CN212880639U

CN212880639U - Vertical self-adaptive radiotherapy system

Info

Publication number: CN212880639U
Application number: CN202020787659.7U
Authority: CN
Inventors: 戴建荣; 李明辉; 牛传猛
Original assignee: Individual
Current assignee: Individual
Priority date: 2020-05-13
Filing date: 2020-05-13
Publication date: 2021-04-06
Anticipated expiration: 2030-05-13

Abstract

The utility model relates to a vertical self-adaptation radiotherapy system, include: simulation positioner, treatment plan design device, vertical treatment device, wherein: the simulation positioning device comprises one or more medical imaging devices and is used for collecting positioning images of patients in horizontal or other body positions; the treatment plan design device comprises an image registration module, an image density setting module, an interested region defining module, an optimization parameter setting module and a dosage calculating module; the vertical treatment device comprises a vertical positioning module, a vertical imaging module and a beam treatment module, and is used for performing posture fixation, online image acquisition and radiotherapy on a patient in a standing or sitting posture. The utility model discloses the dose deviation that the position inconsistent and in the gradation and between the gradation anatomical structure's change brought when fully having considered patient position when the simulation location and treatment has had the significance to improving patient's curative effect.

Description

Vertical self-adaptive radiotherapy system

Technical Field

The utility model relates to a vertical self-adaptation radiotherapy system belongs to medical technical field.

Background

Radiotherapy is carried out on a patient in a standing, sitting or other posture, for example, radiotherapy by using the treatment device described in chinese patent 201921379096.1, before the radiotherapy, simulation positioning and design of an off-line radiotherapy plan are required, but when simulation positioning is carried out, the patient posture is generally in a horizontal posture, so the off-line radiotherapy plan is also designed based on the horizontal posture of the patient, and the dose distribution of the region of interest in the plan is also obtained in the horizontal posture. When the patient is subjected to radiotherapy, because the posture and the posture of the patient are inconsistent with those of the patient during positioning, the posture change can cause the position and the shape of an internal organ (relatively positioned) to be significantly changed, and if the patient is directly treated without correcting an off-line radiotherapy plan, the radiotherapy dose actually received by the region of interest (relatively off-line radiotherapy plan) can be significantly changed. Furthermore, over time during treatment, the target area and the organs at risk may also change in shape and location, which ultimately can lead to significant patient outcome if treatment is performed according to an off-line radiotherapy plan, also resulting in dose variations.

Aiming at the problems, especially dosage influence caused by posture change during positioning and treatment, no solution is available at home and abroad at present.

Chinese patent CN 109771850a discloses a method for correcting adaptive radiotherapy plan, which comprises: acquiring a reference image, a reference sketch, a reference radiotherapy plan and a target image; carrying out image registration on the target image and the reference image to generate a three-dimensional deformation field; generating a fusion image and a target sketch which are the same as the coverage range of the reference image according to the three-dimensional deformation field; determining a two-dimensional deformation field of ray intensity in each beam direction according to the three-dimensional deformation field in the region of interest; deforming the two-dimensional ray intensity distribution in the corresponding beam direction according to the two-dimensional deformation field to generate new two-dimensional ray intensity distribution; and generating corresponding grating and tungsten gate motion data according to the new two-dimensional ray intensity distribution.

The above method assumes that the patient adopts the same horizontal position for both simulated positioning and treatment. When the body positions are different, the coordinate systems of the reference image and the target image are inconsistent, and the two images in the method cannot be directly fused and registered; for the target image which is not a CT image and needs to be set for the image density, the method is not mentioned; in addition, the above-mentioned method of beam optimization based on two-dimensional deformation field may have poor dose distribution and may not meet clinical requirements for patients with large target variation. Therefore, the method is only suitable for the situations that the body position is the same as the body position during positioning and treatment, the deformation degree of the target area is small, and the target image is CT, and is not suitable for the situations that the body position is different, the deformation degree of the target area is large, or the target image is not CT.

SUMMERY OF THE UTILITY MODEL

In order to solve the problem, the utility model provides a vertical self-adaptation radiotherapy system carries out the coordinate system transform through the off-line image that the patient was in horizontal gesture when will simulate the location for off-line image is unanimous with the on-line image coordinate system, and two sets of images are through registering the back, according to the change condition of interesting region shape and position, revises on line, thereby ensures that target area and organs at risk accept correct dose, improves the radiotherapy curative effect.

The technical scheme of the utility model as follows:

a vertical adaptive radiotherapy system comprising: simulation positioner, treatment plan design device, vertical treatment device, wherein:

the simulation positioning device comprises one or more medical imaging devices and is used for collecting positioning images of patients in horizontal or other body positions;

the treatment plan design device comprises an image registration module, an image density setting module, an interested region defining module, an optimization parameter setting module and a dose calculation module, and is used for designing an off-line radiotherapy plan and an on-line adaptive radiotherapy plan of a patient;

the vertical treatment device comprises a vertical positioning module, a vertical imaging module and a beam treatment module, and is used for performing posture fixation, online image acquisition and radiotherapy on a patient in a standing or sitting posture.

Preferably, the image registration module supports images of different postures and modalities to perform coordinate system conversion, and can perform rigid or flexible registration to generate a deformation matrix.

Preferably, the medical imaging device comprises CT, nuclear magnetic and/or ultrasound.

The utility model discloses a vertical self-adaptation radiotherapy system carries out the radiotherapy according to following step:

s1: acquiring a patient positioning image for a patient in a horizontal or other body position by using a simulation positioning device;

s2: designing an off-line radiotherapy plan for the patient using a treatment plan designing apparatus;

s3: the vertical positioning module in the vertical treatment device is used for carrying out posture fixing and positioning on the patient in a standing or sitting posture;

s4: acquiring a pre-treatment image of a patient by using an online imaging module in the vertical treatment device;

s5: according to the change conditions of the shape and the position of the region of interest before treatment and during positioning of the patient, carrying out online correction;

s7 performing the therapy using the beam therapy module in the vertical therapy device.

Preferably, the online modification in step S5 includes one or more of the following steps:

SS 1: registering the pre-treatment image with the positioning image;

SS 2: no correction is made;

SS 3: only the positioning error is corrected;

SS 4: designing an online adaptive radiotherapy plan;

the specific implementation mode is as follows: judging the change situation of the shape of the region of interest through the step SS1, and if the change situation exceeds the allowable range, implementing the step SS 4; if the position of the region of interest is within the allowable range, the change of the position of the region of interest is judged by the step SS1, if the position is beyond the allowable range, the step SS3 is carried out, and if the position is within the allowable range, the step SS2 is carried out.

Preferably, said registering comprises: firstly, a coordinate system of a positioning image is converted into a coordinate system consistent with a pre-treatment image, then, rigid or flexible registration is carried out on the two sets of images, the change condition of the shape and the position of an interested region is obtained, and a deformation matrix is generated.

Preferably, step SS4 includes the steps of:

SSS 1: setting the image density;

SSS 2: defining a region of interest;

SSS 3: setting a field parameter;

SSS 4: calculating the dosage;

SSS 5: and (4) planning and evaluating.

Preferably, the step SSS1 is implemented by directly mapping the density of the positioning image onto the pre-treatment image through a deformation matrix; or by defining the density of the regions of interest.

Preferably, the step SSS2 is implemented by automatically transforming the region of interest in the offline radiotherapy plan into the region of interest in the online adaptive radiotherapy plan through a transformation matrix; or by manually modifying or redrawing the region of interest.

Preferably, which kind of region of interest definition is specifically selected in the step SSS2 depends on the accuracy of region of interest delineation; and if the accuracy of the region of interest automatically generated through the deformation matrix cannot meet the clinical requirement, modifying or redrawing the region of interest manually.

Preferably, the step SSS3 is implemented by automatically converting the field parameters in the offline radiotherapy plan into the field parameters in the online adaptive radiotherapy plan according to the change condition of the region of interest; or the optimization parameters of the off-line radiotherapy plan are modified manually to carry out plan optimization again.

Preferably, which way to set the portal parameter is specifically selected in the step SSS3 depends on whether the plan quality evaluation can meet the clinical requirement; and if the plan quality of the radiation field parameters automatically generated through the deformation matrix cannot meet the clinical requirement, modifying the optimization parameters of the off-line radiotherapy plan in a manual mode, and carrying out plan optimization again.

The beneficial effects of the utility model reside in that provide an adaptive radiotherapy system for standing, sitting or the patient of other position gestures, the dose deviation that the position probably is inconsistent and in the gradation and the change of organs between the gradation and brought has been fully considered patient position when simulation location and treatment, has the significance to improving patient's curative effect, simultaneously the utility model discloses realize above-mentioned technique based on existing equipment, reduced equipment cost.

Drawings

In order to make the technical solution and the advantageous technical effects of the present invention easier to understand, the present application is described in detail with reference to the embodiments of the present invention shown in the accompanying drawings. The appended drawings depict only typical embodiments of the invention and are not therefore to be considered to limit its scope, for the invention may:

FIG. 1 is a flow chart of the vertical adaptive radiotherapy method of the present invention;

FIG. 2 is a schematic view of an off-line image acquisition using an analog positioning device;

figure 3 is a flow chart for planning an offline radiotherapy plan using the treatment plan planning apparatus;

FIG. 4 is a schematic illustration of positioning a patient using the vertical positioning module;

FIG. 5 is a schematic illustration of acquiring a pre-treatment image of a patient using a vertical imaging module;

FIG. 6 is an online correction flow chart;

FIG. 7 is a flow chart of an online adaptive radiotherapy planning process;

figure 8 is a schematic diagram of treatment implemented using a beam therapy module.

Detailed Description

The present invention will be described in further detail with reference to the accompanying fig. 1-8.

As shown in fig. 1-8, the vertical adaptive radiotherapy system of the present invention comprises: a simulation positioning device 1, a treatment plan designing device, and a vertical treatment device shown in fig. 2, wherein: the simulation positioning device comprises one or more medical imaging devices and is used for acquiring positioning images of patients in horizontal or other body positions, such as CT (computed tomography), nuclear magnetism, ultrasound and other devices; the treatment plan design device comprises an image registration module, an image density setting module, a region of interest defining module, an optimization parameter setting module and a dose calculating module, and is used for designing an off-line radiotherapy plan and an on-line adaptive radiotherapy plan of a patient. The image registration module, the image density setting module, the region of interest defining module, the optimization parameter setting module and the dose calculation module are processing modules existing in the prior art, and can be selected and used by a person skilled in the art according to needs.

The vertical treatment apparatus comprises a vertical positioning module 2 as shown in fig. 4, a vertical imaging module 3 as shown in fig. 5 and a beam treatment module 4 as shown in fig. 8 for postural fixation, on-line image acquisition and radiotherapy of a patient in a standing or sitting posture. The vertical therapeutic device can adopt the structure disclosed in the Chinese patent application CN105268120A (a barrel type supporting and fixing method and a device for radiotherapy patients).

The image registration module supports images of different body positions and modes to perform coordinate system conversion, and can perform rigid or flexible registration to generate a deformation matrix. For example, for the coordinate system conversion, the coordinates X1, Y1, and Z1 of each pixel in the CT image of the patient can be converted by programming through the matlab third-party program, and the specific conversion method is as follows: for example, when the patient is in a lying posture, assuming that the coordinate of the head and foot direction is Z1, the coordinate of the left and right direction is X1, and the coordinate of the front and back direction is Y1, and when the patient is in a standing posture, assuming that the coordinate of the head and foot direction is Y2, the coordinate of the left and right direction is X2, and the coordinate of the front and back direction is Z2, the coordinate of each pixel in the CT image of the patient lying on the bed is reassigned, wherein Y2 is Z1, X2 is X1, and Z2 is Y1. Rigid registration, flexible registration, and deformation matrices are prior art.

The principle of the vertical self-adaptive radiotherapy method of the utility model is as follows: the patient is in a lying posture, and a patient positioning image is acquired by using the simulation positioning device 1 (figure 2); guiding the positioning image into a treatment plan design device, setting the positioning image density, manually drawing an interested region, manually setting optimization parameters, generating a field parameter through optimization, obtaining dose distribution after calculating the dose, and completing off-line radiotherapy plan design after plan evaluation meets clinical requirements (figure 3); the patient is in a standing or sitting posture, and the patient is positioned by using the vertical positioning module 2 (figure 4); acquiring an online image of a patient through the vertical imaging module 3 (fig. 5); and (3) introducing the online image into a planning system, converting a coordinate system of the offline image into a coordinate system consistent with the online image, then carrying out rigid and flexible registration on the offline image and the online image, observing the shape change degree of the region of interest in the offline image and the online image, evaluating the position change condition of the region of interest if the difference between the offline image and the online image is in an allowable range, carrying out radiotherapy by using the original plan if the difference between the offline image and the online image is in the allowable range, and carrying out radiotherapy after repositioning correction if the difference between the offline image and the online image is beyond the allowable range. If the shape change degree of the interested region in the off-line image and the on-line image exceeds the allowable range, executing on-line adaptive radiotherapy planning (figure 6); designing an online self-adaptive radiotherapy plan, firstly, directly mapping the density of an offline image to an online image through a deformation matrix to generate the electron density of the online image. And then automatically deforming the region of interest in the off-line radiotherapy plan into the region of interest in the on-line adaptive radiotherapy plan according to the deformation matrix. And observing the accuracy of the region of interest delineation, and if the clinical requirement cannot be met, modifying or redrawing the region of interest in a manual mode until the clinical requirement is met. Automatically converting the radiation field parameters in the off-line radiotherapy plan into the radiation field parameters in the on-line adaptive radiotherapy plan according to the shape change of the region of interest during positioning and positioning, evaluating the plan quality after calculating the dose, modifying the optimized parameters of the off-line radiotherapy plan in a manual mode if the clinical requirement is not met, and re-optimizing the plan until the plan meets the clinical requirement (figure 7). The online adaptive radiotherapy plan is delivered into the beam therapy module 4 to deliver the treatment (fig. 8).

The invention can be embodied in other specific forms without however departing from the scope of protection of the invention, which is limited only by the accompanying claims.

Claims

1. A vertical adaptive radiotherapy system comprising: simulation positioner, treatment plan design device, vertical treatment device, its characterized in that:

the simulation positioning device comprises one or more medical imaging devices and is used for collecting positioning images of the patient in a horizontal, standing or sitting-standing position;

the vertical treatment device comprises a vertical positioning module, a vertical imaging module and a beam treatment module, and is used for performing posture fixation, online image acquisition and radiation on a patient in a standing or sitting posture.

2. The vertical adaptive radiotherapy system of claim 1, wherein the image registration module supports coordinate system transformation of images of different postures and modalities, and can perform rigid or flexible registration to generate a deformation matrix.

3. The vertical adaptive radiotherapy system of claim 1 or 2, wherein the medical imaging device comprises CT, nuclear magnetism and/or ultrasound.