CN111712298B - 放射疗法系统 - Google Patents
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Abstract
光子疗法递送系统可以通过光子束将放射疗法递送给患者。该系统可以利用被配置为促进通过光子束以及粒子束的放射疗法的递送的控制器。这可以包括接收用于利用粒子束和光子束对患者进行放射疗法治疗的放射疗法束信息。另外,可以在放射疗法治疗期间接收患者磁共振成像(MRI)数据。利用患者MRI数据,可以考虑粒子束通过的软组织的相互作用特性,确定粒子束和光子束的剂量沉积位置的实时计算。
Description
相关申请
本申请要求于2017年12月6日提交的美国临时申请号62/595,478的优先权和权益,该临时申请的全部内容通过引用合并于此。
背景技术
放射疗法使用放射束杀死细胞以治疗疾病,通常是增殖性组织疾病,例如癌症。放射疗法可用于治疗需要一定剂量的电离放射以达到疗效的患者的靶标,例如总体上可观察到的肿瘤、包含微观疾病或潜在疾病扩散的解剖区域或包括运动和/或递送不确定性裕度的区域。放射疗法束递送的电离放射会破坏患病细胞的DNA和其他重要组成,并阻止细胞复制。
典型的放射疗法涉及治疗计划,以确定如何将处方规定的放射剂量递送至靶标,同时通过将剂量限制在可接受的阈值以下以防止致命或使人衰弱的副作用,从而使附近的健康组织免受破坏。
发明内容
公开了放射疗法系统(例如,光子疗法递送系统),用于将放射疗法(例如,通过光子束)递送给患者。某些实施例可以包括控制器,该控制器被配置为促进通过光子束以及还通过粒子束的放射疗法的递送。
可以在无需移动患者的情况下完成利用光子束的放射疗法的递送和通过粒子束的放射治疗的递送。光子疗法递送系统可以被配置为通过来自多个方向的光子束将放射疗法递送给患者。而且,该系统可以包括磁共振成像系统(MRI),该磁共振成像系统被配置为在放射疗法的施用期间获取患者的图像。
还公开了计算机程序产品,该计算机程序产品允许接收放射疗法束信息以利用粒子束和光子束对患者进行放射疗法治疗。可以在放射疗法治疗期间接收患者磁共振成像(MRI)数据。此外,可以考虑到粒子束通过的软组织的相互作用特性,利用患者MRI数据对粒子束和光子束的剂量沉积位置执行实时计算。
在某些实施例中,在执行剂量沉积位置的实时计算时,还可以考虑由MRI系统产生的磁场对粒子束和光子束的影响。患者MRI数据和放射疗法束信息可用于在放射疗法治疗期间计算对患者的累积剂量沉积。可选地,可以基于计算的剂量沉积来重新优化放射疗法治疗。
还公开了另一种计算机程序产品,其使得能够接收患者放射疗法处方信息并接收患者磁共振成像(MRI)数据。可以确定包括结合了光子束递送和粒子束递送的放射疗法治疗计划。放射疗法治疗计划的确定可以利用患者放射疗法处方信息和MRI数据。
当前主题的实施方式可以包括但不限于与本文提供的描述一致的方法以及包括有形地实现的机器可读介质的物品,所述有形地实现的机器可读介质可操作成使得一个或多个机器(例如,计算机等)产生实现一个或多个描述的特征的操作。类似地,也设想了计算机系统,其可以包括一个或多个处理器和耦接到一个或多个处理器的一个或多个存储器。可以包括计算机可读存储介质的存储器可以包括、编码、存储使得一个或多个处理器执行本文描述的一个或多个操作的一个或多个程序,或者对所述一个或多个程序进行其他操作。与本主题的一个或多个实施方案一致的计算机实施的方法可以通过驻存在单个计算系统或多个计算系统之间的一个或多个数据处理器实施。这样的多计算系统可以经由一个或多个连接、经由多计算系统中的一个或多个之间的直接连接等被连接并且可以交换数据和/或命令或其他指令等,所述一个或多个连接包括但不限于通过网络(例如,互联网、无线广域网、局域网、有线网络等)的连接。
在附图和以下描述中阐述了本文描述的主题的一个或多个变型的细节。从说明书和附图以及从权利要求书中,本文描述的主题的其他特征和优点将是显而易见的。尽管出于与特定实现有关的说明性目的描述了当前公开的主题的某些特征,但是应当容易理解,这些特征并非旨在进行限制。本公开之后的权利要求旨在限定受保护主题的范围。
附图说明
结合在本说明书中并构成本说明书的一部分的附图示出了本文所公开的主题的某些方面,并且与说明书一起,有助于解释与所公开的实施方式相关联的一些原理。在附图中:
图1是示出了进入人体组织的放射疗法的各种示例性形式的穿透深度的曲线图;
图2是利用MRI数据的用于粒子放射疗法的放射疗法治疗计划的方法的流程图,该方法可以由软件实现;
图3是具有与本说明书一致的一个或多个特征的放射疗法系统的图示;
图4是具有与本说明书一致的一个或多个特征的放射疗法系统的图示;
图5A-5B示出了用于屏蔽例如粒子疗法系统的剂量测定系统的一部分的屏蔽系统,该屏蔽系统具有与本说明书一致的一个或多个特征;
图6是具有与本说明书一致的一个或多个要素的粒子放射疗法治疗的方法的流程图;
图7是具有与本说明书一致的一个或多个特征的组合放射疗法系统的图示;
图8是具有与本说明书一致的一个或多个特征的组合放射疗法系统的图示;和
图9是具有与本说明书一致的一个或多个特征的组合放射疗法系统的图示。
具体实施方式
本文公开了用于执行放射疗法的系统、方法和计算机软件,该放射疗法可以利用由光子束(例如,X射线)以及由粒子束提供的疗法。如本文所述,可以结合磁共振成像来利用这样的方法。
下面的公开内容首先介绍与粒子疗法、粒子疗法的治疗计划以及利用磁共振成像的粒子疗法有关的特定概念。接着这些的是可以将粒子疗法与光子束疗法相结合的疗法的描述。可以想到并理解,所描述的与粒子疗法有关的大多数概念类似地适用于粒子疗法与光子束疗法的组合。
粒子疗法是使用高能粒子束治疗疾病(例如癌症)的放射疗法的一种形式。粒子束可以瞄准患者体内的靶标,并可以导致靶标细胞的DNA和其他重要细胞组成受损,最终导致细胞死亡。癌细胞比非癌细胞具有更弱的修复放射损伤的能力,因此特别容易受到粒子疗法的影响。取决于上下文,“粒子疗法”有时用于指利用强子(例如质子、中子、反质子、介子等)的疗法,同时也可以指利用离子或原子核(例如锂离子,氦气)的疗法。尽管没有精确限定“轻离子”和“重离子”之间的界线,但通常说利用诸如碳离子的离子的疗法是“重离子疗法”。如本文所用,术语粒子疗法、粒子放射疗法、粒子束等是指利用强子以及原子核(或离子)的疗法。该术语特别地排除诸如光子疗法或电子束疗法之类的疗法。
图1是曲线图100,其示出了进入人体组织的放射疗法的各种形式的穿透深度。对于给定的能量,与其他放射疗法形式相比,电子束具有进入人体组织的低穿透深度(如迹线102所示)。X射线束穿透人体组织的深度大于电子,但组织吸收的剂量随X射线的穿透深度而降低,如迹线104所示。粒子疗法束在其范围的末端将其更多的能量沉积在进入患者组织的特定深度处,如迹线108所示。在其范围的末端附近的该深度可称为布拉格峰(BraggPeak),示为108。粒子疗法提供的益处是较少的能量被沉积到靶标外的健康组织中,从而降低了损伤健康组织的可能性。另外,与X射线束相比,超过布拉格峰,沉积的剂量非常小。
在可以进行粒子放射疗法之前,必须产生治疗计划。本公开设想到以特定方式在产生治疗计划时可选地使用磁共振成像(MRI)数据,该治疗计划将具有与递送给患者的实际剂量紧密匹配且与期望剂量紧密匹配的预测剂量沉积。X射线计算机断层扫描(CT)成像数据还可用于确定例如患者组织的质量密度,以及患者的包含低密度和高密度组织的区域或诸如肺、空气和骨骼的区域。可以对所有粒子束路径执行分析。
可以采用磁共振成像系统来获得MRI数据,当对该MRI数据进行分析时,可以更准确地确定沿着到达和穿过靶标的束路径的软组织的类型。然后,可以从MRI数据确定粒子的相互作用特性,从而允许更准确地确定递送到患者组织和靶标的剂量。另外,MRI数据可以使得能够更准确地确定粒子束疗法的生物学有效性。
本公开内容设想到MRI数据可以与X射线CT数据结合(例如,通过使用可变形图像配准)以提高化学组成和质量密度确定的准确性,从而改善粒子疗法剂量的确定。如果X射线CT数据不可用,则可以通过超短回波时间(TE)MR成像来确定包含骨骼的区域,而肺和空气可以从质子密度加权MR成像来确定。
X射线CT非常适合产生人体中的电子密度图,并且由于光子的主要相互作用概率与电子密度成比例,因此可用于确定由光子束放射疗法递送的剂量。电子密度也与质量密度密切相关,这是由于以下事实:对于人体组织,原子序数较低,而原子核的中子与质子比率相当恒定。CT霍恩斯菲尔德数(Hounsfield number)反映了人体组织对X射线的衰减系数。因此,对于元素组成、元素重量和质量密度的各种不同组合,霍恩斯菲尔德数可以是相同的,更不用说由于像束硬化效应和其他伪像,所测量的霍恩斯菲尔德数可能是不准确的。使用X射线CT限定组织时引入的元素组成的不确定性和霍恩斯菲尔德数可能导致所确定的粒子束范围明显错误。该错误可能直接导致剂量计算错误,例如,因为需要粒子阻挡本领(stopping power)来准确地建模沿高能粒子路径的剂量沉积并确定粒子到达其范围末端的位置。如图1所示,阻挡本领的不确定性直接转化为布拉格峰108位置的不确定性,这可能会使大剂量区域脱离靶标和肿瘤,从而无法将有效剂量递送给治疗靶标,而是将粒子放射疗法递送到应被屏蔽为不接收高剂量的粒子放射的健康组织。
与用X射线CT上成像相比,当用MRI系统进行成像时,软组织具有更好的对比度和清晰度。如前所述,由于X射线CT的低或高的对比度以及低或高的霍恩斯菲尔德数,X射线CT在确定密度非常不同的组织的质量密度以及限定包含空气或皮质骨的区域方面非常出色。但是,许多软组织的密度非常相似,具有非常不同的元素组成。例如,组织在具有非常相似的质量密度的同时可以具有脂肪(fat-like)样(或脂肪样(adipose-like))性质或水样(或肌肉样)性质,因此很难用X射线CT数据对它们区分。X射线CT数据中的图像噪声、伪影和低对比度共同导致使用当前方法常常会误识别组织类型。就阻挡本领而言,除去任何密度依赖性,脂肪样组织(CH2)或水样组织(OH2)之间的阻挡本领差异主要由O和C之间的原子序数差异决定。对于高于数10MeV/核子的能量,如在粒子疗法中使用时,阻挡本领之比很显著(significant)。
利用仅对水或仅对脂肪敏感的脉冲序列来获取MRI数据,允许通过例如Dixon方法或夹层回波(sandwich echo)确定组织的水脂比。然后,可以将所确定的在治疗靶标附近的水脂比用于改善对软组织的元素组成的了解。MRI可以通过在不同时间和/或以不同方式读取激发质子的信号获得不同的“对比度”(取决于氢所附着的分子类型,信号不同地衰减)。因此,可以更好地区分不同的组织类型并利用MRI推断化学组成。
粒子束与粒子束通过的组织的相互作用(相互作用的频率和类型)取决于许多因素,包括束粒子的类型、粒子能量以及组织的质量密度和化学组成。至少对于带电粒子而言,粒子相互作用包括库仑相互作用(即电磁相互作用)。库仑相互作用几乎总是导致入射粒子的能量损失小和/或方向的偏转小。导致束扩散的偏转称为库仑散射。每单位长度的能量损失量可以称为阻挡本领。粒子在库仑相互作用中经历的小能量损失是由于组织的原子和分子的电离和激发所致。这样的相互作用的频率决定了沿着粒子路径的电离密度。电离密度越高,细胞受损的概率越高。通常用称为线性能量传递(linear energy transfer,LET)的量来对其进行测量。
粒子相互作用还包括核相互作用,其与库仑相互作用相比较不频繁,但灾难性要大得多。它们往往会导致原子核被击中分解成碎片(例如单个质子和中子、氘核、氚核、锂、α等)。这样的碎片的类型和数量取决于入射粒子的类型和能量以及被击中的原子核。核相互作用还留下放射性核,其会衰变并沉积额外的剂量。
核相互作用和库仑散射高度依赖于核的原子序数。它们都导致布拉格峰的变宽。对于离子而言,核相互作用也是造成超过布拉格峰沉积的剂量尾部的原因。当光路中存在异质性(例如,气腔、骨头)时,库仑散射会导致异质性后面的复杂的剂量沉积结构。
当在本文中使用术语相互作用特性时,它是指相互作用特性(例如上述库仑相互作用和核相互作用)的任何组合。用于例如放射疗法的治疗计划或实时MRI引导的本公开的一些实施例将利用在确定患者组织中剂量沉积的位置和数量时所需要的尽可能多的相互作用特性。
诸如碳离子之类的“重离子”往往比质子对细胞具有大得多的破坏性作用。它们的核相互作用碎片(fragment)具有较高的LET,并且倾向于将其能量局部地沉积在相互作用部位周围。这是导致碳离子具有比质子高得多的“生物学有效性”的主要机理。与光子、电子甚至质子相比,对于离子来说这导致更多的细胞被杀死(或损伤)沉积在组织中的更多的每单位能量。沉积在组织中的能量称为吸收剂量,以戈瑞(Gray(Gy))为单位进行测量。由于生物学有效性的差异,从碳离子束吸收1Gy的剂量将比从光子或电子束吸收1Gy的剂量杀死的细胞多3-12倍。
对于粒子束疗法,生物学有效性的确定对于正确治疗是有益的甚至是必需的。有许多不同的方法可以确定生物学有效性。例如,生物学有效剂量(BED)的确定旨在定量地指示特定放射疗法治疗的生物学效果,其中考虑到多个因素,例如疗法类型、每分次剂量、剂量率等。此外,相对生物学有效性(RBE)是将特定疗法模式的吸收剂量与光子疗法的吸收剂量进行比较的比率,其中,每种剂量导致相同的生物学效果。
对于质子,多年来一直假设RBE恒定在1.1左右,但是有人认为这会导致次优的计划结果。由于质子的RBE非常接近1.0,因此忽略执行这种生物学有效性计算可能不会对疗法产生太大的影响,但是对于中子、离子、介子等,RBE会高得多并且如果不被考虑在内的话会对疗法具有非常大的影响。
为了确定生物学有效性,需要知道入射束的能量谱以及束通过的材料或组织的相互作用特性。因此,对组织化学组成的精确了解对于准确确定生物学有效性绝对至关重要。确定入射粒子束损失大部分能量的位置(即布拉格峰)也很重要。另外,由于核反应、组织的活化、时间剂量分次以及细胞损伤与恢复的关系而对剂量分布的贡献可以被纳入生物学有效性的确定中。由于这些原因,患者MRI数据在确定生物学有效性度量时很重要,类似于其在剂量计算和治疗计划中的重要性。
MRI数据可以类似地用于允许组织元素组成的评估和准确的剂量计算,以用于评估递送前的递送计划的质量。如果要递送的剂量质量不足,则可以使用在设置(setup)时收集的数据在递送之前重新优化粒子疗法治疗计划。这可以就在递送疗法之前、当患者在治疗卧榻上时、或在患者到达以进行实际治疗之前执行。
图2是利用MRI数据的用于粒子放射疗法的放射疗法治疗计划的方法200的流程图,该方法200可以由软件实现,该方法具有与本说明书一致的一个或多个特征。可以使用可以是系统控制器一部分的一个或多个数据处理器来实现该软件。该软件可以包括机器可读指令,该机器可读指令在由一个或多个数据处理器执行时可以使一个或多个数据处理器执行一个或多个操作。
在图2中,在202处,可以接收患者放射疗法处方信息。患者放射疗法处方信息可以包括诸如靶标肿瘤所需的最小剂量、附近感兴趣的器官所允许的最大剂量等数据。本文所述的患者放射疗法处方信息并非旨在进行限制。在放射疗法治疗计划系统处接收的患者放射疗法处方信息可以包括一般用于放射疗法治疗计划的处方信息。
在204处,可以接收患者MRI数据。在一些变型中,可以从与粒子疗法系统集成的磁共振成像设备接收患者MRI数据。患者MRI数据可以涵盖要治疗的感兴趣区域,包括例如患者的靶标治疗区域以及放射疗法束可能通过并且应当对其进行放射剂量监测的周围组织。可以在治疗之前从与治疗本身不同的位置获取MRI数据,或者可以在MRI与粒子放射疗法系统集成的治疗台上获取MRI数据。
在206处,可以确定放射疗法治疗计划以与粒子束一起使用。放射疗法治疗计划可以利用患者放射治疗处方信息并利用患者MRI数据以考虑到粒子束通过的患者中的软组织的相互作用特性。放射疗法治疗计划可以包括,例如,要利用的束的数量、束将被递送的方向、束的能量、准直仪配置等。
放射疗法治疗计划的确定还可以考虑MRI的磁场对粒子束的影响。这涉及包括MRI的强磁场对患者体内电离放射沉积剂量传输(transport)的影响。相互作用的横截面不受自旋极化的强烈影响,因为它们与热效应竞争(例如,在体温下,每百万个自旋中只有约四分之一的自旋在1特斯拉磁场中对齐),但是磁场会对运动带电粒子施加外部洛伦兹力,可以将其考虑在内以产生更准确的剂量计算。
放射疗法治疗计划的确定还可以包括通过利用患者磁共振成像数据来确定通过粒子束递送到患者的软组织的剂量的生物学有效性。
图3是具有与本说明书一致的一个或多个特征的粒子疗法系统300的图示。为了激励粒子,首先通过粒子加速器302使粒子加速。粒子加速器可以是同步加速器、回旋加速器、线性加速器等。同步加速器可以由低能回旋加速器或低能线性加速器供给。在任何下游调整之前,粒子束304的能量确定被激励的粒子进入患者306的穿透深度。粒子加速器通常产生具有限定的能量的被激励的粒子束。在一些变型中,可以例如通过使束穿过衰减介质来降低粒子的能量。由于次级中子会增加对患者的不必要的剂量,因此可以远离患者这样做。衰减介质可以是轮子或线性驱动器上的楔形材料,其可以被旋转以增加或减少能量。通过在束中不施加任何衰减材料来获得最大能量。通过在束中施加最厚量的衰减材料来获得最小值。对于已知的材料,可以确定厚度,该厚度将阻止所有被激励的粒子到达患者,以停止或中断束而无需停用系统。
同步加速器还可被配置为通过增加或减少通过同步加速器环中的加速元件的通过次数来控制束能量。原则上,线性加速器还可以在一定范围内将加速单元的数量改变为几个固定能量。使用适当的设备,脉冲到脉冲的能量变化也是可能的。
在一些变型中,粒子疗法机架(gantry)312可以用于将被激励的粒子束304引导至患者306。患者306可以定位在粒子疗法机架312的中心内的卧榻(couch)314上。粒子疗法机架312可包括机架电磁体316,其被配置为通过剂量测定系统318将束引向患者306。
粒子疗法机架312可以被配置为旋转以促进以不同角度进行粒子疗法的递送。在一些变型中,粒子疗法机架312可以被配置为旋转360度。可以采用一个或多个滑环(slipring)来促进向布置在粒子疗法机架312上的电磁体其他组件的电力输送。在一些变型中,粒子疗法机架312可以被配置为以大约360度的旋转域进行旋转。在这样的变型中,粒子疗法机架312可以在一个方向上旋转直至其将能够移动的极限,然后在另一方向上回转直至其将能够移动的极限。围绕患者306旋转粒子疗法机架312可以促进以不同角度将被激励的粒子束304递送到靶标,从而改善了健康组织的免受损伤和治疗计划的质量。
粒子疗法机架312可包括扫描束磁体320。扫描束磁体320可包括例如成对的电磁体。成对电磁体可以布置成使其磁场在彼此正交的平面内。扫描束磁体320可以被配置为操纵被激励的粒子束304的方向。在一些变型中,扫描束磁体320可以被配置为以扫描运动的方式在患者的治疗靶标上来回引导被激励的粒子束。
在一些变型中,该系统可以包括固定的束线(beamline)322。固定的束线322可以被配置为通过剂量测定系统318将被激励的粒子直接递送给患者,而无需机架。该系统还可以包括一个或多个扫描束电磁体320,其被配置为修改固定线束的被激励粒子的方向。
粒子疗法系统还可包括散射器(scatter)。该散射器可以被配置成使被激励的粒子束304向外散射。该系统还可以包含一个束摇摆器(wobbler)或光栅(raster)扫描机构以使束扩展。该系统还可以包括准直仪。准直仪可以是包括多个薄金属叶片的多叶准直仪。薄金属叶片可以是可移动的,其位置可以由计算机控制。薄金属叶片可以被配置为吸收高能粒子。薄金属叶片可以由控制器布置成使得它们形成的孔的形状与患者体内的靶标互补。以这种方式,准直仪可以促进屏蔽靶标周围的健康组织,同时允许被激励的粒子穿透到靶标。在一些变型中,可以使用雕刻成永久形状的准直仪。类似地,可以在被激励的粒子束304的路径中定位团块(bolus),其可以由对被激励的粒子半透的材料形成,并且可以被雕刻以补充肿瘤的形状。
图4是具有与本公开一致的一个或多个特征的粒子疗法递送系统400的图示。粒子疗法递送系统400可具有与图3中所示的系统300的元件相似的一个或多个元件。根据本公开,粒子疗法系统400可包括用于通过粒子束向患者递送放射疗法的粒子疗法递送系统;磁共振成像系统402,其被配置为在放射疗法期间获得患者磁共振成像(MRI)数据;以及控制器424,其配置为在放射治疗期间接收患者MRI数据,并利用患者MRI数据对粒子束的剂量沉积位置执行实时计算,这考虑了粒子束通过的患者中的软组织的相互作用特性。
粒子疗法递送系统400可以包括分裂磁体(split magnet)MRI 402。分裂磁体MRI402可以包括两个分裂主磁体404和406。放射疗法系统可以包括等中心407。两个分裂主磁体404和406可以由多个支柱(buttress)408分开。多个支柱408可以离等中心407不超过两个分裂主磁体404和406的外周边。虽然将两个分裂主磁体404和406均称为单个磁体,但该术语并非旨在进行限制。为了获得患者的MRI数据,两个分裂主磁体404和406可各自包括多个磁体。
在图4中示出了分裂MRI系统,这仅出于说明目的。所使用的MRI系统可以是任何类型的MRI系统。例如,主磁体可包括垂直开放磁体、短孔磁体、具有门形或薄截面的磁体等。
卧榻410可以设置在分裂MRI系统402内。分裂MRI系统402可以被配置为通过两个分裂主磁体404和406的内部孔接收在卧榻410上的患者412。
分裂磁体MRI系统402、卧榻410和患者412都可以设置在粒子疗法机架内,例如图3中所示的机架312。粒子疗法机架可以被配置为围绕患者412旋转,从而从多个角度向患者递送疗法。
多个支柱408可以设置在两个主MRI磁体404和406之间,并位于两个主MRI磁体404和406的外周边内,以便不进一步增加MRI系统的整体直径。作为示例,该系统可以包括围绕两个主MRI磁体404和406以相等角度间隔开的三个支柱408。该系统可以被操作为使得粒子束在分裂磁体之间引向患者,并且是以它不将穿过任何支撑408的方式引向患者。
粒子疗法系统可以被配置为便于将被激励的粒子递送给患者,使得被激励的粒子被引导到两个主MRI磁体404和406之间的间隙419中。
粒子疗法递送系统400可以包括用于监测对患者的放射疗法的剂量测定系统416。剂量测定系统416还可包括一个或多个组件,以例如通过向控制器提供反馈来促进向患者递送粒子疗法。
粒子疗法递送系统400可以包括一个或多个屏蔽结构420,该屏蔽结构420可以例如包围剂量测定系统的至少一部分。屏蔽结构420可以被配置为容纳电子设备,否则这些电子设备将受到射频干扰或主MRI磁体404和406产生的磁场的不利影响。
图5A-5B示出了示例性的屏蔽结构500,该屏蔽结构500用于屏蔽粒子疗法递送系统的剂量测定系统502的至少一部分,该屏蔽结构具有与本公开一致的一个或多个特征。屏蔽结构500可以包括多个壳。该多个壳可以由一系列同心屏蔽罩(shield)形成,该同心屏蔽罩被配置为屏蔽由分裂磁体MRI系统402产生的磁场,如图4所示。同心屏蔽罩可以被配置为包围剂量测定系统502的至少一部分。本公开进一步设想到可以包括一层或多层RF吸收材料或RF反射材料或两者的组合的屏蔽结构,以例如使在本公开的某些方面中利用的线性加速器发出的RF放射的潜在不利影响最小化。
屏蔽结构500可以包括第一屏蔽容器504。第一屏蔽容器504可以包括圆柱体部分506和跨过圆柱体部分的一端设置的环形盘508。环形盘508可包括孔510,以允许粒子不受阻碍地通过。在一些变型中,第一屏蔽容器504可具有大约十七英寸的直径。可以选择第一屏蔽容器504的直径以充分容纳剂量测定系统502的至少一部分组件。
屏蔽结构500可以包括多个壳。例如,图5B中的504、512和514等。多个壳504、512、514可以嵌套在一起。多个壳中的至少一个包括环形盘516、518等。
屏蔽结构500可以相对于分裂磁体MRI系统402定位在固定位置,或者可以被配置为与机架(例如图3中所示的机架312)一起旋转。可以相对地设置一个或多个结构或在分裂磁体MRI系统402的周围设置一个或多个结构,并且将其配置为模仿屏蔽结构500的磁特性,以最小化对MRI磁场的均匀性的干扰。
图6是利用MRI数据的、用于粒子放射疗法的放射疗法治疗的方法600的流程图,该方法可以由软件来实现,该方法具有与本说明书一致的一个或多个特征。可以使用一个或多个数据处理器来实现该软件。该软件可以包括机器可读指令,该机器可读指令在由一个或多个数据处理器执行时可以使一个或多个数据处理器执行一个或多个操作。如本文所讨论的,方法600是可以由控制器424执行的操作的示例。
在602处,可以接收用于利用粒子束对患者进行放射疗法治疗的放射疗法束信息。放射疗法束信息可以包括粒子束的一个或多个特性。该一个或多个特性可以包括粒子束的穿透能力的指示、粒子束的扩展特性、粒子束的数量等。
在604处,可以在放射疗法治疗期间接收患者磁共振成像(MRI)数据。
在606处,如本文所讨论的,可以考虑到粒子束通过的患者体内的软组织的相互作用特性,将患者MRI数据用于对粒子束的剂量沉积位置执行实时计算。如上所述,在执行对剂量沉积位置的实时计算时,还可以考虑由MRI系统产生的磁场对粒子束的影响。并且,还可以结合实时剂量计算来执行通过利用患者磁共振成像数据确定由粒子束递送至软组织的剂量的生物学有效性。
在608处,如果对剂量沉积位置的实时计算指示沉积发生在靶标外,则可以中断粒子束。
在一些变型中,如果对剂量沉积位置的实时计算指示沉积发生在靶标外,则可以调整粒子束的能量。在其他变型中,可以利用患者MRI数据以及对剂量沉积位置的实时计算来修改粒子束的方向,以便跟踪靶标。
如本文中进一步详述,关于图6的放射疗法的示例性方法描述的概念也可以用于将粒子疗法与光子疗法结合的系统、方法和计算机软件中。
在本公开的某些实施方式中,粒子疗法递送系统可以与光子疗法递送系统结合,并且系统控制器可以被配置为促进粒子束和光子束两者的递送。例如,粒子疗法(例如质子疗法)可以与来自被配置成递送X射线束的线性加速器的疗法相结合地递送。组合的系统可以被配置为使得粒子疗法和光子疗法在治疗时段期间被择一地递送,但是不需要在治疗类型之间移动患者。患者优选相对于由粒子疗法系统和光子疗法系统两者共享的等中心位于卧榻上(尽管在本公开的精神内可以设想到小的患者运动)。
在组合的粒子/光子疗法系统中,粒子疗法系统可以被配置为具有单个固定束线、多个固定束线或机架系统,并且光子疗法系统可以被配置为从多个角度递送光子束(例如,通过旋转机架、机器人臂等)。
本公开的优选实施例消除了对粒子疗法机架系统的需要,取而代之的是从一个或较少量的固定束线递送粒子疗法,并且用可以从更多数量的教导被递送的光子束疗法来补充这样的疗法。这样的组合疗法系统可以产生更高质量的治疗计划,例如,该治疗计划可以改善治疗靶标周围的健康组织的免受损伤。
图7示出了示例性的放射疗法系统,其结合了光子疗法递送系统702和粒子疗法递送系统704(在图中仅示出了其一部分)的各个方面。图7示例中的光子疗法系统702是被配置为产生x射线束的线性加速器,但是,本公开内容设想了包括放射性同位素等的替代性光子疗法系统。也可以使用电子束系统。
图7描绘了光子疗法递送系统702的一种特定实施方式,其中,线性加速器的一些部分设置在机架706周围。这样的部分可以分离到机架706上的不同位置,并且可以利用RF波导708彼此连接。本公开还预期光子疗法系统的一个或多个部分可以被包含在屏蔽结构710内,该屏蔽结构可以采取与以上关于图5讨论的屏蔽结构类似的形式。
机架706还可以包括附加的空屏蔽结构712,该空屏蔽结构712被配置为屏蔽粒子疗法系统704的剂量测定系统416的至少一部分。这样的空屏蔽结构712可以类似地采用上面参考图5进行了讨论的任何屏蔽结构的形式。尽管图7中所示的实施例示出了安装在机架上的空屏蔽结构712,但是还可以想到,粒子疗法剂量测定系统的屏蔽结构可以独立于机架安装,例如,直接安装到地板上,邻近光子疗法系统702及其机架706。
在操作中,光子疗法递送系统702被配置为从各种角度向患者递送光子束714,并且可以利用组合的放射系统以图8和图9中部分描绘的示例性方式递送粒子疗法。在这种示例性的操作方式中,可以旋转机架706,以使空屏蔽结构712与粒子疗法束线716对准,如图8所示。之后,可以利用束线延伸器(beam line extender)718来将粒子疗法系统的剂量测定系统416延伸到至少部分位于空屏蔽结构712内的位置,如图9所示。伸缩式真空室是束线延伸器的一个示例,但是可以考虑采用改变粒子疗法系统的剂量测定元件的位置的其他方法。
如上所述,本公开还设想了其中粒子剂量测定系统的屏蔽结构位于机架之外的实施例。在这样的实施例中,可以不需要束线延伸器。另外,在机架706上可以不需要空屏蔽结构,取而代之的是,机架706可以简单地旋转到将确保光子疗法系统设备对粒子疗法束的干扰最小的位置。
在本公开的一些实施方式中,某些粒子疗法递送系统组件可以有利地位于远离光子疗法递送系统的位置。在一个示例中,粒子疗法系统的偏转/弯曲磁体可以远离光子疗法系统放置,或者甚至位于患者疗法库(vault)之外。边缘屏蔽(fringe shielding)可用于将此类组件720与光子疗法递送系统702隔离,并且可包括例如RF屏蔽722和/或磁屏蔽724。此类边缘屏蔽还可用于将此类组件720与可以与组合的光子/粒子疗法系统一起使用的磁共振成像系统隔离。
本公开的组合的光子和粒子疗法系统可以与磁共振成像系统一起使用,如上面关于粒子疗法先前所述。例如,图4中描绘的磁共振成像系统402可以与组合的粒子/光子系统结合使用,其示例在图7中示出。在这样的示例中,光子疗法系统702及其机架706可以设置在图4的磁共振成像系统402的间隙419内。
如以上关于粒子疗法所讨论的,将磁共振成像与组合的粒子/光子疗法系统的集成类似地导致实现许多益处。本公开内容设想了通过组合的粒子/光子系统实现以上讨论的每个适用的益处,包括但不限于该系统在治疗期间接收患者磁共振成像(MRI)数据并利用这种数据来执行粒子束和光子束的剂量沉积位置的实时计算的能力。此外,如果对剂量沉积位置的实时计算指示剂量沉积发生在靶标之外,则系统控制器可以被配置为中断粒子束和/或光子束。而且,该系统可以被配置为在放射疗法治疗期间计算对患者的累积剂量沉积,并且基于计算的剂量沉积来重新优化治疗。
本公开设想本文的实施例中公开的计算可以以应用本文教导的同一概念的众多方式来执行,并且这些计算等价于公开的实施例。
本文描述的主题的一个或多个方面或特征可以实现在数字电子电路、集成电路、特别设计的专用集成电路(ASIC)、现场可编程门阵列(FPGA)计算机硬件、固件、软件和/或其组合中。这些各种方面或特征可以包括实现在一个或多个计算机程序中,计算机程序可以在可编程系统上执行和/或解释,可编程系统包括至少一个可编程处理器,其可以是专用或通用目的,可编程处理器耦接为从存储系统、至少一个输入设备以及至少一个输出设备接收数据和指令和向它们发送数据和指令。可编程系统或计算系统可以包括客户端和服务器。一般来说,客户端和服务器彼此远离,并且通常通过通信网络交互。通过运行在各个计算机并且彼此具有客户端-服务器关系的计算机程序而形成的客户端和服务器的关系。
这些计算机程序(也可以称为程序、软件、软件应用、应用、部件或者代码)可以包括用于可编程处理器的机器指令,并且可以以高级程序化语言、面向对象编程语言、函数式程序语言、逻辑编程语言和/或以汇编/机器语言来实现。如本文所使用的,术语“机器可读介质”(或“计算机可读介质”)指任何计算机程序制品、装置和/或设备,例如磁盘、光盘、存储器和可编程逻辑器件(PLD),其用于为可编程处理器提供机器指令和/或数据,包括将机器指令作为机器可读信号接收的机器可读介质。术语“机器可读信号”(或“计算机可读信号”)指用于为可编程处理器提供机器指令和/或数据的任何信号。机器可读介质可以非临时地存储这些机器指令,例如非临时性固态存储器或磁盘硬驱动器或者任何等价存储介质那样。机器可读介质可以替代地或额外地以临时的方式存储这些机器指令,例如处理器缓存或与一个或多个物理处理器核心相关的其他随机存取存储器。
为了提供与用户的交互,本文描述的主题的一个或多个方面或特征可以实现在具有显示设备和键盘和指针设备的计算机上,显示设备例如用于为用户显示信息的阴极射线管(CRT)或液晶显示(LCD)或发光二极管(LED)监视器上,键盘和指针设备例如鼠标或轨迹球,用户可以通过其为计算机提供输入。其他类型的设备也可以用于提供与用户的交互。例如,提供给用户的反馈可以是任何形式的感知反馈,例如视觉反馈、音频反馈或触觉反馈;并且来自用户的输入可以以任何形式被接收,包括但不限于声音、说话或触觉输入。其他可能的输入设备包括但不限于:触摸屏或者其他触觉灵敏的设备,例如单点或多点电阻式或电容式触控板、声音识别硬件和软件、光学扫描仪、光学指向器、数字图像捕获设备以及相关的解释软件及类似设备。
在上述说明书以及权利要求中,诸如“至少一个”或“一个或多个”的词组后面可以跟随元件或特征的连接词列表。术语“和/或”也可以出现在两个或多个元件或特征的列表中。队非与其使用的上下文暗示地或明确地矛盾,这种词组用于指独立列出的元件或特征中的任意一个,或者引述的元件或特征中的任意一个以及其他引述的元件或特征中的任何一个。例如,词组“A和B中的至少一个”,“A和B中的一个或多个”以及“A和/或B”均指“单指A、单指B或A和B一起”。类似地解释也适用于包括三个或多个项的列表。例如,词组“A、B和C中的至少一个”,“A、B和C中的一个或多个”以及“A、B和/或C”均指“单指A、单指B、单指C、A和B一起、A和C一起、B和C一起或者A和B和C一起”。上文和权利要求中的术语“基于”的使用旨在指“至少部分基于”,从而未引述的特征或元件也是可允许的。
根据期望的配置,本文描述的主题可以实施在系统、装置、方法、计算机程序和/或物品中。附图中描绘的和/或本文描述的任何方法或逻辑流程不一定需要所示出的特定顺序或者连续顺序来实现期望的结果。前述说明书中列出的实施不代表与本文描述的主题一致的所有实施。相反,它们仅仅是与描述的主题相关的方面一致的一些实例。尽管上文详细描述了一些变化,但其他改进或添加是可能的。具体地,除了本文列出的特征和变化,可以提供其他特征和/或变化。上文描述的实施方式可以涉及公开的特征的各种组合和子组合和/或上文提及的其他特征的组合和子组合。此外,上述优势不用于将任何公开的权利要求的应用限制于完成任意或全部优势的处理或结构。
此外,分段标题不应该限制或表征可能由本公开发布的任何权利要求中所列出的发明。此外,“背景技术”中的技术的描述不应该解释为承认技术是本公开中任何发明的现有技术。“发明内容”也不应该被认为是公开的权利要求中列出的发明的表征。此外,对本公开的大体上的任何引用或者词语“发明”的单数使用不用于暗示下文列出的权利要求的范围的任何限制。多项发明可以根据从本公开发布的多个权利要求的限制来列出,并且这些权利要求相应地限定发明及其等价物(它们也由此被保护)。
Claims (11)
1.一种放射疗法系统,包括:
光子疗法递送系统,用于通过光子束将放射疗法递送给患者,所述光子疗法递送系统至少部分地安装在机架上,并且所述光子疗法递送系统的至少一部分包含在屏蔽结构内,所述光子疗法递送系统被配置为通过来自多个方向的光子束将放射疗法递送给患者;
控制器,被配置为促进通过光子束以及还通过粒子束的放射疗法的递送;和
安装在所述机架上并被配置为屏蔽粒子疗法剂量测定系统的至少一部分的第二屏蔽结构。
2.根据权利要求1所述的放射疗法系统,其中,通过光子束的放射疗法的递送和通过粒子束的放射疗法的递送都能够在不必移动患者的情况下完成。
3.根据权利要求1所述的放射疗法系统,其中,所述光子疗法递送系统是线性加速器,并且所述光子束是X射线束。
4.根据权利要求1所述的放射疗法系统,还包括束线延伸器,所述束线延伸器被配置为:便于从至少部分地在被配置为屏蔽粒子疗法剂量测定系统的至少一部分的所述第二屏蔽结构内的位置处,重新定位所述粒子疗法剂量测定系统,以递送疗法。
5.根据权利要求4所述的放射疗法系统,还包括粒子疗法递送系统。
6.根据权利要求5所述的放射疗法系统,其中,所述粒子疗法递送系统是质子疗法系统,并且所述粒子束是质子束。
7.根据权利要求5所述的放射疗法系统,还包括边缘场屏蔽。
8.根据权利要求1所述的放射疗法系统,还包括:
磁共振成像系统,被配置为在放射疗法的施用期间获取患者的图像。
9.根据权利要求1所述的放射疗法系统,其中,所述第二屏蔽结构包括多个壳。
10.根据权利要求9所述的放射疗法系统,还包括跨过所述多个壳中的至少一个壳的一端设置的环形盘,所述环形盘包括孔,所述孔被配置为允许所述粒子束的粒子通过。
11.根据权利要求4所述的放射疗法系统,其中,所述束线延伸器是伸缩式真空室。
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CN116036499A (zh) | 2023-05-02 |
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JP7127126B2 (ja) | 2022-08-29 |
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