CN104117151B - Optimization method of online self-adaption radiotherapy plan - Google Patents
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Abstract
The invention discloses an optimization method of an online self-adaption radiotherapy plan. The method comprises the steps of performing rigid registration and deformation registration on an image in a primary plan after a fractional guide image is input, so as to generate a target section and a fractional sketch outline which dangers organs; recalculating a dosage distribution and dosage volume histogram according to the parameters, fractional guide image and the fractional sketch outline in an original plan; judging whether the radiotherapy plan needs to be altered by combining the restriction of an original formula; combining a clinical requirement to perform rapid online alteration of the patient radiotherapy plan if needed, so as to generate the fractional guide image and perform an automatic radiotherapy plan quality guarantee. According to the optimization method provided by the invention, the optimization of the radiotherapy plan can be quickly finished at short time before every fractional therapy by comprehensively considering the change of a therapy in a patient treating process, based on a deformation rectification and dosage computational algorithm accelerated by a CPU (Central Processing Unit). Compared with an off-line self-adaption radiotherapy method based on a commercial treatment planning system, the optimization method is high in efficiency and meets clinical demands.
Description
Technical field
The present invention relates to the optimization method for the treatment of plan is and in particular to a kind of optimization method of radiotherapy planning.
Background technology
Usually before the treatment starts, positioning ct based on patient is generating radiotherapy meter for current tumour radiotherapy process
Draw, then keep radiotherapy planning constant in subsequent therapeutic process, some interval procedures are carried out to patient.Such treatment mould
Formula does not account for the anatomical structure change of patient in therapeutic process, the change of such as gross tumor volume and position, patient body wheel
Wide change, the change of gastrointestinal expanded state and the surrounding causing jeopardize change of organ site etc., lead to that patient is actual to be connect
The dosage being subject to deviates the prescribed dose of doctor, and then causes the decline of tumor control rate and the increasing of Normal Tissue Complication probability
Plus.
When great changes will take place for differences in patient, traditional self adaptation Therapeutic Method is usually used to correction radiotherapy
Plan.Positioning ct of certain gradation front scanning patient over the course for the treatment of is passed through in traditional self adaptation radiotherapy, then by doctor
Again drawing target outline and the profile jeopardizing organ, then passes through commercial therapeutic planning system by physics teacher or radiation supervisor
(treatment planning system, tps) redesigns and optimizes treatment plan, and by physics Shi Jinhang treatment plan matter
Amount ensure, last treatment plan just can be used for after gradation treatment.However, generating the process of new treatment plan with design
Original radiotherapy planning is the same, and the time is long, delays the treatment time of new plan, and needs to put into a lot of man power and materials,
So also seldom being adopted by hospital.
Therefore, make a general survey of current home and abroad existing radiotherapy pattern, do not accounted for based on traditional radiotherapy
The change of anatomical structure during patient, does not therefore enable expected therapeutic goal, if based on commercial therapeutic plan
System does offline adaptive radiation therapy, and efficiency is low, takes time and effort, therefore, it is difficult to clinically widely using.
Content of the invention
Goal of the invention: in order to overcome the deficiencies in the prior art, the present invention provides a kind of online adaptive radiotherapy meter
Draw optimization method, enabling be rapidly completed the optimization of whole treatment plan before each interval procedure starts, meet well
Clinical needs.
Technical scheme: for solving above-mentioned technical problem, the online adaptive radiotherapy planning optimization method that the present invention provides, bag
Include following steps:
1) import gradation navigational figure；
2) image rigid registration in gradation navigational figure and original radiotherapy planning；
3) gradation navigational figure is registering with the image deformation in original radiotherapy planning；
4) generate and adjust target area and jeopardize organ this sketch outline (i.e. when secondary gradation sketches outline) by several times so as to
Anatomical structure with gradation navigational figure is consistent；
5) according to the image in gradation navigational figure and original radiotherapy planning, whether judge the change of anatomical structure of patient
Exceed change threshold, in this way, then enter step 6)；As no, then preserve original radiotherapy planning as this fractionated radiotherapy plan (i.e. when
Secondary fractionated radiotherapy plan), terminate；
6) according to the parameter in original radiotherapy planning, sketched outline by several times with this based on gradation navigational figure and recalculate agent
Amount distribution (dose distribution) and dose volume histogram (dose volume histogram, dvh)；
7) judge whether dose distribution that step 6) obtains and dose volume histogram meet original prescription constraint, such as no,
Then enter step 8)；In this way, then it is used original radiotherapy planning as this fractionated radiotherapy plan, terminate；
8) sketched outline by several times based on this of step 4) generation, in conjunction with clinical requirement, carry out the quick of patient's radiotherapy planning
Online modification, generates this fractionated radiotherapy plan (i.e. when secondary fractionated radiotherapy plan), and carries out the automatic radiotherapy planning quality assurance
(quality assurance, qa), terminates.
Preferably, in described step 1), described gradation navigational figure includes ct(computed tomography), cone-beam
Ct(cone-beam ct), ultrasonic (ultrasound), pet(positron emission tomography) or magnetic resonance
At least one in images such as (magnetic resonance, mr)；In described step 3), quickly counted by deformable registration algorithm
Calculation deformation vector field, and the stressing conditions of each volume elements are calculated based on FEM (finite element) model, the error of analysis deformation vector field, automatically
Check the gradation navigational figure degree of accuracy registering with the image deformation in original radiotherapy planning；
Comprise the steps: in described step 4)
4.1) the deformation vector field that the gradation navigational figure obtaining with reference to step 1) and step 3) obtain, based on original scheme
Upper target area sketches outline with jeopardizing sketching outline of organ, the initial gradation of generation；
4.2) by initial gradation sketch outline with original scheme on sketch outline and contrasted, enter in conjunction with clinical requirement
Row modification is so as to the anatomical structure with gradation navigational figure is consistent, thus generating target area and jeopardizing this of organ and delineate wheel by several times
Wide；
In described step 6), it is that the gradation navigational figure that obtains the parameter of original radiotherapy planning, step 1), step 4) obtain
To this sketch outline by several times, dose distribution is recalculated by fast dose computational algorithm, and then is calculated dose volume
Rectangular histogram dvh；
Comprise the steps: in described step 8)
8.1) when original radiotherapy planning is static intensity-modulated radiation therapy plan (static imrt), obtained based on step 4)
To this sketch outline by several times, obtain beam direction view (beam eye along frame angle using fast projection algorithm
View, bev), change and confirm each Ziye of static intensity-modulated radiation therapy plan (segment) according to beam direction view
Multi-blade collimator (multi-leaf collimator, mlc) shape；When original radiotherapy planning is volume Intensity Modulation Radiated Therapy (IMRT) meter
When drawing (vmat), this being obtained based on step 4) is sketched outline by several times, is obtained along each control point using fast projection algorithm
Beam direction view, in conjunction with the blade maximum movement speed of multi-blade collimator, changes according to beam direction view and confirms volume
The multi-blade collimator shape of Intensity Modulation Radiated Therapy (IMRT) each Ziye of plan；
8.2) with original radiotherapy planning dose volume histogram as reference, adjust automatically this sketch outline by several times in each device
The weight of official, in conjunction with the impact of multi-blade collimator transmission photons and tongue and groove transmission photons, using fast dose computational algorithm meter
Calculate the dose distribution of each Ziye amended；
8.3) when original radiotherapy planning is static intensity-modulated radiation therapy plan (static imrt), using rapid Optimum
The weight of each Ziye of algorithm optimization, i.e. the jumping figure (mu) of each Ziye, obtain the dosage of this fractionated radiotherapy plan after optimizing
Distribution；When original radiotherapy planning is adjustment with volume strong radiotherapy treatment planning (vmat), then each is optimized using rapid optimizing algorithm
The weight of Ziye, obtains multi-blade collimator blade movement speed and accelerator close rate and irradiates ginseng in interior radiotherapy accelerator machine
Number, obtains the dose distribution of this fractionated radiotherapy plan after optimizing；
8.4) combine clinical requirement, generate this fractionated radiotherapy plan, that is, when secondary fractionated radiotherapy plan；
8.5) using different from step 8.2) another kind of fast dose computational algorithm carry out Rapid Dose Calculation again, and with step
Whether the dose distribution that rapid 8.3) obtain carries out three-dimensional gamma index value and calculates assessment, judge gamma percent of pass less than default gamma
Percent of pass threshold value, then enters step 8.1 in this way) recalculate, such as otherwise terminate.
Preferably, the change threshold in described step 5) is 30%.Can certainly be to set as needed, such as 10%,
15%th, 20% or 25%.
Preferably, the deformable registration algorithm in described step 3), described step 6), step 8.2) with step 8.5) in fast
Fast Dose calculation algorithm, described step 8.1) and step 8.3) in rapid optimizing algorithm, described step 8.5) in three-dimensional gal
It is by being realized based on gpu, cpu or distributed cloud computing platform that horse index value calculates assessment.
Preferably, the deformable registration algorithm of described step 3) is demons algorithm or b-spline algorithm；Described step 6),
Step 8.2) with step 8.5) in fast dose computational algorithm be convolution superposition algorithm or Monte carlo algorithm；Described step
8.1) the fast projection algorithm in is ray-tracing algorithm；Described step 8.3) in rapid optimizing algorithm be conjugate
Gradient barzilai-borwein algorithm；
Preferably, described step 8.5) in default gamma percent of pass threshold value be 95%.Can certainly be as needed
Set, such as 96%, 97%, 98% or 99%.
Beneficial effect: the invention provides a kind of online adaptive radiotherapy planning optimization method, it passes through importing and draws by several times
Carry out Rigid Registration and deformable registration with the image in original radiotherapy planning after leading image, generate target area and jeopardize organ when time
Sketch outline by several times, when the change of the anatomical structure of patient exceedes change threshold, according to the parameter in original radiotherapy planning, divide
Secondary navigational figure and gradation that ought be secondary sketch outline and recalculate dose distribution and dose volume histogram, combine thereafter original place
Side's constraint judges whether to need to change radiotherapy planning, when dose distribution and dose volume histogram do not meet original prescription constraint
When, sketch outline, in conjunction with this, the quick online modification carrying out patient's radiotherapy planning with clinical requirement by several times, ultimately generate when time
Fractionated radiotherapy plan, and carry out the automatic radiotherapy planning quality assurance.
Present method invention, by the deformable registration that accelerates based on gpu and Dose calculation algorithm, considers patient
During anatomical structure change, and make the whole radiotherapy planning optimization process can be in a few minutes after patient lies down on one's sick bed
Complete within clock, the optimization of whole radiotherapy planning can be rapidly completed before each interval procedure starts.Compared to based on business
The offline self adaptation radiotheraping method for the treatment of planning systems, efficiency high of the present invention, save time and human cost, meet well
Clinical needs, can clinically be applicable, have significant social meaning.
Brief description
Fig. 1 is the flow chart of present method invention；
Fig. 2 is the flow chart of step 8) in present method invention.
Specific embodiment
With reference to embodiment, the present invention is described in further detail, and this enforcement row do not constitute restriction to the present invention.
Before original radiotherapy planning is first or before certain interval procedure execution of certain course for the treatment of, based on patient tumors and about
The image information of organ-tissue, through Target delineations, the radiotherapy planning of confirmation.Original prescription is constrained to the one of original radiotherapy planning
Part.
First or before certain interval procedure execution after therapeutic process in, also will carry out interval procedure to patient,
Before such interval procedure (this interval procedure) execution, the present invention considers the change of anatomical structure during patient
Change, original radiotherapy planning is optimized to generate this fractionated radiotherapy plan, the online adaptive radiotherapy that the present embodiment is provided
Plan optimization method, as shown in figure 1, it comprises the following steps:
1) import gradation navigational figure: described gradation navigational figure is patient tumors and about before this interval procedure executes
The image information of organ-tissue, including ct(computed tomography), cone-beam ct(cone-beam ct), ultrasonic
(ultrasound, us), pet(positron emission tomography) or magnetic resonance (magnetic
Resonance, mr) etc. at least one in image；
2) image rigid registration in gradation navigational figure and original radiotherapy planning；
3) gradation navigational figure is registering with the image deformation in original radiotherapy planning: is quickly calculated by deformable registration algorithm
Deformation vector field (deformation vector field, dvf), described deformable registration algorithm is demons algorithm or b-
Spline algorithm；And the stress feelings of each volume elements are calculated based on FEM (finite element) model (finite element modeling, fem)
Condition, the error of analysis deformation vector field, automatically check that gradation navigational figure is registering with the image deformation in original radiotherapy planning
Degree of accuracy；
4) generate and adjust target area and jeopardize organ this sketch outline (i.e. when secondary gradation sketches outline) by several times so as to
Anatomical structure with gradation navigational figure is consistent, comprising:
4.1) the deformation vector field that the gradation navigational figure obtaining with reference to step 1) and step 3) obtain, based on original scheme
Upper target area sketches outline with jeopardizing sketching outline of organ, the initial gradation of generation；
4.2) by initial gradation sketch outline with original scheme on sketch outline and contrasted, enter in conjunction with clinical requirement
Row modification is so as to the anatomical structure with gradation navigational figure is consistent, thus generating target area and jeopardizing this of organ and delineate wheel by several times
Wide；
5) according to the image in gradation navigational figure and original radiotherapy planning, whether judge the change of anatomical structure of patient
Exceed change threshold, in this way, then enter step 6)；As no, then preserve original radiotherapy planning as this fractionated radiotherapy plan (i.e. when
Secondary fractionated radiotherapy plan), terminate；Change threshold in step 5) is 30%.Can certainly be to set as needed, be such as
10%th, 15%, 20% or 25%.
6) according to the parameter in original radiotherapy planning, sketched outline by several times with this based on gradation navigational figure and recalculate agent
Amount distribution and dose volume histogram dvh: gradation navigational figure that the parameter of original radiotherapy planning, step 1) are obtained, step
4) this obtaining sketches outline by several times, recalculates dose distribution by fast dose computational algorithm, and then is calculated dosage
Volume histogram dvh；Fast dose computational algorithm used herein is convolution superposition algorithm or Monte carlo algorithm；
7) judge whether to need to change radiotherapy planning with reference to original prescription constraint, that is, judge the dose distribution that step 6) obtains
Whether meet original prescription constraint with dose volume histogram, such as no, then enter step 8)；In this way, then using original radiotherapy meter
Draw as this fractionated radiotherapy plan, terminate；
8) sketched outline by several times based on this of step 4) generation, in conjunction with clinical requirement, carry out the quick of patient's radiotherapy planning
Online modification, generates this fractionated radiotherapy plan (i.e. when secondary fractionated radiotherapy plan), and carries out the automatic radiotherapy planning quality assurance
(quality assurance, qa), as shown in Fig. 2 step 8) comprises the steps:
8.1) when original radiotherapy planning is static intensity-modulated radiation therapy plan (static imrt), obtained based on step 4)
To this sketch outline by several times, obtain beam direction view (beam eye along frame angle using fast projection algorithm
View, bev), change and confirm each Ziye of static intensity-modulated radiation therapy plan (segment) according to beam direction view
Multi-blade collimator (multi-leaf collimator, mlc) shape；When original radiotherapy planning is volume Intensity Modulation Radiated Therapy (IMRT) meter
When drawing (vmat), this being obtained based on step 4) is sketched outline by several times, along each control point (control point) using fast
Fast projection algorithm obtains beam direction view, in conjunction with the blade maximum movement speed of multi-blade collimator, according to beam direction view
Change and confirm the multi-blade collimator shape of adjustment with volume each Ziye of strong radiotherapy treatment planning；
8.2) with original radiotherapy planning dose volume histogram as reference, adjust automatically this sketch outline by several times in each device
The weight of official, in conjunction with the impact of multi-blade collimator transmission photons and tongue and groove transmission photons, using fast dose computational algorithm meter
Calculate the dose distribution of each Ziye amended；
8.3) when original radiotherapy planning is static intensity-modulated radiation therapy plan (static imrt), using conjugate
The weight of gradient barzilai-borwein each Ziye of algorithm optimization, i.e. the jumping figure (mu) of each Ziye, obtain and optimize
The dose distribution of this fractionated radiotherapy plan afterwards；When original radiotherapy planning is adjustment with volume strong radiotherapy treatment planning (vmat), then
Also using the weight of conjugate gradient barzilai-borwein each Ziye of algorithm optimization, obtain multipage collimation
, in interior radiotherapy accelerator machine radiation parameters, this after acquisition optimizes is put by several times for device blade movement speed and accelerator close rate
Treat the dose distribution of plan；
8.4) combine clinical requirement, generate this fractionated radiotherapy plan, that is, when secondary fractionated radiotherapy plan；
8.5) carry out the automatic radiotherapy planning quality assurance, that is, adopt different from step 8.2) the calculating of another kind of fast dose
Algorithm carries out Rapid Dose Calculation again, and with step 8.3) dose distribution that obtains carries out three-dimensional gamma index value and calculates assessment, sentence
Disconnected gamma percent of pass, whether less than default gamma percent of pass threshold value, then enters step 8.1 in this way) recalculate, such as otherwise terminate.
Step 8.5) in default gamma percent of pass threshold value be 95%.Can certainly be to set as needed, such as 96%, 97%, 98%
Or 99%.
Step 8.2 in the present embodiment) in fast dose computational algorithm be convolution superposition algorithm, step 8.5) in quick
Dose calculation algorithm is Monte carlo algorithm；Can certainly be set as needed: step 8.2) in fast dose calculate
Algorithm be Monte carlo algorithm, step 8.5) in fast dose computational algorithm be convolution superposition algorithm.
Deformable registration algorithm in step 3) in the present embodiment, step 6), step 8.2) with step 8.5) in quick agent
Amount computational algorithm, step 8.1) and step 8.3) in rapid optimizing algorithm, step 8.5) in the calculating of three-dimensional gamma index value
Assessment is by being realized based on gpu, cpu or distributed cloud computing platform.
Claims (6)
1. a kind of online adaptive Radiotherapy dosimetry evaluates and optimizes method it is characterised in that comprising the following steps:
1) import gradation navigational figure；
2) image rigid registration in gradation navigational figure and original radiotherapy planning；
3) gradation navigational figure is registering with the image deformation in original radiotherapy planning；
4) generate and adjust target area and jeopardize this of organ and sketch outline the anatomical structure one so as to gradation navigational figure by several times
Cause；
5) according to the image in gradation navigational figure and original radiotherapy planning, judge whether the change of the anatomical structure of patient exceedes
Change threshold, in this way, then enters step 6)；As no, then preserve original radiotherapy planning as this fractionated radiotherapy plan, terminate；
6) according to the parameter in original radiotherapy planning, based on gradation navigational figure and this sketch outline by several times and recalculate dosage and divide
Cloth and dose volume histogram；
7) judge step 6) whether the dose distribution that obtains and dose volume histogram meet original prescription constraint, such as no, then enter
Enter step 8)；In this way, then it is used original radiotherapy planning as this fractionated radiotherapy plan, terminate；
8) be based on step 4) generate this sketch outline by several times, in conjunction with clinical requirement, carry out the quickly online of patient's radiotherapy planning
Modification, generates this fractionated radiotherapy plan and carries out the automatic radiotherapy planning quality assurance, terminates；
Wherein:
Described step 3) in, deformation vector field is quickly calculated by deformable registration algorithm, and each is calculated based on FEM (finite element) model
The stressing conditions of volume elements, the error of analysis deformation vector field, automatically check the figure in gradation navigational figure and original radiotherapy planning
Degree of accuracy as deformable registration；
Described step 4) in comprise the steps:
4.1) combine step 1) the gradation navigational figure that obtains and step 3) the deformation vector field that obtains, based on target in original scheme
Area sketches outline with jeopardizing sketching outline of organ, the initial gradation of generation；
4.2) by initial gradation sketch outline with original scheme on sketch outline and contrasted, repaiied in conjunction with clinical requirement
Change so as to the anatomical structure with gradation navigational figure is consistent, thus generating target area and jeopardizing this of organ and sketch outline by several times；
Described step 6) in, be by the parameter of original radiotherapy planning, step 1) the gradation navigational figure that obtains, step 4) obtain
This sketches outline by several times, recalculates dose distribution by fast dose computational algorithm, and then is calculated dose volume histogram
Figure；
Described step 8) in comprise the steps:
8.1) when original radiotherapy planning is static intensity-modulated radiation therapy plan, based on step 4) obtain this delineate wheel by several times
Exterior feature, obtains beam direction view along frame angle using fast projection algorithm, is changed according to beam direction view and confirms quiet
The multi-blade collimator shape of state Intensity Modulation Radiated Therapy (IMRT) each Ziye of plan；When original radiotherapy planning is volume Intensity Modulation Radiated Therapy (IMRT) meter
Draw when, based on step 4) obtain this sketch outline by several times, obtain beam side along each control point using fast projection algorithm
Direction view, in conjunction with the blade maximum movement speed of multi-blade collimator, changes according to beam direction view and confirms that adjustment with volume is put by force
Penetrate the multi-blade collimator shape of each Ziye for the treatment of plan；
8.2) with original radiotherapy planning dose volume histogram as reference, adjust automatically this sketch outline by several times in each organ
Weight, in conjunction with the impact of multi-blade collimator transmission photons and tongue and groove transmission photons, is calculated using fast dose computational algorithm and repaiies
The dose distribution of each Ziye after changing；
8.3) when original radiotherapy planning is static intensity-modulated radiation therapy plan, each Ziye is optimized using rapid optimizing algorithm
Weight, i.e. the jumping figure of each Ziye, obtain the dose distribution of this fractionated radiotherapy plan after optimizing；When original radiotherapy planning is to hold
During long-pending Intensity Modulation Radiated Therapy (IMRT) plan, then optimize the weight of each Ziye using rapid optimizing algorithm, obtain multi-blade collimator blade
Movement velocity and accelerator close rate, in interior radiotherapy accelerator machine radiation parameters, obtain this fractionated radiotherapy plan after optimizing
Dose distribution；
8.4) combine clinical requirement, generate this fractionated radiotherapy plan；
8.5) using different from step 8.2) another kind of fast dose computational algorithm carry out Rapid Dose Calculation again, and and step
8.3) dose distribution obtaining carries out three-dimensional gamma index value and calculates assessment, judges whether gamma percent of pass leads to less than default gamma
Cross rate threshold value, then enter step 8.1 in this way) recalculate, such as otherwise terminate.
2. online adaptive Radiotherapy dosimetry according to claim 1 evaluate and optimize method it is characterised in that:
Described step 1) in, described gradation navigational figure includes at least one in ct, cone-beam ct, ultrasonic, pet or magnetic resonance.
3. online adaptive Radiotherapy dosimetry according to claim 1 evaluate and optimize method it is characterised in that: described step
5) change threshold in is 10% or 15% or 20% or 25% or 30%.
4. online adaptive Radiotherapy dosimetry according to claim 2 evaluate and optimize method it is characterised in that: described step
3) the deformable registration algorithm in, described step 6), step 8.2) with step 8.5) in fast dose computational algorithm, described step
8.1) fast projection algorithm and step 8.3) in rapid optimizing algorithm, described step 8.5) in three-dimensional gamma index value meter
Calculating algorithm is by being realized based on gpu, cpu or distributed cloud computing platform.
5. online adaptive Radiotherapy dosimetry according to claim 2 evaluate and optimize method it is characterised in that: described step
3) deformable registration algorithm is demons algorithm or b-spline algorithm；Described step 6), step 8.2) with step 8.5) in
Fast dose computational algorithm is convolution superposition algorithm or Monte carlo algorithm；Described step 8.1) in fast projection algorithm be
Ray-tracing algorithm；Described step 8.3) in rapid optimizing algorithm be conjugate gradientbarzilai-
Borwein algorithm.
6. online adaptive Radiotherapy dosimetry according to claim 2 evaluate and optimize method it is characterised in that: described step
8.5) the default gamma percent of pass threshold value in is 95% or 96% or 97% or 98% or 99%.
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