JP4514438B2 - Treatment device control system - Google Patents

Description

  The present invention relates to a treatment control system using a medical image diagnostic apparatus such as an MRI apparatus or an X-ray CT apparatus, and more particularly to a treatment control system used in combination with a treatment apparatus such as thermotherapy or cryotherapy.

  There is a real-time dynamic imaging method called fluoroscopy as an imaging method using a medical image diagnostic apparatus such as an MRI apparatus or an X-ray apparatus, and its clinical application is being promoted. Fluoroscopy has heretofore been realized by fluoroscopic imaging using an X-ray apparatus, but has recently been put into practical use with the development of high-speed imaging methods for MRI apparatuses. Such fluoroscopy, combined with the development of an open type MRI apparatus, enables interventional MRI (IMRI) for performing surgery and treatment while taking a monitor image with an image diagnostic apparatus. Specific uses of fluoroscopy in IMRI include monitoring when guiding puncture needles and catheters, thermotherapy (hyperthermia treatment) that kills tumor cells by irradiating them with electromagnetic waves and infrared rays, and cryosurgery (cryotherapy). ) Has been confirmed, and imaging techniques for this have been proposed.

For example, Patent Document 1 discloses a technique for imaging a temperature change by MRI in thermotherapy, and Patent Document 2 discloses a technique for sequentially displaying temperature information together with form MR images during the thermotherapy. Further, Non-Patent Document 1, Non-Patent Document 2, and the like have reported attempts at imaging frozen regions by MRI and CT in cryosurgery.
As described above, X-ray, CT, ultrasonic diagnostic apparatus (US), MRI, etc. are used to depict the heat / freezing region in heat / freezing treatment, but in particular, MRI provides a sharp surface line in cryotherapy, It is used because of its excellent ability to draw ice.
Japanese Patent Publication No. 6-14911 JP 2001-357362 A `` Imaging of Interstitial Cryotherapy-An in Vitro Comparison of Ultrasound, Computed Tomography, and Magnetic Resonance Imaging '' Josef Tacke, et al, Cryobiology 38, 250-259 (1999) "Sequential study after Cryosurgery by MRI / CT I" Haruo Hamada, Journal of Japan Medical Association: 49 (9), 1096-1101 (1989)

  On the other hand, various types of cryotherapy and thermotherapy devices have been developed in consideration of combined use with an MRI apparatus. As a cryotherapy device, for example, an MRI-compatible medical cryotherapy device using the Joule-Thompson effect and combining argon gas for freezing with high pressure gas and helium gas for thawing has been developed, mainly liver cancer, kidney cancer, uterus It is used to treat myomas. In thermotherapy, an RF thermocoagulation device has been developed that includes an RF wave generator, a puncture electrode that derives an RF wave and communicates it with the living body, and a counter electrode that collects current from the living body. This device performs so-called BME (Biomedical Engineering) treatment that generates Joule heat and dielectric heating due to tissue impedance by RF alternating current to generate heat in the tissue itself and coagulate and denature biological proteins. It is attracting attention as having an effect.

In general, in heat / freezing treatment, it is required to surely treat without leaving a lesion in order to prevent recurrence, and to prevent side effects due to overheating and overfreezing. However, since the frozen region is usually a low signal region in an MRI image, the position and shape of the lesion cannot be drawn, it is difficult to grasp the positional relationship, and the lesion can be heated or frozen to a desired temperature without excess or deficiency. Have difficulty.
In MRI, a temperature distribution image can be obtained. By displaying this simultaneously with a morphological image, it is possible to know the progress of thermotherapy or cryotherapy. There is a problem that it is necessary to always perform monitoring, and the burden on the user is heavy.

  Accordingly, an object of the present invention is to enable an appropriate treatment using a monitor image and reduce a burden on a user in a heat / freezing treatment using an image diagnostic apparatus such as an MRI apparatus.

  In order to solve the above problems, the present invention provides a treatment control system that combines a thermal / freezing treatment apparatus and an image diagnostic apparatus. That is, the treatment control system of the present invention comprises a thermal or cryotherapy apparatus comprising a probe that is punctured into a lesion part of a living body, and a drive unit that drives and controls heating or freezing of the lesion part via the probe, An image diagnostic apparatus including an imaging unit that continuously captures images of a biological lesion and a display unit that displays the image, and a difference between a pretreatment image captured by the image diagnostic apparatus and an image during treatment that is continuously captured An arithmetic unit is provided that determines the progress of treatment based on the image and displays the result.

In one aspect of the treatment control system of the present invention, the computing device calculates the distance between the outer edge of the lesion and the outer edge of the treatment area based on the difference image, and determines the treatment progress state based on the distance.
In a preferred aspect of the treatment control system of the present invention, the arithmetic device feeds back information on the progress of treatment to the treatment device, and controls the drive unit of the treatment device according to the progress.

In the treatment control system of the present invention, the computing device may be configured as a unit independent of the therapy device and the image diagnostic device, or may be configured as a part of either.
In one aspect of the present invention, the diagnostic imaging apparatus is a magnetic resonance imaging apparatus, and the imaging unit captures continuous images by fluoroscopy imaging.

  According to the present invention, it is possible to clearly grasp the relationship between a lesion and a treatment area by using a difference image between a pre-treatment image photographed by the photographing means and a continuously-treated image, and thereby treatment is performed. Information on the progress of the disease is calculated, so the user can easily determine whether to continue or end the treatment based on the results, and prevent the recurrence of the lesion due to insufficient treatment or the occurrence of side effects due to overtreatment. it can. According to a preferred aspect of the present invention, human error can be reduced by feeding back the result determined by the arithmetic device to the treatment device and controlling the treatment device.

Hereinafter, embodiments of the treatment control system of the present invention will be described.
FIG. 1 is a diagram showing an outline of a treatment control system of the present invention.
This treatment control system includes an image diagnostic apparatus 10 capable of creating a real-time image (monitor image) of a patient such as an X-ray apparatus, a CT apparatus, and an MRI apparatus, and a treatment apparatus 20 such as a thermal treatment apparatus and a cryotherapy apparatus. And a computing device 30 that controls the treatment device 20 based on the monitor image obtained by the diagnostic imaging device 10. In the figure, the calculation device 30 is provided separately from the image diagnosis device 10 and the treatment device 20, but the control unit provided in the image diagnosis device 10 or the treatment device 20 has the function of the calculation device 30. You may also serve.

  In this treatment control system, as will be described in detail later, the thermal region or the frozen region is monitored based on the monitor image reconstructed by the diagnostic imaging apparatus 10, and the region where the lesion to be treated is reliably covered To the user. At the same time, the operation of the treatment apparatus can be automatically stopped.

An overall configuration of a cryotherapy apparatus as an example of the treatment apparatus 20 is shown in FIG. This cryotherapy apparatus is an MR-compatible cryotherapy device that can be frozen and thawed using the Joule-Thompson effect. A probe 220 and an operation unit 230 for operating the drive unit 210. The driving unit 210 includes a gas cylinder 211 filled with a frozen gas, a gas cylinder 212 filled with a thawing gas, supply pipes 213 and 214 connected to the gas cylinders 211 and 212, and a path of the supply pipes 213 and 214. Valves 215 and 216 provided respectively are provided.
For example, argon gas is used as the freezing gas, and helium gas is used as the thawing gas, for example. The probe 220 has a two-chamber structure, and includes a hose 221 connected to each of the freezing gas and the thawing gas cylinders 211 and 212, a heat exchanger 222 for cooling the gas sent through the hose 221, and a heat exchanger 222. And a connected nozzle 223.

  In the operation unit 230, in addition to the operation button 231 such as a start button and a stop button for sending the injection / stop command of the frozen gas / thawing gas to the drive unit 210, numerical values such as the treatment time, the number of treatments, and the interval are set. For example, a numerical input unit 232 and means 233 for notifying the end of treatment, for example, an alarm lamp, an alarm buzzer, an alarm display unit, and the like are provided.

  In this cryotherapy apparatus, when treatment is started by pressing the start button 231, the valve 215 is opened, and a high-pressure (24 to 27 MPa) frozen gas is injected. The high-pressure frozen gas ejected from the nozzle 223 at the tip of the probe 220 is cooled by the Joule-Thomson effect, cools the frozen gas in the outward path while passing through the heat exchanger 211 (return path), and releases it to the atmosphere through the hose 221 Is done. Due to this double cooling, when the frozen gas is ejected into the small chamber at the tip of the nozzle 223, the tip of the probe becomes, for example, a low temperature of -185 ° C. When the treatment by freezing is completed and the freeze gas stop button 232 is pressed, high-pressure defrost gas (17 to 27 MPa) is injected into the small chamber for a certain period of time. As a result, the temperature rises and the frozen tissue can be thawed. The size of the probe tip is about 2 cm, and the number of probes can be increased or decreased according to the size of the lesion.

  Note that the cryotherapy may be performed not only in a single operation but also repeatedly in freeze / thaw multiple times at predetermined intervals. In this treatment apparatus, it is possible to set the number of treatments and the interval when performing the treatment a plurality of times, in addition to the treatment time as a whole, via the numerical value input unit 232 described above.

  In the treatment control system of the present invention, in addition to the control by the operation button of the control unit 210 of the treatment apparatus described above, information related to the end of treatment is sent from the arithmetic unit 30. Therefore, the arithmetic unit 30 scans the image of the diagnostic imaging apparatus 10 and determines the outer edge of the thermal / frozen area and the outer edge of the lesion, and sets the distance between the outer edge of the thermal / frozen area and the outer edge of the lesion. And a calculation unit 32 that determines that the treatment is completed when the distances at all the positions are within a predetermined range, and sends a notification signal to the treatment device 20. The calculation unit 32 can calculate time information such as the treatment elapsed time and the remaining treatment time, and additional image information such as the diameter of the treatment area, in addition to the above-described distance calculation and treatment progress state determination.

  When a notification signal is sent from the computing unit 32 to the treatment device 20, for example, a notification lamp is turned on to notify the user of the end of treatment. Thus, the user finishes the treatment, that is, the injection of the frozen gas at an appropriate timing.

Next, an embodiment in which an MRI apparatus is used as the diagnostic imaging apparatus 10 will be described.
FIG. 3 is a diagram showing an outline of an MRI apparatus to which the present invention is applied. This MRI apparatus includes a static magnetic field generating magnet 2 that generates a static magnetic field in a space where a subject (patient) 1 is placed, a gradient magnetic field generating system 4 that generates a gradient magnetic field in this space, and a high-frequency magnetic field to the subject 1. A transmission system 5 for irradiating, a receiving system 6 for detecting an NMR signal generated by the subject 1, a signal processing system 7 for processing the NMR signal received by the receiving system 6, a gradient magnetic field generating system 3, and a transmission A sequencer 4 for operating the system 5 and the receiving system 6 according to a predetermined pulse sequence, and a control system (CPU) 8 that constitutes a part of the signal processing system 7 and controls the operation of the apparatus via the sequencer 3 I have.

  The static magnetic field generating magnet 2 generates a uniform static magnetic field around the subject 1 in the direction of the body axis or in a direction perpendicular to the body axis, and a magnetic field generating means such as a permanent magnet system, a normal conducting system, or a superconducting system. Consists of. Although not shown, the MRI apparatus of the present embodiment is an open type in which a pair of static magnetic field generating magnets 2 are disposed so as to be opposed to each other above and below the subject 1, for example, and can be accessed from the side surface of the subject 1. This makes IMRI possible.

  The gradient magnetic field generation system 4 includes a gradient magnetic field coil 41 that integrates three gradient magnetic field coils in three axial directions of X, Y, and X, and a gradient magnetic field power source 42 that drives them. By driving the gradient magnetic field power source 42 of the coil, the gradient magnetic fields Gx, Gy, and Gz in the three-axis directions are applied to the subject 1. The imaging surface (slice) of the subject 1 can be determined by applying this gradient magnetic field, and the position information can be added by phase encoding the NMR signal. The open time MRI apparatus shown in the figure has a structure in which a pair of gradient magnetic field coils 41 are vertically opposed to each other across a static magnetic field space.

  The transmission system 5 includes a high-frequency oscillator 51, a modulator 52, a high-frequency amplifier 53, and a high-frequency coil 54 on the transmission side. The high-frequency pulse output from the high-frequency oscillator 51 is amplified by the modulator 52 according to a command from the sequencer 3. The subject 1 is irradiated with electromagnetic waves by modulating and amplifying the amplitude-modulated high-frequency pulse by the high-frequency amplifier 53 and then supplying it to the high-frequency coil 54 disposed close to the subject 1. Yes.

  The reception system 6 includes a reception-side high-frequency coil 61 arranged close to the subject 1, an amplifier 62, a quadrature phase detector 63, and an A / D converter 64. The high-frequency coil 61 detects the reception system 6. The NMR signal (echo signal) is input to the A / D converter 64 via the amplifier 62 and the quadrature phase detector 63 and converted into a digital quantity. At this time, it is sent to the signal processing system 7 as two series of collected data sampled by the quadrature detector 63 at a timing according to a command from the sequencer 4.

  The signal processing system 7 includes a CPU 8, a display 71, a storage medium such as a magnetic tape 72 and a magnetic disk 73, and operation units such as a keyboard 74 and a mouse 75 for inputting necessary commands to the signal processing system 7 and the CPU 8. 76, and performs processing such as Fourier transform, correction coefficient calculation, image reconstruction, etc. on the signal from the receiving system 6, and performs appropriate calculations on the signal intensity distribution of an arbitrary section and signals from multiple sections The distribution obtained in this way is imaged and displayed on the display 71. Data necessary for the above process and data after the process are stored in a storage medium. The CPU 8 incorporates a pulse sequence that determines the operation timing of the gradient magnetic field generation system 4, the transmission system 5, and the reception system 6 as a program. There are various pulse sequences according to the imaging method, and the MRI apparatus of the present invention incorporates a pulse sequence for fluoroscopy (dynamic imaging). Specifically, it is a gradient echo short TR imaging pulse sequence or an EPI pulse sequence, which may be two-dimensional measurement or three-dimensional measurement.

  Further, the signal processing system 7 can be connected to a therapy device such as a thermotherapy device or a cryotherapy device, and in addition to the above-described processing such as image reconstruction, the image during the thermotherapy / freezing treatment is processed and a necessary command is obtained. Can be delivered to the treatment device. That is, in the MRI apparatus of this embodiment, the signal processing system and the control system function as the arithmetic unit 30 of the treatment control system shown in FIG.

  Next, a cryotherapy control method using the MRI apparatus having such a configuration as a monitor will be described. FIG. 4 shows the procedure.

  First, the subject 1 is carried into the static magnetic field space of the MRI apparatus, a positioning image is taken (step 401), and the subject (target) to be treated is positioned so as to be located approximately at the center of the static magnetic field space. Next, a three-axis cross section including the target is imaged (step 402), and puncture for inserting the probe tip of the cryotherapy apparatus is performed (step 403). For the insertion of the puncture needle (probe) to the target, an interactive scan using fluoroscopy can be used. This method is a method of repeatedly capturing and displaying a real-time image while appropriately changing the imaging section in accordance with the insertion direction of the puncture needle, and guiding the puncture needle to the target. Imaging (step 402) and puncture (step 403) are repeated while confirming whether the puncture needle has reached the target with a monitor image (step 404). In this repetition, the imaging section is determined so that the target is always included in the three-axis section captured in step 402. In imaging, a contrast agent is used as necessary to give contrast to a target lesion or organ. If it is confirmed on the monitor image that the puncture needle has reached the target, the puncture is stopped (step 405), and cryotherapy is started (step 406). The triaxial cross-sectional image when the puncture is stopped is stored in the storage medium as a reference image for confirming the therapeutic effect in the subsequent cryotherapy.

  In the cryotherapy, as described above, first, cryogenic gas is injected into the small chamber at the tip of the probe at a high pressure, and the tip is cooled. Fluoroscopy is started simultaneously with the start of cryotherapy, and a triaxial section including the probe and target is imaged (step 407). FIG. 5 shows changes in MR images as the cryotherapy progresses. As shown in the figure, in the image (reference image) 501 when the puncture is stopped, the lesion L is depicted with high contrast, and the MR probe P is depicted with a low signal. When the tissue around the probe tip is frozen by the cryotherapy, an image 502 in which the signal of the frozen portion is missing is obtained. When the frozen portion (signal missing portion) F expands as the treatment progresses, the image changes to 503, 504, and 505, and the frozen portion F covers the lesion L. However, it cannot be determined from these images how much the frozen portion F covers the lesion L.

  Therefore, the difference between the images 502 to 505 being treated and the reference image 501 is performed to create difference images 506 to 509 and an addition image obtained by adding the difference images 506 to 509 and the reference image 501 is created. The timing for ending the cryotherapy is automatically determined from the added image (step 408). The creation of the difference image and the addition image can be performed by a known method, and in particular, it is preferable to employ a technique (synchronous measurement or body motion correction method) for eliminating cross-sectional displacement due to body motion such as respiratory movement. . The timing of the end of the cryotherapy is when the frozen area completely covers the lesion and extends to a range that is not too wide. In this embodiment, the distance between the outer edge of the frozen area and the outer edge of the lesion is automatically set in a plurality of directions. Determine by measuring and monitoring. A method for measuring the distance will be described later.

  First, it is determined whether or not the frozen region covers the entire lesion (step 409). In step 409, when the set distance is not reached even in one direction, it is determined whether to continue the cryotherapy or add the number of probes (step 411). In this determination, for example, if the difference between the measured distances is smaller than a predetermined value, the cryotherapy is continued, and if the difference is larger than the predetermined value, a probe is added. For example, as shown in FIG. 6, if the set distance is exceeded for the top and bottom of the lesion L, but the set distance is not reached for the left and right, a probe is added. In this case, returning to step 401, a new probe is punctured while imaging. If the set distance is not reached in most directions, the cryotherapy is continued.

  If the frozen area covers the entire lesion, it is then determined whether or not the distance between the outer edge of the frozen area and the outer edge of the lesion has become a preset distance for all measured directions (step 410). Also in this step 410, until the measured distances in all directions reach the set distance, it is determined whether the cryotherapy is continued or the probe is added (step 411), and necessary processing is repeated. When the measured distances in all directions reach the set distance, the treatment is terminated unless additional treatment is required (steps 412 and 413). Termination of treatment can be automatically performed by sending the command to the cryotherapy apparatus, or can be manually performed by a user who confirms the notification means by driving the notification means of the treatment apparatus according to the command. In the case of automatically ending, upon receiving a command, the cryotherapy apparatus stops the injection of the frozen gas, injects the thawing gas for a certain time, and stops the apparatus. Threshold values such as predetermined values and set distances used in the series of determination steps 409 to 411 can be set in advance by the user via the operation unit 76 of the MRI apparatus (FIG. 3), for example. It is also possible to set a predetermined value as a default.

  In the embodiment shown in FIG. 4, a step (step 411) for determining whether or not a probe needs to be added after the start of cryotherapy is provided, but depending on the size of the lesion site prior to the start of cryotherapy. It is also possible to increase the number of probes.

  Next, a method for measuring the distance between the outer edge of the frozen region and the outer edge of the lesion will be described with reference to FIG. As shown in FIG. 7A, the entire line (all pixels) of the difference image 701 or the added image is scanned, and the signal intensity of each pixel is calculated. The contour of the frozen region (outer edge) and the contour of the lesion (outer edge) are automatically discriminated from the change in signal intensity, and the distance between the contour and the contour is calculated. The contour can be determined by manually setting the ROI, as shown in FIG. 7B, instead of automatically determining the boundary of each region. Specifically, by operating the pointer on the image displayed on the display with the mouse of the operation unit (FIGS. 3 and 76), the contours Roi2 and Roi1 of the frozen region and the lesion are determined, and the pixel value of the contour is determined. . The distance between the contour of the frozen region and the contour of the lesion is preferably calculated in a plurality of directions, at least in two intersecting directions (for example, the vertical direction and the horizontal direction).

  Note that, in the difference image, only the frozen area is rendered with a high signal, and therefore, if the frozen area covers the entire lesion as in the difference images 508 and 509, the frozen area and the lesion in the difference image are displayed. However, while the frozen region remains inside the lesion, only the image of the frozen region in which the signal value has changed can be obtained in the difference image, so the added image obtained by adding the difference image and the reference image Is preferably used.

  The calculation of the distance between the contours is performed for each image or a plurality of images continuously captured, and preferably for all three-axis cross sections, and the change is monitored. Thus, by monitoring the distance between the outer edge of the frozen region and the outer edge of the lesion in this way, it is possible to perform cryotherapy in an appropriate range, and minimize damage due to relapse or overfreezing due to incomplete treatment be able to. In particular, by using a three-axis cross section as a reference image and a real-time image during treatment, it is possible to treat a region that reliably covers the whole of a large lesion and minimizes the influence on an adjacent organ or the like. The three-axis cross-sectional image may be two-dimensional measurement or three-dimensional measurement, and a known imaging method can be employed.

  The processing results (difference image, distance calculation) in step 407 and step 408 described above are displayed on the display 71 together with information related to the progress of other treatments and patient information. A display example of the display is shown in FIG. In the illustrated example, the display forms a GUI (graphic user interface), an image display unit that displays a preoperative image (reference image) 801, a treatment image 802, a difference image 803, and an added image 804, and an imaging scan selection. Buttons 805 and 806, various protocol input screens 807, and a display unit 808 for displaying treatment progress information and patient information are provided. The display unit 808 displays a real-time image that schematically represents the relationship between the treatment area, the lesion, and the probe, and the automatically calculated distance, and also displays the following information regarding the progress of treatment. These pieces of information can be calculated by the signal processing unit 7 (arithmetic unit 30) together with automatic distance calculation.

Maximum value (MAX) and minimum value (MIN) of the distance between contours calculated for a plurality of directions
Elapsed time from treatment start and remaining treatment time: The remaining treatment time is calculated by calculating a difference from the elapsed time when the treatment time is set in advance in the treatment apparatus 20. These can be displayed in analog form with different colors (lightness) on a bar-shaped display with a set treatment time of 100%.
Size of lesion and treatment region: The size of the lesion and treatment region is calculated as, for example, the distance between the pixel position of the probe tip and the outline in four directions.
Interval time: When repeating multiple treatments, the number of intervals is displayed.
As patient information, in addition to the patient ID, when a pulse, blood pressure, and the like are simultaneously measured, signals from these measuring instruments can be captured and displayed as numerical values or graphs.

  Note that these displays are not the display 71 of the signal processing system 7 of the MRI apparatus, but if the arithmetic unit 30 of the treatment control system is independent, the monitor associated therewith or the treatment apparatus 20 includes a monitor. Alternatively, it may be displayed on the monitor of the treatment device 20. It is also possible to display necessary information on a plurality of displays or monitors. When displaying on the monitor of the treatment apparatus 20, these displays themselves function as notification means for the operation unit 230 of the treatment apparatus 20.

  As described above, the operation of the treatment control system of the present invention has been described focusing on the embodiment shown in FIG. 4, but the treatment control system of the present invention is not limited to these embodiments and can be variously modified. For example, in the automatic imaging step 407 of FIG. 4, even during the treatment, it is possible to add a step in which the user changes the imaging sequence and imaging parameters according to the progress of the treatment. Such a change can be performed by, for example, imaging scan selection buttons 805 and 806 shown in FIG. This makes it possible to select imaging with improved temporal resolution or imaging with improved spatial resolution as necessary.

  Moreover, although the case where the function of the arithmetic unit 30 in the treatment system of FIG. 1 was performed with an MRI apparatus was demonstrated in the said embodiment, it is also possible to give such a function to an independent arithmetic unit or a therapeutic apparatus. In this case, the image taken by the MRI apparatus in real time or the image data of the difference image / addition image is sent to the arithmetic device, and the arithmetic device or the therapeutic device relates to the determination of the end of treatment and the progress of treatment based on the image data. Information is calculated.

  Further, as an image diagnostic apparatus, an X-ray fluoroscopic apparatus, an X-ray CT apparatus, an ultrasonic diagnostic apparatus, and the like can be used in addition to the MRI apparatus. For example, when an X-ray CT apparatus is used as an image diagnostic apparatus, CT fluoroscopy is executed as a dynamic imaging method and the freezing process is monitored. In this case as well, a reference CT image is acquired when the probe reaches the target, and a difference from the CT image being treated next is performed. Similar to the case of the MRI apparatus, the distance between the contours of the lesion and the frozen region is obtained from the difference image, and the progress of the treatment is determined.

  Moreover, although the case where the cryotherapy apparatus shown in FIG. 2 was used as a treatment apparatus was demonstrated in the said embodiment, a thermal treatment apparatus can also be employ | adopted as a treatment apparatus. The thermotherapy device includes a monopolar method using a pair of electrodes and a deployment needle method, either of which may be adopted. FIG. 9 shows a schematic configuration of a monopolar thermotherapy apparatus. This apparatus includes a drive unit 901 including a generator 903 that generates an RF alternating current, a probe 902 including a handpiece (puncture electrode) 904 and a counter electrode plate 907 connected to the generator 903 via disposable cables 905 and 906. The drive unit 901 includes an operation unit (not shown).

  In this thermotherapy device, a high-frequency current from the generator 903 is transmitted to the diseased tissue L via the handpiece 904, and the diseased tissue is thermally coagulated and necrotic. At this time, the disposable cables 905 and 906 are provided with a temperature sensor so that the solidification temperature can be monitored in real time. The number of handpieces can be increased or decreased according to the size of the lesion.

  By incorporating such a thermal treatment apparatus into the treatment control system of the present invention, the progress of treatment (for example, the distance from the lesion L to the surface of the thermal area H using the information of the image diagnostic apparatus in addition to the monitor by the temperature sensor). ) Can be monitored, and the accuracy of treatment can be improved, such as termination of treatment at an appropriate timing, addition of treatment, and increase in the number of handpieces 904. In addition, the treatment progress can be automated by feeding back the progress of the treatment to the drive unit 901.

The figure which shows the whole outline | summary of the treatment control system of this invention The figure which shows one Embodiment of the treatment apparatus (freezing treatment apparatus) used for the treatment control system of this invention The figure which shows one Embodiment of the image diagnostic apparatus (MRI apparatus) used for the treatment control system of this invention The flowchart explaining operation | movement of the treatment control system of this invention The figure which shows the dynamic image which is obtained with the diagnostic imaging equipment The figure explaining progress of treatment and addition of a probe in the cryotherapy apparatus of FIG. The figure explaining the image processing in the treatment control system of this invention The figure which shows an example of the display in the treatment control system of this invention The figure which shows one Embodiment of the treatment apparatus (thermal treatment apparatus) used for the treatment control system of this invention

Explanation of symbols

10 ... diagnostic imaging device, 20 ... treatment device, 30 ... arithmetic device

Claims (6)

A thermal or cryotherapy device comprising a probe that is punctured into a lesioned part of a living body, and a drive unit that drives and controls heating or freezing of the lesioned part via the probe;
An image diagnostic apparatus comprising: an imaging unit that continuously captures images of the biological lesion; and a display unit that displays the image;
Calculates the difference image between the treatment in the images successively captured pre-treatment image taken by the image diagnostic apparatus, extracts the treatment region outer edge and the outer edge of the lesion based on the difference image, these lesions A treatment control system comprising: an arithmetic device that calculates a distance between an outer edge and a treatment region outer edge , determines a treatment progress state based on the distance , and displays the result. The treatment control system according to claim 1, wherein
The arithmetic device creates an added image obtained by adding the difference image and the pre-treatment image, and determines a range in which a treatment region covers the lesioned part based on the added image or the difference image. And treatment control system. The treatment control system according to claim 1 or 2,
The said arithmetic unit corrects body movement and produces the said difference image or the said addition image, The treatment control system characterized by the above-mentioned . The treatment control system according to any one of claims 1 to 3,
The said arithmetic unit controls the drive part of the said treatment apparatus according to the progress state of a treatment, The treatment control system characterized by the above-mentioned. The treatment control system according to any one of claims 1 to 4,
The treatment control system, wherein the arithmetic device is a part of the treatment device or the diagnostic imaging device. The treatment control system according to any one of claims 1 to 5,
The diagnostic imaging system is a magnetic resonance imaging apparatus, and the imaging means captures continuous images by fluoroscopy imaging.

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