CN216653158U

CN216653158U - Positioning device and tomography imaging system

Info

Publication number: CN216653158U
Application number: CN202120685023.6U
Authority: CN
Inventors: A.卢克; B.乔维克
Original assignee: Siemens Healthineers AG
Current assignee: Siemens Healthineers AG
Priority date: 2020-04-06
Filing date: 2021-04-02
Publication date: 2022-06-03
Anticipated expiration: 2031-04-02
Also published as: DE202020101880U1

Abstract

The present invention relates to an apparatus for positioning a patient for medical imaging for radiation therapy planning and a tomographic imaging system. The device comprises an elongated plate-like base part having a support surface for supporting the patient in the calculus removal position. Corresponding rails for receiving a holder device for supporting the legs of a patient in the stone-removal position are provided on the base part. The device can be arranged on a patient bed or a bed device fixed on the patient bed and can be slid and locked relative to the patient bed or the bed device in the longitudinal direction. At least one sliding bar is arranged on the flat underside of the base part in the longitudinal direction of the base part, said sliding bar providing a sliding support of the base part in the longitudinal direction on a flat surface of a patient bed or a bed plate arrangement.

Description

Positioning device and tomography imaging system

Technical Field

The present invention relates to a positioning device for positioning a patient for medical imaging for radiation therapy planning and a tomographic imaging system.

Background

In radiation therapy, also known as radiotherapy, ionizing radiation is applied to a patient to cure a disease or delay the progression of a disease. One form of radiotherapy is brachytherapy, in which an enclosed radioactive ray source is placed in or in close proximity to the area to be irradiated within the patient, for example by means of a corresponding guide, a so-called applicator. With the aid of a medical imaging system, a diagnosis can be derived and the region to be irradiated can be determined. Furthermore, the correct position of the applicator can be checked by the medical imaging system. Particularly suitable as medical imaging systems are tomographic imaging systems, such as computed tomography, magnetic resonance tomography or positron emission tomography. In particular, in the treatment of gynecology, urology and recta, it may be necessary and advantageous to support the patient in a so-called colectomy position (steinschnittage, or colectomy position). The patient should not be repositioned between the examination of the patient by the imaging system and the brachytherapy to avoid movement of the area to be irradiated and/or the applicator.

The brachytherapy can be carried out, for example, on a table specifically provided for this purpose, or a corresponding adaptation of an existing patient couch can be carried out. A holding device for fixing the patient in the lithotomy position, for example, can be provided on the table or on the bed, for example. For medical imaging, the table or couch can be designed such that the patient can be moved directly into a tunnel, the so-called gantry, of the imaging system, or the table or couch can comprise a couch board (Liegenbretter). The couch plate may be transferred together with the patient and the holding device to a table of an imaging system.

In connection with this, patent document EP 3498248 a1 discloses a patient trolley and a patient transfer device. The patient cart is designed for transporting a patient to a target device, such as a medical imaging system. The patient cart includes an upper section having an upper surface and a projection area along at least one side of the upper section, a lower section carrying the upper section, and a side rail connected with the upper section for movement between a removed position and an moved-in position. The patient cart is designed such that it can be docked alongside the target device such that the reach area can extend over at least a portion of the target device. The patient cart may be combined with a patient transfer device to more easily transfer a patient from the upper side of the patient cart onto the patient support surface of the target device. The patient transfer device has a hose connection to receive air from one end of the hose. The opposite end of the hose is connected to an air source to provide an air bearing for the patient transfer device that enables transfer of the patient from the surface of the patient cart to the target device.

SUMMERY OF THE UTILITY MODEL

The object of the utility model is to improve the positioning of a patient for medical imaging for radiation therapy planning.

The object is achieved by a positioning device for positioning a patient for medical imaging for a radiation therapy planning and a tomographic imaging system.

A positioning device for positioning a patient for medical imaging of a radiation therapy plan comprises an elongated plate-like base part (or base) having a support surface for supporting the patient. Radiation treatment planning may include, for example, planning and/or administering of brachytherapy. The positioning device further comprises two rails which are disposed on the base part and extend in the longitudinal direction of the base part and perpendicularly to the supporting surface. The positioning device further comprises first and second guide means. The first guide means is disposed on a first longitudinal side of the base member and the second guide means is disposed on a second longitudinal side of the base member. The first longitudinal side and the second longitudinal side are mutually opposite sides of the basic element. The first and second guides are each engageable with a corresponding longitudinal guide on a patient couch of the medical imaging apparatus. The guide devices can in particular engage with the respective longitudinal guides in such a way that they can slide (or move) in the longitudinal direction. The positioning device further comprises a locking device which can be engaged with a recess arranged on the patient bed in order to selectively prevent a sliding movement of the base part relative to the patient bed in the longitudinal direction by means of the locking device.

The patient can be supported and fixed on a plate-shaped base part and can be moved together with the plate-shaped base part in the longitudinal direction relative to the patient bed by means of a first and a second guide device. This makes it possible, on the one hand, without resetting, to place the patient in a position in which the treating physician can, for example, insert an applicator for brachytherapy and, on the other hand, to place the patient in a position in which, for example, medical imaging can take place in the computer tomography apparatus.

The at least two rails can be designed to accommodate a holder device (Halteb ü gelvorrichtung) for supporting the leg of the patient in the stone resection position. For example, a respective holder device can be provided on each of the at least two rails, which holder device holds the patient's leg in the stone resection position. The holder device may have a strap for securing the patient's leg. Such a holding device is also referred to as a Stirrup (Stirrup).

In one embodiment, the first and/or second guide device may comprise a holding corner piece which extends from the base piece in such a way that it forms a U-shaped structure in combination with the base piece. For example, a respective holding corner fitting can be provided on each longitudinal side of the plate-shaped base part, which holding corner fitting extends in the direction of the lower side of the base part, i.e. opposite the bearing surface of the base part. The holding corner pieces can together with the underside of the base piece form a U-shaped structure which can at least partially surround a corresponding longitudinal guide on the patient bed. The U-shaped structure can surround, for example, a longitudinal guide on the patient bed from the side, so that the base part can be slid in the longitudinal direction relative to the patient bed, but in conjunction with a corresponding longitudinal guide on the patient bed ensures that upward (in the direction of the support surface) and downward (in the direction of the underside of the base part) movements are prevented. This makes it possible for the base part to project at least partially out of the patient bed in the longitudinal direction without tilting it away from the patient bed. In the position in which the base part projects at least partially out of the patient bed, the doctor can more easily access the patient proximally from the foot side.

In another embodiment, the patient bed includes a bed plate arrangement. The couch device includes a couch for supporting a patient. The couch plate can be attached to the patient couch in a stationary manner. The above-mentioned guide device, in particular the U-shaped structure formed together with the base part, can engage with a corresponding longitudinal guide on the bed plate device, for example a longitudinal edge of the bed plate. Through set up the bed board device between positioner and patient's bed, can use positioner and different patient beds jointly, and need not to propose special requirements to the patient bed. The bed plate device can be, for example, the bed plate device disclosed in patent document DE 202018003540.8.

The base member may have a length in the range of 100cm to 250cm, for example about 150cm, and a width in the range of 40cm to 80cm, for example about 53 cm.

In one embodiment, at least one sliding strip is arranged in the longitudinal direction of the base part on a flat underside of the base part opposite the support surface. The sliding bar provides a sliding support of the base part in the longitudinal direction on a flat surface of the patient bed. The plate-shaped base part can thus be placed flat (or planar) on the patient bed or on the bed arrangement described above, for example, and can be slid easily in the longitudinal direction onto the patient bed or bed arrangement by means of the one or more longitudinal sliding strips. For example, two or more sliding strips can be arranged on the underside of the base part, which strips extend parallel to the longitudinal direction of the base part. The sliding strip can be made of plastic, for example, and has a low coefficient of friction. The sliding friction coefficient between the sliding strip and a typical surface of the patient bed or the bed plate arrangement may be in the range of 0.1 to 0.4, for example. In addition, a sliding strip can also be provided on the surface of the patient bed or couch arrangement opposite the sliding strip of the positioning device in order to reduce the friction between the positioning device and the patient bed or couch arrangement. The use of a slide bar makes it easier for the operator to move the patient arranged on the positioning device in the longitudinal direction. Furthermore, the slide bars make it possible to distribute the weight force of the patient uniformly over a large area on the patient bed or bed plate arrangement, so that no local high loads occur on the patient bed or bed plate arrangement. As an alternative to the sliding strip, a plurality of ball bearings or roller bearings arranged on the underside of the positioning device can also be used.

In a further embodiment, the operating element of the at least one locking device is arranged on the bearing surface. The locking device acts on the underside of the positioning device in order to engage in a recess provided on the patient couch or on the couch plate arrangement. However, the actuating element can preferably be arranged on the upper side of the positioning device, i.e. on the support surface, so that the locking device can be actuated simply from above, for example when a patient is arranged on the positioning device.

The base member of the positioning device has a first end and an opposite second end along a longitudinal direction. The first end may be, for example, the end of the positioning device where the legs or feet of the patient are usually arranged, while the second end may be, for example, the end of the positioning device where the head of the patient is usually arranged. The at least two rails are arranged at a first end, i.e. foot side. The first and second guide means are arranged on the second end, i.e. the head end. By arranging the first and second guide devices on the second end, the positioning device can be moved in the direction of the foot-side end beyond the end of the patient bed or couch board arrangement. The first and second guide means on the second end also provide a reliable, in particular tilt-proof, guidance and fixing of the positioning device in this position.

The base part can be designed in particular in the examination region between the first end and the second end in such a way that it makes it possible or does not influence the generation of diagnostic images, for example due to artifacts (artifacts). The base part can, for example, have no metal in the examination region. When the patient is usually supported in the lithotomy position on the positioning device, the region of interest for the examination patient is usually viewed in the longitudinal direction between the two rails on the first end on the foot side and the guide on the second end on the head side. Interference-free examinations, in particular in computed tomography systems, for example, can be carried out by means of the artifact-free examination region. The examination zone may have a length in the longitudinal direction, for example in the range of 30cm to 80cm or even outside said range. The examination zone preferably has a length of 55cm, for example.

In a further embodiment of the positioning device, a recess (or recess) can be provided between the at least two rails on the first end, i.e. on the foot side. The recess may for example have a width of at least 20cm, preferably at least 30cm, and a length of at least 15cm in the longitudinal direction of the base element. The recess may be semicircular in shape, for example, at least in one region and may have a length of 28cm and a width of 31cm, for example. The treating physician can better access the lower torso region of the patient arranged in the lithotomy position on the positioning device via this recess, for example, in order to position the applicator during brachytherapy.

In a further embodiment of the positioning device, the fastening device is arranged on the opposite longitudinal side of the base part. The fixing device is designed for fixing at least one patient fixing strap for fixing a patient. The fixing device can, for example, comprise corresponding longitudinal grooves on the longitudinal sides of the base part, into which the ends of the patient fixing strap can be inserted. A secure fixation of the patient on the positioning device is thereby achieved, so that changes in the patient's arrangement between medical imaging, radiation therapy planning and radiation therapy delivery can be prevented.

As already mentioned, the positioning device can be used in particular in combination with a couch plate device which is attached to the patient couch or is designed as a component of the patient couch. In other words, according to one embodiment, the patient bed may comprise a bed plate arrangement. The couch device includes a couch for supporting a patient and a reference position system for providing a reference position relative to the couch. When the positioning device is used, the patient is not supported directly on the bed board, but indirectly, i.e. the patient lies on the positioning device and the positioning device is in turn located on the bed board. The reference position system has an arrangement of recesses on a first longitudinal side of the bed and a further arrangement of recesses on a second longitudinal side of the bed opposite the first longitudinal side. At least one locking device is designed in such a way that it can be selectively engaged with a recess on the bed plate. The positioning device can thus slide in the longitudinal direction along the bed plate when the locking device is unlocked and can be coupled to the bed plate in a positionally fixed manner when the locking device is locked. The reference position system allows an easy and reliable repeatable displacement into a defined position on the bed, so that, for example, the patient can be first displaced into a first position in which medical imaging is carried out for the radiation treatment planning, and then into a second position in which, for example, the applicator is inserted and can then be displaced back into the first position in order to check whether the applicator is inserted into the desired position. The radiation treatment can then take place in the first position, in the second position or in any other position which is, for example, advantageously suitable for an (automatic) input radiation source.

The tomography imaging system comprises a computer tomography device, a patient couch and the positioning device.

The features mentioned above and further features described below can be used not only in the respective combinations specified in detail but also in other combinations or individually without exceeding the scope of the utility model.

Drawings

The present invention is described in detail below with reference to the accompanying drawings.

Fig. 1 shows a schematic perspective view of a patient bed with a positioning device according to an embodiment of the utility model;

fig. 2 shows a schematic side view of a patient bed with a positioning device according to an embodiment of the utility model;

FIG. 3 schematically illustrates a perspective view of an upper side of a positioning device according to an embodiment of the present invention;

FIG. 4 schematically illustrates an upper side perspective view of a foot-side end of a positioning device, in accordance with an embodiment of the present invention;

FIG. 5 schematically illustrates a perspective view of the underside of a positioning device in accordance with an embodiment of the present invention;

FIG. 6 schematically illustrates a partial view of the underside of the cephalad end of the positioning device in accordance with an embodiment of the present invention;

fig. 7 schematically shows a perspective partial view of a fixing device on a longitudinal side of a positioning device according to an embodiment of the utility model.

Detailed Description

The foregoing features, characteristics and advantages of the present invention and the manner of attaining them will become more apparent and be better understood by reference to the following description of embodiments of the utility model, which are set forth in detail in connection with the accompanying drawings.

The utility model is explained in more detail below with reference to the drawings according to a preferred embodiment. In the drawings, like reference characters designate the same or similar elements. The figures are schematic views of different embodiments of the utility model. The elements shown in the figures are not necessarily shown to scale. But rather the different elements shown in the figures are presented so that one of ordinary skill in the art can appreciate the function and general purpose of the elements. The connections and couplings shown in the figures between functional units and elements may also be implemented as indirect connections or couplings.

The embodiments described below represent a way of enabling a user, for example a doctor or a medical person, to place a patient in a so-called calculus removal position and to analyze the pelvis or lower torso region of the patient by means of medical imaging. The images thus acquired may be used for diagnosis and treatment planning (or treatment planning), for example treatment planning for brachytherapy. Furthermore, the various embodiments present ways of enabling the corresponding treatment to be carried out.

Fig. 1 schematically shows a perspective view of a patient table 20, which is used, for example, in conjunction with a medical imaging device. The medical imaging device may be, for example, a computed tomography device (CT) operating with X-rays, or a magnetic resonance tomography device (MRT) or a positron emission tomography device (PET). The patient table 20 comprises a carrier 21 and a patient bed 22 which can be slid thereon in a

longitudinal direction

23, 24. The patient couch 22, together with the patient arranged thereon, can be moved at least partially into a tunnel opening of the computer tomography apparatus along a direction 24 and out of the tunnel opening along a direction 23, for example.

The couch top 25 may be fixed to the patient couch 22. The couch top 25 may be designed as an attachment to the patient couch 22 or integrated with the patient couch 22. The bed arrangement 25 essentially comprises a flat bed 26 with a reference position system 27 for providing a reference position relative to the bed 25. The reference position system 27 is formed by an arrangement of recesses on both longitudinal sides of the bed plate 26. The recesses can be arranged, for example, equidistantly at a distance of a few centimeters, for example 5cm to 10cm, along the longitudinal sides of the bed 26. The bed plate device 25 can be produced, for example, from carbon fiber-reinforced plastic and has further features, for example, a guide rail for attaching a patient securing strap, which is not shown in detail in fig. 1 for reasons of clarity of illustration. The bed board 26 has a substantially flat surface on which the positioning device 30 is arranged.

The positioning device 30 comprises a plate-like base member 31 having an upper side and a lower side. The upper side of the plate-shaped base part 31 forms a support surface for supporting a patient. On the upper side of the base part 31, a mat 32 can be attached, for example. The positioning device 30 also comprises two

rails

33 and 34, which are disposed on the foot side in the longitudinal direction on the end of the positioning device 30 (the end on the left in fig. 1). As shown in fig. 1, positioning device 30 may point in direction 23 with the foot side. However, it is also conceivable for the positioning device to point with the foot side in the direction 24 and to support the patient behind the imaging device 50 for examination.

Fig. 2 schematically shows a patient table 20 in combination with a medical imaging apparatus 50. The medical imaging device has a tunnel-like opening 51 in which the examination region is located and into which a patient 60 can be moved at least partially together with the patient bed 22. The bed plate 26 of the bed plate arrangement 25 is located on the patient bed 22, and the plate-shaped base part 31 of the positioning device 30 is located on the bed plate 26. In the side view shown in fig. 2, only the rail 33 is visible and the rail 34 behind the rail 33 is hidden from view. A respective holder device 70, for example with clamping

blocks

71, 72, can be fastened to each of the

rails

33, 34. The holder device 70 can be designed such that it holds the leg of the patient 60 in the stone resection position when the patient 60 is arranged lying on the back on the base part 31.

Fig. 3 shows a perspective view of the upper side of the positioning device 30. The plate-shaped base part 31 can be logically divided into three

regions

35, 36 and 37. The boundaries of the three

regions

35, 36 and 37 are indicated by dashed lines in fig. 3. Viewed in the longitudinal direction of the base part 31, the first region 35 is located on the foot side at a first end of the base part 31, the third region 37 is located on the head side at a second end of the base part 31 opposite the first end, and the second region 36 is located between the first region 35 and the third region 37.

The positioning device 30 can be slid into different positions. For example, the base part 31 can be placed on the table arrangement 25 over the entire surface, i.e. all three regions 35 to 37 are placed on the table arrangement 25, in order to examine the patient 60 by the imaging device 50. Based on the information acquired during imaging, the physician can determine the position of the applicators, for example for brachytherapy, and place these applicators in the appropriate position in the patient 60. To achieve or simplify this, the base part 31 can be slid in the direction 23 at least partially out of the edge of the bed arrangement 25. After insertion of the applicator, the base part 31 can be slid back into the inspection position in the direction 24 again in order to check the correct position of the applicator when imaging is subsequently carried out by the imaging device 50. This may be followed by brachytherapy.

The two

rails

33, 34 are fixed in a first region 35 in the longitudinal direction of the base part 31, i.e. parallel to the respective longitudinal sides of the base part 31. The

rails

33, 34 can be fastened, for example, to corresponding corner pieces or blocks which are designed integrally with the base part 31 or are attached thereto. A recess 44 may be provided in the base member 31 between the

rails

33, 34. The recess 44 may, for example, have a width of 20cm to 40cm, for example 31cm, and a length of 20cm to 50cm, for example 28cm, in the longitudinal direction of the base part 31. The notch 44 can improve contact with the lower torso or pelvic region of the patient when the patient is disposed on the positioning device 30 in the stone resection position.

In the third region 37, i.e. the head-side end of the base part 31, a guide 38 can be provided on the longitudinal side of the base part 31. The guide device 38 can extend from the base part 31 in the downward direction, i.e., for example vertically downward, in order to thereby achieve lateral guidance of the base part 31 relative to the bed board arrangement 25. For example, one or more corresponding guides 38 may be provided on each longitudinal side of the base part 31. The guide 38 keeps the base part 31 in the path in the longitudinal direction, so that the base part 31 cannot twist and therefore is skewed during sliding. The guide 38 thus enables the base part 31 to be displaced relative to the bed arrangement 25 only in the

longitudinal direction

23, 24. The guide 38 can also be formed as a U-profile (or U-profile) in conjunction with the underside of the base part 31, so that the bed 26 is at least partially enclosed by the guide 38. This prevents the positioning device 30 from falling out of the bed 26 when the base part 31 is slid out of the bed 26 in the direction 23 relative to the bed 26, so that only the third region 37 still covers the bed 26.

In the third region 37, a locking device 40 can also be provided, which is arranged on a longitudinal side of the base part 31. For example, a respective locking device 40 can be provided on each of the two longitudinal sides of the base part 31. The respective locking device 40 can engage in a corresponding recess of the reference position system 27 of the table arrangement 25. The bolt of the locking device 40 can engage laterally, for example, into a corresponding recess of the reference position system 27. Thereby establishing a locked state. In the locked state, the base part 31 cannot be moved in the

direction

23 or 24 relative to the bed arrangement 25. The locking device 40 may have an unlocking mechanism, for example a push button 41, by means of which the locking device 40 can be brought into an unlocked state. In the unlocked state, the bolt of the locking device does not engage in a corresponding recess of the reference position system 27, but is arranged, for example, outwardly away from the recess of the reference position system 27. In the unlocked state, the positioning device 30 can thus be slid in the

direction

23 or 24 relative to the bed arrangement 25.

Finally, a handle 39 can also be provided in the third region 37, which can be used, for example, to move the positioning device 30 in the

directions

23, 24 relative to the bed plate arrangement 25 or to arrange the positioning device 30 on the bed plate arrangement 25 or to remove it therefrom. Finally, the handle 39 can be used to hang the positioning device from the storage wall when not in use, for example by means of a wall fixture 42. The shape of the handle 39 and the position of said handle 39 are only exemplary. Other handles and other arrangements of handles are contemplated. The handle is basically used to provide a point of action for the sliding movement of the positioning device 30.

A second region 36 is located between the first region 35 and a third region 37, which second region forms an examination region. When the patient 60 is arranged on the positioning device 30, for example as shown in fig. 2, its lower torso region is located in the second region 36, i.e. the examination region. In order to avoid interference or undesired effects during the examination of the patient 60 during the imaging by means of the imaging device 50, the second region 36 of the base part 31 can be designed such that it does not produce artifacts or shadows, for example in X-ray images. The second region 36 may, for example, be substantially free of structures that could possibly produce artifacts, such as edges, unreasonably arranged rounding or air bubbles that may occur during lamination. Furthermore, the second region 36 of the base part 31 may, for example, be free of metal.

On the longitudinal sides of the base part 31, fixing devices can be provided, which are designed for fixing a patient fixing strap. For example, a longitudinal groove can be provided on each longitudinal side of the base part 31, into which a fixing element 43, for example a patient fixing strap, can be inserted. The fixing elements 43 can be arranged in different positions as desired by using longitudinal grooves. Furthermore, a plurality of fixing elements 43 can be provided at different locations, for example for a plurality of patient fixing bands.

Fig. 4 shows schematically in an enlarged perspective view a region 35 of the base part 31 of the positioning device 30. Fig. 4 shows, in particular, the recess 44 between the

rails

33 and 34 and the fastening of the

rails

33 and 34 to the base part 31 by means of the blocks 46 to 49. The blocks 46 to 49 can be formed, for example, integrally with the base part 31 or can be fastened to the latter by means of screws or adhesive connections. The

rails

33 and 34 may be fixed to the blocks 46 to 49 by screwing, riveting or adhesive bonding. As shown in fig. 4, for example, two

blocks

46 and 47 are located on one longitudinal side of base member 31, and two

other blocks

48 and 49 are located on the opposite longitudinal side of base member 31. It is clear that more or less than two blocks, for example one block or three or four blocks, can be provided for the fixation of the track. Fig. 4 also shows a longitudinal groove 80 for fixing the fixing element 43, which is described in detail below in fig. 7.

Fig. 5 schematically shows the underside of the base part 31. On the longitudinal sides of the base part 31, on each longitudinal side in the third region 37, a locking device 40 and a guide device 38 are respectively provided. The guide 38 can be designed, for example, as an angle profile. The first leg of the angle profile is arranged on a longitudinal side of the base part 31 and projects beyond the base part 31 in the direction of the underside of the base part 31. The second limb of the angle profile extends substantially at right angles from the first limb in the direction of the opposite longitudinal side of the base part 31. The angle profile thus forms, together with the underside of the base part 31, a U-shaped profile which can surround the longitudinal edges of the bed 26, for example. The second leg of the angle profile can alternatively engage in a corresponding groove in the reclining plate 26.

Fig. 5 also shows a wall fastening 42, which may be designed, for example, as an opening or a hole in base part 31, as well as a locking device 40 and a fastening element 43.

Two slide bars 81 and 82 are provided on the lower side of the base member 31 in the longitudinal direction of the base member 31. The slide bars 81 and 82 are arranged in parallel. In the case of a width of the base part 31 of, for example, 50cm to 60cm, the sliding

strips

81 and 82 can, for example, each be arranged at a distance of about 5cm to 15cm, preferably 10cm, from the longitudinal edges of the base part 31. The width of the sliding

strips

81, 82 can be, for example, 1cm to 5cm, preferably 3 cm. The sliding bars 81, 82 can be produced, for example, from a material with a polished surface and a low coefficient of friction in conjunction with the material of the bed plate 26, for example, polished plastic or teflon (polytetrafluoroethylene). More than the two sliding

bars

81, 82 shown can be provided, for example a third sliding bar, which is arranged parallel to the sliding

bars

81, 82 almost in the middle of the base part 31.

Fig. 6 schematically shows a partial region of the underside of the base part 31. In particular, the guide 38, the locking device 40 and the fastening element 43 are shown in the partial region. As already mentioned, the guide 38 can comprise an angle profile which extends from a longitudinal edge of the base part 31 beyond the underside of the base part 31 and thus forms a U-profile with the underside of the base part 31, for example in order to surround an edge of the bed board 26.

As described above, the reference position system 27 can be recessed into the bed 26. The locking device 40 can be laterally engaged into a recess of the reference position system 27 by means of a corresponding projection, for example a bolt 83 shown in fig. 6. The locking device 40 can be designed in such a way that, by actuating a correspondingly assigned push button 41 on the upper side of the base part 31, the bolt 83 is deflected outward in the direction of the arrow 84, so that it no longer engages in the recess of the reference position system 27 and the locking device is thus in the unlocked state. In the unlocked state, the base part 31 can be slid in the longitudinal direction relative to the bed 26. The bolt 83 can be prestressed inward, i.e. opposite to the direction of the arrow 84, for example by means of a spring force, so that, after the push button 41 is released, it moves into a corresponding recess of the reference position system 27 as soon as the corresponding position is reached. The locking device 40 is then in a locked state, and in the locked state the base part 31 cannot slide longitudinally relative to the bed plate 26.

The fixing element 43 can be detachably and slidably mounted on a longitudinal edge of the base part 31. For this purpose, the base part 31 can have, for example, longitudinal grooves 80 on its longitudinal edges, which are shown, for example, in fig. 7 in a perspective partial view of the base part 31. The fastening element 43 can be moved, for example, from the end of the longitudinal side into the longitudinal groove 80 or, with a corresponding deformability of the fastening element 43, can be clamped in any position in the longitudinal groove 80.

In summary, the positioning device 30 is a positioning Aid (Position Aid) that can be used in conjunction with a bed board device 25, also referred to as a "covering". The bed arrangement 25 provides, for example, a reference position system 27 for fixing the positioning device 30 in a defined position relative to the bed arrangement 25 by means of a locking device 40. The positioning device 30 can alternatively also be used in combination with a patient table, which provides a flat support surface and a corresponding reference position system 27. For better contact with the patient, the positioning device 30 can be positioned on the foot side beyond the patient bed 22. The recess 44 at the foot end of the positioning device 30 may be, for example, semicircular. The notch 44 enables optimal contact with the patient when supporting the patient as close to the foot end as possible. The couch cover, for example the mattress 32, can have a similar shape or any other shape to the base part 31 of the positioning device 30 and allows for an ergonomic support of the patient 60 and a soft support for said patient.

The lateral guide 38 allows an optimum sliding movement of the positioning device 30. Lateral locking can be achieved by means of the locking device 40. The lateral locking can be operated by a push mechanism from the upper side of the positioning device 30 by means of a push button 41. When unlocked, the bolt 83 of the locking device 40 can be automatically released and opened outwards. The

rails

33, 34 arranged laterally on the positioning device 30 serve as an interface for fixing a holding device for holding or supporting a patient, for example a so-called holding frame device (english: students) for fixing the thigh of a patient positioned supine at right angles. The holding device can be screwed or fixed by a corresponding fixing mechanism, for example a clamping block. The securing mechanism may be standardized or standardized.

On the longitudinal side of the base part 31, an interface for using a patient belt, which is used as in a CT couch, can be provided. The interface may include, for example, a longitudinal slot 80 as shown in fig. 7. These interfaces may also be designed such that further accessories, for example arm supports, for additionally fixing the limbs of the patient can be installed. The patient 60 fixed on the positioning device 30 can be moved together with the positioning device, for example, into a tunnel-like opening of the computed tomography apparatus, without having to reposition the patient. Reliable imaging and reliable execution of the radiation therapy can thereby be ensured for the radiation therapy planning.

In order to slide the positioning device 30 easily and longitudinally on the patient bed 22, in particular on the bed plate arrangement 25, sliding

bars

81, 82 are provided on the underside of the base part 31. The friction is reduced by the sliding

strips

81, 82. The handle 39 facilitates simple handling during reception/removal and during sliding of the positioning device 30. The integrated wall fixture 42 enables simple storage of the fixture when not in use, such as on a wall. Although only two

rails

33, 34 are shown in the foregoing description and drawings, other rails may be provided on the positioning device for mounting other accessories.

The positioning device 30 can be produced, for example, from plastic, preferably from a CFK or CKF composite and is therefore correspondingly light in weight in order to be placed and handled by a single person. By using the positioning device it is not necessary to transport the patient by other systems, since medical imaging, insertion of the applicator, checking of the correct placement of the applicator and the execution of the radiation treatment can be carried out on the positioning device. The simple design of the positioning device, in particular by using a sliding strip on the underside of the base part 31, makes it possible to produce the positioning device cost-effectively.

The features of the foregoing embodiments and aspects of the utility model can of course be combined with each other. The features mentioned above can in particular be used not only in the combination mentioned but also in other combinations or alone without departing from the scope of the utility model. Other features or variations are also possible. For sliding the positioning device on the patient bed, the slide bar can be replaced, for example, by a rail mechanism or a rolling system. Furthermore, it is conceivable to provide a corresponding sliding bar on the patient bed or bed plate arrangement in order to further improve the sliding behavior of the positioning device relative to the patient bed or bed plate arrangement.

Claims

1. A positioning apparatus (30) for positioning a patient (60) for medical imaging for radiation therapy planning, the positioning apparatus comprising:

an elongated plate-like base part (31) having a support surface for supporting a patient (60),

-at least two rails (33, 34) disposed on a base part (31) and extending in the longitudinal direction (23, 24) of the base part (31) and perpendicular to the bearing surface,

-a first and a second guide device (38), wherein the first guide device (38) is disposed on a first longitudinal side of the base part (31) and the second guide device (38) is disposed on a second longitudinal side of the base part (31) opposite the first longitudinal side, wherein the first and the second guide device (38) are each slidably engageable with a corresponding longitudinal guide on a patient couch (22) of a medical imaging apparatus (50) in the longitudinal direction, and

-at least one locking device (40) which can be engaged with a recess arranged on the patient bed (22) in order to selectively prevent the base part (31) from sliding relative to the patient bed (22) in the longitudinal direction (23, 24).

2. The positioning device (30) according to claim 1, wherein the elongated plate-like base part (31) is designed for positioning a patient in a calculus removal position.

3. The positioning device (30) according to claim 1 or 2, wherein the at least two rails (33, 34) are designed for accommodating a holder device (70) for supporting a leg of a patient (60) in a stone resection position.

4. The positioning device (30) according to claim 1 or 2, characterized in that the first and/or the second guide device (38) comprises a holding angle, which extends from the base part (31) in such a way that it forms, in conjunction with the base part (31), a U-shaped structure, which is designed to at least partially surround a corresponding longitudinal guide on the patient bed (22).

5. The positioning device (30) according to claim 1 or 2, characterized in that at least one sliding bar (81, 82) is provided on a flat underside of the base part (31) opposite the bearing surface in the longitudinal direction (23, 24) of the base part (31), said sliding bar providing a sliding bearing of the base part (31) in the longitudinal direction (23, 24) on a flat surface of the patient bed (22).

6. Positioning device (30) according to claim 5, characterized in that at least two sliding strips (81, 82) extending in parallel in the longitudinal direction (23, 24) of the base part (31) are provided on the underside of the base part (31).

7. The positioning device (30) according to claim 1 or 2, wherein the operating element (41) of the at least one locking device (40) is arranged on a support surface.

8. The positioning device (30) according to claim 1, wherein the base part (31) has a first end (35) and an opposite second end (37) along the longitudinal direction (23, 24), wherein the at least two rails (33, 34) are arranged on the first end (35), and wherein the first and second guide means (38) are arranged on the second end (37).

9. The positioning device (30) according to claim 8, wherein the base part (31) is adapted to take diagnostic images in an examination region (36) between the first end (35) and the second end (37).

10. The positioning device (30) according to claim 9, wherein the length of the examination region (36) in the longitudinal direction (23, 24) is at least 30 cm.

11. The positioning device (30) according to one of claims 8 to 10, wherein the base part (31) has a recess (44) between the at least two rails (33, 34) at a first end (35).

12. The positioning device (30) according to claim 11, wherein the recess (44) has a width of at least 20cm in a transverse direction of the base part (31) and a length of at least 15cm in a longitudinal direction (23, 24) of the base part (31).

13. The positioning device (30) according to claim 1 or 2, characterized in that fixing means (80) are provided on mutually opposite longitudinal sides of the base part (31), which fixing means are designed for fixing at least one patient fixing strap for fixing a patient (60).

14. The positioning device (30) according to claim 1 or 2, wherein the radiation therapy plan includes an administration of brachytherapy.

15. The positioning device (30) according to claim 1 or 2, characterized in that the patient bed (22) comprises a bed arrangement (25) comprising a bed (26) for supporting a patient (60) and a reference position system (27) for providing a reference position relative to the bed (26), wherein the reference position system (27) has an arrangement of recesses on a first longitudinal side of the bed (26) and a further arrangement of recesses on a second longitudinal side of the bed (26) opposite the first longitudinal side, wherein the at least one locking device (40) is designed for selectively engaging with the recesses.

16. A tomographic imaging system comprising a computer tomography apparatus (50), a patient couch (22) and a positioning apparatus (30) according to one of claims 1 to 15.