JP2006122452A - Pointer for positioning irradiation center, radiotherapy planning system incorporated with the pointer, and irradiation system for therapy - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To dispense with dimming of illumination in the case of positioning the irradiation center of radiation for a therapy to a patient. <P>SOLUTION: In the case of this pointer, the optical image of the body surface of the patient M placed on a top plate 1 is photographed by an optical picture photographing camera 13 and displayed substantially in real time by an optical picture display monitor 15, and a cross-shaped picture as an irradiation center position indication mark is superimposed to the optical picture of the body surface of the patient M displayed by the monitor 15 by a mark picture superimposing part 11. On the screen of the monitor 15, the indication mark appears with sufficient brightness in the optical picture of the body surface of the patient M, so that an index can be put on the body surface of the patient M by tracing the indication mark with an ink pen, or the like, without dimming the illumination, so that positioning of the irradiation center of radiation for the therapy to the patient is completed rapidly. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to an irradiation center positioning used for positioning an irradiation center (aiming center) of therapeutic radiation in a subject placed on a top plate of a radiotherapy planning apparatus or therapeutic radiation irradiation apparatus. BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a pointer for use, and a radiation treatment planning apparatus and treatment radiation irradiating apparatus in which the pointer is incorporated, and more particularly, to a technique for avoiding dropping illumination when positioning an irradiation center of therapeutic radiation in a subject.

Conventionally, when performing radiotherapy on a subject, a radiotherapy plan is first prepared using the radiotherapy planning apparatus shown in FIGS. At the time of this radiotherapy planning, positioning of the irradiation center of the therapeutic radiation and range determination of the irradiation area in the subject are performed as follows.
In the conventional radiotherapy planning apparatus, as shown in FIG. 11, the X-ray output from the two-dimensional X-ray detector 82 for transmission X-ray image detection in accordance with the X-ray irradiation to the subject M by the X-ray tube 81. Based on the line detection signal, an X-ray fluoroscopic image of the subject M placed on the top 83 is acquired, and an X-ray fluoroscopic image Ra acquired by the subsequent image display monitor 84 is displayed.

In addition, in the X-ray fluoroscopic image Ra displayed on the image display monitor 84, in addition to the image ma of the X-ray shielding crosshair 85 indicating the position of the irradiation center of the therapeutic radiation, the irradiation range of the therapeutic radiation is displayed. The image mb of the prescribed simulated aperture 86 is displayed in a superimposed manner.
Then, the operator moves the top plate 83 so that the appropriate position as the irradiation center of the therapeutic radiation in the X-ray fluoroscopic image Ra coincides with the image ma of the crosshair 85. Subsequently, the simulated diaphragm 86 is moved to match the image mb of the simulated diaphragm 86 with the therapeutic radiation irradiation range in the X-ray fluoroscopic image Ra.

  On the other hand, in the conventional radiotherapy planning apparatus, as shown in FIG. 12, positioning of the irradiation center of therapeutic radiation and range determination of the irradiation area in the subject M placed on the top 83 are performed. An irradiation center positioning pointer 87 to be used is incorporated. The pointer 87 includes a visible light source 88 that emits visible light such as a laser or an incandescent lamp, a reflection mirror 89, a crosshair 85 having light shielding properties, and a simulated diaphragm 86. When the visible light source 88 is turned on, the visible light is applied to the subject M while passing through the reflecting mirror 89 and hitting the crosshair 85 and the simulated aperture 86, so that the shadow of the crosshair 85 and the simulated aperture 86 is the body surface of the subject M. (See, for example, Patent Documents 1 and 2).

Therefore, the operator traces the shadow of the cross line 85 projected on the body surface of the subject M and the shadow of the simulated aperture 86 with an ink pen or the like and marks them.
In the conventional radiotherapy planning apparatus, the necessary markings are usually made on a total of three locations, that is, the front surface of the subject M and the left and right lateral surfaces of the subject M. The range of the therapeutic radiation irradiation region may be determined only for the front of the subject M, for example. When all necessary markings are completed, the positioning of the irradiation center of the therapeutic radiation and the range determination of the irradiation area by the pointer 87 are completed.

  After the positioning of the irradiation center of the therapeutic radiation and the range determination of the irradiation area in the radiotherapy planning apparatus, as shown in FIG. 13, the top plate 91 of the therapeutic radiation irradiation apparatus that performs the irradiation of the therapeutic radiation is used. The subject M is placed thereon, and first, the irradiation center positioning pointer 92 incorporated in the therapeutic radiation irradiation apparatus is used to position the irradiation center of the therapeutic radiation and determine the range of the irradiation area.

  In the case of the pointer 92, projectors 93 to 95 that project cross-shaped light lines (not shown) as irradiation center position instruction marks to a total of three locations on the front surface of the subject M and the left and right lateral surfaces of the subject M. It has. The operator moves the top plate 91 and moves the crosshairs to the front of the subject M placed on the top plate 91 and the cross-shaped light lines projected on the left and right lateral surfaces of the subject M, respectively. By aligning the shape of the 85 marking, the irradiation center of the therapeutic radiation in the subject M is positioned (see, for example, Patent Document 1).

Further, in the case of the pointer 92, a diaphragm shadow projection mechanism (not shown) for projecting the shadow of the radiation irradiation diaphragm (not shown) onto the body surface of the subject M is provided, and this mechanism applies the shadow of the radiation irradiation diaphragm. The irradiation area of the therapeutic radiation is determined by moving the radiation irradiation diaphragm while projecting onto the body surface of the specimen M, and matching the shadow of the radiation irradiation diaphragm with the marking shape of the previous simulation diaphragm 86. .
In this way, when the positioning of the irradiation center of the therapeutic radiation and the range determination of the irradiation area in the subject M are completed, the process proceeds to the next irradiation process of the therapeutic radiation.
JP-A-11-155851 (page 5, columns 7-8, FIG. 6) JP 2000-287966 A (2nd page, FIGS. 6 to 8)

  However, in the case of a conventional radiation therapy planning apparatus or therapeutic radiation irradiation apparatus, there is a problem that the illumination must be turned off when using the irradiation center positioning pointer. In order to clearly project the shadow of the crosshair 85 and the shadow of the simulated diaphragm 86 onto the body surface of the subject M by the pointer 87, it is necessary to turn off the illumination. It is also necessary to turn off the illumination so that the pointer 92 can clearly project the cross-shaped light line and the shadow of the radiation irradiation stop onto the body surface of the subject M.

  However, if the illumination is turned off when the pointer is used, the surrounding area becomes dark, so the anxiety of the subject increases, the operator's work efficiency deteriorates, and it becomes difficult to ensure the safety of the subject and the operator. Will cause various inconveniences.

  The present invention has been made in view of such circumstances, and an irradiation center positioning pointer capable of not having to turn off illumination when positioning the irradiation center of therapeutic radiation in a subject, and radiation therapy It is an object of the present invention to provide a planning apparatus and a therapeutic radiation irradiation apparatus.

In order to achieve such an object, the present invention has the following configuration.
That is, the irradiation center positioning pointer according to the first aspect of the present invention is a subject placed on a top plate of a radiation therapy planning apparatus that captures and displays a radiation image for planning a radiation therapy plan, or In an irradiation center positioning pointer used for positioning the irradiation center (aiming center) of therapeutic radiation in a subject placed on a top plate of a therapeutic radiation irradiation apparatus that performs irradiation of therapeutic radiation Taking an optical image of the body surface of the subject placed on the top plate of the radiation treatment planning apparatus or an optical image of the body surface of the subject placed on the top plate of the therapeutic radiation irradiation apparatus Optical image photographing means, optical image display means for displaying an optical image photographed by the optical image photographing means in substantially real time, and therapeutic radiation on the optical image displayed by the optical image display means And it is characterized in that it comprises a mark image superimposing means for superimposing an image of the radiation center position indication mark for indicating the position of the irradiation center.

  [Operation / Effect] When the radiation center is positioned by the radiation treatment planning apparatus in the subject using the irradiation center positioning pointer (hereinafter referred to as “pointer” where appropriate) according to the first aspect of the invention. Each case where the treatment is performed by the therapeutic radiation irradiation apparatus will be described.

  When the pointer is incorporated in the radiotherapy planning apparatus, first, the radiotherapy planning apparatus captures a radiographic image of the subject placed on the top plate, and the radiographic image captured is the center of irradiation of the therapeutic radiation. It is displayed together with an image of an irradiation center position indicating mark indicating the position. While observing the radiation image, the operator moves the top board so that an appropriate position as the irradiation center of the therapeutic radiation in the radiation image matches the position of the image of the irradiation center position indicating mark.

Subsequently, an optical image of the body surface of the subject placed on the top plate of the radiation treatment planning apparatus is photographed by the optical image photographing means of the pointer and displayed substantially in real time by the optical image display means, An image of an irradiation center position indicating mark that indicates the position of the irradiation center of therapeutic radiation is superimposed on the optical image displayed by the optical image display means by the mark image superimposing means. Therefore, on the screen of the optical image display means, an irradiation center position indication mark that indicates the position of the irradiation center of the therapeutic radiation appears in the optical image of the body surface of the subject with sufficient brightness.
Then, the operator traces the image of the irradiation center position indicating mark appearing with sufficient brightness on the optical image of the body surface of the subject displayed in real time by the optical image display means with an ink pen or the like. By attaching an index to the body surface of the subject, the positioning of the irradiation center of the therapeutic radiation in the subject is completed.

  Further, when the pointer is incorporated in the therapeutic radiation irradiation apparatus, the therapeutic radiation irradiation apparatus captures an optical image of the body surface of the subject placed on the top board by the optical image capturing means of the pointer. An image of the irradiation center position indication mark for indicating the position of the irradiation center of the therapeutic radiation by the mark image superimposing means is superimposed on the optical image displayed by the optical image display means in substantially real time by the optical image display means. To do. Accordingly, on the screen of the optical image display means, an irradiation center position indication mark that indicates the position of the irradiation center of the therapeutic radiation appears in the optical image of the body surface of the subject with sufficient brightness.

  Subsequently, the operator moves the top board and displays the index attached to the body surface of the subject by positioning the irradiation center of the therapeutic radiation in the radiotherapy planning apparatus in substantially real time by the optical image display means. By matching the irradiation center position indication mark that appears with sufficient brightness in the optical image of the subject's body surface, the positioning of the irradiation center of the therapeutic radiation in the subject is completed.

  That is, in the case of the pointer of the first aspect of the invention, an optical image of the body surface of the subject placed on the top plate of the radiation treatment planning device or the therapeutic radiation irradiation device is photographed by the optical image photographing means. An irradiation center position which is displayed in real time by the image display means and indicates the position of the irradiation center of the therapeutic radiation by the mark image superimposing means on the optical image of the body surface of the subject displayed by the optical image display means The image of the indication mark is superposed, and on the screen of the optical image display means, there is sufficient irradiation center position indication mark for indicating the position of the irradiation center of the therapeutic radiation in the optical image of the body surface of the subject. Because it appears at a high brightness, an indicator is attached to the body surface of the subject according to the irradiation center position indication mark, or the indicator attached to the body surface of the subject is set to the irradiation center position without turning off the illumination. By matching the shown marks, the positioning of the irradiation center of the therapeutic radiation in a subject placed on the top plate of the radiation therapy planning apparatus to the therapeutic radiation irradiation device can be completed quickly.

  The pointer of the invention of claim 2 is the irradiation center positioning pointer according to claim 1, wherein the irradiation center of the therapeutic radiation in the subject is used as the therapeutic radiation in positioning of the irradiation center of the therapeutic radiation in the subject. This is the isocenter of the irradiation device.

  [Operation / Effect] In the case of the pointer of the invention of claim 2, since the irradiation center of the therapeutic radiation in the subject becomes the isocenter of the therapeutic radiation irradiation device by positioning the irradiation center of the therapeutic radiation in the subject, After completion of positioning of the irradiation center, there is no need to perform an operation of aligning the irradiation center of the therapeutic radiation on the subject with the isocenter of the therapeutic radiation irradiation apparatus.

  According to a third aspect of the present invention, there is provided a pointer for positioning an irradiation center according to the first or second aspect, wherein the photographing viewpoint of the optical image photographing means is a photographing viewpoint of a radiation image for planning a radiation treatment plan, or for treatment. It is in a position that is geometrically equivalent to the radiation focal point of radiation (the focal point of the radiation source), and the photographing direction of the optical image photographing means is the radiation image photographing direction for radiation treatment planning or the radiation direction of therapeutic radiation. And a geometrically equivalent orientation.

  [Operation / Effect] In the case of the pointer of the invention of claim 3, the photographing viewpoint and photographing direction of the optical image photographing means are the photographing viewpoint and photographing direction of the radiation image for radiation therapy planning, or the radiation focus of the therapeutic radiation. Since the position is geometrically equivalent to the radiation direction, it is easy to accurately correspond the image of the irradiation center position indicating mark indicating the irradiation center of the therapeutic radiation on the subject to the irradiation center of the therapeutic radiation.

  According to a fourth aspect of the present invention, there is provided the pointer for irradiating center positioning according to any one of the first to third aspects, wherein the optical image photographing means is a radiation image photographing mechanism or therapeutic radiation for radiation treatment planning. It is attached to the irradiation mechanism.

  [Operation / Effect] In the case of the pointer of the invention of claim 4, the optical image photographing means is attached to a radiation image photographing mechanism or a radiation irradiation mechanism for radiation treatment planning, and the optical image photographing means is provided. Since it moves together with the radiographic imaging mechanism or the therapeutic radiation irradiation mechanism, the imaging direction of the optical image imaging means can be changed following the change in the radiographic imaging direction or the therapeutic radiation emission direction.

  According to a fifth aspect of the present invention, there is provided a simulation for defining an irradiation range of therapeutic radiation in an optical image displayed by an optical image display means in the irradiation center positioning pointer according to any one of the first to fourth aspects. A diaphragm image superimposing means for superimposing the image of the aperture diaphragm or the radiation irradiation diaphragm is provided.

  [Operation / Effect] In the case of the pointer of the invention of claim 5, a simulated diaphragm or radiation irradiation diaphragm for defining the irradiation range of therapeutic radiation in the optical image displayed by the optical image display means by the diaphragm image superimposing means. Since the image appears with sufficient brightness, it is possible to determine the range of the therapeutic radiation irradiation region in the subject without turning off the illumination.

  According to a sixth aspect of the present invention, there is provided a pointer for positioning an irradiation center according to any one of the first to fifth aspects, wherein the mark image superimposing means superimposes an image of the irradiation center position indicating mark by signal processing. The aperture image superimposing means is configured to superimpose images of a simulated aperture or a radiation irradiation aperture by signal processing.

  [Operation and Effect] In the case of the pointer of the invention of claim 6, since the image of the irradiation center position indicating mark and the image of the simulated aperture are superimposed by software by signal processing, the irradiation center position indicating mark and the simulated aperture There is no need to provide a diaphragm for the image of the radiation irradiation diaphragm as hardware.

  Furthermore, a radiotherapy planning apparatus according to the invention described in claim 7 is a radiotherapy planning apparatus that captures and displays a radiographic image for radiotherapy planning for a subject placed on a top board. The irradiation center positioning pointer according to any one of claims 1 to 6 is incorporated.

  [Operation / Effect] In the case of the apparatus of the invention of claim 7, since the irradiation center positioning pointer according to any of claims 1 to 6 is incorporated, the top of the radiation therapy planning apparatus can be operated without turning off the illumination. The positioning of the irradiation center of the therapeutic radiation in the subject placed on the plate can be completed quickly.

  Furthermore, the therapeutic radiation irradiation apparatus according to the invention described in claim 8 is a therapeutic radiation irradiation apparatus for irradiating a subject placed on a top plate with therapeutic radiation, The irradiation center positioning pointer according to any one of 1 to 6 is incorporated.

  [Operation / Effect] In the case of the device of the invention of claim 8, since the irradiation center positioning pointer according to any one of claims 1 to 6 is incorporated, the treatment radiation irradiating device can be operated without turning off the illumination. Positioning of the irradiation center of the therapeutic radiation on the subject placed on the top board can be quickly completed.

In the case of the pointer according to the first aspect of the present invention, an optical image of the body surface of the subject placed on the top plate of the radiation treatment planning apparatus or therapeutic radiation irradiation apparatus is photographed by the optical image photographing means to display an optical image. An irradiation center position indication mark that is displayed in real time by the means and indicates the position of the irradiation center of the therapeutic radiation by the mark image superimposing means on the optical image of the body surface of the subject displayed by the optical image display means The irradiation center position indication mark for indicating the position of the irradiation center of the therapeutic radiation in the optical image of the body surface of the subject is sufficiently bright on the screen of the optical image display means. Therefore, even if the illumination is not turned off, an index is attached to the body surface of the subject according to the irradiation center position indication mark, or the index attached to the body surface of the subject is set to the irradiation center position finger. By matching the mark it is quickly complete the positioning of the irradiation center of the therapeutic radiation in the subject placed on the top plate of the radiation therapy planning apparatus to the therapeutic radiation irradiation device.
Therefore, according to the irradiation center positioning pointer of the first aspect of the present invention, it is possible to avoid dropping the illumination when positioning the irradiation center of the therapeutic radiation in the subject.

  Furthermore, according to the radiotherapy planning apparatus of the invention of claim 7, since the irradiation center positioning pointer according to any of claims 1 to 6 is incorporated, positioning of the irradiation center of therapeutic radiation in the subject is determined. In this case, you can save the lighting.

  Further, according to the therapeutic radiation irradiation apparatus of the eighth aspect of the invention, since the irradiation center positioning pointer according to any one of the first to sixth aspects is incorporated, the irradiation center of the therapeutic radiation in the subject is determined. It is possible to avoid dropping the illumination during positioning.

Embodiment 1 of the present invention will be described below with reference to the drawings. FIG. 1 is a block diagram showing the overall configuration of a radiation treatment planning apparatus according to a first embodiment in which an example of an irradiation center positioning pointer according to the present invention is incorporated. FIG. 2 is an X-ray image of the treatment planning apparatus according to the first embodiment. It is a schematic diagram which shows a mechanism and an optical image photographing mechanism.
The treatment planning apparatus of FIG. 1 includes a top board 1 on which a subject M who is a radiation treatment subject is placed, an X-ray tube 2 that irradiates the subject M with X-rays, and a transmission X-ray image of the subject M. An X-ray imaging mechanism in which a flat panel X-ray sensor (hereinafter abbreviated as “FPD” where appropriate) 3 as a two-dimensional X-ray detector to be detected is disposed opposite to the subject M on the top 1. X-ray fluoroscopic image acquisition for acquiring an X-ray fluoroscopic image of the subject M based on an X-ray detection signal output from the FPD 3 with X-ray irradiation to the subject M by the X-ray tube 2 The apparatus includes a display monitor 6 that displays an X-ray fluoroscopic image of the unit 5 and the subject M, and is also referred to as an X-ray simulator.

The X-ray tube 2 and the FPD 3 are respectively attached to one end and the other end of the support arm 7, and as the support arm 7 is rotated about the horizontal axis as the rotation axis by the imaging mechanism rotating unit 8, While the X-ray irradiation axis XA always passes through the isocenter AC of the treatment planning apparatus, the X-ray tube 2 and the FPD 3 are located around the subject M while maintaining the opposing arrangement state with the subject M on the top 1 sandwiched between them. It is configured to move. Further, the imaging system rotation control unit 9 drives the imaging mechanism rotation unit 8 according to the operation by the operation unit 10 to set the imaging direction when imaging the X-ray fluoroscopic image of the subject M by the operation of the operation unit 10. Set the direction.
That is, the imaging direction when imaging the X-ray fluoroscopic image of the subject M is not limited to the direction directly above the front as shown in FIG. 2 by the operation of the operation unit 10 configured by an input device such as a keyboard and a mouse. For example, it can be set in the right lateral direction as shown in FIG. 3 (a) or in the left lateral direction as shown in FIG. 3 (b).

  Further, as shown in FIG. 4A, the treatment planning apparatus according to the first embodiment displays a cross-shaped image Ma of an irradiation center position indicating mark indicating the position of the isocenter AC as the position of the irradiation center of therapeutic radiation. A mark image superimposing unit 11 that superimposes on the fluoroscopic image Pa, and a diaphragm image superimposing unit 12 that superimposes the well-shaped image Mb of the simulated aperture that defines the irradiation range of the therapeutic radiation on the X-ray fluoroscopic image Pa. Yes. The well-shaped image Mb is composed of four straight line images Mb1 to Mb4. The straight line images Mb1 and Mb2 can be individually moved left and right by the operation of the operation unit 10, and the straight line images Mb3 and Mb4 can be individually moved. Can be moved up and down. Since the region surrounded by the four straight line images Mb1 to Mb4 is the therapeutic radiation irradiation range, the position and size of the therapeutic radiation irradiation range are changed by the movement of the linear images Mb1 to Mb4. It should be noted that the isocenter AC of the apparatus of the first embodiment is set to have a one-to-one correspondence with the isocenter of the therapeutic radiation apparatus.

  Furthermore, an irradiation center positioning pointer (hereinafter abbreviated as “pointer” as appropriate) is incorporated in the treatment planning apparatus of the first embodiment. In the case of the pointer of the apparatus of Example 1, the optical image capturing camera 13 that captures an optical image of the body surface of the subject M on the top board 1 through the reflection mirror 14 and the optical image capturing camera 13 were captured. As shown in FIG. 5 (a), the optical image PA displayed on the optical image display monitor 15 is provided on the optical image display monitor 15 in addition to the hand-arranged optical image display monitor 15 that displays the optical image substantially in real time. The mark image superimposing unit 11 superimposes the cross-shaped image MA of the irradiation center position indicating mark indicating the position of the isocenter AC as the position of the therapeutic radiation irradiation center, and the aperture image superimposing unit 12 irradiates the therapeutic radiation. It is configured such that a well-shaped image MB with a simulated aperture defining the range is superimposed.

  Since the optical imaging camera 13 is attached to the X-ray imaging mechanism 4 and the optical imaging camera 13 moves together with the X-ray imaging mechanism 4 as shown in FIGS. The photographing direction of the camera 13 can be changed following the change in the photographing direction of the X-ray image photographing mechanism 4. That is, the imaging direction of the optical imaging camera 13 can be changed in conjunction with the change of the imaging direction of the X-ray imaging mechanism 4. In addition, the photographing direction of the optical image photographing camera 13 is configured to be changed by the operation of the hand operation unit 16 attached to the top board 1.

  In the case of the optical imaging camera 13, as shown in FIG. 1, the distance between the focal point of the camera 13 and the subject M is substantially the same as the distance between the focal point of the X-ray tube 2 and the subject M, and the reflection mirror 14. From the beginning, the optical axis of the camera 13 coincides with the X-ray irradiation axis XA. Therefore, the photographing viewpoint of the optical image photographing camera 13 is in a position geometrically equivalent to the photographing viewpoint of the X-ray fluoroscopic image, and the photographing direction of the optical image photographing camera 13 is geometrically equivalent to the photographing direction of the X-ray fluoroscopic image. The orientation is equivalent. As a result, the cross-shaped image MA appearing in the optical image PA displayed on the optical image display monitor 15 can be easily made to correspond accurately to the irradiation center of the therapeutic radiation, and the well-shaped image MB also has an irradiation range of the therapeutic radiation. Easy to correspond accurately.

The X-ray tube 2 irradiates the subject M with X-rays under the control of the X-ray irradiation control unit 17 including a high voltage generator. Control by the X-ray irradiation control unit 17 is executed according to irradiation conditions set by operating the operation unit 10 or the like.
The top board 1 is moved forward / backward, left / right / up / down by the control of the top board movement control unit 18 with the subject M placed thereon. The control by the top board movement control unit 18 is also executed according to the movement conditions set by the operation of the operation unit 10 or the like.
The host control unit 19 is mainly configured by a computer and its control program. The host control unit 19 transmits and receives command signals and data according to the operation of the operation unit 10 and the hand operation unit 16 and the progress of the device operation. Is responsible for the normal operation.

Next, positioning of the irradiation center of therapeutic radiation and range determination of the irradiation area in the treatment planning apparatus of the first embodiment having the above-described configuration will be described with reference to the drawings. FIG. 4 is a schematic diagram showing an X-ray fluoroscopic image Pa in which the cross-shaped image Ma of the irradiation center position instruction mark and the well-shaped image Mb of the simulated aperture are superimposed. FIG. 5 is a schematic diagram showing an optical image PA in which the cross-shaped image MA of the irradiation center position instruction mark and the simulated aperture-like image MB are superimposed.
Positioning of the irradiation center for treatment radiation and range determination of the irradiation area are usually performed in the directions just above the front, right side, and left side of the subject, but the work is virtually the same except that the directions are different. Since there is, only the right side is described here. Depending on the purpose of irradiation of therapeutic radiation, etc., the range of the irradiation region may be determined only just above the front of the subject M, for example.

  As shown in FIG. 3A, the X-ray tube 2 of the X-ray imaging mechanism 4 and the FPD 3 are set so as to face each other in the horizontal direction, and the head of the subject M placed on the top board 1 is placed. The X-ray fluoroscopic image of the head of the subject M is imaged by the X-ray image radiographing mechanism 4 from the right side of the unit, and the radiographic image Pa captured is displayed on the display monitor 6 as shown in FIG. The mark image superimposing unit 11 and the aperture image superimposing unit 12 superimpose and display the cross-shaped image Ma of the irradiation center position instruction mark and the well-shaped image Mb of the simulated aperture on the screen.

Subsequently, by operating the operation unit 10 to move the top board 1, as shown in FIG. 4B, an appropriate position as the irradiation center of the therapeutic radiation in the X-ray fluoroscopic image Pa is formed in a cross shape. Match the image Ma.
Further, by operating the operation unit 10 to move the straight line images Mb1 to Mb4 of the well-shaped image Mb, as shown in FIG. 4C, the therapeutic radiation irradiation region in the X-ray fluoroscopic image Pa A suitable range is surrounded by the straight line images Mb1 to Mb4 of the well-shaped image Mb.

Next, the operator approaches the subject M to use the pointer. An optical image of the head surface of the subject M is photographed from the right side of the head of the subject M placed on the top board 1 from the right side of the head, and is shown in FIG. As described above, the cross-shaped image MA of the irradiation center position indicating mark is displayed on the screen of the optical image display monitor 15 placed beside the top 1 by the mark image superimposing unit 11 and the aperture image superimposing unit 12. The well-shaped image MB of the simulated aperture is superimposed as it is set based on the previous X-ray fluoroscopic image Pa and is displayed together substantially in real time. On the screen of the optical image display monitor 15, an irradiation center position indicating mark indicating the position of the irradiation center of the therapeutic radiation and a simulated aperture appear in the optical image PA with sufficient brightness.
When there is a difference in magnification between the optical image PA and the X-ray fluoroscopic image Pa, the aperture image superimposing unit 12 changes the magnification difference between the optical image PA and the X-ray fluoroscopic image Pa in the well-shaped image MB. Since the corresponding correction is performed, even if the optical image PA is different from the X-ray fluoroscopic image Pa, the erroneous area of the well-shaped image MB is not designated as the therapeutic radiation irradiation region.

Then, as shown in FIG. 5B, the operator appears with sufficient brightness in the optical image PA of the head surface of the subject displayed substantially in real time on the optical image display monitor 15. By tracing the cross-shaped image MA of the irradiation center position indicating mark and the well-shaped image MB of the simulated aperture with the ink pen IP, the irradiation center of the therapeutic radiation is placed on the head surface of the subject M as shown in FIG. The cross-shaped index mA to be instructed and the well-shaped index mB to indicate the irradiation area of the therapeutic radiation are marked. Since the tip of the ink pen IP is also displayed on the optical image PA, it is easy to trace the image with the ink pen IP.
This completes the positioning of the irradiation center of the therapeutic radiation and the determination of the range of the irradiation region in the subject M.

As described above, in the case of the pointer of the treatment planning apparatus according to the first embodiment, an optical image of the body surface of the subject M placed on the top board 1 is captured by the optical image capturing camera 13 and the optical image is captured. An irradiation center position indicating mark is displayed on the optical image of the body surface of the subject M displayed on the display monitor 15 in real time and displayed on the optical image display monitor 15 by the mark image superimposing unit 11 and the aperture image superimposing unit 12. The cross-shaped image MA and the simulated aperture well-shaped image MB are superposed. On the screen of the optical image display monitor 15, the irradiation center position indicating mark is included in the optical image of the body surface of the subject M. And the simulated diaphragm appears with sufficient brightness, so that the index is attached to the body surface of the subject M by tracing the irradiation center position indicating mark and the simulated diaphragm with an ink pen or the like without turning off the illumination. Quickly brought complete Ranging and positioning the irradiation area of the irradiation center of the therapeutic radiation in the specimen.
Therefore, in the case of the apparatus according to the first embodiment, the built-in pointer can be used for positioning the irradiation center of the therapeutic radiation in the subject and determining the range of the irradiation area without having to turn off the illumination.

In the case of the pointer of the apparatus according to the first embodiment, the irradiation center of the therapeutic radiation in the subject M becomes the isocenter of the therapeutic radiation irradiation apparatus by positioning the irradiation center of the therapeutic radiation in the subject M. After the center positioning is completed, it is not necessary to perform an operation for aligning the irradiation center of the therapeutic radiation on the subject M with the isocenter of the therapeutic radiation irradiation apparatus.
In addition, in the pointer of the apparatus of the first embodiment, the cross-shaped image MA of the irradiation center position indication mark and the well-shaped image MB of the simulated aperture are superimposed by software based on signal processing. There is no need to provide a simulated aperture as hardware.

Next, Embodiment 2 of the present invention will be described. FIG. 7 is a block diagram showing a main configuration of a therapeutic radiation irradiation apparatus according to Embodiment 2 in which an example of the irradiation center positioning pointer of the present invention is incorporated. The therapeutic radiation irradiation apparatus according to the second embodiment is substantially the same as the apparatus according to the first embodiment except for the points described below, so only the differences will be described and the description of the common points will be omitted. Also, the same numbers as those in the first embodiment are used for the same functions as those in the first embodiment.
The radiation irradiation apparatus of FIG. 7 includes a radiation irradiation mechanism 20 including a top plate 1 on which a subject M who is a subject of radiation treatment is placed, and a radiation source 21 that irradiates the subject M with therapeutic radiation. Specific examples of the apparatus include a linac.

  The radiation source 21 is attached to the tip of the support arm 22, and the radiation irradiation axis XB of the radiation source 21 is irradiated with radiation as the support arm 22 is rotated about the horizontal axis by the irradiation imaging mechanism rotating unit 23. The radiation source 21 is configured to move around the subject M while constantly passing through the isocenter BC of the apparatus. Further, the irradiation imaging system rotation control unit 24 drives the irradiation imaging mechanism rotation unit 23 according to the operation by the operation unit 25 to set the irradiation direction when irradiating the subject M with radiation by the operation by the operation unit 25. Set to.

The radiation source 21 irradiates the subject M with X-rays under the control of the radiation irradiation control unit 26. The radiation emitted from the radiation source 21 is not limited to specific radiation, and includes various radiations such as neutrons in addition to high energy X-rays and γ rays. The radiation source 21 may be a radioisotope.
Further, in the radiation irradiation mechanism 20, a radiation irradiation diaphragm 27 that defines an irradiation region of therapeutic radiation is provided in front of the radiation source 21, and the opening degree of the radiation irradiation diaphragm 27 is changed by the control of the diaphragm opening / closing control unit 28. Thus, the irradiation area of the therapeutic radiation is changed.
The top board 1 is moved forward / backward, left / right / up / down by the control of the top board movement control unit 18 with the subject M placed thereon. The control by the top board movement control unit 18 is executed according to the movement condition set by the operation of the operation unit 25 or the hand operation unit 33.
The display monitor 29 displays an operation menu for operating the apparatus and necessary images.

  Furthermore, an irradiation center positioning pointer (hereinafter abbreviated as “pointer” as appropriate) is incorporated in the radiation irradiation apparatus of the second embodiment. In the case of the pointer of the apparatus according to the second embodiment, the optical image capturing camera 30 that captures an optical image of the body surface of the subject M on the top board 1 through the reflecting mirror 31 and the optical image capturing camera 30 were captured. As shown in FIG. 8A, the optical image QA displayed on the optical image display monitor 32 is provided in addition to the optical image display monitor 32 for local installation that displays the optical image in substantially real time. The mark image superimposing unit 34 superimposes the cross-shaped image NA of the irradiation center position indicating mark indicating the position of the isocenter BC as the position of the therapeutic radiation irradiation center, and the aperture image superimposing unit 35 superimposes the therapeutic radiation. The well-shaped image NB of the radiation irradiation diaphragm 27 that defines the irradiation range is superposed.

  Since the optical imaging camera 30 is attached to the radiation irradiation mechanism 20 and the optical imaging camera 30 moves together with the radiation irradiation mechanism 20, the imaging direction of the optical imaging camera 30 is set to the irradiation direction of the radiation irradiation mechanism 20. It can be changed following the change. The photographing direction of the optical image photographing camera 30 can be changed by the operation of the hand operation unit 33 attached to the top board 1.

  Also in the case of the optical imaging camera 30, as shown in FIG. 7, the distance between the focal point of the camera 30 and the subject M is substantially the same as the distance between the focal point of the radiation source 21 and the subject M, and the reflection mirror 31. From the beginning, the optical axis of the camera 30 coincides with the radiation irradiation axis XB. Therefore, the photographing viewpoint of the optical imaging camera 30 is in a position geometrically equivalent to the radiation focus of the therapeutic radiation, and the imaging direction of the optical imaging camera 30 is geometrically equivalent to the irradiation direction of the therapeutic radiation. In the right direction. As a result, the cross-shaped image NA appearing in the optical image QA displayed on the optical image display monitor 32 can be easily made to accurately correspond to the position of the irradiation center of the therapeutic radiation, and the well-shaped image NB is irradiated with the therapeutic radiation irradiation range. It is easy to make it correspond to.

The well-shaped image NB is composed of four straight line images NB1 to NB4. In the case of the straight line images NB1 and NB2, the straight line images NB1 and NB2 can be individually moved to the left and right by the operation by the hand operation unit 33. It can be moved up and down individually. Since the region surrounded by the four linear images Mb1 to Mb4 is the therapeutic radiation irradiation range, the position / size of the therapeutic radiation irradiation range changes due to the movement of the linear images NB1 to NB4. In the case of the second embodiment, the change in the well-shaped image NB by the hand operation unit 33 is transmitted to the aperture opening / closing control unit 28 via the aperture image superimposing unit 35 and the irradiation indicated by the well-shaped image NB. The opening of the radiation irradiation diaphragm 27 is adjusted so that only the range is irradiated with radiation.
The host control unit 19 is mainly composed of a computer and its control program, and performs transmission / reception of command signals and data corresponding to the operation of the operation unit 25 and the hand operation unit 33 and the progress of device operation. Is responsible for the normal operation.

Subsequently, positioning of the irradiation center of the therapeutic radiation and determination of the irradiation area range in the subject M using the irradiation center positioning pointer of the radiation irradiation apparatus according to the second embodiment having the above-described configuration will be described with reference to the drawings. To do. FIG. 8 is a schematic diagram showing an optical image QA in which the cross-shaped image NA of the irradiation center position indication mark and the well-shaped image NB of the radiation irradiation stop 27 are superimposed.
The positioning of the irradiation center of therapeutic radiation and the determination of the range of the irradiation area in the apparatus of the second embodiment are normally performed in the respective directions just above the front of the subject M, right next to the right, and right next to the left. Since only the difference is practically the same, only the right side is described here. Depending on the purpose of irradiation of therapeutic radiation, etc., the range of the irradiation region may be determined only just above the front of the subject M, for example.

  The operator leans beside the subject M to use the pointer, and drives the irradiation imaging mechanism rotating unit 23 by operating the hand operating unit 33 so that the imaging direction of the optical imaging camera 30 of the pointer is right next to the subject M. Set the direction. Then, the surface of the head of the subject M placed on the top 1 is imaged by the optical image capturing camera 30 from the right side of the subject M, and the captured optical image QA is captured as shown in FIG. The cross-shaped image NA of the irradiation center position indicating mark and the well-shaped image NB of the radiation irradiation stop 27 are superimposed on the screen of the optical image display monitor 32 placed beside the plate 1 and displayed together substantially in real time. On the screen of the optical image display monitor 32, the irradiation center position indication mark for indicating the position of the irradiation center of the therapeutic radiation in the optical image QA obtained by photographing the head surface of the subject M and the radiation irradiation diaphragm are sufficiently bright. Appears at.

  Then, the operator operates the hand operation unit 33 to move the top 1 so that the head surface of the subject M displayed on the optical image display monitor 32 is displayed as shown in FIG. A cross-shaped index mA indicating the irradiation center of therapeutic radiation marked on the head surface of the subject M in the cross-shaped image NA of the irradiation center position indicating mark appearing with sufficient brightness in the optical image QA. Match.

Subsequently, the operator marks the surface of the head of the subject M as shown in FIG. 8C by moving the straight line images NB1 to NB4 of the well-like image NB by operating the hand operation unit 33. The cross-shaped index mB indicating the irradiated region of therapeutic radiation is matched with the straight line images NB1 to NB4 of the well-shaped image NB.
This completes the positioning of the irradiation center of the therapeutic radiation and the range determination of the irradiation region. The opening degree of the radiation irradiation diaphragm 27 is adjusted by the diaphragm opening / closing control unit 28 so as to irradiate only the irradiation range designated by the well-shaped image NB.

As described above, in the case of the pointer of the radiation irradiation apparatus according to the second embodiment, an optical image of the body surface of the subject M placed on the top board 1 is captured by the optical image capturing camera 30, and the optical image is captured. Indication of the irradiation center position is performed by the mark image superimposing unit 34 and the aperture image superimposing unit 35 on the optical image QA of the body surface of the subject M displayed on the display monitor 32 substantially in real time and displayed on the optical image display monitor 32. The cross-shaped image NA of the mark and the well-shaped image NB of the radiation irradiation aperture 27 are superposed. On the screen of the optical image display monitor 32, the irradiation center is included in the optical image QA of the body surface of the subject M. Since the position indication mark and the radiation irradiation stop 27 appear with sufficient brightness, the cross-shaped index mA and illumination indicating the irradiation center of the therapeutic radiation marked on the body surface of the subject can be obtained without turning off the illumination. The cross-shaped image NA instructing region is matched to the well Getah shaped image NB irradiation aperture 27, is rapidly complete the Ranging and positioning the irradiation area of the irradiation center of the therapeutic radiation in a subject.
Therefore, in the case of the apparatus according to the second embodiment as well, the built-in pointer can be used for positioning the irradiation center of therapeutic radiation in the subject and determining the range of the irradiation area without having to turn off the illumination.

Also, in the case of the pointer of the apparatus of Example 2, the irradiation center of the therapeutic radiation in the subject M becomes the isocenter of the therapeutic radiation irradiation apparatus by positioning the irradiation center of the therapeutic radiation in the subject M. After completion of positioning of the irradiation center, there is no need to perform an operation of aligning the irradiation center of the therapeutic radiation on the subject M with the isocenter of the therapeutic radiation irradiation apparatus.
In addition, even with the pointer of the apparatus of the first embodiment, the cross-shaped image NA of the irradiation center position indicating mark and the well-shaped image NB of the radiation irradiation stop 27 are superimposed by software based on signal processing. It is not necessary to provide a diaphragm for the image of the radiation irradiation diaphragm as hardware.

The present invention is not limited to the above-described embodiment, and can be modified as follows.
(1) In the apparatus of the first embodiment, the X-ray imaging mechanism is configured for X-ray fluoroscopic imaging, but the X-ray imaging mechanism may be configured for X-ray CT imaging.

  (2) In the case of the apparatuses of Examples 1 and 2, the image of the simulated aperture and the radiation irradiation aperture indicating the radiation irradiation area was a well-shaped image. The image is not limited to a well-like image, and may be an image of a circle or a point, or may be an image PQ having a complex shape with unevenness as shown in FIG.

  (3) In the apparatus of the first embodiment, the two-dimensional X-ray detector for detecting the transmission X-ray image of the subject M is the FPD, but the two-dimensional X-ray detector for detecting the transmission X-ray image is limited to the FPD. For example, an image intensifier may be used.

  (4) The apparatus of the second embodiment is also provided with the same X-ray image photographing mechanism as that of the apparatus of the first embodiment, and the X-ray fluoroscopic image of the subject M is photographed and displayed to position and irradiate the therapeutic radiation. An apparatus having the same configuration as that of the embodiment except that the area range determination result can be checked can be cited as a modified example of the embodiment 2. In the case of this modification, the optical imaging camera 30 may be further attached to the X-ray imaging mechanism.

(5) In the apparatus according to the second embodiment, only one optical imaging camera 30 is provided. However, as shown in FIG. 10, three optical imaging cameras 30 are provided, right above the front of the subject and on the right side. It is good also as a structure which image | photographs a surface and a left side surface with the separate optical imaging camera 30. FIG.
Even in the case of the apparatus of the first embodiment, three optical image capturing cameras 13 may be provided, and the optical image capturing camera 13 may be used to capture the right upper surface, right lateral surface, and left lateral surface of the subject. Good.

  (6) In the case of the apparatus of the first embodiment and the apparatus of the second embodiment, the image of the simulated diaphragm and the radiation irradiation diaphragm is not based on software, but hardware formed of an X-ray opaque material or a visible light opaque material. It may be due to.

It is a block diagram which shows the whole structure of the radiotherapy planning apparatus of Example 1. FIG. It is a schematic diagram which shows the X-ray image imaging mechanism and optical image imaging mechanism of the treatment plan apparatus of Example 1. It is a schematic diagram which shows the state when the imaging | photography direction of an X-ray image imaging mechanism or an optical image imaging mechanism is changed with the apparatus of Example 1. FIG. It is a schematic diagram which shows the X-ray fluoroscope image on which the image of the irradiation center position instruction | indication mark and the image of the simulated aperture was superimposed. It is a schematic diagram which shows the optical image with which the image of the irradiation center position instruction | indication mark and the image of the simulated aperture was superimposed. It is a side view which shows the head of the subject which attached | subjected the parameter | index which instruct | indicates the irradiation center and irradiation area | region of therapeutic radiation. It is a block diagram which shows the principal part structure of the therapeutic radiation irradiation apparatus of Example 2. FIG. It is a schematic diagram which shows the optical image with which the image of the irradiation center position instruction | indication mark and the radiation irradiation diaphragm was superimposed. It is a schematic diagram which shows the other example of the image of a simulated stop thru | or a radiation irradiation stop. It is a perspective view which shows typically the other example of arrangement | positioning of the optical imaging camera in the apparatus of Example 2. FIG. It is a schematic diagram which shows schematic structure for imaging | photography and a display of the X-ray fluoroscopic image of the conventional radiotherapy planning apparatus. It is the schematic which shows the irradiation center positioning pointer of the conventional radiotherapy planning apparatus. It is the schematic which shows the irradiation center positioning pointer of the conventional therapeutic radiation irradiation apparatus.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Top plate 4 ... X-ray image imaging mechanism 11, 34 ... Mark image superimposition part 12, 35 ... Aperture image superimposition part 13, 30 ... Optical imaging camera 15, 32 ... Optical image display monitor 20 ... Radiation irradiation mechanism AC, BC ... Isocenter M ... Subject MA, Ma, NA ... Cross-shaped image of irradiation center position indication mark MB, Mb ... Simulated aperture well-like image NB ... Radiation irradiation aperture well-like image PA, QA ... Optical Image Pa ... X-ray fluoroscopic image

Claims (8)

  An object placed on the top plate of a radiotherapy planning apparatus that captures and displays radiographic images for radiotherapy planning, or the top plate of a therapeutic radiation irradiation apparatus that performs irradiation of therapeutic radiation In the irradiation center positioning pointer used for positioning the irradiation center (aiming center) of the therapeutic radiation in the subject placed on the object, the subject placed on the top plate of the radiation treatment planning apparatus An optical image photographing means for photographing an optical image of a body surface or an optical image of a body surface of a subject placed on a top plate of a therapeutic radiation irradiation apparatus, and an optical image photographed by the optical image photographing means are substantially An optical image display means for displaying in real time, and a mask for superimposing an image of an irradiation center position indicating mark indicating the position of the irradiation center of therapeutic radiation on the optical image displayed by the optical image display means. Irradiation center positioning pointer, characterized in that it comprises a click image superimposing means.   3. The irradiation center positioning pointer according to claim 1, wherein the positioning of the irradiation center of the therapeutic radiation in the subject is performed by using the irradiation center of the therapeutic radiation in the subject as an isocenter of the therapeutic radiation irradiation apparatus. Pointer.   The irradiation center positioning pointer according to claim 1 or 2, wherein the imaging viewpoint of the optical image imaging means is a radiographic imaging viewpoint for radiation therapy planning, or a radiation focus of radiation for treatment (a focus of a radiation source). Irradiation that is in a geometrically equivalent position and whose imaging direction of the optical imaging means is the imaging direction of the radiation image for radiation therapy planning or the direction that is geometrically equivalent to the radiation direction of the therapeutic radiation Center positioning pointer.   4. The irradiation center positioning pointer according to claim 1, wherein the optical image capturing means is attached to a radiation image capturing mechanism or a therapeutic radiation irradiation mechanism for radiation therapy planning. Pointer.   5. The irradiation center positioning pointer according to claim 1, wherein a simulated diaphragm or an image of the radiation irradiation diaphragm for defining an irradiation range of therapeutic radiation is superimposed on the optical image displayed by the optical image display means. An irradiation center positioning pointer provided with aperture image superimposing means.   6. The irradiation center positioning pointer according to claim 1, wherein the mark image superimposing means superimposes the image of the irradiation center position indicating mark by signal processing, and the aperture image superimposing means is a simulated aperture or An irradiation center positioning pointer which is configured to superimpose an image of a radiation irradiation diaphragm by signal processing.   7. A radiation treatment planning apparatus for photographing and displaying a radiation image for radiation treatment planning for a subject placed on a top board, wherein the irradiation center positioning pointer according to claim 1 is used. A radiotherapy planning apparatus characterized in that is incorporated. A therapeutic radiation irradiation apparatus for irradiating a subject placed on a top board with therapeutic radiation, wherein the irradiation center positioning pointer according to any one of claims 1 to 6 is incorporated. A therapeutic radiation irradiation apparatus characterized by comprising:

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