JP4728996B2 - 粒子線治療装置及び粒子線照射線量算出方法 - Google Patents
粒子線治療装置及び粒子線照射線量算出方法 Download PDFInfo
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粒子線治療装置は、線量モニタの測定値から照射済みの線量を求めるため、治療照射時、治療計画から指示された物理線量(Gy)を、線量モニタの測定値であるカウント値に変換する必要がある。物理線量から線量モニタのプリセット値への変換は、気温、気圧のみならず機械的特性にも影響を受けるため、治療照射毎及び患者毎にそれぞれ標準校正深測定及び患者校正深測定を行う必要がある。
治療照射毎及び患者毎に実施する標準校正深測定及び患者校正深測定の作業(時間)は、粒子線治療装置を利用した癌治療において、実際に患者に粒子線を照射する作業(時間)に比べて、非常に高い割合を占めている。このため、治療照射のオペレータの作業が煩雑化し、粒子線治療装置の治療への利用率を低下させる要因となっている。
粒子線治療装置を利用した治療システムは、以上のようになっているので、治療する患者の増大に伴い、オペレータの負担が増大し、患者に対する粒子線治療装置の効率的な運用に支障をきたす恐れがある。また、過去に行った患者校正深測定と同様の測定を何度も行う状況が発生し、治療データの管理の無駄も増大する。
特許文献1には、放射線治療システムの放射線量校正を自動化するものが記載されている。
このため、粒子線の治療照射時間に比べて標準校正深測定などの治療照射に至る前段階の作業量が多く、オペレータの作業が煩雑化し、患者の増加に伴い、オペレータに大きな負担がかかると同時に、患者の治療照射の待ち時間も増大し、粒子線治療装置の医療サービスの低下を引き起す一因にもなっている。
また、粒子線治療装置の治療照射への利用率が低く、粒子線治療装置の採算性を低下させる要因ともなっている。
さらに、新しい患者に対し、過去の患者校正深測定と同様な条件の患者校正深測定を行う状況が発生してきており、類似の患者校正深測定結果が増大し、データベースの運用が非効率的になり、非効率的なデータ管理、人為的なミスを招く恐れも増大し、粒子線治療装置の運用が非効率的、信頼性の低下、安全性の低下などにつながる恐れが出るなどの問題がある。
特許文献1のものでは、個々の放射線量校正の自動化は行えても、標準校正深及び患者校正深測定を毎日実施することの負担を解決するものではなかった。
以下に、この発明の実施の形態1を図に基づいて説明する。
図1は、この発明の実施の形態1による粒子線治療装置の標準校正深測定及び患者校正深測定及び粒子線治療の実施日を示す工程図である。
図1において、本発明の粒子線治療において、粒子線治療装置の運転(運休も含む)日に対する標準校正深測定(含標準分布測定)、患者校正深測定(含患者分布測定)及び粒子線治療の実施日を示している。縦軸に実施項目を、横軸に粒子線治療装置の運転日(日付)D1、D2、D3、D4を示している。
標準校正深測定(結果)S1及びS2は、それぞれ適当な間隔をおいた日付D1及びD3に実施した測定結果である。患者校正深測定(結果)P1は、日付D2に実施した測定結果である。粒子線治療照射R1は、日付D4に実施した粒子線治療装置による患者への粒子線治療照射である。
標準校正深測定は、毎日実施せず、患者校正深測定P1の日及び治療照射R1の日には、当日の標準校正深が存在しない。従って患者校正深測定日D2及び患者への粒子線治療照射日D4での標準校正深は、それぞれ直近日付D1及びD3に取得した標準校正深S1及びS2を採用し、圧力、温度等の補正を行う。治療に必要な標準分布測定は、標準校正深測定日D1及びD3に引き続き必要に応じて実施する。
図2において、粒子線治療装置のモニタリングシステムは、次のように構成される。
粒子線治療装置の粒子線加速器で加速された粒子線3は、ビーム輸送系で照射ヘッド1に導かれ、偏向電磁石で必要な方向に偏向され、散乱体4に入射され、治療照射に必要な散乱角を持った粒子線3に広げられる。散乱体4を出た粒子線3は、リッジフィルタ5を通り、そのエネルギー幅を広げ、さらにレンジフィルタ6を通って、そのエネルギーを減少
させ、線量モニタヘッド7及び、平坦度モニタヘッド8と通って照射される線量及び平坦度がモニタされ、さらにコリメータ9を通って粒子線の照射野が整形され、基準線量計ヘッド19に照射される。
粒子線治療装置の照射ヘッド1は、さらに、線量モニタのアンプ及び制御回路10、及び平坦度モニタの差動アンプ及び制御回路11を有している。
信号処理回路12は、線量モニタのアンプ及び制御回路10からの信号及び平坦度モニタの差動アンプ及び制御回路11からの出力信号を処理し、データ処理計算機13に渡す信号処理回路である。メモリおよびデータベース14(記録装置)は、データ処理計算機13で処理されたデータを記録する。データ処理計算機13には、表示モニタ15、キーボード16、さらに粒子線治療装置の照射系計算機17が接続される。照射パラメータ18は、標準校正深測定結果の特性を支配するパラメータであり、データ処理計算機13に入力される。基準線量計ヘッド19は、校正深測定に用いられ、この基準線量計ヘッド19には、基準線量計本体20が接続され、この基準線量計本体20は、データ処理計算機13に接続されている。
図3において、1、3〜18は図2におけるものと同一のものである。図3では、粒子線3に患者2の患部が照射される。
図4において、メモリM1には、標準校正深測定及び患者校正深測定の結果が記録される。
患者校正深測定前の直近に実施された標準校正深測定S1(第一の手順)は、不定期または適当な所定の間隔で実施される。患者の治療照射前には、患者校正深測定P1(第二の手順)が、実施される。患者校正深測定P1及び患者の治療照射R1は、図1のものと同じである。
Q10は、データベースM1からの患者校正深測定日に測定された患者校正深測定結果の取得である。Q11は、Q10の患者校正深測定結果が適正に取得されたかどうかの妥当性の判断である。Q12は、データベースM1からの患者校正深測定結果の取得が不適切(データ無し等)と判断された場合、治療を中断し、患者校正深の再測定に進む手順である。Q13は、患者校正深測定日を基準日として、データベースM1からの直近の標準校正深測定結果の取得である。Q14は、Q13の標準校正深測定結果の取得が適正に取得されたかどうかの妥当性の判断で、Q15は、Q13の標準校正深測定結果の取得が不適切と判断された場合の手順で、治療を中断し、標準校正深の再測定に進む手順である。
Q16は、患者治療日を基準日として、データベースM1からの直近の標準校正深測定結果の取得である。Q17は、この標準校正深測定結果が適正に取得されたかどうかの妥当性の判断で、Q18は、Q16の標準校正深測定結果の取得が不適切と判断された場合の手順で、照射を中断し、標準校正深の再測定に進む手順である。Q19(第三の手順)は、標準校正深測定結果の取得が適切と判断された場合の次のステップで、取得された患者校正深測定結果及び標準校正深測定結果に基づき線量を計算し、温度、気圧等の補正を行い、照射カウント数を算定する作業である。Q20は、Q19で求めた照射カウント数値を粒子線治療装置のプリセットカウンタに設定する作業である。R1は、患者への粒子線の治療照射(第四の手順)、Q21は、治療照射記録の作成で、作成された結果は、メモリM1にデータベースとして蓄積される(第五の手順)。
図3で、粒子線治療装置の粒子線加速器で加速された粒子線3は、ビーム輸送系で照射ヘッド1に導かれ、偏向電磁石で必要な方向に偏向され、散乱体4に入射され、治療照射に必要な散乱角を持った粒子線3に広げられる。散乱体4を出た粒子線3は、リッジフィルタ5を通りそのエネルギー幅を広げ、さらにレンジフィルタ6を通ってそのエネルギーを減少させ、線量モニタヘッド7及び、平坦度モニタヘッド8を通って照射される線量及び平坦度がモニタされ、さらにコリメータ9を通って粒子線の照射野が整形され、患者2の患部に照射される。
図4において、S1で、標準測定における標準校正深測定を実施する。この測定は、ある間隔の日をおいて、決められた標準の照射条件及び標準の計測条件で、治療装置の照射ヘッド1に具備されている線量モニタと基準位置に設置された基準線量計とに粒子線を照射し、それらの出力を比較し、標準校正定数を求め、その結果をメモリM1に記録する。
標準校正深測定に引き続き、決められた標準の照射条件及び標準の計測条件で、標準分布測定(粒子線をファントムに照射し、水平及び垂直方向の吸収線量分布の測定)も必要に応じて実施し、結果をメモリM1に記録する。
以上で、粒子線治療照射に必要な標準校正深(直近及び患者治療当日の)、患者校正深及び患者分布の校正データの準備が完了する。
データベースからの患者校正深測定結果の取得が適切と判断された場合、Q13で、患者校正深測定日を基準日として、データベースから直近の標準校正深測定結果を取得する。次いで、Q14で、Q13で実施した標準校正深測定結果の取得が適切であるかどうかを判断する。Q13の標準校正深測定結果の取得が不適切と判断された場合、Q15に進み、治療を中断し、標準校正深の再測定の指令を出す。
Q13の標準校正深測定結果の取得が適切と判断された場合、患者治療日を基準日として、Q16で、データベースから直近の標準校正深測定結果を取得する。Q17においては、Q16で実施した標準校正深測定結果の取得が適切であるかどうかを判断する。Q16の標準校正深測定結果の取得が不適切と判断された場合、Q18に進み、治療を中断し、標準校正深の再測定の指令を出す。
Q16の標準校正深測定結果の取得が適切と判断された場合、上記Q10、Q13及びQ16で取得した各校正深に基づき線量を計算し、温度、気圧等の補正を行い、照射かウント値を算定するQ19に進む。次いで、Q20で、照射カウント値を治療照射装置のプリセットカウンタに設定し、治療照射R1を実行する。
治療照射が完了すると、治療照射記録Q21を作成し、その結果をデータベースとしてメ
モリM1に記録することにより、一連の粒子線治療照射が完了する。
また、温度や気圧に関しては、空調の完備等から短期間における有意な差が出がたい環境が整っている。したがって、粒子線治療装置を利用した癌治療において、過去に測定した標準校正深測定結果をデータベースに蓄積し、治療照射時には、標準校正深測定を実施せず、代わりにデータベースから直近の標準校正深測定結果を引き出し、気圧、温度などの補正を実施することにより、治療時の標準校正深とし、線量計算をすることができる。
また、粒子線治療装置の治療への利用率も向上し、短期間により多くの患者の治療ができ、医療サービスの向上にも役立つ他、標準校正深データ、患者校正心データ、校正実績、治療照射などの治療実績を確実に記録・保管できるなどの特徴があり、効率的で、より安全な粒子線治療法及び粒子線治療装置を提供することができる。
実施の形態1において、直近の標準校正深測定結果(測定点及び平均値)が今までの標準校正深測定結果に比べて異なる場合がある。このような測定結果を取得して線量校正すると、誤差が集積し、実際の照射線量の誤差が大きくなる恐れがある。実施の形態2は、このような場合に対処するものである。
図5は、この発明の実施の形態2による粒子線治療装置の粒子線治療における標準校正深測定及び治療照射の手順を示す流れ図である。
図5において、S1、S2、M1、R1、Q16〜Q21は図4におけるものと同一のものである。Q31は、標準校正深測定値の適不適の判断基準、Q32は標準校正深測定値をメモリに記録する時の上記標準校正深測定値に対する適不適の判断、Q33は表示画面に標準校正深測定値の適正値(複数)の表示、Q34は表示画面に表示された標準校正深測定値の適正値(複数)の中から補正に使用するデータを選択する操作である。Q35は補正に使用した標準校正深測定結果の記録である。
なお、図5でも、線量計算には患者校正深の測定結果を用いるが、図中での表示を省略している。
リM1に記録する。
一方、採用した適用標準校正深を用い、Q19で照射線量の計算を行い、補正の精度を上げ、Q20で照射カウント値を設定し、R1で治療照射が実行される。
治療照射が完了すると、Q21で治療照射記録を作成し、メモリM1に記録される。
このため、粒子線治療において、標準校正深測定結果による線量計算の精度と信頼性が向上し、信頼性の高い粒子線治療が期待できる。
実施の形態2において、同一条件(核種、エネルギ、機器条件)で実施した標準校正深測定結果が時間とともに変化する可能性がある。したがって、不定期あるいは所定の間隔で実施した標準校正深測定結果の時間的傾向を表示し、補正に使用する標準校正深の採用に際し、標準校正深測定結果の時間的な傾向を参照し、どの時点で実施した標準校正深測定結果が当該治療の線量計算に最適かを決定することは、線量計算の精度の確保のみならず、機器の運転管理上でも重要なことである。実施の形態3は、このような点を考慮したものである。
図6において、S1、S2、M1、R1、Q16〜Q21、Q31〜Q35は図5におけるものと同一のものである。Q41は、過去一定期間に測定した標準校正深測定結果とその測定条件をメモリM1のデータベースから取得するプロセスである。Q42は、Q41で取得した上記データを表示画面に表示し、参照するプロセスである。Q43は、表示された過去一定期間に測定した標準校正深測定結果とその測定条件を参照し、最適な標準校正深測定結果を選択し、適用標準校正深を決定する。決定した標準校正深測定結果は、線量計算の補正に使用すると同時に当該治療の標準校正深が作成されメモリM1にデータベースとして記録される。
図6では、ある期間に実施した標準校正深測定結果とその測定条件をデータベースか取得し、表示画面に表示し、過去のデータを参照し、適切な適用標準校正深測定結果を採用し、その採用した標準校正深を使用して線量計算を実施して、粒子線治療を行う。
なお、図6でも、線量計算には患者校正深の測定結果を用いるが、図中での表示を省略している。
図7において、データトレンド画面21は、過去一定期間に測定した標準校正深測定結果とその測定条件を表示したものである。表示22は、メモリM1のデータベースから取得された主線量モニタ、副線量モニタ及び平坦度モニタの過去一定期間に実施した標準校正深測定結果のデータを測定日に対応して表示したものである。
縦線23は、オペレータの(マウス)選択が行われていることを示す縦線であり、選択されている測定結果の詳細情報26が表示される。たとえば、図7では、7/31のデータが選択され、詳細情報26内に7/31に測定した結果の詳細が表示されるが、7/24のプロット上をオペレータがマウスにて選択すると、詳細情報26内は、7/24の測定結果の詳細情報が表示される(表示内容が切り替わる)。
領域24は、補正に採用するデータを表示する領域である。領域25は、校正深を測定するときの条件を示すものであり、設定時と読み出し時に表示され、粒子線の照射コースと、粒子線の種類である核種と、照射されるエネルギーと、測定される校正深とが示される。
図7のように、適用線量計算の補正に採用しようとする適用標準校正深測定結果と測定条件を、画面上で選択することにより、その詳細を示すことができる。
図7では、表示22内に採用されているデータがある状況を示しているが、6/19以前のデータを補正用に採用した場合、表示22のみでは、基準となる補正用のデータが判らなくなるため、補正用のデータを表示する領域24を設けている。
ここで、オペレータが、補正に採用しているデータをマウスにて選択した場合、詳細情報26内は、補正に採用しているデータの詳細(測定結果の測定時の温度気圧等)が示されることになる。
6 レンジフィルタ、7 線量モニタヘッド、8 平坦度モニタヘッド、
9 コリメータ、10 アンプ及び制御回路、11 差動アンプ及び制御回路、
12 信号処理回路、13 データ処理計算機、14 メモリ及びデータベース、
15 表示モニタ、16 キーボード、17 照射系計算機、18 照射パラメータ、
19 基準線量計ヘッド、20 基準線量計本体。
Claims (4)
- 患者の患部に粒子線を照射して治療を行う粒子線治療装置において、標準の照射条件により不定期または所定の間隔で実施された標準校正深測定結果及び患者の治療照射条件により実施された患者校正深測定結果が保存される記録装置、及びこの記録装置に保存された上記患者校正深測定結果及びこの患者校正深測定が実施された日に最も近い日に測定された標準校正深測定結果並びに治療照射日に最も近い日に測定された標準校正深測定結果を用いて、患者への上記粒子線の治療照射時の照射線量を算出するデータ処理計算機を備え、上記データ処理計算機により算出された照射線量に基づいて、患者への上記粒子線の治療照射が行われることを特徴とする粒子線治療装置。
- 患者の患部に粒子線を照射して治療を行う粒子線治療装置において、標準の照射条件により不定期または所定の間隔で実施された標準校正深測定結果及び患者の治療照射条件により実施された患者校正深測定結果が保存される記録装置、及びこの記録装置に保存された上記患者校正深測定結果及び上記標準校正深測定結果を用いて、患者への上記粒子線の治療照射時の照射線量を算出するデータ処理計算機を備え、上記データ処理計算機は、上記標準校正深測定結果の変動幅の許容値を設け、この許容値内の変動幅を有する上記標準校正深測定結果の内、最適な上記標準校正深測定結果として選択された上記標準校正深測定結果を用いて上記照射線量の算出を行うとともに、この算出された照射線量に基づいて、患者への上記粒子線の治療照射が行われることを特徴とする粒子線治療装置。
- 患者の患部に粒子線を照射して治療を行う粒子線治療装置において、標準の照射条件により不定期または所定の間隔で実施された標準校正深測定結果及び患者の治療照射条件により実施された患者校正深測定結果が保存される記録装置、及びこの記録装置に保存された上記患者校正深測定結果及び上記標準校正深測定結果を用いて、患者への上記粒子線の治療照射時の照射線量を算出するデータ処理計算機を備え、上記データ処理計算機は、上記標準校正深測定結果が得られたときの測定条件を参照して、選択された上記標準校正深測定結果を用いて、上記照射線量の算出を行うとともに、この算出された照射線量に基づいて、患者への上記粒子線の治療照射が行われることを特徴とする粒子線治療装置。
- 標準の照射条件により不定期または所定の間隔で実施された標準校正深測定結果をデータ処理計算機により記録装置に保存する第一の手順、
患者の治療照射条件により実施された患者校正深測定結果を上記データ処理計算機により上記記録装置に保存する第二の手順、
この第二の手順により得られた患者校正深測定結果及びこの患者校正深測定が実施された日に最も近い日に測定された標準校正深測定結果並びに治療照射日に最も近い日に測定された標準校正深測定結果を用いて、患者への上記粒子線の治療照射時の照射線量をデータ処理計算機により算出する第三の手順を含むことを特徴とする粒子線照射線量算出方法。
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