JP2000105279A - Radiotherapic region setting method, therapic instrument, therapic plan preparing device, and data base system for therapy - Google Patents
Radiotherapic region setting method, therapic instrument, therapic plan preparing device, and data base system for therapyInfo
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- 238000000034 method Methods 0.000 title claims description 11
- 238000002560 therapeutic procedure Methods 0.000 title description 4
- 238000001959 radiotherapy Methods 0.000 claims abstract description 27
- 238000011282 treatment Methods 0.000 claims description 73
- 206010028980 Neoplasm Diseases 0.000 claims description 36
- 230000005855 radiation Effects 0.000 claims description 22
- 238000012360 testing method Methods 0.000 claims description 7
- 238000010176 18-FDG-positron emission tomography Methods 0.000 abstract description 20
- ZCXUVYAZINUVJD-AHXZWLDOSA-N 2-deoxy-2-((18)F)fluoro-alpha-D-glucose Chemical compound OC[C@H]1O[C@H](O)[C@H]([18F])[C@@H](O)[C@@H]1O ZCXUVYAZINUVJD-AHXZWLDOSA-N 0.000 abstract description 20
- AOYNUTHNTBLRMT-SLPGGIOYSA-N 2-deoxy-2-fluoro-aldehydo-D-glucose Chemical compound OC[C@@H](O)[C@@H](O)[C@H](O)[C@@H](F)C=O AOYNUTHNTBLRMT-SLPGGIOYSA-N 0.000 abstract description 6
- 238000007689 inspection Methods 0.000 abstract description 4
- 238000000605 extraction Methods 0.000 abstract 1
- 238000004364 calculation method Methods 0.000 description 7
- 238000010586 diagram Methods 0.000 description 6
- 230000000694 effects Effects 0.000 description 6
- 210000004881 tumor cell Anatomy 0.000 description 4
- 201000011510 cancer Diseases 0.000 description 3
- 238000003384 imaging method Methods 0.000 description 3
- 230000001225 therapeutic effect Effects 0.000 description 3
- 150000001413 amino acids Chemical class 0.000 description 2
- 210000004027 cell Anatomy 0.000 description 2
- 229960001231 choline Drugs 0.000 description 2
- 238000009826 distribution Methods 0.000 description 2
- 238000010894 electron beam technology Methods 0.000 description 2
- 238000010884 ion-beam technique Methods 0.000 description 2
- 210000000056 organ Anatomy 0.000 description 2
- 239000002245 particle Substances 0.000 description 2
- 238000004088 simulation Methods 0.000 description 2
- 101100406487 Drosophila melanogaster Or47a gene Proteins 0.000 description 1
- WQZGKKKJIJFFOK-GASJEMHNSA-N Glucose Natural products OC[C@H]1OC(O)[C@H](O)[C@@H](O)[C@@H]1O WQZGKKKJIJFFOK-GASJEMHNSA-N 0.000 description 1
- FFEARJCKVFRZRR-BYPYZUCNSA-N L-methionine Chemical compound CSCC[C@H](N)C(O)=O FFEARJCKVFRZRR-BYPYZUCNSA-N 0.000 description 1
- NHTGHBARYWONDQ-JTQLQIEISA-N L-α-methyl-Tyrosine Chemical compound OC(=O)[C@](N)(C)CC1=CC=C(O)C=C1 NHTGHBARYWONDQ-JTQLQIEISA-N 0.000 description 1
- 206010058467 Lung neoplasm malignant Diseases 0.000 description 1
- 230000005260 alpha ray Effects 0.000 description 1
- 230000005250 beta ray Effects 0.000 description 1
- 230000017531 blood circulation Effects 0.000 description 1
- 210000001185 bone marrow Anatomy 0.000 description 1
- 210000000133 brain stem Anatomy 0.000 description 1
- 210000005252 bulbus oculi Anatomy 0.000 description 1
- 210000000170 cell membrane Anatomy 0.000 description 1
- OEYIOHPDSNJKLS-UHFFFAOYSA-N choline Chemical compound C[N+](C)(C)CCO OEYIOHPDSNJKLS-UHFFFAOYSA-N 0.000 description 1
- 239000012141 concentrate Substances 0.000 description 1
- 238000012790 confirmation Methods 0.000 description 1
- 238000001514 detection method Methods 0.000 description 1
- 238000011161 development Methods 0.000 description 1
- 238000003745 diagnosis Methods 0.000 description 1
- 230000005251 gamma ray Effects 0.000 description 1
- 239000008103 glucose Substances 0.000 description 1
- 201000005202 lung cancer Diseases 0.000 description 1
- 208000020816 lung neoplasm Diseases 0.000 description 1
- 230000036210 malignancy Effects 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 229930182817 methionine Natural products 0.000 description 1
- FFEARJCKVFRZRR-JJZBXVGDSA-N methionine c-11 Chemical compound [11CH3]SCC[C@H](N)C(O)=O FFEARJCKVFRZRR-JJZBXVGDSA-N 0.000 description 1
- 230000000394 mitotic effect Effects 0.000 description 1
- 210000005036 nerve Anatomy 0.000 description 1
- 238000009206 nuclear medicine Methods 0.000 description 1
- 201000008968 osteosarcoma Diseases 0.000 description 1
- 230000001575 pathological effect Effects 0.000 description 1
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- 238000011160 research Methods 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
- A61B6/02—Arrangements for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis
- A61B6/03—Computed tomography [CT]
- A61B6/037—Emission tomography
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Abstract
Description
【０００１】[0001]
【発明の属する技術分野】本発明は、放射線治療を行う
際の放射線治療領域設定方法、治療装置、治療計画作成
装置、及び治療用データベースシステムに係り、特に、
治療計画における照射標的（ターゲット）の設定を正確
に行うことが可能な、放射線治療領域設定方法、治療装
置、治療計画作成装置、及び治療用データベースシステ
ムに関する。BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a method for setting a radiotherapy area when performing radiotherapy, a therapy apparatus, a therapy planning apparatus, and a database system for therapy.
The present invention relates to a radiation treatment region setting method, a treatment device, a treatment plan creation device, and a treatment database system that can accurately set an irradiation target (target) in a treatment plan.
【０００２】[0002]
【従来の技術】外部照射による放射線治療は、固形癌の
治療において、外科手術と並ぶ重要な治療方法である。
特に、周辺の組織を温存することができるため、患者の
ＱＯＬ（クオリティオブライフ）の高い治療法として、
今後ますます需要が高まると予想される。2. Description of the Related Art Radiation therapy by external irradiation is an important treatment method in the treatment of solid cancer, as well as surgery.
In particular, since the surrounding tissues can be preserved, as a treatment with a high quality of life (QOL) for patients,
Demand is expected to increase in the future.
【０００３】一般に、外部照射の放射線治療では、事前
に撮影するＸ線ＣＴ画像を用いて、治療計画を行う。治
療計画の目的は、 図１に示す如く、照射標的である腫瘍領域１０Ｐ、放
射線感受性の高いその他の重要臓器（眼球１０Ｅ、脳幹
１０Ｂ、骨髄など）の入力、設定、 腫瘍領域１０Ｐへの照射線量の設定、 重要臓器１０Ｂ、１０Ｅを避け、腫瘍１０Ｐに放射線
を集中させるための、照射数、照射方向の入力・設定で
あり、 〜に基づき、図２に示すような線量分布シミュレ
ーションを行う。図において１０Ｃは、患者の体輪郭で
ある。In general, in radiation treatment of external irradiation, a treatment plan is made using an X-ray CT image taken in advance. As shown in FIG. 1, the purpose of the treatment plan is to input and set the tumor region 10P as an irradiation target, other important organs with high radiation sensitivity (such as the eyeball 10E, the brain stem 10B, and bone marrow), and the irradiation dose to the tumor region 10P. The setting and the input / setting of the number of irradiations and the irradiation direction in order to concentrate the radiation on the tumor 10P while avoiding the important organs 10B and 10E. Based on, the dose distribution simulation as shown in FIG. In the figure, 10C is the body contour of the patient.
【０００４】このうち、Ｘ線ＣＴ画像上への領域設定
は、ＲＯＩ（Region Of Interest）設定と呼ばれ、放射
線治療の成否を決める重要な作業である。一般に、治療
計画では、ＲＯＩ設定に際して、ターゲットを、図３の
ように、次のＧＴＶ（Gross Target Volume ）、ＣＴＶ
（Clinical Target Volume）、ＰＴＶ（Planning Targe
t Volume）の３段階で設定する。[0004] Of these operations, setting an area on an X-ray CT image is called ROI (Region Of Interest) setting, and is an important operation for determining the success or failure of radiotherapy. Generally, in the treatment plan, when setting the ROI, the target is set to the next GTV (Gross Target Volume) and CTV as shown in FIG.
(Clinical Target Volume), PTV (Planning Targe)
t Volume).
【０００５】ＧＴＶ Ｘ線ＣＴ画像上で確認できる腫瘍病患部領域で、通常、
医師が手動操作で設定する。[0005] A tumor diseased area that can be confirmed on a GTV X-ray CT image.
Set manually by a physician.
【０００６】ＣＴＶ 通常、腫瘍細胞は、Ｘ線ＣＴ画像で確認できる領域の外
側にも存在していると考えられている。従って、前記Ｇ
ＴＶの外側に、任意のマージン（通常１０ｍｍ程度）を
設定し、ＣＴＶとする。このＣＴＶは、通常、自動的に
作成される。CTV Usually, it is considered that tumor cells exist outside an area that can be confirmed on an X-ray CT image. Therefore, the G
An arbitrary margin (usually about 10 mm) is set outside the TV, and the CTV is set. This CTV is usually created automatically.
【０００７】ＰＴＶ 照射装置の特性を考慮して、前記ＣＴＶを包含する領域
として、ＰＴＶを設定する。このＰＴＶは、治療計画シ
ステムで、自動的に設定される場合もある。[0007] In consideration of the characteristics of the PTV irradiation apparatus, a PTV is set as a region including the CTV. This PTV may be automatically set by the treatment planning system.
【０００８】このようなＲＯＩ設定作業を断層画像（ス
ライスとも称する）毎に行い、３次元データとして構築
する。[0008] Such an ROI setting operation is performed for each tomographic image (also referred to as a slice) to construct three-dimensional data.
【０００９】[0009]
【発明が解決しようとする課題】しかしながら、現状の
治療計画システムでは、次のような問題点を有してい
た。即ち、Ｘ線ＣＴ画像では、腫瘍領域の判定が困難で
あり、ＧＴＣ、ＣＴＶの設定に熟練を要する。又、一律
に、同じマージン領域をＧＴＶに適用して、ＣＴＶを作
成しているが、実際のＣＴＶとは異なる可能性がある。However, the current treatment planning system has the following problems. That is, in an X-ray CT image, it is difficult to determine a tumor region, and skill is required to set GTC and CTV. In addition, the CTV is created by uniformly applying the same margin area to the GTV, but may be different from the actual CTV.
【００１０】即ち、現在の治療計画システムでは、病理
的な知見からターゲット設定を行うことができないた
め、比較的広いマージンを設定せざるを得ず、患者が必
要以上に放射線を浴びて、正常細胞まで放射線による損
傷を受けてしまうことがあるという問題点を有してい
た。That is, in the current treatment planning system, since a target cannot be set based on pathological findings, a relatively wide margin has to be set, and the patient is exposed to radiation more than necessary to Up to this point, there has been a problem that it may be damaged by radiation.
【００１１】本発明は、前記従来の問題点を解消するべ
くなされたもので、治療計画における照射ターゲットの
設定を正確に行うことを第１の課題とする。The present invention has been made to solve the above-mentioned conventional problems, and it is a first object of the present invention to accurately set an irradiation target in a treatment plan.
【００１２】本発明は、又、治療効果の判定を容易に行
えるようにすることを第２の課題とする。A second object of the present invention is to make it possible to easily determine the therapeutic effect.
【００１３】本発明は、又、放射線治療適用決定のため
のデータベースを提供することを第３の課題とする。It is a third object of the present invention to provide a database for determining the application of radiation therapy.
【００１４】[0014]
【課題を解決するための手段】本発明は、放射線治療に
際して、ＰＥＴ（ポジトロンＣＴ）検査を行い、該ＰＥ
Ｔ検査によって得られたＰＥＴ画像を用いて、放射線治
療のための腫瘍領域を設定するようにして、前記第１の
課題を解決したものである。According to the present invention, a PET (positron CT) examination is performed at the time of radiotherapy,
The first problem has been solved by setting a tumor region for radiotherapy using a PET image obtained by a T test.
【００１５】更に、前記ＰＥＴ画像を、Ｘ線ＣＴ画像に
重ね合わせるようにして、位置確認を容易としたもので
ある。Further, the PET image is superimposed on the X-ray CT image to facilitate position confirmation.
【００１６】本発明は、又、放射線治療を行うための放
射線治療装置において、ＰＥＴ検査を行う手段と、該Ｐ
ＥＴ検査によって得られたＰＥＴ画像を用いて、放射線
治療のための腫瘍領域を設定する手段とを備えることに
より、前記第１の課題を解決したものである。The present invention also provides a radiotherapy apparatus for performing radiotherapy, a means for performing a PET test,
Means for setting a tumor region for radiation therapy using a PET image obtained by an ET examination, thereby solving the first problem.
【００１７】又、前記腫瘍領域の３次元的な特徴量を計
算する手段と、計算された特徴量を、患者毎に格納する
患者データベースと、該患者データベースシステムを検
索するための検索手段を更に備えることによって、前記
第３の課題を解決したものである。[0017] Further, there are further provided means for calculating a three-dimensional feature amount of the tumor region, a patient database for storing the calculated feature amount for each patient, and a search means for searching the patient database system. By providing this, the third problem has been solved.
【００１８】本発明は、又、放射線治療を行う際に、そ
の治療計画を作成するための放射線治療計画作成装置に
おいて、ＰＥＴ検査によって得られたＰＥＴ画像を用い
て、放射線治療のための腫瘍領域を設定するようにし
て、前記第１の課題を解決したものである。According to the present invention, there is also provided a radiation treatment plan creating apparatus for creating a treatment plan when performing radiation treatment, using a PET image obtained by a PET examination to obtain a tumor area for radiation treatment. Is set so that the first problem is solved.
【００１９】更に、前記腫瘍領域の３次元的な特徴量を
計算する手段と、計算された特徴量を、患者毎に格納す
る患者データベースとを備えたものである。The apparatus further comprises means for calculating a three-dimensional characteristic amount of the tumor region, and a patient database for storing the calculated characteristic amount for each patient.
【００２０】又、放射線治療用データベースシステム
に、患者情報や治療計画情報と共に、ＰＥＴ検査によっ
て得られたＰＥＴ画像から算出した、治療前後の腫瘍領
域の３次元的な特徴量を示すデータを格納するようにし
て、前記第２及び第３の課題を解決したものである。In addition, together with patient information and treatment plan information, data indicating three-dimensional features of the tumor region before and after the treatment, which are calculated from the PET images obtained by the PET examination, are stored in the radiation treatment database system. Thus, the second and third problems are solved.
【００２１】以下、本発明の作用を説明する。Hereinafter, the operation of the present invention will be described.
【００２２】ＰＥＴ（ポジトロンＣＴ）検査は、ポジト
ロン（陽子）核種のＲＩ（ラジオアイソトープ）を用い
た核医学画像診断である。画像収集の基本原理は、Ｘ線
ＣＴやＭＲＩ等と同じ断層撮影画像であるが、血流や、
糖、蛋白質代謝等、生態機能情報（細胞の活性度）を画
像化するところに特徴がある。特に、18Ｆ−ＦＤＧ（フ
ロロ・デオキシ・グルコース）を用いたＰＥＴ検査は、
腫瘍領域の抽出に優れており、全身のスクリーニングに
用いている施設もある。近い将来、18Ｆ−ＦＤＧによる
ＰＥＴ検査は、保険の適用を受ける見込みであり、多く
の施設で腫瘍検査の重要な役割を担うことと予想され
る。The PET (positron CT) examination is a nuclear medicine imaging diagnosis using a positron (proton) nuclide RI (radio isotope). The basic principle of image acquisition is the same tomographic image as X-ray CT and MRI, but blood flow,
It is characterized by imaging ecological function information (cell activity) such as sugar and protein metabolism. In particular, a PET test using 18 F-FDG (fluoro-deoxy-glucose)
Some facilities are excellent at extracting tumor regions and are used for whole-body screening. In the near future, PET testing with 18 F-FDG is expected to be covered by insurance and will play an important role in oncology testing at many facilities.
【００２３】本発明は、外部照射の放射線治療装置に、
例えば18Ｆ−ＦＤＧのＰＥＴ検査を組合せることによっ
て、前記課題を解決したものである。図４に、肺癌のＸ
線ＣＴ画像とＦＤＧ−ＰＥＴ画像、及び、それらの重ね
合わせの画像を示す。図から明らかなように、ＦＤＧ−
ＰＥＴ画像では、腫瘍領域に高輝度の領域があるのが確
認できる。The present invention provides a radiation therapy apparatus for external irradiation,
For example, the above problem has been solved by combining PET inspection of 18 F-FDG. FIG. 4 shows X of lung cancer.
3 shows a line CT image, an FDG-PET image, and an image obtained by superimposing them. As is clear from the figure, FDG-
In the PET image, it can be confirmed that there is a high-luminance area in the tumor area.
【００２４】なお、腫瘍描出のためのＲＩは、18Ｆ−Ｆ
ＤＧの他にメチオニンが知られており、更に、その他新
しいＲＩが各研究施設で開発中であり、各々、次のよう
な特性が知られている。The RI for tumor delineation is 18 FF
Methionine is known in addition to DG, and other new RIs are under development at each research facility, each of which has the following properties.
【００２５】18Ｆ−ＦＤＧ…ブドウ糖消費量を計測で
き、活性の高い腫瘍細胞の描出に最も有効と評価されて
いる。 18 F-FDG: Glucose consumption can be measured, and is evaluated as the most effective for delineating tumor cells with high activity.
【００２６】11Ｃ−Methionine（メチオニン）…アミノ
酸輸送を計測でき、腫瘍細胞の悪性度を計測できると言
われている。使用頻度はあまり多くない。 11 C-Methionine: It is said that amino acid transport can be measured, and malignancy of tumor cells can be measured. Not very often used.
【００２７】11Ｃ−Choline （コリン）…細胞膜に集積
すると言われている。活性（分裂性）の高い細胞（腫瘍
細胞）の存在を計測できる。 11 C-Choline (choline): It is said that it is accumulated on the cell membrane. The presence of cells (tumor cells) with high activity (mitotic activity) can be measured.
【００２８】ＡＭＴ（αメチルタイロシン）…アミノ酸
輸送ガン、神経（鬱病）、骨肉腫に顕著で、ＦＤＧで現
れない現象が顕著に出ると言われている。AMT (α-methyltyrosine): It is said that it is remarkable in amino acid transport cancer, nerve (depression), and osteosarcoma, and a phenomenon that does not appear in FDG is remarkable.
【００２９】従って、ＰＥＴ検査には、ＦＤＧ以外のこ
れらのＲＩも使用可能である。Therefore, these RIs other than FDG can be used for PET inspection.
【００３０】[0030]
【発明の実施の形態】以下図面を参照して、本発明の実
施形態を詳細に説明する。Embodiments of the present invention will be described below in detail with reference to the drawings.
【００３１】本実施形態は、図５に示す如く、Ｘ線ＣＴ
装置２２、照射システム２４及び治療計画システム３０
を含む従来の放射線治療システム２０に、ＦＤＧによる
ＰＥＴ検査を行うためのＦＤＧ−ＰＥＴシステム４０
と、該ＦＤＧ−ＰＥＴシステム４０によって得られたＦ
ＤＧ−ＰＥＴ画像を、前記治療計画システム３０に入力
するためのＰＥＴ画像入力インタフェース（Ｉ／Ｆ）３
２と、該ＰＥＴ画像入力Ｉ／Ｆ３２を介して取り込まれ
たＦＤＧ−ＰＥＴ画像を用いて、前記治療計画システム
３０で作成された治療計画用データに基づいて、３次元
ＲＯＩ（３Ｄ−ＲＯＩと称する）を計算するための３Ｄ
−ＲＯＩ計算部３４と、該３Ｄ−ＲＯＩ計算部３４から
出力されるデータに基づいて作成される患者データベー
ス（ＤＢ）５０と、該患者ＤＢ５０を検索するための患
者データベース（ＤＢ）検索システム５２とを新しく加
えたものである。In the present embodiment, as shown in FIG.
Apparatus 22, irradiation system 24 and treatment planning system 30
FDG-PET system 40 for performing PET examination by FDG in the conventional radiation therapy system 20 including
And F obtained by the FDG-PET system 40.
PET image input interface (I / F) 3 for inputting a DG-PET image to the treatment planning system 30
2 and an FDG-PET image captured via the PET image input I / F 32, based on the treatment planning data created by the treatment planning system 30, based on the three-dimensional ROI (referred to as 3D-ROI). 3D to calculate)
A ROI calculation unit 34, a patient database (DB) 50 created based on data output from the 3D-ROI calculation unit 34, and a patient database (DB) search system 52 for searching the patient DB 50. Is newly added.
【００３２】前記ＦＤＧ−ＰＥＴシステムは、ＦＤＧの
製造装置及びＰＥＴカメラから構成され、該ＰＥＴカメ
ラによって得られたＦＤＧ−ＰＥＴ画像を出力する。The FDG-PET system comprises an FDG manufacturing apparatus and a PET camera, and outputs an FDG-PET image obtained by the PET camera.
【００３３】前記ＰＥＴ画像入力Ｉ／Ｆ３２は、前記Ｆ
ＤＧ−ＰＥＴシステム４０によって得られた、例えば治
療前後のＦＤＧ−ＰＥＴ画像を前記治療計画システム３
０に取り入れるインタフェース機能を有する。The PET image input I / F 32 is connected to the F
For example, FDG-PET images obtained by the DG-PET system 40 before and after the treatment are obtained by the treatment planning system 3.
It has an interface function that takes in 0.
【００３４】前記３Ｄ−ＲＯＩ計算部３４は、従来の治
療計画システムを用いて、本発明によるＦＤＧ−ＰＥＴ
画像上に設定された３次元ＲＯＩの体積、長さ等の特徴
量を計算し、計算結果を、前記患者データベース５０に
格納する。The 3D-ROI calculation unit 34 uses the conventional treatment planning system and the FDG-PET according to the present invention.
The feature amount such as volume and length of the three-dimensional ROI set on the image is calculated, and the calculation result is stored in the patient database 50.
【００３５】これらのＰＥＴ画像入力Ｉ／Ｆ３２及び３
Ｄ−ＲＯＩ計算部３４の機能は、従来の治療計画システ
ム３０の拡張として組み込むことができる。These PET image input I / Fs 32 and 3
The function of the D-ROI calculation unit 34 can be incorporated as an extension of the conventional treatment planning system 30.
【００３６】前記患者ＤＢ５０は、患者情報、治療計画
情報、ＲＯＩ情報等を格納する。通常、治療計画システ
ム３０では、治療前の治療対象画像にのみ、ＲＯＩを設
定できるが、本実施形態では、治療後の画像に対して設
定されたＲＯＩ情報も、該当患者のデータとして格納で
きるようにされている。The patient DB 50 stores patient information, treatment plan information, ROI information, and the like. Normally, in the treatment planning system 30, the ROI can be set only for the image to be treated before the treatment, but in the present embodiment, the ROI information set for the image after the treatment can be stored as data of the patient. Has been.
【００３７】前記ＤＢ検索システム５２は、前記患者Ｄ
Ｂ５０から、患者情報、治療部位情報等を検索のキーと
して、ＲＯＩ情報、治療計画情報等を検索し、結果を表
示する。The DB search system 52 stores the patient D
From B50, ROI information, treatment plan information, and the like are searched using the patient information, treatment site information, and the like as search keys, and the results are displayed.
【００３８】本実施形態における、腫瘍領域（ＲＯＩ）
設定とＲＯＩデータの計算の様子を図６に示す。In this embodiment, the tumor region (ROI)
FIG. 6 shows how the settings and ROI data are calculated.
【００３９】以下、図７を参照して、本実施形態におけ
る放射線治療作業の手順を詳細に説明する。Hereinafter, the procedure of the radiotherapy operation in the present embodiment will be described in detail with reference to FIG.
【００４０】図７の手順において、（２）（４）（５）
（８）（９）（１１）〜（１６）が、本発明により追加
されている作業であり、以下、その説明を行う。In the procedure of FIG. 7, (2), (4) and (5)
(8) (9) (11) to (16) are operations added according to the present invention, and will be described below.
【００４１】（２）放射線治療では、手順１でＸ線ＣＴ
装置２２によりＸ線ＣＴ画像を撮影するが、このとき
に、前記ＦＤＧ−ＰＥＴシステム４０によって、ＦＤＧ
−ＰＥＴ画像も撮影する。(2) In radiotherapy, the X-ray CT
The apparatus 22 captures an X-ray CT image. At this time, the FDG-PET system 40
-Also take PET images.
【００４２】（４）前記ＦＤＧ−ＰＥＴシステム４０で
撮影したＦＤＧ−ＰＥＴ画像を、ＰＥＴ画像Ｉ／Ｆ３２
を介して治療計画システム３０に入力する。(4) The FDG-PET image photographed by the FDG-PET system 40 is converted into a PET image I / F 32
Is input to the treatment planning system 30 via the.
【００４３】（５）手順４で入力されたＦＤＧ−ＰＥＴ
画像上で、腫瘍領域（ＲＯＩ）を設定する。ここでは、
ＦＤＧ−ＰＥＴ画像を用いているので、正確に領域を設
定できる。(5) FDG-PET input in step 4
On the image, a tumor region (ROI) is set. here,
Since the FDG-PET image is used, the area can be set accurately.
【００４４】（８）手順７で治療計画が確定すると、３
Ｄ−ＲＯＩ計算部３４で、設定された腫瘍領域の体積や
長さ等を計算する。(8) When the treatment plan is determined in step 7, 3
The D-ROI calculation unit 34 calculates the volume, length, and the like of the set tumor region.
【００４５】（９）手順８で計算した３Ｄ−ＲＯＩ特微
量を、患者データや確定した治療計画データと共に、前
記患者ＤＢ５０へ格納する。(9) The 3D-ROI special amount calculated in step 8 is stored in the patient DB 50 together with the patient data and the determined treatment plan data.
【００４６】更に、治療前後のターゲット情報（ターゲ
ットの特徴量）をデータベースに格納することにより、
治療効果の判定や類似症例の検討を行えるようにする。Further, by storing target information before and after treatment (target feature amount) in a database,
To be able to judge treatment effects and examine similar cases.
【００４７】具体的には、（１１）〜（１５）照射シス
テム２４により照射治療した後のフォローアップ検査に
おいても、ＦＤＧ−ＰＥＴ検査を行って、再度ＦＤＧ−
ＰＥＴ画像を撮影し（手順１１）、治療計画システム３
０へ入力し（手順１２）、治療計画システム３０で腫瘍
領域を設定し（手順１３）、設定された治療前後の腫瘍
領域について、３Ｄ−ＲＯＩ特徴量を自動的に計算して
（手順１４）、その他の情報と共に患者ＤＢ５０に格納
する（手順１５）。Specifically, (11) to (15) also in the follow-up examination after the irradiation treatment by the irradiation system 24, the FDG-PET examination is performed and the FDG-PET examination is performed again.
A PET image is taken (procedure 11), and the treatment planning system 3
0 (Step 12), a tumor area is set by the treatment planning system 30 (Step 13), and the 3D-ROI feature is automatically calculated for the set tumor area before and after the treatment (Step 14). Is stored in the patient DB 50 together with other information (procedure 15).
【００４８】格納されたデータは、後で自由に検索、結
果表示することができる。即ち、（１６）ＤＢ検索シス
テム５２を用いて、患者ＤＢ５０上で、治療が完了した
患者のデータを検索すると、治療前後で、ＦＤＧ−ＰＥ
Ｔ画像を用いて設定した腫瘍領域の情報を表示できる。
治療前後の体積や大きさ等を比較して、治療効果の判定
を行うことができる。The stored data can be freely searched later and the results can be displayed. That is, (16) When the data of the patient who has completed the treatment is retrieved from the patient DB 50 using the DB retrieval system 52, the FDG-PE is obtained before and after the treatment.
The information of the tumor area set using the T image can be displayed.
The effect of treatment can be determined by comparing the volume and size before and after treatment.
【００４９】更に、このデータ検索機能を用い、類似症
例の検索を放射線治療適用前に行えば、放射線照射によ
る治療効果を予想することができる。Further, if a similar case is searched using this data search function before applying radiation therapy, the therapeutic effect of the irradiation can be expected.
【００５０】ここで、放射線とは、放射性核種から放出
される粒子線や電磁波をいい、α線、β線、γ線、分子
線、原子線、中性子線、電子線、陽子線、Ｘ線、重粒子
線、イオン線、重イオン線等を含み、特に放射線治療の
分野では、γ線、電子線、陽子線、Ｘ線が用いられる。Here, radiation refers to a particle beam or an electromagnetic wave emitted from a radionuclide, such as α-ray, β-ray, γ-ray, molecular beam, atomic beam, neutron beam, electron beam, proton beam, X-ray, Including heavy particle beams, ion beams, heavy ion beams, etc., particularly in the field of radiation therapy, γ-rays, electron beams, proton beams, and X-rays are used.
【００５１】本発明は、陽子線治療以外に、これらの放
射線治療にも適用可能であるが、特に陽子線治療に適用
した場合は、ＰＥＴ検査は、Ｘ線ＣＴ等、他の検査に比
べて、体表面から腫瘍までの深さ情報を最も精度よく得
ることができる検査である上に、陽子線は、他の放射線
に比べて、体表面から、ある深さの所に精度良くピーク
を持つので、両者の長所を生かし、深さ方向の検出・治
療精度が飛躍的に向上する。Although the present invention can be applied to these radiation treatments in addition to the proton treatment, the PET examination is more effective than the other examinations such as X-ray CT especially when applied to the proton treatment. In addition to being able to obtain the most accurate depth information from the body surface to the tumor, the proton beam has a more accurate peak at a certain depth from the body surface than other radiation. Therefore, taking advantage of both, the detection and treatment accuracy in the depth direction is dramatically improved.
【００５２】[0052]
【発明の効果】本発明によれば、生態機能情報の画像化
による腫瘍領域の描出に優れたＰＥＴ画像を用いている
ので、Ｘ線ＣＴ画像のみを用いる場合に比べて、正確に
腫瘍領域の設定を行うことができる。According to the present invention, since a PET image excellent in delineating a tumor region by imaging of ecological function information is used, the tumor region can be accurately detected as compared with a case where only an X-ray CT image is used. Settings can be made.
【００５３】又、腫瘍領域の体積や長さ等の３次元的な
特徴量を計算し、患者データベースに格納できる。これ
は、治療前後、及び、複数のＰＥＴ画像について行うこ
とができるため、治療前後で、腫瘍領域の大きさの比較
が可能であり、患者の治療効果を判定することができ
る。Further, three-dimensional features such as the volume and length of the tumor region can be calculated and stored in the patient database. Since this can be performed before and after the treatment and for a plurality of PET images, the size of the tumor region can be compared before and after the treatment, and the treatment effect of the patient can be determined.
【００５４】更に、患者データベース検索システムによ
り、類似症例の検索を行うことができ、治療効果の予測
を行うこともできる。Further, a similar case can be searched by the patient database search system, and a therapeutic effect can be predicted.
【図１】外部照射の放射線治療で一般的に行われている
治療計画におけるＸ線ＣＴ画像上での各種領域設定の例
を示す断面図FIG. 1 is a cross-sectional view showing an example of setting various regions on an X-ray CT image in a treatment plan generally performed in external irradiation radiotherapy.
【図２】同じく線量分布シミュレーションの例を示す線
図FIG. 2 is a diagram showing an example of a dose distribution simulation.
【図３】同じくＲＯＩ設定で設定されるターゲットの種
類を説明するための線図FIG. 3 is a diagram for explaining types of targets similarly set in ROI setting.
【図４】本発明の作用を説明するための線図FIG. 4 is a diagram for explaining the operation of the present invention.
【図５】本発明の実施形態の全体構成を示すブロック線
図FIG. 5 is a block diagram showing the overall configuration of an embodiment of the present invention.
【図６】前記実施形態における腫瘍領域（ＲＯＩ）設定
と、ＲＯＩデータの計算の考え方を示す線図FIG. 6 is a diagram showing a concept of setting a tumor region (ROI) and calculating ROI data in the embodiment.
【図７】同じく放射線治療作業の流れを示す線図FIG. 7 is a diagram showing a flow of the radiotherapy operation.
１０…患者 ２０…放射線治療システム ２２…Ｘ線ＣＴ装置 ２４…照射システム ３０…治療計画システム ３２…ＰＥＴ画像入力インタフェース（Ｉ／Ｆ） ３４…３Ｄ−ＲＯＩ計算部 ４０…ＦＤＧ−ＰＥＴシステム ５０…患者データベース（ＤＢ） ５２…患者データベース（ＤＢ）検索システム DESCRIPTION OF SYMBOLS 10 ... Patient 20 ... Radiation therapy system 22 ... X-ray CT apparatus 24 ... Irradiation system 30 ... Treatment planning system 32 ... PET image input interface (I / F) 34 ... 3D-ROI calculation part 40 ... FDG-PET system 50 ... Patient Database (DB) 52 ... Patient database (DB) search system
フロントページの続き Ｆターム(参考） 2G088 EE02 FF02 FF07 4C082 AA01 AA05 AC02 AC03 AC04 AC05 AC06 AC07 AE03 AN01 AN10 4C093 AA21 AA22 AA25 CA15 CA50 DA03 EA05 FF20 FF22 FF23 FF28 FF35 FF37 FF42 FH06 FH08 FH09 5B057 AA08 AA09 BA07 DA08 DB03 DC02 DC03 Continued on the front page F-term (reference) 2G088 EE02 FF02 FF07 4C082 AA01 AA05 AC02 AC03 AC04 AC05 AC06 AC07 AE03 AN01 AN10 4C093 AA21 AA22 AA25 CA15 CA50 DA03 EA05 FF20 FF22 FF23 FF28 FF35 FF37 F08 A07 F08 A08A DC03
Claims (8)
射線治療のための腫瘍領域を設定することを特徴とする
放射線治療領域設定方法。1. A radiation treatment area setting, wherein a PET (positron CT) examination is performed at the time of radiation treatment, and a tumor area for radiation treatment is set using a PET image obtained by the PET examination. Method.
わせることを特徴とする請求項１に記載の放射線治療領
域設定方法。2. The method according to claim 1, wherein the PET image is superimposed on an X-ray CT image.
おいて、 ＰＥＴ検査を行う手段と、 該ＰＥＴ検査によって得られたＰＥＴ画像を用いて、放
射線治療のための腫瘍領域を設定する手段と、 を備えたことを特徴とする放射線治療装置。3. A radiotherapy apparatus for performing radiotherapy, comprising: means for performing a PET test; and means for setting a tumor area for radiotherapy using a PET image obtained by the PET test. A radiation treatment apparatus comprising:
る手段と、 計算された特徴量を、患者毎に格納する患者データベー
スと、 該患者データベースシステムを検索するための検索手段
と、 を備えたことを特徴とする請求項３に記載の放射線治療
装置。4. A means for calculating a three-dimensional feature amount of the tumor region; a patient database for storing the calculated feature amount for each patient; a search means for searching the patient database system; The radiotherapy apparatus according to claim 3, comprising:
成するための放射線治療計画作成装置において、 ＰＥＴ検査によって得られたＰＥＴ画像を用いて、放射
線治療のための腫瘍領域を設定するようにされているこ
とを特徴とする放射線治療計画作成装置。5. A radiation treatment plan creating apparatus for creating a treatment plan when performing radiation treatment, wherein a tumor region for radiation treatment is set using a PET image obtained by a PET examination. A radiation treatment plan creator characterized in that:
る手段と、 計算された特徴量を、患者毎に格納する患者データベー
スと、 を備えたことを特徴とする請求項５に記載の放射線治療
計画作成装置。6. The apparatus according to claim 5, further comprising: means for calculating a three-dimensional characteristic amount of the tumor region; and a patient database for storing the calculated characteristic amount for each patient. Radiation treatment plan creation device.
査によって得られたＰＥＴ画像から算出した、治療前後
の腫瘍領域の３次元的な特徴量を示すデータが格納され
ていることを特徴とする放射線治療用データベースシス
テム。7. The method according to claim 1, wherein data indicating three-dimensional characteristic amounts of the tumor region before and after the treatment, which are calculated from the PET image obtained by the PET examination, are stored together with the patient information and the treatment plan information. Database system for radiation therapy.
査によって得られたＰＥＴ画像から算出した、治療前後
の腫瘍領域の３次元的な特徴量を示すデータを格納する
ことを特徴とする放射線治療用データベースシステムの
作成方法。8. A radiation therapy system which stores, together with patient information and treatment plan information, data indicating a three-dimensional characteristic amount of a tumor region before and after treatment, calculated from a PET image obtained by a PET examination. How to create a database system for
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