CN103785113A - 用于发射引导的放疗的方法和装置 - Google Patents

用于发射引导的放疗的方法和装置 Download PDF

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CN103785113A
CN103785113A CN201310739317.2A CN201310739317A CN103785113A CN 103785113 A CN103785113 A CN 103785113A CN 201310739317 A CN201310739317 A CN 201310739317A CN 103785113 A CN103785113 A CN 103785113A
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S·马赞
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Abstract

一种装置，包括：辐射源；重合正电子发射检测器，其被配置为检测在坐标系统内发生的重合正电子湮没发射；以及控制器，其与所述辐射源和所述重合正电子发射检测器通信，所述控制器被配置为识别与所述坐标系统内的一个或多个体部相交的重合正电子湮没发射路径以及沿识别的重合正电子湮没发射路径对准所述辐射源。

Description

用于发射引导的放疗的方法和装置
本申请是申请日为2009年3月9日，发明名称为“用于发射引导的放疗的方法和装置”的中国专利申请CN200980108991.2（PCT/US2009/001500进入中国国家阶段的申请）的分案申请，在此请求原案的相关优先权权益。
相关申请
本专利申请要求2008年3月14日提交的美国临时专利申请第61/036,709号和2009年2月9日提交的美国专利申请第12/367,679号的优先权；所述申请的全部内容在此引入作为参考。
技术领域
本发明涉及用于放疗的装置和方法，具体地说，涉及使用高能辐射治疗身体内的癌变组织的装置和方法。
背景技术
放疗（RT）是一种使用高能辐射（例如，x射线）治疗身体内的癌变组织以杀死肿瘤细胞的方法。存在两种主要类型的RT：内束和外束。通过将辐射性材料植入患者体内要治疗的癌变部位内部或附近来实现内束RT。通过将高能辐射束瞄准患者以使其穿过要治疗的区域来实现外束RT。外部RT在近几十年来有很大的发展。为了在使健康组织免于受到伤害的同时将致命的辐射剂量施加于肿瘤，使用了诸如三维保角束RT之类的技术以使射束的形状匹配肿瘤在患者表面上的二维投影。此外，围绕患者以各种角度和不断变化的强度施加射束以便最大化对肿瘤的剂量，同时尽量减小对周围健康组织的剂量。这称为强度调制RT（IMRT）。
但是，与肿瘤位置和运动相关的不确定性会限制外束RT的有效性。患者安置的可变性以及由于内部器官的移位造成的肿瘤位置的自然变化都会产生静态误差。它们会随治疗而改变。治疗期间肿瘤的运动（例如，由于患者呼吸）会产生动态误差。例如，已知肺部肿瘤在正常患者呼吸期间移动的量级为1-2厘米。这种持续的问题导致了一类新的RT系统：影像引导RT（IGRT）。这些技术包括使用常规医疗成像的医疗方式（x射线、CT、MRI、PET等）在治疗之前和有时与治疗同时地形成肿瘤区域的影像，以便可以在治疗时知晓肿瘤位置。
但是，IGRT技术受限于肿瘤成像的缺乏确切性（例如，在许多情况下，几乎不可能从x射线CT目测肿瘤边界）或较差的时间分辨率（PET是使癌成像的最灵敏的医疗方式，但是其要花费几分钟来形成良好质量的PET影像）。在任一情况下，在RT期间动态地跟踪肿瘤仍非常困难。
正电子发射断层成像（PET）是一种频繁用于检测身体中的癌变组织的医疗成像医疗方式。首先将标记有辐射性原子（称为PET辐射示踪剂）的分子注入患者体内。患者体内的辐射性原子经历辐射性衰变并发射正电子。一旦从原子发出，正电子就将快速地与附近的电子碰撞，其后两者都将湮没。从湮没点将发出两个高能光子（511keV）并且它们以相反方向移动。当两个PET照相机同时检测到这两个光子时，则知道在沿连接两个PET照相机的线的某处发生了湮没。此线被称为正电子湮没发射路径。从数千个这些发射路径收集的信息用于逐步地组合身体内PET辐射示踪剂分布的影像。最常用的PET辐射示踪剂是氟-18氟代脱氧葡萄糖（FDG）。其是葡萄糖替代物并且因此用于反映体内新陈代谢活动的速率。因为癌变组织往往在新陈代谢上比健康组织更活泼，所以相对于正常组织，肿瘤中的FDG吸收会增加并且因而PET信号将增大。FDG-PET是可用于检测癌症存在的最灵敏的成像医疗方式之一。它广泛用于癌症诊断和疗效观察。但是，与外束RT同时使用PET是不切实际的。PET成像将花费约10分钟来获得合适质量的影像，这严重限制了将PET用作动态跟踪肿瘤位置的试剂。
发明内容
本发明涉及用于沿重合（coincident）正电子湮没发射路径进行扫描和对准辐射的装置和方法。一种方法包括：根据诊疗过程（session）期间与预定体部（volume）相交的辐射性事件检测重合正电子湮没发射路径；以及在所述诊疗过程期间沿所述发射路径对准辐射源。各种实例包括响应于各个检测的发射事件而重复地和及时地对准辐射。各种实例包括接收位置数据以识别预定体部和避免将辐射导向辐射敏感区域。
提供了一种用于在辐射诊疗过程期间对准辐射的装置。所述装置包括：辐射源；重合正电子发射检测器，其被配置为检测在坐标系统内发生的重合正电子湮没发射；以及控制器，其与所述辐射源和所述重合正电子发射检测器通信，所述控制器被配置为识别与所述坐标系统内的一个或多个体部相交的重合正电子湮没发射路径，以及沿识别的重合正电子湮没发射路径对准所述辐射源。
此发明内容是本申请的某些教导的概述，并不是要作为本发明的排他或穷举治疗。在详细描述和所附权利要求中可找到有关本发明的其他细节。本发明的范围由所附权利要求及其法律等同物限定。
附图说明
图1示出了根据本发明的一个实施例的用于沿正电子湮没发射路径对准辐射的装置；
图2是根据本发明的一个实施例的用于沿重合正电子湮没发射路径对准辐射的方法的流程图；
图3是根据本发明的一个实施例的用于对准和引导规定剂量的辐射的方法的流程图；
图4A-4D示出了根据本发明的一个实施例的用于沿正电子湮没发射路径对准辐射的装置；
图5示出了根据本发明的一个实施例的准直组件；以及
图6A-6C示出了根据本发明的一个实施例的用于沿正电子湮没发射路径对准辐射的C臂机架。
具体实施方式
本发明的以下详细描述涉及附图中的主题，所述附图通过例示的方式示出了其中可实现所述主题的特定方面和实施例。以足够的细节描述这些实施例，使得本领域的技术人员能够实现所述主题。本公开中对“一个”、“某一”或“各种”实施例的引用并不必然指同一实施例，并且此类引用构想了多个实施例。因此，不应以限制的意义理解以下详细描述，并且其范围仅由所附权利要求以及此类权利要求所具有的法律等同物的完整范围来限定。
本发明涉及一种新的种类的称为发射引导放疗（“EGRT”）的技术。一种EGRT方法包括，通过使用沿所检测的发射路径的辐射束响应各个发射事件来在治疗阶段直接使用对癌症高度敏感的发射医疗方式。如果辐射响应在发射检测之后的足够短的时间段内发生，则肿瘤部位将不会有明显移动并且将照射到肿瘤部位。因此，在发射引导放疗中内在地实现了肿瘤跟踪并且不需要完全知晓实际肿瘤位置或运动。通过使用一系列相应辐射束响应来自肿瘤部位的一系列发射事件，可以有效地实现治疗而与肿瘤位置不确定性无关。还可以以此方式同时治疗多个肿瘤。此外，可以执行与当前RT规程所采用的程序相同的预先计划的程序，以识别肿瘤将始终存在于其中（包括其运动）的体部，从而不将辐射或将最少的辐射施加于肿瘤不存在的区域，和/或所述治疗可避开体内辐射敏感的器官。
图1示出了根据本发明的一个实施例的用于沿检测的正电子湮没发射路径感测和对准辐射的装置。在各实施例中，装置130包括由框架（未示出）支撑的圆形可移动机架、辐射源131、正电子湮没发射传感器133、运动系统134以及控制器135。在各实施例中，装置包括与辐射源相对布置以测量施加到所关注的体部138的辐射的x射线检测器132。辐射源131、x射线检测器132以及正电子发射传感器133被安装到可移动机架。正电子发射传感器133被安装在辐射源131与x射线检测器132之间的机架上。在各实施例中，所述装置包括相结合的x射线和正电子发射传感器，以便正电子发射传感器从辐射源的一侧到另一侧在接近整个机架圆形上提供感测能力。在一个实施例中，x射线检测器包括但不限于高能百万电子伏特（MeV）检测器。正电子发射传感器133适于通过感测正电子湮没事件期间发射的重合光子路径136而检测所述事件。在各实施例中，运动系统围绕体部138移动机架及附加设备以将辐射源对准所检测的发射的路径。控制器135与辐射源131、正电子发射传感器133、x射线检测器132以及运动系统134相连。控制器135识别与所识别的体部138相交的重合光子发射路径136并协调辐射源131的对准、配置和触发，以便沿所识别的发射路径将辐射导向体部138。在各实施例中，控制器接收一个或多个关注的体部138的位置信息，以便限制任何对关注区域施加的治疗。在各实施例中，控制器编程有系统将不会照射的一个或多个体部。这些体部中的某些实例包括要保护免于辐射线的辐射敏感区域，或者先前可能已治疗并在任何特定诊疗过程中无需治疗的某一区域。在某些实施例中，通过检测若干正电子湮没发射并绘制活动图形来在辐射诊疗过程的第一阶段中识别所关注的体部138。在各实施例中，辐射源包括用于使来自辐射源的辐射成形并精确地引导辐射的准直组件139。
在各实施例中，控制器使用公共坐标系统移动辐射源、正电子发射检测器或同时移动两者。在一个实施例中，正电子发射检测器是固定静止的，并且可使用参考公共坐标系统的机器人运动系统移动辐射源。在某些实施例中，辐射源和正电子发射检测器都可移动并使用参考公共坐标系统的单独运动系统。将理解的是，可存在用于移动辐射源、正电子发射检测器或两者的各种运动系统而不偏离本发明的范围，所述运动系统包括环形机架、直线机架、关节臂式机器人、定制机器人或它们的组合。
图2是根据本发明的一个实施例的用于在辐射诊疗过程期间扫描体部的方法250的流程图。通常，在进行放疗之前以一段较长的时间使肿瘤成像。在治疗期间，辐射被引导到肿瘤最后成像时所在的位置。肿瘤可在相对较短的时间间隔内迁移较长的距离。此类迁移可源自诸如患者改变姿势、咳嗽甚至呼吸之类的无害事件。放疗的典型目标是将足够的辐射施加于肿瘤以杀死肿瘤组织，同时尽量减少施加到非肿瘤组织的辐射。如果肿瘤在成像后发生移动，某些辐射会在辐射期间未命中肿瘤，因而肿瘤的某些部分可能在经历治疗后仍然存活，而某些健康组织可能接收到致命的辐射量。此外，如果在治疗期间将辐射施加到肿瘤的已经死亡的部分，则患者将承受比必须的量更多的辐射。在医疗应用中，本方法提供了存活肿瘤组织的实时跟踪并将辐射引导到肿瘤组织。方法250包括从与体部相交的辐射性事件检测重合正电子湮没发射路径251，以及沿所述发射路径对准辐射源252。在各实施例中，所述方法包括在体部的容纳物显著移动之前沿检测的发射路径将辐射导向所述体部。在医疗应用中，以及时的方式沿检测的正电子湮没发射路径施加辐射提供了将放疗施加于存活肿瘤组织的确定性；即使肿瘤自最后成像以来已经迁移也是如此。
图3是根据本发明的一个实施例的用于在辐射诊疗过程期间将预定剂量的外部辐射引导到所关注的体部的方法360的流程图。所述方法包括接收描述一个或多个所关注体部的位置数据361。在各种情况中，在治疗前的规划阶段生成所述数据。在某些情况中，已执行充分的成像以诊断和跟踪诸如患病组织区域之类的所关注的体部。此成像可用于确定关注的肿瘤存在于其中并在其中移动的可能体部。可从诊断期间完成的成像生成所述数据。在某些实施例中，接收多个体部的位置数据，以便可在诊疗过程期间将辐射导向若干体部。识别诸如癌症肿瘤组织之类的关注体部例如可包括多种医疗方式，包括但不限于X射线成像、计算机断层成像（CT）、磁共振成像（MRI）、正电子发射断层成像（PET）或它们的组合。可以在不偏离本发明的范围的情况下存在其他医疗方式。
在各实施例中，在辐射诊疗过程之前，向所关注的体部提供辐射示踪剂。辐射示踪剂提供了正电子源以便实时跟踪所述体部。所述方法然后接收体部的位置数据361（如果尚未接收）。在各种实施例中，接收体部的位置数据包括用机器的参考点（例如，辐射源）登记所述体部。在各种实施例中，用机器登记所述体部包括使用机器的辐射源执行低剂量CT扫描。在某些实施例中，接收一个或多个体部的位置数据以及用机器登记每个体部包括，检测多个发射事件并绘制事件的图形以识别所述体部。将理解的是，可存在其他用外部辐射机器登记体部的方法而不偏离本发明的范围。在某些实施例中，接收体部的位置数据包括接收不被照射的区域的位置数据。
所述方法还包括：从与关注的体部相交的正电子湮没事件检测重合发射路径362，沿检测的发射路径对准辐射源363，然后沿检测的发射路径将辐射引导到所述体部364。在各实施例中，在检测到发射事件时，所下载的位置数据用于判定事件是否与关注的体部相交。
在各实施例中，辐射源和发射检测器围绕一个或多个体部移动以允许检测发射事件并从多个角度引导辐射。从多个角度将辐射导向体部最大程度上减少了将介入的身体部分（如健康组织）暴露于辐射。在各实施例中，使用在先的成像调整辐射源的强度以考虑所述体部在其他身体部分内的深度。在各实施例中，随着诊疗过程的进展，控制器根据诊疗过程期间检测的发射事件分析一个或多个关注的体部并构建其图形。在各实施例中，随着图形变得更加详细，控制器根据所述图形沿检测的发射路径有选择地对准和引导辐射。
一旦将辐射引导到体部，控制器记录引导到患者的辐射的量或辐射剂量365。在各实施例中，与辐射源相对的x射线检测器记录导向并穿过所述体部的辐射。控制器监视累计的辐射，并继续检测发射事件和沿检测的发射路径引导辐射，直到已将规定的辐射剂量导向每个关注的体部366。在各实施例中，检测的正电子发射事件的累计可用于形成关注的体部和周围身体部分的图像。在医疗应用中，检测的正电子发射事件的累计可用于构建所述体部的新陈代谢活动的图像。在某些实施例中，所述图像数据可用于改变后续的治疗。
在各实施例中，如在医疗应用中使用的那些实施例，诸如癌变肿瘤组织之类的所关注的体部具备辐射示踪剂作为正电子源，以便实时跟踪所述体部。典型的辐射示踪剂包括发射正电子的不稳定核素。正电子与轨道电子具有相同的质量，但是带有正电荷。正电子的独特特性是其不能在自然界中静止地存在。一旦其失去动能，正电子就立即与带有负电荷的电子结合并经历湮没反应，其中两个粒子的质量完全转化成形式为两个0.511MeV湮没光子的能量，所述光子以彼此大约180度的角度离开它们的产生位置。两个511keV伽马射线的检测形成了借助辐射示踪剂瞄准存活肿瘤组织的基础。
在临床实践和癌症研究中常用的辐射示踪剂是氟-18氟代脱氧葡萄糖（FDG），其是一种新陈代谢PET辐射示踪剂。FDG（一种类似葡萄糖的物质）被诸如大脑、肾脏以及癌症细胞之类的利用较高葡萄糖的细胞所吸收，其中磷酸化防止了葡萄糖被完整地释放。这样，存活患病组织将比健康组织更强烈地吸收和聚集新陈代谢PET辐射示踪剂。由于死亡组织不会吸收辐射示踪剂，所以新陈代谢辐射示踪剂的附加益处是其提供了肿瘤的存活组织的实时跟踪。结果，在沿检测的发射路径施加放疗中，所述方法提供了高度的确定性，即辐射不仅被精确地施加到肿瘤，而且被施加到肿瘤的存活组织。将理解的是，在不偏离本发明的范围的情况下，可以使用其他具有正电子发射辐射性核素的辐射示踪剂，包括但不限于氟-18、碳-11、氧-15以及氮-13。
图4A-4D示出了根据本发明的一个实施例的用于检测重合正电子湮没发射路径并将辐射对准所述发射路径的装置401的截面图。图4A-4D包括处于装置401内的患者420。该患者在要照射的体部422内具有存活肿瘤组织。所述装置包括：控制器407、产生高能辐射的辐射源402、帮助使高能辐射成形并精确引导高能辐射的准直组件410、x射线检测器阵列408，以及正电子发射断层成像（PET）传感器阵列404。辐射源402、准直组件410、x射线检测器408以及PET传感器404位于旋转机架406上。机架406被安装到静止框架（未示出）。在各实施例中，与控制器407相连的运动控制系统409将机架406和所安装的设备围绕患者420移动。
图4B示出了装置401执行低剂量MeV CT扫描以登记患者相对于装置401的位置。可以使用解剖学上的标记或其他标记方案来利用所述装置登记患者的身体位置。登记使得控制器能够将一个或多个关注的体部（包括不应被照射的那些体部）的几何坐标与装置401的几何坐标相关。在登记之后，控制器407控制装置401以监视与体部422相交的正电子湮没发射路径、将辐射源对准所述发射路径，以及沿检测的发射路径引导辐射。在监视正电子湮没事件时，辐射源402、准直组件410、PET传感器404以及高能辐射检测器408使用与控制器407相连的运动系统409围绕患者旋转。
图4C示出了与体部422相交的重合正电子发射路径412的检测。在检测到重合发射事件和路径412时，控制器407记录重合发射路径的几何坐标。如果检测的路径412与关注的体部422相交，则控制器407启动辐射源的对准，并在运动系统已将辐射源402移动到与发射路径412对准后沿所述发射路径触发辐射。沿与发射路径相同的路径施加辐射提供了将辐射精确施加到肿瘤的存活组织的高度确定性。除了将辐射源移动到检测的发射路径的角度以外，对准还包括配置准直组件410以沿正电子发射路径精确引导辐射。在各实施例中，精确和及时地对准辐射包括在机架406正在围绕患者旋转时重新配置准直组件。
图4D示出了根据本发明的一个实施例的所述装置沿检测的发射路径引导辐射。所述控制器协调机架的运动、准直组件的配置以及辐射源的触发，以便沿与检测的正电子发射路径相同的路径从辐射源402提供辐射。准直组件410允许分割辐射束，使得扇形束中的期望射线可以通过，同时完全阻隔其他射线。准直组件的重新配置的发生非常迅速，从而可在辐射源402围绕机架406的每个角位置都具有新的配置。
随着机架406的旋转，对于多个正电子发射事件重复检测、对准和触发辐射，直到在每个关注的体部中达到期望的辐射剂量。在各实施例中，控制器记录从x射线检测器408接收的读数以检验总辐射剂量。将理解的是，x射线检测器可以包括一个或多个高能检测器，所述高能检测器包括但不限于MeV检测器、高能千电子伏特（keV）检测器或它们的组合。
在各实施例中，控制器407包括与一个或多个肿瘤的位置有关的数据。在此类实施例中，控制器协调发射事件的检测以及到多个体部的辐射的触发和引导。在各实施例中，从先前成像中将体部位置数据下载到控制器中。所述数据允许控制器以高度的确定性判定检测的发射事件路径是否与关注的体部相交。
如上所述，当检测到与关注的体部相交的正电子发射事件时，控制器407重新配置准直组件410以使得来自辐射源402的辐射在指定时间内遵循与检测的发射路径相同的路径。在各实施例中，在机架406围绕患者420旋转辐射源402和传感器404、408的同时完成准直组件的重新配置。机架旋转速度、控制器的处理延迟以及检测到发射事件时辐射源的位置是决定发射事件与沿发射路径引导和触发辐射之间的延迟的一些因素。在医疗应用中，将辐射源对准发射路径提高了肿瘤跟踪准确性，即使由于诸如呼吸之类的正常身体功能造成肿瘤移动也是如此。在某些实施例中，机架包括多个辐射源。多个辐射源允许更快速地完成治疗，允许减小检测发射事件与对准辐射源之间的延迟，或同时允许更快的治疗和减小的延迟。
在各实施例中，所述装置对准和引导辐射以响应各个正电子湮没事件。在各实施例中，所述控制器在机架旋转时对检测的正电子湮没发射进行排队、对准辐射并将辐射导向先前检测的发射路径。在某些实施例中，沿选定的排队路径顺序地对准和引导辐射源。在某些实施例中，根据辐射源围绕体部的当前位置沿选定的排队路径对准和引导辐射源，从而可选择较新检测到的路径，因为辐射源将在更早检测的路径之前接近该路径。在某些实施例中，所述控制器将选定的辐射路径排队一时间间隔，然后在通过排队附加辐射路径重复所述过程之前沿队列的选定路径对准和引导辐射。通过调整感测事件与沿检测的发射路径递送辐射之间的期望时间间隔，所述装置可建立具有不同数量的辐射递送路径的队列。还可以使用算法以在所述装置的移动量最小的情况下提供辐射。可以存在其他算法和程序而不偏离本发明的范围。
在某些实施例中，所述控制器将对准和触发辐射源的步调调整为患者的诸如呼吸之类的周期性功能的步调。例如，假设感测出患者的呼吸周期为每几秒钟重复一次。在控制器感测与关注体部相交的辐射事件时，控制器记录其中发生这些事件的呼吸周期的阶段并控制移动、对准和触发辐射源中协调后的延迟，以便与呼吸周期的相同阶段保持一致。
本发明的各实施例以二维或三维模式对准和引导辐射。在二维模式中，针对辐射源的每个指定角位置重新配置多叶辐射准直器，以使辐射路径位于顶点在辐射源处的扇形中。图5示出了根据本发明的一个实施例的准直器组件550。紧接多叶准直器553之前的一对准直器夹片（jaw）551将辐射源555的锥形发散554限于特定平面552。下部夹片553的操作允许将辐射对准辐射路径平面内的多个体部。在各实施例中，可以以连续方式或以步进-照射方式平移工作台以治疗体部的多个薄片。如果连续地平移工作台，则工作台速度应考虑到到每个体部的规定剂量。
在采用三维治疗模式的装置的情况下，可以与准直组件叶553协调地移动限制锥形辐射束发散554的准直器夹片551。尽管辐射被限于特定平面，但是准直组件夹片的协调运动允许针对辐射源的给定位置进行各个平面的治疗。对于圆形机架和C臂装置，三维模式允许准直组件以对所述装置的中心轴倾斜的角度提供辐射。此外，与二维模式相比，对于所述装置的给定位置，三维模式允许控制器响应PET传感器阵列的视场的更大部分内的多个重合发射路径。
图6A-6C示出了根据本发明的一个实施例的C臂机架装置660。装置660包括安装到所述装置的旋转部分664的辐射源661、准直组件662和PET照相机663。所述装置的固定部分665提供对旋转部分664的支撑。图6A示出了所述装置的正视图，其中辐射源位于工作台666上方并且PET照相机663位于工作台666的两侧。控制器（未示出）在旋转部分664围绕工作台666移动设备时提供辐射源661、准直组件662、PET照相机663以及运动的控制和协调。图6B示出了所述装置的正视图，其中辐射源661、准直组件662以及PET照相机663围绕工作台666旋转90度。对于三维模式的治疗，针对辐射源的每个指定角位置重新配置多叶x射线准直器，使得辐射路径位于顶点在辐射源处的圆锥内。
在各实施例中，为了治疗体部的多个薄片，可以以连续方式或以步进-照射方式平移工作台666。图6C示出了C臂机架装置660的侧视图，其中朝向所述装置平移工作台666。在各实施例中，在连续平移工作台的情况下，将控制工作台速度以允许将规定的辐射剂量导向每个体部。
在各实施例中，装置660包括与辐射源相对的高能（MeV）检测器，以便记录和检验导向每个体部的辐射量或辐射剂量。在某些实施例中，使用组合的MeV/PET检测器而不是MeV检测器。组合的MeV/PET检测器允许检测511keV PET发射以及高能辐射两者。此类布置增大了PET检测器的覆盖并允许更快的辐射诊疗过程。将理解的是，在不偏离本发明的范围的情况下可以存在PET和高能x射线检测器的其他组合，包括但不限于keV/PET检测器。
在各实施例中，所述辐射包括由线性加速器（linac）产生的x射线。可以存在用于提供辐射的其他辐射类型和辐射源而不偏离本发明的范围。此类辐射和辐射源包括但不限于高能光子、由辐射性同位素（例如，铱或钴60）产生的辐射线或粒子、高能电子、质子束、中子束以及重离子束。
在一个实施例中，使用单光子发射计算的断层成像（SPECT）实现所述装置，所述SPECT设置有针孔照相机和/或准直式SPECT传感器以代替PET传感器检测来自辐射性事件的发射光子的方向。
在一个实施例中，辐射源不旋转。将辐射源（例如，铅封装的钴60）与PET检测器交替地布置在机架周围。在此情况下，来自特定辐射源的辐射将遵循相邻PET传感器对所检测的发射路径。
在一个实施例中，将两个或更多辐射源附加到旋转机架。控制器对准所述辐射源中的每个辐射源以响应不同的发射路径。与仅使用单个辐射源相比，多个辐射源允许在检测发射路径与沿该路径引导辐射之间的更小的时间窗口。
在各实施例中，所述装置针对单独的手术或针对与发射引导放疗同时的手术提供了其他放疗模式。其他放疗模式包括但不限于，基于治疗体部的先前成像的辐射治疗、三维保角束RT、强度调制的RT或它们的组合。
本申请旨在覆盖本发明的改变和变型。将理解的是，上述描述旨在是示例性的而非限制性的。应参考所附权利要求连同所述权利要求的法律等同物的完整范围一起确定本发明的范围。

Claims (38)

1.一种用于导引辐射的装置，包括：
第一机架；
第二机架，其中所述第二机架可旋转；
至少一个正电子发射检测器，安装在所述第一机架上，其中所述至少一个正电子发射检测器配置为检测在坐标系统内发生自体部的正电子湮没发射路径的个体；
至少一个辐射源，安装在所述第二机架上；以及
控制器，其与所述辐射源和所述至少一个正电子发射检测器通信，所述控制器被配置为旋转所述第二机架，以将所述至少一个辐射源相对于所检测的正电子湮没发射路径的个体定位，并在所述体部基本移动之前将辐射施加到所述体部。
2.根据权利要求1的装置，其中所述控制器配置为，在基于检测的正电子湮没发射路径的个体产生图像之前，将辐射施加到所述体部。
3.根据权利要求1的装置，其中所述控制器配置为，将辐射施加到所述体部，而不基于检测的正电子湮没发射路径的个体产生图像。
4.根据上述权利要求中任一个的装置，其中所述控制器配置为，存储在坐标系统内发生自一个或多个体部的一个或多个正电子湮没发射路径的位置数据，并顺序地将所述第二机架相对于所述一个或多个正电子湮没路径进行旋转，直到将预定辐射剂量给予所述一个或多个体部。
5.根据上述权利要求中任一个的装置，其中所述第一和第二机架中的至少一个是圆形机架。
6.根据上述权利要求中任一个的装置，其中所述第一和第二机架中的至少一个是C臂机架。
7.根据上述权利要求中任一个的装置，还包括第二辐射源，安装在所述第二机架上，其中所述控制器被配置为旋转所述第二机架，以将所述第二辐射源相对于第二正电子湮没发射路径定位。
8.根据权利要求1-7中的任一权利要求的装置，其中所述辐射源包括高能光子辐射源。
9.根据权利要求1-7中的任一权利要求的装置，其中所述辐射源包括高能电子辐射源。
10.根据权利要求1-7中的任一权利要求的装置，其中所述辐射源包括质子束辐射源。
11.根据权利要求1-7中的任一权利要求的装置，还包括与所述辐射源相对安装的x射线检测器阵列。
12.根据权利要求1-11中的任一权利要求的装置，其中所述控制器被配置为在检测正电子湮没发射路径的预定时间内，旋转所述第二机架以将辐射源相对于正电子湮没发射路径定位。
13.根据权利要求1-12中的任一权利要求的装置，其中所述第一机架是可旋转的。
14.一种装置，包括：
可旋转的机架；
安装在所述机架上的辐射源；
一个或多个准直伽马射线光子检测器，安装在所述可旋转的机架上，其中所述准直伽马射线光子检测器配置为，检测发生自组织体部的准直伽马射线光子发射；以及
控制器，其与所述辐射源和所述准直伽马射线光子检测器通信，所述控制器被配置为旋转所述机架，以将所述辐射源相对于所检测的准直伽马射线光子发射定位，并将来自所述辐射源的辐射引导到所述组织体部，其中所述辐射在基于准直伽马射线光子发射产生图像之前施加。
15.根据权利要求14的装置，其中所述控制器配置为，在所述组织体部基本移动之前，将所述辐射源对准所述准直伽马射线光子发射。
16.根据权利要求14的装置，还包括连接到所述控制器的运动系统。
17.根据权利要求14的装置，还包括第二辐射源，沿所述可旋转的机架的周围长度安装，其中所述控制器被配置为旋转所述机架，以将所述第二辐射源相对于发生自所述组织体部的第二准直伽马射线光子发射对准。
18.根据权利要求14的装置，其中所述辐射源包括高能光子辐射源。
19.根据权利要求14的装置，其中所述辐射源包括高能电子辐射源。
20.根据权利要求14的装置，其中所述辐射源包括质子束辐射源。
21.根据权利要求14的装置，还包括在所述机架上与所述辐射源相对安装的x射线检测器阵列。
22.根据权利要求14的装置，其中所述控制器被配置为在检测准直伽马射线光子发射的预定时间内，旋转所述机架以将所述辐射源对准所述准直伽马射线光子发射。
23.根据权利要求14的装置，还包括沿所述机架的周围长度安装的多个辐射源。
24.根据权利要求23的装置，其中所述准直伽马射线光子发射检测器与所述辐射源交替。
25.根据权利要求23的装置，还包括在所述机架上与所述多个辐射源相对安装的多个x射线检测器。
26.根据权利要求14的装置，其中所述控制器配置为，存储发生自一个或多个组织体部的一个或多个准直伽马射线光子发射的位置数据，并顺序地旋转所述机架，以将所述辐射源相对于所述一个或多个准直伽马射线光子发射定位，直到在基于所述一个或多个准直伽马射线光子发射产生图像之前将预定辐射剂量给予所述一个或多个组织体部。
27.根据权利要求14的装置，其中所述一个或多个准直伽马射线光子检测器是一个或多个针孔照相机。
28.使用用于导引辐射的装置的方法，包括：
使用安装在可旋转机架上的至少一个准直伽马射线光子检测器检测发生自组织体部的准直伽马射线光子发射的个体；
旋转所述机架，使得安装在所述机架上的辐射源相对于所述准直伽马射线光子发射的个体定位；以及
施加辐射到所述体部，其中所述辐射在基于所述准直伽马射线光子发射的个体产生图像之前施加。
29.根据权利要求28的方法，其中施加辐射包括，在所述组织体部基本移动之前，沿所述准直伽马射线光子发射的个体施加辐射。
30.根据权利要求28的方法，其中旋转所述机架还包括，在旋转机架的同时，检测附加的准直伽马射线光子发射。
31.根据权利要求28的方法，还包括，使用所述辐射源执行所述体部的低剂量断层成像扫描。
32.根据权利要求28的方法，其中检测准直伽马射线光子发射的个体、旋转所述机架以及施加辐射发生在单个治疗诊疗过程期间。
33.根据权利要求32的方法，还包括：使用x射线检测器阵列记录引导到所述体部的辐射剂量。
34.根据权利要求33的方法，其中施加辐射包括：在诊疗过程期间在预定时间内施加辐射。
35.根据权利要求28的方法，还包括：
检测附加的准直伽马射线光子发射；
旋转所述机架，以将辐射源相对于所述附加的准直伽马射线光子发射定位；以及
在基于所述附加的准直伽马射线光子发射产生图像之前，相对于所述附加的准直伽马射线光子发射施加辐射。
36.根据权利要求35的方法，还包括：
记录辐射的剂量；以及
累计辐射的总辐射剂量，直到所累计的总辐射剂量满足规定剂量。
37.根据权利要求28的方法，其中旋转所述机架将所述辐射源相对于所述准直伽马射线光子发射的个体成一角度定位。
38.一种用于导引辐射的装置，包括：
可旋转的机架；
安装在所述可旋转的机架上的辐射源；
正电子发射检测器，安装在所述可旋转的机架上，其中所述正电子发射检测器配置为检测在坐标系统内发生自体部的正电子湮没发射路径；以及
控制器，其与所述辐射源和所述正电子发射检测器通信，所述控制器被配置为旋转所述机架，以将所述辐射源相对于所检测的正电子湮没发射路径定位，并在所述体部基本移动之前将辐射施加到所述体部。
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