CN108992164A - Treatment system and its operating method associated with a kind of ultrasonic and radiation - Google Patents
Treatment system and its operating method associated with a kind of ultrasonic and radiation Download PDFInfo
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- CN108992164A CN108992164A CN201811016778.6A CN201811016778A CN108992164A CN 108992164 A CN108992164 A CN 108992164A CN 201811016778 A CN201811016778 A CN 201811016778A CN 108992164 A CN108992164 A CN 108992164A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
Abstract
The invention belongs to field of medical device, disclose treatment system and its operating method associated with a kind of ultrasonic and radiation, angiography system, for carrying out radiography to the focal zone containing radiography agent composition, it indicates position, size and the boundary of tumour, and judges whether to reach pre-set dimension；HIFU Treatment system, for carrying out ultrasonic therapy to focal zone, ablation is not up to the large scale tumour of pre-set dimension；BNCT treatment system removes the small size tumour for reaching pre-set dimension for carrying out radiation therapy to focal zone；Patient's bogey is matched for carrying patient, and with the angiography system, the HIFU Treatment system, the BNCT treatment system；Control system.The treatment system and its operating method combine high intensity focused ultrasound technology and boron neutron capture therapy technology, first carry out the ablation of large scale tumour, then remove small size tumour, and tumour, the especially curative effect of large volume malignant tumour can be improved.
Description
Technical field
The present invention relates to field of medical device, more particularly to ultrasound and spoke associated with a kind of ultrasonic therapy and radiation therapy
Treatment system associated with penetrating and its application method.
Background technique
With the development of atomics, using radioactive ray (such as Co-60 radionuclide, electronics, photon, proton, again from
Son) to carry out treatment of cancer be one of main means, with operation, chemotherapy, and referred to as 3 big cancer treatment methods.So
And conventional photonic or electronic therapy are limited by radioactive ray physical condition itself, and tumour and normal tissue are not identified
Power, therefore while killing cancer cell, also can normal tissue cell damage, now often through multi-angle irradiation with
Interval procedure isotype disperses normal tissue dose, and dose of radiation is concentrated on tumor tissues；In addition, different radioactive ray pair
Different biological effects can be generated in tumour cell, the relative biological effect of electronics, photon that traditional radiation therapy uses is matter
The 1/3~1/20 of son, heavy charged particle, that is, if desired reach identical biological terminal, electronics, photon need to give 3 times~
20 times of dose of radiation.Also therefore, electronics, Photon beam are for the malignant tumor tissue into dormant state or anaerobic zone
Therapeutic effect is often bad.
In order to reduce radiation injury (the normal tissue complication of tumour surrounding normal tissue
Probability, NTCP) and improve the cure rates (tumor control probability, TCP) of tumor tissues, Chemo-Therapy
Target therapy concept in treatment is just used in radiotherapy；And it is directed to the tumour cell of radiation resistance, it also actively sends out at present
Exhibition just has the radiation source of high relative biological effect, such as proton therapeutic, heavy particle therapy, neutron capture therapy.Wherein neutron is captureed
Obtain treatment be combine above two concept, as boron neutron capture therapy (Boron Neutron Capture Therapy,
BNCT), boron preparation nutrient needed for tumor tissues are metabolized is combined, through the process of tumor tissues intake nutrient, automatically will
Boron preparation, which is accurately sent to, needs treatment position, i.e., boron preparation is rich in close tumour property；Cooperate accurately neutron beam adjustment again, provides
Treatment of cancer selection more better than conventional radiation.
However, boron neutron capture therapy also suffers from certain drawbacks, its application is caused to be subject to significant restrictions.Due to current
Boron preparation tumor tissues (Tumor) and the ratio in normal tissue (Normal tissue) be about 3:1 (i.e. T/N=3:
1), that is, still there is the boron preparation of part to build up in the normal tissue, cause the damage of neutron irradiation normal tissue.Meanwhile
Since boron preparation has very big neutron action section (cross section), obtained generally proximate to the tumour in neutron beam direction
Maximum absorbed dose, but as depth gradually increases, the number of neutrons that can enter tumor tissues is quickly reduced, and causes dosage point
Often there is dosage situation unevenly distributed for large volume of tumour, lead to deep tumor in the situation that cloth quickly falls
Since neutron dose is reduced without can be carried out effective treatment.That is, boron neutron capture therapy have for the tumour of small size it is good
Curative effect, and it is poor for the tomor rejection effect of large volume.
Therefore, it is necessary to design a kind for the treatment of system of curative effect problem that can effectively solve the problem that large volume of tumour
And method, so that boron neutron capture therapy is more widely used.
Summary of the invention
Based on this, it is an object of the present invention to propose treatment system associated with a kind of ultrasonic and radiation, the treatment system
System combines in high-strength focusing ultrasonic therapy technology (High Intensity Focused Ultrasound, HIFU) and boron
Neutron capture therapy technology, wherein HIFU Treatment system is first used, after being melted using focusing ultrasonic wave to large scale tumour, then
Using BNCT treatment system, using the charged particle released after neutron and the effect of boron preparation, Auto-Sensing borderline tumor simultaneously gives
It removes remaining small size tumour and tumour, especially large volume malignant tumour can be improved by the combination of two kinds for the treatment of technologies
Curative effect.
It is another object of the present invention to propose the operating method of a kind of ultrasound and treatment system associated with radiation, behaviour
Make simply, it is convenient to carry out, and the curative effect of tumour can be improved.
To achieve this purpose, the present invention adopts the following technical scheme:
Treatment system associated with a kind of ultrasonic and radiation, comprising:
Angiography system indicates position, size and the boundary of tumour, and judge whether to reach for carrying out radiography to focal zone
To pre-set dimension；
HIFU Treatment system carries out ultrasonic therapy for focal zone, melts large scale tumour；
BNCT treatment system carries out radiation therapy for focal zone, removes small size tumour；
Patient's bogey, for carrying patient, and with the angiography system, the HIFU Treatment system, the BNCT
Treatment system matches；
Control system, respectively with the angiography system, the HIFU Treatment system, the BNCT treatment system, the trouble
Person's bogey connection, for controlling the movement of each component.
The combination that high-strength focusing ultrasonic therapy technology and boron neutron capture therapy technology are used in the present invention, can first lead to
It crosses high intensity focused ultrasound treatment technology the malignant tumour ablation of large volume becomes smaller, becomes the malignant tumour of small size, then lead to
The malignant tumour for the small size that boron neutron capture therapy is removed after ablation is crossed, so that the malignant tumour for effectively improving large volume is cured
Effect and cure rate.
Preferably, the pre-set dimension is that diameter of tumor is less than 4cm or gross tumor volume is less than 250cc.
Specifically, when the size of tumour is not up to pre-set dimension, referred to as large scale tumour, at this point, the size of tumour
It is excessive, when using boron neutron capture therapy, due to the limitation of depth of shine, it is unable to reach good therapeutic effect, it is therefore desirable to
It first passes through high-strength focusing ultrasonic therapy tumour ablation becomes smaller；When the size of tumour reaches pre-set dimension, referred to as small ruler
Very little tumour can achieve good therapeutic effect using boron neutron capture therapy at this point, the size of tumour is sufficiently small, and if
High-strength focusing ultrasonic therapy is selected to small size tumour, due to that may have tumor tissues and normal tissue at tumor boundaries
Interweave there are the case where, when high-strength focusing ultrasonic therapy can by treatment region tumor tissues and normal tissue is whole " cut
Except ", meaningless injury can be caused to human body.
Preferably, the angiography system is used for before ultrasonic therapy, makes in treatment, after treatment to patient's focal zone
Shadow.The angiography system is selected from MRI contrast apparatus, CT contrast apparatus, PET contrast apparatus or combinations thereof.
As a kind of perferred technical scheme, the angiography system be MRI contrast apparatus, for determine tumour position,
Size and boundary, and judge whether tumor size reaches pre-set dimension.
Preferably, the MRI contrast apparatus carries out radiography to the focal zone containing radiography agent composition, to determine tumour
Exact boundary.
It is further preferred that the radiography agent composition includes boron preparation and contrast agent.It is carried out when using MRI contrast apparatus
When radiography, the contrast agent is MRI contrast agent.
Specifically, injecting radiography agent composition to patient before radiography, wherein boron preparation is mixed into MRI contrast agent is made
Shadow agent composition, such radiography agent composition rich in high tumor affinity, can be both enriched in human tumor region, while contrast agent
Mixture can be measured again by MRI contrast apparatus, therefore in MRI image, can be by mixing colours high boron formulation concentrations tumor area
Domain and low boron formulation concentrations tumor region and tumor region and normal tissue are distinguished, and can be hooked according to the difference of color
Exact tumor region is drawn, the boundary of clearly determining tumour and the wherein concentration distribution of boron preparation, the concentration of boron preparation can
It is scaled boron concentration.
Preferably, the MRI contrast apparatus includes: magnet, spectrometer, MRI screening arrangement.
It is further preferred that the magnet is selected from open magnet or cyclic formula magnet.
Specifically, the structure of the open magnet is that a magnetic material, the generated constant magnetic of master are respectively arranged up and down
Field is perpendicular to ground；The structure of the cyclic formula magnet is a closed annular, and main perseverance is generated in closed annular space
Fixed-field.
As a kind of perferred technical scheme, the angiography system is CT contrast apparatus and PET contrast apparatus, and the CT makes
Image device is used to determine position and the size of tumour, and the PET contrast apparatus is used to determine the exact boundary of tumour.Specifically,
Before PET radiography, radiography agent composition is injected to patient's body, wherein it is mixed to be mixed into contrast agent for boron preparation and PET contrast agent
Object is closed, i.e., when carrying out radiography using PET contrast apparatus, contrast agent is PET contrast agent, and such radiography agent composition is both rich in high swollen
Tumor affinity can be enriched in human tumor region, while radiography agent composition can be measured again by PET contrast apparatus, be schemed in PET
It, equally can be by mixing colours high boron formulation concentrations tumor region and low boron formulation concentrations tumor region and tumor region as in
It is distinguished with normal tissue, exact tumor region can be sketched out according to the difference of color, clearly determines the boundary of tumour
And wherein the concentration distribution of boron preparation, the concentration of boron preparation can be scaled boron concentration.
As a kind of perferred technical scheme, the angiography system is MRI contrast apparatus and PET contrast apparatus, wherein institute
MRI contrast apparatus is stated for determining position and the size of tumour, the PET contrast apparatus is used for containing radiography agent composition
Focal zone carries out radiography, to determine the exact boundary of tumour.
It is further preferred that the radiography agent composition includes boron preparation and contrast agent.At this point, that injects before radiography is described
It include PET contrast agent in radiography agent composition.
Preferably, the HIFU Treatment system includes signal generator, power amplifier and energy converter.
For generating source of ultrasound signal, the power amplifier is connect the signal generator with the signal generator,
For amplifying the ultrasonic signal, the energy converter is connect with the power amplifier, described in the power amplifier driving
Energy converter generates ultrasonic wave, and the energy converter conducts the ultrasonic wave to focal zone, is focused, is led in focal zone using ultrasonic wave
The fuel factor for crossing high-intensity focusing ultrasonic wave makes focal zone tumor temperature moment rise to 65 DEG C or more, kills tumor tissues, reaches
Ablated tumor is arrived, the purpose for making tumour become smaller.
Preferably, the BNCT treatment system includes: neutron generation device, moderation of neutrons device and neutron beam outlet.Institute
Neutron generation device is stated for generating high-throughput neutron beam, specifically, providing neutron using nuclear reactor, accelerator or nucleic
Beam；The moderation of neutrons device is connect with the neutron generation device, the neutron beam for generating the neutron generation device
Energy adjusting to being suitble to the energy range that uses of boron neutron capture therapy, the neutron beam energy range be 0.5eV~
40keV；The neutron beam outlet is connect with the moderation of neutrons device, for neutron beam to be exported to and reached patient's focal zone,
It is irradiated using specimens position of this neutron beam to intake boron preparation, achievees the purpose that eliminate tumour.
Preferably, patient's bogey includes therapeutic bed and lifting device, the lifting device and the therapeutic bed
Connection, and drive the pendulum position in the directions such as therapeutic bed progress upper and lower, left and right.It is further preferred that the patient carries dress
Setting need to can be worked by magnetic compatibility test under strong magnetic field circumstance.
Specifically, the lifting device drives the therapeutic bed to be moved to the angiography system, the HIFU Treatment system
With the corresponding position of the BNCT treatment system so that patient can lie in therapeutic bed complete tumor imaging, ultrasonic therapy and
Radiation therapy process.
As a kind of perferred technical scheme, the angiography system, the HIFU Treatment system and BNCT treatment system
System is set in same therapeutic room.
Specifically, by patient setup in the therapeutic bed, controlling the radiography by the control system in treatment
The switching of system, the HIFU Treatment system and the BNCT treatment system, can be completed tumor imaging, tumour ablation, tumour
Reset procedure reduces the movement of patient, can it is safer, faster complete tumor therapeutic procedure.
As a kind of perferred technical scheme, the angiography system and the HIFU Treatment system are set to same therapeutic room
In, the BNCT treatment system is set in another therapeutic room.Such as, the angiography system and the HIFU Treatment system are set to
In first therapeutic room, the BNCT treatment system is set in the second therapeutic room.
Specifically, in treatment, when patient passes through the angiography system and the HIFU Treatment system in the first therapeutic room
System completes radiography, ultrasonic therapy process, after reaching tumour ablation effect, then described in patient is transferred in the second therapeutic room
BNCT treatment system carries out radiation therapy process, to reach tumor clearance effect, meanwhile, next patient can be in the first therapeutic room
Middle progress tumor imaging, ultrasonic therapy process.As it can be seen that one of them is suffered from the present solution, different patients can treat simultaneously
Person carries out ultrasonic therapy, another patient carries out radiation therapy, and the utilization for the treatment of system associated with ultrasound and radiation can be improved
Rate.
As a kind of perferred technical scheme, the HIFU Treatment system is arranged above the therapeutic bed, is overhead
HIFU Treatment system, the overhead HIFU Treatment system are from top to bottom irradiated patient, complete ultrasonic therapy process.
As a kind of perferred technical scheme, the HIFU Treatment system is arranged below the therapeutic bed, is underneath type
HIFU Treatment system, the overhead HIFU Treatment system are from the bottom up irradiated patient, complete ultrasonic therapy process.
As a kind of perferred technical scheme, the quantity of the HIFU Treatment system is two groups, respectively overhead HIFU
Treatment system and underneath type HIFU Treatment system, the overhead HIFU Treatment system are arranged above the therapeutic bed, from upper
Patient is irradiated down, the underneath type HIFU Treatment system is arranged below the therapeutic bed, from the bottom up to patient
It is irradiated, by the ultrasonic irradiation of upper and lower both direction, completes ultrasonic therapy process.
On the other hand, the application method of a kind of ultrasound and treatment system associated with radiation is provided, comprising the following steps:
S1: radiography agent composition is injected in patient's body；
S2: the contrastographic picture of patient is obtained using angiography system, obtains position, size and the boundary of patient tumors；
S3: judging whether tumor size is less than pre-set dimension, when no, executes S4, when being, executes S5；
S4: ultrasonic therapy is carried out using HIFU Treatment system, melts large scale tumour, then execute S2 step；
S5: radiation therapy is carried out using BNCT treatment system, removes small size tumour；
S6: terminate.
Preferably, the radiography agent composition includes boron preparation and contrast agent.
Preferably, the pre-set dimension is that diameter of tumor is less than 4cm or gross tumor volume is less than 250cc.
Preferably, radiation therapy is being carried out, when removing small size tumour, comprising:
S51: radiation therapy plan is formulated according to tumor size；
S52: detection patient's body boron concentration, and be compared with the boron concentration in radiation therapy plan, when lower than radiation
When boron concentration in treatment plan, need to adjust treatment plan；
S53: opening BNCT treatment system, carries out neutron exposure；
S54: when exposure dose reaches the dosage of radiation therapy plan, stop neutron exposure.
The invention has the benefit that
The present invention proposes that treatment system associated with a kind of ultrasonic and radiation, the treatment system combine high intensity focused ultrasound
Treatment technology and boron neutron capture therapy technology after first carrying out tumour ablation with HIFU Treatment system, reuse BNCT treatment system
System, using the charged particle released after neutron and the effect of boron preparation, Auto-Sensing borderline tumor is simultaneously removed tumors remaining, can
To improve tumour, the especially curative effect of large volume malignant tumour.
While the present invention also proposes the application method of a kind of ultrasound and treatment system associated with radiation, passes through in this method and makes
Shadow system carries out radiography to focal zone, and boron preparation is mixed in contrast agent, so that angiography system can determine that focal zone is swollen
Tumor position, size and boundary, then judge whether the size of tumour reaches pre-set dimension, it is to carry out ultrasonic therapy or spoke with selection
Treatment is penetrated, two kinds of technologies of high-strength focusing ultrasonic therapy technology and boron neutron capture therapy are effectively combined, are given full play to
The advantages of respective technology, achievees the effect that preferably to treat tumour.
Detailed description of the invention
Fig. 1 is the block schematic illustration of ultrasound and treatment system associated with radiation in the present invention；
Fig. 2 is the structural schematic diagram of ultrasound and treatment system associated with radiation in the present invention；
Fig. 3 is the MRI image and its image for ticking boundary for not having radiography agent composition in the prior art；
Fig. 4 is the MRI image and its image for ticking boundary containing radiography agent composition in the present invention；
Fig. 5 is the dosage distribution schematic diagram in different volumes tumour；
Fig. 6 is the flow chart of ultrasound and the application method for the treatment of system associated with radiation in the present invention；
Fig. 7 is the process of ultrasound and the ultrasound procedure of the application method for the treatment of system associated with radiation in the present invention
Figure；
Fig. 8 is the process of ultrasound and the radiation therapy step of the application method for the treatment of system associated with radiation in the present invention
Figure.
Wherein, angiography system 100；HIFU Treatment system 200；BNCT treatment system 300, neutron generation device 310, neutron
Slowing down device 320, neutron beam outlet 330；Patient's bogey 400, therapeutic bed 410, lifting device 420；Patient 500.
Specific embodiment
, there are further understanding and understanding in the effect of to make to structure feature of the invention and being reached, to preferable
Examples and drawings cooperation detailed description, is described as follows:
Embodiment one
As shown in Figure 1 and Figure 2, a kind of ultrasound and treatment system associated with radiation, comprising: angiography system 100, HIFU Treatment
System 200, BNCT treatment system 300, patient's bogey 400 and control system.
In the present embodiment, angiography system 100 be MRI contrast apparatus, for before ultrasonic therapy, treatment in, treatment after it is right
Focal zone containing radiography agent composition carries out radiography, indicates position, size and the exact boundary of tumour, and judge tumor size
Whether pre-set dimension is reached；It include: magnet, spectrometer, MRI screening arrangement.Magnet is selected from cyclic formula magnet, ring in the present embodiment
The structure of shape formula magnet is a closed annular, and main stationary magnetic field is generated in closed annular space.In other embodiments
In, magnet can be selected from open magnet, and the structure of open magnet is that a magnetic material, generated master are respectively arranged up and down
Stationary magnetic field is perpendicular to ground.
Radiography agent composition includes boron preparation and contrast agent.In the present embodiment, contrast agent is MRI contrast agent.
Specifically, being combined to carry out high-strength focusing ultrasonic therapy technology and boron neutron capture therapy technology, judgement is swollen
Knurl product size is a crucial factor.It is also required to judge tumour side by radiography in conventional high-strength focusing ultrasonic therapy
Boundary, for benign tumour, sharpness of border can determine its boundary, and for there are the offensive malignant tumours of height to come
Say, boundary be it is fuzzy, can not clearly sketch the contours of tumor boundaries can not also thoroughly remove malignant tumor tissue.
In order to accurately judge position, size and the exact boundary of human tumor, MRI radiography is used in the present embodiment and is filled
It sets and radiography is carried out to focal zone, sketch out the boundary of tumor region accordingly.But since MRI radiography belongs to structural radiography and NOT function
Energy property radiography, therefore can not be fully validated for the boundary of malignant tumour, it can not also pick out pernicious group for having invaded surrounding
It knits.In addition, being clinically also often used gadolinium contrast medium (or being contrast agent) carries out enhancing radiography, gadolinium contrast medium is can be in MRI
The molecule to bleach rapidly on radiography, tranmittance is to the MRI image before and after injection gadolinium contrast medium, it can be seen that the blood vessel at some position
The appearance of traveling, it is more obvious to make lesion region, but cannot be distinguished from out having suffered tumor tissues infiltration but not yet form obvious tumour
Tissue.
When needing to obtain tumour exact boundary with MRI contrast apparatus, need to make before radiography to patient's body injection MRI
Shadow agent composition, radiography agent composition include boron preparation and MRI contrast agent, then carry out function development, and benefit using boron preparation
Structure development is carried out with MRI contrast agent, using the clear tumor tissues Infiltrating extrent of the radiography agent composition, carries out treatment region accordingly
Picture and successive treatment are enclosed, to reach optimal therapeutic effect.
Fig. 3, Fig. 4 are the MRI image and its image for ticking boundary in malignant tumour lesion area, and wherein Fig. 3 is existing skill
Figure in art not containing radiography agent composition is the figure containing radiography agent composition in the present embodiment in Fig. 4.It can by comparison
Know, the tumor boundaries showed in traditional MRI image are not actual boundary, by assembling contrast agent mixing in focal zone
The real boundary of tumour can be showed, can accurately obtain tumor boundaries and its size by object.
In the present embodiment, radiography agent composition is injected to patient 500 before radiography, wherein boron preparation and MRI contrast agent are mixed
Radiography agent composition is synthesized, such radiography agent composition rich in high tumor affinity, can be both enriched with, together in human tumor region
Shi Zaoying agent composition can be measured again by angiography system 100, therefore in MRI image, can be dense by high boron preparation by mixing colours
Degree tumor region and low boron formulation concentrations tumor region and tumor region and normal tissue are distinguished, can be according to color
Difference sketch out exact tumor region, the boundary for clearly determining tumour and the wherein concentration distribution of boron preparation, boron preparation
Concentration can be scaled boron concentration.
Certainly, in other some embodiments, angiography system 100 can be CT contrast apparatus and PET contrast apparatus, or
Person is MRI contrast apparatus and PET contrast apparatus, to determine position, size and the boundary of tumour.
HIFU Treatment system 200 is used to carry out ultrasonic therapy to focal zone, melts large scale tumour；Occur including signal
Device, power amplifier and energy converter.Signal generator is for generating source of ultrasound signal, power amplifier and the signal generator
Connection, for amplifying ultrasonic signal, energy converter is connect with power amplifier, and power amplifier drives energy converter to generate ultrasound
Wave, energy converter conduct ultrasonic wave to focal zone, are focused using ultrasonic wave in focal zone, pass through the heat of high-intensity focusing ultrasonic wave
Effect makes focal zone tumour ablation, has reached ablated tumor, the purpose for making tumour become smaller.
The main mechanism of high-strength focusing ultrasonic therapy tumour is: can penetrate soft tissue using ultrasonic wave and can focus
Physical property form high-energy-density by external low energy focus ultrasonic in in-vivo tumour focal zone in focal point, make focal point
Tumor tissues are brought rapidly up (>=65 DEG C), make tumor tissues that irreversible coagulation necrosis occur, also cry ablation, and outside focal zone
Tissue do not damage, achieve the purpose that " to cut off " tumour, be one of the means of non-invasive therapy tumour.Meanwhile focusing ultrasound also
2mL tumor by local below can be destroyed and nourish thin vessels, make tumor tissues that secondary ischemic necrosis occur；And it can pass through cavitation
Effect realizes and induces internal antineoplastic immune effect, enhancement effect when reaching in conjunction with radiotherapy, chemotherapy expands to swollen
The killing ability of tumor tissue；The fuel factor for focusing ultrasound separately can induced tumor cell synthesis heat shock protein (heat shock
Protrin, HSP), excitation is directed to the specific toxicities T lymphocyte of homologous tumour cell, reaches and inhibits tumor tissue growth
Purpose.
However, for there are for the offensive malignant tumour of height, on the one hand since high-strength focusing ultrasonic therapy needs
Crisperding carried out to tumor lesion area and determine knub position and size, carry out focusing ultrasonic wave further according to the position that crisperding determines,
And the obscurity boundary of malignant tumour, it can not clearly be sketched the contours of, so that will lead to malignant tumour boundary in therapeutic process may
There is the tumor region of omission, on the other hand, since the focal zone diameter of high-strength focusing ultrasonic therapy is only several millimeters, point and point
Between be difficult to be overlapped sometimes, along with there are Energy distribution non-uniform phenomenons in focal zone, will appear in the tissue after treatment " residual
Stay cancer cell island ", one of the reason of this is all tumor recurrence.Therefore, for a long time, high-strength focusing ultrasonic therapy can will dislike
Property tumour ablation, which becomes smaller, to be but difficult to thoroughly remove malignant tumor tissue.
BNCT treatment system 300 removes small size tumour for carrying out radiation therapy to focal zone；It include: that neutron generates
Device 310, moderation of neutrons device 320 and neutron beam outlet 330.Neutron generation device 310 has for generating high-throughput neutron beam
Body, neutron beam is provided using nuclear reactor, accelerator, nucleic；Moderation of neutrons device 320 and the neutron generation device
310 connections, the energy adjusting of the neutron beam for generating the neutron generation device 310 make to suitable boron neutron capture therapy
Energy, the neutron beam energy range are 0.5eV~40keV；Neutron beam outlet 330 and the moderation of neutrons device 320
Connection, exports for neutron beam and reaches 500 focal zone of patient, using this neutron beam to 500 tumour of patient of intake boron preparation
Tissue site is irradiated, and achievees the purpose that tumour is eliminated in treatment.
The main mechanism of boron neutron capture therapy is based on boron preparation (- 10 element of boron that ingredient is 99% or more) to thermal neutron
It is thousands of times or more of tissue (C, H, O, N) with the up to capture cross-section of 3840barn.By in 10B (n, α) 7Li
Muon capture and nuclear fission reaction generate two heavy burden charged particle of 7Li of the 4He and 1.48MeV of 0.85MeV, two heavy burden charged particle
Range be respectively 9um and 5um, the integrated range of two heavy burden charged particle is approximately equivalent to a cell size, therefore for biology
Caused by radiation injury can be confined to cell level, while boron preparation has close tumour property, can be highly enriched in tumor region,
When boron preparation is selectively gathered in tumour cell, neutron appropriate of arranging in pairs or groups penetrates source, just can cause too in not normal tissue
Under the premise of major injury, achieve the purpose that kill tumour cell.
Before neutron exposure, count not androgynous by volume-dose histogram (Dose Volume Histogram, DVH)
Dosage in product tumour is distributed, and DVH is calculated using the dose of radiation that calculator program in Mondicaro is completed in the present embodiment, is adopted
Use Snyder moulds as computation model, Snyder head module is made into point with reference to No. ICRU-46 report, and using corresponding
The KERMA factor counts thermal neutron flux, fast neutron flux counts, photon flux count assessment result is converted to dose of radiation,
Dosage group ingredient is 4 classes such as boron dosage, fast neutron dosage, thermal-neutron dose, photon doses.Wherein, different tissues have relatively
The relative biological effect (Relative biological effectiveness, RBE) and compound biological effect answered
(Compound biological effectiveness, CBE), therefore the calculating of equivalent dose (equivalent dose) is public
Formula is as follows:
Deq=CBE × Bcon×DB+RBEf×Df+RBEth×Dth+RBEγ×Dγ
The parameters that use is calculated in the present embodiment are as shown in the table:
The dose-volume histogram assessment result of Snyder moulds, assessment side are carried out using Mondicaro calculator program
Method as previously mentioned, by dosage group ingredient be boron dosage, fast neutron dosage, thermal-neutron dose, 4 class of photon doses, consider different groups
The whole equivalent dose of acquisition after the biological effects of radiation knitted.In general, doctor's prescribed dose to be administered is 70Gy-Eq, also
That is, tissue dose, which reaches 70Gy-Eq or more, can remove tumor tissues, tumor control rate (Tumor Control is improved
Probability)；Conversely, may cause to recur since tumor clearance is incomplete if underdosage.
As shown in figure 5, being volume-dose histogram of two kinds of variety classes size tumours, it can be seen that work as diameter of tumor
When for 8cm, the tumor tissues of only 40% volume receive enough prescribed doses (70Gy-Eq), meet wanting for prescribed dose
It asks, the tumor tissues of remaining 60% volume are unsatisfactory for the requirement of prescribed dose, and a large amount of underdosage tumor tissues will likely become
Future recurs hidden danger again；When diameter of tumor is 4cm, 100% volumetric tumor receives high dosage irradiation, meets prescribed dose
It is required that.That is, Partial tumors region does not receive the treatment of punishment dosage when diameter of tumor is 8cm, it cannot reach good and control
Therapeutic effect, when diameter of tumor is 4cm, whole tumor regions can receive the treatment of punishment dosage, can achieve good
Therapeutic effect.
As it can be seen that boron neutron capture therapy has good curative effect for the malignant tumour of small size, first pass through high-strength
Spend focus ultrasonic for tumour ablation, make its size reduction to diameter 4cm or within, then can will be disappeared using boron neutron capture therapy
Become smaller after melting and remaining malignant tumour is removed, it is more than prescribed dose that 100% tumour is acceptable at this time, be can reach
Good tumour control effect.
In this present embodiment, the pre-set dimension is that diameter of tumor is less than 4cm or gross tumor volume is less than 250cc.Work as tumour
Size when being that diameter of tumor is less than 4cm or gross tumor volume and is less than 250cc, referred to as small size tumour, at this point, the size of tumour
It is sufficiently small, it can achieve good therapeutic effect using boron neutron capture therapy, and if selection high-strength focusing ultrasonic therapy,
Due to may exist at tumor boundaries tumor tissues and normal tissue interweave there are the case where, when high-strength focusing ultrasonic therapy
Tumor tissues and normal tissue entirety " excision " in treatment region can be caused meaningless injury to human body.
The combination that high-strength focusing ultrasonic therapy technology and boron neutron capture therapy technology are used in the present invention, can first lead to
It crosses high intensity focused ultrasound treatment technology the malignant tumour ablation of large volume becomes smaller, becomes the malignant tumour of small size, then lead to
The malignant tumour for the small size that boron neutron capture therapy is removed after ablation is crossed, so that the malignant tumour for effectively improving large volume is cured
Effect and cure rate.As it can be seen that requiring injection boron preparation in angiographic procedure and BNCT therapeutic process in the present embodiment.It is treating
When, due to being filled with boron preparation to patient's body before MRI radiography, before BNCT irradiation, need to detect patient's body
The concentration of interior boron preparation, and be compared with the therapeutic scheme of BNCT, when satisfaction treatment requires, without re-injecting boron system
Agent.When discontented foot therapy requires, needing to adjust treatment plan, one can choose boron make-up preparation injection patient's body, to
Meet after treatment requires and carries out BNCT treatment again；Secondly required prescription can be treated to supply by adjusting parameters such as irradiation times
Dosage.
It should be noted that the method for the concentration of detection patient's body boron preparation can be and patient's body blood sample is taken to be examined
It surveys, is also possible to be detected by obtaining the particular ray that patient tumors region occurs, if SPECT contrast apparatus detects,
It can be and detected by MRI or PET contrast apparatus, in the present embodiment without limitation for detection method.
Patient's bogey 400, for carrying patient 500, and with angiography system 100, HIFU Treatment system 200, BNCT
Treatment system 300 matches；Including therapeutic bed 410 and lifting device 420, lifting device 420 is connect with therapeutic bed 410, and is driven
Dynamic therapeutic bed 410 carries out the pendulum position in the directions such as upper and lower, left and right.Patient's bogey 400 need to pass through magnetic compatibility test, Fang Ke
It works under strong magnetic field circumstance.
Specifically, lifting device 420 drives therapeutic bed 410 to be moved to angiography system 100,200 and of HIFU Treatment system
The corresponding position of BNCT treatment system 300, so that patient 500 can lie in progress focal zone radiography, ultrasound in therapeutic bed 410 and control
Treatment and radiation therapy process.
Control system carries with angiography system 100, HIFU Treatment system 200, BNCT treatment system 300, patient fill respectively
400 connections are set, for controlling the movement of each component.
Control system is used to control the movement of each component, each component of switching control according to demand, those skilled in the art
Can the control program (computer program) wanted of easy design, control system belongs to the prior art, herein no longer
It repeats.
In this present embodiment, angiography system 100, HIFU Treatment system 200 and BNCT treatment system 300 are set to same control
It treats in room.Specifically, patient 500 is placed in therapeutic bed 410, controls angiography system by control system in treatment
100, tumor imaging, tumour ablation, tumor clearance can be completed in the switching of HIFU Treatment system 200 and BNCT treatment system 300
Process reduces the movement of patient 500, can it is safer, faster complete tumor therapeutic procedure.
In this present embodiment, HIFU Treatment system 200 is arranged above therapeutic bed 410, is overhead HIFU Treatment system
200, patient 500 can be irradiated from top to bottom, complete ultrasonic therapy process.
The present embodiment also provides a kind of operating method for the treatment of system associated with above-mentioned ultrasound and radiation, as shown in fig. 6, packet
It includes:
S1: radiography agent composition is injected in 500 body of patient；
S2: obtaining the contrastographic picture of patient 500 using angiography system 100, obtain the position of 500 tumour of patient, size and
Boundary；
S3: judging whether tumor size is less than pre-set dimension, when no, executes S4, when being, executes S5；
S4: ultrasonic therapy is carried out using HIFU Treatment system 200, melts large scale tumour, then execute S2 step；
S5: radiation therapy is carried out using BNCT treatment system 300, removes small size tumour；
S6: terminate.
In step S1: the radiography agent composition injected in 500 body of patient is made when angiography system is MRI contrast apparatus
Shadow agent composition is the mixture of MRI contrast agent and boron preparation；When angiography system be CT contrast apparatus and PET contrast apparatus, or
When person is MRI contrast apparatus and PET contrast apparatus, radiography agent composition is the mixture of PET contrast agent and boron preparation.
In step S2: the contrastographic picture of patient 500 is obtained, position, size and the boundary of 500 tumour of patient are obtained, it can be with
It is to sketch out tumor boundaries by image processing software to obtain position, size and the boundary of 500 tumour of patient, is also possible to pass through
Experienced doctor sketches out tumor boundaries and obtains position, size and the boundary of 500 tumour of patient, can also be through computer people
Work intelligence (AI) method automatic discrimination tumor boundaries obtain position, size and the boundary of 500 tumour of patient.
In step S3: judging whether tumor size reaches pre-set dimension, pre-set dimension is that diameter of tumor is less than 4cm or tumour
Volume is less than 250cc, and deterministic process is completed by control system.
As shown in fig. 7, in step S4: carrying out ultrasonic therapy, melt large scale tumour, then execute in S2 step, specifically
Ultrasonic step includes:
S41: according to the contrastographic picture of tumour, layer-by-layer crisperding is carried out to tumour, determines the exact position of tumour；
S42: high-strength focusing ultrasonic therapy parameter, high intensity focused ultrasound is arranged in position and size further according to tumour
Treating parameter includes power, focus temperature etc.；
S43: open signal generator, power amplifier, energy converter generate ultrasonic wave；
S44: focusing ultrasonic wave is subjected to high intensity focused ultrasound in one of region of knub position through energy converter
Treatment, then focal position is adjusted to other regions of knub position, until completing the high intensity focused ultrasound of entire tumor region
Treatment.
The mode of adjustment focal position can be machinery adjustment treatment head position or machinery adjustment patient position, or
Person is jumped automatically through more element transducers.
In this present embodiment, in step s 4, further include executing following steps:
S45: the contrastographic picture of real time monitoring patient 500.
Specifically, by the contrastographic picture of real time monitoring patient 500, medical staff can observe the life of patient 500 at any time
Sign is ordered, and the impression of inquiry patient 500 can be passed through, it is ensured that safety.
As shown in figure 8, in step S5: carrying out radiation therapy, remove in small size tumour, comprising:
S51: radiation therapy plan is formulated according to tumor size；
S52: boron concentration in detection 500 body of patient, and be compared with the boron concentration in radiation therapy plan, when lower than spoke
When penetrating the boron concentration in treatment plan, need to adjust treatment plan；
S53: opening BNCT treatment system, carries out neutron exposure；
S54: when exposure dose reaches the dosage of radiation therapy plan, stop neutron exposure.
Need to adjust treatment plan, can choose boron make-up preparation injection patient's body, wait meet treatment require after again into
Row BNCT treatment；Required prescribed dose can also be treated to supply by adjusting parameters such as irradiation times.
In this present embodiment, formulate radiation therapy plan be first by neutrons characteristic input Mondicaro calculator program, and
It is Mondicaro calculator program input format by 500 radiography video conversion of patient；Boron neutron capture therapy parameter is obtained again, is wrapped
Include treatment angle, time, boron formulation concentrations etc.；Finally boron neutron capture therapy is calculated using Mondicaro calculator program to treat
500 internal dosage distribution statistics of patient are dose-volume histogram, until 100% by preceding 500 internal dosage of patient distribution
Volumetric tumor meets the requirement of prescribed dose.
Specifically, boron formulation concentrations needed for different patients 500 or different types of tumour are not quite similar, therefore, often
Boron formulation concentrations needed for the treatment of a patient 500 are different.Based on the above situation, patient 500 needs after injecting boron preparation
Calculate or detect that 500 internal dosage of patient is distributed, it is ensured that 100% volumetric tumor meets the requirement of prescribed dose.
In this present embodiment, the image that the mode of boron concentration in 500 body of patient can be obtained by angiography system 100 is detected
It is converted to obtain boron concentration, is also possible to be converted to obtain boron concentration by the ray signal that detection tumor region is released.
In this present embodiment, neutron generation device 310 is opened, when being irradiated, neutron beam passes through moderation of neutrons device 320
It is projected afterwards from neutron beam outlet 330, irradiated lesion area, until radiation therapy is completed.
Specifically, entire tumor therapeutic procedure includes tumor imaging process, ultrasonic therapy process and radiation therapy process,
Middle tumor imaging process and ultrasonic therapy process may may require that repeatedly, after tumor size reaches pre-set dimension,
Radiation therapy can be carried out, after completing boron neutron capture therapy, entire tumor therapeutic procedure can be completed.
Embodiment two
The present embodiment and the difference of embodiment one are:
In this present embodiment, angiography system 100 and HIFU Treatment system 200 are set in the first therapeutic room, BNCT treatment
System 300 is set in the second therapeutic room.
Specifically, in treatment, when patient 500 passes through the angiography system 100 and HIFU Treatment system in the first therapeutic room
200 complete radiographies, ultrasonic therapy process, after reaching tumour ablation effect, then patient 500 are transferred in the second therapeutic room
HIFU Treatment system 200 carries out radiation therapy process, to reach tumor clearance effect, meanwhile, next patient 500 can be first
Tumor imaging, ultrasonic therapy process are carried out in therapeutic room.As it can be seen that in the present solution, different patient 500 can treat simultaneously,
One of patient 500 carries out ultrasonic therapy, another patient 500 carries out radiation therapy, and ultrasound and radiation combination can be improved
Treatment system utilization rate.
Embodiment three
The present embodiment and the difference of embodiment one are:
In this present embodiment, the quantity of HIFU Treatment system 200 is one group, and the setting of HIFU Treatment system 200 is controlled described
Treat the lower section of bed 410, be underneath type HIFU Treatment system 200, underneath type HIFU Treatment system 200 from the bottom up to patient 500 into
Row irradiation, completes ultrasonic therapy process.
Example IV
The present embodiment and the difference of embodiment one are:
In this present embodiment, the quantity of HIFU Treatment system 200 is two groups, respectively overhead HIFU Treatment system 200
With HIFU Treatment system 200, overhead HIFU Treatment system 200 is arranged above the therapeutic bed 410, from top to bottom to patient
500 are irradiated, underneath type HIFU Treatment system 200 be arranged below the therapeutic bed 410, from the bottom up to patient 500 into
Row irradiation completes ultrasonic therapy process by the ultrasonic irradiation of upper and lower both direction.
Finally, it should be noted that the above embodiments are merely illustrative of the technical solutions of the present invention, rather than its limitations；Although
Present invention has been described in detail with reference to the aforementioned embodiments, it will be understood by those of skill in the art that it still can be right
Technical solution documented by previous embodiment is modified, or is replaced on an equal basis to part of technical characteristic；And these
It modifies or replaces, the spirit and scope for technical solution of various embodiments of the present invention that it does not separate the essence of the corresponding technical solution.
Claims (10)
1. treatment system associated with a kind of ultrasound and radiation characterized by comprising
Angiography system (100) indicates position, size and the boundary of tumour, and judge whether to reach for carrying out radiography to focal zone
To pre-set dimension；
HIFU Treatment system (200), for carrying out ultrasonic therapy to focal zone, the large scale that ablation is not up to pre-set dimension is swollen
Tumor；
BNCT treatment system (300) removes the small size tumour for reaching pre-set dimension for carrying out radiation therapy to focal zone；
Patient's bogey (400), for carrying patient, and with the angiography system (100), the HIFU Treatment system
(200), the BNCT treatment system (300) matches；
Control system, respectively with the angiography system (100), the HIFU Treatment system (200), the BNCT treatment system
(300), patient's bogey (400) connection, for controlling the movement of each component.
2. treatment system associated with ultrasound according to claim 1 and radiation, which is characterized in that the angiography system
(100) MRI contrast apparatus, CT contrast apparatus, PET contrast apparatus or combinations thereof are selected from.
3. treatment system associated with ultrasound according to claim 1 and radiation, which is characterized in that the focal zone, which contains, to be made
Shadow agent composition, the radiography agent composition include boron preparation and contrast agent.
4. treatment system associated with ultrasound according to claim 1 and radiation, which is characterized in that the pre-set dimension is swollen
Tumor diameter is less than 4cm or gross tumor volume is less than 250cc.
5. treatment system associated with ultrasound according to claim 2 and radiation, which is characterized in that the MRI contrast apparatus
It include: magnet (110), spectrometer, MRI screening arrangement.
6. treatment system associated with ultrasound according to claim 1 and radiation, which is characterized in that the HIFU Treatment system
It (200) include: signal generator, power amplifier and energy converter.
7. treatment system associated with ultrasound according to claim 1 and radiation, which is characterized in that the BNCT treatment system
It (300) include: neutron generation device (310), moderation of neutrons device (320) and neutron beam outlet (330).
8. treatment system associated with ultrasound according to claim 1 and radiation, which is characterized in that patient's bogey
It (400) include: therapeutic bed (410) and lifting device (420), the lifting device (420) connect with the therapeutic bed (410),
And drive the pendulum position in the directions such as the therapeutic bed (410) progress upper and lower, left and right.
9. the operating method for the treatment of system associated with the described in any item ultrasounds of claim 1-8 and radiation, which is characterized in that packet
Include following steps:
S1: radiography agent composition is injected in vivo in patient (500)；
S2: the contrastographic picture of patient (500) is obtained using angiography system (100), obtains position, the size of patient (500) tumour
The boundary and；
S3: judging whether tumor size reaches pre-set dimension, when no, executes S4, when being, executes S5；
S4: ultrasonic therapy is carried out using HIFU Treatment system (200), melts large scale tumour, then execute S2 step；
S5: radiation therapy is carried out using BNCT treatment system (300), removes small size tumour；
S6: terminate.
10. it is according to claim 9 ultrasound and radiation associated with treatment system operating method, which is characterized in that into
Row radiation therapy, when removing small size tumour, comprising:
S51: radiation therapy plan is formulated according to tumor size；
S52: the internal boron concentration of detection patient (500), and be compared with the boron concentration in radiation therapy plan, when lower than radiation
When boron concentration in treatment plan, radiation therapy plan is adjusted；
S53: opening BNCT treatment system (300), carries out neutron exposure；
S54: when exposure dose reaches the dosage of radiation therapy plan, stop neutron exposure.
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