CN112089991B - System and method for real-time monitoring and correcting patient-guided positioning and target area displacement - Google Patents
System and method for real-time monitoring and correcting patient-guided positioning and target area displacement Download PDFInfo
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Abstract
The invention relates to a system and a method for real-time monitoring and correcting the displacement of a patient-guided positioning and target area, which is characterized by comprising the following steps: 1) a patient guiding positioning and target area displacement real-time monitoring and correcting system is set up in a simulation room and a treatment room of the heavy ion treatment device, and patient tumor target area calibration data under a treatment isocenter coordinate system are obtained in the simulation room; 2) guiding the patient to carry out positioning and carrying out positioning verification according to the acquired patient tumor target area calibration data under the isocenter coordinate system of the treatment room; 3) the displacement of the target area of the tumor of the patient is monitored in real time, and the position of the target area of the tumor of the patient is corrected on line according to the real-time monitoring result of the displacement of the target area of the tumor of the patient and a preset threshold value. The invention can be widely applied to the field of heavy ion treatment.
Description
Technical Field
The invention relates to the technical field of heavy ion radiotherapy, in particular to a system and a method for real-time monitoring and correcting patient guiding positioning and tumor target area displacement in the heavy ion beam radiotherapy process.
Background
Heavy ion radiotherapy is different from traditional photon radiotherapy because the heavy ion beam has unique physical and biological effects, so that the heavy ion beam has more advantages in treating malignant tumors. The Bragg peak of the heavy ion beam can control the beam current to release the maximum dose at the tumor tissue, so that the situation that the normal tissue of a patient receives excessive dose to induce new pathological changes is avoided, and the positioning requirement on the patient in the heavy ion beam radiotherapy process is stricter than that of the conventional radiotherapy. Before heavy ion beam radiotherapy, doctors need to diagnose specific positions of tumors according to images of patients such as CT (computed tomography) and Magnetic Resonance Imaging (MRI), a reasonable radiotherapy plan is formulated according to image data of the patients, and beam parameters, radiotherapy times and the like of radiotherapy of the patients are determined. In order to improve the application efficiency of the heavy ion beam current, when heavy ion radiotherapy is carried out, a patient can firstly carry out the positioning of a tumor target area in a simulation room and mark the tumor target area, and after the patient enters a treatment room, the positioning and positioning verification of the patient is carried out by referring to the marking of the tumor target area of the patient in the simulation room by means of positioning equipment in the treatment room. Therefore, the positioning accuracy of the patient is directly related to the radiotherapy effect of the patient.
The conventional radiotherapy patient positioning technology is mainly characterized in that positioning stitches are drawn on a target area of a tumor on the body surface of a patient in a simulation room by means of imaging equipment such as DR (digital radiography) and positioning laser, and then the patient is positioned by the positioning laser in a treatment room; however, these devices generate radiation dose in the imaging and positioning process, and the positioning trace drawn on the body surface is changed in real time due to the respiration of the patient in the positioning process, so that the alignment accuracy of the positioning laser and the positioning trace is reduced. And the positioning process is relatively complex and tedious, so that the positioning efficiency of the patient is reduced, and the treatment cost of the patient is increased. In addition, the target tumor region is often moved by the involuntary movement of the patient during the treatment after positioning, and especially for the tumor radiotherapy of some patients who are not easy to keep the positioning posture for a long time, the target tumor region of the patient is often moved to cause the radiotherapy effect to be poor. Although there are corrections for patient positioning errors and organ motion in each treatment plan, these corrections are made by taking new images using DR and other equipment after a single radiation treatment, and then comparing the new images with the images in the treatment plan to obtain patient positioning errors.
Researchers have now conducted many studies on the problem of patient positioning during radiotherapy, but there still exist many technical problems, such as:
1. by using a radiographic imaging device in the treatment room to guide the patient in a radiation treatment setup, but the guide image and the verification image of the radiation treatment setup of the patient are acquired by radioactive rays, the patient can receive an additional radiation dose during the positioning process, and further, the side effect of the radiation treatment is larger.
2. The method includes the steps that the patient is guided to be in a position by methods of three-dimensional laser body surface scanning imaging, an infrared mark point combined laser camera is installed above the tumor of the patient and the like, but the position verification systems of the three-dimensional laser scanning, the infrared mark and the like can only detect the relative position deviation of the patient, and the three-dimensional laser scanning system is expensive in price, large in data calculation amount and complex in operation.
3. The method comprises the steps that the patient can be placed and verified by a method of shooting human body images through a plurality of cameras and matching the human body images through standard reference images and real-time video images, but the cameras of the method do not have position reference and coordinate conversion relative to isocenters of a simulation room and a treatment room, the patient can not be guided to be placed through the method of simulating the placement, and absolute position deviation of isocenters of a tumor and the treatment room of the patient can not be visually displayed; and the method does not consider factors such as the change of the breathing of the patient to the human body image in the monitoring of the real-time treatment of the patient. The above methods have disadvantages and advantages, and none of them relate to a method of correction after displacement of the target region of the patient's tumor during treatment.
Disclosure of Invention
Aiming at the problem that the positioning efficiency and positioning precision of a patient are low in heavy ion radiotherapy, the invention aims to provide a system and a method for real-time monitoring and correcting the displacement of a patient guide positioning and tumor target area in heavy ion beam radiotherapy, wherein a high-precision three-dimensional control network of a laser tracker distributed by a dual-camera photogrammetric system and a treatment room is combined to guide the patient to perform positioning before radiotherapy every time, so that the positioning efficiency and positioning precision of the patient are improved; monitoring the position parameters of a tumor target area of a patient in real time in the radiotherapy process, and performing real-time online correction and position compensation according to the position deviation of a treatment isocenter; by means of the calibration data of the patient in the states of expiration and inspiration respectively when the patient is in the initial positioning, the target area in the treatment process of the patient is monitored in real time, and a radiotherapy doctor can correct the position deviation of the tumor target area according to the target area displacement monitoring data, so that the reliability and the safety in the treatment process are improved.
In order to achieve the purpose, the invention adopts the following technical scheme:
in a first aspect of the present invention, a method for real-time monitoring and online correction of patient-guided positioning and tumor target displacement is provided, which comprises the following steps:
1) a patient guiding positioning and target area displacement real-time monitoring and correcting system is set up in a simulation room and a treatment room of the heavy ion treatment device, and patient tumor target area calibration data under a treatment isocenter coordinate system are obtained in the simulation room;
2) guiding the patient to carry out positioning and carrying out positioning verification according to the acquired patient tumor target area calibration data under the isocenter coordinate system of the treatment room;
3) the displacement of the target area of the tumor of the patient is monitored in real time, and the position of the target area of the tumor of the patient is corrected on line according to the real-time monitoring result of the displacement of the target area of the tumor of the patient and a preset threshold value.
Further, in the step 1), a method for acquiring calibration data of a target region of a tumor of a patient in a treatment isocenter coordinate system in a simulation room comprises the following steps:
1.1) respectively establishing a set of double-camera close-range photogrammetry system in a simulation room and a treatment room of the heavy ion treatment device;
1.2) laying a new three-dimensional control net around the treatment beds of the simulation room and the treatment room respectively, wherein the new three-dimensional control net comprises a plurality of three-dimensional control net target points which can be measured by using a laser tracker and a double-camera close-range photogrammetry system;
1.3) unifying a newly-arranged three-dimensional control network and a global control network of the heavy ion treatment device in a global coordinate system by using a laser tracker through a best fitting method, and establishing three-dimensional theoretical coordinates of target points of the newly-arranged three-dimensional control network relative to treatment isocenters of a simulation room and a treatment room;
1.4) sticking specially-made RRT coding mark points or RRT characteristic mark points on a tumor target area on the body surface of a patient, wherein the distribution principle is that the RRT coding mark points or RRT mark points with the number more than 3 uniformly cover the whole tumor target area of the patient;
1.5) in a simulation room, measuring three-dimensional control network target points arranged in a meeting visual field range around a treatment couch by adopting a double-camera close-range photogrammetry system, and carrying out control orientation of the double-camera close-range photogrammetry system in the simulation room so that the origin of a measurement coordinate system of the double-camera close-range photogrammetry system is positioned at a treatment isocenter of the simulation room;
1.6) referring to tumor image data of a patient, and performing simulated positioning on the patient by using a mobile DR device in a simulation room;
1.7) in a simulation room, using a double-camera close-range photogrammetry system to obtain calibration data of a tumor of a patient after simulated positioning relative to a treatment isocenter of the simulation room;
1.8) converting a coordinate system between the simulation room treatment isocenter and the treatment room treatment isocenter, converting the tumor target area calibration data of the patient under the simulation room treatment isocenter coordinate system into patient tumor calibration data under the treatment room treatment isocenter coordinate system, and storing the patient tumor calibration data in a computer control system according to the ID of the patient.
Further, in step 1.1), the method for establishing a set of two-camera close-range photogrammetry system in each of the simulation room and the treatment room of the heavy ion treatment device comprises: the double cameras are arranged at the tops of the treatment beds of the simulation room and the treatment room, and the erection posture and the angle of the double cameras are adjusted, so that the intersection visual field of the double cameras completely covers the whole moving range of the treatment bed.
Further, in the step 1.4), the sticking surfaces of the RRT coding mark points and the RRT characteristic mark points are environment-friendly adhesive glue which does not harm human skin, the sizes of the RRT coding mark points are 30mm x 30mm, and the sizes of the RRT characteristic mark points are 8mm x 8 mm.
Further, in step 1.7), the method for acquiring the tumor target calibration data of the patient by using the dual-camera close-range photogrammetry system comprises: and respectively measuring the characteristic mark point data of the tumor target region when the patient inhales and exhales in the free breathing state after being positioned for multiple times, and taking the average value of the multiple measurements as the tumor calibration data of the patient in the inhaling and exhaling states.
Further, in the step 2), the method for guiding the patient to perform the positioning and performing the positioning verification includes:
2.1) in the treatment room, using a double-camera close-range photogrammetry system to measure three-dimensional control network target points arranged in the intersection visual field range around the treatment couch, and carrying out control orientation of the double-camera close-range photogrammetry system in the treatment room, so that the origin of a measurement coordinate system of the double-camera close-range photogrammetry system is positioned at the treatment isocenter of the treatment room;
2.2) measuring the characteristic mark point data of the patient tumor target area in real time through a double-camera close-range photogrammetry system, converting the characteristic mark point data into the three-dimensional coordinate position deviation of the patient tumor target area relative to the treatment isocenter, and sending the three-dimensional coordinate position deviation to a control system and a display screen, so that a doctor can guide a patient to be positioned according to the actual position of the patient tumor on the display screen and the deviation of the treatment isocenter;
and 2.3) after guiding the patient to finish the positioning, performing positioning verification by using the DR of the treatment room, continuing the next treatment if the verification is passed, and otherwise, returning to the step 2.2) to adjust the positioning of the patient.
Further, in the step 3), the method for monitoring and correcting the target area displacement in real time includes:
3.1) monitoring the displacement information of the tumor target area of the patient in real time by using a double-camera close-range photogrammetry system, and displaying the displacement information on display screens of a treatment room and a control system in real time;
3.2) the control system judges whether the position of the tumor target area of the patient needs to be corrected or not according to the received displacement information of the tumor target area of the patient and a preset threshold, if the displacement of the tumor target area of the patient exceeds the preset threshold, the control system sends an alarm signal and corrects the tumor target area within preset time, if the correction is not completed within the preset time, the control system automatically cuts off the beam, and if the displacement of the tumor target area of the patient does not exceed the preset threshold, the control system returns to the step 3.1) to continuously monitor the displacement information of the tumor target area of the patient; the preset threshold value refers to the allowable moving range of the target region of the tumor of the patient, which is determined according to the size and the position of the tumor of the patient.
Further, in the step 3.2), the method for correcting the tumor target area comprises: a doctor refers to the monitored deviation value of the target area position of the patient relative to the treatment isocenter, and corrects the target area position of the tumor of the patient through remote control of the treatment couch, or a correction program is embedded into a control system of the treatment couch, so that the treatment couch automatically corrects and compensates according to the monitored deviation value of the tumor of the patient relative to the treatment isocenter, and the tumor of the patient can be located at the treatment isocenter in real time.
In a second aspect of the present invention, a system for real-time monitoring and online correction of patient-guided positioning and tumor target displacement is provided, which comprises: the device comprises a close-range photogrammetry system with two double cameras, a control system and a display screen;
the two double-camera close-range photogrammetry systems are respectively arranged at the top of a simulation room of the heavy ion treatment device and a treatment room treatment couch, and the first double-camera close-range photogrammetry system is used for collecting the position of a tumor target area of a patient on the treatment couch and the positions of three-dimensional control mesh points arranged around the treatment couch;
the control system is arranged in the control hall and used for calibrating a patient tumor target area according to the position of the patient tumor target area and the position data of the three-dimensional control network point, which are acquired by the first double-camera close-range photogrammetry system and the laser tracker in the simulation room, converting the patient tumor target area into patient tumor target area calibration data in the treatment room, guiding the patient to be positioned according to the patient tumor target area calibration data and the real-time tumor target area position of the patient, which is acquired by the second double-camera close-range photogrammetry system, in the ion radiotherapy process, and correcting when the displacement of the tumor target area exceeds a preset threshold value;
the display screens are respectively arranged in the treatment room and the control hall and are used for displaying the position of the target area of the tumor of the patient acquired by the second double-camera close-range photogrammetry system in real time and guiding a doctor to carry out on-line correction of position deviation in the process of ion radiotherapy.
Due to the adoption of the technical scheme, the invention has the following advantages: (1) in the process of guiding the patient to be positioned, the absolute position of the treatment isocenter is provided, and the positioning accuracy of the patient is improved; (2) in the guiding and positioning process, the positioning precision of the patient is improved by referring to the calibration data of the characteristic mark points of the tumor target area of the patient in the inspiration and expiration states respectively; (3) in the whole radiotherapy treatment course of the patient, the patient can be positioned every time, and a radiotherapy doctor can position according to calibration data of the characteristic points of the body surface of the patient monitored by the photogrammetric system, so that the operation is visual and simple, and the positioning efficiency of the patient is improved. (4) The position deviation of the tumor relative to the treatment isocenter is monitored by a method of arranging the characteristic mark points on the target area of the tumor, the monitoring data acquisition amount is small, the data operation speed is high, the monitoring displacement deviation amount can be visually displayed on a screen in real time, and real-time monitoring is achieved. (5) In the treatment process, a radiotherapy doctor can perform online correction according to the tumor position deviation on the display screen, so that the treatment precision of a patient is improved; (6) the reasonable threshold value of the position deviation of the tumor target area and the time range of normal tissues near the tumor of the patient, which can be borne under the set dose rate, are arranged in the control system, so that the treatment safety of the patient is improved, the beam current can be prevented from being frequently cut off by the system under the unnecessary condition, and the utilization efficiency of the beam current is improved.
Drawings
FIG. 1 is a block diagram of a system for real-time monitoring and correction of patient-guided positioning and target displacement in accordance with the present invention;
FIG. 2 is a flow chart of a method for real-time monitoring and correcting patient-guided positioning and target displacement according to the present invention;
FIGS. 3a and 3b are screenshots of display interfaces for real-time monitoring of the displacement of a tumor target region of a phantom (patient) in a validation experiment performed at a HIRFL deep treatment terminal according to the present invention; fig. 3a is a three-dimensional graph of real-time monitoring of position deviation of a phantom (patient) tumor target area relative to a deep treatment terminal treatment isocenter in an experiment; FIG. 3b is a three-dimensional coordinate data display of real-time monitoring of positional deviation of a phantom (patient) tumor target area relative to a deep treatment terminal treatment isocenter in an experiment;
fig. 4a and 4b are screenshots of monitoring and displaying interfaces for online correction of position deviation of target area of phantom (patient) in a verification experiment performed by a hirl deep treatment terminal, wherein fig. 4a is a three-dimensional graph for online correction of position deviation of target area of phantom (patient) in the experiment; FIG. 4b is a three-dimensional coordinate data display of on-line correction of the position deviation of the target area of the phantom (patient) in the experiment;
FIG. 5 is a three-dimensional coordinate difference diagram of the tumor target area of the phantom (patient) after on-line monitoring and correction and the laser tracker monitoring in the verification experiment performed by the HIRFL deep treatment terminal;
the respective symbols in the figure are as follows: 1. a dual-camera close-range photogrammetry camera; 2. a control system; 3. a display screen; 4. characteristic mark points of the tumor target area; 5. three-dimensional control mesh points; 6. a therapeutic bed.
Detailed Description
The following detailed description describes embodiments of the invention, examples of which are illustrated in the accompanying drawings, which are meant to be exemplary and intended to be illustrative of the invention, and not to be construed as limiting the invention.
The first embodiment is as follows:
as shown in fig. 1, the system for real-time monitoring and correcting patient-guided positioning and target displacement provided in this embodiment includes: the device comprises two double-camera close-range photogrammetry systems 1, a control system 2 and a display screen 3, wherein the two double-camera close-range photogrammetry systems 1 are respectively arranged at the top of a treatment couch in a simulation room and a treatment room of the heavy ion treatment device, and the first double-camera close-range photogrammetry system 1 is used for collecting the position of a tumor target area of a patient on the treatment couch 6 and the positions of three-dimensional control network points arranged around the treatment couch; the control system is arranged in the control hall and used for calibrating a patient tumor target area according to the position data of the three-dimensional control network points acquired by the first double-camera close-range photogrammetry system 1 and the laser tracker in the simulation room and converting the data into patient tumor target area calibration data in the treatment room, then guiding the patient to be positioned according to the patient tumor target area calibration data and the real-time tumor target area position of the patient acquired by the second double-camera close-range photogrammetry system in the ion radiotherapy process, and correcting when the displacement of the tumor target area exceeds a preset threshold value; the display screens 3 are respectively arranged in the treatment room and the control hall and are used for displaying the position of the target area of the tumor of the patient acquired by the second double-camera close-range photogrammetry system in real time and guiding a doctor to carry out on-line correction of position deviation in the process of ion radiotherapy.
Example two:
as shown in fig. 2, the present invention provides a real-time monitoring and correcting method for patient-guided positioning and target displacement, which specifically comprises the following steps:
1) preparation before radiotherapy: a patient guiding positioning and target area displacement real-time monitoring and correcting system is set up in a simulation room and a treatment room, and patient tumor target area calibration data under a treatment isocenter coordinate system is obtained in the simulation room;
2) guiding and verifying the position: according to the acquired patient tumor target area calibration data under the treatment isocenter coordinate system, guiding the patient to carry out positioning and carrying out positioning verification in the whole treatment process;
3) monitoring and correcting displacement of the target area in real time: in the whole treatment process, the displacement of the target area of the tumor of the patient is monitored in real time, and the position of the target area of the tumor of the patient is corrected according to the real-time monitoring result of the displacement of the target area of the tumor of the patient and a preset threshold value.
In the step 1), the method for preparing before radiotherapy comprises the following steps:
1.1) respectively establishing a set of double-camera close-range photogrammetry system in a simulation room and a treatment room of the heavy ion treatment device.
1.2) arranging a new three-dimensional control net around the treatment beds of the simulation room and the treatment room respectively, wherein the three-dimensional control net comprises a plurality of three-dimensional control net target points which can be measured by using a laser tracker and a double-camera close-range photogrammetry system.
1.3) unifying the newly-arranged three-dimensional control net and the global control net of the heavy ion treatment device in a global coordinate system by a best fitting method by using a laser tracker, and establishing three-dimensional theoretical coordinates of target points of the newly-arranged three-dimensional control net relative to treatment isocenters of a simulation room and a treatment room.
1.4) sticking special small-size (30mm x 30mm) RRT coding mark points or special RRT characteristic mark points (the sticking surface is environment-friendly adhesive which is harmless to the skin of a human body) on the target tumor area on the body surface of the patient, wherein the arrangement principle is that the small-size RRT coding mark points or the RRT mark points with the number more than 3 uniformly cover the target tumor area of the patient.
1.5) in the simulation chamber, a double-camera close-range photogrammetry system is adopted to measure three-dimensional control net target points arranged in the intersection visual field range around the treatment couch, and the control orientation of the double-camera close-range photogrammetry system in the simulation chamber is carried out, so that the origin of a measurement coordinate system of the double-camera close-range photogrammetry system is positioned at the treatment isocenter of the simulation chamber.
1.6) referring to the tumor image data of CT/MRI and the like of the patient, the patient is simulated and positioned in a simulation room by using a mobile DR device.
1.7) in the simulation room, a double-camera close-range photogrammetry system is used for acquiring calibration data of a tumor target area after the patient is simulated to be positioned relative to a treatment isocenter of the simulation room.
1.8) using measurement software to convert a coordinate system between the simulation room treatment isocenter and the treatment room treatment isocenter, converting the tumor target calibration data of the patient in the simulation room isocenter coordinate system into the patient tumor target calibration data in the treatment room isocenter coordinate system, and storing the patient tumor target calibration data in a control system according to the ID of the patient.
In the step 1.1), the method for respectively establishing a set of two-camera close-range photogrammetry system in the simulation room and the treatment room of the heavy ion treatment device comprises the following steps: the dual cameras are mounted on top of the treatment couch in the simulation room and the treatment room so that the convergent vision field of the dual cameras can completely cover the full range of motion of the treatment couch.
In the step 1.7), the method for acquiring the tumor calibration data of the patient by using the dual-camera close-range photogrammetry system in the simulation room comprises the following steps: the target feature point data of the tumor target area during inspiration and expiration in the free breathing state after the patient is positioned are measured for multiple times, for example, the target feature point data can be measured 20 times respectively during inspiration and expiration in the free breathing state after the patient is positioned, and the average value of the 20 measurements is taken as the tumor calibration data of the patient in the inspiration and expiration states.
In the step 2), the method for guiding the patient to perform positioning and positioning verification comprises the following steps:
2.1) in the treatment room, using the double-camera close-range photogrammetry system to measure three-dimensional control net target points arranged in the intersection visual field range around the treatment couch, and carrying out control orientation of the double-camera close-range photogrammetry system in the treatment room, so that the origin of the measurement coordinate system of the double-camera close-range photogrammetry system is positioned at the treatment isocenter of the treatment room.
2.2) in the whole radiotherapy treatment course of the patient, when the patient is guided to be positioned in the treatment room each time, the characteristic mark point calibration data of the tumor target area of the patient is measured in real time by the double-camera close-range photogrammetry system and is sent to the control system 2 and the display screen 3, so that a doctor can guide the patient to be positioned according to the actual position of the tumor of the patient on the display screen 3 and the deviation of the treatment isocenter of the treatment room.
And 2.3) after guiding the patient to finish the positioning, performing positioning verification by using the DR of the treatment room, starting treatment if the verification is passed, and otherwise, adjusting the positioning of the patient.
In the step 3), the method for monitoring and correcting the displacement of the target area in real time comprises the following steps:
3.1) in the treatment process, the double-camera close-range photogrammetry system is used for monitoring the displacement information of the tumor target area of the patient in real time and displaying the displacement information on the display screens of the treatment room and the control system in real time.
3.2) the control system judges whether the position of the tumor target area of the patient needs to be corrected according to the received displacement information of the tumor target area of the patient and a preset threshold value, if so, the step 3.3) is carried out, otherwise, the step 3.1) is returned to continuously monitor the displacement information of the tumor target area of the patient. The preset threshold value refers to the allowable moving range of the target region of the tumor of the patient, which is determined according to the size and the position of the tumor of the patient.
3.3) in the treatment process, if patient's tumour target area displacement surpassed the threshold value, then control system can send the chimes of doom and suggestion doctor and patient, the doctor can refer to the deviation value of patient's target area position relative to treatment isocenter that monitors, carry out patient's tumour target area position through remote control treatment bed and correct, perhaps imbed the rectification procedure in the control system of treatment bed, make the treatment bed according to the deviation value of patient's target area relative to treatment isocenter that monitors automatically correct the compensation, make patient's tumour target area can be in treatment isocenter position in real time. If the displacement of the tumor target area of the patient exceeds the set threshold value and the position deviation of the tumor target area of the patient is not corrected in time within the time range which can be borne by the set dose rate of the normal tissue of the patient, the control system automatically cuts off the beam current, and the condition that the normal tissue of the patient receives excessive dose to induce new pathological changes is avoided.
Example three:
in the method for monitoring and correcting the patient guide positioning and target area displacement in real time provided by the embodiment, experimental verification for monitoring and correcting the patient guide positioning and the tumor target area position in real time and on line is performed on a deep treatment terminal of a HIRFL (Lanzhou heavy ion research device), and the invention is further described in detail by adopting a rubber phantom simulating a tumor patient. Specifically, the method comprises the following steps:
(1) erecting a double camera in a treatment room of the HIRFL deep treatment terminal, establishing a double camera close-range photogrammetry system, adjusting the erection posture and the angle of the double camera, and ensuring that the intersection visual field of the double camera can cover the whole moving range of the treatment couch; in order to verify the precision of guiding positioning, real-time monitoring and online correction of a double-camera close-range photogrammetric system, a laser tracker measuring target seat is adhered to the corner of a treatment couch and serves as a coordinate position monitoring point, and a laser tracker is erected near the treatment couch.
(2) The rubber phantom simulating a tumor patient is placed on a treatment bed of a deep treatment terminal, and the special RRT characteristic mark points are pasted on the tumor target area on the surface of the phantom (patient) to ensure that the characteristic mark points are uniformly distributed around the tumor target area to form a covering state for the tumor of the patient.
(3) Three-dimensional control network points which can be measured by a laser tracker and a double-camera close-range photogrammetry system are distributed around the treatment bed, the laser tracker is used for connecting the distributed new three-dimensional control network points with the overall control network points of the deep treatment terminal, and three-dimensional theoretical coordinates of the three-dimensional control network points relative to the treatment isocenter of the treatment room are established.
(4) The laser tracker is positioned at the treatment isocenter of a treatment room, the three-dimensional control network points distributed around the treatment couch are measured by using the measuring target balls of the 1.5-inch laser tracker, and the three-dimensional coordinates of the three-dimensional control network points newly distributed around the treatment couch relative to the treatment isocenter are established in a best fitting mode. The method comprises the steps of placing 1.5-inch steel target balls special for photogrammetry upwards on three-dimensional control net target seats newly distributed on the periphery of a treatment bed, measuring three-dimensional control network points on the periphery of the treatment bed by using a double-camera close-range photogrammetry system, and positioning the double-camera close-range photogrammetry system at a treatment isocenter of a deep treatment terminal by controlling orientation according to target data of the three-dimensional control network points measured by a laser tracker.
(5) The tumor target area (simulated tumor) of the phantom is placed to the position of the treatment isocenter by means of positioning laser of a deep treatment terminal, and the positioning of a simulation room of a patient is simulated.
(6) And measuring characteristic mark points of the tumor target area on the surface of the phantom by using a double-camera close-range photogrammetry system, and simulating the calibration of the tumor target area of the patient after the patient is positioned in a simulation room.
(7) The patient body model is randomly moved for a certain distance along the horizontal direction, the vertical direction and the longitudinal direction respectively through the displacement of the treatment bed in each axial direction through manual operation. The positional deviation of the patient relative to the isocenter treatment point prior to setup in the treatment room is simulated.
(8) Under the monitoring mode of the double-camera close-range photogrammetry system, the characteristic mark points of the patient tumor target area are measured in real time, the calibration data of the tumor target area is referred, the position deviation of the patient tumor target area relative to the treatment isocenter in each direction is calculated through the 6-degree-of-freedom parameter calculation of the position coordinates of the plurality of characteristic mark points, and all the deviation directions are visually displayed on a computer screen. According to the deviation of each direction displayed on the computer screen relative to the position of the treatment isocenter, the treatment bed is controlled to gradually move the phantom (patient) to the position of the treatment isocenter in the treatment room, and the process of guiding the patient to swing is simulated.
(9) After the patient is guided to be positioned by using the double-camera close-range photogrammetry system, a laser tracker is used for measuring a reference target seat (coordinate position monitoring point) on the treatment couch, the positioning of the patient is verified by comparing the deviation values of the initial calibration coordinate and the measurement position coordinate before the movement of the treatment couch, and the precision of guiding the patient to be positioned by using the double-camera close-range photogrammetry system is verified.
(10) After the positioning verification, a group of characteristic mark points attached to a target area on the body surface of a phantom (patient) is measured again by using a double-camera close-range photogrammetry system, the three-dimensional coordinates of each mark point are recorded in a control system, and calibration data of the tumor target area relative to a treatment isocenter point after the patient is positioned in a simulation room are simulated.
(11) After the simulation treatment starts, the characteristic mark points attached to the target area on the body surface of the patient are measured in real time through the double-camera close-range photogrammetry system, matching and resolving of image points and object points are carried out through matched software of the double-camera close-range photogrammetry system, the real-time offset of the tumor of the patient relative to the treatment isocenter is resolved by combining the displacement of tumor calibration data of the patient relative to the characteristic mark points through matched developed fitting software, and the offset values in all directions are visually displayed on a control computer screen in real time.
(12) The treatment bed is moved artificially and randomly, and the unconscious movement of the patient in the treatment process is simulated. The position deviation of the target area of the tumor displayed on a control computer screen is remotely controlled by the real-time monitoring system of the double cameras to move towards the reverse direction of the position deviation, so that the displacement deviation of the target area is corrected on line. After on-line correction, a laser tracker is used for measuring a coordinate position monitoring point on the treatment couch, and the accuracy of on-line monitoring and correction of the double cameras is verified by comparing the deviation value of the initial calibration coordinate before the movement of the treatment couch with the corrected coordinate.
3 a-3 b and 4 a-4 b, are screenshots of displays for guiding patient positioning and on-line monitoring and correction in an embodiment; fig. 5 shows the deviation of the coordinate values displayed by the dual-camera close-range photogrammetric system and the (coordinate position monitoring points) reset coordinate values measured by the laser tracker in each direction after the displacement of the phantom (patient) is monitored and corrected in real time by continuously repeating the above experimental verification for 15 times under the guidance of the dual-camera close-range photogrammetric system; the maximum deviation of the reset coordinates of the double-camera close-range photogrammetry system and the laser tracker is not more than 0.15mm, the standard deviation is about 0.07mm, and the precision can meet the requirement of the positioning precision of the patient in the radiotherapy process. Through multiple times of patient positioning simulation experiments, the method for guiding the positioning of the patient and monitoring and correcting the position of the target area of the tumor in real time can meet the requirements of practical application.
The above embodiments are only used for illustrating the present invention, and the structure, connection mode and the like of each component can be changed, and all equivalent changes and improvements made on the basis of the technical scheme of the present invention should not be excluded from the protection scope of the present invention.
Claims (8)
1. A method for real-time monitoring and online correction of patient-guided positioning and tumor target displacement is characterized by comprising the following steps:
1) a patient guiding positioning and target area displacement real-time monitoring and correcting system is set up in a simulation room and a treatment room of the heavy ion treatment device, and patient tumor target area calibration data under a treatment isocenter coordinate system are obtained in the simulation room;
in the step 1), the method for acquiring the calibration data of the target area of the tumor of the patient under the coordinate system of the treatment isocenter in the simulation room comprises the following steps:
1.1) respectively establishing a set of double-camera close-range photogrammetry system in a simulation room and a treatment room of the heavy ion treatment device;
1.2) laying a new three-dimensional control net around the treatment beds of the simulation room and the treatment room respectively, wherein the new three-dimensional control net comprises a plurality of three-dimensional control net target points which can be measured by using a laser tracker and a double-camera close-range photogrammetry system;
1.3) unifying a newly-arranged three-dimensional control network and a global control network of the heavy ion treatment device in a global coordinate system by using a laser tracker through a best fitting method, and establishing three-dimensional theoretical coordinates of target points of the newly-arranged three-dimensional control network relative to treatment isocenters of a simulation room and a treatment room;
1.4) sticking specially-made RRT coding mark points or RRT characteristic mark points on a tumor target area on the body surface of a patient, wherein the distribution principle is that the RRT coding mark points or RRT mark points with the number more than 3 uniformly cover the whole tumor target area of the patient;
1.5) in a simulation room, measuring three-dimensional control network target points arranged in a meeting visual field range around a treatment couch by adopting a double-camera close-range photogrammetry system, and carrying out control orientation of the double-camera close-range photogrammetry system in the simulation room so that the origin of a measurement coordinate system of the double-camera close-range photogrammetry system is positioned at a treatment isocenter of the simulation room;
1.6) referring to tumor image data of a patient, and performing simulated positioning on the patient by using a mobile DR device in a simulation room;
1.7) in a simulation room, using a double-camera close-range photogrammetry system to obtain calibration data of a tumor of a patient after simulated positioning relative to a treatment isocenter of the simulation room;
1.8) converting a coordinate system between the simulation room treatment isocenter and the treatment room treatment isocenter, converting the tumor target area calibration data of the patient under the simulation room treatment isocenter coordinate system into patient tumor calibration data under the treatment room treatment isocenter coordinate system, and storing the patient tumor calibration data in a computer control system according to the ID of the patient;
2) guiding the patient to carry out positioning and carrying out positioning verification according to the acquired patient tumor target area calibration data under the isocenter coordinate system of the treatment room;
3) the displacement of the target area of the tumor of the patient is monitored in real time, and the position of the target area of the tumor of the patient is corrected on line according to the real-time monitoring result of the displacement of the target area of the tumor of the patient and a preset threshold value.
2. The method of claim 1, wherein the real-time monitoring and online correction of patient-guided positioning and tumor target displacement comprises: in the step 1.1), the method for respectively establishing a set of two-camera close-range photogrammetry system in the simulation room and the treatment room of the heavy ion treatment device comprises the following steps: the double cameras are arranged at the tops of the treatment beds of the simulation room and the treatment room, and the erection posture and the angle of the double cameras are adjusted, so that the intersection visual field of the double cameras completely covers the whole moving range of the treatment bed.
3. The method of claim 1, wherein the real-time monitoring and online correction of patient-guided positioning and tumor target displacement comprises: in the step 1.4), the sticking surfaces of the RRT coding mark points and the RRT characteristic mark points are all environment-friendly adhesive glue which does not harm human skin, and the RRT coding mark points are 30mm x 30mm in size and the RRT characteristic mark points are 8mm x 8mm in size.
4. The method of claim 1, wherein the real-time monitoring and online correction of patient-guided positioning and tumor target displacement comprises: in the step 1.7), the method for acquiring the calibration data of the tumor target area of the patient by using the dual-camera close-range photogrammetry system comprises the following steps: and respectively measuring the characteristic mark point data of the tumor target region when the patient inhales and exhales in the free breathing state after being positioned for multiple times, and taking the average value of the multiple measurements as the tumor calibration data of the patient in the inhaling and exhaling states.
5. The method of claim 1, wherein the real-time monitoring and online correction of patient-guided positioning and tumor target displacement comprises: in the step 2), the method for guiding the patient to perform positioning and performing positioning verification comprises the following steps:
2.1) in the treatment room, using a double-camera close-range photogrammetry system to measure three-dimensional control network target points arranged in the intersection visual field range around the treatment couch, and carrying out control orientation of the double-camera close-range photogrammetry system in the treatment room, so that the origin of a measurement coordinate system of the double-camera close-range photogrammetry system is positioned at the treatment isocenter of the treatment room;
2.2) measuring the characteristic mark point data of the patient tumor target area in real time through a double-camera close-range photogrammetry system, converting the characteristic mark point data into the three-dimensional coordinate position deviation of the patient tumor target area relative to the treatment isocenter, and sending the three-dimensional coordinate position deviation to a control system and a display screen, so that a doctor can guide a patient to be positioned according to the actual position of the patient tumor on the display screen and the deviation of the treatment isocenter;
and 2.3) after guiding the patient to finish the positioning, performing positioning verification by using the DR of the treatment room, continuing the next treatment if the verification is passed, and otherwise, returning to the step 2.2) to adjust the positioning of the patient.
6. The method of claim 1, wherein the real-time monitoring and online correction of patient-guided positioning and tumor target displacement comprises: in the step 3), the method for monitoring and correcting the displacement of the target area in real time comprises the following steps:
3.1) monitoring the displacement information of the tumor target area of the patient in real time by using a double-camera close-range photogrammetry system, and displaying the displacement information on display screens of a treatment room and a control system in real time;
3.2) the control system judges whether the position of the tumor target area of the patient needs to be corrected or not according to the received displacement information of the tumor target area of the patient and a preset threshold, if the displacement of the tumor target area of the patient exceeds the preset threshold, the control system sends an alarm signal and corrects the tumor target area within preset time, if the correction is not completed within the preset time, the control system automatically cuts off the beam, and if the displacement of the tumor target area of the patient does not exceed the preset threshold, the control system returns to the step 3.1) to continuously monitor the displacement information of the tumor target area of the patient; the preset threshold value refers to the allowable moving range of the target region of the tumor of the patient, which is determined according to the size and the position of the tumor of the patient.
7. The method of claim 6, wherein the real-time monitoring and online correction of the patient-guided positioning and tumor target displacement comprises: in the step 3.2), the method for correcting the tumor target area comprises the following steps: a doctor refers to the monitored deviation value of the target area position of the patient relative to the treatment isocenter, and corrects the target area position of the tumor of the patient through remote control of the treatment couch, or a correction program is embedded into a control system of the treatment couch, so that the treatment couch automatically corrects and compensates according to the monitored deviation value of the tumor of the patient relative to the treatment isocenter, and the tumor of the patient can be located at the treatment isocenter in real time.
8. A system for real-time monitoring and online correction of patient-guided positioning and tumor target displacement, which is suitable for the method according to any one of claims 1 to 7, comprising: the device comprises a close-range photogrammetry system with two double cameras, a control system and a display screen;
the two double-camera close-range photogrammetry systems are respectively arranged at the top of a simulation room of the heavy ion treatment device and a treatment room treatment couch, and the first double-camera close-range photogrammetry system is used for collecting the position of a tumor target area of a patient on the treatment couch and the positions of three-dimensional control mesh points arranged around the treatment couch;
the control system is arranged in the control hall and used for calibrating a patient tumor target area according to the position of the patient tumor target area and the position data of the three-dimensional control network point, which are acquired by the first double-camera close-range photogrammetry system and the laser tracker in the simulation room, converting the patient tumor target area into patient tumor target area calibration data in the treatment room, guiding the patient to be positioned according to the patient tumor target area calibration data and the real-time tumor target area position of the patient, which is acquired by the second double-camera close-range photogrammetry system, in the ion radiotherapy process, and correcting when the displacement of the tumor target area exceeds a preset threshold value; wherein, when obtaining the calibration data of the target area of the tumor of the patient in the treatment room: respectively establishing a set of double-camera close-range photogrammetric system in a simulation room and a treatment room of the heavy ion treatment device; new three-dimensional control nets are respectively arranged around the treatment beds of the simulation room and the treatment room, and each new three-dimensional control net comprises a plurality of three-dimensional control net target points which can be measured by using a laser tracker and a double-camera close-range photogrammetry system; unifying a newly-arranged three-dimensional control network and a global control network of the heavy ion treatment device in a global coordinate system by using a laser tracker through a best fitting method, and establishing three-dimensional theoretical coordinates of target points of the newly-arranged three-dimensional control network relative to treatment isocenters of a simulation room and a treatment room; sticking special RRT coding mark points or RRT characteristic mark points on the tumor target area on the body surface of the patient, wherein the distribution principle is that the RRT coding mark points or RRT mark points with the number more than 3 uniformly cover the whole tumor target area of the patient; in the simulation room, a double-camera close-range photogrammetry system is adopted to measure three-dimensional control network target points arranged in a meeting visual field range around the treatment couch, and the control orientation of the double-camera close-range photogrammetry system in the simulation room is carried out, so that the origin of a measurement coordinate system of the double-camera close-range photogrammetry system is positioned at the treatment isocenter of the simulation room; referring to tumor image data of a patient, and performing simulated positioning on the patient by using a mobile DR device in a simulation room; in the simulation room, a double-camera close-range photogrammetry system is used for acquiring calibration data of the tumor of the patient after the simulated positioning relative to the treatment isocenter of the simulation room; converting a coordinate system between the simulation room treatment isocenter and the treatment room treatment isocenter, converting the tumor target area calibration data of the patient under the simulation room treatment isocenter coordinate system into patient tumor calibration data under the treatment room treatment isocenter coordinate system, and storing the patient tumor calibration data in a computer control system according to the ID of the patient;
the display screens are respectively arranged in the treatment room and the control hall and are used for displaying the position of the target area of the tumor of the patient acquired by the second double-camera close-range photogrammetry system in real time and guiding a doctor to carry out on-line correction of position deviation in the process of ion radiotherapy.
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