CN115364391A - SBRT radiotherapy body position fixing system and method - Google Patents
SBRT radiotherapy body position fixing system and method Download PDFInfo
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- CN115364391A CN115364391A CN202211291812.7A CN202211291812A CN115364391A CN 115364391 A CN115364391 A CN 115364391A CN 202211291812 A CN202211291812 A CN 202211291812A CN 115364391 A CN115364391 A CN 115364391A
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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
- A61N2005/1074—Details of the control system, e.g. user interfaces
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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
- A61N2005/1092—Details
- A61N2005/1097—Means for immobilizing the patient
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Abstract
The invention relates to a system and a method for fixing SBRT (body posture) radiotherapy, which comprises a rail, a radiotherapy bed, a laser three-dimensional scanning system and a control system, wherein a head supporting mechanism, a neck fixing mechanism, a chest fixing belt mechanism, an abdomen fixing belt mechanism and a leg fixing belt mechanism are arranged on the radiotherapy bed. When the three-dimensional scanning laser radiotherapy bed is used, the radiotherapy bed scans a patient, the chest fixing belt mechanism, the abdomen fixing belt mechanism and the leg fixing belt mechanism through the three-dimensional scanning laser scanning system and constructs a three-dimensional model, and the control system controls the chest fixing belt mechanism, the abdomen fixing belt mechanism and the leg fixing belt mechanism to fix the chest, the abdomen and the legs of the patient respectively according to the three-dimensional model. The invention is flexible and convenient to use, is suitable for patients with various body shapes, and can be repeatedly used to save cost.
Description
Technical Field
The invention belongs to the technical field of radiotherapy, and particularly relates to a system and a method for fixing the position of SBRT radiotherapy.
Background
Radiotherapy is the main method of treating tumour at present, and during radiotherapy, the patient needs to keep fixed so that the ray can accurately irradiate the pathological change part. The patient's fixed body position fixing system that needs to adopt, traditional SRS (stereotactic radiosurgery, the radiotherapy of mainly used brain) and SBRT (the radiotherapy of somatic part stereotactic radiotherapy, the radiotherapy of mainly used somatic part) body position fixing system all import from abroad, though the precision is high, but import cost and maintenance cost are all very high, if can realize homemade, can reduce equipment cost by a wide margin to reduce tumour patient's radiotherapy cost, alleviate patient's burden.
At present, a series of radiotherapy body position fixing systems and methods are provided by domestic medical companies, hospitals and the like, for example, CN216169421U discloses a radiotherapy body position fixing device, which uses a fixing band to position limbs, but the operation is troublesome, and the body shape difference of different patients is large, so that the radiotherapy body position fixing device is difficult to be applied to patients with various body shapes. In addition, CN201710128307.3 discloses a method and a system for manufacturing a radiotherapy body position fixing device based on three-dimensional scanning, which establish a three-dimensional model of a patient contour by performing three-dimensional laser scanning on the patient, determine the shape and size of the fixing device according to the three-dimensional model, prepare the fixing device in a 3D printing manner, and then apply the fixing device clinically. This approach is suitable for patients of various body shapes, but the fixation device is temporarily manufactured, cannot be used immediately, is not suitable for patients requiring immediate treatment, and is a disposable device, which is costly.
In addition, CN109621234a discloses an arbitrary curved surface radiotherapy bed system, which comprises upper computer software, a lower computer control system and a treatment bed body, wherein the treatment bed body is a three-dimensional motorized device assembled by a plurality of lifting motor modules, and after the combined control of the upper computer software and the lower computer control system, the top of the treatment bed body can be deformed into an arbitrary curved surface. The curved surface shape of the top of the treatment bed body is determined according to the human body three-dimensional model, and then the lifting height of each lifting motor module is controlled, so that the shape of the top of the treatment bed body corresponds to the shape of a human body, and the human body is supported and fixed. The system can only support the middle and lower parts of the human body, and the fixing effect is general. In addition, the supporting block upper surface of elevator motor module is the rectangle that has certain area, and the upper surface of each supporting block can not form the curved surface of complete smoothness, and patient's comfort level is relatively poor.
Disclosure of Invention
The invention aims to solve the technical problem of providing an SBRT radiotherapy body position fixing system and method, which are flexible and convenient to use, suitable for patients with various body shapes and capable of being repeatedly used so as to save cost.
In order to solve the problems, the technical scheme adopted by the invention is as follows: the SBRT radiotherapy body position fixing system comprises a track, a radiotherapy bed, a laser three-dimensional scanning system and a control system;
the radiotherapy bed comprises a support frame, wherein a head supporting mechanism, a neck fixing mechanism, a chest fixing belt mechanism, an abdomen fixing belt mechanism and a leg fixing belt mechanism are sequentially arranged at the top of the support frame from one end to the other end, elastic supporting pads are arranged between the neck fixing mechanism and the chest fixing belt mechanism, on two sides of the abdomen fixing belt mechanism and on two sides of the leg fixing belt mechanism, and the chest fixing belt mechanism, the abdomen fixing belt mechanism and the leg fixing belt mechanism are all connected with a control system;
the laser three-dimensional scanning system is positioned above the track and connected with the control system;
the radiotherapy bed is installed in the track and cooperatees with the track, just the radiotherapy bed is connected with third actuating mechanism, third actuating mechanism is used for driving the radiotherapy bed along the track removal, and when the radiotherapy bed was through laser three-dimensional scanning system, laser three-dimensional scanning system scanned patient, chest fixed band mechanism, belly fixed band mechanism and shank fixed band mechanism and found three-dimensional model, control system fixes patient's chest, belly and shank respectively according to three-dimensional model control chest fixed band mechanism, belly fixed band mechanism and shank fixed band mechanism.
Furthermore, the chest fixing belt mechanism and the abdomen fixing belt mechanism both comprise a first horizontal guide rail, a first sliding support block, a first fastening belt and a first tightening mechanism, the first horizontal guide rail is arranged at the top of the support frame, and the length direction of the first horizontal guide rail is perpendicular to the length direction of the support frame; the two first sliding support blocks are in sliding fit with the first horizontal guide rail, and both the two first sliding support blocks are connected with a first driving mechanism for driving the first sliding support blocks to slide along the first horizontal guide rail; one end of the first fastening belt is fixed on the support frame, and the other end of the first fastening belt penetrates through one first sliding support block from bottom to top and then penetrates through the other first sliding support block from top to bottom and is connected with a first tightening mechanism which is fixed on the support frame;
the leg fixing belt mechanism comprises second horizontal guide rails, second sliding support blocks, second fastening belts, third sliding support blocks and a second tightening mechanism, the second horizontal guide rails are arranged at the top of the support frame and are parallel to the first horizontal guide rails, the number of the second sliding support blocks is two, the second sliding support blocks are in sliding fit with the second horizontal guide rails, the third sliding support blocks are located between the two second sliding support blocks and are in sliding fit with the second horizontal guide rails, and the second sliding support blocks and the third sliding support blocks are connected with second driving mechanisms for driving the second sliding support blocks and the third sliding support blocks to slide along the second horizontal guide rails; the two second tightening mechanisms are fixed on the support frame, one end of the second tightening belt is fixed on the support frame, the other end of the second tightening belt penetrates through the third sliding support block from bottom to top and then penetrates through one second sliding support block from top to bottom and is connected to one second tightening mechanism, one end of the third tightening belt is fixed on the support frame, the other end of the third tightening belt penetrates through the third sliding support block from bottom to top and then penetrates through the other second sliding support block from top to bottom and is connected to the other second tightening mechanism.
Further, the lower surfaces of the first fastening belt, the second fastening belt and the third fastening belt are provided with first pressure sensors, and the first pressure sensors are connected with a control system.
Furthermore, one side of the first sliding support block, one side of the second sliding support block and one side of the third sliding support block facing the human body are respectively provided with a horizontal support part and an arc-shaped support surface, and the horizontal support part and the arc-shaped support surface are provided with soft pads.
Further, neck fixed establishment includes a plurality of curved left branch vaulting poles and a plurality of curved right branch vaulting poles, every the inside wall of left branch vaulting pole and every right branch vaulting pole is provided with second pressure sensor and cushion, every the lateral wall of left branch vaulting pole and every right branch vaulting pole all articulates there is first telescopic machanism, second pressure sensor and first telescopic machanism all link to each other with control system.
Furthermore, a plurality of vertical second telescopic mechanisms are arranged below two sides of the chest fixing belt mechanism and the abdomen fixing belt mechanism, the second telescopic mechanisms are in a rectangular array, a supporting plate is hinged to the top of each second telescopic mechanism, a third pressure sensor is arranged on the upper surface of the supporting plate, and the third pressure sensor and the second telescopic mechanisms are connected with a control system.
The SBRT radiotherapy body position fixing method adopts the SBRT radiotherapy body position fixing system and comprises the following steps:
s1, determining the body position of a patient according to the radiotherapy part of the patient;
s2, the patient lies on a radiotherapy bed according to the determined body position, the neck of the patient is fixed by using a neck fixing mechanism, and the chest fixing belt mechanism, the abdomen fixing belt mechanism and the leg fixing belt mechanism are preliminarily installed in place;
s3, the third driving mechanism drives the radiotherapy bed to move along the track, so that the radiotherapy bed passes through the lower part of the laser three-dimensional scanning system, and the laser three-dimensional scanning system scans the patient, the chest fixing belt mechanism, the abdomen fixing belt mechanism and the leg fixing belt mechanism;
s4, establishing an integral three-dimensional model of the patient, the chest fixing belt mechanism, the abdomen fixing belt mechanism and the leg fixing belt mechanism according to the scanning result, and determining the operation process of the chest fixing belt mechanism, the abdomen fixing belt mechanism and the leg fixing belt mechanism according to the integral three-dimensional model;
and S5, controlling the chest fixing belt mechanism, the abdomen fixing belt mechanism and the leg fixing belt mechanism to operate according to the operation process determined in the step S4 by using the control system, and fixing the patient.
Further, in step S2, the chest and abdomen of the patient are located between the two corresponding first sliding support blocks, the third sliding support block is located between the two legs of the patient, and the second sliding support block is located outside the legs of the patient; wrapping around the chest and abdomen of the patient using the first fastening strap, and wrapping around both legs of the patient using the second fastening strap and the third fastening strap;
in the step S3, the laser three-dimensional scanning system scans the patient, the first sliding support block, the second sliding support block and the third sliding support block;
in the step S4, an integral three-dimensional model of the patient, the first sliding support block, the second sliding support block and the third sliding support block is established according to the scanning result, the position relation among the first sliding support block, the second sliding support block and the third sliding support block and the patient is determined, and the distance among the first sliding support block, the second sliding support block and the third sliding support block and the fixed position of the patient is calculated, so that the moving distance L of the first sliding support block, the second sliding support block and the third sliding support block is determined;
in the step S5, the control system controls the first driving mechanism and the second driving mechanism to operate to drive the first sliding support block, the second sliding support block and the third sliding support block to move by a distance L, so that the first sliding support block is in contact with the chest and the abdomen of the patient, and the second sliding support block and the third sliding support block are in contact with the legs of the patient; and then the first tightening mechanism and the second tightening mechanism are controlled to move to tighten the first fastening belt, the second fastening belt and the third fastening belt, the first pressure sensor detects the fastening pressure of the first fastening belt, the second fastening belt and the third fastening belt on a patient, and the first tightening mechanism and the second tightening mechanism stop tightening when the fastening pressure reaches a set value.
Further, in step S2, the first telescoping mechanism is used to push the left support rod and the right support rod to rotate, so that the elastic pads at the inner sides of the left support rod and the right support rod contact the neck of the patient, the second pressure sensor detects the pressure of the left support rod and the right support rod on the neck, and the first telescoping mechanism stops operating when the pressure reaches a set value.
Further, in step S2, the initial position of the support plate is the lower surface of the elastic support pad, and after the patient lies on the radiotherapy bed, the weight is transferred to a part of the support plate;
in the step S4, finding out all supporting plates positioned below the outline of the patient as effective supporting plates;
in the step S5, the third pressure sensors on the effective support plates detect the pressure born by the effective support plates, and the average pressure of each effective support plate is calculated; for the effective support plate with the pressure greater than the average pressure, the control system controls the effective support plate to descend until the pressure is equal to the average pressure; for an active support plate with a pressure less than the average pressure, the control system controls the active support plate to rise until the pressure equals the average pressure.
The invention has the beneficial effects that: 1. the during operation, make the patient be in the radiotherapy position that medical personnel set for, to the patient, chest fixed band mechanism, belly fixed band mechanism and shank fixed band mechanism carry out whole scanning, obtain whole three-dimensional model, then according to chest fixed band mechanism, position relation between belly fixed band mechanism and shank fixed band mechanism and the patient, confirm chest fixed band mechanism, the motion process of belly fixed band mechanism and shank fixed band mechanism, make chest fixed band mechanism, patient's chest can accurately be fixed to belly fixed band mechanism and shank fixed band mechanism, belly and shank.
2. After the scanning and modeling are finished, the body position of the patient can be immediately fixed, the temporary manufacturing of fixing equipment is not needed, and the efficiency is high.
3. The chest fixing belt mechanism, the abdomen fixing belt mechanism and the leg fixing belt mechanism all adopt the sliding support block, the tightening mechanism and the fastening belt, the fastening operation is simpler, the patient can be repeatedly used by patients with different body shapes, and the equipment cost is low.
Drawings
FIG. 1 is an overall top schematic view of the present invention;
FIG. 2 isbase:Sub>A schematic cross-sectional view A-A of FIG. 1;
FIG. 3 is a schematic cross-sectional view of B-B of FIG. 1;
FIG. 4 is a schematic cross-sectional view of C-C of FIG. 1;
FIG. 5 is a schematic cross-sectional view of D-D of FIG. 1;
FIG. 6 is a schematic cross-sectional view of E-E of FIG. 3;
reference numerals: 1-a track; 2-radiotherapy bed; 21-a support frame; 22 — a head support mechanism; 23 — a first sliding support block; 24-a first fastening strip; 25 — a first tightening mechanism; 26-a second horizontal guide rail; 27-a second sliding support block; 28-a second fastening strap; 29-a third fastening strap; 210-a third sliding support block; 211 — a second tightening mechanism; 212 — a first pressure sensor; 213-left support bar; 214-right support bar; 215-a second pressure sensor; 216 — a first telescoping mechanism; 217-a second telescopic mechanism; 218-a support plate; 219 — third pressure sensor; 220-horizontal support; 221-arc support surface; 223-cushion; 224-a resilient pad; 225-a resilient support pad; 226 — first horizontal rail; 227 — a first drive mechanism; 228 — a second drive mechanism; 3-laser three-dimensional scanning system; and 4, controlling the system.
Detailed Description
The invention is further illustrated with reference to the following figures and examples.
The SBRT radiotherapy body position fixing system disclosed by the invention is shown in figures 1 to 6 and comprises a track 1, a radiotherapy bed 2, a laser three-dimensional scanning system 3 and a control system 4.
The track 1 is fixedly arranged on the ground, and the laser three-dimensional scanning system 3 is positioned above the track 1 and used for scanning a patient to construct a three-dimensional model. The position of the rail 1 and the laser three-dimensional scanning system 3 is kept fixed.
Radiotherapy bed 2 is installed in track 1 and is cooperated with track 1, and radiotherapy bed 2 is connected with the third actuating mechanism, and the third actuating mechanism is used for driving radiotherapy bed 2 to remove along track 1. The third actuating mechanism can be the motor, can set up drive shaft and gyro wheel in the bottom of radiotherapy bed 2, and the gyro wheel cooperates with track 1, and when the motor drove the drive shaft and rotates, can make the gyro wheel roll along track 1, and then drive 2 global movements of radiotherapy bed.
The track 1 is used for controlling the moving path of the radiotherapy bed 2, and the radiotherapy bed 2 moves along the track 1, so that the radiotherapy bed 2 is located at a better scanning position when passing through the laser three-dimensional scanning system 3 every time.
The radiotherapy bed 2 comprises a support frame 21, and the support frame 21 can be of various frame structures formed by splicing metal pipes, sectional materials, metal blocks and other materials and has enough strength.
The head supporting mechanism 22, the neck fixing mechanism, the chest fixing belt mechanism, the abdomen fixing belt mechanism and the leg fixing belt mechanism are sequentially arranged at the top of the supporting frame 21 from one end to the other end, the head supporting mechanism 22 is used for supporting the head, and because the invention aims at body stereotactic radiotherapy (SBRT), the radiotherapy part is not positioned at the head, the head does not need to be precisely positioned, and an elastic supporting piece with a downward sunken upper surface is adopted.
Neck fixed band mechanism is used for fixing patient's neck, chest fixed band mechanism, belly fixed band mechanism and shank fixed band mechanism are used for respectively through the fixed band to patient's chest, belly and shank are fixed, between neck fixed band mechanism and the chest fixed band mechanism, belly fixed band mechanism both sides and shank fixed band mechanism both sides all are provided with elastic supporting pad 225, chest fixed band mechanism, belly fixed band mechanism and shank fixed band mechanism all link to each other with control system 4. The thickness of elastic support pad 225 is about 1 to 2cm, can adopt silica gel pad etc. to improve patient's travelling comfort.
Laser three-dimensional scanning system 3, chest fixed band mechanism, belly fixed band mechanism and shank fixed band mechanism all link to each other with control system 4, when radiotherapy bed 2 when laser three-dimensional scanning system 3, laser three-dimensional scanning system 3 is to the patient, chest fixed band mechanism, belly fixed band mechanism and shank fixed band mechanism scan and establish three-dimensional model, control system 4 is according to three-dimensional model control chest fixed band mechanism, belly fixed band mechanism and shank fixed band mechanism are respectively to the patient's chest, belly and shank are fixed.
The control system 4 comprises a main control computer and a plurality of local controllers, wherein three-dimensional modeling software is arranged in the main control computer, the main control computer can be used for three-dimensional modeling and can transmit instructions to the local controllers, and the local controllers respectively control the operation of the chest fixing belt mechanism, the abdomen fixing belt mechanism and the leg fixing belt mechanism to realize the fixation of the patient.
At present, laser three-dimensional scanning and three-dimensional modeling belong to mature technologies, and the laser three-dimensional scanning system 3 and the specific modeling mode of the invention can be realized by adopting the prior art.
The SBRT radiotherapy body position fixing method adopts the SBRT radiotherapy body position fixing system and comprises the following steps:
s1, determining the body position of a patient according to the radiotherapy part of the patient. The body position is the body position of the patient during radiotherapy and is determined by medical staff.
S2, the patient lies on the radiotherapy bed 2 according to the determined position, the neck of the patient is fixed by the neck fixing mechanism, the chest fixing belt mechanism, the abdomen fixing belt mechanism and the leg fixing belt mechanism are preliminarily installed in place, and the chest fixing belt mechanism, the abdomen fixing belt mechanism and the leg fixing belt mechanism are not fastened at the moment, but fastening preparation is made.
S3, the radiotherapy bed 2 is driven by the third driving mechanism to move along the track 1, so that the radiotherapy bed 2 passes through the lower part of the laser three-dimensional scanning system 3, and the laser three-dimensional scanning system 3 scans the patient, the chest fixing belt mechanism, the abdomen fixing belt mechanism and the leg fixing belt mechanism.
S4, establishing an integral three-dimensional model of the patient, the chest fixing belt mechanism, the abdomen fixing belt mechanism and the leg fixing belt mechanism according to the scanning result, and determining the operation process of the chest fixing belt mechanism, the abdomen fixing belt mechanism and the leg fixing belt mechanism according to the integral three-dimensional model.
Through scanning and the back of modelling, can the accurate position relation that calculates under the radiotherapy position, between patient and chest fixed band mechanism, belly fixed band mechanism and the shank fixed band mechanism to calculate the operation process of chest fixed band mechanism, belly fixed band mechanism and shank fixed band mechanism, realize fixed to the patient.
And S5, controlling the chest fixing belt mechanism, the abdomen fixing belt mechanism and the leg fixing belt mechanism to operate according to the operation process determined in the step S4 by using the control system 4, and fixing the patient.
The scanning is carried out when the patient is in the position of radiotherapy, and the patient, the chest fixing belt mechanism, the abdomen fixing belt mechanism and the leg fixing belt mechanism are integrally scanned and modeled, so that the position relation between each fixing mechanism and the patient is more accurate, the chest fixing belt mechanism, the abdomen fixing belt mechanism and the leg fixing belt mechanism are controlled to accurately position the patient, and the precision of position fixing is improved.
After scanning and modeling, the body position can be immediately fixed, the whole process time is short, and the method is suitable for patients with critical illness. The chest fixing belt mechanism, the abdomen fixing belt mechanism and the leg fixing belt mechanism can fix patients with different body shapes, the flexibility is better, and the equipment cost can be reduced.
The neck fixing mechanism can adopt a fixing piece matched with the shape of the neck, in order to improve the comfort of the neck, the neck fixing mechanism is shown in fig. 2 and comprises a plurality of arc-shaped left supporting rods 213 and a plurality of arc-shaped right supporting rods 214, the lower ends of the left supporting rods 213 and the right supporting rods 214 are hinged with the supporting frame 21, the inner side walls of each left supporting rod 213 and each right supporting rod 214 are provided with a second pressure sensor 215 and an elastic cushion 224, the outer side walls of each left supporting rod 213 and each right supporting rod 214 are hinged with a first telescopic mechanism 216, and the second pressure sensor 215 and the first telescopic mechanism 216 are connected with the control system 4.
In the step S2, the first telescopic mechanism 216 is used to push the left support rod 213 and the right support rod 214 to rotate, so that the elastic pads 224 at the inner sides of the left support rod 213 and the right support rod 214 contact the neck of the patient and gradually press the neck of the patient, the second pressure sensor 215 detects the pressure of the left support rod 213 and the right support rod 214 on the neck, and transmits the detection result to the control system, and when the pressure reaches a set value, the control system controls the first telescopic mechanism 216 to stop operating.
The neck is fixed by the left support rods 213 and the right support rods 214, so that the left support rods 213 and the right support rods 214 can be better attached to the neck, and the comfort of a patient is improved; and the pressure of each left supporting rod 213 and right supporting rod 214 to the neck is controlled, so that the phenomenon that the fixation is unstable due to too small pressure is prevented, and the discomfort of the patient due to too large pressure is avoided while the fixation effect is ensured.
The chest fixing strap mechanism and the abdomen fixing strap mechanism of the present invention have the same structure, and specifically as shown in fig. 3, the chest fixing strap mechanism comprises a first horizontal guide rail 226, a first sliding support block 23, a first fastening strap 24 and a first tightening mechanism 25, wherein the first horizontal guide rail 226 is arranged on the top of the support frame 21, and the length direction of the first horizontal guide rail 226 is perpendicular to the length direction of the support frame 21; the number of the first sliding support blocks 23 is two, and the first sliding support blocks 23 are in sliding fit with the first horizontal guide rail 226, and both the first sliding support blocks 23 are connected with a first driving mechanism 227 for driving the first sliding support blocks 23 to slide along the first horizontal guide rail 226; one end of the first fastening belt 24 is fixed on the support frame 21, and the other end of the first fastening belt penetrates through one first sliding support block 23 from top to bottom, then penetrates through the other first sliding support block 23 from top to bottom, is connected with the first tightening mechanism 25, and the first tightening mechanism 25 is fixed on the support frame 21.
The cross section of the first horizontal guide rail 226 is in a shape of Chinese character 'ao', and the first horizontal guide rail 226 is arranged in pairs, the openings of the two first horizontal guide rails 226 are opposite, and have a certain distance for the first fastening belt 24 to pass through, a positioning cavity is enclosed between the two guide rails, the lower end of the first sliding support block 23 is positioned in the positioning cavity, and the first sliding support block 23 can slide along the first horizontal guide rail 226 and has a function of preventing falling.
The first driving mechanism 227 can adopt a cylinder, a linear motor, a screw-nut mechanism driven by a servo motor, and the like, and can also be provided with a rack on the lower surface of the first sliding support block 23, a gear is arranged on a main shaft of the servo motor, the gear is meshed with the rack, and the servo motor can drive the first sliding support block 23 to translate when rotating. Each of the first sliding support blocks 23 is connected to a first driving mechanism 227 so that the position of each of the first sliding support blocks 23 can be controlled.
The first fastening belt 24 is a conventional safety belt, one end of the first fastening belt is a fixed end and is used for being connected with the support frame 21, the other end of the first fastening belt is a retractable end and is connected with the first tightening mechanism 25, and the fixed end can be connected with the support frame 21 through a buckle, and the first fastening belt can be quickly fixed and detached similarly to the connection mode of an automobile safety belt.
The first tightening mechanism 25 can tighten and loosen the first fastening belt 24, a tightening and loosening roller can be adopted, the tightening and loosening end of the first fastening belt 24 is wound on the tightening and loosening roller, the tightening and loosening roller is connected with a servo motor, and when the servo motor drives the tightening and loosening roller to rotate, the first fastening belt 24 can be tightened.
The leg fixing strap mechanism is shown in fig. 4, and includes a second horizontal guide rail 26, a second sliding support block 27, a second fastening strap 28, a third fastening strap 29, a third sliding support block 210 and a second tightening mechanism 211, the second horizontal guide rail 26 is disposed on the top of the support frame 21 and is parallel to the first horizontal guide rail 226, the second sliding support blocks 27 are two and are in sliding fit with the second horizontal guide rail 26, the third sliding support block 210 is located between the two second sliding support blocks 27 and is in sliding fit with the second horizontal guide rail 26, and the second sliding support blocks 27 and the third sliding support blocks 210 are connected with a second driving mechanism 228 for driving the second sliding support blocks 27 and the third sliding support blocks 210 to slide along the second horizontal guide rail 26; the two second tightening mechanisms 211 are fixed on the support frame 21, one end of the second tightening strap 28 is fixed on the support frame 21, the other end of the second tightening strap passes through the third sliding support block 210 from bottom to top, passes through one second sliding support block 27 from top to bottom, is connected to one second tightening mechanism 211, one end of the third tightening strap 29 is fixed on the support frame 21, and the other end of the third tightening strap passes through the third sliding support block 210 from bottom to top, passes through the other second sliding support block 27 from top to bottom, and is connected to the other second tightening mechanism 211.
The second horizontal guide rail 26 has the same configuration as the first horizontal guide rail 226, the second slide support block 27 has the same configuration as the first slide support block 23, the second tightening mechanism 211 has the same configuration as the first tightening mechanism 25, and the second fastening band 28 and the third fastening band 29 are tightened and fixed in the same manner as the first fastening band 24.
The second driving mechanism 228 may be a pneumatic cylinder, a linear motor, a servo motor driven lead screw and nut mechanism, a servo motor driven rack and pinion mechanism, or the like. Each of the second and third sliding support blocks 27 and 210 is connected to a second drive mechanism 228, respectively, to control the position of the second and third sliding support blocks 27 and 210. The second driving mechanisms 228 of the second sliding support block 27 and the third sliding support block 210 may be the same or different, for example, the second driving mechanisms 228 of the two second sliding support blocks 27 use linear motors, and the third sliding support block 210 uses a rack and pinion mechanism driven by a servo motor, etc.
The lower surfaces of the first fastening strip 24, the second fastening strip 28 and the third fastening strip 29 are each provided with a first pressure sensor 212, the first pressure sensor 212 being connected to the control system 4. The first pressure sensor 212 may detect the fastening pressures of the first fastening band 24, the second fastening band 28, and the third fastening band 29 and transmit the detection results to the control system 4.
In the step S2, in the initial state, there is a sufficient distance between the two first sliding support blocks 23, there is a sufficient distance between the second sliding support block 27 and the third sliding support block 210, and the fixed ends of the first fastening strip 24, the second fastening strip 28 and the third fastening strip 29 are removed from the support frame 21. After the patient lies on the radiotherapy bed 2, the chest and the abdomen of the patient are located between the two corresponding first sliding support blocks 23, the third sliding support block 210 is located between the two legs of the patient, and the second sliding support block 27 is located on the outer side of the legs of the patient. The first fastening band 24 is used for winding around the chest and abdomen of the patient, the fixed end of the first fastening band 24 is downwards passed through the first sliding support block 23 and then fixed on the support frame 21, the second fastening band 28 and the third fastening band 29 are used for winding around the two legs of the patient, the second fastening band 28 and the third fastening band 29 are downwards passed, and the second sliding support block 27 is then fixed on the support frame 21.
In step S3, the laser three-dimensional scanning system 3 scans the patient, the first sliding support block 23, the second sliding support block 27, and the third sliding support block 210.
In step S4, an overall three-dimensional model of the patient, the first sliding support block 23, the second sliding support block 27, and the third sliding support block 210 is established according to the scanning result, the positional relationship between the first sliding support block 23, the second sliding support block 27, and the third sliding support block 210 and the patient is determined, and the distance between the first sliding support block 23, the second sliding support block 27, and the third sliding support block 210 and the patient fixing position is calculated, thereby determining the moving distance of the first sliding support block 23, the second sliding support block 27, and the third sliding support block 210.
In step S5, the control system 4 controls the first driving mechanism 227 and the second driving mechanism 228 to operate, so as to drive the first sliding support block 23, the second sliding support block 27 and the third sliding support block 210 to move by the distance determined in step S4, so that the first sliding support block 23 contacts the chest and abdomen of the patient, and the second sliding support block 27 and the third sliding support block 210 contact the leg of the patient; then, the first tightening mechanism 25 and the second tightening mechanism 211 are controlled to move, the first fastening band 24, the second fastening band 28 and the third fastening band 29 are tightened, the first pressure sensor 212 detects the fastening pressure of the first fastening band 24, the second fastening band 28 and the third fastening band 29 on the patient, and the first tightening mechanism 25 and the second tightening mechanism 211 stop tightening when the fastening pressure reaches the set value.
The first sliding support block 23 may be abutted against both sides of the chest and abdomen of the patient, and the first fastening band 24 may apply a downward fastening force to the patient, and the first and second fastening bands cooperate to effectively fix the chest and abdomen of the patient. The second sliding support block 27 and the third sliding support block 210 can abut against both sides of the leg of the patient, and the second fastening strap 28 and the third fastening strap 29 can apply downward fastening force to the leg of the patient, and cooperate with each other to keep the leg of the patient stable.
The chest fixing belt mechanism, the abdomen fixing belt mechanism and the leg fixing belt mechanism are relatively simple in structure, the positions of the sliding supporting blocks can be accurately controlled by adopting the existing electric control system, and the accuracy of body position fixing is ensured; and the positioning to the patient is reliable, and the position change of the patient in the radiotherapy process is effectively prevented. In addition, through all setting up first pressure sensor 212 at the lower surface of first fastening area 24, second fastening area 28 and third fastening area 29, detect fastening pressure for control system 4 can adjust the fastening pressure of first fastening area 24, second fastening area 28 and third fastening area 29, makes fastening pressure size suitable, improves patient's travelling comfort when guaranteeing the fastening effect. The fastening pressure of the first fastening strip 24, the second fastening strip 28 and the third fastening strip 29 is determined by the medical staff.
Because patient's radiotherapy position may be at the chest, belly or leg, first fastening area 24, second fastening area 28 or third fastening area 29 may shelter from the radiotherapy position, if the radiotherapy position is at the chest, receive sheltering from of the first fastening area 24 of chest, can not adopt chest fixed band mechanism this moment, only adopt belly fixed band mechanism and leg fixed band mechanism, equally, if the first fastening area 24 of belly shelters from in the radiotherapy position, can only adopt chest fixed band mechanism and leg fixed band mechanism. The leg length is bigger, can adopt two or three shank fixed band mechanisms, and the radiotherapy position is sheltered from the back by second fastening area 28 or third fastening area 29, can adopt remaining shank fixed band mechanism to fix.
Because the human body is curved, the first sliding support block 23, the second sliding support block 27 and the third sliding support block 210 are provided with a horizontal support part 220 and an arc support surface 221 on the sides facing the human body, and the horizontal support part 220 and the arc support surface 221 are provided with a soft cushion 223. The upper surface of the horizontal support part 220 is also an arc surface, and the arc-shaped support surface 221 and the horizontal support part 220 can be better attached to a human body, so that the comfort level and the fixing effect are improved.
Because the trunk has a large weight and is irregular in shape, in order to better support the trunk of a patient, a plurality of vertical second telescopic mechanisms 217 are arranged below two sides of the chest fixing belt mechanism and the abdomen fixing belt mechanism, as shown in fig. 5, the second telescopic mechanisms 217 are distributed in a rectangular array, a support plate 218 is hinged to the top of each second telescopic mechanism 217, a third pressure sensor 219 is arranged on the upper surface of the support plate 218, and the third pressure sensor 219 and the second telescopic mechanisms 217 are connected with the control system 4. The height of each support plate 218 is adjusted by the second telescopic mechanism 217, so that the support plates 218 are combined with each other to form a support surface with various shapes, and the principle of the support surface is the same as that of CN 109621234A.
The support plate 218 of the invention is hinged with the top of the second telescopic mechanism 217, and the support plate 218 can be connected with the second telescopic mechanism 217 by adopting a universal joint, so that the support plate 218 can rotate at a certain angle towards all directions, and can better fit the human body.
In addition, by providing a third pressure sensor 219 on the upper surface of the support plate 218, the supporting force of each support plate 218 is detected to determine whether the support plate 218 is effectively supported, and the magnitude of the supporting force can be adjusted.
The procedure for supporting the patient with the matrix of support plates 218 is:
in step S2, the initial position of the supporting plate 218 is the lower surface of the elastic supporting pad 225, and all the supporting plates 218 are at the same height and support the elastic supporting pad 225. After the patient lies on the radiotherapy bed 2, the weight of the patient is transferred to a portion of the support plate 218.
In step S4, the individual support plates 218 located below the contour of the patient are found as effective support plates. Since it is not possible for the patient to cover all of the support plates 218, only a portion of the support plates 218 need to bear the weight of the patient, and therefore the support plates 218 that are below the patient contour are used as effective support plates, and the support plates 218 that are outside the patient contour remain stationary during the subsequent procedure, always in the initial position.
The contour of the patient and the position relationship between the patient and the radiotherapy bed 2 can be obtained by laser three-dimensional scanning, and the horizontal position of the support plates 218 is fixed relative to the radiotherapy bed 2, so that which support plates 218 are under the contour of the patient can be determined according to the contour of the patient and the position of the patient on the radiotherapy bed 2, and the support plates 218 can be used for supporting and positioning the patient.
In step S5, the third pressure sensors 219 on the effective support plates detect the pressures borne by the effective support plates, and calculate the average pressure of each effective support plate; for an active support plate with a pressure greater than the average pressure, the control system 4 controls the active support plate to descend until the pressure equals the average pressure; for an active support plate with a pressure less than the average pressure, the control system 4 controls the active support plate to rise until the pressure equals the average pressure.
The mean pressure of the effective support plate is calculated in the following manner: adding the pressure on all the effective supporting plates, and dividing by the number of the effective supporting plates. The height of the effective supporting plates is adjusted according to the pressure on the effective supporting plates, so that the pressure of all the effective supporting plates is the same, namely the supporting pressure of all the effective supporting plates to a patient is the same, the effective support to the patient is further ensured, meanwhile, the stress of all the positions of the patient is more balanced, and the comfort is improved.
The invention can fix a plurality of body positions, such as supine, side lying, prone position and the like, when lying on side, the two legs can be overlapped, at the moment, only the third sliding support block 210 and one second sliding support block 27 are needed, and the other second sliding support block 27 is idle.
The above description is only a preferred embodiment of the present invention and is not intended to limit the present invention, and various modifications and changes may be made by those skilled in the art. Any modification, equivalent replacement, or improvement made within the spirit and principle of the present invention should be included in the protection scope of the present invention.
Claims (10)
- An SBRT radiotherapy body position fixing system is characterized by comprising a track (1), a radiotherapy bed (2), a laser three-dimensional scanning system (3) and a control system (4);the radiotherapy bed (2) comprises a support frame (21), a head supporting mechanism (22), a neck fixing mechanism, a chest fixing belt mechanism, an abdomen fixing belt mechanism and a leg fixing belt mechanism are sequentially arranged at the top of the support frame (21) from one end to the other end, elastic supporting pads (225) are arranged between the neck fixing mechanism and the chest fixing belt mechanism, on two sides of the abdomen fixing belt mechanism and on two sides of the leg fixing belt mechanism, and the chest fixing belt mechanism, the abdomen fixing belt mechanism and the leg fixing belt mechanism are all connected with a control system (4);the laser three-dimensional scanning system (3) is positioned above the track (1) and is connected with the control system (4);radiotherapy bed (2) install in track (1) and cooperate with track (1), just radiotherapy bed (2) are connected with third actuating mechanism, third actuating mechanism is used for driving radiotherapy bed (2) and removes along track (1), when radiotherapy bed (2) through laser three-dimensional scanning system (3), laser three-dimensional scanning system (3) scan and establish three-dimensional model to patient, chest fixed band mechanism, belly fixed band mechanism and shank fixed band mechanism, control system (4) are fixed patient's chest, belly and shank respectively according to three-dimensional model control chest fixed band mechanism, belly fixed band mechanism and shank fixed band mechanism.
- 2. The SBRT radiotherapy body position fixing system of claim 1, wherein the chest fixing strap mechanism and the abdomen fixing strap mechanism each comprise a first horizontal guide rail (226), a first sliding support block (23), a first fastening strap (24) and a first tightening mechanism (25), the first horizontal guide rail (226) is arranged on top of the support frame (21), and the length direction of the first horizontal guide rail (226) is perpendicular to the length direction of the support frame (21); the number of the first sliding support blocks (23) is two, the first sliding support blocks (23) are in sliding fit with the first horizontal guide rail (226), and the two first sliding support blocks (23) are both connected with a first driving mechanism (227) for driving the first sliding support blocks (23) to slide along the first horizontal guide rail (226); one end of the first fastening belt (24) is fixed on the support frame (21), the other end of the first fastening belt penetrates through one first sliding support block (23) from bottom to top, then penetrates through the other first sliding support block (23) from top to bottom and is connected with a first tightening mechanism (25), and the first tightening mechanism (25) is fixed on the support frame (21);the leg fixing belt mechanism comprises second horizontal guide rails (26), second sliding support blocks (27), second fastening belts (28), third fastening belts (29), third sliding support blocks (210) and a second tightening mechanism (211), the second horizontal guide rails (26) are arranged at the top of the support frame (21) and are parallel to the first horizontal guide rails (226), the number of the second sliding support blocks (27) is two, the second sliding support blocks (27) are in sliding fit with the second horizontal guide rails (26), the third sliding support blocks (210) are located between the two second sliding support blocks (27) and are in sliding fit with the second horizontal guide rails (26), and the second sliding support blocks (27) and the third sliding support blocks (210) are connected with second driving mechanisms (228) for driving the second sliding support blocks (27) and the third sliding support blocks (210) to slide along the second horizontal guide rails (26); the second tightening mechanism (211) is two and fixed on the support frame (21), one end of the second tightening belt (28) is fixed on the support frame (21), the other end of the second tightening belt penetrates through the third sliding support block (210) from bottom to top, penetrates through the second sliding support block (27) from top to bottom and is connected to the second tightening mechanism (211), one end of the third tightening belt (29) is fixed on the support frame (21), the other end of the third tightening belt penetrates through the third sliding support block (210) from bottom to top, penetrates through the other second sliding support block (27) from top to bottom and is connected to the other second tightening mechanism (211).
- 3. An SBRT radiotherapy posture fixation system according to claim 2, wherein the lower surfaces of the first fastening strap (24), the second fastening strap (28) and the third fastening strap (29) are provided with a first pressure sensor (212), and the first pressure sensor (212) is connected with the control system (4).
- 4. The SBRT radiotherapy body position fixing system of claim 2, wherein the first sliding support block (23), the second sliding support block (27) and the third sliding support block (210) are provided with a horizontal support part (220) and an arc support surface (221) on the side facing the human body, and the horizontal support part (220) and the arc support surface (221) are provided with soft pads (223).
- 5. An SBRT radiotherapy body position fixing system according to claim 1, wherein the neck fixing mechanism comprises a plurality of arc-shaped left supporting rods (213) and a plurality of arc-shaped right supporting rods (214), the inner side wall of each of the left supporting rods (213) and each of the right supporting rods (214) is provided with a second pressure sensor (215) and an elastic pad (224), the outer side wall of each of the left supporting rods (213) and each of the right supporting rods (214) is hinged with a first telescopic mechanism (216), and the second pressure sensor (215) and the first telescopic mechanism (216) are connected with the control system (4).
- 6. An SBRT radiotherapy body position fixing system according to claim 1, wherein a plurality of vertical second telescopic mechanisms (217) are arranged below two sides of the chest fixing belt mechanism and the abdomen fixing belt mechanism, the second telescopic mechanisms (217) are in a rectangular array, a supporting plate (218) is hinged to the top of each second telescopic mechanism (217), a third pressure sensor (219) is arranged on the upper surface of the supporting plate (218), and the third pressure sensor (219) and the second telescopic mechanisms (217) are both connected with the control system (4).
- An SBRT radiotherapy posture fixing method, which adopts the SBRT radiotherapy posture fixing system of any one of claims 1 to 6, comprising the following steps:s1, determining the body position of a patient according to the radiotherapy part of the patient;s2, the patient lies on the radiotherapy bed (2) according to the determined body position, the neck of the patient is fixed by the neck fixing mechanism, and the chest fixing belt mechanism, the abdomen fixing belt mechanism and the leg fixing belt mechanism are preliminarily installed in place;s3, the radiotherapy bed (2) is driven by the third driving mechanism to move along the track (1), so that the radiotherapy bed (2) passes through the lower part of the laser three-dimensional scanning system (3), and the laser three-dimensional scanning system (3) scans the patient, the chest fixing belt mechanism, the abdomen fixing belt mechanism and the leg fixing belt mechanism;s4, establishing an integral three-dimensional model of the patient, the chest fixing belt mechanism, the abdomen fixing belt mechanism and the leg fixing belt mechanism according to the scanning result, and determining the operation process of the chest fixing belt mechanism, the abdomen fixing belt mechanism and the leg fixing belt mechanism according to the integral three-dimensional model;and S5, controlling the chest fixing belt mechanism, the abdomen fixing belt mechanism and the leg fixing belt mechanism to operate according to the operation process determined in the step S4 by using the control system (4) to fix the patient.
- 8. An SBRT radiotherapy posture immobilization method according to claim 7, wherein in step S2, the patient ' S chest and abdomen are located between the corresponding two first sliding support blocks (23), the third sliding support block (210) is located between the patient ' S two legs, and the second sliding support block (27) is located outside the patient ' S legs; passing around the chest and abdomen of the patient with the first fastening strap (24), and passing around both legs of the patient with the second fastening strap (28) and the third fastening strap (29);in the step S3, the laser three-dimensional scanning system (3) scans the patient, the first sliding support block (23), the second sliding support block (27) and the third sliding support block (210);in the step S4, an integral three-dimensional model of the patient, the first sliding support block (23), the second sliding support block (27) and the third sliding support block (210) is established according to the scanning result, the position relation among the first sliding support block (23), the second sliding support block (27) and the third sliding support block (210) and the patient is determined, and the distance among the first sliding support block (23), the second sliding support block (27) and the third sliding support block (210) and the patient fixing position is calculated, so that the moving distance among the first sliding support block (23), the second sliding support block (27) and the third sliding support block (210) is determined;in the step S5, the control system (4) controls the first driving mechanism (227) and the second driving mechanism (228) to operate, and drives the first sliding support block (23), the second sliding support block (27) and the third sliding support block (210) to move, so that the first sliding support block (23) contacts the chest and the abdomen of the patient, and the second sliding support block (27) and the third sliding support block (210) contact the legs of the patient; and then controlling the first tightening mechanism (25) and the second tightening mechanism (211) to move, tightening the first fastening belt (24), the second fastening belt (28) and the third fastening belt (29), detecting the tightening pressure of the first fastening belt (24), the second fastening belt (28) and the third fastening belt (29) on the patient by the first pressure sensor (212), and stopping tightening the first tightening mechanism (25) and the second tightening mechanism (211) when the tightening pressure reaches a set value.
- 9. An SBRT radiotherapy posture fixing method as claimed in claim 7, wherein in step S2, the first telescopic mechanism (216) is used to push the left support rod (213) and the right support rod (214) to rotate, so that the elastic pads (224) at the inner sides of the left support rod (213) and the right support rod (214) contact the neck of the patient, the second pressure sensor (215) detects the pressure of the left support rod (213) and the right support rod (214) on the neck, and when the pressure reaches a set value, the first telescopic mechanism (216) stops operating.
- 10. The SBRT radiotherapy posture fixing method of claim 7, wherein in step S2, the support plate (218) is initially positioned on the lower surface of the elastic support pad (225), and the weight of the patient is transferred to a portion of the support plate (218) after lying on the radiotherapy bed (2);in step S4, finding out each support plate (218) positioned below the outline of the patient as an effective support plate;in the step S5, a third pressure sensor (219) on each effective support plate detects the pressure born by the effective support plate, and calculates the average pressure of each effective support plate; for an effective support plate with pressure greater than the average pressure, the control system (4) controls the effective support plate to descend until the pressure is equal to the average pressure; for an active support plate with a pressure less than the average pressure, the control system (4) controls the active support plate to rise until the pressure equals the average pressure.
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