JP2003117010A - Radiotherapy device, program and computer-readable recording medium recording program - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a radiotherapy device of non-invasion and high safety capable of applying the radiation with high accuracy by detecting the behavior of a treated part caused by patient's breathing and pulsation, or the movement of the body without enlarging or excessively complicating the device itself, and to provide a program used in operating the device, and a computer-readable recording medium recording the program. SOLUTION: An ultrasonic image for treatment plan is simultaneously picked up in picking up a CT image for treatment plan, whether a correlation value of both ultrasonic images is more than a predetermined value or not is determined on the basis of the comparison of the ultrasonic image for treatment picked up at real time with the ultrasonic image for treatment plan in the treatment, and a radiation applying means is controlled to apply the radiation to the treated part only when the correlation value is more than the predetermined value.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a radiation treatment apparatus, a program used for operating the apparatus, and a computer-readable recording medium recording the program.

[0002]

2. Description of the Related Art Conventionally, when radiation treatment is performed by irradiating a treatment target region of a patient, the treatment target region as an irradiation target moves due to the patient's own breathing, pulsation, or body movement. This has been one of the major impediments to improving the accuracy of radiation irradiation.

Regarding this problem, for example, Hiroki Shira
to the paper "FOUR-DIMENSIONAL TREATMENT PLANIN
G AND FLUOROSCOPIC REAL-TIME TUMOR TRACKING RADIOT
HERAPY FOR MOVING TUMOR "(Int. J. Radiation Oncolo
gy Biol. Phys., vol.48, No.2, pp.435-442, 2000), a gold ball is embedded in the patient's body in advance, and the gold ball is imaged and tracked by an X-ray ТV camera. Therefore, it has been proposed to detect the behavior of the irradiation target caused by the patient's respiration, pulsation, body movement, etc., and use this for the treatment plan of the radiotherapy for the patient, and eventually for the actual radiation irradiation.

[0004]

However, in this conventional technique, a highly invasive procedure of implanting a gold ball in the patient's body is required, and moreover, while tracking this target (gold ball). This is not preferable because it is necessary to constantly irradiate the patient with X-rays, and there is a drawback in that the apparatus itself becomes considerably large-scaled.

The present invention has been made in view of the above technical problems, and a treatment caused by a patient's breathing, pulsation, body movement, or the like, without causing an increase in size or excessive complication of the device itself. Non-invasive and highly safe radiotherapy device capable of detecting the behavior of a target site and performing radiation irradiation with high accuracy, a program used for operating the device, and a computer reading recording the program The basic purpose is to provide a possible recording medium.

[0006]

Therefore, the first aspect of the present invention is as follows.
The radiation therapy apparatus according to the invention is provided by: a radiation irradiating means capable of irradiating a treatment target region with radiation; a CT imaging means for capturing a CT image of a predetermined region including at least the treatment target region; and the CT imaging device. Image processing means for performing image processing on the CTOR image, ultrasonic imaging means for capturing an ultrasonic image of a predetermined region including at least the treatment target portion, and image processing for the ultrasonic image obtained by the ultrasonic imaging means. Ultrasonic image processing means, position measuring means for measuring the position of the ultrasonic imaging means, control means connected to each of the above means so as to be able to exchange signals, and controlling the operation of each means, for treatment planning Comparing means for comparing the ultrasonic image for treatment planning obtained by simultaneous imaging when capturing the CT image of With and The control means controls the operation of the radiation irradiation means so that the radiation irradiation is performed on the treatment target region only when the correlation value between the ultrasonic images is equal to or more than a predetermined value. It is a thing.

Further, the radiation treatment apparatus according to the invention of claim 2 is a radiation irradiating means capable of irradiating a treatment target portion with radiation, and a CT imaging means for picking up a CT image of a predetermined region including at least the treatment target portion. A CT image processing means for image-processing the CT image obtained by the CT imaging means; an ultrasonic imaging means for imaging an ultrasonic image of a predetermined region including at least the treatment target region; and the ultrasonic imaging means. Ultrasonic image processing means for image-processing the obtained ultrasonic image, position measuring means for measuring the position of the ultrasonic imaging means, and signals connected to the respective means so as to be able to send and receive signals to operate the respective means. The control means for controlling, the irradiation area of the radiation set on the CT image for treatment planning, and the corresponding area corresponding to the irradiation area in the ultrasonic image for treatment taken during the treatment are compared, and Comparing means for checking the correlation between the CT image of the irradiation area and the ultrasonic image of the corresponding area is provided, and the control means is for the treatment target site only when the correlation value of both images is equal to or more than a predetermined value. It is characterized in that the operation of the radiation irradiation means is controlled so that the radiation irradiation is performed.

Furthermore, the invention of claim 3 of the present application is the same as the invention of claim 1 or 2, wherein C for the treatment plan is used.
When capturing the Т image, the CТ is selected according to the patient's respiratory phase.
Each image is captured, and a CT image in a respiratory phase in which the treatment target site and the attention target organ are separated by a predetermined value or more is used as data for treatment planning.

Further, in the invention of claim 4 of the present application, in the invention of claim 3, the separated state between the treatment target portion and the attention target organ is simultaneously imaged when the CT image for the treatment plan is imaged. It is characterized in that the determination is made based on the ultrasonic image for the treatment plan obtained in this way.

Furthermore, the invention of claim 5 of the present application is, in the invention of claim 1 or claim 2, when the CT image for the treatment plan is taken, the CT synchronized with an arbitrary respiratory phase of the patient. An image is taken, and data for treatment planning is obtained based on the CT image.

Furthermore, in the invention of claim 6 of the present application, in the invention of claim 1, an irradiation region of radiation is set in the treatment plan, and the irradiation region is set to both ultrasonic images for the treatment plan and the treatment. When it is set and the ultrasonic image for the treatment plan is compared with the ultrasonic image for the treatment, only the partial region including the irradiation region is compared.

Still further, in the invention of claim 7 of the present application, in the invention of claim 1, when the ultrasonic image for the treatment plan and the ultrasonic image for the treatment are compared, both ultrasonic waves are used. It is characterized in that a part of the image data of the image is thinned out and compared.

Furthermore, in the invention of claim 8 of the present application, in the invention of claim 1, when the ultrasonic image for the treatment plan and the ultrasonic image for the treatment are compared, irradiation of radiation is performed. It is characterized in that the image data length in the direction in which the movement amount of the target is larger is set longer and compared.

Further, the invention of claim 9 is the invention of any one of claims 1 to 8, wherein the ultrasonic image capturing means is disposed at a position where the radiation irradiation target is an ultrasonic image. It is characterized in that it is set in a position that can be confirmed inside and does not intersect with the irradiation beam from the radiation irradiation means.

Furthermore, the invention of claim 10 of the present application is based on any one of the inventions of claims 1 to 9 in which the position measuring means has an arm-shaped member, and the arm-shaped member is It is characterized in that a holding unit for holding the ultrasonic image pickup means is provided.

Still further, in the invention of claim 11 of the present application, in the invention of claim 10, the ultrasonic image capturing means and the arm member are covered with the ultrasonic image capturing means at a tip end portion thereof. It is characterized in that they are attached to each other so that they can be brought into contact with the outside without being.

Furthermore, the invention of claim 12 of the present application is based on any one of the inventions of claims 1 to 10 above.
The ultrasonic image capturing means is installed at a predetermined site in the patient placement area of the treatment table.

Furthermore, the invention of claim 13 of the present application is based on any one of the inventions of claims 1 to 10 above.
Belt means for fixing the ultrasonic image pickup means to a patient is provided.

Furthermore, the invention of claim 14 of the present application is based on any one of the inventions of claims 1 to 13 above.
The ultrasonic image capturing means includes an ultrasonic image diagnostic apparatus having a video signal output means, while the ultrasonic image processing means is an external computer system provided at least outside the ultrasonic image diagnostic apparatus. And the external computer system comprises video signal input means for receiving and inputting a video signal from the video signal output means, and the external computer system is provided from the video signal output means of the ultrasonic diagnostic imaging apparatus. It is characterized in that the output video signal is read by the video signal input means to perform ultrasonic image processing.

Furthermore, the program according to the fifteenth aspect of the present invention causes a computer to perform a C for medical treatment planning on a CT imaging means for a predetermined region including at least a treatment target region.
A function of capturing a T image, a function of causing a C image processing unit to perform image processing of the C image for the treatment plan, and a predetermined region including at least the treatment target site when the C image for the treatment plan is captured. A function of simultaneously capturing an ultrasonic image for a treatment plan by the ultrasonic image capturing means, a function of causing the ultrasonic image processing means to image-process the ultrasonic image for the treatment plan, and a predetermined region including at least the treatment target region Regarding the function of causing the ultrasonic image capturing means to capture a therapeutic ultrasonic image, the function of causing the ultrasonic image processing means to perform image processing of the therapeutic ultrasonic image, and the ultrasonic image for the treatment plan. Compared with the therapeutic ultrasonic image, the function of determining whether the correlation value of both ultrasonic images is a predetermined value or more, and only when the correlation value of both ultrasonic images is a predetermined value or more ,the above As radiation is performed on the care target site, in which is characterized in that a function of outputting a control signal, it is for realizing the relative radioactive radiation means.

[0021] Furthermore, the program according to the invention of claim 16 causes a computer to perform a treatment planning C for a predetermined region including at least a treatment target region.
A function of capturing a T image, a function of causing a C image processing unit to image a C image for the treatment plan, and an ultrasonic image for treatment in the ultrasonic image capturing unit for at least a predetermined region including the treatment target region. And the function to image
A function of causing the ultrasonic image processing means to perform image processing of the therapeutic ultrasonic image; a function of setting a radiation irradiation region on the treatment planning CT image; and a function of setting a radiation irradiation region on the therapeutic ultrasonic image. A function of setting a corresponding area corresponding to the irradiation area and a function of comparing the CT image of the irradiation area with the ultrasonic image of the corresponding area and determining whether the correlation value of both images is a predetermined value or more. And a function of outputting a control signal to the radiation irradiating means so that the radiation irradiation to the treatment target region is performed only when the correlation value between the both images is a predetermined value or more. It is characterized by being.

Furthermore, the invention of claim 17 is the invention of claim 15 or claim 16, wherein the computer uses the CT imaging means to capture the respiratory phase of the patient during the imaging of the CT image for the treatment plan. In order to further realize a function of capturing a CТ image corresponding to each of the above, and a function of using the CТ image in the respiratory phase in which the treatment target site and the attention target organ are separated by a predetermined value or more, as data for treatment planning. It is characterized by being a thing.

Furthermore, the invention of claim 18 of the present application is, in the invention of claim 17, the state of separation between the treatment target site and the attention target organ in the computer, when the CT image for the treatment plan is taken. And a function for making a determination based on an ultrasonic image for treatment planning obtained by simultaneous imaging with.

Furthermore, the invention of claim 19 of the present application is the invention of claim 15 or claim 16, wherein when the CT image for the treatment plan is captured by the computer, the CT imaging means selects an arbitrary patient. CТ synchronized with the breathing phase
The present invention is characterized in that it further realizes the function of capturing an image and the function of obtaining data for treatment planning based on the CT image.

Furthermore, the invention of claim 20 of the present application is the same as the invention of claim 15, wherein the computer has a function of setting a radiation irradiation area in a treatment plan, and the irradiation area is used for treatment planning and treatment. The function of setting to both ultrasonic images, and the function of comparing only the partial region including the irradiation region when comparing the ultrasonic image for the treatment plan and the ultrasonic image for the treatment, The feature is that it is intended to be realized.

[0026] Furthermore, the invention of claim 21 of the present application is, in the invention of claim 15, when the ultrasonic image for the treatment plan and the ultrasonic image for the treatment are compared by the computer, The feature is to further realize a function of thinning out a part of the image data of both ultrasonic images and comparing.

Furthermore, the invention of claim 22 of the present application is, in the invention of claim 15, when the computer compares the ultrasonic image for the treatment plan with the ultrasonic image for the treatment, The feature is to further realize a function of setting a longer image data length in a direction in which the movement amount of the irradiation target of the radiation is larger and comparing the image data length.

Further, a computer-readable recording medium recording the program according to the invention of claim 23 of the present application is a recording medium recording the program according to any one of claims 15 to 22. It is characterized by.

[0029]

BEST MODE FOR CARRYING OUT THE INVENTION Embodiments of the present invention will be described in detail below with reference to the accompanying drawings. Embodiment 1. FIG. 1 is an explanatory diagram schematically showing the overall configuration of the radiation therapy apparatus according to the first embodiment of the present invention. As shown in this figure, the radiation treatment apparatus according to the present embodiment irradiates a patient M placed on the table 12 of the treatment table 11 with radiation to a treatment target region Т (for example, a tumor part). A linac gantry 21 as a radiation irradiating means to be obtained and at least the above-mentioned treatment target part
A CT scanner device 31 as CT imaging means for capturing a CT (Computed Tomography: Computed Tomography) image of a predetermined region including an ultrasonic wave, and an ultrasonic wave capturing an ultrasonic image of a predetermined region including at least the treatment target region T An ultrasonic probe 41 as an image pickup means is provided. still,
The table 12 of the treatment table 11 is rotatable around the treatment table support shaft 14.

The CT scanner device 31 includes the device 3
An ultrasonic image processing device for electrically processing the ultrasonic image obtained by the probe 41 is electrically connected to the ultrasonic image processing device 35 for image-processing the CT image obtained in 1. 45 is electrically connected. Further, the image processing devices 35 and 45 are provided with monitor devices 36 and 46 having a liquid crystal screen or a CRTOR screen, respectively.

The ultrasonic probe 41 includes the arm member 5
1 (position sensor arm) is attached and held to the tip holder portion 52. The base end of the position sensor arm 51 is installed in the treatment room (for example, the floor of the treatment room). In the treatment using the fixture for fixing the patient M, more preferably, the position sensor arm 5 is attached to the fixture.
The base end of 1 is installed. The position sensor arm 51
Is a three-dimensional position adjustable type, preferably a multi-joint type having a high degree of freedom assembled with a plurality of universal joints 53, and more preferably configured as a so-called robot arm. Then, by driving and controlling the arm 51, the ultrasonic probe 41 mounted / held on the tip holder portion 52 can be positioned at a desired three-dimensional position, and is defined by this position sensor system. The ultrasonic probe 4 in the position sensor coordinate system (Sc)
The position of 1 can be accurately detected and measured.

As described above, the position measuring means (position sensor arm 51) for detecting and measuring the position of the ultrasonic imaging means (ultrasonic probe 41) has an arm-shaped member, and the arm-shaped member has an ultrasonic probe. Since the holding portion (tip holding portion 52) for holding 41 is provided, it is not necessary to separately provide a dedicated member for holding the ultrasonic probe 41. That is, since the position sensor arm 51 can perform both the position measurement of the ultrasonic probe 41, the holding of the ultrasonic probe 41, and the fixing to the patient M, the structure of the radiotherapy apparatus can be further simplified. Can be done.

FIG. 4 shows another example of the position sensor arm. Also in this case, the position sensor arm 5
1'is configured as a multi-joint type robot arm having a high degree of freedom assembled with a plurality of universal joints 53 ', and a holding portion 52' for mounting and holding the ultrasonic probe 41 is provided at the tip thereof. Therefore, the same operation as that of the position sensor arm 51 shown in FIG. 1 can be performed.

In the above radiotherapy apparatus, a central control unit 60 is provided to comprehensively control the operation of each of the above components. The central control device 60 is configured, for example, by a microcomputer as a main part, and is connected to each of the above-mentioned constituent elements (specifically, to each control section of each constituent element) so that signals can be transmitted and received. In the present embodiment, the central control device 60 allows the central control unit 60 to simultaneously obtain an ultrasonic image for a treatment plan obtained by simultaneously capturing an image of a CT image for a treatment plan, and an ultrasonic image for treatment captured at the time of treatment. A comparison determination unit 61 is provided as a comparison unit that compares the two ultrasonic images with each other to check the correlation between the two ultrasonic images.

An irradiation control unit 62 which transmits a control signal for radiation irradiation to the control unit 22 of the linac gantry 21 is connected to the comparison / determination unit 61 so as to be able to exchange signals. Then, the comparison determination unit 61 calculates the correlation value of both ultrasonic images, and the irradiation control unit 62 controls the irradiation of the treatment target site T so that the radiation irradiation is performed only when the correlation value is a predetermined value or more. A radiation irradiation control signal is output.

The radiation treatment apparatus having the above components is subjected to various adjustments and settings prior to its use. For example, the ultrasonic image data and the ultrasonic probe 4
With respect to the image pickup characteristic of No. 1 or the position detection data by the position sensor arm 51 and the actual position of the ultrasonic probe 41, the calibration is completed in advance. A so-called phantom or the like can be used for this calibration, for example.

The linac gantry 21 and the position sensor arm 51, that is, the linac coordinate system Lc defined by the linac gantry 21 and the position sensor coordinate system Sc defined by the position sensor system are calibrated, for example, when the device is installed. deep. A so-called phantom or the like can be used for this calibration, for example.
Accordingly, the ultrasonic image captured by the ultrasonic probe 41 is converted into the linac coordinate system Lc via the position sensor coordinate system Sc. The origin of the position sensor coordinate system Sc is, for example, on the rotation center line of the base 13 of the treatment table 11, and the origin of the linac coordinate system Lc is on the rotation center line of the linac gantry 21.

With reference to the flow chart of FIG. 2, the basic procedure of making a radiation treatment plan using the radiation treatment apparatus constructed and adjusted as described above and performing the radiation treatment in accordance with this plan will be mainly described. explain. First, in order to make a treatment plan, in step # 1, the CT scanner 31 captures a CT image (Cp) for a treatment plan for a predetermined region including the treatment target region T of the patient M. In step # 2 which is performed at the same time as the process of step # 1, at the same time (at the same phase) as the imaging of the treatment planning CT image (Cp), the ultrasound image for the treatment planning (U
p) is imaged. At this time, the position sensor arm 51 measures the position of the ultrasonic probe 41.

Next, the treatment staff, mainly the doctor in charge, confirms the treatment target region Т based on the above-mentioned treatment planning CT image (Cp) taken while the patient M holds his breath for a short time. In addition, the irradiation target of radiation is specified. Further, for example, because of being in the vicinity of the irradiation target or the like, other organs (so-called organs of interest referred to in the invention of the present application) that should be particularly targeted during radiation irradiation are designated.
Then, a treatment plan is prepared. As a result, the radiation irradiation area is set based on the treatment planning CT image (Cp) (step # 3).

As described above, the radiation treatment plan for the patient M is prepared, and the CT image Cp for the treatment plan is prepared.
When imaging (see step # 1 above), preferably, the breathing control of the patient M is performed. That is, for various respiratory phases of the patient M, C corresponding to each respiratory phase
Each T image is captured. Specifically, for example, the respiratory phase of the patient M is maximum exhalation, maximum inspiration under normal breathing,
With respect to various stages such as an intermediate state, the CT image Cp is captured in a breath-hold state. Then, the CT image at the respiratory phase in which the treatment target region T and the attention target organ are separated from each other by a predetermined value or more (preferably, most separated) is used as the data for the treatment plan.

In this way, by capturing the CTOR image Cp for the treatment plan under the respiratory control of the patient M, it is safer and more efficient for the behavior of the treatment target site T according to the respiratory phase of the patient M. It is possible to make a proper treatment plan. In particular,
The accuracy of the treatment plan itself can be improved by using the CTOR image at the respiratory phase in which the treatment target region Т and the attention target organ are separated from each other by a predetermined value or more (preferably the most separated). You can do it. In addition, the influence of the target organ, which is an erroneous recognition element around the treatment target region T (irradiation target), can be suppressed, so that the correlation accuracy with the therapeutic ultrasonic image taken during the treatment can be improved.

When planning a treatment plan based on the respiratory control of the patient M as described above, when the treatment plan CT image Cp is imaged, the separation state between the treatment target region T and the attention target organ is taken. You may make it visually based on the ultrasonic image Up for a treatment plan obtained by carrying out simultaneous imaging. In this case, the treatment target region T and the attention target organ are separated from each other by a predetermined value or more (preferably, separated from each other) CT.
The respiratory phase from which an image is obtained can be obtained in real time and with high accuracy.

In the case of performing radiation treatment based on the treatment plan prepared as described above, first, the isocenter position set at the time of the treatment plan of the patient M is made to coincide with the isocenter position of the linac gantry 21. 1
1 is aligned. Next, the ultrasonic probe 41 mounted and held in the tip holder portion 52 of the position sensor arm 51.
With the patient M. At that time, the ultrasonic probe 41 is set at a position where the treatment target region (irradiation target) T can be visually recognized. The position where the ultrasonic probe 41 is arranged is more preferably set at a position where the irradiation target T of the radiation can be confirmed in the ultrasonic image and the irradiation beam from the linac gantry 21 does not intersect. By setting the position in this way, the planned treatment plan can be executed more accurately.

Then, an ultrasonic image (the ultrasonic image for treatment Ut) is picked up in real time with respect to a predetermined region including the treatment target region T of the patient M (FIG. 2: step # 4). This therapeutic ultrasonic image (Ut) is similar to that for the treatment planning, and the linac coordinate system L via the position sensor coordinate system Sc.
converted to c. Next, this therapeutic ultrasound image (Ut)
Is compared with the treatment planning CT image (Cp) and the treatment planning ultrasonic image (Up) simultaneously imaged, and the correlation between both images is examined. That is, the comparison determination unit 61 of the central controller 60 calculates the correlation value of both ultrasonic images (step # 5), and determines whether this correlation value is equal to or greater than a preset predetermined value (threshold value). (Step # 6). As this correlation, for example, in order to detect the movement of the irradiation target T in three dimensions, a normalized correlation using the three-dimensional data of the ultrasonic image is obtained.

If the determination result in step # 6 is YES, the irradiation control unit 62 transmits an irradiation signal to the control unit 22 of the linac gantry 21 (step # 7), and the irradiation target Т is irradiated. Radiation is emitted. After that, each step after step # 4 is repeatedly executed. On the other hand, if the decision result in the step # 6 is NO, the irradiation signal is not transmitted from the irradiation control section 62, and the steps after the step # 4 are repeatedly executed. By repeating the steps from step # 4 onward, when a predetermined amount of radiation based on the treatment plan is applied to the irradiation target T, the treatment ends.

FIGS. 3 (a) and 3 (b) show a treatment plan ultrasonic image Up1 and a treatment ultrasonic image Ut1 which are imaged in the above-mentioned treatment plan and treatment steps and are compared at the time of treatment and the correlation is calculated. It is an explanatory view showing typically. In these figures, the symbol Тp indicates the irradiation target (treatment target site) at the time of treatment planning, and the symbol Тt indicates the irradiation target at a certain point during the treatment. In the state of FIG. 3A, the correlation between the two ultrasonic images Ut1 and Up1 is low, and radiation is not emitted in this state. On the other hand, in the case of FIG. 3B, since the correlation between the two ultrasonic images Ut1 and Up1 is sufficiently high (the correlation value is equal to or more than the threshold value), irradiation of the irradiation target Tt is performed.

The steps described above are basically executed in sequence by operating and controlling the radiotherapy apparatus using the computer of the central controller 60. However, the functions of the computer are realized. The program for, for example, although not specifically shown, is stored in the memory unit of the central controller 60, and is called and applied when the radiation therapy apparatus is operated. The program is recorded in a computer-readable recording medium (for example, an optical disc medium such as a compact disc (CD) or a DVD), and the recording medium is read out by the central control unit 60 (or
It may be mounted on an external reading device (electrically connected to the central control device 60) so that the program is read and used.

As described above, according to the present embodiment, the ultrasonic image Up for the treatment plan obtained by simultaneously capturing the CT image Cp for the treatment plan and the real time during the treatment are obtained. The ultrasonic image Ut for medical treatment imaged in the above is compared, the correlation between the ultrasonic images Up and Ut is examined, and only when the correlation value is a predetermined value or more, that is, the breathing or pulsation of the patient M or Treatment area Т due to body movement
The operation of the linac gantry 21 is controlled so that the radiation irradiation to the treatment target region Т is performed only when the behavior of 1 has a high degree of coincidence with the behavior at the time of treatment planning. Therefore, with respect to the behavior of the treatment target site Т caused by the breathing, pulsation, or body movement of the patient M, it is possible to perform radiation irradiation in a state in which the degree of coincidence with the time of treatment planning is extremely high, and more accurate radiation treatment is performed. be able to. In this case, as in the conventional method in which, for example, a gold ball or the like is embedded in the body of the patient M in advance and the image is tracked by an X-ray TV camera, the radiotherapy apparatus itself becomes large and excessively complicated. It does not cause any specialization and is not invasive. That is, it is non-invasive, the burden on the patient M is light, and
It is possible to perform highly safe radiation treatment.

Embodiment 2. Next, a second embodiment of the present invention will be described. In the following description, the same reference numerals are given to those having the same configuration and the same operation as those in the first embodiment,
Further explanation is omitted. As described above, the CTOR image for treatment planning and the ultrasonic image for treatment planning are simultaneously captured at the time of planning a treatment plan. As the ultrasonic image for treatment plan, for example, one slice image including an isocenter is used. When used, it is desirable to select the slice direction in which the irradiation target T is displaced the most, in order to improve the accuracy of radiotherapy when the irradiation target T moves.

Therefore, for example, as schematically shown in FIG. 5, the ultrasonic probe 41 is set on the patient M, and ultrasonic images Up2, Up3, U for treatment planning are set in various directions.
p4 is imaged and the most preferred slice direction is
Set visually or from the velocity field of the irradiation target Т. Incidentally, FIG.
Shows the irradiation target Тp and its displacement state on a specific slice plane Fs5 of a certain ultrasound image Up5 for treatment planning. When the treatment planning ultrasonic image and the treatment ultrasonic image captured in this state are compared and the correlation therebetween is obtained, it is possible to perform the radiotherapy in which the position of the irradiation target T is accurately detected. In this case, the therapeutic ultrasonic image includes an isocenter, and is an image in the same slice plane as when the treatment is planned.

Further, it is desirable that the position of the ultrasonic probe 41 does not intersect with the direction of the irradiation beam of the linac gantry 21 during the treatment as described above. Therefore, a shape model of the ultrasonic probe 41 is created and converted from the position sensor coordinate system Sc to the linac coordinate system Lc to determine whether or not the beam of the linac gantry 21 is three-dimensionally intersected. Then, the ultrasonic probe 41 is placed at a position satisfying the condition.
Is installed. In this case, since the beam direction in the treatment plan is taken into consideration during the treatment, the ultrasonic probe 41 can be installed efficiently.

Embodiment 3. Next, a third embodiment of the present invention will be described. The third embodiment is mainly intended to shorten the processing time when comparing the ultrasonic images for treatment planning and the ultrasonic images for treatment and calculating the correlation value between them. As described above, at the time of planning a radiation treatment plan, the radiation irradiation region is set in the treatment plan CT image. FIG. 7A schematically shows the treatment planning CT image Cp6 in which the irradiation region Acp is set in a predetermined range including the irradiation target Tp.

Next, the ultrasound image Up6 for treatment planning, which is simultaneously imaged with the CT image Cp6 for treatment planning (FIG. 7 (b)).
Refer to the above) and set the irradiation area. This setting is performed, for example, by converting each data in the treatment planning CT image Cp6 into the linac coordinate system Lc. on the other hand,
Regarding the treatment planning ultrasonic image Up6, each data in the image is converted into the position sensor coordinate system Sc and then further converted into the linac coordinate system Lc. Note that these conversion matrices are obtained by performing calibration using a phantom when installing the device. Both images Cp
As a result of arranging each data of 6 and Up6 in the same coordinate system, the irradiation region Acp in the treatment planning CT image Cp6 is shown in FIG.
As shown in (b), it can be set in the ultrasound image Up6 for treatment planning (irradiation region Aup).

At the time of treatment, a therapeutic ultrasonic image Ut6
(See FIG. 7C) is imaged in real time. This therapeutic ultrasonic image Ut6 is a therapeutic planning ultrasonic image Up6.
In the same manner as in the case of, each data in the image is converted into the position sensor coordinate system Sc, and then the linac coordinate system Lc.
To the irradiation area Aut of the therapeutic ultrasonic image Ut6.
The correlation calculation is performed inside the irradiation area Aup of the treatment planning ultrasonic image Up6. When performing this correlation calculation,
In practice, both the irradiation region Aut of the therapeutic ultrasonic image Ut6 and a region obtained by adding a certain margin region to the irradiation region Aut of the therapeutic planning ultrasonic image Up6 It is more preferable to perform the correlation calculation for obtaining the correlation value of. This is actually
This is because it is often difficult to make a judgment only by the correlation within the irradiation area, and if there is an area outside the irradiation area that serves as a mark that increases the correlation value between the two, it is effective to include such area as a margin. is there.

That is, the irradiation area of radiation is set in the treatment plan, and the irradiation areas are set in both the ultrasonic images Up6 and Ut6 for the treatment plan and the ultrasonic image Up6 for the treatment plan and the treatment. When comparing the ultrasonic image Ut6 for use with the ultrasonic images Up6 and Ut6, only the partial regions including the irradiation regions Aup and Aut (actually, the region including the margin region) are compared.
It is possible to reduce the processing time when comparing 6 to obtain the correlation value,
In addition, since the comparison is made only within the radiation irradiation areas Aup and Aut (actually, the area including the margin area), there is no erroneous recognition target, and thus a highly accurate correlation value can be obtained. Then, the irradiating target Т that is displaced can be gating and irradiated in real time.

Fourth Embodiment Next, a fourth embodiment of the present invention will be described. The fourth embodiment is also mainly intended to shorten the processing time when comparing the ultrasonic images for treatment planning and the ultrasonic images for treatment and calculating the correlation value between them. In the present embodiment, when comparing an ultrasonic image for treatment planning and an ultrasonic image for treatment, a part of the image data of both ultrasonic images is thinned out and compared.

FIG. 8 is a schematic explanatory view of an ultrasonic image U8 showing a case where three-dimensional image data of an ultrasonic image is thinned out in one direction. In this case, when comparing the ultrasonic image for treatment planning with the ultrasonic image for treatment, a part of the three-dimensional image data of both ultrasonic images is thinned out, and as shown in FIG. The image data on the slice planes FV1 to FV3 that are parallel to each other in the direction (vertical direction in the drawing) is compared, and the correlation value is calculated only for this small number of image data.

Further, FIG. 9 shows an ultrasonic image U showing a case where the image data of the ultrasonic image is thinned out in two orthogonal directions.
9 is a schematic explanatory diagram of FIG. In this case, when comparing the ultrasonic image for treatment planning with the ultrasonic image for treatment, a part of the three-dimensional image data of both ultrasonic images is thinned out, and as shown in FIG. (Up and down direction in the figure)
Image data on the parallel slice planes FV1 to FV3, and image data on the slice planes FH1 to FH3 orthogonal to these slice planes FV1 to FV3,
The correlation value is calculated only for this small number of image data.

The slice planes FV1 to FV3 and / or the slice planes FH1 to FH obtained by thinning out as described above are used.
For H3, we also culled the data from that plane,
The amount of data used for arithmetic processing may be reduced. In addition, as a result of thinning out, the image data for which the calculation processing of the correlation value should be performed is
There may be only one two-dimensional slice image.

In this embodiment, when comparing an ultrasonic image for treatment planning and an ultrasonic image for treatment, a part of the image data of both ultrasonic images is thinned out and compared. The processing time for obtaining the correlation value by comparing the sound wave images can be shortened, and gating irradiation can be performed in real time.

When comparing the ultrasonic image for treatment planning with the ultrasonic image for treatment, the irradiation target Тu of the radiation is
It is more preferable to set a longer image data length in the direction in which the movement amount is larger and compare. In this case, when calculating the correlation value by comparing both ultrasonic images, it becomes possible to perform a highly accurate correlation calculation for a limited processing time.

Fifth Embodiment Next, a fifth embodiment of the present invention will be described. The fifth embodiment mainly relates to a method of installing the ultrasonic probe 41. FIG. 10 shows the ultrasonic probe 4 according to the present embodiment.
It is explanatory drawing which shows the installation structure of 1 typically. As shown in this figure, in the present embodiment, the ultrasonic probe 41 is
The treatment table 12 is arranged at a predetermined site in a region where the patient M is placed. Specifically, the cushion member 19 is disposed between the treatment table 12 and the patient M lying on the treatment table 12 in the prone position.

FIG. 11 is an explanatory view schematically showing a modified example of the fixing structure of the ultrasonic probe 41 according to this embodiment. In this case, the cushion member is not provided between the patient M and the treatment table 12, and the ultrasonic probe 41 is directly installed on the treatment table 12. Incidentally, in FIG. 10 and FIG. 11, the treatment table 1
2 is an opening through which the probe 41 or a part of the position sensor arm 51 including the tip holding portion 52 is inserted in order to set the ultrasonic probe 41 on the abdominal side of the patient M lying on the prone position. A part (not shown) is provided at a predetermined portion of the treatment table 12. Further, when the ultrasonic probe 41 and / or the tip holding portion 52 positioned through the opening is set on the cushion member 19 or the treatment table 12 itself, for example, screwing or a band or belt. Although various known methods such as fixing by means of fixing can be applied, the orientation of the ultrasonic probe 41 and / or the tip holding portion 52 can be easily adjusted by applying a universal joint or the like to this installation portion. It is preferable to install so as to obtain.

When the region to be treated with radiation is, for example, the prostate, the patient M usually receives the radiation treatment as shown in FIGS. 10 and 11, for example.
A prone position is taken on the treatment table 12. In such a case, it is generally difficult to obtain a useful ultrasonic image due to the influence of the spine or the like if the image is taken from the back side of the patient M by the holding method of the ultrasonic probe 41 as shown in FIG. Therefore, there may be a case where the patient M is forced to perform ultrasonic imaging from the abdominal side in the prone position.

In such a case, for example, as shown in FIG. 10 and FIG. 11, the ultrasonic probe 41 is placed on a predetermined portion (for example, the treatment table 1) in the patient placement area of the treatment table.
2 is installed on the cushion member 19 or the treatment table 12 itself), the ultrasonic probe 41 is applied to the patient M by the weight of the patient M placed in the prone position on the treatment table 12, for example. Since more reliable and strong crimping is performed, a higher resolution ultrasonic image can be obtained.

Sixth Embodiment Next, a sixth embodiment of the present invention will be described. The sixth embodiment also mainly relates to a method of installing the ultrasonic probe 41. FIG. 12 shows the ultrasonic probe 4 according to the present embodiment.
It is explanatory drawing which shows the installation structure of 1 typically. As shown in this figure, in the present embodiment, a probe crimping belt 71 is provided for crimping and fixing the ultrasonic probe 41 to the patient M. The belt 71 is made of a material having a predetermined elasticity, such as rubber, and the ultrasonic probe 41 is attached to the patient M by using the pressure bonding belt 71.
By fixing the ultrasonic probe 41 to a predetermined portion of the patient M, the ultrasonic probe 41 is fixed to the patient M while maintaining a reliable contact state.

When taking an ultrasonic image of a predetermined portion of the patient M, in order to obtain a good ultrasonic image, as is well known, the ultrasonic probe 41 surely maintains the contact state with the patient M. Although it is necessary, the contact between the ultrasonic probe 41 and the patient M may be weakened due to the breathing motion of the patient M or a motion such as a slight body movement. In such a case, by fixing the ultrasonic probe 41 to the patient M using the probe pressure bonding belt 71, the ultrasonic probe 41 is more reliably and firmly fixed to the patient M. Therefore, it is possible to reliably prevent the ultrasonic probe 41 from being separated from the patient M due to, for example, breathing, pulsation, or body movement of the patient, and to stably obtain a high-resolution ultrasonic image.

Embodiment 7. Next, a seventh embodiment of the present invention will be described. The seventh embodiment relates to a structure for fixing an ultrasonic probe and a position sensor arm. FIG. 13 is an explanatory view schematically showing the fixing structure of the ultrasonic probe 41 and the position sensor arm 91 according to the present embodiment. As shown in this figure, in the present embodiment, an ultrasonic diagnostic apparatus 80 including an ultrasonic image processing apparatus is provided.
When fixing the ultrasonic probe 41 of 1 to the position sensor arm 91 as a three-dimensional position sensor, the tip portion 91a to which the sensor element of the position sensor arm 91 is attached is not covered with the ultrasonic probe 41. At the same time,
In order that the tip portion 91a can contact an external observation point (preferably, the tip portion 91a is the ultrasonic probe 41).
It is fixed so that it protrudes to a certain extent).

By adopting such a fixing structure, since the ultrasonic probe 40 is fixed to the position sensor arm 91, it can be effectively applied to the radiotherapy apparatus in each of the above-mentioned embodiments. Moreover, in that case, the tip portion 91a provided with the sensor element of the position sensor arm 91 is fixed so that the tip portion 91a can be brought into contact with the outside without being covered with the ultrasonic probe 41 (that is, in a state of protruding to some extent or more). Therefore, the ultrasonic probe 41
When performing the calibration of the three-dimensional position sensor 91 and the three-dimensional position sensor 91, the reference point position of the phantom can be obtained without the need to remove the both, and the calibration accuracy can be effectively improved.

Eighth Embodiment Next, an eighth embodiment of the invention will be described. The eighth embodiment is mainly concerned with a case where it is not possible to simultaneously capture ultrasound images for treatment planning when capturing CT images for treatment planning. For example, depending on the positional relationship between the position sensor arm 51 and the CT scanner device 31, etc., the ultrasonic probe 4
1 cannot be arranged at a required position, and when the CТ image and the ultrasonic image cannot be taken at the same time during the treatment plan, the radiation irradiation area set on the CТ image for the treatment plan and In a therapeutic ultrasonic image taken in real time during treatment, the corresponding region corresponding to the irradiation region is compared to obtain a correlation value between the two.

Specifically, the irradiation area of the radiation set on the CT image for treatment planning is used as a so-called mask area, the ultrasonic image for treatment taken during the treatment is masked, and the masking is performed in these mask areas. Then, the average and variance of the pixel values of are calculated, and the degree of similarity with the average and variance of the irradiation regions in the ultrasonic image that have been obtained in advance is calculated. This degree of similarity corresponds to the correlation value in the first embodiment. Then, only when the correlation value (similarity) between the two is above, that is, the behavior of the treatment target site Т caused by the breathing, pulsation, or body movement of the patient M has a degree of coincidence with the behavior at the time of treatment planning. The operation of the linac gantry 21 is controlled so that the irradiation of the treatment target region T is performed only when the temperature is high.

Therefore, according to the present embodiment, basically, the same operational effect as in the case of the first embodiment can be obtained, and particularly, the treatment plan at the time of capturing the treatment plan CT image. Even if it is not possible to simultaneously capture medical ultrasound images, regarding the behavior of the treatment target site caused by the respiration, pulsation, or body movement of the patient M, radiation irradiation in a state of extremely high agreement with the time of treatment planning It will be possible to do.

Ninth Embodiment Next, a ninth embodiment of the invention will be described. This ninth embodiment also mainly relates to a method of capturing a CT image for treatment planning. In the present embodiment, when capturing a CT image for treatment planning, a CT image synchronized with an arbitrary respiratory phase of the patient is captured. Specifically, when capturing a CT image for treatment planning, an image is taken under normal breathing of the patient M by a respiratory sensor, and an arbitrary respiratory phase image is reconstructed by respiratory gating CT imaging or post-processing. be able to.

As the breathing sensor, an external strain gauge or an ultrasonic image can be applied. The above-mentioned post-processing is a method in which respiratory phase information is given to each projection data in the X-ray tube rotation of the CT scanner device, and an image is reconstructed only from the projection data for a predetermined respiratory phase. It is possible to obtain CT images of a plurality of respiratory phases all at once.

According to the present embodiment, when the CT image for the treatment plan is taken, the CT image synchronized with the desired respiratory phase of the patient M is taken, so that the desired respiratory phase of the patient M is obtained. Since it is possible to obtain a CTOR image for treatment planning without blurring due to the respiration, and to obtain data for a treatment plan based on the CTOR image, it is possible to further improve the accuracy of the treatment plan.

Embodiment 10. Next, a tenth embodiment of the present invention will be described. In each of the above-described embodiments, for example, as shown in FIG. 1, an ultrasonic imaging unit (ultrasonic probe 41) that captures an ultrasonic image of a predetermined region including at least a treatment target portion, and the ultrasonic imaging unit. The ultrasonic image processing means (ultrasonic image processing device 45) for image-processing the obtained ultrasonic image is provided as being present in the same system or device. However, both these means do not necessarily have to be provided in one system.

In this embodiment, as shown in the block diagram of FIG. 14, the ultrasonic image pickup means includes an ultrasonic image diagnostic apparatus 100 having a video signal output means 102. On the other hand, the ultrasonic image processing means is composed of an external computer system 110 provided at least outside the ultrasonic image diagnostic apparatus 100, more preferably outside the radiotherapy apparatus. The external computer system 110 includes a video signal input unit 112 capable of receiving and inputting a video signal from the video signal output unit 102 of the ultrasonic diagnostic imaging apparatus 100. It should be noted that this external computer system does not need to be dedicated to the radiotherapy apparatus.

A general ultrasonic image diagnostic apparatus is often equipped with a video printer, and in most cases, a video signal output means (for example, so-called NTSC video signal output means).
Is equipped as standard. Therefore, also in the present embodiment, when the ultrasonic image data obtained by the ultrasonic image diagnostic apparatus 100 is output as a video signal, the video signal output means 102 provided as standard in the ultrasonic image diagnostic apparatus 100 is used. Therefore, it is not necessary to newly provide such output equipment (video signal output means). Further, when the ultrasonic image data is transferred at the video signal level, there is no need to change the program inside the ultrasonic image diagnostic apparatus 100. Therefore, the system according to the present embodiment can be easily realized only by inserting a board for inputting a video signal into a so-called PCI bus of the external computer system 110, which is very advantageous in practice.

In the above-mentioned structure, the ultrasonic image data obtained by the ultrasonic image diagnostic apparatus 100 is supplied to the video signal input means 112 of the external computer system 110 via the video signal output means 102, and the video signal level is outputted. Is transferred and input in real time. That is, the external computer system 110 reads the video signal output from the video signal output means 102 of the ultrasonic image diagnostic apparatus 100 by the video signal input means 112 and performs ultrasonic image processing.

As the video input means, the above-mentioned NT
Those corresponding to the SC video signal (see paragraph number [0078]) can be used. In addition, as other video input means, those corresponding to signals of VGA, SVGA, XGA, SXGA standard supplied to the CRT monitor of the ultrasonic diagnostic imaging apparatus 100 are commercially available. In this case, as the video signal output means 102, a video card used in a general computer can be used. Further, in recent years, a digital output video card has been put into practical use, so that a video signal input means capable of inputting a digital signal can be used. According to these methods, there is an advantage that video image information having a higher spatial resolution than the above-mentioned NTSC signal can be transmitted.

As described above, the external computer system 11 is used as the ultrasonic image processing means for image-processing the ultrasonic image obtained by the ultrasonic imaging means (ultrasound image diagnostic apparatus 100).
By using 0, it is possible to use a computer system capable of high-speed processing without particularly complicating the configuration of the ultrasonic image diagnostic apparatus 100, and thus the configuration of the radiotherapy apparatus itself, and shortening the image processing time. Further, it becomes possible to deal with image processing which is complicated and requires a large amount of data processing.

In this embodiment, it is necessary to transfer the ultrasonic image data obtained by the ultrasonic image diagnostic apparatus 100 to the external computer system 110 at high speed. As the transfer method, in addition to the transfer method at the video signal level as described above, a local area
It is also possible to apply a method of connecting at a communication line such as a network and transferring data at high speed by a method such as a socket communication method.

In the embodiment shown in FIG. 1, the comparison determination unit 61 for comparing the ultrasonic image for treatment planning with the ultrasonic image for treatment to check the correlation between the ultrasonic images, and the linac. The irradiation control unit 62 that transmits a control signal for radiation irradiation to the gantry 21 was both provided in the central control device 60, but such a comparison determination unit and irradiation control unit are separate from the central control device 60. It may be provided in the.
As described above, the present invention is not limited to the above-described embodiment, and various modifications and design improvements can be made without departing from the scope of the invention.
Needless to say.

[0084]

According to the first aspect of the present invention, the ultrasonic image for the treatment plan obtained by simultaneously capturing the CT image for the treatment plan and the therapeutic image captured in real time during the treatment. The ultrasonic images of the two are compared, and the correlation between both ultrasonic images is examined, and only when the correlation value is a predetermined value or more, that is, the treatment target site caused by the patient's breathing, pulsation, or body movement The operation of the radiation irradiating means is controlled so that the irradiation of the treatment target site is performed only when the behavior has a high degree of coincidence with the behavior at the time of treatment planning. Therefore, regarding the behavior of the treatment target part caused by the patient's breathing, pulsation, or body movement, it is possible to perform radiation irradiation in a state in which the degree of coincidence with the time of treatment planning is extremely high, and more accurate radiation treatment can be performed. it can. In this case,
As in the conventional method in which a marker (for example, a gold ball) is embedded in the patient's body in advance and the image is tracked by an X-ray ТV camera, the size of the device itself and the excessive complexity thereof are particularly brought about. There is also no invasiveness. That is, non-invasive and highly safe radiotherapy can be performed.

According to the second aspect of the present invention, the irradiation area of radiation set on the CT image for treatment planning and the irradiation area in the ultrasonic image for treatment taken in real time at the time of treatment are set to the irradiation area. Corresponding corresponding areas are compared, and the correlation between the CT image of the irradiation area and the ultrasonic image of the corresponding area is examined, and only when the correlation value is equal to or more than a predetermined value, that is, the patient's breathing or pulsation or The operation of the radiation irradiating means is controlled so that the irradiation of the treatment target site is performed only when the behavior of the treatment target site due to body movement or the like has a high degree of coincidence with the behavior at the time of treatment planning. Therefore, regarding the behavior of the treatment target part caused by the patient's breathing, pulsation, or body movement, it is possible to perform radiation irradiation in a state in which the degree of coincidence with the time of treatment planning is extremely high, and more accurate radiation treatment can be performed. it can. In particular, even when it is not possible to simultaneously capture ultrasound images for treatment planning at the time of capturing the CT image for treatment planning, regarding the behavior of the treatment target site caused by the respiration, pulsation or body movement of the patient,
It becomes possible to perform radiation irradiation in a state in which the degree of coincidence with the time of treatment planning is extremely high. In this case, a marker (for example, a gold ball) is embedded in the patient's body in advance, and the marker X
Unlike the conventional method in which a line V camera is used for imaging and tracking, there is no particular increase in size or excessive complication of the device itself, and there is no invasiveness. That is, non-invasive and highly safe radiotherapy can be performed.

Further, according to the invention of claim 3 of the present application, the same effect as that of the invention of claim 1 or 2 can be obtained. In particular, when capturing the CT image for the treatment plan, each CTOR image corresponding to the respiratory phase of the patient is captured, and the CT image in the respiratory phase in which the treatment target site and the target organ are separated by a predetermined value or more. Is used as the data for the treatment plan, it is possible to make a safer and more efficient treatment plan for the behavior of the treatment target site according to the respiratory phase of the patient. Further, the accuracy of the treatment plan itself can be improved by using the CT image in the respiratory phase in which the treatment target site and the attention target organ are separated from each other by a predetermined value or more as the data for the treatment plan. Furthermore, since it is possible to suppress the influence of the attention target organ, which is an erroneous recognition element around the treatment target portion (irradiation target), it is possible to improve the correlation accuracy with the therapeutic ultrasonic image captured during the treatment.

Furthermore, according to the invention of claim 4 of the present application, the same effect as that of the invention of claim 3 can be obtained.
In particular, the separation state between the treatment target portion and the attention target organ is determined based on the ultrasound image for the treatment plan obtained by simultaneously capturing the CT image for the treatment plan. It is possible to obtain in real time and with high accuracy the respiratory phase at which a CT image in which the target site and the target organ are separated by a predetermined value or more are obtained.

Furthermore, according to the invention of claim 5 of the present application, the same effect as that of the invention of claim 1 or claim 2 can be obtained. In particular, when capturing the CT image for the treatment plan, by capturing the CTOR image synchronized with an arbitrary respiratory phase of the patient, the CT image for the therapeutic plan without blur due to respiration in the arbitrary respiratory phase of the patient. You can get
Since the data for the treatment plan is obtained based on the CT image, the accuracy of the treatment plan can be further improved.

Furthermore, according to the invention of claim 6 of the present application, the same effect as that of the invention of claim 1 can be obtained.
In particular, the irradiation area of radiation is set in the treatment plan, and the irradiation area is set in both the ultrasonic image for treatment planning and the ultrasonic image for treatment, and the ultrasonic image for treatment planning and the ultrasonic image for treatment are set. When comparing, only the partial area including the irradiation area is compared, so that the processing time for obtaining the correlation value by comparing both ultrasonic images can be shortened, and moreover, within the partial area including the irradiation area of radiation. Since only the comparison is performed and the number of erroneous recognition targets is reduced, it is possible to obtain a highly accurate correlation value.

Furthermore, according to the invention of claim 7, the same effect as that of the invention of claim 1 can be obtained.
In particular, when comparing an ultrasonic image for treatment planning with an ultrasonic image for treatment, a part of the image data of both ultrasonic images is thinned out and compared, so both ultrasonic images are compared and correlated. The processing time for obtaining the value can be shortened, and gating irradiation can be performed in real time.

Furthermore, according to the invention of claim 8 of the present application, the same effect as that of the invention of claim 1 can be obtained.
In particular, when comparing an ultrasonic image for treatment planning and an ultrasonic image for treatment, the image data length in the direction in which the movement amount of the irradiation target of radiation is larger is set longer and compared. When comparing the ultrasonic images and obtaining the correlation value,
It becomes possible to perform more accurate correlation calculation within a limited processing time.

Further, according to the invention of claim 9 of the present application,
It is possible to obtain the same effect as that of any one of the first to eighth aspects of the invention. In particular, the arrangement position of the ultrasonic image capturing means is set at a position where the irradiation target of radiation can be confirmed in the ultrasonic image and the irradiation beam from the irradiation means does not intersect, so that the planned treatment is performed. The plan can be executed more accurately.

Furthermore, according to the invention of claim 10 of the present application, it is possible to obtain the same effect as that of the invention of any one of claims 1 to 9. In particular, the position measuring means has an arm-shaped member, and since the arm-shaped member is provided with a holding portion for holding the ultrasonic image capturing means, a dedicated member for holding the ultrasonic image capturing means. It is not necessary to separately provide. That is, the position measurement of the ultrasonic image capturing means, the holding of the ultrasonic image capturing means, and the fixing to the patient can be performed at the same time, and the structure of the apparatus can be further simplified.

Further, according to the invention of claim 11 of the present application, the same effect as that of the invention of claim 10 can be obtained. In particular, the arm member and the ultrasonic image capturing means are
Since the distal ends of the arm members are attached to each other without being covered by the ultrasonic image capturing means so that they can be brought into contact with the outside, there is no need to remove them from each other when performing calibration. The accuracy can be effectively increased.

Furthermore, according to the invention of claim 12 of the present application, the same effect as that of the invention of any one of claims 1 to 10 can be obtained. In particular, since the ultrasonic image capturing means is installed at a predetermined site in the patient mounting area of the treatment table, the ultrasonic image capturing means is used for a patient placed on the treatment table in a prone position, for example. Depending on the body weight, the patient is more surely and strongly crimped to the patient, and a higher-resolution ultrasonic image can be obtained.

Furthermore, according to the invention of claim 13 of the present application, the same effect as that of the invention of any one of claims 1 to 10 can be obtained. In particular, since the belt means for fixing the ultrasonic image capturing means to the patient is provided, by using the belt means, the ultrasonic image capturing means can be more reliably and firmly fixed to the patient, For example, it is possible to prevent the ultrasonic image capturing means from separating from the patient due to the breathing, pulsation, or body movement of the patient, and to stably obtain a high-resolution ultrasonic image.

Furthermore, according to the invention of claim 14 of the present application, the same effect as that of the invention of any one of claims 1 to 13 can be obtained. In particular, at least an external computer system provided outside the ultrasonic image diagnostic apparatus should be used as the ultrasonic image processing means for image-processing the ultrasonic image obtained by the ultrasonic imaging means (ultrasonic image diagnostic apparatus). Therefore, it is possible to use a computer system capable of high-speed processing without shortening the image processing time, without particularly complicating the configuration of the ultrasonic image diagnostic apparatus, and thus the configuration of the radiotherapy apparatus itself. be able to. Further, it becomes possible to more easily deal with complicated image processing that requires a large amount of data processing. Furthermore, since the transfer of the ultrasonic image data obtained by the ultrasonic image diagnostic apparatus to the external computer system is performed at the video signal level, when the ultrasonic image data is output as a video signal, the ultrasonic image diagnostic is performed. It is possible to use the video signal output means generally provided as standard equipment in the apparatus, it is not necessary to newly provide such output equipment (video signal output means), and the program inside the ultrasonic diagnostic imaging apparatus can be used. There is no particular need to change. Therefore, it can be easily realized only by providing the video signal input means to the external computer system.

Furthermore, claim 15 to claim 22 of the present application.
According to the present invention, it is possible to provide a program for realizing substantially the same operational effects as those of the inventions of claims 1 to 8 by using a computer.

Furthermore, according to the invention of claim 23 of the present application, it is possible to provide a computer-readable recording medium in which the program described in any one of claims 15 to 22 is recorded. .

[Brief description of drawings]

FIG. 1 is an explanatory diagram schematically showing the overall configuration of a radiotherapy apparatus according to a first embodiment of the present invention.

FIG. 2 is a flow chart for schematically explaining a procedure of radiotherapy by the radiotherapy apparatus.

FIG. 3 is an explanatory diagram schematically showing an example of an ultrasonic image for treatment planning and an ultrasonic image for treatment.

FIG. 4 is an explanatory diagram showing a modification of the position sensor arm.

FIG. 5 is an explanatory diagram schematically showing an ultrasonic imaging state according to the second embodiment of the present invention.

FIG. 6 is an explanatory diagram schematically showing an example of an image obtained by ultrasonic imaging according to the second embodiment.

FIG. 7 is an explanatory diagram schematically showing a treatment planning CT image, a treatment planning image, and a treatment ultrasonic image in the third embodiment of the invention.

FIG. 8 is a schematic explanatory diagram of an ultrasonic image showing a case where three-dimensional image data of an ultrasonic image is thinned out in one direction in the fourth embodiment of the present invention.

FIG. 9 is a schematic explanatory diagram of an ultrasonic image showing a case where three-dimensional image data of an ultrasonic image is thinned out in two orthogonal directions in the fourth embodiment.

FIG. 10 is an explanatory diagram schematically showing the installation structure of the ultrasonic probe according to the fifth embodiment of the present invention.

FIG. 11 is an explanatory diagram schematically showing a modified example of the installation structure of the ultrasonic probe according to the fifth embodiment.

FIG. 12 is an explanatory diagram schematically showing the installation structure of the ultrasonic probe according to the sixth embodiment of the present invention.

FIG. 13 is an explanatory view schematically showing a fixing structure of an ultrasonic probe and a position sensor arm according to a seventh embodiment of the present invention.

FIG. 14 is a block configuration diagram showing an ultrasonic diagnostic imaging apparatus and an external computer system according to a tenth embodiment of the present invention.

[Explanation of symbols]

11 treatment table, 12 treatment table, 21 linac gantry, 31 CT scanner device, 35 CT image processing device, 41 ultrasonic probe, 45 ultrasonic image processing device, 51 position sensor arm, 52 tip holding part (of position sensor arm) , 60 central control unit, 61 comparison judgment unit, 62 irradiation control unit, 71 probe crimping belt, 100 ultrasonic image diagnostic apparatus, 102 video signal output means, 110 external computer system, 112 video signal input means, M patient, Т Target site (irradiation target).

Continued front page    (72) Inventor Masahiro Hiraoka             54 Shogoin Kawaramachi, Sakyo Ward, Kyoto City, Kyoto Prefecture Kyoto             University Graduate School of Medicine (72) Inventor Yasushi Nagata             54 Shogoin Kawaramachi, Sakyo Ward, Kyoto City, Kyoto Prefecture Kyoto             University Graduate School of Medicine (72) Inventor Masaki Kokubo             54 Shogoin Kawaramachi, Sakyo Ward, Kyoto City, Kyoto Prefecture Kyoto             University Graduate School of Medicine F-term (reference) 4C082 AA01 AC02 AE01 AJ08 AJ11                       AN02 AN05 AP07 AP08                 4C093 AA21 CA15 CA21 FA47 FF27                 4C301 AA02 BB13 EE11 EE19 FF25                       FF27 GA01 GD03 JB28 JC14                       KK17 KK18                 4C601 BB03 EE09 EE16 FF08 FF11                       FF15 GA01 GA17 GA18 GA21                       GA22 JB34 JB41 JC15 JC20                       JC21 JC25 JC26 KK21 KK22                 5B057 AA09 BA03 BA05 CH18 DA07                       DB02 DB05 DB09 DC34 DC36

Claims (23)

[Claims] 1. A radiation irradiating unit capable of irradiating a treatment target region with radiation, a CT image pickup unit for picking up a CT image of a predetermined region including at least the treatment target region, and a CT image obtained by the CT image pickup unit. Image processing CТ
Image processing means, ultrasonic imaging means for picking up an ultrasonic image of a predetermined region including at least the treatment target region, ultrasonic image processing means for image-processing the ultrasonic image obtained by the ultrasonic imaging means, Position measuring means for measuring the position of the ultrasonic imaging means, control means connected to each of the above means so as to be able to send and receive signals to control the operation of each means, and when capturing a CT image for treatment planning An ultrasonic image for treatment planning obtained by simultaneous imaging, and an ultrasonic image for treatment captured at the time of treatment are compared, and comparison means for examining the correlation between both ultrasonic images is provided. The radiotherapy apparatus is characterized in that the operation of the radiation irradiation means is controlled so that the irradiation of the treatment target region is performed only when the correlation value between the two ultrasonic images is a predetermined value or more. 2. A radiation irradiating unit capable of irradiating a treatment target region with radiation, a CT image pickup unit for picking up a CT image of a predetermined region including at least the treatment target region, and a CT image obtained by the CT image pickup unit. Image processing CТ
Image processing means, ultrasonic imaging means for picking up an ultrasonic image of a predetermined region including at least the treatment target region, ultrasonic image processing means for image-processing the ultrasonic image obtained by the ultrasonic imaging means, Position measuring means for measuring the position of the ultrasonic imaging means, control means connected to each of the above means so as to be able to exchange signals with each other, and controlling the operation of each means, and set on the CT image for treatment planning A comparison of comparing a radiation irradiation region with a corresponding region corresponding to the irradiation region in a therapeutic ultrasonic image captured during treatment, and examining the correlation between the CT image of the irradiation region and the ultrasonic image of the corresponding region. The control means controls the operation of the radiation irradiation means such that the radiation irradiation is performed on the treatment target region only when the correlation value between the both images is equal to or more than a predetermined value. And a radiotherapy device. 3. A respiratory phase in which the CT image corresponding to the respiratory phase of the patient is captured when the CT image for the treatment plan is captured, and the treatment target site and the attention target organ are separated by a predetermined value or more. The radiotherapy apparatus according to claim 1 or 2, wherein the CT image in (1) is used as data for treatment planning. 4. The separation state between the treatment target site and the attention target organ is determined based on the ultrasonic image for the treatment plan obtained by simultaneously capturing the CT image for the treatment plan. The radiotherapy device according to claim 3, wherein the radiotherapy device is a radiotherapy device. 5. When capturing the CT image for the treatment plan, a CTOR image synchronized with an arbitrary respiratory phase of the patient is imaged, and data for the treatment plan is obtained based on the CTOR image. The radiotherapy apparatus according to claim 1 or 2, which is characterized. 6. An irradiation region of radiation is set in a treatment plan, the irradiation region is set in both ultrasonic images for treatment planning and treatment, and the ultrasonic image for the treatment plan and the ultrasonic image for the treatment are set. The radiotherapy apparatus according to claim 1, wherein, when compared with a sound wave image, only a partial region including the irradiation region is compared. 7. The ultrasonic image for treatment planning and the ultrasonic image for treatment are compared by thinning out a part of the image data of both ultrasonic images. The radiotherapy apparatus according to claim 1. 8. When the ultrasonic image for the treatment plan and the ultrasonic image for the treatment are compared, the image data length in the direction in which the movement amount of the irradiation target of radiation is larger is set longer. The radiotherapy apparatus according to claim 1, wherein the radiotherapy apparatus is compared with each other. 9. The arrangement position of the ultrasonic image pickup means is
9. The radiation irradiation target can be confirmed in the ultrasonic image and is set at a position where it does not intersect with the irradiation beam from the radiation irradiation means.
The radiotherapy device according to any one of 1. 10. The position measuring means has an arm-shaped member, and the arm-shaped member is provided with a holding portion for holding the ultrasonic image capturing means. Item 10. The radiotherapy device according to any one of items 9. 11. The ultrasonic image capturing means and the arm member are attached to each other such that the tip of the arm member is not covered with the ultrasonic image capturing means and is in contact with the outside. The radiotherapy apparatus according to claim 10, wherein 12. The radiotherapy apparatus according to claim 1, wherein the ultrasonic image capturing means is installed at a predetermined site in a patient placement area of the treatment table. . 13. The radiotherapy apparatus according to claim 1, further comprising belt means for fixing the ultrasonic image pickup means to a patient. 14. The ultrasonic image pickup means includes an ultrasonic image diagnostic apparatus having a video signal output means, while the ultrasonic image processing means is provided at least outside the ultrasonic image diagnostic apparatus. The external computer system is provided with a video signal input unit capable of receiving and inputting a video signal from the video signal output unit, and the external computer system is provided in the ultrasonic diagnostic imaging apparatus. 14. The radiotherapy apparatus according to claim 1, wherein the video signal output from the video signal output means is read by the video signal input means to perform ultrasonic image processing. 15. A function of causing a computer to capture a CТ image for treatment planning in a CT imaging means for a predetermined area including at least a treatment target portion, and a function of causing a CТ image processing means to image the CТ image for treatment planning. And a function of causing the ultrasonic image capturing means to simultaneously capture an ultrasonic image for treatment planning in a predetermined region including at least the treatment target portion when capturing the CT image for treatment planning, A function of causing the ultrasonic image processing means to perform image processing of the ultrasonic image; a function of causing the ultrasonic image capturing means to capture a therapeutic ultrasonic image for a predetermined region including at least the treatment target region; The function of causing the ultrasonic image processing means to perform image processing on the ultrasonic image is compared with the ultrasonic image for the treatment plan and the ultrasonic image for the treatment, and both ultrasonic images are compared. Correlation value and a function equal to or larger than the predetermined value, the correlation value of both ultrasound image only when more than a predetermined value,
A program for realizing a function of outputting a control signal to a radiation irradiating means so that the radiation irradiation is performed on the treatment target site. 16. A function of causing a computer to capture a CТ image for treatment planning in a CT imaging means for a predetermined region including at least a treatment target region, and a function of causing a CТ image processing means to image the CТ image for treatment planning. A function of causing the ultrasonic image capturing means to capture a therapeutic ultrasonic image for a predetermined region including at least the treatment target portion, and a function of causing the ultrasonic image processing means to perform image processing of the therapeutic ultrasonic image And a function of setting a radiation irradiation region on the treatment planning CT image, a function of setting a corresponding region corresponding to the irradiation region on the treatment ultrasonic image, and a CT image of the irradiation region. And a function of determining whether or not the correlation value of both images is equal to or more than a predetermined value by comparing the ultrasonic images of the corresponding area with each other, and when the correlation value of the both images is equal to or more than a predetermined value. Only the therapeutic as radiation is performed on the target site, the program for realizing a function of outputting a control signal to the radiation unit. 17. A function of causing the computer to respectively capture a CT image according to a respiratory phase of a patient by the CT imaging device when capturing the CT image for the treatment plan, and the treatment target region and the target organ to be treated. 17. The program according to claim 15 or 16, which further realizes a function of using a CT image in a respiratory phase separated by a predetermined value or more as data for treatment planning. 18. The computer displays the separation state between the treatment target site and the attention target organ in the computer for the treatment plan.
18. The program according to claim 17, which further realizes a function of making a determination based on an ultrasonic image for treatment planning obtained at the time of capturing a T image and at the same time. 19. A function of causing the computer to capture a CT image in synchronization with an arbitrary respiratory phase of a patient by the computer when capturing a CT image for the treatment plan, and a treatment plan based on the CT image. Claim 15 or Claim 16 for further realizing the function of obtaining data for
The program described in. 20. A function of setting an irradiation region of radiation in a treatment plan, a function of setting the irradiation region in both a treatment plan and ultrasonic images for treatment in the computer, and a supercomputer for the treatment plan. 16. The program according to claim 15, which further realizes a function of comparing only a partial region including the irradiation region when comparing a sound wave image and the therapeutic ultrasonic image. 21. The computer has a function of thinning out a part of image data of both ultrasonic images when comparing the ultrasonic image for the treatment plan and the ultrasonic image for the treatment. The program according to claim 15, which is further realized. 22. When the ultrasonic image for the treatment plan and the ultrasonic image for the treatment are compared to each other by the computer, the image data length in the direction in which the movement amount of the irradiation target of radiation is larger is calculated. The program according to claim 15, which further realizes a function of setting for a long time and comparing. 23. A computer-readable recording medium in which the program according to any one of claims 15 to 22 is recorded.