EP1973480A1

EP1973480A1 - Treatment device

Info

Publication number: EP1973480A1
Application number: EP07702800A
Authority: EP
Inventors: Brian Walsh; Ralph Senft
Original assignee: Dornier Medtech Systems GmbH
Current assignee: Dornier Medtech Systems GmbH
Priority date: 2006-01-17
Filing date: 2007-01-16
Publication date: 2008-10-01
Also published as: US20100286574A1; WO2007082716A1; DE102006002273A1

Abstract

The present invention relates to a treatment device which can be connected to a radiation source and which can be used in particular in lithotripsy, wherein a shockwave source producing shockwaves, which can be used to emit shockwaves to an object to be treated, and a radiation localization device integrated into the shockwave source are provided. In order to provide such a treatment device, which enables, irrespective of the user, good image quality and good bundling of the shockwaves using a radiation source in as simple a manner as possible, the radiation localization device has a radiation receiving unit designed as a solid-state detector.

Description

treatment facility

The present invention relates to a treatment device which can be used with a radiation source and which can be used in particular in lithotripsy.

A generic treatment device is known from US 5,795,311. The treatment device has as wave source a shock wave source, in which an X-ray locating device is integrated. In this way, the X-ray central beam passes through the treatment device.

From DE 39 16093 A1 it is known how such a treatment device is arranged in an overall system. The X-ray radiation emitted by the X-ray locating device of the shockwave source is received by an image intensifier opposing the shockwave source and processed into a visible image. In the shockwave source, the X-radiation must pass through the coupling liquid contained in a coupling bellows. As a result, the X-radiation is attenuated, which reduces the image quality.

To remedy this, it is proposed to use an air-filled tube. This displaces the coupling fluid in the area of the emitted X-ray lobe and thus improves the image quality. However, the tube affects the bundling of the shock waves generated by the shockwave source. Because it not only displaces the coupling liquid required for propagating the shock waves, but also creates disturbing reflection surfaces which scatter the shock waves, that is counteract their bundling.

The present invention has for its object to provide a generic treatment device which can be used with a radiation source and still allows the simplest possible way a good image quality and good delivery of the pressure waves.

The object is achieved according to the invention with a treatment device having the features of claim 1. By integrating the beam receiving unit into the wave source, the image pickup plane is close to the object to be treated with the wave source. Already by the proximity itself an increase in image sharpness is achieved. As a solid state detector, the radiation receiving unit is compact formable. As a result, the dimensions of the wave source can be maintained substantially despite the integration. The solid-state detector enables the use of low radiation doses and opens up possibilities for computer-aided image processing.

Advantageously, the solid-state detector can be arranged behind a wave generator of the wave source with respect to the main pressure wave emission direction of the wave source. As a result, the solid state detector can be formed relatively large in the wave source, whereby a large radiation entrance area can be detected. Even if parts of the wave generator are imaged, still a sharp picture is achieved.

Particularly preferably, the solid-state detector with respect to the main Druckwellenaussenderichtung the wave source in front of a wave generator of the wave source can be arranged. The image remains free of shadowing by the wave generator. Surprisingly, even with this arrangement, a sufficiently large radiation entrance area can be detected with good image quality.

Particularly preferably, the solid-state detector can be integrated in a wave generator of the wave source. In this way, the pressure waves from the solid state detector can be emitted unaffected. Despite the structural coordination of the solid state detector with respect to the wave generator, a sufficient radiation entrance area can be detected with good image quality.

Conveniently, the solid-state detector can be arranged approximately centrally in the wave source. This enables inline positioning, which can be executed quickly with high precision. With inline locating, the object to be treated is displayed "from view" of the wave source. Preferably, a wave generator of the wave source may have a substantially annular shape corresponding to the shape and / or position of the solid-state detector. In this way, the wave generator and the solid-state detector make good use of the available cross-sectional area of the wave source for emitting pressure waves and for receiving radiation.

Particularly advantageously, the solid-state detector can be provided movably in the wave source. This makes it possible to align the solid-state detector with different radiation source positions, in particular with regard to the location of the object to be treated. In this case, the position of the wave source with respect to the object to be treated, that is z. B. with respect to a patient. This makes the tracking faster. Because the wave source can remain in position in itself, movements of the object to be treated, z. B. a patient avoided, which could be caused by this. By tracking the solid state detector its alignment with the radiation source can be well adjusted to avoid image distortion.

Preferably, at least two radiations from different directions receiving solid state detectors may be provided. As a result, a quick spatial location is possible in a simple manner, in which the position of the wave source itself relative to the object to be treated, that is z. B. with respect to a patient, can be maintained.

Advantageously, the treatment device can have an ultrasonic location device integrated into the wave source. This makes it possible to use the advantages of both locating systems with the treatment device according to the invention.

In one development of the invention, the solid-state detector can have at least one ultrasonic location unit. In this way, a tracking unit combines both locating principles.

Conveniently, the solid state detector may alternately comprise beam locating units and ultrasonic locating units. This can be used at local locations of the solid state Detector both incoming radiation and incoming ultrasound are evaluated.

Preferably, the solid-state detector may have alternately radiation detection units and ultrasonic detection units in a matrix-like manner. As a result, both a beam image and an ultrasound image can be created from the same position. This can optionally be done simultaneously.

Advantageously, the solid state detector may be linear, flat and / or lattice-like. This makes it possible to design the solid-state detector adapted to the conditions of the shock wave source and / or to the requirements of pressure wave generation and bundling. Thus, the solid-state detector can also be formed by the use of separate detector fragments.

Embodiments of the present invention are illustrated in the drawings and will be explained below. Show it:

FIG. 1 shows a schematic sectional illustration of a treatment device of a first and second embodiment of the invention,

FIG. 2 is a schematic sectional view of a treatment device of a third embodiment of the invention,

FIG. 3 shows a schematic sectional illustration of a treatment device of a fourth embodiment of the invention,

FIG. 4 is a schematic sectional view of a treatment device of a fifth embodiment of the invention,

FIG. 5 is a schematic sectional view of a treatment device of a sixth embodiment of the invention,

6 shows a perspective view of the treatment device of the sixth embodiment in a more concrete embodiment, FIG. 7 is a plan view of a treatment device of a seventh embodiment of the invention;

Figure 8 is a schematic sectional view of a treatment device according to an eighth and ninth embodiment of the present invention and

Figures 9 to 12 in sections representations of embodiments of solid-state detectors inventive treatment facilities.

In the following description, like reference numerals will be used for like parts throughout the various embodiments.

A treatment device according to the invention has a wave source, with which acoustic energy can be generated, for. B. in the form of pressure waves or shock waves. A wave generator of the wave source is designed accordingly. That is, in each treatment device according to the invention, a wave source generating a general acoustic energy and / or a pressure wave source and / or a shock wave source can be used as the wave source.

FIG. 1 shows a schematic sectional view of a treatment device 1 according to the invention, which has a shock wave source 2 as the wave source. The shock wave source 2 has as a wave generator a shock wave generator 3, with which shock waves can be generated. In this embodiment of the invention, this is done according to the electromagnetic principle by means of a provided in the shock wave generator 3 coil 4. The shocks generated by the coil 4 are discharged by means of a membrane 5 to a coupling medium 6, which is located in a coupling bellows 7.

The shock waves can be generated in all embodiments of the invention in other ways, for example by means of electro-hydraulic methods, in which a Spark discharge between electrodes takes place, or by means of piezoelectric methods.

The shock waves generated by the shock wave generator are bundled with the aid of bundling elements, not shown, on a lying outside of the shock wave source 2, not shown focus. The focus is on a main shock wave emission direction, which is also referred to as shock wave path 8. The shock wave path runs approximately centrally through the membrane 5 and approximately perpendicular to this.

It is also possible in all embodiments of the invention to use unfocused shock or blast waves, i. so-called ballistic shock or pressure waves.

The treatment device 1 can be used in therapeutic applications in which pressure waves, shock waves or generally acoustic waves are used, e.g. as a lithotripter. It is also possible to use the treatment device 1 outside of medicine on materials or components, i. no patient is being treated.

The treatment device 1 has an integrated into the shock wave source 2, designed as a solid state detector 9 radiation receiving unit. With the solid-state detector 9, radiation emitted by a radiation source can be received and converted into further processed signals. From the signals, for example, a radiation image can be created. As the radiation, it is possible to use any of the surroundings of the object to be treated and / or the object to be treated itself transmitted light radiation, such. radioactive radiation and / or X-radiation.

In this embodiment of the invention, the solid-state detector with respect to the shock wave path 8 is arranged in front of the shock wave generator 3 and is arranged approximately centrally in the shock wave source 2. It has a receiving surface 10, the radiation incident from the outside into the shock wave source 2, in particular by the coupling bellows 7 impinges. In this embodiment of the invention, the shockwave path 8 coincides approximately with a central axis 11 of the centrally provided solid state detector 9 running transversely through the receiving surface 10. It can also be provided more solid state detectors. In FIG. 1, according to a second embodiment of the invention, two solid-state detectors 13, 14 arranged in the region of outer sections 15, 16 of the shockwave generator are shown in dashed lines. The solid state detectors 13, 14 may also be arranged between the shock wave generator and a housing 12 of the shock wave source.

FIG. 2 shows a third embodiment of the invention, in which an annular or frame-type solid-state detector 22 is arranged in front of the shockwave generator 3.

FIG. 3 shows a treatment device 31 according to the invention of a fourth embodiment of the invention in a schematic sectional illustration. In contrast to the first embodiment, a solid state detector 32 is provided, which is arranged with respect to the shock wave path 8 behind the shock wave generator 3. The size of a receiving surface 33 of the solid-state detector 32 corresponds approximately to the size of the shock wave generator 3. The membrane 5 of the shock wave generator 3 is formed radiolucent.

On the beam image created with the solid state detector 32, the coil 4 of the shock wave generator 3 is detected. However, this does not affect the image sharpness. Also, the location of the object to be treated can still be performed easily.

FIG. 4 shows a treatment device 41 of a fifth embodiment of the invention in a schematic sectional representation. In contrast to the fourth embodiment, a shock wave source 42 with an approximately cylindrical shock wave generator 43 and a reflector 44 is provided. The shock wave generator 43 radiates the shock waves generated by means of its coil 45 substantially transversely with respect to the shock wave path 8, whereas in the shock wave generator 3 of the first to third embodiments, this takes place substantially parallel to the shock wave path 8.

The shock wave generator can also be designed according to the electrohydraulic principle, ie have an electrode arrangement for generating spark discharges. The shock waves are directed by means of the reflector 44 to the outside of the shock wave source 42 lying, not shown focus focusing. The reflector 44 is radiolucent, which is why the solid-state detector 32 can detect incident radiation in the region of the reflector 44.

If the reflector is radiopaque, a solid-state detector can be arranged in front of or inside the reflector.

FIG. 5 shows a treatment device 51 according to a sixth embodiment of the present invention in a schematic sectional illustration. In contrast to the treatment devices of the first to fourth embodiments, it has a shock wave generator 53 in which a solid-state detector 54 is integrated. Apart from this, the shock wave source 52 is constructed like the shock wave source 2 used in the first to third embodiments. The shock wave generator 53 has a coil 55 and a diaphragm 56 in an analogous manner. A receiving surface 57 of the solid-state detector 54 is provided approximately transversely to the shockwave path 8.

The shock wave generator 53 has a substantially annular or frame-like shape, which corresponds to the position and shape of the solid state detector 54. In this case, the propagation of the shock waves emitted by the shock wave generator by the solid state detector remains essentially unaffected. Conversely, the beam reception of the solid-state detector remains essentially unaffected by the shock wave generator.

The receiving surface 57 and the membrane 56 may be substantially aligned with each other.

FIG. 6 shows the treatment device 51 in a specific embodiment. The receiving surface 57 of the solid state detector 54 has an approximately rectangular shape. Corresponding to this shape, a recess 71 of approximately rectangular shape is provided in a shock wave emission direction after the shock wave generator arranged acoustic lens 72 having a surface 73. The solid-state detector 64 is disposed in this recess 71 and projects slightly from the surface 73. The recess 71 may extend into the shock wave generator. FIG. 7 shows a part of a treatment device 81 of a seventh embodiment of the invention from above, the structure of which corresponds in principle to that of the sixth embodiment. In a shock wave generator 84 of the shock wave source 82, a recess 86 is formed in which a socket 92 is received approximately form-fitting rectangular shape. In the version 92, a solid state detector 87 is received positively integrated.

The shock wave generator 84 has a groove 88, in which a to the solid state detector 87 extending cable 89 is received. The cable 89 connects the solid-state detector 87 with a plug 90, which is provided on an outer region 91 of a housing 83 of the treatment device 81.

FIG. 8 shows a treatment device 101 of an eighth embodiment of the present invention in a schematic sectional illustration. This treatment device is a development of the treatment device 1 of the first embodiment shown in FIG. In contrast to the first embodiment, the solid state detector is movably provided in the shock wave source 2. It can be aligned to different positions of radiation sources. In addition, it can be readjusted with respect to a radiation source to avoid distortions in the radiation reception.

FIG. 8 shows the solid-state detector with the reference symbol 109 in a first position, as corresponds approximately to the position of the solid state detector 9 in FIG. In the first position, the solid-state detector 109 is aligned with a radiation source 111 at a first position, wherein a central ray 112 of the radiation source 111 extends approximately along the shock wave path 8 and approximately perpendicular to a receiving surface 100 of the solid state detector 109.

The reference numeral 109 'shows the solid-state detector in dashed lines in a second position in which it is aligned with a radiation source 111' in a second position. In this case, the central beam 112 'of the radiation source 111' of the second position approximately perpendicular to the receiving surface 110 'of the solid state detector There may also be two solid-state detectors, each of which receives radiation from another (main) direction. According to a ninth embodiment of the invention, in the first position of the solid state detector 109 of the eighth embodiment, a first solid state detector may be provided and angularly offset therefrom, a second solid state detector 113 shown in phantom in FIG.

The radiation source may be provided as a radiation source movable between the two positions 111 and 111 'shown in FIG.

Alternatively, a separate radiation source can be provided at each of the positions 111 and 111 'shown in FIG. A mechanism for moving between the two positions 111 and 111 ^* is not required here.

There may be a movement coupling between a radiation source and its associated solid state detector, with which both are held in alignment with each other. However, it is also possible to provide radiation source and solid-state detector decoupled. A three-dimensional location is still possible.

The radiation source and / or the shock wave source may comprise a collimator device used in a setting in which substantially only the surface of the solid-state detector is irradiated. Preferably, the collimator device is adjusted to account for the angular position of the associated solid state detector (s).

The radiation sources can have point, line and / or surface radiators. The latter are z. B. used in nuclear medicine.

The solid-state detectors can be angled and / or movable in all embodiments. In particular, in the case of integrated, movable or angular design of the solid state detector, the solid state detector and / or the shock wave generator can be designed asymmetrically and / or arranged asymmetrically with respect to one another. In any embodiment of the treatment device according to the invention, the solid-state detector can be designed as a so-called flat-panel detector.

Various embodiments of solid-state detectors which can be used in the treatment devices according to the invention are shown schematically in FIGS. 9 to 12. The solid-state detectors may be formed like a line, such. B. shown in Figures 9 and 10. The line-like shape may be straight, Figure 10, or curved, e.g. As can be seen from FIG. 11, the solid-state detector can have a planar design. FIG. 12 illustrates a grid-like embodiment of a solid state detector.

The solid state detectors comprise a plurality of locating units 121, 131, 141, 151, which may all be radiation locating units, e.g. B. X-ray detection units. However, it is also possible to provide, at least proportionally, alternating radiation detection units and ultrasonic detection units, as indicated in FIGS. 9 to 12 by an "X" for radiation detection units and by "US" for ultrasonic detection units. The radiation and ultrasound locating units may alternate immediately, but several consecutive radiation locating units may alternate with several consecutive ultrasound locating units. In planar solid state detectors, a structure may be provided in which radiation detection units "X" alternate in a matrix-like manner with ultrasonic detection units "US", as shown in FIG.

As a result of the alternating arrangement of radiation and ultrasound locating units, both radiation and ultrasound can be received virtually at the same location, since the locating units can be made very small. A solid state detector having radiation and ultrasonic location units is a solid state hybrid solid state detector.

On the surface of a solid-state detector according to the invention, a location mark can be provided, which is imaged on the radiation and / or ultrasonic location image. The location mark can be z. B. annular and / or reticule-like shape. In addition to a solid state detector, a separate ultrasonic location device may be provided in a treatment device according to the invention.

A control device may be provided, which enables the generation of shock waves as a function of the position of the shock wave source relative to the object to be treated. The control device allows the emission of shock waves only with sufficiently accurate alignment of the shock wave source to the object to be treated. Only when the focus and the object to be treated, z. As a gallstone, substantially coincident, the control device is allowed to generate shock waves. In this way it is avoided that surrounding body parts are unnecessarily affected by inaccurate or incorrect alignment of the shockwave source.

The shock wave source and / or an object storage, z. As a patient table, can be provided automatically movable. The position of the shock wave source relative to the object to be treated is adjusted by means of the control device. This can be a first time setting. But a correction of the situation is possible in this way. Thus, positional deviations resulting from movements of a patient can be corrected. Also, due to the breathing of a patient resulting positional deviations are compensated.

Claims

claims

1. treatment device (1, 21, 31, 41, 51, 61, 81, 101) which can be used with a radiation source (111, 111 ') and which can be used in particular in lithotripsy, wherein a pressure wave generating shaft source (2, 42, 52, 62, 82), with which pressure waves can be emitted to an object to be treated, and a radiation locating device integrated in the wave source is provided, characterized in that the radiation locating device is a solid-state detector (9, 22, 23, 32, 54, 64, 87, 109, 109 ') formed radiation receiving unit.

2. treatment device (31, 41) according to claim 1, characterized in that the solid state detector (32) with respect to the main Druckwellenaussenderichtung (8) of the wave source (2, 42) behind a wave generator (3, 43) of the wave source is arranged.

3. treatment device (1, 21, 101) according to claim 1 or 2, characterized in that the solid state detector (9, 22, 23, 109, 109 ') with respect to the main Druckwellenaussenderichtung (8) of the wave source (2) in front of a wave generator (3) the wave source is arranged.

4. treatment device (51, 61, 81) according to at least one of the preceding claims, characterized in that the solid state detector (54, 64, 87) in a wave generator (53, 63, 84) of the

Wave source (52, 62, 82) is arranged integrated.

5. treatment device (1. 31, 41, 51, 61, 81, 101) according to at least one of the preceding claims, characterized in that the solid state detector (9, 32, 54, 64, 87, 109) approximately centrally in the wave source

(2, 52, 62, 82) is arranged.

6. Treatment device (51, 61, 81) according to at least one of the preceding claims, characterized in that a wave generator (53, 63, 84) of the wave source (52, 62, 82) has a substantially annular shape and / or position of the solid-state detector (54, 64, 87) has a corresponding shape.

7. treatment device (101) according to at least one of the preceding claims, characterized in that the solid state detector (109, 109 ') in the wave source (2) is provided movable.

8. treatment device (101) according to at least one of the preceding claims, characterized in that at least two radiations from different directions receiving

Solid state detectors (109, 109 ') are provided.

9. Treatment device according to at least one of the preceding claims, characterized in that the treatment device has an integrated into the wave source ultrasound locating device.

10. Treatment device according to at least one of the preceding claims, characterized in that the solid-state detector (120, 130, 140, 150) has at least one ultrasound locating unit (US).

11. Treatment device according to at least one of the preceding claims, characterized in that the solid-state detector (120, 130, 140, 150) alternately Strahlortungseinheiten (X) and ultrasonic detection units (US).

12. Treatment device according to at least one of the preceding claims, characterized in that the solid state detector (140) has a matrix-like alternation beam detection units (X) and ultrasonic detection units (US).

13. Treatment device according to at least one of the preceding claims, characterized in that the solid state detector line-like (120, 130), flat (140) and / or lattice-like (150) is formed.