CN111991710B - Radiotherapy position and dose real-time monitoring and positioning device and tumor radiotherapy system - Google Patents
Radiotherapy position and dose real-time monitoring and positioning device and tumor radiotherapy system Download PDFInfo
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- A—HUMAN NECESSITIES
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- A61N5/00—Radiation therapy
- A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
- A61N5/1048—Monitoring, verifying, controlling systems and methods
- A61N5/1049—Monitoring, verifying, controlling systems and methods for verifying the position of the patient with respect to the radiation beam
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
- A61N5/1048—Monitoring, verifying, controlling systems and methods
- A61N5/1071—Monitoring, verifying, controlling systems and methods for verifying the dose delivered by the treatment plan
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
- A61N5/1048—Monitoring, verifying, controlling systems and methods
- A61N5/1071—Monitoring, verifying, controlling systems and methods for verifying the dose delivered by the treatment plan
- A61N2005/1072—Monitoring, verifying, controlling systems and methods for verifying the dose delivered by the treatment plan taking into account movement of the target
Abstract
The invention provides a radiotherapy position and dose real-time monitoring and positioning device and a tumor radiotherapy system based on CLI and structured light technology, aiming at solving the technical problems that the position of a Cerenkov radiation signal acquired by the existing tumor radiotherapy real-time monitoring and synchronous acquisition device may have inconsistency with the position of a target radiation area, and specific deviation positions and reasons cannot be positioned when clinical deviation occurs. According to the invention, three-dimensional body surface dose distribution of a patient is obtained in real time through three CLI cameras, three-dimensional body surface contour distribution of the patient is obtained in real time through three groups of position synchronous monitoring modules, registration fusion of the three-dimensional body surface dose and the body surface contour is realized through space coordinate transformation, and the accuracy of the radiotherapy dose and the treatment position of the patient is monitored in real time. Once the position dosage exceeds the clinical deviation, the accurate position of the dosage with the deviation can be positioned, and the reason of the deviation can be judged, so that a basis is provided for adjusting the body position of a patient or the dosage of an accelerator.
Description
Technical Field
The invention relates to a radiotherapy position and dose real-time monitoring and positioning device based on a Cerenkov light-emitting imaging technology and a structured light technology and a tumor radiotherapy system.
Background
Cerenkov Radiation (CR) means that when high-speed charged particles travel in a non-vacuum medium, when the velocity of the particles is greater than the velocity of light passing through the medium, local polarization is generated in the direction of a motion path, and visible light and near-infrared photons are released in the process of returning to an equilibrium state, and similarly, when radioactive particles enter a biological tissue, the Cerenkov Radiation (CR) phenomenon also occurs.
Robertson et al first applied Cerenkov radiation to the field of biomedical Imaging and proposed the Cerenkov Luminescence Imaging (CLI) concept. The Cerenkov Luminescence Imaging (CLI) technology is widely applied to body surface position imaging in the tumor radiotherapy process and is used as quality assurance of the treatment process, and CLI images comprise the information of body surface blood vessels of patients. The technology has the advantages of high imaging speed, no radiation, simple operation and the like, and has wide application prospect in tumor radiotherapy.
The existing Cerenkov luminescence imaging device is applied to the research of tumor radiotherapy. The equipment comprises a support frame and a CLI data acquisition device arranged on the support frame. The CLI data acquisition device comprises a detector and a digital reading assembly which are arranged on a support frame. The detector collects CLI signals, the CLI signals are read out through a digital reading assembly to generate a two-dimensional image, and the two-dimensional image is converted into two-dimensional human body surface dose distribution through a GAMOS software module in a computer, so that accurate monitoring of radiotherapy positioning and dose quantification is realized.
The existing Cerenkov luminescence imaging device combines an image intensifier and a CMOS camera aiming at the characteristics of weak light and pulse type radiation of radiotherapy Cerenkov radiation, develops a Cerenkov radiation detector which is synchronous with radiotherapy rays, has high gain and high frame rate, but exposes some outstanding problems in the application process:
firstly, in the tumor radiotherapy process, the treatment angle is multiple and continuously changed, but because the existing cerenkov luminescence imaging device is positioned at one side of the accelerator, in the process of using the advanced tumor radiotherapy technology (such as intensity modulated radiotherapy and volume rotation intensity modulated radiotherapy), the position of the frame head easily shields cerenkov photons, so that the cerenkov photons cannot reach the region to be detected, and the detector cannot image when part of angles are irradiated in the radiotherapy process.
Secondly, because the accelerator treatment head rotates all the time, the direction of the accelerator radiation changes all the time, while the position of the detector in the existing Cerenkov luminescence imaging device does not change all the time, the Cerenkov radiation of the radiotherapy target area is detected all the time at a fixed angle, and because the angle of signal acquisition is inconsistent with the ray incidence angle, the position of the acquired Cerenkov radiation signal is inconsistent with the position of the radiotherapy target area, thereby bringing difficulty to the quantification of the radiation dose.
In order to overcome the above drawbacks, chinese patent application No. 201910612838.9 discloses a CLI-based tumor radiotherapy real-time monitoring and synchronous acquisition device and a monitoring apparatus, wherein the CLI data acquisition device images a radiotherapy target region from different angles through three sets of ICCD detectors located above a treatment couch, and the three sets of ICCD detectors rotate synchronously with an accelerator treatment handpiece, so that the CLI imaging is not affected by the accelerator handpiece. However, this solution still has the following drawbacks:
1. the position of the treatment couch is easy to shield Cerenkov photons, so that the Cerenkov photons cannot reach a region to be detected, and the detector cannot image when partial angles are irradiated in the radiotherapy process.
2. The detector detects Cerenkov radiation of a radiotherapy target area by rotating an angle synchronous with the accelerator treatment head. The accelerator sends a handpiece motion angle signal to the control unit, the control unit drives the CLI data acquisition device to synchronously rotate and collect Cerenkov signals, and the handpiece angle of the accelerator continuously changes at high speed in volume rotation intensity-modulated radiotherapy and the signals are acquired after synchronization, so that signal acquisition is delayed, and the acquired Cerenkov radiation signal position possibly has inconsistency with a radiation target area position.
3. The angle synchronization needs high-precision hardware and software matching, and the manufacturing cost is high.
4. Because the Cerenkov radiation signal boundary is fuzzy, the accurate boundary of the radiotherapy treatment position cannot be monitored, the accurate space quantitative analysis cannot be carried out on the body surface of the patient, once the radiotherapy dose exceeds the clinical deviation, the position of the clinical deviation on the body surface of the patient cannot be known, and the reason of the clinical deviation cannot be judged to be the deviation of the patient body position or the ray dose.
Chinese patent document No. 201920752658.6 discloses a device for synchronously acquiring tumor radiotherapy real-time dose and position monitoring, which obtains patient two-dimensional body surface dose distribution in real time through a CLI acquisition system (1 ICCD detector), and obtains patient two-dimensional body surface profile distribution in real time through a profile acquisition system (1 infrared camera and 1 infrared projector) by adopting a structured light technology, thereby realizing all-around real-time monitoring of dose and position of a radiotherapy target area in the radiotherapy process. The ICCD detector, the infrared camera and the infrared projector synchronously and real-timely image the dose and the position of a radiotherapy target area from different angles, and synchronously rotate with the accelerator treatment machine head without being influenced by the accelerator machine head. However, this solution still has the following drawbacks:
1. the position of the treatment couch is easy to shield Cerenkov photons, so that the Cerenkov photons cannot reach a region to be detected, and the detector cannot image when partial angles are irradiated in the radiotherapy process.
2. The detector rotates at a synchronous angle with the accelerator treatment head to detect Cerenkov radiation of a radiotherapy target area. The aircraft nose motion angle signal that the accelerator sent gives the control unit, and the control unit drive CLI data acquisition device synchronous revolution collects Cerenkov signal, because the continuous high-speed change of accelerator aircraft nose angle in volume rotation intensity modulated radiation therapy, and gather the signal after synchronous earlier, therefore signal acquisition has the time delay, leads to the Cerenkov radiation signal position of gathering probably to have the nonconformity with the radiation target area position.
3. The angle synchronization needs high-precision hardware and software matching, and the manufacturing cost is high.
4. The formed dose and position images are two-dimensional images and cannot reflect three-dimensional dose and position information of the body surface of the patient.
5. The dose and position images are not correlated, and once the radiotherapy dose exceeds the clinical deviation, the position of the clinical deviation on the body surface of the patient cannot be known, and the reason of the clinical deviation cannot be judged to be the body position movement of the patient or the deviation of the radiation dose.
Disclosure of Invention
The invention provides a radiotherapy position and dose real-time monitoring and positioning device and a tumor radiotherapy system based on CLI and structured light technology, and aims to solve the technical problems that the position of a Cerenkov radiation signal acquired by the conventional tumor radiotherapy real-time monitoring and synchronous acquisition device may be inconsistent with the position of a target radiation area, and specific deviation positions and reasons cannot be positioned when clinical deviation occurs.
The technical scheme of the invention is as follows:
radiotherapy position and dose real-time supervision and positioner, its characterized in that: the device comprises a position synchronous acquisition module, a dose synchronous acquisition module, a communication and triggering module, an image reconstruction module and a position dose deviation acquisition module, wherein the position synchronous acquisition module, the dose synchronous acquisition module and the communication and triggering module are packaged in a high-energy ray shielding shell;
the high-energy ray shielding shell is of an annular columnar structure made of lead alloy or black alloy with high absorption characteristics, and is matched with the shape of an accelerator head or a KV generator so as to be conveniently nested and installed;
the position synchronous acquisition module comprises three groups, wherein each group consists of an infrared projector and an infrared camera; the infrared projector emits infrared light in different wave bands with Cerenkov light, and projects a stripe image with structural information to the body surface of a patient; the infrared camera captures a structured light signal reflected by the body surface of the patient and transmits the structured light signal to the image reconstruction module;
the dose synchronous acquisition module comprises three CLI cameras, and the three CLI cameras and the three groups of position synchronous acquisition modules are alternately and uniformly arranged on the same circumference and are positioned in the high-energy ray shielding shell; the CLI camera collects two-dimensional Cerenkov signals in three directions in real time and transmits the two-dimensional Cerenkov signals to the image reconstruction module;
the communication and trigger module is used for receiving a trigger signal sent by the accelerator and controlling the position synchronous acquisition module and the dose synchronous acquisition module to start working after receiving the trigger signal;
the image reconstruction module realizes the reconstruction of a three-dimensional body surface structure by utilizing the structured light information of the modulated stripe image on the body surface of the patient and the corresponding relation between the phase information and the space position to obtain an actually measured three-dimensional body surface contour image; the image reconstruction module can also obtain actually-measured three-dimensional body surface dose distribution through three-dimensional reconstruction based on two-dimensional Cerenkov signals acquired by the CLI camera;
the position dose deviation acquisition module monitors the body surface position and dose of a patient in treatment in real time by taking a TPS body surface contour image and TPS three-dimensional body surface dose distribution calculated by an existing radiotherapy planning system (TPS) as a reference, and further judges the position and dose deviation, and the specific method comprises the following steps:
step 3, matching the actually measured three-dimensional body surface dose distribution with the TPS three-dimensional body surface dose distribution;
and 4, acquiring the dose deviation.
Further, step 1 specifically comprises:
taking the TPS body surface contour image as a reference, aligning the actually measured three-dimensional body surface contour image with the TPS body surface contour image through translation, matching the three-dimensional body surface contour image and the TPS body surface contour image by adopting contour feature points in real time in the translation process, finding out pixel points with biological features in the TPS body surface contour image and the actually measured three-dimensional body surface contour image, and extracting local features comprising at least one of tumor body surface shape features, body surface texture features, Gaussian Laplace filtering features and wavelet features from the TPS body surface contour image and the actually measured three-dimensional body surface contour image according to the pixel points with the biological features, wherein the local features are of the same type;
comparing the difference values of the local features extracted from the TPS body surface contour image and the actually measured three-dimensional body surface contour image, and determining the minimum difference value of the local features by adopting an iterative closest point method, so as to respectively obtain the minimum difference values corresponding to each type of local features;
then adding weight to each local feature, calculating a weighted minimum difference value in a weighted average mode, and when the weighted minimum difference value is smaller than 0.5mm, indicating that the actually measured three-dimensional body surface contour and the TPS contour are registered at the moment, wherein the translation amount of the actually measured three-dimensional body surface contour image is the position deviation between the current radiotherapy position and the preset position in the TPS body surface contour image;
comparing the position deviation with a clinical allowable deviation value, if the current position deviation is less than or equal to the clinical allowable deviation value, indicating that the current radiotherapy position is accurate, and entering the step 2; if the deviation of the current position is larger than the clinically allowable deviation value, the current radiotherapy position is inaccurate, the treatment should be stopped, and the technician repositions the current patient again until the position deviation obtained in the step 1 is smaller than the clinically allowable deviation value.
Further, step 2 specifically comprises:
the time and position synchronization characteristics of the determined geometric relationship and the height of the actually measured three-dimensional body surface profile image and the actually measured three-dimensional body surface dose distribution are utilized, the actually measured three-dimensional body surface profile image is used as a matching reference, and the coordinates of each position in the actually measured three-dimensional body surface dose distribution are aligned with the coordinates of each position in the actually measured three-dimensional body surface profile image through image coordinate translation conversion.
Further, step 4 specifically includes:
extracting the actual radiotherapy dose value of each pixel at the current radiotherapy irradiation area from the actually measured three-dimensional body surface dose distribution, extracting the preset radiotherapy dose value of the pixel at the corresponding position from the TPS three-dimensional body surface dose distribution, comparing the actual radiotherapy dose value with the preset radiotherapy dose value, and if the deviation of the actual radiotherapy dose value and the preset radiotherapy dose value is less than 3%, determining that the current actual radiotherapy dose is accurate; and if not, the current actual radiotherapy dose deviation is overlarge, the current treatment is stopped, the radiotherapy plan is re-made in the TPS, a new three-dimensional body surface dose distribution is obtained, and the steps 1-4 are repeated until the pixel average deviation of the actual radiotherapy dose value and the preset radiotherapy dose value is less than 3%, so that the treatment can be continued.
Furthermore, the radiotherapy treatment device also comprises a radiotherapy effect judging module which runs on a computer outside the high-energy ray shielding shell; the radiotherapy effect judging module is used for realizing the following steps:
step 2: during each radiotherapy period, extracting the surface tumor vessel diameter of the radiotherapy part from the three-dimensional surface vessel image by using a boundary detection extraction technology;
and step 3: comparing the blood vessel diameter of the radiotherapy part body surface tumor obtained in the current radiotherapy process with the blood vessel diameter of the radiotherapy part body surface tumor obtained in the first radiotherapy process, wherein if the blood vessel diameter is reduced compared with the blood vessel diameter of the radiotherapy part body surface tumor obtained in the first radiotherapy process, the early-stage radiotherapy dosage is sufficient, and the treatment is effective; if the radiotherapy is unchanged compared with the first radiotherapy, the early-stage radiotherapy dosage is insufficient, and the effect is poor.
Further, the method for reconstructing the three-dimensional body surface contour of the patient by the image reconstruction module comprises the following steps:
the image reconstruction module analyzes the frequency spectrum of the structured light signal to extract the phase principal value of the structured light signal, then adjusts the discontinuous phase principal value into continuous phase information by using a phase unwrapping algorithm to realize phase recovery, corresponds the recovered phase with the body surface space position of the patient, realizes accurate three-dimensional body surface contour reconstruction and obtains an actually measured three-dimensional body surface contour image.
Further, the method for acquiring three-dimensional body surface dose distribution by the image reconstruction module through three-dimensional reconstruction is as follows: the method comprises the steps of reconstructing two-dimensional Cerenkov signals synchronously acquired by three CLI cameras into a high-resolution and high-precision three-dimensional CLI image based on a genetic algorithm and a sparse constraint CLI three-dimensional reconstruction algorithm, so that actually measured three-dimensional body surface dose distribution is obtained.
The invention also provides a tumor radiotherapy system, which comprises a KV generator and an accelerator head; the method is characterized in that: the radiotherapy device also comprises the radiotherapy position and dose real-time monitoring and positioning device; the radiotherapy position and dose real-time monitoring and positioning device is arranged outside the KV generator and/or the accelerator head.
The invention has the advantages that:
1. the invention is oriented to the clinical problem of precise radiotherapy, and based on the physical phenomenon of radiotherapy Cerenkov light, high-sensitivity real-time monitoring equipment is developed, so that precise monitoring and deviation positioning of radiotherapy dosage and position without dead angles are realized, and the research idea is novel and clear.
2. Currently, no effective means is available for measuring the size of blood vessels of body surface tumors; the three-dimensional body surface dose distribution of the patient is obtained by the three CLI cameras in real time, the three-dimensional body surface blood vessel distribution and the diameter of the body surface tumor blood vessel can be obtained by utilizing the boundary extraction technology, and the diameter of the body surface tumor blood vessel is closely related to the body surface tumor blood supply which is closely related to the radiotherapy curative effect, so that the three-dimensional body surface dose distribution and the diameter of the body surface tumor blood vessel can provide reference basis for clinical diagnosis.
3. According to the invention, three CLI cameras are used for obtaining the three-dimensional body surface dose distribution of a patient in real time, the structured light technology is adopted, three groups of position synchronous monitoring modules are used for obtaining the three-dimensional body surface profile distribution of the patient in real time, and finally the three-dimensional body surface dose distribution and the three-dimensional body surface profile distribution are fused and registered, so that the comprehensive real-time monitoring of the dose and the position of a radiotherapy target area in the radiotherapy process is realized.
4. The invention realizes the registration and fusion of the three-dimensional body surface dose and the three-dimensional body surface contour by utilizing the time consistency and the space synchronization and through the space coordinate transformation, and can realize the accuracy of monitoring the radiotherapy dose and the treatment position of the patient in real time. Once the position dose exceeds the clinical deviation, the accurate position of the deviation of the dose can be positioned by fusing the body surface outline in the image, and whether the body surface moves or the body surface dose deviation is caused by the accelerator ray dose deviation can be judged, so that the basis is provided for adjusting the body position of a patient or the accelerator dose, and the aim of precise radiotherapy is fulfilled.
5. The radiotherapy position and dose real-time monitoring and positioning device is nested outside an accelerator head or a KV generator in a tumor radiotherapy treatment system, at the moment, the angle of a camera is consistent with that of rays emitted by an accelerator or forms a fixed 90-degree angle, angle synchronization and matched software and hardware are not needed, signal acquisition delay caused by angle synchronization does not exist, the consistency of the acquired Cerenkov radiation signal position and the position of a radiation target area is ensured, and the imaging efficiency is high.
6. When the accelerator head reaches the lower part of the treatment bed, if the radiotherapy position and dose real-time monitoring and positioning device is nested at the outer side of the accelerator head in the tumor radiotherapy treatment system, the radiotherapy position and dose real-time monitoring and positioning device can be blocked by the treatment bed, and the dose of the body surface position of a patient can not be monitored. At the moment, the radiotherapy position and dose real-time monitoring and positioning device can be nested outside the KV generator in the tumor radiotherapy treatment system and forms a 90-degree angle with the rays emitted by the accelerator, so that the influence of the treatment couch can be avoided.
Drawings
FIG. 1 is a schematic structural diagram of a radiotherapy dose and position real-time monitoring and deviation positioning device of the present invention.
FIG. 2 is a schematic diagram of the working timing sequence of the CLI acquisition unit of the present invention.
FIG. 3 is a first schematic view of the device of the present invention nested in the accelerator head.
Fig. 4 is a schematic diagram of a second use body of the device of the present invention nested in a KV generator.
Fig. 5 is a schematic view of the device of the present invention.
Description of reference numerals:
1-a dose synchronous acquisition module; 2-a position synchronous acquisition module; 3-high energy ray shielding shell; 4-radiotherapy position and dose real-time monitoring and positioning device; a 5-KV generator; a 6-KV receiver; 7-accelerator head.
Detailed Description
The invention is further described below with reference to the accompanying drawings.
As shown in fig. 1 and 5, the radiotherapy position and dose real-time monitoring and positioning device provided by the present invention includes a position synchronous acquisition module, a dose synchronous acquisition module, a communication and triggering module encapsulated in a high-energy ray shielding housing, and an image reconstruction module, a position dose deviation acquisition module and a radiotherapy effect determination module (the image reconstruction module, the position dose deviation acquisition module and the radiotherapy effect determination module are program instructions running on a computer) running on a computer outside the high-energy ray shielding housing.
The high-energy ray shielding shell is made of lead alloy or black alloy with high absorption characteristics, and the influence of rays emitted by an accelerator in the tumor radiotherapy system on the dose synchronous acquisition module is prevented. The high-energy ray shielding shell is of an annular columnar structure so as to be embedded on an accelerator handpiece or a KV generator in the tumor radiotherapy system and not to block the accelerator handpiece and the KV generator from emitting X rays.
The position synchronous acquisition module has three groups, and each group comprises an infrared projector and an infrared camera. In the process of irradiating a patient by an accelerator, an infrared projector emits infrared light which is in different wave bands with Cerenkov light, projects a stripe image with structural information to the body surface of the patient, adopts an infrared camera to capture a structural light signal reflected by the body surface of the patient, and transmits the structural light signal to an image reconstruction module.
The dose synchronous acquisition module comprises three CLI cameras, and the three CLI cameras and the three groups of position synchronous acquisition modules are alternately and uniformly arranged on the same circumference and are positioned in the high-energy ray shielding shell. When a patient is subjected to radiotherapy, the body surface interacts with radiotherapy rays to generate Cerenkov signals, the CLI camera collects the two-dimensional Cerenkov signals in three directions in real time, and transmits the two-dimensional Cerenkov signals to the image reconstruction module. Fig. 2 is a timing diagram of the operation of a single CLI camera, after the radiotherapy beam switch is turned on, the trigger signal is sent out while the tumor of the patient is irradiated by the accelerator emergent ray. When the exit ray of the accelerator irradiates the tumor to generate Cherenkov light, the CLI camera opens an image intensifier gate control switch in the CLI camera, and the CLI camera acquires a signal image.
The communication and trigger module is used for receiving a trigger signal sent by the accelerator and controlling the position synchronous acquisition module and the dose synchronous acquisition module to start working after receiving the trigger signal.
The image reconstruction module utilizes structured light information obtained by modulating the stripe image by the body surface of the patient, and realizes the reconstruction of a three-dimensional body surface structure through the corresponding relation between phase information and a space position, so as to obtain an actually measured three-dimensional body surface contour image. Due to the fact that optical imaging and reconstruction are fast in time, the accuracy of the body surface position of the patient can be monitored in real time.
The image reconstruction module can also obtain actually-measured three-dimensional body surface dose distribution (namely the radiotherapy dose corresponding to different positions of the body surface) through three-dimensional reconstruction based on the two-dimensional Cerenkov signals acquired by the CLI camera, and is used for monitoring the accuracy of the radiotherapy dose in real time.
The method for reconstructing the three-dimensional body surface contour of the patient by the image reconstruction module comprises the following steps:
the image reconstruction module analyzes the frequency spectrum of the structured light signal to extract the phase principal value of the structured light signal, then adjusts the discontinuous phase principal value into continuous phase information by using a phase unwrapping algorithm to realize phase recovery, corresponds the recovered phase with the body surface space position of the patient, realizes accurate three-dimensional body surface contour reconstruction and obtains an actually measured three-dimensional body surface contour image.
The method for acquiring the three-dimensional body surface dose distribution by the image reconstruction module through three-dimensional reconstruction comprises the following steps:
the method comprises the steps of reconstructing two-dimensional Cerenkov signals synchronously acquired by three CLI cameras into a high-resolution and high-precision three-dimensional CLI image based on a genetic algorithm and a sparse constraint CLI three-dimensional reconstruction algorithm, so that actually measured three-dimensional body surface dose distribution is obtained.
After the actual measurement three-dimensional body surface contour image and the actual measurement three-dimensional body surface dose distribution are obtained through the method, the position dose deviation obtaining module monitors the body surface position and the dose of a patient in treatment in real time by taking the TPS body surface contour image and the TPS three-dimensional body surface dose distribution calculated by an existing radiotherapy planning system (TPS) as reference, and further judges the position and dose deviation, and the specific method is as follows:
taking a TPS body surface outline image as a reference, aligning an actually measured three-dimensional body surface outline image with the TPS body surface outline image by translation, matching the outline feature points in real time in the translation process to find out pixel points with biological features in the TPS body surface outline image and the actually measured three-dimensional body surface outline image, respectively extracting local features comprising at least one of tumor body surface shape features, body surface texture features, Gaussian Laplace filter features and wavelet features from the TPS body surface outline image and the actually measured three-dimensional body surface outline image according to the pixel points with the biological features, comparing the difference values of the local features extracted from the TPS body surface outline image and the actually measured three-dimensional body surface outline image for the same type of local features, and determining the minimum difference value of the local features by adopting an Iterative Closest Point method (ICP), respectively obtaining minimum difference values corresponding to various types of local features, then adding weight to each local feature, calculating the weighted minimum difference value in a weighted average mode, when the weighted minimum difference value is smaller than 0.5mm, indicating that the actually measured three-dimensional body surface contour and the TPS contour are registered at the moment, and the translation amount of the actually measured three-dimensional body surface contour image is the position deviation between the current radiotherapy position and the preset position in the TPS body surface contour image; comparing the position deviation with a clinical allowable deviation value (3mm), if the current position deviation is less than or equal to 3mm, indicating that the current radiotherapy position is accurate, and entering the step 2; if the deviation of the current position is more than 3mm, the current radiotherapy position is inaccurate, the treatment should be stopped, and the technician repositions the current patient again until the deviation of the position obtained in the step 1 is less than 3 mm.
the time and position synchronization characteristics of the determined geometric relationship and the height of the actually measured three-dimensional body surface profile image and the actually measured three-dimensional body surface dose distribution are utilized, the actually measured three-dimensional body surface profile image is used as a matching reference, and the coordinates of each position in the actually measured three-dimensional body surface dose distribution are aligned with the coordinates of each position in the actually measured three-dimensional body surface profile image through image coordinate translation conversion.
Step 3, matching the actually measured three-dimensional body surface dose distribution with the TPS three-dimensional body surface dose distribution:
as the TPS three-dimensional body surface dose distribution provided by a radiotherapy planning system (TPS) is matched with the TPS body surface contour image, the position matching of the actually measured three-dimensional body surface dose distribution and the TPS three-dimensional body surface dose distribution can be realized after the steps 1 and 2, and the TPS three-dimensional body surface dose distribution can be used as a basis for monitoring and comparing in the radiotherapy process.
extracting an actual radiotherapy dose value of each pixel at a current radiotherapy irradiation area from the actually measured three-dimensional body surface dose distribution, extracting a preset radiotherapy dose value of a pixel at a corresponding position from the TPS three-dimensional body surface dose distribution, and comparing the actual radiotherapy dose value with the preset radiotherapy dose value, wherein if the deviation of the actual radiotherapy dose value and the preset radiotherapy dose value is less than 3%, the current actual radiotherapy dose is accurate; and if not, the current actual radiotherapy dose deviation is overlarge, the current treatment is stopped, the radiotherapy plan is re-made in the TPS, a new three-dimensional body surface dose distribution is obtained, and the steps 1-4 are repeated until the pixel average deviation of the actual radiotherapy dose value and the preset radiotherapy dose value is less than 3%, so that the treatment can be continued.
The invention not only can monitor the radiotherapy position and dosage in real time and judge whether the current radiotherapy position and dosage are accurate, but also can provide reference for clinical radiotherapy curative effect diagnosis, and the specific implementation mode is that the invention also comprises a radiotherapy effect module which is used for realizing the following steps:
step 2: during each radiotherapy period, extracting the surface tumor vessel diameter of the radiotherapy part from the three-dimensional surface vessel image by using a boundary detection extraction technology;
and step 3: comparing the blood vessel diameter of the radiotherapy part body surface tumor obtained in the current radiotherapy process with the blood vessel diameter of the radiotherapy part body surface tumor obtained in the first radiotherapy process, wherein if the blood vessel diameter is reduced compared with the blood vessel diameter of the radiotherapy part body surface tumor obtained in the first radiotherapy process, the early-stage radiotherapy dosage is sufficient, and the treatment is effective; if the radiotherapy is unchanged compared with the first radiotherapy, the early-stage radiotherapy dosage is insufficient, and the effect is poor.
In order to clarify the installation position of the radiotherapy position and dose real-time monitoring and positioning device of the present invention in use, the accelerator head, the KV generator and the KV receiver in the tumor radiotherapy system will be briefly described.
The accelerator head of the tumor radiotherapy system can emit MV-grade X-ray or electron beam to irradiate the tumor position of a patient. During irradiation, the accelerator head can rotate 360 degrees around the center point of the tumor, and the rays can be emitted to irradiate the tumor at any angle.
KV generator and KV receiver in tumor radiotherapy system: the KV generator emits KV level X-rays, which penetrate through a patient and are received by a KV receiver formed by an amorphous silicon array. Before or after the accelerator head irradiates the tumor, the KV generator rotates for a certain angle around the center point of the tumor, the KV receiver receives the signal intensity after penetrating through the patient, and after three-dimensional reconstruction, the three-dimensional anatomical result of the patient before or during treatment can be obtained, whether the position of the patient changes during treatment can be monitored, and the accuracy of the position can be monitored. However, the KV generator and the receptor need a certain time to rotate around the patient, and the real-time position monitoring cannot be realized.
When the radiotherapy position and dose real-time monitoring and positioning device provided by the invention is used, the radiotherapy position and dose real-time monitoring and positioning device can be embedded outside a handpiece of a accelerator in a tumor radiotherapy system, as shown in fig. 3; can also be nested outside the KV generator in the tumor radiotherapy system, as shown in FIG. 4. When the accelerator head rotates to the position above the treatment bed, the radiotherapy position and dose real-time monitoring and positioning device provided by the invention is nested in the accelerator head, and the radiotherapy dose and treatment position of a patient are monitored in real time. When the accelerator head rotates to the position near or below the treatment bed, the radiotherapy position and dose real-time monitoring and positioning device provided by the invention is taken off from the accelerator head and is embedded outside the KV generator instead, and is fixed at 90 degrees with the treatment head, so that the radiotherapy dose and treatment position of a patient are monitored in real time.
Claims (8)
1. Radiotherapy position and dose real-time supervision and positioner, its characterized in that: the device comprises a position synchronous acquisition module, a dose synchronous acquisition module, a communication and triggering module, an image reconstruction module and a position dose deviation acquisition module, wherein the position synchronous acquisition module, the dose synchronous acquisition module and the communication and triggering module are packaged in a high-energy ray shielding shell;
the high-energy ray shielding shell is of an annular columnar structure made of lead alloy or tungsten alloy with high absorption characteristics, and is matched with the shape of an accelerator head or a KV generator so as to be conveniently nested and installed;
the position synchronous acquisition modules comprise three groups, and each group consists of an infrared projector and an infrared camera; the infrared projector emits infrared light in different wave bands with Cerenkov light, and projects a stripe image with structural information to the body surface of a patient; the infrared camera captures a structured light signal reflected by the body surface of the patient and transmits the structured light signal to the image reconstruction module;
the dose synchronous acquisition module comprises three CLI cameras, and the three CLI cameras and the three groups of position synchronous acquisition modules are alternately and uniformly arranged on the same circumference and are positioned in the high-energy ray shielding shell; the CLI camera collects two-dimensional Cerenkov signals in three directions in real time and transmits the two-dimensional Cerenkov signals to the image reconstruction module;
the communication and trigger module is used for receiving a trigger signal sent by the accelerator and controlling the position synchronous acquisition module and the dose synchronous acquisition module to start working after receiving the trigger signal;
the image reconstruction module realizes the reconstruction of a three-dimensional body surface structure by utilizing the structured light information of the modulated stripe image on the body surface of the patient and the corresponding relation between the phase information and the space position to obtain an actually measured three-dimensional body surface contour image; the image reconstruction module can also obtain actually-measured three-dimensional body surface dose distribution through three-dimensional reconstruction based on the two-dimensional Cerenkov signal acquired by the CLI camera;
the position dose deviation acquisition module monitors the body surface position and dose of a patient in treatment in real time by taking a TPS body surface contour image and TPS three-dimensional body surface dose distribution calculated by an existing radiotherapy planning system (TPS) as a reference, and further judges the position and dose deviation, and the specific method comprises the following steps:
step 1, registering an actually measured three-dimensional body surface contour image and a TPS contour image, and acquiring a radiotherapy position deviation value;
step 2, registering the actually measured three-dimensional body surface contour image and the actually measured three-dimensional body surface dose distribution;
step 3, matching the actually measured three-dimensional body surface dose distribution with the TPS three-dimensional body surface dose distribution;
and 4, acquiring the dose deviation.
2. The radiotherapy position and dose real-time monitoring and positioning device of claim 1, wherein: the step 1 specifically comprises the following steps:
taking the TPS body surface contour image as a reference, aligning the actually measured three-dimensional body surface contour image with the TPS body surface contour image through translation, matching the three-dimensional body surface contour image and the TPS body surface contour image by adopting contour feature points in real time in the translation process, finding out pixel points with biological features in the TPS body surface contour image and the actually measured three-dimensional body surface contour image, and extracting local features comprising at least one of tumor body surface shape features, body surface texture features, Gaussian Laplace filtering features and wavelet features from the TPS body surface contour image and the actually measured three-dimensional body surface contour image according to the pixel points with the biological features, wherein the local features are of the same type;
comparing the difference values of the local features extracted from the TPS body surface contour image and the actually measured three-dimensional body surface contour image, and determining the minimum difference value of the local features by adopting an iterative closest point method, so as to respectively obtain the minimum difference values corresponding to each type of local features;
then adding weight to each local feature, calculating a weighted minimum difference value in a weighted average mode, and when the weighted minimum difference value is smaller than 0.5mm, indicating that the actually measured three-dimensional body surface contour and the TPS contour are registered at the moment, wherein the translation amount of the actually measured three-dimensional body surface contour image is the position deviation between the current radiotherapy position and the preset position in the TPS body surface contour image;
comparing the position deviation with a clinical allowable deviation value, if the current position deviation is less than or equal to the clinical allowable deviation value, indicating that the current radiotherapy position is accurate, and entering the step 2; if the deviation of the current position is larger than the clinically allowable deviation value, the current radiotherapy position is inaccurate, the treatment should be stopped, and the technician repositions the current patient again until the position deviation obtained in the step 1 is smaller than the clinically allowable deviation value.
3. The radiotherapy position and dose real-time monitoring and positioning device of claim 2, wherein: the step 2 specifically comprises the following steps:
the time and position synchronization characteristics of the determined geometric relationship and the height of the actually measured three-dimensional body surface profile image and the actually measured three-dimensional body surface dose distribution are utilized, the actually measured three-dimensional body surface profile image is used as a matching reference, and the coordinates of each position in the actually measured three-dimensional body surface dose distribution are aligned with the coordinates of each position in the actually measured three-dimensional body surface profile image through image coordinate translation conversion.
4. The radiotherapy position and dose real-time monitoring and positioning device of claim 3, wherein: the step 4 specifically comprises the following steps:
extracting an actual radiotherapy dose value of each pixel at a current radiotherapy irradiation area from the actually measured three-dimensional body surface dose distribution, extracting a preset radiotherapy dose value of a pixel at a corresponding position from the TPS three-dimensional body surface dose distribution, and comparing the actual radiotherapy dose value with the preset radiotherapy dose value, wherein if the deviation of the actual radiotherapy dose value and the preset radiotherapy dose value is less than 3%, the current actual radiotherapy dose is accurate; and if not, the current actual radiotherapy dose deviation is overlarge, the current treatment is stopped, the radiotherapy plan is re-made in the TPS, a new three-dimensional body surface dose distribution is obtained, and the steps 1-4 are repeated until the pixel average deviation of the actual radiotherapy dose value and the preset radiotherapy dose value is less than 3%, so that the treatment can be continued.
5. The radiotherapy position and dose real-time monitoring and positioning device of any one of claims 1-4, wherein: the radiotherapy effect judging module runs on a computer outside the high-energy ray shielding shell; the radiotherapy effect judging module is used for realizing the following steps:
step 1, during each radiotherapy period, extracting a three-dimensional body surface blood vessel image from actually-measured three-dimensional body surface dose distribution matched with a TPS three-dimensional body surface dose distribution position by using a boundary detection extraction technology;
step 2: during each radiotherapy period, extracting the surface tumor vessel diameter of the radiotherapy part from the three-dimensional surface vessel image by using a boundary detection extraction technology;
and step 3: comparing the blood vessel diameter of the radiotherapy part body surface tumor obtained in the current radiotherapy process with the blood vessel diameter of the radiotherapy part body surface tumor obtained in the first radiotherapy process, wherein if the blood vessel diameter is reduced compared with the blood vessel diameter of the radiotherapy part body surface tumor obtained in the first radiotherapy process, the early-stage radiotherapy dosage is sufficient, and the treatment is effective; if the radiotherapy is unchanged compared with the first radiotherapy, the early-stage radiotherapy dosage is insufficient, and the effect is poor.
6. The radiotherapy position and dose real-time monitoring and positioning device of claim 5, wherein: the method for reconstructing the three-dimensional body surface contour of the patient by the image reconstruction module comprises the following steps:
the image reconstruction module analyzes the frequency spectrum of the structured light signal to extract the phase principal value of the structured light signal, then adjusts the discontinuous phase principal value into continuous phase information by using a phase unwrapping algorithm to realize phase recovery, corresponds the recovered phase with the body surface space position of the patient, realizes accurate three-dimensional body surface contour reconstruction and obtains an actually measured three-dimensional body surface contour image.
7. The radiotherapy position and dose real-time monitoring and positioning device of claim 5, wherein: the method for acquiring the three-dimensional body surface dose distribution by the image reconstruction module through three-dimensional reconstruction comprises the following steps:
the method comprises the steps of reconstructing two-dimensional Cerenkov signals synchronously acquired by three CLI cameras into a high-resolution and high-precision three-dimensional CLI image based on a genetic algorithm and a sparse constraint CLI three-dimensional reconstruction algorithm, so that actually measured three-dimensional body surface dose distribution is obtained.
8. The tumor radiotherapy system comprises a KV generator and an accelerator head; the method is characterized in that: further comprises a radiotherapy position and dose real-time monitoring and positioning device of any one of claims 1-7; the radiotherapy position and dose real-time monitoring and positioning device is arranged outside the KV generator and/or the accelerator head.
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