CN117205451A - Three-dimensional image guided radiotherapy system based on operation, application and medium - Google Patents
Three-dimensional image guided radiotherapy system based on operation, application and medium Download PDFInfo
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- CN117205451A CN117205451A CN202310509772.7A CN202310509772A CN117205451A CN 117205451 A CN117205451 A CN 117205451A CN 202310509772 A CN202310509772 A CN 202310509772A CN 117205451 A CN117205451 A CN 117205451A
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- 238000001959 radiotherapy Methods 0.000 title claims abstract description 31
- 206010028980 Neoplasm Diseases 0.000 claims abstract description 6
- 238000000034 method Methods 0.000 claims description 16
- 238000004458 analytical method Methods 0.000 claims description 13
- 238000002722 intraoperative radiotherapy Methods 0.000 claims description 11
- 238000005286 illumination Methods 0.000 claims description 9
- 238000004590 computer program Methods 0.000 claims description 5
- RTAQQCXQSZGOHL-UHFFFAOYSA-N Titanium Chemical compound [Ti] RTAQQCXQSZGOHL-UHFFFAOYSA-N 0.000 claims description 4
- 238000004364 calculation method Methods 0.000 claims description 4
- 239000010936 titanium Substances 0.000 claims description 4
- 229910052719 titanium Inorganic materials 0.000 claims description 4
- 238000004422 calculation algorithm Methods 0.000 claims description 3
- 238000012937 correction Methods 0.000 claims description 3
- 238000011156 evaluation Methods 0.000 claims description 3
- 238000013507 mapping Methods 0.000 claims description 3
- 238000001356 surgical procedure Methods 0.000 claims description 3
- 125000006850 spacer group Chemical group 0.000 claims 5
- 230000005855 radiation Effects 0.000 abstract description 4
- 230000009286 beneficial effect Effects 0.000 abstract description 2
- 230000000694 effects Effects 0.000 description 5
- 230000002980 postoperative effect Effects 0.000 description 5
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- 238000013461 design Methods 0.000 description 2
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- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 2
- 206010061902 Pancreatic neoplasm Diseases 0.000 description 1
- 230000006978 adaptation Effects 0.000 description 1
- 238000002725 brachytherapy Methods 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 230000003631 expected effect Effects 0.000 description 1
- 238000002786 image-guided radiation therapy Methods 0.000 description 1
- 230000001678 irradiating effect Effects 0.000 description 1
- 230000004807 localization Effects 0.000 description 1
- 208000015486 malignant pancreatic neoplasm Diseases 0.000 description 1
- 229910052751 metal Inorganic materials 0.000 description 1
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- 238000010827 pathological analysis Methods 0.000 description 1
- 239000013589 supplement Substances 0.000 description 1
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Abstract
The application provides an intraoperative radiation treatment system based on intraoperative three-dimensional image guidance, application and medium, wherein the treatment system comprises an operation treatment bed and a three-dimensional image acquisition device, wherein the operation treatment bed and the three-dimensional image acquisition device are electrically connected with each other; the source irradiation mechanism is used for short-distance tumor irradiation in operation; the light source irradiation mechanism comprises an illuminator, a low-density locating plate matched with the illuminator and a central control mechanism. The application has the beneficial effects that: the system adopts the low-density locating plate matched with the illuminator, thereby effectively eliminating the artifacts in the image and improving the influence quality. The three-dimensional image acquisition device is matched to acquire the three-dimensional image, so that the accurate three-dimensional irradiation dose of the interested position in the target area can be rapidly estimated and calculated, and a theoretical basis is provided for rapidly formulating, evaluating and confirming the radiotherapy scheme.
Description
Technical Field
The application belongs to the technical field of brachytherapy, and particularly relates to a three-dimensional image guided radiotherapy system, application and medium based on operation.
Background
Radiotherapy is one of the main modes of tumor treatment, and intraoperative radiotherapy (Intraoperative Radiation Therapy, IORT) is a comprehensive treatment mode integrating rapid intraoperative pathological diagnosis, treatment, obstruction relief, pain relief and the like, and has the advantages of being accurate, effective, immediate, safe, convenient and the like. However, even experienced doctors, when encountering many vital organs (such as pancreatic cancer) near the target area, the 3D dose distribution cannot be obtained, and the choices of the size of the illuminator and the size of the prescription dose tend to be conservative, which may lead to insufficient dose at the target area and further affect the effect of radiotherapy during operation.
The IORT has the defects that the single irradiation cannot give radical cure dose, the irradiation range is not complete, the dose is not uniform, and the like, and sometimes the expected effect cannot be achieved, and the better treatment effect can be achieved only by matching with the postoperative (external irradiation) radiotherapy supplement. Due to the lack of 3D images and dose distribution information in the operation, IORT dose distribution cannot be overlapped in the design of a postoperative radiotherapy plan, so that the dose range and the dose size cannot be accurately judged. This may result in insufficient target area dose or significant organ dose exceeding a limit value, affecting the effect of post-operative radiation therapy. The mobile IORT accelerator only solves the problem of convenient surgery, but the condition that IORT has no image-guided localization and 3D treatment planning design has not been changed yet, and still has no intraoperative 3D image and dose distribution information. When acquiring intra-operative images, the current positioning device can cause great artifacts to influence the image quality; and the method for setting the IORT parameters only by naked eye observation and experience has larger quality and potential safety hazards, and cannot superimpose the 3D dose distribution of the postoperative radiotherapy plan and influence the postoperative radiotherapy effect. These are all serious restrictions on the popularization and application of IORT, and are the problems which need to be solved urgently at present.
Disclosure of Invention
In order to overcome the defects of the prior art, the application aims to provide a radiation therapy system guided by three-dimensional images in operation, application and medium thereof, so as to overcome the defect that the radiation therapy effect is finally affected due to inaccurate monitoring of dose distribution in the current radiation therapy.
The application adopts the following technical scheme:
an intraoperative three-dimensional image-based guided radiation therapy system comprises a plurality of medical devices which are electrically connected with each other,
a surgical treatment bed;
the three-dimensional image acquisition device is used for acquiring three-dimensional images of tissues and carrying out calculation and evaluation on target position positioning and intraoperative planning radiotherapy dosage;
the source irradiation mechanism is used for short-distance tumor irradiation; the illumination source irradiation mechanism comprises an illuminator and a low-density locating plate matched with the illuminator; the density of the locating sheet is 0.5-1.3 g/cm 3 ；
The central control mechanism comprises an image display module, a storage module, a main control module and an analysis module and is used for planning and evaluating the dosage of the intraoperative radiotherapy scheme according to the acquired intraoperative three-dimensional image.
Preferably, the three-dimensional image acquisition device is a mobile C-arm CT or an O-shaped CT.
Preferably, the method is based on the use of the intra-operative three-dimensional image-guided radiation therapy system in radiation therapy.
Preferably, the application method described above comprises the following steps:
s1, performing position identification of a target position region of interest;
s2, fixing the positioning sheet according to a pre-irradiation plan;
s3, performing image acquisition of a three-dimensional image of the target position through a three-dimensional image acquisition device, and transmitting acquired image information to a central control mechanism;
s4, carrying out identification analysis on the positioning sheet and the region-of-interest region position identification on the image acquired in the S3, selecting corresponding illuminators and corresponding dose models in the system according to the identified positioning sheet parameters, loading the irradiation centers and the irradiation directions of the illuminators based on the positions and the directions of the positioning sheets, and setting default irradiation time to form an intraoperative radiotherapy planning scheme;
s5, calculating a three-dimensional dose distribution area based on a three-dimensional image according to the intraoperative radiotherapy planning scheme, and displaying the three-dimensional dose distribution area in a superposition manner;
s6, evaluating and calculating a dose statistic value corresponding to the position mark of the region of interest by combining the three-dimensional dose distribution region in the S5;
s7, if the three-dimensional dose distribution in S5 or the dose statistic value of the interested region in S6 is evaluated to not meet the requirement of the planning target of the scheme, readjusting the illumination parameters in the scheme, and then turning to S5; if the plan target requirements of the plan are met, outputting the plan for reference by clinical treatment, wherein the irradiation parameters comprise an illuminator model, a Shi Zhao center, an irradiation direction and irradiation time.
Preferably, the location identifier of the region of interest in S1 is a titanium clip identifier.
Preferably, the identification analysis of the locating plate in S4 includes a size, a direction and a position of the locating plate.
Preferably, the tile identification analysis can automatically identify from the three-dimensional image based on customized tile known features including tile density, shape, and mark points.
Preferably, the calculating in S5 is based on the three-dimensional dose distribution under the three-dimensional image, and may be performed by directly mapping the in-water dose distribution model corresponding to the illuminator on the three-dimensional image without considering the tissue non-uniformity dose correction or by using a Monte Carlo in-operative treatment dose distribution simulation algorithm.
Preferably, the dose statistics corresponding to the region of interest in S6 include a maximum dose, a minimum dose, an average dose, a dose conformality index, and a dose volume histogram in the region of interest.
A computer readable storage medium having stored thereon a computer program for execution by a processor of a method of applying a three-dimensional image-based intraoperative radiation therapy system as defined in any one of the above in radiation therapy.
Compared with the prior art, the application has the beneficial effects that: the system adopts the low-density locating plate matched with the illuminator, thereby effectively eliminating the artifacts in the image and improving the image quality. The three-dimensional image acquisition device is matched to acquire the three-dimensional image, so that the accurate irradiation dose of the interested position in the target area can be rapidly estimated and calculated, and a theoretical basis is provided for the follow-up establishment of a radiotherapy scheme.
The foregoing description is only an overview of the present application, and is intended to provide a better understanding of the present application, as it is embodied in the following description, with reference to the preferred embodiments of the present application and the accompanying drawings. Specific embodiments of the present application are given in detail by the following examples and the accompanying drawings.
Drawings
The accompanying drawings, which are included to provide a further understanding of the application and are incorporated in and constitute a part of this specification, illustrate embodiments of the application and together with the description serve to explain the application and do not constitute a limitation on the application.
FIG. 1 is a flow chart of an application method of the present application;
description of the embodiments
The present application will be further described with reference to the accompanying drawings and detailed description, wherein it is to be understood that, on the premise of no conflict, the following embodiments or technical features may be arbitrarily combined to form new embodiments.
A radiation guiding treatment system based on three-dimensional images in operation comprises operation treatment beds electrically connected with each other; the device comprises a three-dimensional image acquisition device, a source applying and irradiating mechanism and a central control mechanism.
The three-dimensional image acquisition device is used for acquiring three-dimensional images of tissues and carrying out target position location and calculation and evaluation of planned radiotherapy dosage in operation; the three-dimensional image acquisition device can be a mobile C-arm CT or a cone beam CT or an O-shaped CT, or other three-dimensional image acquisition devices.
The source irradiation mechanism is used for tumor irradiation at a short distance in an operation; the illumination source irradiation mechanism comprises an illuminator and a low-density locating plate matched with the illuminator; in this embodiment, the low-density positioning sheet refers to an improvement made to avoid metal artifacts caused by the current positioning sheet, so as to improve the quality of the image, and the low-density range refers to a density range of 0.5-1.3 g/cm 3 Is provided.
The central control mechanism is used for planning an intraoperative treatment plan, evaluating the dosage and confirming the plan according to the acquired intraoperative three-dimensional image and comprises an image display module, a storage module, a main control module and an analysis module which are electrically connected with each other. The image display module can be a display, and the storage module, the main control module and the analysis module are integrated in a computer.
The application also discloses application of the radiation guiding treatment system based on the intraoperative three-dimensional image in radiation treatment. The specific application method comprises the following steps:
s1, performing position identification of a target position region of interest; and the position mark of the region of interest in the S1 is a titanium clamp mark.
S2, fixing the positioning sheet according to a pre-irradiation plan;
s3, performing image acquisition of a three-dimensional image of the target position through a three-dimensional image acquisition device, and transmitting acquired image information to a central control mechanism;
s4, carrying out identification analysis on the positioning sheet and the region-of-interest region position identification on the image acquired in the S3, selecting corresponding illuminators and corresponding dose models in the system according to the identified positioning sheet parameters, loading the irradiation centers and the irradiation directions of the illuminators based on the positions and the directions of the positioning sheets, setting default irradiation time, and forming an intraoperative radiotherapy planning scheme. The selection of the illuminator is meant to include the selection of the type of illuminator required, the center of Shi Zhao, the direction of illumination, etc. The system has integrated therein virtual models of each model of applicator, and for each model of applicator a corresponding physical model of dose distribution is established to facilitate selection of applicators.
And the identification analysis of the locating plate in the S4 comprises the size, the direction, the position and the outline of the locating plate. The identification analysis method of the locating sheet can automatically identify the locating sheet from the three-dimensional image according to the known characteristics (density, shape, mark points and the like) of the customized locating sheet.
S5, calculating a three-dimensional dose distribution area based on a three-dimensional image according to the intraoperative radiotherapy planning scheme, and displaying the three-dimensional dose distribution area in a superposition manner; the three-dimensional dose distribution area can be calculated by directly mapping an in-water dose distribution model corresponding to the illuminator on a three-dimensional image without considering tissue non-uniformity dose correction; the calculation can also be performed by using a simulation algorithm of the dose distribution of the radiotherapy in Monte Carlo operation.
And S6, combining the three-dimensional dose distribution area in the step S5, and calculating a dose statistic value corresponding to the position mark of the region of interest, wherein the dose statistic value comprises the maximum dose, the minimum dose, the average dose, the dose conformality index, the dose volume histogram and the like in the region of interest.
If the three-dimensional dose distribution in S5 or the dose statistic value of the interested region in S6 is evaluated to not meet the requirement of the planning target of the scheme, readjusting the illumination parameters (such as the type of the illuminator, the Shi Zhao center, the illumination direction, the illumination time and the like) in the scheme, and then turning to S5; if the plan goal requirements of the plan are met, the plan is output for reference to the clinical treatment.
For a better understanding of the method of calculating the three-dimensional dose, a flat applicator will be described below as an example, and the physical model D (D, r) corresponding to the flat applicator takes the center of the end face of the flat applicator as the origin, and the depth direction is from the origin to the outside perpendicular to the end face of the applicator, and the radial direction is from the perpendicular to the center axis to the outside. After the system obtains the image, the positioning sheet is automatically identified according to the three-dimensional model, and the interesting points (Points of Interest, POIs) corresponding to the titanium clips are automatically identified through a threshold method. And then, taking the center of the side, which is close to the tumor bed, of the positioning sheet identified in the image as the center of the end face of the flat-panel applicator, taking the direction perpendicular to the plane of the positioning sheet as the application direction of the flat-panel applicator, automatically reconstructing an applicator virtual model corresponding to the positioning sheet, loading the corresponding dose distribution physical model into a three-dimensional image, displaying in a mode of isodose lines and dose cloud pictures, and simultaneously displaying in a numerical mode the dose value corresponding to the statistical POIs. At this time, the absolute value of the dose distribution corresponding to the whole irradiation area and POIs and the dose statistics value (the maximum dose value, the average dose value in the appointed irradiation depth range and the like) in the irradiation area can be obtained in real time by adjusting the prescription dose value, so that a clinician can conveniently determine the final prescription dose plan after sequentially evaluating.
The application also discloses a computer readable storage medium, on which a computer program is stored, which computer program is executed by a processor for the application method of the radiation therapy system in radiotherapy based on three-dimensional image operation as described in any one of the above.
The above is only a preferred embodiment of the present application, and is not intended to limit the present application in any way; those skilled in the art can smoothly practice the application as shown in the drawings and described above; however, those skilled in the art will appreciate that many modifications, adaptations, and variations of the present application are possible in light of the above teachings without departing from the scope of the application; meanwhile, any equivalent changes, modifications and evolution of the above embodiments according to the essential technology of the present application still fall within the scope of the present application.
Claims (10)
1. An intraoperative three-dimensional image-based guided radiation therapy system, characterized in that: comprises a plurality of connecting plates which are electrically connected with each other,
a surgical treatment bed;
the three-dimensional image acquisition device is used for acquiring three-dimensional images of tissues and carrying out calculation and evaluation on target position positioning and intraoperative planning radiotherapy dosage;
the source irradiation mechanism is used for short-distance tumor irradiation; the illumination source irradiation mechanism comprises an illuminator and a low-density locating plate matched with the illuminator; the density of the locating sheet is 0.5-1.3 g/cm 3 ；
The central control mechanism comprises an image display module, a storage module, a main control module and an analysis module and is used for planning and evaluating the dosage of the intraoperative radiotherapy scheme according to the acquired intraoperative three-dimensional image.
2. An intraoperative three-dimensional image-based guided radiation therapy system as set forth in claim 1 wherein: the three-dimensional image acquisition device is a movable C-shaped arm CT or an O-shaped CT.
3. Use of an intra-operative three-dimensional image-based guided radiation therapy system as claimed in claim 1 in radiation therapy.
4. A method of use as claimed in claim 3, comprising the steps of:
s1, performing position identification of a target position region of interest;
s2, fixing the positioning sheet according to a pre-irradiation plan;
s3, performing image acquisition of a three-dimensional image of the target position through a three-dimensional image acquisition device, and transmitting acquired image information to a central control mechanism;
s4, carrying out identification analysis on the positioning sheet and the region-of-interest region position identification on the image acquired in the S3, selecting corresponding illuminators and corresponding dose models in the system according to the identified positioning sheet parameters, loading the irradiation centers and the irradiation directions of the illuminators based on the positions and the directions of the positioning sheets, and setting default irradiation time to form an intraoperative radiotherapy planning scheme;
s5, calculating a three-dimensional dose distribution area based on a three-dimensional image according to the intraoperative radiotherapy planning scheme, and displaying the three-dimensional dose distribution area in a superposition manner;
s6, evaluating and calculating a dose statistic value corresponding to the position mark of the region of interest by combining the three-dimensional dose distribution region in the S5;
s7, if the three-dimensional dose distribution in S5 or the dose statistic value of the interested region in S6 is evaluated to not meet the requirement of the planning target of the scheme, readjusting the illumination parameters in the scheme, and then turning to S5; if the plan target requirements of the plan are met, outputting the plan for reference by clinical treatment, wherein the irradiation parameters comprise an illuminator model, a Shi Zhao center, an irradiation direction and irradiation time.
5. The application method according to claim 4, wherein: and the position mark of the region of interest in the S1 is a titanium clamp mark.
6. The application method according to claim 4, wherein: and the identification analysis of the locating plate in the S4 comprises the size, the direction and the position of the locating plate.
7. The application method according to claim 6, wherein: the spacer identification analysis can automatically identify the spacer from the three-dimensional image according to the customized spacer known characteristics, wherein the spacer known characteristics comprise spacer density, shape and mark points.
8. The application method according to claim 4, wherein: and S5, calculating the three-dimensional dose distribution based on the three-dimensional image, wherein the three-dimensional dose distribution can be calculated by directly mapping an underwater dose distribution model corresponding to the illuminator on the three-dimensional image without considering tissue non-uniformity dose correction or by adopting a Monte Carlo intraoperative radiotherapy dose distribution simulation algorithm.
9. The application method according to claim 4, wherein: and the dose statistic value corresponding to the region of interest in the S6 comprises a maximum dose, a minimum dose, an average dose, a dose conformality index and a dose volume histogram in the region of interest.
10. A computer-readable storage medium having stored thereon a computer program, characterized by: the computer program is executed by a processor to perform the method of using a three-dimensional image-based intraoperative radiotherapy system as claimed in any one of claims 4 to 9 in radiotherapy.
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| Application Number | Priority Date | Filing Date | Title |
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| CN202310509772.7A CN117205451A (en) | 2023-05-08 | 2023-05-08 | Three-dimensional image guided radiotherapy system based on operation, application and medium |
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| CN202310509772.7A CN117205451A (en) | 2023-05-08 | 2023-05-08 | Three-dimensional image guided radiotherapy system based on operation, application and medium |
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| CN117205451A true CN117205451A (en) | 2023-12-12 |
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