, so that the treatment beam avoids sensitive tissues or organs, and the gamma angle adjustment device 031 can bypass the fixed gamma
  • the Mayer axis of rotation rotates in a vertical plane, for example, it can rotate in the YOZ plane shown in FIG. 1.
  • the axis of the rotation axis of the gamma angle is parallel to the horizontal plane and perpendicular to the length direction of the treatment bed 03.
  • the angle ⁇ between the support surface n of the support portion for supporting the patient and the vertical plane m in the gamma angle adjusting device 031 can be called a gamma angle.
  • the CT image is scanned when the patient is lying down (that is, the gamma angle ⁇ is 90°).
  • the treating physician chooses a 70° gamma angle treatment
  • the acquired CT reconstructed image is directly compared with the IGS image, the offset cannot be obtained due to the patient's body position deflection, and accurate positioning and accurate treatment cannot be achieved.
  • the position under the gamma angle needs to be considered, that is, the coordinates of the treatment bed under the gamma angle need to be considered to ensure that The accuracy of the swing position at different gamma angles can ensure the accuracy of radiotherapy.
  • the embodiment of the present invention provides a positioning method, which can calculate the coordinates of the treatment bed 03 when the target point A3 coincides with the isocenter A2 of the device at different gamma angles. After the gamma angle changes, the host computer 02 can also accurately adjust the position of the treatment bed 03 according to the calculated coordinates of the treatment bed 03, and improve the alignment accuracy of the target point A3 and the isocenter A2 of the device, thereby improving the radiation The accuracy of treatment.
  • FIG. 3 is a flowchart of a positioning method provided by an embodiment of the present invention.
  • the positioning method can be applied to the host computer 02 shown in FIG. 1. As shown in FIG. 3, the method may include:
  • Step 301 Obtain the gamma angle to be treated.
  • the gamma angle to be treated may refer to the current gamma angle to be treated.
  • the treating physician can fix the patient to a certain gamma angle through the gamma angle adjusting device 031, and input the current gamma angle to the upper computer 02, that is, the upper computer 02 can obtain the input of the treating physician to be treated Gamma angle ⁇ .
  • the upper computer 02 can automatically detect the gamma angle ⁇ to be treated.
  • the host computer 02 can also determine the gamma angle ⁇ to be treated according to the treatment plan obtained in advance.
  • the embodiment of the present invention does not limit the manner in which the host computer 02 obtains the gamma angle to be treated.
  • Step 302 Obtain the first coordinates of the treatment bed, where the first coordinates are the coordinates of the treatment bed when the preset filming point coincides with the imaging point of the image guidance system IGS.
  • the host computer 02 can acquire a CT reconstructed image under the gamma angle to be treated.
  • the CT created image may be an image reconstructed by the IGS system 01 based on the electronic image (eg, CT image) of the affected part acquired in advance, and the CT reconstructed image may include preset filming points.
  • the IGS system 01 can acquire the IGS image of the affected part of the patient, and send the acquired IGS image to the host computer 02.
  • the host computer 02 can perform image registration on the acquired IGS image and CT reconstructed image, and can continuously adjust the position of the treatment bed 03 during the registration process.
  • the preset shooting point coincides with the imaging point A1.
  • the host computer 02 can obtain the first coordinate of the treatment bed 03 at this time.
  • Step 303 Determine the first relative position of the target point of the affected part and the imaging point according to the gamma angle to be treated.
  • the host computer 02 can determine the position of the target point A3 according to the treatment plan.
  • the host computer 02 can acquire CT reconstruction images at different gamma angles to be treated, and the treating physician can formulate a target point A3 and a preset filming point position for the patient according to the CT reconstruction image And input the treatment plan to the host computer 02, and then the host computer 02 can obtain the position of the target point A3 from the treatment plan. Since the position of the imaging point A1 is fixed, the host computer 02 can directly obtain the position of the imaging point A1. And because the target point A3 and the imaging point A1 are in different coordinate systems, the host computer 02 can also convert the positions of the target point A3 and the imaging point A1 to the same coordinate system, and then calculate the target point A3 and the imaging point The first relative position of A1.
  • Step 304 Acquire a second relative position of the imaging point and the isocenter of the device.
  • the position of the equipment isocenter A2 is also fixed, so the host computer 02 can also directly obtain the position of the equipment isocenter A2. And because the imaging point A1 and the device isocenter A2 are in the same coordinate system, the host computer 02 can directly calculate the imaging point A1 and the device isocenter A2 according to the acquired positions of the device isocenter A2 and the imaging point A1 The second relative position.
  • Step 305 Calculate the second coordinate of the treatment bed when the target point coincides with the isocenter of the device at the gamma angle to be treated according to the first coordinate, the first relative position, and the second relative position.
  • the upper computer 02 After the upper computer 02 obtains the first coordinate, the first relative position and the second relative position, it can be accurately calculated according to the first coordinate, the first relative position and the second relative position under the gamma angle to be treated When the target point coincides with the isocenter of the device, the second coordinate of the treatment bed.
  • Step 306 Adjust the position of the treatment bed according to the second coordinate.
  • the host computer 02 can accurately adjust the position of the treatment bed 03 according to the calculated second coordinates.
  • the alignment accuracy of the target point A3 and the equipment isocenter A2 under the gamma angle to be treated is improved, thereby further improving the accuracy of radiotherapy.
  • the embodiment of the present invention provides a positioning method, which can be based on the first coordinate of the treatment bed obtained when the preset filming point coincides with the imaging point, the target point of the affected part and the imaging point A relative position, and the second relative position of the imaging point and the isocenter of the device, calculate the second coordinate of the treatment bed when the target point coincides with the isocenter of the device at the gamma angle to be treated, and according to the second coordinate Adjust the position of the treatment bed. Therefore, when the gamma angle is adjusted during the radiotherapy process, the second coordinate of the treatment bed can be calculated accurately when the target point coincides with the isocenter of the device under the adjusted gamma angle. Improve the alignment accuracy of the target point and the isocenter of the device at different gamma angles, which can improve the accuracy of radiotherapy.
  • the upper computer 02 establishes a communication connection with the IGS system 01 and the treatment bed 03, respectively, and may be performed by the upper computer 02 performing the above steps 301 to 306 as an example.
  • the treatment bed 03 and the IGS system 01 may be respectively provided with processors.
  • the treatment bed 03 and the IGS system 01 may also perform the corresponding steps in the foregoing embodiments through their respective processors. This is not a limitation, and it will be illustrated by taking FIG. 3 and the above embodiments as examples.
  • FIG. 4 is a flowchart of another positioning method provided by an embodiment of the present invention.
  • the positioning method can be applied to the host computer 02 shown in FIG. 1. Or, referring to the above description, it can be known that the positioning method can also be applied to the IGS system 01 or the treatment bed 03 shown in FIG. 1, which is not limited in the embodiment of the present invention, and the following embodiment uses the positioning method to apply
  • the host computer 02 will be described as an example.
  • the method may include:
  • Step 401 Obtain the gamma angle to be treated.
  • the gamma angle to be treated may refer to the current gamma angle to be treated.
  • the treating physician fixes the patient at a certain gamma angle through the gamma angle adjusting device 031, and can input the current gamma angle ⁇ to be treated to the upper computer 02, that is, the upper computer 02 can obtain
  • the gamma angle ⁇ to be treated input by the treating physician is relatively reliable.
  • the host computer 02 can automatically detect the gamma angle ⁇ to be treated, which is more efficient high.
  • the host computer 02 may determine the gamma angle ⁇ to be treated according to the treatment plan acquired in advance.
  • the treating physician can adjust the gamma angle adjustment device 031 shown in FIG. 1 so that the gamma angle ⁇ is 70°.
  • Step 402 Acquire a reconstructed image of the gamma angle to be treated.
  • the reconstructed image may be an image reconstructed from an electronic image (eg, CT image) of the affected part acquired in advance.
  • the reconstructed image may be an image reconstructed by the IGS system 01 based on the electronic image.
  • the reconstructed image may also be an image reconstructed by the electronic image generating device (for example, CT device) according to the electronic image.
  • the reconstructed image may also be a reconstructed image generated by another image processing system based on the electronic image.
  • the embodiment of the present invention does not limit the device that generates the reconstructed image.
  • the reconstructed image may be a digitally reconstructed radiographic DRR image, and the DRR image may be an image reconstructed from the CT image of the IGS system 01 after acquiring the CT image of the affected part.
  • the reconstructed image can also be called CT-DRR slice.
  • the CT-DRR film may include: the positions of the target point A3 and the preset filming point A4.
  • FIG. 5 shows a CT-DRR film including two target points A3.
  • the electronic image acquired by the IGS system 01 may be a plurality of continuous tomographic images obtained by scanning the affected part with a CT device, that is, the electronic image may be a set of image sequences.
  • Each tomographic image in the image sequence is perpendicular to the horizontal axis of the treatment bed 03, and the extending direction of the horizontal axis may be parallel to the movement direction (ie, the advancing direction) of the treatment bed 03 when it moves closer to the treatment chamber. Since each tomographic image is a two-dimensional image, the multiple consecutive tomographic images can be reconstructed into three-dimensional volume data of the affected part by computer processing.
  • the CT device can scan the affected part with a layer thickness of no more than 2 mm and no layer spacing.
  • the IGS system 01 can first determine the rotation axis according to the preset filming point A4 in the CT image, which can be the specified coordinate axis of the coordinate system where the filming point A4 is located, or parallel to the specified coordinate axis Linear axis. For example, in the coordinate system where the filming point A4 is located, a linear axis passing through the filming point A4 and parallel to the specified coordinate axis (for example, X axis) may be determined as the rotation axis. Further, for each gamma angle, the IGS system 01 can rotate the CT image by a deflection angle with the rotation axis as an axis, so as to reconstruct the reconstructed image of the gamma angle.
  • the deflection angle is the deflection angle between the gamma angle and the initial gamma angle when acquiring the electronic image.
  • the IGS system 01 can rotate the three-dimensional volume data corresponding to the multiple tomographic images by the deflection angle about the rotation axis, and project the rotated three-dimensional volume data to the IGS according to the installation parameters of the IGS system 01 The virtual imaging plane of the system 01 to obtain the reconstructed image of the gamma angle.
  • the filming point A4 in the CT image is a preset point in the CT image, and the position of the filming point A4 can be described by the coordinates of three coordinate axes in the three-dimensional coordinate system where the filming point A4 is located.
  • the virtual imaging surface is the imaging surface of the IGS system 01 virtually constructed in the coordinate system where the filming point A4 is located.
  • the position of the virtual imaging surface in the three-dimensional coordinate system where the filming point A4 is located is the same as that of the detector in the IGS system 01
  • the imaging plane has the same position in the coordinate system (also referred to as device coordinate system) where the treatment bed 03 is located.
  • the IGS system 01 may include: multiple sets of image acquisition components, and each set of image acquisition components may include a detector 011 and a tube 012 that are relatively disposed. Since the installation parameters of each group of image acquisition components will affect the virtual imaging surface of the IGS system 01 when generating the reconstructed image, the IGS system 01 will project the rotated three-dimensional volume data onto the virtual imaging surface of the IGS system 01 The position of the virtual imaging surface of the IGS system 01 in the coordinate system where the filming point is located can also be determined according to the installation parameters of the image acquisition component.
  • the installation parameters may include: the angle between the rays of the two sets of image acquisition components, the distance between the detector 011 and the bulb 012 in each group of image acquisition components, and the distance between the intersection point of the rays and the detector 011.
  • the radiation of each group of image acquisition components may be the connection between the detector 011 and the bulb 012 in the group of image acquisition components, and the imaging surface of the detector 011 is perpendicular to the radiation emitted by the bulb 012.
  • the rotation of the three-dimensional volume data can be determined according to the deflection direction of the gamma angle relative to the initial gamma angle at the time of CT image acquisition Direction to ensure that the rotation direction of the three-dimensional volume data in the image coordinate system is consistent with the deflection direction of the gamma angle in the coordinate system where the treatment bed 03 is located, and the deflection angle is also consistent.
  • the IGS system 01 can send the reconstructed CT-DRR slices of multiple gamma angles to the upper computer 02, and after the upper computer 02 obtains the gamma angle to be treated, it can be obtained from at least one gamma angle In the reconstructed image of, the reconstructed image of the gamma angle to be treated is retrieved.
  • the host computer 02 may retrieve the reconstructed image of the gamma angle ⁇ to be treated from a plurality of reconstructed images received in advance.
  • the IGS system 01 can reconstruct 60°, 70°, 80°, 90°, 100°, and 110° reconstructed images from the CT images, and send the reconstructed images corresponding to the multiple gamma angles to the host computer 02. If the upper computer 02 acquires the current gamma angle ⁇ to be treated as 70°, it can directly retrieve the reconstructed image of the gamma angle of 70°.
  • Step 403 Acquire the IGS image of the affected part under the gamma angle to be treated.
  • the IGS image is an image generated by the image guidance system 01 (that is, the IGS system 01).
  • the host computer 02 can adjust the position of the treatment bed 03 according to the preset fixed coordinate value, and send the affected part of the patient into the imaging area of the IGS system. Since the current patient is already fixed under the gamma angle ⁇ to be treated, the IGS system 01 can directly acquire the IGS image of the affected part under the gamma angle ⁇ to be treated through multiple sets of image acquisition components, and the IGS system 01 can Send the acquired IGS image to the host computer 02.
  • the host computer 02 can send an imaging instruction to the IGS system 01.
  • the IGS system 01 can control the two bulbs 012 shown in FIG. 2 to emit rays.
  • the two detections shown in FIG. 2 All the devices 011 can receive the radiation from the bulb 012, and the IGS system 01 can generate an IGS image according to the radiation received by each detector 011, and send it to the host computer 02.
  • Step 404 Perform image registration of the reconstructed image and the IGS image by adjusting the position of the treatment bed, so that the preset filming point coincides with the imaging point.
  • the host computer 02 in order to determine whether the preset filming point A4 and the imaging point A1 in the reconstructed image (ie, CT-DRR film) coincide, the host computer 02 can perform image registration on the CT-DRR film and the IGS image , And can continuously adjust the position of the treatment bed 03 in the process of image registration. After the image registration, the preset filming point A4 and imaging point A1 are finally made.
  • one image can usually be designated as the reference image, and the other image is the image to be registered.
  • the purpose of registration is to make the coordinates of all points on the image to be registered and the reference image. All reached consensus.
  • Step 405 Obtain the first coordinates of the treatment bed.
  • the first coordinates are the coordinates of the treatment bed when the preset filming point coincides with the imaging point of the image guidance system IGS.
  • the host computer 02 can obtain the first coordinates of the treatment bed 03 at this time.
  • the first coordinate may include a first-dimensional coordinate X1 extending in the width direction of the treatment bed 03, a second-dimensional coordinate Y1 extending in the length direction of the treatment bed 03, and a third dimension extending in the height direction of the treatment bed 03 Coordinate Z1. That is, the first coordinate can be expressed as (X1, Y1, Z1).
  • Step 406 Determine the first relative position of the target point of the affected part and the imaging point according to the gamma angle to be treated.
  • the host computer 02 may first determine the position of the target A3 of the affected part according to the treatment plan.
  • the host computer 02 can obtain CT-DRR films at different gamma angles to be treated, and the treating physician can formulate a target point A3 and filming point A4 for the patient according to the CT-DRR film
  • the treatment plan of the positional relationship is input to the host computer 02, and then the host computer 02 can obtain the position of the target point A3 from the treatment plan.
  • the host computer 02 can obtain CT-DRR slices with a gamma angle of 70°, 90° or 110° to be treated.
  • the host computer 02 can also directly obtain the position of the imaging point A1.
  • the host computer 02 can also convert the acquired positions of the target point A3 and the imaging point A1 to the same coordinate system, thereby calculating the target point A3 and The first relative position of the imaging point A1.
  • FIG. 6 is a flowchart of a method for determining a first relative position of a target point of an affected part and an imaging point according to an embodiment of the present invention. As shown in FIG. 6, the method may include:
  • Step 4061 Acquire the initial relative position of the target point and the imaging point according to the treatment plan.
  • the host computer 02 can first convert the acquired position coordinates of the target point A3 to the coordinate system where the treatment bed 03 is located, so that the target point A3 and the imaging point A1 are located in the same coordinate system. It can be seen with reference to FIGS.
  • the device coordinate system may be a first axis X extending along the width direction of the treatment bed 03, a second axis Y extending along the length direction of the treatment bed 03, and a height along the treatment bed 03
  • a three-dimensional coordinate system composed of a third axis Z extending in the direction.
  • the initial relative position may include: a first initial relative distance TIx of the target point A3 and the imaging point A1 in the width direction of the treatment bed 03, and a second initial relative distance TIy in the length direction of the treatment bed 03, And the third initial relative distance TIz in the height direction of the treatment bed 03. That is, the initial relative position of the target point A3 and the imaging point A1 can be expressed as: (TIx, TIy, TIz).
  • the host computer 02 converts the acquired position of the target point A3 to the device coordinate system.
  • the coordinates of the target point A3 are: (Xb, Yb, Zb), the coordinates of the acquired imaging point A1 in the device coordinate system For: (Xi, Yi, Zi).
  • Step 4062 Calculate the target distance between the target point and the imaging point in the first plane according to the second initial relative distance and the third initial relative distance.
  • the first plane may be the plane where the third axis Z extending along the length direction of the treatment bed and the second axis Y extending along the height direction of the treatment bed, that is, the YOZ plane shown in FIG. 1.
  • FIG. 7 is a schematic structural diagram of a gamma angle adjustment device 031 provided by an embodiment of the present invention.
  • the gamma angle adjustment device 031 may include a fixing frame 31a and a supporting frame 31b, and the fixing frame 31a may be fixed On the treatment bed 03, the support frame 31b is rotatably connected to the fixing frame 31a.
  • 8 and 9 are side views of a gamma angle adjusting device 031 provided by an embodiment of the present invention. It can be seen in conjunction with FIGS.
  • the support frame 31b may include a support portion (such as a head) for supporting the patient
  • the supporting panel b1 and two connecting rods b2 disposed oppositely, one end of each connecting rod b2 is fixedly connected to the supporting panel b1, and the other end is rotatably connected to the fixing frame 31a.
  • the connecting rod b2 can drive the support panel b1 to rotate in the vertical plane, that is, the YOZ plane, so that the gamma angle ⁇ can be adjusted.
  • the embodiment of the present invention does not limit the specific structure of the gamma angle adjusting device 031, and only uses the examples shown in FIG. 7 to FIG. 9 as examples for illustration.
  • the gamma angle adjusting device 031 can only rotate in the first plane YOZ, that is, in the process of adjusting the gamma angle, the position of the target point A3 changes only in the first plane YOZ, the The coordinates of the target point A3 on the first axis X will not change, so after the host computer 02 calculates the initial relative position (TIx, TIy, TIz), it can first according to the second initial relative distance TIy and the third initial relative distance TIz, calculate the target distance L TI of the target point A3 and the imaging point A1 in the first plane YOZ, the target distance L TI can satisfy:
  • Step 4063 Determine the initial gamma angle according to the second initial relative distance and the third initial relative distance.
  • the host computer 02 may determine the initial gamma angle ⁇ 0 according to the second initial relative distance TIy and the third initial relative distance TIz.
  • the process of determining the initial gamma angle ⁇ 0 can be realized by the following logic:
  • the initial gamma angle ⁇ 0 can be determined to be 90°.
  • the IGS system may determine the initial gamma angle ⁇ 0 to be -90°.
  • the initial gamma angle ⁇ 0 is the arc tangent of the ratio of the third initial relative distance TIz to the second initial relative distance TIy.
  • the initial gamma angle ⁇ 0 is the sum of the arc tangent of the ratio of the third initial relative distance TIz and the second initial relative distance TIy to 180 degrees.
  • Step 4064 Calculate the first relative position of the target point and the imaging point according to the gamma angle to be treated, the first initial relative distance, the target distance, and the initial gamma angle.
  • the first relative position may include the first relative distance TIxg between the target point A3 and the imaging point A1 in the width direction of the treatment bed 03 at the gamma angle ⁇ to be treated, and the treatment bed 03 The second relative distance TIyg in the length direction of, and the third relative distance TIzg in the height direction of the treatment bed 03.
  • the host computer 02 calculates the first relative position (TIxg, TIyg, TIzg) calculated based on the acquired gamma angle ⁇ to be treated, the first initial relative distance TIx, the target distance L TI, and the initial gamma angle ⁇ 0.
  • the host computer 02 calculates the first relative position (TIxg, TIyg, TIzg) calculated based on the acquired gamma angle ⁇ to be treated, the first initial relative distance TIx, the target distance L TI, and the initial gamma angle ⁇ 0.
  • TIxg TIx formula (1)
  • TIzg L TI ⁇ sin( ⁇ 0+90°- ⁇ ) Formula (3).
  • the product of the target distance L TI and the cosine value of the first angle ⁇ can be determined as the second relative distance TIyg.
  • Step 407 Acquire the second relative position of the imaging point and the isocenter of the device.
  • the position of the equipment isocenter A2 is also fixed, so the host computer 02 can directly obtain the position of the equipment isocenter A2, and because the equipment isocenter A2 is also located in the equipment coordinate system. Therefore, the host computer 02 can directly calculate the second relative position of the imaging point A1 and the device isocenter A2 according to the acquired position coordinates of the device isocenter A2 and the imaging point A1.
  • the second relative position may include: a first distance Xiso of the imaging point A1 and the isocenter A2 of the device in the width direction of the treatment bed 03, and a second distance Yiso in the length direction of the treatment bed 03, in the treatment bed The third distance Ziso in the height direction of 03.
  • Step 408 Based on the first coordinate, the first relative position, and the second relative position, calculate the second coordinate of the treatment bed when the target point coincides with the isocenter of the device at the gamma angle to be treated.
  • the host computer 02 may add the first coordinate to the second relative position and then subtract the first relative position to obtain the target A3 and the isocenter of the device under the gamma angle ⁇ to be treated
  • the second coordinate may also include: a first-dimensional coordinate Xt extending in the width direction of the treatment bed 03, a second-dimensional coordinate Yt extending in the length direction of the treatment bed 03, and a first dimension extending in the width direction of the treatment bed 03 Three-dimensional coordinates Zt. That is, the second coordinate can be expressed as: (Xt, Yt, Zt), and the second coordinate (Xt, Yt, Zt) can satisfy:
  • the first dimensional coordinate Xt can be obtained by adding the first dimensional coordinate X1 in the first coordinate to the first distance Xiso and then subtracting it from the first relative distance TIxg.
  • the second dimensional coordinate Yt can be obtained by adding the second dimensional coordinate Y1 in the first coordinate to the second distance Yiso and then subtracting the second relative distance TIyg.
  • Step 409 Adjust the position of the treatment bed according to the second coordinate.
  • the host computer 02 can accurately adjust the position of the treatment bed 03 according to the calculated second coordinates (Xt, Yt, Zt).
  • the alignment accuracy of the target point A3 and the equipment isocenter A2 under the gamma angle to be treated is improved, thereby further improving the accuracy of radiotherapy.
  • the host computer 02 can also obtain the target point A3 to rotate around the rotation axis of the gamma angle according to the registration situation after registering the CT reconstructed image and the IGS image when the preset filming point A4 coincides with the imaging point A1 Rotation angle. That is, when the preset filming point A4 coincides with the imaging point A1, the rotation angle of the patient's head around the rotation axis of the gamma angle is determined.
  • the gamma angle rotation axis is a rotation axis used for adjusting the gamma angle in the gamma angle adjusting device 031.
  • the rotation angle may include a first angle ⁇ x rotating around a first axis X extending in the width direction of the treatment bed 03, a second angle ⁇ y rotating around a second axis Y extending in the length direction of the treatment bed 03, and a treatment
  • the third axis Z of the third axis extending in the height direction of the bed 03 rotates by a third angle ⁇ z.
  • the IGS system 01 can correct the first relative position (TIxg, TIyg, TIzg) according to the acquired rotation angle ( ⁇ x, ⁇ y, ⁇ z).
  • the sequence of the rotation of the target point A3 around each rotation axis is as follows: first rotate ⁇ z around the third axis Z, then rotate ⁇ y around the second axis Y, and finally rotate ⁇ x around the first axis X. That is, the sequence of the patient's head rotating around each rotation axis is: Z, Y and X, then the first relative position (TIxg, TIyg, TIzg) is corrected according to the rotation angle ( ⁇ x, ⁇ y, ⁇ z)
  • the corrected first relative position (Tx, Ty, Tz) can satisfy:
  • the above step 408 can be calculated according to the first coordinates (X1, Y1, Z1), the corrected first relative position (Tx, Ty, Tz) and the second relative position (Xiso, Yiso, Ziso)
  • the order of the steps of the positioning method provided by the embodiment of the present invention can be adjusted appropriately, and the steps can also be increased or decreased according to the situation.
  • the above steps 401 to 405 can be performed after the above step 407, that is, the first relative position of the target point of the affected part and the imaging point can be determined according to the gamma angle to be treated, and the imaging point and the center of the device can be obtained first The second relative position of the point, and then obtain the first coordinate.
  • the above steps 401 to 405 can be performed after the above step 407, that is, the first relative position of the target point of the affected part and the imaging point can be determined according to the gamma angle to be treated, and the imaging point and the center of the device can be obtained first The second relative position of the point, and then obtain the first coordinate.
  • the embodiment of the present invention provides a positioning method, which can be based on the first coordinate of the treatment bed obtained when the preset filming point coincides with the imaging point, the target point of the affected part and the imaging point A relative position, and the second relative position of the imaging point and the isocenter of the device, calculate the second coordinate of the treatment bed when the target point coincides with the isocenter of the device at the gamma angle to be treated, and according to the second coordinate Adjust the position of the treatment bed. Therefore, when the gamma angle is adjusted during the radiotherapy process, the second coordinate of the treatment bed can be calculated accurately when the target point coincides with the isocenter of the device under the adjusted gamma angle. Improve the alignment accuracy of the target point and the isocenter of the device at different gamma angles, which can improve the accuracy of radiotherapy.
  • FIG. 10 is a block diagram of a positioning device provided by an embodiment of the present invention, the device can be applied to the host computer 02 shown in FIG. 1, or, referring to the above description, it can be seen that the positioning device can also be applied to FIG. 1 In the IGS system 01 or the treatment bed 03 of the present invention, this embodiment of the present invention does not limit this, and the following embodiments take the positioning device applied to the host computer 02 as an example for description.
  • the device may include:
  • the first obtaining module 501 is used to obtain the gamma angle to be treated.
  • the second acquisition module 502 is used to acquire the first coordinates of the treatment bed.
  • the first coordinates are the coordinates of the treatment bed when the preset filming point coincides with the imaging point of the image guidance system IGS.
  • the first determining module 503 is used to determine the first relative position of the target point of the affected part and the imaging point according to the gamma angle to be treated.
  • the third acquisition module 504 is used to acquire the second relative position of the imaging point and the isocenter of the device.
  • the calculation module 505 is configured to calculate the second coordinate of the treatment bed when the target point coincides with the isocenter of the device at the gamma angle to be treated according to the first coordinate, the first relative position, and the second relative position.
  • the first adjustment module 506 is used to adjust the position of the treatment bed according to the second coordinate.
  • the embodiment of the present invention provides a positioning device, in which the calculation module may obtain the first treatment bed acquired when the preset filming point coincides with the imaging point acquired by the second acquisition module Coordinates, the first relative position of the target point of the affected part and the imaging point determined by the first determination module, and the second relative position of the imaging point and the isocenter of the device obtained by the third acquisition module, calculated at the gamma angle to be treated Next, the second coordinate of the treatment bed when the target point coincides with the isocenter of the device, and the adjustment module may adjust the position of the treatment bed according to the second coordinate.
  • the second coordinate of the treatment bed can be calculated accurately when the target point coincides with the isocenter of the device under the adjusted gamma angle.
  • FIG. 11 is a block diagram of another positioning device provided by an embodiment of the present invention.
  • This device can be applied to the host computer 02 shown in FIG. 1, or, referring to the above description, it can be known that the positioning device can also be applied to the IGS system 01 or the treatment bed 03 shown in FIG. 1. Without limitation, the following embodiments take the positioning device applied to the host computer 02 as an example for description.
  • the device may further include:
  • the fourth acquisition module 507 is used to acquire a reconstructed image of the gamma angle to be treated before acquiring the first coordinates of the treatment bed, the reconstructed image being an image reconstructed according to the electronic image of the affected part acquired in advance.
  • the fifth acquisition module 508 is used to acquire the IGS image of the affected part under the gamma angle to be treated, the IGS image being an image generated by the image guidance system.
  • the second adjustment module 509 is used to perform image registration of the reconstructed image and the IGS image by adjusting the position of the treatment bed, so that the preset filming point coincides with the imaging point.
  • the device may further include:
  • the second determination module 510 may be used to determine the rotation angle of the target point about the rotation axis when the preset imaging point coincides with the imaging point after image registration of the reconstructed image and the IGS image by adjusting the position of the treatment bed.
  • the rotation angle includes a first angle of rotation about a first axis extending in the width direction of the treatment bed, a second angle of rotation about a second axis extending in the length direction of the treatment bed, and a third axis extending about the height direction of the treatment bed The third angle of rotation.
  • the correction module 511 may be used to correct the first relative position according to the rotation angle.
  • the calculation module 505 can be used to: according to the first coordinate, the corrected first relative position and the second relative position, calculate the target point and the isocenter of the device under the gamma angle to be treated, the treatment The second coordinate of the bed.
  • FIG. 12 is a block diagram of a first determination module 503 provided by an embodiment of the present invention. As shown in FIG. 12, the first determining module 503 may include:
  • the obtaining submodule 5031 is used to obtain the initial relative positions of the target point and the imaging point according to the treatment plan.
  • the initial relative position may include: a first initial relative distance between the target point and the imaging point in the width direction of the treatment bed, a second initial relative distance in the length direction of the treatment bed, and in the height direction of the treatment bed The third initial relative distance.
  • the first calculation submodule 5032 is configured to calculate the target distance between the target point and the imaging point in the first plane according to the second initial relative distance and the third initial relative distance.
  • the first plane is a plane where a first axis extending along the length direction of the treatment bed and a second axis extending along the height direction of the treatment bed are located.
  • the determination submodule 5033 is configured to determine the initial gamma angle according to the second initial relative distance and the third initial relative distance.
  • the second calculation submodule 5034 is configured to calculate the first relative position of the target point and the imaging point according to the gamma angle to be treated, the first initial relative distance, the target distance, and the initial gamma angle.
  • the determination submodule 5033 may be used for:
  • the initial gamma angle is 90 degrees.
  • the initial gamma angle is negative 90 degrees.
  • the initial gamma angle is the arc tangent of the ratio of the third initial relative distance to the second initial relative distance.
  • the initial gamma angle is the sum of the arc tangent of the ratio of the third initial relative distance to the second initial relative distance and 180 degrees.
  • the first relative position may include: at the gamma angle to be treated, the first relative distance between the target point and the imaging point in the width direction of the treatment bed, in the length direction of the treatment bed The second relative distance, and the third relative distance in the height direction of the treatment bed.
  • the second calculation submodule 5034 may be used for:
  • the first initial relative distance is determined as the first relative distance.
  • the product of the target distance and the cosine value of the first angle is determined as the second relative distance.
  • the first angle is the angle obtained by adding the initial gamma angle to 90 degrees and then subtracting it from the gamma angle to be treated.
  • the product of the target distance and the sine value of the first angle is determined as the third relative distance.
  • the calculation module 505 may be used to add the first coordinate to the second relative position and then subtract the first coordinate to obtain the second coordinate of the treatment bed.
  • the embodiments of the present invention provide a positioning device, in which the calculation module can obtain the first treatment bed acquired when the preset filming point coincides with the imaging point acquired by the second acquisition module Coordinates, the first relative position of the target point of the affected part and the imaging point determined by the first determination module, and the second relative position of the imaging point and the isocenter of the device acquired by the third acquisition module, calculated at the gamma angle to be treated Next, the second coordinate of the treatment bed when the target point coincides with the isocenter of the device, and the adjustment module may adjust the position of the treatment bed according to the second coordinate.
  • the second coordinate of the treatment bed can be calculated accurately when the target point coincides with the isocenter of the device under the adjusted gamma angle.
  • the positioning device may include: a processor and a memory, where instructions are stored in the memory, and the instructions may be loaded and executed by the processor to implement the positioning method as shown in any of FIG. 3, FIG. 4, and FIG. 6.
  • an embodiment of the present invention provides a storage medium in which instructions are stored.
  • the processing component can be executed as shown in any of FIG. 3, FIG. 4, and FIG. 6. Method of positioning.
  • An embodiment of the present invention also provides a radiation therapy system.
  • the radiation therapy system may include: a positioning device as shown in any one of FIGS. 10 and 11.

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Abstract

La présente invention concerne un procédé et un appareil de positionnement, et un système de radiothérapie, ceux-ci concernant le domaine technique de la radiothérapie. Selon le procédé, de secondes coordonnées d'une table de traitement lorsqu'un point cible d'une partie affectée coïncide avec un isocentre de dispositif sous un angle gamma pour le traitement sont calculées selon de premières coordonnées de la table de traitement acquises lorsqu'un point de prélèvement prédéfini de rayons X coïncide avec un point d'imagerie, de premières positions relatives du point cible et du point d'imagerie et de secondes positions relatives du point d'imagerie et de l'isocentre de dispositif, et la position de la table de traitement est ajustée selon les secondes coordonnées. Par conséquent, après que l'angle gamma est ajusté durant la radiothérapie, les secondes coordonnées de la table de traitement lorsque le point cible coïncide avec l'isocentre de dispositif au niveau de l'angle gamma ajusté peuvent être calculées de manière exacte, de sorte que la précision de l'alignement du point cible et de l'isocentre de dispositif sous différents angles gammas puisse être améliorée, ce qui permet d'améliorer à son tour la précision de la radiothérapie.
PCT/CN2018/123964 2018-12-26 2018-12-26 Procédé et appareil de positionnement, et système de radiothérapie Ceased WO2020132958A1 (fr)

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