CN102306239A - Method for evaluating and optimizing radiotherapy dose based on cone beam CT (Computer Tomography) image CT value correction technology - Google Patents
Method for evaluating and optimizing radiotherapy dose based on cone beam CT (Computer Tomography) image CT value correction technology Download PDFInfo
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Abstract
The invention discloses a method for evaluating and optimizing radiotherapy dose based on a cone beam CT (Computer Tomography) image CT value correction technology. The method comprises the following steps of: a, collecting image information; b, making an initial radiotherapy plan; c, acquiring a CT value correction table; d, correcting a CT value of a cone beam CT image; e, drawing a target region and an outline; f, setting a current radiotherapy plan; g, judging whether rigid registration needs to be carried out or not; h, evaluating the current radiotherapy plan; j, carrying out local optimization by taking the current radiotherapy plan as the initial plan if the current radiotherapy plan needs to be optimized; k, off-line evaluating the radiotherapy plan; and l, judging whether the radiotherapy plan needs to be regenerated within a global range or not. According to the method disclosed by the invention, the accuracies of the dose calculation and the dose evaluation are ensured, and the fastness and convenience of the online optimization of the radiotherapy plan are also ensured; and the fastness and convenience of the online optimization are ensured by the local optimization, and the accuracy of the optimization is ensured by the global optimization, thus effective therapy on the target region is ensured, and the damage on normal tissues is avoided as much as possible.
Description
Technical field
The present invention relates to a kind of radiotherapy dosage and evaluate and optimize method based on conical beam CT image C T value alignment technique; In particular; Relate in particular to a kind of CT value of the fladellum CT image of gathering when being used for reference to radiotherapy localization; The CT value of the conical beam CT image of online acquisition is carried out the technology that individuation is proofreaied and correct during to radiotherapy; And carry out online to radiotherapy dosage on this basis and the off-line assessment, and then implement the method for the optimization of radiotherapy planning.
Background technology
The modern radiotherapy technology such as emphasical radiotherapy, can project static target area with the dose distribution of highly fitting shape.Yet radiation therapy process adopts the fractionated irradiation technology usually, i.e. radiotherapy need divide several times to carry out.In the fractionated radiotherapy process, tumour and position and the shape of vitals possibly produce between the radiotherapy gradation and change (like the increase of lump, shrink back or twist) on every side.In addition, also can there be the change in location that pendulum bit error etc. causes in each treatment.Based on the consideration of these motion change, conventional way is that tumor area is put certain limit outward as the plan target area, and this can cause more normal structure to receive radiation insult.When bigger variations takes place in the position of tumour and shape, need usually to gather again and locate CT, reformulate radiotherapy planning.
Be integrated in conical beam CT scanning system on the accelerator can be when radiotherapy the online patient's of obtaining conical beam CT image, thereby patient's in-vivo tumour or other jeopardize the position and the shape information of organ when obtaining treatment.To tumour with jeopardize these change informations of organ, the online radiotherapy planning of optimizing again can be avoided tumour and jeopardize that motion causes wrong dose delivery between the radiotherapy gradation of organ.
Yet the online radiotherapy planning of optimizing again need obtain electron density information from online conical beam CT image.Owing to the intrinsic reasons such as electron scattering of online conical beam CT scanning system, the mapping relations between the CT value of the online conical beam CT image that causes rebuilding and the electron density of imageable target are uncertain.Mapping relations between the CT value of online conical beam CT image and the electron density of imageable target not only change with the difference of imageable target, and the mapping relations between the corresponding electron density with it of the CT value of the different parts of same imageable target also can change.This makes that on the conical beam CT image, optimizing radiotherapy planning again becomes difficult.
Online evaluation target area and jeopardize the influence that changes between the gradation of organ dose distribution, for estimating radiotherapeutic effect, it is also very important whether decision optimizes radiotherapy planning again.Owing to can't obtain electron density information accurately, make that also online evaluation is carried out with the dose distribution that jeopardizes organ in the target area can't be to treatment the time from online conical beam CT image.
What current radiotherapy planning system adopted when carrying out Rapid Dose Calculation is the method that source modeling and patient's modeling are separated.Promptly calculate the flux of energy of high energy X line earlier and distribute, calculate the dose distribution that this flux of energy produces again in the patient body on certain plane.So current radiotherapy planning system mainly contains two kinds of methods when carrying out planning optimization; A kind of is to optimize earlier to obtain Flux Distribution optimum on each launched field direction, cuts apart Flux Distribution to the launched field sequence that can throw in according to the physical parameter of concrete beam limiting device again.This method in two steps can make the dose distribution of cutting apart the plan that obtains different with the dose distribution that initial optimization flux obtains; This usually causes final plan can not satisfy the dose constraint of setting; Need doctor's adjustment constraint repeatedly to optimize again, this is for being unacceptable to the exigent on-line planning of optimization time.What another kind of directly launched field optimization method adopted is nonumeric random optimization algorithm, such as simulated annealing etc., comes the directly shape and the accelerator jumping figure of each launched field of optimization.These nonumeric random optimization algorithms are searched for the optimum launched field shape accelerator jumping figure corresponding with each launched field in global scope, this needs long optimization time usually.Even some direct launched field optimized Algorithm reducing optimization time, but confirms that in global scope the starting point of local optimum still needs long computing time in the last employing Local Optimization Algorithm of optimizing.Particularly for online situation about optimizing again, optimization is again to implementing irradiation again from Image Acquisition to plan, and whole process patient need be fixed on the therapeutic bed, and oversize optimization time is unacceptable.In order to reduce optimization time, the method for some direct modification launched field shapes is developed, and these methods directly change the shape of launched field according to the distortion of target area projection on the launched field direction, and then optimizes the accelerator jumping figure of each launched field.But directly the shape (rather than optimize produce launched field shape) of revising launched field according to the distortion of target area not have consideration to jeopardizing the influence of organ, can make final Optimization result can not satisfy clinical requirement in some cases.
Summary of the invention
The present invention is in order to overcome the shortcoming of above-mentioned technical matters, provides a kind of radiotherapy dosage based on conical beam CT image C T value alignment technique that is used to gather conical beam CT image and location fladellum CT image and handles to evaluate and optimize method.
Radiotherapy dosage based on conical beam CT image C T value alignment technique of the present invention evaluates and optimizes method; Its special feature is; May further comprise the steps: a. images acquired information; Gather patient's location fladellum CT image and online conical beam CT image; And fladellum CT image information stored online acquisition conical beam CT image during radiotherapy; B. formulate radiotherapy planning, according to the target area of on the fladellum CT image of location, delineating, generation fractionated radiotherapy plan information is also stored; C. obtain CT value table of corrections,, generate the CT value table of corrections of online conical beam CT image according to the relation between location fladellum CT image and the online conical beam CT image; D. proofread and correct the conical beam CT image, during fractionated radiotherapy, at first gather patient's online conical beam CT image each time, utilize CT value table of corrections to proofread and correct the CT value of online each pixel of conical beam CT image again; E. delineate target area and profile, on the online conical beam CT image after the correction, delineate the profile of target area and organ; F. set current radiotherapy planning, set in the radiotherapy planning information that the last off-line that fractionated radiotherapy plan that step b generates or step l generate optimizes again with it information corresponding as current radiotherapy planning; G. judge whether to carry out the rigid body registration,, then online conical beam CT image after proofreading and correct and location fladellum CT image are carried out the rigid body registration if need carry out the rigid body registration; If need not to carry out the rigid body registration, then execution in step h; H. assess current radiotherapy planning, make assessment result, and determine whether that according to assessment result needs optimize current radiotherapy planning according to the dose distribution that current radiotherapy planning produced; I. as need not to optimize current radiotherapy planning, then adopt current radiotherapy planning; J. optimize current radiotherapy planning as needing, then carry out local optimum as original plan, the current radiotherapy planning after optimizing with acquisition with current radiotherapy planning; K. off-line assessment radiotherapy planning is made assessment result according to the dose distribution that the last radiotherapy planning produced, and determines whether that according to assessment result the needs off-line optimizes current radiotherapy planning again; L. as needing off-line optimize radiotherapy planning again, then the conical beam CT image of gathering according to the last time and corresponding target area and organ contours regenerates radiotherapy planning in global scope.The distortion of fladellum CT image is low, and the distortion of conical beam CT image is high, on fladellum CT image, is easy to manually delineate out the target area.In the steps d, the CT value table of corrections that obtains among the online conical beam CT imagery exploitation step c that gathers is proofreaied and correct; Delineate target area and profile for delineating formation automatically described in the step e.Whether need carry out the judgement of rigid body registration in the step g, can be through online conical beam CT image after proofreading and correct and location fladellum CT image to be judged in the alternate position spike in space, the position adjustment signal of output can be therapeutic bed position adjustment signal.Among the step f; In the fractionated radiotherapy plan information that the last off-line that fractionated radiotherapy plan that described step b generates or step k generate is optimized again with it information corresponding be meant, in step b or k, generate with the corresponding treatment plan of this interval procedure step.If not carrying out off-line optimizes again; Then the fractionated radiotherapy that generates of optional step b in the works with the corresponding treatment plan of this interval procedure step; Again optimized if carry out off-line, then the fractionated radiotherapy optimized again of the last off-line that generates of optional step k in the works with the corresponding treatment plan of this interval procedure step.
Radiotherapy dosage based on conical beam CT image C T value alignment technique of the present invention evaluates and optimizes method, and the current radiotherapy planning of the assessment described in the step h may further comprise the steps: h-1. carries out Rapid Dose Calculation according to current radiotherapy planning to the online conical beam CT image after proofreading and correct; H-2. obtain target area and the current dose distribution that jeopardizes organ; H-3. judge current dose distribution whether the target area with jeopardize in the dose constraint and dose volume restriction range of organ, as within restriction range, then need not to optimize current radiotherapy planning; As not within restriction range, then need optimize current radiotherapy planning.
Radiotherapy dosage based on conical beam CT image C T value alignment technique of the present invention evaluates and optimizes method, and said CT value table of corrections is the individuation table of corrections that comprises Local C T value control information; And CT value table of corrections is the beam images deformable registration method of altering an agreement that adopts based on gradient fields, obtains the corresponding relation between online conical beam CT image and the location fladellum CT image pixel CT value.Is open during the invention of CN201010520917.6 is applied for a patent based on the beam images deformable registration method of altering an agreement of gradient fields in the patent No..
Radiotherapy dosage based on conical beam CT image C T value alignment technique of the present invention evaluates and optimizes method, and delineate target area and profile among the step e are producing automatically on the conical beam CT image or adopting the method for deformable registration will locate on the online conical beam CT image after target area and organ contours on the fladellum CT image is mapped to correction automatically for adopting based on the method for threshold values or based on the method for template matches.
Radiotherapy dosage based on conical beam CT image C T value alignment technique of the present invention evaluates and optimizes method, and the rigid body registration described in the step g is to the target area on online conical beam CT image and the location fladellum CT image or the registration of anatomical structure undetermined.
Radiotherapy dosage based on conical beam CT image C T value alignment technique of the present invention evaluates and optimizes method, and delineate target area and profile described in the step e comprise and delineate target area and profile and manual modification target area and profile automatically.
The invention is based on the CT values of cone beam CT image correction technique radiation dose assessment and optimization method, said step c comprises: c-1. Region segmentation, the cone-beam CT image and the fan-beam CT image after registration overlap three-dimensional region according to the specified size of a rectangular parallelepiped is divided into N stages local area; Let the n-th rectangular length, width, and height respectively
,
and
, (n +1) stage partial area included in the n-th partial areas, and the local level (n +1) regional side lengths
,
and
; N and n are positive integers and 1 ≤ n ≤ N, N ≥ 3; c-2. correction table CT values obtained through statistics and calculated for each local area cone beam CT CT values of pixels in the image and the fan-beam CT image corresponding to the CT value of the pixel, to give N-level local area CT values of cone beam CT image to a fan-beam CT image correction table CT values.N+1 level regional area in the step (c-1) is the part of n level regional area, and n level regional area volume is 8 times of n+1 level regional area volume.Utilize the multistage CT value table of corrections that obtains in the step (c-2), can be converted into the CT value of conical beam CT image the CT value of corresponding fladellum CT image, so that carry out Rapid Dose Calculation.
Radiotherapy dosage based on conical beam CT image C T value alignment technique of the present invention evaluates and optimizes method, comprises also among the said step a that foundation is by the step of the CT value of locating fladellum CT image to the mapping relations the electron density of imageable target.Foundation is helped the information of conical beam CT image is converted into electron density information, so that carry out Rapid Dose Calculation by the electron density mapping relations of the CT value of locating fladellum CT image to imageable target.
Radiotherapy dosage based on conical beam CT image C T value alignment technique of the present invention evaluates and optimizes method; Carrying out local optimum with current radiotherapy planning as original plan among the step j is meant with the starting point of current planning as local optimum; Utilize the derivative of optimization aim function multi-diaphragm collimator leaf position and accelerator jumping figure in each launched field; Adopt Local Optimization Algorithm directly to optimize multi-diaphragm collimator leaf position and accelerator jumping figure in each launched field, obtain the current radiotherapy planning of new local optimum.
The invention has the beneficial effects as follows: the present invention is through formulating radiotherapy planning on the fladellum CT image of gathering when the radiotherapy localization; Online acquisition conical beam CT image before the per minute time radiotherapy; And the CT value of the online conical beam CT image gathered carried out the individuation correction; The accuracy of Rapid Dose Calculation and dosage assessment had guaranteed the rapidity and the convenience of the on-line optimization radiotherapy planning in the interval procedure process again when both having guaranteed the on-line optimization radiotherapy planning; Through online local optimum radiotherapy planning of integrated use and off-line global optimization radiotherapy planning; The rapidity and the convenience of on-line optimization had both been guaranteed through local optimum; Guaranteed the accuracy of optimizing through global optimization again; When further having guaranteed the effective treatment to the target area, avoided damage as far as possible to normal structure.
Description of drawings
Fig. 1 is a method program process flow diagram of the present invention;
Fig. 2 is the module diagram of method program of the present invention.
Fig. 3 is cut apart synoptic diagram for conical beam CT image and fladellum CT image tertiary zone;
Fig. 4 is the synoptic diagram of first order table of corrections;
Fig. 5 is the synoptic diagram of second-order correction table;
Fig. 6 is the synoptic diagram of second-order correction table.
Embodiment
Below in conjunction with accompanying drawing and embodiment the present invention is described further.
As shown in Figure 1, provided the program flow diagram of an embodiment of the radiotherapy dose evaluating method that the present invention is based on individuation conical beam CT image C T value alignment technique, it comprises following concrete steps:
A. gather patient's location fladellum CT image, and it is stored;
B. formulate radiotherapy planning, according to the target area of on the fladellum CT image of location, manually delineating, generation fractionated radiotherapy plan information is also stored;
C. obtain CT value table of corrections, adopt the beam images deformable registration method of altering an agreement, obtain the CT value table of corrections of the corresponding relation between online conical beam CT image and the location fladellum CT image pixel CT value based on gradient fields;
In this step, the CT value table of corrections of generation can be for comprising the multistage CT value of the individuation table of corrections of Local C T value control information;
D. proofread and correct the conical beam CT image, during fractionated radiotherapy, at first gather patient's online conical beam CT image each time, utilize CT value table of corrections to proofread and correct the CT value of online each pixel of conical beam CT image again;
E. delineate target area and profile, on the online conical beam CT image after the correction, delineate the profile of target area and organ automatically, form current radiotherapy planning;
In this step, can also make amendment to the target area of automatic generation and the profile of organ with hand;
Delineate automatically target area and profile in this step are producing automatically on the conical beam CT image or are adopting the method for deformable registration will locate on the online conical beam CT image after target area and organ contours on the fladellum CT image is mapped to correction automatically for adopting based on the method for threshold values or based on the method for template matches.
F. set current radiotherapy planning, set in the radiotherapy planning information that the last off-line that fractionated radiotherapy plan that step b generates or step l generate optimizes again with it information corresponding as current radiotherapy planning.
G. judge whether to carry out the rigid body registration,, then online conical beam CT image after proofreading and correct and location fladellum CT image are carried out the rigid body registration if need carry out the rigid body registration, and according to registration results output patient position adjustment signal; If need not to carry out the rigid body registration, then execution in step h;
In this step; Can if the alternate position spike of two images surpasses specialized range, then carry out the rigid body registration through online conical beam CT image after proofreading and correct and location fladellum CT image are judged in the alternate position spike in space; If alternate position spike then need not to carry out the rigid body registration in the scope of regulation;
H. assess current radiotherapy planning, make assessment result, and determine whether that according to assessment result needs optimize current radiotherapy planning according to the dose distribution that current radiotherapy planning produced; Specifically may further comprise the steps:
H-1. assess current radiotherapy planning, the online conical beam CT image after proofreading and correct is carried out Rapid Dose Calculation according to current radiotherapy planning;
H-2. obtain target area and the current dose distribution that jeopardizes organ;
H-3. judge current dose distribution whether the target area with jeopardize in the dose constraint and dose volume restriction range of organ, as within restriction range, then need not to optimize current radiotherapy planning; As not within restriction range, then need optimize current radiotherapy planning;
I. as need not to optimize current radiotherapy planning, then according to current radiotherapy planning output radiotherapy control signal;
J. as need to optimize current radiotherapy planning, utilize then in the fractionated radiotherapy plan information that step b generates with it that information corresponding is optimized,, and export the radiotherapy control signal according to this plan with the current radiotherapy planning after obtaining to optimize;
K. off-line assessment radiotherapy planning is made assessment result according to the dose distribution that the last radiotherapy planning produced, and determines whether that according to assessment result the needs off-line optimizes current radiotherapy planning again;
L. as needing off-line optimize radiotherapy planning again, then the conical beam CT image of gathering according to the last time and corresponding target area and organ contours regenerates radiotherapy planning in global scope.
As shown in Figure 2, provided the module diagram of method program of the present invention, it comprises DICOM communication module, registration module, conical beam CT value correction module, delineates module, evaluation module, schedule module and rigid body registration module.Shown DICOM communication module is used for realizing communication function with accelerator control desk, server and conical beam CT control desk.
The DICOM communication module reads the location fladellum CT image of having stored, online conical beam CT image, fractionated radiotherapy plan, dosage and organ contours data through the DICOM agreement from server; Perhaps directly obtain online conical beam CT image from the conical beam CT control desk; And will utilize the new organ contours that produces on the CT value table of corrections image that produces of proofreading and correct the back, the online conical beam CT image, optimize the plan and the dose data that obtain again and store server into, or will optimize the plan that obtains again and directly send to the accelerator control desk.
Registration module is mainly accomplished the deformable registration of location fladellum CT image and online conical beam CT image; To confirm that when navigating to treatment target area and each jeopardize motion and distortion between the gradation of organ; Registration Algorithm adopts the beam images deformable registration method of altering an agreement based on gradient fields; The method is open during the invention of CN201010520917.6 is applied for a patent in the patent No., and the deformation field that registration produces is exported to conical beam CT value correction module and delineated module.Deformable registration algorithm based on gradient fields can be through multiple programming parallel enforcement on GPU.
Another function of registration module is the rigid body registration between location fladellum CT image and the online conical beam CT image.This rigid body is registered in after target area and organ contours generate on the conical beam CT.Can accomplish the rigid body registration to the organ of target area or appointment, the therapeutic bed adjustment parameter translation or the rotation therapy bed that produce according to the rigid body registration, with proofread and correct the pendulum bit error and can partly proofread and correct the target area or the gradation of crisis organ between the influence that produces of motion.The therapeutic bed adjustment parameter that the rigid body registration produces is outputed to evaluation module, so that adjusted dose distribution is assessed.
Conical beam CT value correction module is used for the CT value of online conical beam CT image is proofreaied and correct, so that it can reflect correct electron density information, carries out Rapid Dose Calculation.The method is when obtaining the primary conical beam CT image of certain patient; The deformation field that produces according to registration module is accomplished the extraction of the table of corrections that includes Local C T value control information of individuation, and this table is applied to the correction of this patient this and the online conical beam CT value in future.The online conical beam CT image that this module will be accomplished the correction of CT value outputs to evaluation module and schedule module.
Delineate module and accomplish the automatic generation of organ contours on the conical beam CT image, and allow the inaccurate profile of automatic generation is carried out manual modification.The automatic generation of organ contours can adopt the method based on threshold value, the method for template matches or target area and the organ contours that will locate on the fladellum CT image according to the deformation field that registration produces to be mapped to automatically on the conical beam CT image.This module outputs to evaluation module and schedule module with target area and the organ contours on the newly-generated online conical beam CT image.
Evaluation module is on the online conical beam CT image of proofreading and correct through the CT value; In conjunction with current treatment bed adjustment parameter; Current radiotherapy planning is carried out Rapid Dose Calculation; Compare with the dose data and the dose constraint of appointment that jeopardize in the organ contours in target area through adding up online generation; Or show target area and the dose volume histogram that jeopardizes organ, whether auxiliary doctor's decision need carry out the optimization again of radiotherapy planning.If do not need to optimize again radiotherapy planning, then still use current radiotherapy planning to treat.Again optimize radiotherapy planning if desired, then get into schedule module and optimize radiotherapy planning again.In order to save time, the Rapid Dose Calculation process is quickened through the GPU parallel computation.
Schedule module according to preassigned target area and the dose constraint that jeopardizes organ to online generation, is optimized radiotherapy planning on the online conical beam CT image of proofreading and correct through the CT value again.And Optimization result exported to the DICOM communication module.In order to save computing time, direct launched field optimization is quickened through the GPU parallel computation.
The conical beam CT image of gathering when fladellum CT image of gathering during certain patient's radiotherapy localization of registration and radiotherapy for the first time; Patient is when treating for the first time; Because the acquisition interval between the two CT images is very short; Generally the variation of tumour and normal surrounding tissue organ thereof is little; Can accomplish treatment through rigid body registration and accurate pendulum position, described in the present invention can the off-line completion for obtaining rigid body or the deformable registration that the corresponding relation of pixel carries out in the pixel and fladellum CT in the conical beam CT.For few patients when treating for the first time; Tumour and normal surrounding tissue organ thereof just have bigger variation need revise the situation of treatment plan; The registration process of describing among the present invention needs online completion; The new treatment plan of working out of attaching most importance to provides the conical beam CT image corresponding electron density information; This need spend the long time, but the CT value correction of the conical beam CT image in the treatment later on then can utilize a series of table of corrections that comprise partial correction information of current foundation to accomplish fast.
The method that the registration that carries out for the corresponding relation that obtains pixel among pixel in the conical beam CT and the location fladellum CT can adopt the rigid body registration with (or) method of deformable registration.For the situation that between location fladellum CT scan and conical beam CT scanning for the first time, does not almost have the anatomical structure distortion,, only need the rigid body registration just can obtain the corresponding relation of pixel among enough conical beam CTs accurately and the fladellum CT such as intracranial lesion.For the situation that has the anatomical structure distortion, the method that then needs to adopt deformable registration separately or adopt the rigid body registration to combine with deformable registration obtains the corresponding relation between the pixel.
According to the corresponding relation of pixel among pixel and the fladellum CT in the conical beam CT of registration results generation, according to a plurality of conical beam CT image C T value table of corrections of the automatic generation of the corresponding relation of pixel among pixel in the conical beam CT and the fladellum CT with partial correction information.In generating the process of table of corrections, the pixel corresponding relation of the mistake that do not satisfy condition is carried out filtering.These wrong corresponding relations possibly caused by registration error or other reason.Foundation with conical beam CT image C T value table of corrections of partial correction information, the CT value control information that preferentially use the part to obtain.
The conical beam CT that same patient obtains later on needs to use identical sweep parameter with the conical beam CT of gathering for the first time.The a series of table of corrections that comprise partial correction information that obtain after the conical beam CT scanning first time are applied to the CT value correction of the conical beam CT that same patient obtains later on; The conical beam CT after these corrections promptly adopt the CT value table of corrections that comprises this regional local message of the correspondence of before having obtained to proofread and correct, so that can obtain electron density information accurately to the electron density conversion table through the location fladellum CT value that prestores in the planning system for certain regional area in the conical beam CT of new collection.Provide a concrete implementation step below:
(1) confirms the CT value to the electron density mapping relations, both confirm by the CT value of locating fladellum CT image to the mapping relations the electron density of imageable target, so that transfer use in the back; Usually these mapping relations are stored in the radiotherapy planning system.
(2) CT image acquisition is gathered the conical beam CT image of the same body part of patient and is located fladellum CT image, adopts and based on the beam images deformable registration method of altering an agreement of gradient fields two CT images is carried out registration; This deformable registration method has open in detail in application number is the patent of CN201010520917.6;
(3) region division, the cone-beam CT image and positioning of the fan beam CT image after the registration of the three-dimensional region overlapping the specified size of a rectangular parallelepiped is divided into N stages local area; Let the n-th rectangular length, width, and height respectively
,
and
(n +1) stage partial area included in the n-th partial area, and the first partial area n +1 stage side were
,
and
; N and n are positive integers and 1 ≤ n ≤ N, N ≥ 3;
(4) obtain the multistage CT value of individuation table of corrections; Through the CT value of adding up and calculate pixel in each regional area inner cone pencil of forms CT image and the CT value of locating respective pixel in the fladellum CT image, obtain the individuation table of corrections of N level regional area conical beam CT image C T value fladellum CT image C T value to the location;
(5) correction of conical beam CT value, for the conical beam CT image that obtains each time afterwards, the CT value table of corrections that utilizes step (4) to obtain is proofreaied and correct it, so that make the conical beam CT image after the correction can be used for the electron density information calculations;
(6) map to electron density,, calculate the electron density of imageable target, can carry out Rapid Dose Calculation by electron density information to the mapping relations that obtain in the conical beam CT imagery exploitation step (1) after proofreading and correct.
Like Fig. 3, Fig. 4, Fig. 5 and shown in Figure 6; Provided N and equaled 3 o'clock synoptic diagram by conical beam CT image C T value fladellum CT image C T value table of corrections to the location; Shown conical beam CT image and fladellum CT image are 3-D view; Shown first order table of corrections comprises the mapping relations of whole volume images inner cone pencil of forms CT image C T value to fladellum CT image C T value, and the second level and the littler third level then only comprise the mapping relations of corresponding subrange.As shown in the figure, first order correcting area is 8 times of second-order correction zone, and the second-order correction zone is 8 times of third level correcting area; If the value of N is greater than 3, then progression is big more, and corresponding zone is just more little.It can also be seen that from Fig. 2, Fig. 3 and Fig. 4 the control information corresponding from first order table of corrections to third level table of corrections reduces gradually.In this embodiment; Parameter N min is set at 10; Both for a regional area; The pixel count of specific conical beam CT value correspondence is greater than 10, and then the mean value of the CT value of the pairing fladellum CT of the image pixel that these conical beam CT values are identical image pixel is as the corresponding fladellum CT corrected value of this conical beam CT value in the table of corrections.The pixel count of specific conical beam CT value correspondence is less than 10, and then this conical beam CT value is not participated in the foundation of this regional area table of corrections.In said process, when being not integer like pixel in the conical beam CT image through the corresponding fladellum CT location of pixels of deformation field, we utilize the CT value of eight adjacent summit pixels, obtain the CT value of correspondence through the method for three-way interpolation.Parameter Diff is set at 700 in this embodiment, both differs 700 the situation that surpasses for pixel CT value in pixel CT value in the conical beam CT image and the corresponding fladellum CT image, and we think wrong correspondence, and this pixel is not participated in the statistics of mean value.
When the conical beam CT that carries out same patient was later on gathered, sweep parameter was identical in the time of will be with first time conical beam CT image scanning.The conical beam CT image that obtains, the multi-stage taper bundle CT image C T value that direct utilization has obtained is to the table of corrections of fladellum CT image C T value, by proofreading and correct of pixel.Proofread and correct the preferential corresponding first degree table of corrections (being third level table of corrections) of affiliated area that adopts here.Because rudimentary table of corrections only comprises less control information; When in the trimming process when prime partial correction table does not comprise the CT value control information of needs; Then use the table of corrections of the upper level (second-order correction table) at current local place, up to obtaining corresponding control information.After whole three-dimensional cone beam CT adjustment of image was accomplished, the image information after the correction was carried out Rapid Dose Calculation according to fladellum CT value to the mapping table of electron density again.
For four-dimensional conical beam CT image, be three-dimensional cone beam CT image construction by a plurality of different breathing states.Use is based on the beam images deformable registration method of altering an agreement of gradient fields, and certain is with reference to the three-dimensional cone beam CT image and the previous fladellum CT image of gathering of breathing state in the four-dimensional conical beam CT image that registration is gathered for the first time.
It is identical with method recited above to the method for the table of corrections of fladellum CT image C T value to obtain regional area conical beam CT image C T values at different levels according to above-mentioned registration results.When the four-dimensional conical beam CT that carries out same patient was later on gathered, acquisition methods was identical in the time of will scanning with the first time with sweep parameter.It is identical with method recited above to utilize multistage table of corrections that the three-dimensional cone beam CT image of each breathing state of expression in the four-dimensional conical beam CT is carried out method of correcting.After whole four-dimensional conical beam CT adjustment of image was accomplished, the image after the correction can directly carry out Rapid Dose Calculation (having the mapping table of fladellum CT value to electron density in the planning system) in planning system.
Claims (9)
1. the radiotherapy dosage based on conical beam CT image C T value alignment technique evaluates and optimizes method, it is characterized in that, may further comprise the steps:
A. images acquired information is gathered patient's fladellum CT image during radiotherapy localization, and fladellum CT image information is stored online acquisition conical beam CT image during radiotherapy;
B. formulate radiotherapy planning, according to the target area of on the fladellum CT image of location, delineating, generation fractionated radiotherapy plan information is also stored;
C. obtain CT value table of corrections,, generate the CT value table of corrections of online conical beam CT image according to the relation between location fladellum CT image and the online conical beam CT image;
D. proofread and correct the conical beam CT image, during fractionated radiotherapy, at first gather patient's online conical beam CT image each time, utilize CT value table of corrections to proofread and correct the CT value of online each pixel of conical beam CT image again;
E. delineate target area and profile, on the online conical beam CT image after the correction, delineate the profile of target area and organ;
F. set current radiotherapy planning, set in the radiotherapy planning information that the last off-line that fractionated radiotherapy plan that step b generates or step l generate optimizes again with it information corresponding as current radiotherapy planning;
G. judge whether to carry out the rigid body registration,, then online conical beam CT image after proofreading and correct and location fladellum CT image are carried out the rigid body registration if need carry out the rigid body registration; If need not to carry out the rigid body registration, then execution in step h;
H. assess current radiotherapy planning, make assessment result, and determine whether that according to assessment result needs optimize current radiotherapy planning according to the dose distribution that current radiotherapy planning produced;
I. as need not to optimize current radiotherapy planning, then adopt current radiotherapy planning;
J. optimize current radiotherapy planning as needing, then carry out local optimum as original plan, the new current radiotherapy planning after optimizing with acquisition with current radiotherapy planning;
K. off-line assessment radiotherapy planning is made assessment result according to the dose distribution that the last radiotherapy planning produced, and determines whether that according to assessment result the needs off-line optimizes current radiotherapy planning again;
L. as needing off-line optimize radiotherapy planning again, then the conical beam CT image of gathering according to the last time and corresponding target area and organ contours regenerates radiotherapy planning in global scope.
2. the radiotherapy dosage based on conical beam CT image C T value alignment technique according to claim 1 evaluates and optimizes method, it is characterized in that the current radiotherapy planning of the assessment described in the step h may further comprise the steps:
H-1. according to current radiotherapy planning the online conical beam CT image after proofreading and correct is carried out Rapid Dose Calculation;
H-2. obtain target area and the current dose distribution that jeopardizes organ;
H-3. judge current dose distribution whether the target area with jeopardize in the dose constraint and dose volume restriction range of organ, as within restriction range, then need not to optimize current radiotherapy planning; As not within restriction range, then need optimize current radiotherapy planning.
3. the radiotherapy dosage based on conical beam CT image C T value alignment technique according to claim 1 and 2 evaluates and optimizes method, and it is characterized in that: said CT value table of corrections is the individuation table of corrections that comprises Local C T value control information; And CT value table of corrections is the beam images deformable registration method of altering an agreement that adopts based on gradient fields, obtains the corresponding relation between online conical beam CT image and the location fladellum CT image pixel CT value.
4. the radiotherapy dosage based on conical beam CT image C T value alignment technique according to claim 1 and 2 evaluates and optimizes method, it is characterized in that: delineate target area and profile among the step e are producing automatically on the conical beam CT image or are adopting the method for deformable registration will locate on the online conical beam CT image after target area and organ contours on the fladellum CT image is mapped to correction automatically for adopting based on the method for threshold values or based on the method for template matches.
5. the radiotherapy dosage based on conical beam CT image C T value alignment technique according to claim 1 and 2 evaluates and optimizes method, it is characterized in that: the rigid body registration described in the step g is to the target area on online conical beam CT image and the location fladellum CT image or the registration of anatomical structure undetermined.
6. the radiotherapy dosage based on conical beam CT image C T value alignment technique according to claim 1 and 2 evaluates and optimizes method, it is characterized in that: delineate target area and profile described in the step e comprise and delineate target area and profile and manual modification target area and profile automatically.
7. the radiotherapy dosage based on conical beam CT image C T value alignment technique according to claim 1 and 2 evaluates and optimizes method, it is characterized in that said step c comprises:
C-1. Region Segmentation; 3D region overlapping after conical beam CT image and the location fladellum CT image registration is divided into N level regional area by the cuboid of specified size; If the length and width and the height of n level cuboid are respectively
,
and
; N+1 level regional area is contained in n level regional area; And the length of side of n+1 level regional area is respectively
,
and
; N and n are positive integer; And 1≤n≤N, N >= 3;
C-2. obtain CT value table of corrections; Through the CT value of adding up and calculate pixel in each regional area inner cone pencil of forms CT image and the CT value of locating respective pixel in the fladellum CT image, obtain the table of corrections of N level regional area conical beam CT image C T value fladellum CT image C T value to the location.
8. the radiotherapy dosage based on conical beam CT image C T value alignment technique according to claim 1 and 2 evaluates and optimizes method; It is characterized in that, comprise also among the said step a that foundation is by the step of the CT value of locating fladellum CT image to the mapping relations the electron density of imageable target.
9. the radiotherapy dosage based on conical beam CT image C T value alignment technique according to claim 1 evaluates and optimizes method; It is characterized in that; Said step j comprises leaf position and the accelerator jumping figure of on the basis of initial radiotherapy plan, optimizing each launched field according to leaf position constraint condition, current conical beam CT image employing Local Optimization Algorithm simultaneously, obtains the radiotherapy planning of local optimum.
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