CN102306239B - 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 dosimetry based on conical beam CT image C T value alignment technique and evaluate and optimize method, in particular, relate in particular to a kind of CT value of the fan-beam image gathering when with reference to radiotherapy localization, during to radiotherapy, the CT value of the conical beam CT image of online acquisition is carried out the technology of individual calibration, and on this basis Radiotherapy dosimetry is carried out to online and off-line assessment, and then implement the method for the optimization of radiotherapy planning.
Background technology
Modern radiotherapy technology, such as emphasizing radiotherapy, can distribute highly conformal dosage to project static target area.But radiation therapy process adopts fractionated irradiation technology conventionally, i.e. radiotherapy need to divide several times to carry out.In fractionated radiotherapy process, the position of tumour and around vitals and shape may produce between radiotherapy gradation and to change (as the increase of lump, shrink back or distortion).In addition, also can there is the change in location that pendulum bit error etc. causes in each treatment.Based on the consideration of these motion change, conventional way is outside tumor area, to put certain limit as plan field, and this can cause more normal structure to be subject to radiation insult.In the time there is larger variations in the position of tumour and shape, conventionally need Resurvey to locate CT, reformulate radiotherapy planning.
The conical beam CT scanning system being integrated on accelerator can be obtained online patient's conical beam CT image in the time of radiotherapy, thereby obtains patient's in-vivo tumour or other position and shape information that jeopardizes organ while treatment.For tumour with jeopardize these change informations of organ, again optimize online radiotherapy planning, can avoid tumour and jeopardize motion between the radiotherapy gradation of organ causing wrong dose delivery.
But, again optimize online radiotherapy planning and need to from online conical beam CT image, obtain electron density information.Due to reasons such as the intrinsic electron scatterings of online conical beam CT scanning system, cause the mapping relations between CT value and the electron density of imageable target of the online conical beam CT image of rebuilding uncertain.Mapping relations between CT value and the electron density of imageable target of online conical beam CT image not only change with the difference of imageable target, and mapping relations between the CT value of the different parts of same imageable target and its corresponding electron density also can change.This makes again to optimize radiotherapy planning on conical beam CT image and becomes difficulty.
Online evaluation target area and jeopardize between the gradation of organ and change the impact that dosage is distributed, for estimating radiotherapeutic effect, determines whether again optimize radiotherapy planning also very important.Owing to obtaining electron density information accurately from online conical beam CT image, also make cannot to when treatment target area and the dosage that jeopardizes organ distribute and carry out online evaluation.
Current radiotherapy planning system in the time carrying out Rapid Dose Calculation employing be the method that source modeling and patient's modeling are separated.First calculate high-energy X-ray and distribute at the flux of energy of certain plane, then calculate the dosage distribution that this flux of energy produces in patient body.So current radiotherapy planning system mainly contains two kinds of methods in the time carrying out planning optimization, be first to optimize to obtain a Flux Distribution optimum in each launched field direction, then cut apart Flux Distribution to the launched field sequence that can throw according to the physical parameter of concrete beam limiting device.This method in two steps can make the dosage of cutting apart the plan obtaining distribute different from the dosage distribution that optimization flux obtains at first, this usually causes final plan can not meet the dose constraint of setting, need adjustment repeatedly of doctor constraint again to optimize, this is for being unacceptable to optimizing the very high on-line planning of time requirement.What another kind of directly launched field optimization method adopted is nonumeric Stochastic Optimization Algorithms, such as simulated annealing etc., directly optimizes shape and the accelerator jumping figure of each launched field.These nonumeric Stochastic Optimization Algorithms are searched for optimum launched field shape and accelerator jumping figure corresponding to each launched field, the optimization time that this conventionally need to be longer in global scope.Even if some direct launched field optimized algorithm to reduce the optimization time, but determines that in global scope the starting point of local optimum still needs the computing time of growing in the last employing Local Optimization Algorithm of optimizing.Particularly, for online situation about again optimizing, again optimize and irradiate to enforcement to plan from Image Acquisition, whole process patient needs to be fixed in therapeutic bed, and the oversize optimization time is unacceptable.In order to reduce the optimization time, some methods of directly revising launched field shape are developed, and these methods, according to the distortion of target area projection in launched field direction, directly change the shape of launched field, and then optimize the accelerator jumping figure of each launched field.But directly do not have to consider jeopardizing the impact of organ according to the shape (instead of production optimization launched field shape) of the distortion amendment launched field of target area, can make in some cases final optimum results can not meet clinical requirement.
Summary of the invention
The present invention, in order to overcome the shortcoming of above-mentioned technical matters, provides a kind of and has evaluated and optimized method for the Radiotherapy dosimetry based on conical beam CT image C T value alignment technique that gathers conical beam CT image and location fan-beam image and process.
Radiotherapy dosimetry based on conical beam CT image C T value alignment technique of the present invention evaluates and optimizes method, its special feature is, comprise the following steps: a. gathers image information, gather patient's location fan-beam image and online conical beam CT image, and fan-beam image information is stored to online acquisition conical beam CT image when radiotherapy; B. formulate radiotherapy planning, according to the target area of delineating on the fan-beam image of location, generate fractionated radiotherapy plan information and store; C. obtain CT value table of corrections, according to the relation between location fan-beam image and online conical beam CT image, generate the CT value table of corrections of online conical beam CT image; D. proofread and correct conical beam CT image, when fractionated radiotherapy, first gather patient's online conical beam CT image each time, recycling CT value table of corrections is proofreaied and correct the CT value of the each pixel of online conical beam CT image; E. delineate target area and profile, on the online conical beam CT image after correction, delineate the profile of target area and organ; F. set current radiotherapy planning, the information of answering in contrast in the radiotherapy planning information that the last off-line that the fractionated radiotherapy plan that setting step b generates or step l generate is optimized is again as current radiotherapy planning; G. judge whether to carry out rigid registration, if need carry out rigid registration, the online conical beam CT image after proofreading and correct and location fan-beam image are carried out to rigid registration; If without carrying out rigid registration, perform step h; H. assess current radiotherapy planning, the dosage producing according to current radiotherapy planning distributes and makes assessment result, and determines whether to optimize current radiotherapy planning according to assessment result; I. as without optimizing current radiotherapy planning, adopt current radiotherapy planning; J. optimize current radiotherapy planning as needed, carry out local optimum using current radiotherapy planning as original plan, to obtain the current radiotherapy planning after optimization; K. off-line assessment radiotherapy planning, the dosage producing according to the last radiotherapy planning distributes and makes assessment result, and determines whether to need off-line again to optimize current radiotherapy planning according to assessment result; L. as needed off-line again to optimize radiotherapy planning,, according to the conical beam CT image of the last time collection and corresponding target area and organ contours, in global scope, regenerate radiotherapy planning.The distortion of fan-beam image is low, and the distortion of conical beam CT image is high, is easy to manually sketch out target area on fan-beam image.In steps d, the CT value table of corrections obtaining in the online conical beam CT imagery exploitation step c gathering is proofreaied and correct; Described in step e, delineate target area and profile for automatically delineating formation.In step g, whether need to carry out the judgement of rigid registration, can judge in the alternate position spike in space by the online conical beam CT image to after proofreading and correct and location fan-beam image, signal is adjusted in the position of output can adjust signal for therapeutic bed position.In step f, the information of answering in contrast in the fractionated radiotherapy plan information that the last off-line that the fractionated radiotherapy plan that described step b generates or step k generate is optimized again refers to, the treatment plan corresponding with this interval procedure step generating in step b or k.If not carrying out off-line optimizes again, the fractionated radiotherapy treatment plan corresponding with this interval procedure step in the works that optional step b generates, again optimized the fractionated radiotherapy again optimized of the last off-line that optional step k the generates treatment plan corresponding with this interval procedure step in the works if carry out off-line.
Radiotherapy dosimetry 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 step h comprises the following 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. obtaining target area distributes with the predose of working as that jeopardizes organ; H-3. judge that whether current dosage distribute in target area and jeopardize in the dose constraint and dose volume restriction range of organ, as within restriction range, without optimizing current radiotherapy planning; If not within restriction range, need to optimize current radiotherapy planning.
Radiotherapy dosimetry based on conical beam CT image C T value alignment technique of the present invention evaluates and optimizes method, and described CT value table of corrections is the individual calibration table 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 adopting based on gradient fields, obtain the corresponding relation between online conical beam CT image and location fan-beam image pixel CT value.Open in the patent application patent that the beam images deformable registration method of altering an agreement based on gradient fields is CN201010520917.6 in the patent No..
Radiotherapy dosimetry based on conical beam CT image C T value alignment technique of the present invention evaluates and optimizes method, in step e delineate target area and profile be adopt the method based on threshold value or the method based on template matches automatically to produce on conical beam CT image or the method that adopts deformable registration by the target area on the fan-beam image of location and organ contours automatic mapping to the online conical beam CT image after proofreading and correct.
Radiotherapy dosimetry based on conical beam CT image C T value alignment technique of the present invention evaluates and optimizes method, and the rigid registration described in step g is to the target area on online conical beam CT image and location fan-beam image or the registration of anatomical structure undetermined.
Radiotherapy dosimetry 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 step e comprise and automatically delineate target area and profile and manual modification target area and profile.
Radiotherapy dosimetry based on conical beam CT image C T value alignment technique of the present invention evaluates and optimizes method, described step c comprises: c-1. Region Segmentation, is divided into N level regional area by 3D region overlapping after conical beam CT image and fan-beam image registration by the rectangular parallelepiped of specified size; If length and width and the height of n level rectangular parallelepiped are respectively
,
with
, 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
,
with
; N and n are positive integer, and 1≤n≤N, N>=3; C-2. obtain CT value table of corrections, by adding up and calculate the CT value of respective pixel in the CT value of pixel in each regional area inner cone pencil of forms CT image and fan-beam image, obtain the table of corrections of N level regional area conical beam CT image C T value to fan-beam image C T value.N+1 level regional area in step (c-1) is a part for 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 obtaining in step (c-2), the CT value of conical beam CT image can be converted into the CT value of corresponding fan-beam image, to carry out Rapid Dose Calculation.
Radiotherapy dosimetry based on conical beam CT image C T value alignment technique of the present invention evaluates and optimizes method, also comprises and set up by locating the CT value of fan-beam image to the step of the mapping relations the electron density of imageable target in described step a.Set up by locating the CT value of fan-beam image to the electron density mapping relations of imageable target, be conducive to the information of conical beam CT image to be converted into electron density information, to carry out Rapid Dose Calculation.
Radiotherapy dosimetry based on conical beam CT image C T value alignment technique of the present invention evaluates and optimizes method, in step j, carry out local optimum using current radiotherapy planning as original plan and refer to the starting point using current planning as local optimum, utilize the derivative of optimization aim function to multi-diaphragm collimator leaf position in each launched field and accelerator jumping figure, 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 by formulating radiotherapy planning on the fan-beam image gathering when the radiotherapy localization, online acquisition conical beam CT image before every fractionated radiotherapy, and the CT value of the online conical beam CT image gathering is carried out to individual calibration, both the accuracy of Rapid Dose Calculation and dosage assessment while having ensured on-line optimization radiotherapy planning, has ensured again rapidity and the convenience of the on-line optimization radiotherapy planning in interval procedure process; By the online local optimum radiotherapy planning of integrated use and off-line global optimization radiotherapy planning, both rapidity and the convenience of on-line optimization had been ensured by local optimum, guarantee by global optimization the accuracy of optimizing again, when further having ensured the effective treatment to target area, avoid as far as possible the damage of normal tissue.
Brief description of the drawings
Fig. 1 is 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 that conical beam CT image and fan-beam image tertiary zone are cut apart schematic diagram;
Fig. 4 is the schematic diagram of first order table of corrections;
Fig. 5 is the schematic diagram of second-order correction table;
Fig. 6 is the schematic diagram of second-order correction table.
embodiment
Below in conjunction with accompanying drawing and embodiment, the invention will be further described.
As shown in Figure 1, provided the program flow diagram of an embodiment of the Radiotherapy dosimetry appraisal procedure 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 fan-beam image, and it is stored;
B. formulate radiotherapy planning, according to the target area of manually delineating on the fan-beam image of location, generate fractionated radiotherapy plan information and store;
C. obtain CT value table of corrections, adopt the beam images deformable registration method of altering an agreement based on gradient fields, obtain the CT value table of corrections of the corresponding relation between online conical beam CT image and location fan-beam image pixel CT value;
In this step, the CT value table of corrections of generation can be the multistage CT value of the individuation table of corrections that comprises Local C T value control information;
D. proofread and correct conical beam CT image, when fractionated radiotherapy, first gather patient's online conical beam CT image each time, recycling CT value table of corrections is proofreaied and correct the CT value of the each pixel of online conical beam CT image;
E. delineate target area and profile, on the online conical beam CT image after correction, automatically delineate the profile of target area and organ, form current radiotherapy planning;
In this step, can also be with hand the profile of the target area to automatic generation and organ modify;
In this step automatically delineate target area and profile be adopt the method based on threshold value or the method based on template matches automatically to produce on conical beam CT image or the method that adopts deformable registration by the target area on the fan-beam image of location and organ contours automatic mapping to the online conical beam CT image after proofreading and correct.
F. set current radiotherapy planning, the information of answering in contrast in the radiotherapy planning information that the last off-line that the fractionated radiotherapy plan that setting step b generates or step l generate is optimized is again as current radiotherapy planning.
G. judge whether to carry out rigid registration, if need carry out rigid registration, the online conical beam CT image after proofreading and correct and location fan-beam image are carried out to rigid registration, and adjust signal according to registration results output patient position; If without carrying out rigid registration, perform step h;
In this step, can judge in the alternate position spike in space by the online conical beam CT image to after proofreading and correct and location fan-beam image, if the alternate position spike of two images exceedes specialized range, carry out rigid registration, if alternate position spike within the limits prescribed, without carrying out rigid registration;
H. assess current radiotherapy planning, the dosage producing according to current radiotherapy planning distributes and makes assessment result, and determines whether to optimize current radiotherapy planning according to assessment result; Specifically comprise the following steps:
H-1. assess current radiotherapy planning, according to current radiotherapy planning, the online conical beam CT image after proofreading and correct is carried out to Rapid Dose Calculation;
H-2. obtaining target area distributes with the predose of working as that jeopardizes organ;
H-3. judge that whether current dosage distribute in target area and jeopardize in the dose constraint and dose volume restriction range of organ, as within restriction range, without optimizing current radiotherapy planning; If not within restriction range, need to optimize current radiotherapy planning;
I. as without optimizing current radiotherapy planning, export radiotherapy control signal according to current radiotherapy planning;
J. optimize current radiotherapy planning as needed, the information of answering in contrast in the fractionated radiotherapy plan information that utilizes step b to generate is optimized, and to obtain the current radiotherapy planning after optimization, and exports according to this plan radiotherapy control signal;
K. off-line assessment radiotherapy planning, the dosage producing according to the last radiotherapy planning distributes and makes assessment result, and determines whether to need off-line again to optimize current radiotherapy planning according to assessment result;
L. as needed off-line again to optimize radiotherapy planning,, according to the conical beam CT image of the last time collection and corresponding target area and organ contours, in global scope, regenerate radiotherapy planning.
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 registration module.Shown DICOM communication module is for realizing communication function with Accelerator control platform, server and conical beam CT control desk.
DICOM communication module reads the location fan-beam image of having stored, online conical beam CT image, fractionated radiotherapy plan, dosage and organ contours data by DICOM agreement from server, or directly obtain online conical beam CT image from conical beam CT control desk, and will utilize the organ contours of new generation on the rear image producing of CT value table of corrections correction, online conical beam CT image, plan and the dose data that optimization obtains again to store server into, or directly send to Accelerator control platform by again optimizing the plan obtaining.
Registration module mainly completes the deformable registration of location fan-beam image and online conical beam CT image, with determine from navigate to when treatment target area and each jeopardize motion and deformation between the gradation of organ, registration Algorithm adopts the beam images deformable registration method of altering an agreement based on gradient fields, open in the patent application patent that the method is CN201010520917.6 in the patent No., and the deformation field that registration is produced is exported to conical beam CT value correction module and is delineated module.Deformable registration algorithm based on gradient fields can be by multiple programming parallel practice on GPU.
Another function of registration module is the rigid registration between location fan-beam image and online conical beam CT image.This rigid registration is after on conical beam CT, target area and organ contours generate.Can complete rigid registration to the organ of target area or appointment, the therapeutic bed producing according to rigid registration is adjusted parameter translation or rotating therapeutic bed, with proofread and correct pendulum bit error and can partial correction target area or the gradation of crisis organ between the impact that produces of motion.The therapeutic bed that rigid registration produces is adjusted parameter and is output to evaluation module, so that the dosage after adjusting is distributed and to be assessed.
Conical beam CT value correction module is used for the CT value of online conical beam CT image to proofread and correct, so that it can reflect correct electron density information, carries out Rapid Dose Calculation.The method is in the time obtaining the primary conical beam CT image of certain patient, the deformation field producing according to registration module completes 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 the online conical beam CT value in this patient this and future.The online conical beam CT image that completes the correction of CT value is outputed to evaluation module and schedule module by this module.
Delineate module and complete the automatic generation of organ contours on conical beam CT image, and allow the inaccurate profile of automatic generation to carry out manual modification.The automatic generation of organ contours can adopt the method for method based on threshold value, template matches or the deformation field that produces according to registration by the target area on the fan-beam image of location and organ contours automatic mapping to conical beam CT image.Target area and organ contours on newly-generated online conical beam CT image are outputed to evaluation module and schedule module by this module.
Evaluation module is on the online conical beam CT image of proofreading and correct through CT value, adjust parameter in conjunction with current therapeutic bed, current radiotherapy planning is carried out to Rapid Dose Calculation, by adding up the target area of online generation and jeopardizing dose data in organ contours and the dose constraint of appointment is compared, or showing target area and the dose volume histogram that jeopardizes organ, auxiliary doctor determines whether to need to carry out the optimization again of radiotherapy planning.If do not need again to optimize radiotherapy planning, still use current radiotherapy planning to treat.If need to again optimize radiotherapy planning, enter schedule module and again optimize radiotherapy planning.In order to save time, by GPU parallel computation, Rapid Dose Calculation process is accelerated.
Schedule module, on the online conical beam CT image of proofreading and correct through CT value,, is optimized radiotherapy planning the target area of online generation and the dose constraint that jeopardizes organ again according to preassigned.And optimum results is exported to DICOM communication module.In order to save computing time, by GPU parallel computation, direct launched field optimization is accelerated.
The conical beam CT image gathering when the fan-beam image gathering when certain patient's radiotherapy localization of registration and radiotherapy for the first time, patient is in the time treating for the first time, because the acquisition interval between two CT images is very short, the variation of tumour and normal surrounding tissue organ thereof is little under normal circumstances, can be by rigid registration and an accurate pendulum position completed treatment, can complete by off-line for obtaining rigid body or the deformable registration that in conical beam CT, in pixel and fan-beam, the corresponding relation of pixel carries out described in the present invention.For a few patients in the time treating for the first time, tumour and normal surrounding tissue organ thereof just have larger variation need to revise the situation for the treatment of plan, the registration process of describing in the present invention need to complete online, the new treatment plan of working out of attaching most importance to provides the electron density information that conical beam CT image is corresponding, this need to spend the longer time, but the CT value correction of conical beam CT image in later treatment can utilize a series of table of corrections that comprise partial correction information of current foundation to complete fast.
Can adopt the method for rigid registration and (or) the method for deformable registration for obtaining pixel in conical beam CT with the registration that the corresponding relation of locating pixel in fan-beam carries out.For the situation that almost there is no anatomical structure distortion between location fan-beam scanning and conical beam CT scanning for the first time, such as intracranial lesion, only need rigid registration just can obtain the corresponding relation of pixel in enough conical beam CTs accurately and fan-beam.For the situation that has anatomical structure distortion, need the method that adopts separately deformable registration or adopt rigid registration and deformable registration to combine to obtain the corresponding relation between pixel.
The corresponding relation of pixel in pixel and fan-beam in the conical beam CT producing according to registration results, generates multiple conical beam CT image C T value table of corrections with partial correction information automatically according to the corresponding relation of pixel in pixel in conical beam CT and fan-beam.Generating in the process of table of corrections, the wrong pixel corresponding relation not satisfying condition is carried out to filtering.These wrong corresponding relations may be caused by registration error or other reason.There is the foundation of the conical beam CT image C T value table of corrections of partial correction information, the CT value control information that preferentially use part to obtain.
The conical beam CT that same patient obtains later needs and the conical beam CT of collection for the first time uses identical sweep parameter.The a series of table of corrections that comprise partial correction information that obtain after the scanning of conical beam CT are for the first time applied to the CT value correction of the conical beam CT that same patient obtains later, the conical beam CT after these corrections adopt the corresponding CT value table of corrections that comprises this region local message previously having obtained to proofread and correct for certain regional area in the conical beam CT of new collection, so that can obtain electron density information accurately to electron density conversion table by the location fan-beam value prestoring in planning system.Provide a concrete implementation step below:
(1) determine that CT value is to electron density mapping relations, both determined by the CT value of locating fan-beam image to the mapping relations the electron density of imageable target, to transfer in the back use; Conventionally these mapping relations are stored in radiotherapy planning system.
(2) CT image acquisition, gathers the conical beam CT image of the same body part of patient and locates fan-beam image, adopts the beam images deformable registration method of altering an agreement based on gradient fields that two CT images are carried out to registration; In the patent that this deformable registration method is CN201010520917.6 at application number, have open in detail;
(3) Region Segmentation, is divided into N level regional area by overlapping 3D region after conical beam CT image and location fan-beam image registration by the rectangular parallelepiped of specified size; If length and width and the height of n level rectangular parallelepiped are respectively
,
with
, 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
,
with
; N and n are positive integer, and 1≤n≤N, N>=3;
(4) obtain the multistage CT value of individuation table of corrections, by adding up and calculate the CT value and the CT value of locating respective pixel in fan-beam image of pixel in each regional area inner cone pencil of forms CT image, obtain the individual calibration table of N level regional area conical beam CT image C T value to location fan-beam image C T value;
(5) correction of conical beam CT value, for the conical beam CT image obtaining each time afterwards, utilizes the CT value table of corrections that step (4) is obtained to proofread and correct it, to make the conical beam CT image after correction can be used for the calculating of electron density information;
(6) map to electron density, to the mapping relations that obtain in the conical beam CT imagery exploitation step (1) after proofreading and correct, calculate the electron density of imageable target, can carry out Rapid Dose Calculation by electron density information.
As shown in Fig. 3, Fig. 4, Fig. 5 and Fig. 6, provided N equal 3 o'clock by conical beam CT image C T value the schematic diagram to location fan-beam image C T value table of corrections, shown conical beam CT image and fan-beam 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 fan-beam image C T value, and the second level and the less third level only comprise the mapping relations of corresponding subrange.As shown in the figure, first order correcting area is 8 times of second-order correction region, and second-order correction region is 8 times of third level correcting area; If the value of N is greater than 3, progression is larger, and corresponding region is just less.From Fig. 2, Fig. 3 and Fig. 4, it can also be seen that, reduce gradually to control information corresponding to third level table of corrections from first order table of corrections.In this embodiment, parameter N min is set as 10, both for a regional area, specific pixel count corresponding to conical beam CT value is greater than 10, and the mean value of the CT value of the corresponding fan-beam image pixel of image pixel that these conical beam CT values are identical is as fan-beam corrected value corresponding to this conical beam CT value in table of corrections.Specific pixel count corresponding to conical beam CT value is less than 10, and this conical beam CT value does not participate in the foundation of this regional area table of corrections.In said process, while being not integer as pixel in conical beam CT image by fan-beam location of pixels corresponding to deformation field, we utilize the CT value of eight adjacent summit pixels, obtain corresponding CT value by the method for three line interpolation.Parameter Diff is set as 700 in this embodiment, both differs with pixel CT value in corresponding fan-beam image the situation that exceedes 700 for pixel CT value in conical beam CT image, and we think wrong correspondence, and this pixel does not participate in the statistics of mean value.
When the conical beam CT that later carries out same patient gathers, sweep parameter is identical will be with conical beam CT image scanning for the first time time.The conical beam CT image obtaining, the multi-stage taper bundle CT image C T value that directly utilization has obtained is to the table of corrections of fan-beam image C T value, by proofreading and correct of pixel.Proofread and correct preferential first degree table of corrections (being third level table of corrections) corresponding to affiliated area that adopt here.Because rudimentary table of corrections only comprises less control information, when in trimming process in the time that prime partial correction table does not comprise the CT value control information of needs, use the table of corrections of the upper level (second-order correction table) at current local place, until obtain corresponding control information.After whole three-dimensional cone beam CT adjustment of image completes, the image information after correction is carried out Rapid Dose Calculation according to fan-beam value again to the mapping table of electron density.
For four-dimensional conical beam CT image, it is the three-dimensional cone beam CT image construction by multiple different breathing states.Use the beam images deformable registration method of altering an agreement based on gradient fields, certain three-dimensional cone beam CT image with reference to breathing state and the previous fan-beam image gathering in the four-dimensional conical beam CT image that registration gathers for the first time.
Obtain regional area conical beam CT image C T values at different levels according to above-mentioned registration results identical with method recited above to the method for the table of corrections of fan-beam image C T value.When the four-dimensional conical beam CT that later carries out same patient gathers, acquisition methods and sweep parameter are identical when scanning for the first time.Utilize multistage table of corrections identical with method recited above to the method that represents the three-dimensional cone beam CT image of each breathing state in four-dimensional conical beam CT and proofread and correct.After whole four-dimensional conical beam CT adjustment of image completes, the image after correction can directly carry out Rapid Dose Calculation (having the mapping table of fan-beam value to electron density in planning system) in planning system.
Claims (9)
1. the Radiotherapy dosimetry based on conical beam CT image C T value alignment technique evaluates and optimizes a method, it is characterized in that, comprises the following steps:
A. gather image information, when radiotherapy localization, gather patient's fan-beam image, and fan-beam image information is stored, online acquisition conical beam CT image when radiotherapy;
B. formulate radiotherapy planning, according to the target area of delineating on the fan-beam image of location, generate fractionated radiotherapy plan information and store;
C. obtain CT value table of corrections, according to the relation between location fan-beam image and online conical beam CT image, generate the CT value table of corrections of online conical beam CT image;
D. proofread and correct online conical beam CT image, when fractionated radiotherapy, first gather patient's online conical beam CT image each time, recycling CT value table of corrections is proofreaied and correct the CT value of the each pixel of online conical beam CT image;
E. delineate target area and profile, on the online conical beam CT image after correction, delineate the profile of target area and organ;
F. set current radiotherapy planning, the information of answering in contrast in the radiotherapy planning information that the last off-line that the fractionated radiotherapy plan that setting step b generates or step l generate is optimized is again as current radiotherapy planning;
G. judge whether to carry out rigid registration, if need carry out rigid registration, the online conical beam CT image after proofreading and correct and location fan-beam image are carried out to rigid registration; If without carrying out rigid registration, perform step h;
H. assess current radiotherapy planning, the dosage producing according to current radiotherapy planning distributes and makes assessment result, and determines whether to optimize current radiotherapy planning according to assessment result;
I. as without optimizing current radiotherapy planning, adopt current radiotherapy planning;
J. optimize current radiotherapy planning as needed, carry out local optimum using current radiotherapy planning as original plan, to obtain the new current radiotherapy planning after optimization;
K. off-line assessment radiotherapy planning, the dosage producing according to the last radiotherapy planning distributes and makes assessment result, and determines whether to need off-line again to optimize current radiotherapy planning according to assessment result;
L. as needed off-line again to optimize radiotherapy planning,, according to the online conical beam CT image of the last time collection and corresponding target area and organ contours, in global scope, regenerate radiotherapy planning.
2. the Radiotherapy dosimetry 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 step h comprises the following steps:
H-1. according to current radiotherapy planning, the online conical beam CT image after proofreading and correct is carried out to Rapid Dose Calculation;
H-2. obtaining target area distributes with the predose of working as that jeopardizes organ;
H-3. judge that whether current dosage distribute in target area and jeopardize in the dose constraint and dose volume restriction range of organ, as within restriction range, without optimizing current radiotherapy planning; If not within restriction range, need to optimize current radiotherapy planning.
3. the Radiotherapy dosimetry 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: described CT value table of corrections is the individual calibration table 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 adopting based on gradient fields, obtain the corresponding relation between online conical beam CT image and location fan-beam image pixel CT value.
4. the Radiotherapy dosimetry 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: in step e delineate target area and profile be adopt method that the method based on threshold value or the method based on template matches adopt deformable registration on online conical beam CT image by the target area on the fan-beam image of location and organ contours automatic mapping to the online conical beam CT image after proofreading and correct.
5. the Radiotherapy dosimetry 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 registration described in step g is to the target area on online conical beam CT image and location fan-beam image or the registration of anatomical structure undetermined.
6. the Radiotherapy dosimetry 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 step e comprise and automatically delineate target area and profile and manual modification target area and profile.
7. the Radiotherapy dosimetry 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, described step c comprises:
C-1. Region Segmentation, is divided into N level regional area by overlapping 3D region after online conical beam CT image and location fan-beam image registration by the rectangular parallelepiped of specified size; If length and width and the height of n level rectangular parallelepiped are respectively
,
with
, 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
,
with
; N and n are positive integer, and 1≤n≤N, N>=3;
C-2. obtain CT value table of corrections, the CT value of respective pixel in CT value by adding up and calculate in each regional area pixel in online conical beam CT image and location fan-beam image, the online conical beam CT image C of acquisition N level regional area T value is to the table of corrections of locating fan-beam image C T value.
8. the Radiotherapy dosimetry 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, in described step a, also comprise and setting up by locating the CT value of fan-beam image to the step of the mapping relations the electron density of imageable target.
9. the Radiotherapy dosimetry based on conical beam CT image C T value alignment technique according to claim 1 evaluates and optimizes method, it is characterized in that, described 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 online conical beam CT image employing Local Optimization Algorithm simultaneously, obtains the radiotherapy planning of local optimum.
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