CN115671577A - Radiotherapy equipment for treating cardiomyopathy based on cardiac muscle positioning - Google Patents

Abstract

The application relates to radiotherapy equipment based on myocardial location treatment cardiomyopathy, include: acquiring a heart image of a patient to be treated; determining a ventricular interval myocardium image based on the cardiac image; controlling and positioning an irradiation position area and an irradiation dose of radiotherapy equipment based on the ventricular septal myocardial image; the irradiation position areas comprise a fourth irradiation position area, a fifth irradiation position area, a sixth irradiation position area and a seventh irradiation position area which are sequentially and continuously distributed along the longitudinal direction of the ventricular myocardium shown by the ventricular myocardium image, the junction position of the fifth irradiation position area and the sixth irradiation position area is located at the middle position of the longitudinal direction, the fourth irradiation position area is located at the junction of the ventricular myocardium and the ventricle, the seventh irradiation position area is located at the junction of the ventricular myocardium and the ventricle, the irradiation dose of the fifth irradiation position area is greater than that of the fourth irradiation position area, and the irradiation dose of the sixth irradiation position area is greater than that of the seventh irradiation position area.

Description

Radiotherapy equipment for treating cardiomyopathy based on cardiac muscle positioning

The application is a divisional application of Chinese patent application with the application number of 202111484599.7, namely 'a radiotherapy method and equipment for treating cardiomyopathy based on myocardial localization', which is submitted by Chinese intellectual property office in 12 months and 07 days in 2021, and specifically is a divisional application made according to an examination comment notice of a letter number 2022060102687920.

Technical Field

The embodiment of the application relates to the technical field of medical equipment, in particular to radiotherapy equipment for treating cardiomyopathy based on myocardial positioning.

Background

Cardiomyopathy such as Hypertrophic Obstructive Cardiomyopathy (HOCM) is a hereditary Cardiomyopathy which causes angina, dyspnea and even sudden death of heart muscle at ventricular intervals, HOCM is the most common cause of sudden death in young people, and medical treatment cannot improve the outcome of the disease.

In the related art, the therapeutic means employed for HOCM include: 1) Surgical thoracotomy direct vision under hypertrophic cardiomyopathy resection, however, the surgery is invasive, high in risk, difficult and poor in safety, is only developed in a few hospitals at home, is limited by the fact that the surgery visual field is difficult to ensure the surgery effect, and is extremely low in repeatability; 2) Trans-catheter trans-luminal ventricular alcohol ablation (PTSMA): the method can cause myocardial damage and necrosis, has uncontrollable damage range, high risk and poor safety, has high requirements on anatomy, is suitable for only part of patients and has poor repeatability; (3) Percutaneous myocardial inner chamber interval radiofrequency ablation, percutaneous endocardial chamber interval radiofrequency ablation: these methods are new, yet immature, invasive and also not safe.

Disclosure of Invention

In order to solve the technical problems or at least partially solve the technical problems, embodiments of the present application provide a radiation therapy apparatus for treating cardiomyopathy based on myocardial positioning.

The embodiment of the application provides a radiotherapy equipment based on cardiomyopathy of cardiac muscle location treatment, includes:

data acquisition means for acquiring a cardiac image of a patient to be treated;

image processing means for determining an interventricular myocardium image based on the cardiac image;

the control device is used for controlling and positioning the irradiation position area and the irradiation dose of the radiotherapy equipment based on the ventricular septal myocardium image; the irradiation position area comprises a fourth irradiation position area, a fifth irradiation position area, a sixth irradiation position area and a seventh irradiation position area, the fourth irradiation position area, the fifth irradiation position area, the sixth irradiation position area and the seventh irradiation position area are sequentially and continuously distributed along the longitudinal direction of the ventricular septal myocardium shown by the ventricular septal myocardium image, the boundary position of the fifth irradiation position area and the sixth irradiation position area is located in the middle position of the longitudinal direction, the fourth irradiation position area is located at the boundary position of the ventricular septal myocardium and the ventricle, the seventh irradiation position area is located at the boundary position of the ventricular myocardium and the ventricle, the irradiation dose of the fifth irradiation position area is greater than that of the fourth irradiation position area, and the irradiation dose of the sixth irradiation position area is greater than that of the seventh irradiation position area.

Compared with the prior art, the technical scheme provided by the embodiment of the application has the following advantages:

according to the radiotherapy method and the radiotherapy equipment for treating cardiomyopathy based on myocardial positioning, a data acquisition device acquires a heart image of a patient to be treated; the image processing device determines an interventricular myocardium image based on the heart image; the control device controls and positions an irradiation position area and an irradiation dose of the radiotherapy equipment based on the ventricular septal myocardium image; the irradiation position area comprises a fourth irradiation position area, a fifth irradiation position area, a sixth irradiation position area and a seventh irradiation position area, the fourth irradiation position area, the fifth irradiation position area, the sixth irradiation position area and the seventh irradiation position area are sequentially and continuously distributed along the longitudinal direction of the ventricular septum myocardium shown in the ventricular septum myocardium image, the boundary position of the fifth irradiation position area and the sixth irradiation position area is located in the middle position of the longitudinal direction, the fourth irradiation position area is located at the boundary position of the ventricular septum myocardium and the ventricle, the seventh irradiation position area is located at the boundary position of the ventricular septum myocardium and the ventricle, the irradiation dose of the fifth irradiation position area is greater than that of the fourth irradiation position area, and the irradiation dose of the sixth irradiation position area is greater than that of the seventh irradiation position area. Thus, in the embodiment, the radiotherapy equipment is applied to treatment of hypertrophic obstructive cardiomyopathy, the irradiation position area and the irradiation dose of the radiotherapy equipment are controlled and positioned based on the ventricular septal myocardium image of the heart of the patient, and the ventricular septal myocardium is treated by a partition radiotherapy irradiation mode of different irradiation position areas, so that the method is noninvasive, low in risk, good in safety, capable of performing individualized treatment on different patients based on the heart image, high in repeatability and simple to operate.

Drawings

The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments consistent with the present application and together with the description, serve to explain the principles of the application.

In order to more clearly illustrate the embodiments of the present application or the technical solutions in the prior art, the drawings needed to be used in the description of the embodiments or the prior art will be briefly described below, and it is obvious for those skilled in the art to obtain other drawings without inventive exercise.

FIG. 1 is a schematic diagram of a radiotherapy apparatus for treating cardiomyopathy based on myocardial localization according to an embodiment of the present application;

FIG. 2 is a schematic diagram of a radiotherapy apparatus for treating cardiomyopathy based on myocardial localization according to an embodiment of the present application;

FIG. 3 is a schematic cross-sectional view of a patient's heart in an embodiment of the present application;

FIG. 4 is an ultrasound contrast image of a patient's heart in an embodiment of the present application;

FIG. 5 is a schematic view of the segmentation of the illuminated region based on the cardiac ultrasound contrast image of FIG. 4;

FIG. 6 is an ultrasound contrast image of a patient's heart in another embodiment of the present application;

fig. 7 is a schematic view of the division of the irradiation region based on the cardiac ultrasound contrast image shown in fig. 6.

Detailed Description

In order that the above-mentioned objects, features and advantages of the present application may be more clearly understood, the solution of the present application will be further described below. It should be noted that the embodiments and features of the embodiments of the present application may be combined with each other without conflict.

In the following description, numerous specific details are set forth in order to provide a thorough understanding of the present application, but the present application may be practiced in other ways than those described herein; it is to be understood that the embodiments described in this specification are only some embodiments of the present application and not all embodiments.

It is to be understood that, hereinafter, "at least one" means one or more, "a plurality" means two or more. "and/or" is used to describe the association relationship of the associated objects, meaning that there may be three relationships, for example, "a and/or B" may mean: only A, only B and both A and B are present, wherein A and B may be singular or plural. The character "/" generally indicates that the former and latter associated objects are in an "or" relationship. "at least one of the following" or similar expressions refer to any combination of these items, including any combination of single item(s) or plural items. For example, at least one (one) of a, b, or c, may represent: a, b, c, "a and b", "a and c", "b and c", or "a and b and c", wherein a, b, c may be single or plural.

Fig. 1 shows a radiotherapy apparatus 10 for treating cardiomyopathy based on myocardial localization according to an exemplary embodiment of the present application, which may include a data acquisition device 101, an image processing device 102, and a control device 103. The control device 103 may be a device with a logic calculation function, such as a microprocessor, a microcontroller, or a programmable logic device. In an embodiment of the present application, the radiotherapy apparatus 10 may be a stereotactic radiotherapy apparatus, and the specific structure of the radiotherapy apparatus 10 can be understood by referring to the prior art, which is not limited in the present embodiment.

The data acquisition device 101 is used to acquire images of the heart of a patient to be treated. Illustratively, the patient to be treated is a patient with hypertrophic obstructive cardiomyopathy HOCM. The data acquisition device 101 may include a wired or wireless communication module through which the cardiac image of the patient to be treated may be acquired interactively with a hospital medical center server. The cardiac image may be a cardiac image, such as a cardiac ultrasound contrast image or the like, obtained during a pre-treatment examination of the patient, i.e. the cardiac image may be an ultrasound contrast image of the heart of a patient suffering from hypertrophic obstructive cardiomyopathy.

The image processing device 102 is configured to determine a ventricular interval myocardial image based on the cardiac image. For example, the image processing apparatus 102 may identify a ventricular septal myocardium region from the cardiac image, such as an ultrasound contrast image, based on an image identification technique, and then perform image segmentation to obtain a ventricular septal myocardium image, i.e., a lesion region image.

The control device 103 is used for controlling and positioning the irradiation position area and the irradiation dose of the radiotherapy equipment based on the ventricular septal myocardium image; the irradiation position area includes a first irradiation position area and a second irradiation position area, as shown in fig. 3, the first irradiation position area is a first area 301 of a central position of the ventricular septum myocardium 30 of the heart of the patient, the second irradiation position area is a second area 302 of the ventricular septum myocardium 30 of the heart of the patient, the first area 301 and the second area 302 are not overlapped, the second area 302 surrounds and wraps the first area 301, and an irradiation dose of the first irradiation position area, that is, the first area 301, is greater than an irradiation dose of the second irradiation position area, that is, the second area 302.

Illustratively, hypertrophic obstructive cardiomyopathy is characterized in that ventricular septal myocardium 30 is hypertrophic, a first region 301 in the central position of ventricular septal myocardium 30 is generally the most hypertrophic part of ventricular septal myocardium, parameters such as the shape and the size of the most hypertrophic part of ventricular septal myocardium can be determined through images of ventricular septal myocardium, irradiation region control parameters are generated according to the parameters, irradiation dose of irradiation position regions of a positioning radiotherapy device, such as a first irradiation position region and a second irradiation position region, and each region is controlled based on the irradiation region control parameters, the first region 301 is a core irradiation region and the irradiation dose is larger, and the peripheral region 301, i.e., a second region 302, is a secondary irradiation region and the irradiation dose is smaller. Therefore, the hypertrophic obstructive cardiomyopathy can be effectively treated by controlling and positioning the irradiation position area and the irradiation dose of the radiotherapy equipment, and the safety is better.

In the embodiment, the radiotherapy equipment is applied to treatment of hypertrophic obstructive cardiomyopathy, the irradiation position area and the irradiation dose of the radiotherapy equipment are controlled and positioned based on the ventricular septal myocardium image of the heart of the patient, and the ventricular septal myocardium is treated by a partition radiotherapy irradiation mode of the first irradiation position area and the second irradiation position area, so that the method is noninvasive, low in risk, good in safety, capable of performing individualized treatment on different patients based on the heart image, high in repeatability and simple to operate.

In order to improve the effectiveness and safety of the radiotherapy hypertrophic obstructive cardiomyopathy, in an example, the image processing device 102 may further identify a ventricular septal myocardium region from the cardiac image, such as an ultrasound contrast image, based on an image identification model, and then perform image segmentation to obtain a ventricular septal myocardium image, that is, a lesion region image.

For example, the image recognition model may be obtained by training an original image recognition model based on a convolutional neural network in advance based on sample data; the sample data comprises a sample heart image and preset information in the sample heart image, wherein the preset information comprises coordinate position data of a ventricular septal myocardium region in the sample heart image. The specific training process can be understood by referring to the prior art, and is not described in detail here.

The general image recognition model training is only based on a sample heart image such as an ultrasound contrast image, the preset information of the sample heart image is added for assisting training to obtain the image recognition model, and when the image recognition model is applied to recognizing the heart image of a patient, the ventricular septal myocardial region can be recognized more accurately, so that the subsequently positioned irradiation position region can be more accurate, and the effectiveness and the safety of the radiotherapy hypertrophic obstructive cardiomyopathy are improved.

In order to further improve the safety and reduce the treatment risk, as shown in fig. 3, based on the above embodiment, in an embodiment of the present application, the irradiation position region determined by the control device 103 based on the ventricular septal myocardium image may further include a third irradiation position region 303, the third irradiation position region 303 includes a third region of the ventricular septal myocardium 30 of the heart of the patient, the third region is located on the upper side and the right side of the second region 302, an upper edge of the third irradiation position region 303 does not exceed a membrane septal region of the heart of the patient, a right edge does not exceed a coronary sinus region of the heart of the patient, a left edge does not exceed a papillary muscle region of the heart of the patient, and an irradiation dose of the third irradiation position region 303 is zero.

In this embodiment, the first region 301 of the central position of the ventricular septum myocardium 30 is usually the most hypertrophic part of the ventricular septum, so the irradiation dose of the first region 301 is larger, while the irradiation dose of the peripheral region of 301, i.e. the second region 302, is smaller, and the irradiation dose of the peripheral region of the second region 302, i.e. the third region 303, is zero, so as to avoid damage to the non-focal region of the patient's heart. Therefore, the effective treatment of the hypertrophic obstructive cardiomyopathy can be realized by controlling three irradiation position areas and irradiation doses of the positioning radiotherapy equipment, the three-area irradiation treatment is realized, and the treatment safety is further improved.

Alternatively, in another embodiment of the present application, shown in fig. 4 and 5, the approximate location area of the ventricular septum myocardium 30 within the dashed line in fig. 4. The first region, i.e., the core irradiation region, includes a first sub-region 3, a second sub-region 4, a third sub-region 7, and a fourth sub-region 8, which are rectangular, the first sub-region 3 and the second sub-region 4 are symmetrically distributed on both sides of a central axis in the longitudinal direction of the ventricular septal myocardium (i.e., a central axis passing through the B point), the third sub-region 7 and the fourth sub-region 8 are symmetrically distributed on both sides of the central axis in the longitudinal direction of the ventricular septal myocardium, and the first sub-region and the third sub-region are connected to a first straight line (i.e., a straight line passing through the C point, which is perpendicular to the central axis), and the second sub-region and the fourth sub-region are also connected to the first straight line, wherein the first straight line is a straight line passing through an upper edge C of the papillary muscle and perpendicular to the central axis; the second region, i.e. the secondary irradiation region, includes a fifth sub-region 2, a sixth sub-region 5, a seventh sub-region 6 and an eighth sub-region 9, the fifth sub-region 2 is located immediately outside the first sub-region 3, the sixth sub-region 5 is located immediately outside the second sub-region 4, the seventh sub-region 6 is located immediately outside the third sub-region 7, and the eighth sub-region 9 is located immediately outside the fourth sub-region 8.

In this embodiment, by subdividing the first region and the peripheral region, i.e., the second region, more precise irradiation control can be achieved to further avoid damage to the non-focal region of the patient's heart. Therefore, the effective treatment of the hypertrophic obstructive cardiomyopathy can be realized by accurately controlling and positioning three irradiation position areas and irradiation dose of the radiotherapy equipment, the three-area irradiation treatment is realized, and the treatment safety is further improved.

Alternatively, on the basis of the above embodiment, in another embodiment, as shown in fig. 5, the third region may include a ninth sub-region 1 and a tenth sub-region 10, in this embodiment, four lines perpendicular to the central axis are respectively made along four points of ABCD, so as to divide the ventricular septum myocardium into four parts (non-equal parts). Wherein, point D is the junction point of the ventricular septum myocardium and the anterior wall of the left ventricle, point A is the intersection point of the aortic sinus bottom and the central axis, and point B is the bottom of the ventricular septum. In the coronary surface of the present embodiment, the ventricular septal myocardium is divided into 1-10 regions, wherein region 1 includes the membrane ventricular septal and adjacent aortic sinus, region 10 is the junction between the ventricular septal and the left ventricle, and regions 6-9 are flush with and quartered to the "papillary muscle" plane. 2. 5, 6, 9 are close to the conduction beam, which is the secondary irradiation zone, the irradiation dose is small, 3, 4, 7 and 8 are the core irradiation zone, the irradiation dose is large, and 1 and 10 are the irradiation protection zones, the irradiation dose can be zero.

Like this, this embodiment scheme can realize the effective treatment to hypertrophic obstructive cardiomyopathy through the regional and dose of shining of three irradiation position of accurate control location radiotherapy equipment, realizes three subregion and shines the treatment, further improves treatment security.

Optionally, in an embodiment of the present application, as shown in fig. 2, the radiotherapy apparatus 10 for treating cardiomyopathy based on myocardial positioning may further comprise a data processing device 201. The data acquiring device 101 is further configured to acquire heart rate and/or respiration data of the patient to be treated, for example, acquire heart rate data through a heart rate detecting sensor. The data processing device 201 is configured to generate an irradiation position adjustment parameter based on the ventricular interval myocardial image, the heart rate and/or the respiration data. In the present embodiment, heart rate and/or respiration data of the patient to be treated may also be acquired, and then an irradiation position adjustment parameter is generated based on the ventricular interval myocardial image and the heart rate and/or respiration data, and the irradiation position adjustment parameter is used to fine-tune the irradiation position region, such as the first irradiation position region and/or the second irradiation position region. The control device 103 is configured to control and adjust the first irradiation position area and/or the second irradiation position area of the radiotherapy apparatus based on the irradiation position adjustment parameter. That is, the control device 103 completes the fine adjustment operation of the irradiation position region, so that the accuracy of positioning the irradiation position region during radiation treatment can be improved, and the effectiveness and safety of treatment can be further improved.

Specifically, in an example, the data processing device 201 is configured to determine beating amplitude data of the heart of the patient based on the heart rate and/or the respiration data, and comprehensively determine an irradiation position adjustment parameter based on the beating amplitude data and the ventricular septal myocardium image, so as to implement a fine adjustment operation on the irradiation position area, where a distance between the fine adjustment and the upper, lower, left and right sides is less than 5mm, such as within 3mm, and the like. Therefore, the accuracy of positioning the irradiation position area during radiotherapy can be further improved, and the effectiveness and the safety of the treatment are further improved.

Optionally, in an embodiment of the present application, referring again to fig. 3, the first region 301 is an ellipse, the second region 302 is an elliptical ring, and an area of the first region 301 is larger than an area of the second region 302. Specifically, since the HOCM causes the center of the ventricular septum myocardium 30 to be generally the most hypertrophic part of the ventricular septum and the two end parts to be relatively thinner, the first region 301 is determined to be elliptical, and can cover the most hypertrophic part of the ventricular septum as much as possible, that is, the lesion area as much as possible, thereby achieving better treatment during radiation treatment and improving the effectiveness of the treatment.

Optionally, further, in an embodiment of the present application, a ratio of an area of the first region 301 to an area of the second region 302 is greater than or equal to 90%, for example, 92%,95%, and the like. By setting the area ratio of the two areas, the part with the maximum hypertrophy of the ventricular septum can be covered in a large range, namely the focus area can be covered in a large range, so that the better treatment aim is further achieved during radiotherapy, and the treatment effectiveness is improved.

Optionally, in an embodiment of the present application, a ratio of the irradiation dose of the first irradiation position area to the irradiation dose of the second irradiation position area is greater than or equal to 85%. I.e. the ratio of the irradiation dose of the first region 301 to the irradiation dose of the second region 302 is greater than or equal to 85%, such as 87%,90%, etc. In this embodiment, the radiation dose ratio of the first region 301, i.e., the focal region, to the peripheral region is controlled such that a large radiation dose is mainly located in the focal region, thereby improving the effectiveness and safety of radiotherapy HOCM.

In order to achieve accurate positioning of the ventricular interval irradiation position region by the radiotherapy apparatus and improve the effectiveness and safety of the treatment, optionally, in another embodiment of the present application, the image processing device 102 may be further configured to reconstruct a three-dimensional model of the heart of the patient based on the cardiac image, and obtain images of the myocardium in the ventricular interval based on the three-dimensional model of the heart.

Illustratively, the image processing device 102 performs three-dimensional reconstruction of one or more cardiac images of the patient, for example, based on 3D reconstruction techniques, to obtain a three-dimensional model of the heart, and then obtains images of the ventricular septum myocardium based on the three-dimensional model of the heart. The heart three-dimensional model obtained through the 3D reconstruction technology can more accurately represent the heart structure size of a patient, so that ventricular interval myocardial images can be more accurately obtained, further, when the ventricular interval myocardial images are used for controlling, positioning and zoning to irradiate, ventricular interval irradiation position areas can be accurately positioned, and effectiveness and safety of radiotherapy equipment in treating HOCM (HoCM) are improved. For the 3D reconstruction technique, various existing 3D reconstruction techniques can be referred to, and this is not limited in this embodiment.

The scheme of the embodiment of the present application is described below with reference to a specific embodiment. This embodiment provides an accurate radiotherapy equipment to hypertrophic obstructive cardiomyopathy HOCM to reach the purpose of having not having the room interval of noninvasive ablation HOCM, improve HOCM patient's symptom, reduce the sudden death risk, and guarantee the security of treatment through the subregion irradiation. The HOCM treatment equipment which is noninvasive, safe, high in repeatability and good in effectiveness is provided clinically at present.

The scheme of the embodiment adopts Stereotactic Body Radiotherapy (SBRT) equipment to realize ventricular septal myocardial radiotherapy and generate good clinical effect. The stereotactic radiotherapy equipment utilizes a highly accurate radiotherapy technology to focus a radical high radiotherapy dose to the position of a focus in a body in an external irradiation mode, so that the aim of eliminating the focus is fulfilled, and surrounding normal tissues are not damaged as much as possible. In the embodiment, a stereotactic radiotherapy technology is fused with an electrocardio/image technology, an accurate radiotherapy scheme aiming at the hypertrophic obstructive cardiomyopathy without wound is creatively provided, and a treatment target area is definitively provided by adopting 'three-subarea irradiation' to ensure the safety of treatment operation.

Specifically, the scheme of the embodiment realizes three-partition irradiation based on the ventricular septal myocardium image, partitions the ventricular septal myocardium for radiation treatment, and ensures the safety of the radiation treatment. Illustratively, as shown in fig. 3, the hypertrophy cell compartment 30 is identified, the first region 301 is a radiotherapy "core irradiation region", which is a target radiotherapy ablation region, and the irradiation energy is concentrated in a region around 10mm around the center of the hypertrophy region; the second region 302 is a "secondary irradiation region", which is a potentially affected region for radiotherapy, and is a region extending about 5mm to the periphery of the first region 301; the third region 303 is a "deliberately protected region" containing the critical conduction bundle, papillary muscle, etc. cardiac structures, and in order to deliberately avoid the radiation region, the upper edge of the region is not covered by the "membrane", i.e. the region does not extend upward beyond the membrane compartment, the right edge does not cover the "sinus", i.e. the region does not extend rightward beyond the periphery of the coronary sinus, and the left edge does not illuminate the "breast", i.e. the region does not extend leftward beyond the papillary muscle region.

Furthermore, a respiration and heart rate correction technology is adopted in treatment, for example, each irradiation position area is finely adjusted based on the irradiation position adjustment parameters, namely, fine adjustment is carried out on a treatment target area, and noninvasive accurate radiotherapy ablation chamber intervals are realized.

The applicant verifies that the scheme is safe and feasible on the basis of repeated animal tests, combines a large number of conventional cardiac CT, MR and interventional image researches, overcomes the technical difficulty that the heart rate, the respiration and the like influence the accurate positioning of ventricular interval radiotherapy, successfully implements the global first HOCM noninvasive accurate radiotherapy operation, shows that the first patient has obviously improved symptoms and activity tolerance after 6 months of operation, has good safety, does not have complications such as conduction block and the like, and shows that the strain rate of a treatment area is obviously reduced by cardiac ultrasound.

The main problems of previous surgical treatments of HOCM: the scheme of the embodiment of the application is based on ventricular septal myocardial partition radiotherapy, so that the technology has high safety, the treatment effectiveness is considered, and noninvasive, low-risk, repeatable and easy-to-operate treatment is realized.

Another embodiment of the present application provides a radiotherapy apparatus for treating cardiomyopathy based on myocardial location, which may be a stereotactic radiotherapy apparatus, comprising: data acquisition means for acquiring a cardiac image of a patient to be treated; image processing means for determining an interventricular myocardium image based on the cardiac image; the control device is used for controlling and positioning the irradiation position area and the irradiation dose of the radiotherapy equipment based on the ventricular septal myocardium image; the irradiation position area comprises a fourth irradiation position area, a fifth irradiation position area, a sixth irradiation position area and a seventh irradiation position area, the fourth irradiation position area, the fifth irradiation position area, the sixth irradiation position area and the seventh irradiation position area are sequentially and continuously distributed along the longitudinal direction of the ventricular septum myocardium shown in the ventricular septum myocardium image, the boundary position of the fifth irradiation position area and the sixth irradiation position area is located in the middle position of the longitudinal direction, the fourth irradiation position area is located at the boundary position of the ventricular septum myocardium and the ventricle, the seventh irradiation position area is located at the boundary position of the ventricular septum myocardium and the ventricle, the irradiation dose of the fifth irradiation position area is greater than that of the fourth irradiation position area, and the irradiation dose of the sixth irradiation position area is greater than that of the seventh irradiation position area.

It is understood that, in the present embodiment, reference may be made to the detailed description in the above embodiment shown in fig. 1 for the data acquisition device, the image processing device, and other parts not shown, which are not described herein again. Illustratively, as shown in fig. 6 and 7, the irradiation position areas in this embodiment are different, and the cross section divides the ventricular septal myocardium 30 into 4 areas 1-4, the fifth irradiation position area 2 and the sixth irradiation position area 3 are core irradiation areas and have a large irradiation dose, and the fourth irradiation position area 1 and the seventh irradiation position area 4 are ventricular septal myocardium and ventricular junction areas and serve as irradiation protection areas and have a small irradiation dose.

In the embodiment, the radiotherapy equipment is applied to treatment of hypertrophic obstructive cardiomyopathy, the irradiation position area and the irradiation dose of the radiotherapy equipment are controlled and positioned based on the ventricular septal myocardium image of the heart of a patient, the ventricular septal myocardium is treated in a partition radiotherapy irradiation mode, and the method is noninvasive, low in risk, good in safety, capable of performing individualized treatment on different patients based on the heart image, high in repeatability and simple to operate.

It should be noted that although in the above detailed description several modules or units of the device for action execution are mentioned, such a division is not mandatory. Indeed, the features and functionality of two or more modules or units described above may be embodied in one module or unit, according to embodiments of the application. Conversely, the features and functions of one module or unit described above may be further divided into embodiments by a plurality of modules or units. The components shown as modules or units may or may not be physical units, i.e. may be located in one place or may also be distributed over a plurality of network units. Some or all of the modules can be selected according to actual needs to achieve the purpose of the wood-disclosed scheme. One of ordinary skill in the art can understand and implement it without inventive effort.

The embodiment of the present application further provides a radiotherapy method for treating cardiomyopathy based on myocardial localization, which can be implemented based on the radiotherapy device of any of the above embodiments, and specifically, the method can include the following steps:

step 1: acquiring a heart image of a patient to be treated;

step 2: determining a ventricular interval myocardium image based on the cardiac image;

and step 3: controlling and positioning an irradiation position area and an irradiation dose of radiotherapy equipment based on the ventricular septal myocardium image; wherein the irradiation position area comprises a first irradiation position area and a second irradiation position area, the first irradiation position area is a first area of the center position of the ventricular septum myocardium of the heart of the patient, the second irradiation position area is a second area of the ventricular septum myocardium of the heart of the patient, the first area and the second area are not overlapped, the second area surrounds and wraps the first area, and the irradiation dose of the first irradiation position area is larger than that of the second irradiation position area.

Specifically, in step 1, a heart image of a patient to be treated is acquired by the data acquisition device. In step 2, the image processing device determines a ventricular septum myocardial image based on the cardiac image. In step 3, the control device controls and positions an irradiation position area and an irradiation dose of the radiotherapy equipment based on the ventricular septal myocardium image; wherein the irradiation position area comprises a first irradiation position area and a second irradiation position area, the first irradiation position area is a first area of the center position of the ventricular septum myocardium of the heart of the patient, the second irradiation position area is a second area of the ventricular septum myocardium of the heart of the patient, the first area and the second area are not overlapped, the second area surrounds and wraps the first area, and the irradiation dose of the first irradiation position area is larger than that of the second irradiation position area.

In the embodiment, the radiotherapy method based on the radiotherapy equipment is applied to the treatment of hypertrophic obstructive cardiomyopathy, the irradiation position area and the irradiation dose of the radiotherapy equipment are controlled and positioned based on the ventricular septal myocardium image of the heart of the patient, and the ventricular septal myocardium is treated by the regional radiotherapy irradiation mode of the first irradiation position area and the second irradiation position area, so that the method is noninvasive, low in risk, good in safety, capable of performing individualized treatment on different patients based on the heart image, high in repeatability and simple to operate.

In one example, in step 2, the image processing device identifies a ventricular septal myocardium region from the cardiac image, such as an ultrasound contrast image, based on the image identification model, and then performs image segmentation to obtain a ventricular septal myocardium image, i.e., a lesion region image.

For example, the image recognition model may be obtained by training an original image recognition model based on a convolutional neural network in advance based on sample data; the sample data comprises a sample heart image and preset information in the sample heart image, wherein the preset information comprises coordinate position data of a ventricular septal myocardium region in the sample heart image. The specific training process can be understood by referring to the prior art, and is not described in detail herein.

The general image recognition model training is only based on a sample heart image such as an ultrasound contrast image, the preset information of the sample heart image is added for assisting training to obtain the image recognition model, and when the image recognition model is applied to recognizing the heart image of a patient, the ventricular septal myocardial region can be recognized more accurately, so that the subsequently positioned irradiation position region can be more accurate, and the effectiveness and the safety of the radiotherapy hypertrophic obstructive cardiomyopathy are improved.

Optionally, in an embodiment of the present application, the irradiation position area further includes a third irradiation position area, the third irradiation position area includes a third area of the interventricular septum myocardium of the heart of the patient, the third area is located on the upper side and the right side of the second area, an upper edge of the third irradiation position area does not exceed the membraneous septum area of the heart of the patient, a right edge of the third irradiation position area does not exceed the coronary sinus area of the heart of the patient, a left edge of the third irradiation position area does not exceed the papillary muscle area of the heart of the patient, and an irradiation dose of the third irradiation position area is zero.

Optionally, in an embodiment of the present application, the method further includes the following steps:

the data acquisition device acquires heart rate and/or respiratory data of the patient to be treated;

a data processing device generates an illumination position adjustment parameter based on the ventricular interval myocardial image, the heart rate and/or respiratory data;

the control device controls and adjusts the first irradiation position area and/or the second irradiation position area of the radiotherapy equipment based on the irradiation position adjustment parameter.

Optionally, in an embodiment of the present application, the first region is an ellipse, the second region is an elliptical ring, and an area of the first region is larger than an area of the second region; the ratio of the area of the first region to the area of the second region is greater than or equal to 90%.

Optionally, in an embodiment of the present application, a ratio of the irradiation dose of the first irradiation position area to the irradiation dose of the second irradiation position area is greater than or equal to 85%.

Optionally, in an embodiment of the application, the cardiac image is an ultrasound contrast image of a heart of a patient with hypertrophic obstructive cardiomyopathy.

Optionally, in an embodiment of the present application, in step 2, the image processing device performs an image segmentation process on the ultrasound contrast image to obtain an image of the myocardium in the ventricular interval.

Optionally, in another embodiment of the present application, in step 2, the image processing apparatus reconstructs a three-dimensional model of the heart of the patient based on the cardiac image, and obtains an image of the myocardium in the ventricular interval based on the three-dimensional model of the heart.

For the specific implementation content and the technical effects brought by the embodiment of the method, reference may be made to the corresponding description content in the foregoing embodiment of the apparatus, and details are not described here.

It is noted that, in this document, relational terms such as "first" and "second," and the like, may be used solely to distinguish one entity or action from another entity or action without necessarily requiring or implying any actual such relationship or order between such entities or actions. Also, the terms "comprises," "comprising," or any other variation thereof, are intended to cover a non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements does not include only those elements but may include other elements not expressly listed or inherent to such process, method, article, or apparatus. Without further limitation, an element defined by the phrase "comprising a … …" does not exclude the presence of another identical element in a process, method, article, or apparatus that comprises the element.

The above description is merely exemplary of the present application and is presented to enable those skilled in the art to understand and practice the present application. Various modifications to these embodiments will be readily apparent to those skilled in the art, and the generic principles defined herein may be applied to other embodiments without departing from the spirit or scope of the application. Thus, the present application is not intended to be limited to the embodiments shown herein but is to be accorded the widest scope consistent with the principles and novel features disclosed herein.

Claims (1)

1. Radiotherapy equipment for treating cardiomyopathy based on myocardial positioning is characterized by comprising:

data acquisition means for acquiring a cardiac image of a patient to be treated;

image processing means for determining an interventricular myocardium image based on the cardiac image;

the control device is used for controlling and positioning the irradiation position area and the irradiation dose of the radiotherapy equipment based on the ventricular septal myocardium image; the irradiation position area comprises a fourth irradiation position area, a fifth irradiation position area, a sixth irradiation position area and a seventh irradiation position area, the fourth irradiation position area, the fifth irradiation position area, the sixth irradiation position area and the seventh irradiation position area are sequentially and continuously distributed along the longitudinal direction of the ventricular septal myocardium shown by the ventricular septal myocardium image, the boundary position of the fifth irradiation position area and the sixth irradiation position area is located in the middle position of the longitudinal direction, the fourth irradiation position area is located at the boundary position of the ventricular septal myocardium and the ventricle, the seventh irradiation position area is located at the boundary position of the ventricular myocardium and the ventricle, the irradiation dose of the fifth irradiation position area is greater than that of the fourth irradiation position area, and the irradiation dose of the sixth irradiation position area is greater than that of the seventh irradiation position area.

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