JP2007268292A - X-ray device for radiation therapy to locate cancer and make the cancer disappear - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a radiation therapy for malignant neoplasm and a method and system for determining its location, using the same X-ray beams both for the determination on tissue structure and location of the malignant lesion and for the irradiation. <P>SOLUTION: A radiation therapy for malignant neoplasm using X-ray beams from an X-ray emitter 1 includes: a first stage in which images of an inside structure portion including a malignant tumor 7 inside the body of a patient 5 and of its surrounding organs and tissues are obtained based on information on a point 4 in the form of a three-dimensional coordinate set in relation to measurement results as well as tissue density values corresponding to those coordinates; the next procedures in which by using results of a diagnosis conducted in advance, after identifying structural element images associated with the malignant neoplasm regarding various portions of the malignant neoplasm 7 defined by the set of determined point coordinates, an irradiation program is created in the form of an X-ray dose set; and then a second stage in which the created irradiation program is performed. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

(Field of Invention)
The present invention relates to means for determining malignant neoplasms in a patient and its treatment by X-ray irradiation.

(Background technology)
In a known method, it is envisaged to prepare a topometry after confirming the diagnosis and deciding to carry out radiotherapy for a malignant neoplasm by X-ray irradiation. In the process of preparing topometry, the size, area, and volume of specific patient lesions, organs and anatomical structures are determined, and their relative positional relationships are quantitatively described (for example, , Radiation thermal of a marginant neoplasm. Physicians guide, edited by ES Kiseleva, Moscow, “Medistina”, 1996 [1], pages 46-47). The main challenge when preparing the topometry is to integrate all the information obtained in the disease diagnosis process and create an irradiation program, all topographic anatomical data about the site to be irradiated at 1: 1 scale Is to be provided to oncologists. The selection of irradiation program variables and parameters is most important in terms of target organ morphology and size, location, as well as peripheral organ and tissue synchronization, target, and radiation load distribution. Need to know the distance between the anatomical structure and the sensitive organs. By constructing topometry and creating an irradiation program, particularly characteristic points and regions of the patient's body surface are selected, after which the direction of the X-ray beam is determined during irradiation with respect to these points and regions.

  The main drawback of the above combination of patient preparation for irradiation and irradiation itself is that they are performed in different stages, in particular in different ways, both temporally and spatially. A high-power directional radiation source is used for irradiation (the effect of radiation on cell lesions of malignant neoplasms). For radiological examinations prior to irradiation, not only are the irradiation done at a much lower level, but also a combination of several types: angiography, excretory urography, gastrointestinal tract, skeleton and skull, and chest Examination; Radionuclide diagnosis of bone and liver; Imaging of abdominal cavity, pelvis, and soft tissue organs by ultrasonic diagnosis (ecoscopy, sonographic tomography); Computerized tomography (imaging by high-performance X-ray imaging) Processing); Usually, only one examination is performed from among magnetic resonance tomography. Therefore, it is always difficult to obtain the action of radiation with high accuracy. As a result, irradiation of some malignant lesions may be overlooked, or high-level X-rays may be intensively irradiated on areas exceeding the range of malignant lesions. In the latter case, the surrounding healthy tissue will be significantly more damaged than if the healthy tissue was inevitably irradiated during the course of radiation to the malignant lesion.

  When performing such a method, not only is the direction of the X-ray beam and the “sighting” selection at the time of the action of radiation inaccurate, but also the location of the internal organs is not constant and the treatment cools This also reveals that patient placement is inaccurate during the action of radiation. Even the fractional irradiation done to avoid over-irradiation of healthy tissue is not sufficient for single doses to malignant lesions for irreversible lesions, creating a vicious circle (in the case of fractional irradiation, the number of total doses It is known to be a fraction of a strength) [1 (84, 91)].

  Among many known technical solutions to overcome such drawbacks, special measures are taken that emphasize the high accuracy and stability of patient positioning (for example, on November 16, 1999). See published US Pat. No. 5,983,424).

  Using an X-ray diagnostic device, similar to a remote irradiation device in terms of geometric and dynamic possibilities, as a so-called simulator is another way of overcoming the deficiencies pointed out. [1 (page 55)]. Using the simulator, it is possible to “transmit” the patient in different directions without changing the position of the patient. When preparing the patient's topometry, the patient is laid down in a posture that would be taken during irradiation on the simulator table and an X-ray examination is performed. The center and contour of the irradiation volume are selected by the movement of the crosshairs and the X-ray contrast filament, and a plane through which the central axis of the radiation beam passes when the radiation is applied is displayed.

  However, neither of these approaches will overcome the problem of correctly directing the beam of radiation that acts on the malignant neoplasm to the “sight”, but rather leads to tumor enlargement. It can be seen that such challenges are important during long-term treatment when the irradiation course is temporally separated from the end of the patient's diagnostic examination.

  The technical solution closest to the envisaged invention is described in US Pat. No. 5,207,223 (published May 4, 1993). The method and apparatus according to this patent used a directional radiation beam that allowed the acquisition of an image of the patient's tissue structure, and obtained and used such an image immediately prior to the application of radiation. By comparing with the result of the diagnostic examination, the irradiation program is optimized. In this case, however, the acquisition of this image and the radiation action on the malignant lesion tissue use different beams, which cannot in principle avoid errors in the direction of the irradiation beam. Furthermore, an image cannot be obtained with reasonable accuracy unless a computer-aided tomography algorithm is executed. This means that the corresponding technical measures are not only complicated, but also require a relatively high level of irradiation dose.

The present invention provides the following:
(1) Radiotherapy for malignant neoplasms using an X-ray beam, the method comprising:
Spatial coordinates of the point to which the result of measuring the internal structure of the part of the patient's body (5) including the malignant neoplasm of the patient's body (5) and the surrounding organs and tissues, Obtained based on the information obtained as a set with the spatial coordinates of the density values of the biological tissue of the body, and then using the previous diagnostic results to identify images of structural elements related to malignant neoplasms Then, a set of X-ray irradiation doses to be irradiated to each site of the malignant neoplasm, which is a set of determined point coordinates, as a set, create an irradiation program, and then move to the second stage, the first stage,
The stage of the malignant neoplasm represented by a set of coordinates determined by identifying the image of the structural elements related to the malignant neoplasm in the first stage and the position occupied by the focusing region (16) in the second stage; Are scanned using the same means as in the first stage to scan the spatial region occupied by the malignant neoplasm while focusing the X-ray, and then increase the intensity of the X-ray from the first stage. And executing the irradiation program created in the first stage while controlling the irradiation time, the second stage,
Including two stages,
In the first stage, to obtain information about the internal structure of the patient's body, the area including the point to which the result being measured belongs and including the point inside the part of the patient's body containing the malignant neoplasm The X-ray is focused on (16), the secondary radiation generated in this region is delivered to one or more detectors (6, 20), and the patient is moved while moving the radiation focused region and the patient's body relatively. Scanning the part of the body that contains malignant neoplasm and using one or more detectors, the coordinates of the point of the X-ray focusing area to which the measurement result belongs and the secondary determined simultaneously Based on a combination set with radiation intensity values, determine the density of biological tissue at this point and use together quantitative indicators that are considered biological composition densities and their corresponding coordinate values The part of the patient's body that contains malignant neoplasms Obtaining an image of the density distribution of the tissue,
A method characterized by.
(2) Using one or more X-ray sources (1, 17) placed in space, the point to which the results being measured belong and within the part of the patient's body containing a malignant neoplasm X-ray focusing on the containing region (16) is performed using a corresponding number of collimators (13, 18) and the delivery of the generated secondary radiation to one or more detectors is also: This is done using one or more collimators (15, 19), wherein all collimators are oriented so that they intersect their central channel axis, the point to which the result being measured belongs. The method according to Item 1.
(3) One or more X-ray focusings on the region (16) to which the measurement result belongs and which includes a point inside the part of the patient's body that contains a malignant neoplasm. Is performed using one or more X-ray half-lenses (21) that convert the radiation emitted from the X-ray source (1) into approximately parallel radiation and generated to one or more detectors Secondary radiation delivery using one or more X-ray half-lenses (22, 23) that focus the radiation onto a detector (6, 20) or produce the radiation approximately parallel. The method according to item 1, wherein all X-ray half-lenses are oriented such that their optical axes intersect with the point to which the result of measurement belongs. .
(4) X-ray focusing on a region (16) to which the result being measured belongs and which includes a point within the patient's body that includes a portion containing a malignant neoplasm may comprise one or more arranged in space. This is done using one or more X-ray half-lenses (21) that convert the radiation emitted from the X-ray source (1) into approximately parallel radiation and generated to one or more detectors. The delivery of secondary radiation takes place using one or more X-ray lenses (3) that focus this radiation onto the detector (6), where all X-ray half-lenses and lenses are Method according to item 1, characterized in that their optical axes are oriented such that they intersect the point to which the result being measured belongs.
(5) X-ray focusing on a region (16) including a point to which a measurement result belongs and a point in a patient's body that includes a malignant neoplasm is included in a plurality of X's arranged in space. Delivery of secondary radiation generated using a corresponding number of X-ray half-lenses (21) that convert radiation emitted from the source and to one or more detectors is one or more. X-ray half-lenses and collimators are used to measure the optical axis of all X-ray half-lenses and the optical axis of the central channel of all collimators. The method according to item 1, characterized in that the result is oriented so as to intersect with the point to which the result belongs.
(6) One or more X-ray focusings on the region (4) to which the result being measured belongs and which includes a point in the patient's body that includes a point within the part containing the malignant neoplasm This is done using an X-ray source (1) and a corresponding number of X-ray lenses (3) that focus the X-rays emitted from each source to the point to which the measurement result belongs. And the delivery of the generated secondary radiation to the one or more detectors focuses the radiation onto the detector (6) and has a second focal point above the point ( 3. The method according to item 1, wherein the method is performed using 3).
(7) X-ray focusing on a region (16) that includes a point to which the result being measured belongs and that is inside a portion of the patient's body that contains a malignant neoplasm may comprise one or more x-rays arranged in space. This is done using an X-ray source (1) and a corresponding number of X-ray lenses (2) that focus the X-rays emitted from each source to the point to which the measurement result belongs. And delivery of the generated secondary radiation to the one or more detectors (6, 20) using the collimator oriented so that the central channel of the collimator (15, 19) intersects the above point. The method according to item 1, wherein the method is performed.
(8) A method for determining the position of a malignant neoplasm, the method using an X-ray beam, the spatial coordinates of points to which the results being measured belong, and the biology corresponding to these coordinates Based on the information obtained as a set of density values of the target tissue, an image of the internal structure of the patient's body part, including the malignant neoplasm and surrounding organs and tissues, is acquired and then a pre-diagnosed Using the results to identify images of structural elements related to malignant neoplasms,
Here, in order to obtain the above information about the internal structure of the patient's body, the X-ray is focused on a region including the point to which the measurement result belongs and which is inside the part of the patient's body containing the malignant neoplasm. The secondary radiation generated in this area is delivered to one or more detectors, and the part of the patient's body containing a malignant neoplasm is scanned while the relative movement between the radiation focusing area and the patient's body is performed. And this point based on a set of secondary radiation intensity values obtained using one or more detectors and determined by the coordinates of the point of the X-ray focusing region to which the measurement result belongs. In order to determine the density of the biological tissue in the body and to obtain an image of the density distribution of the biological tissue of the part of the patient's body containing malignant neoplasms, Use them together with their corresponding coordinate values, then And coordinates, characterized in that to determine the combination of the density of the biological tissue corresponding thereto, the method.
(9) X-ray focusing on a region (16) containing a point to which the result being measured belongs and which is inside a part of the patient's body (5) containing a malignant neoplasm may comprise one or more collimators ( 13, 18), using radiation emitted from a corresponding number of one or more X-ray sources (1, 17) arranged in space, and to one or more detectors The delivery of the generated secondary radiation is likewise carried out using one or more collimators (15, 19), where all the collimators have their central channel axis attributed to the result being measured. 9. The method according to item 8, characterized in that the method is oriented so as to intersect.
(10) Focusing of X-rays on a region (16) that includes a point to which the result being measured belongs and that is inside a portion of the patient's body that contains a malignant neoplasm may comprise one or more arranged in space Secondary radiation generated using one or more X-ray half-lenses (21) that convert radiation emitted from the X-ray source into approximately parallel radiation and generated to one or more detectors. Is delivered using one or more X-ray half-lenses (22) that focus this radiation onto a detector (6, 20) or produce said radiation that is approximately parallel. 9. A method according to item 8, characterized in that all X-ray half-lenses are oriented so that their optical axis intersects the point to which the result being measured belongs.
(11) X-ray focusing on a region (16) that includes a point to which the result being measured belongs and that is inside a portion of the patient's body (5) that contains a malignant neoplasm, is arranged in space. One or more X-ray half lenses (21) that convert radiation emitted from one or more X-ray sources (1) into approximately parallel radiation and one or more detectors ( The delivery of the generated secondary radiation to 6) is performed using one or more X-ray lenses (22) that focus this radiation onto the detector, with all X-ray half lenses and 9. A method according to item 8, characterized in that the lens is oriented such that its optical axis intersects the point to which the result being measured belongs.
(12) X-ray focusing on a region (16) including a point to which a measurement result belongs and a point in a patient's body that includes a malignant neoplasm is included in a plurality of X's arranged in space. Secondary generated by using a corresponding number of X-ray half-lenses (21) that convert the radiation emitted from the source (1) and generated to one or more detectors (6, 20) The delivery of radiation takes place using one or more collimators (15, 19), where the X-ray half-lenses and collimators are the optical axes of the central channels of all X-ray half-lenses and all collimators. 9. The method according to item 8, wherein the method is oriented so that the result of measuring intersects with the point to which the result belongs.
(13) One or more X-ray sources arranged in space may be used to focus X-rays on a region including a point to which a measurement result belongs and a point in the patient's body that includes a malignant neoplasm. (1) and an X-ray lens (2) that focuses to a point (4) to which the result of measuring X-rays emitted from a corresponding number of each source belongs, and Delivery of the generated secondary radiation to one or more detectors focuses the secondary radiation on the detector (6) and has a second focal point on said point (3) 9. The method according to item 8, wherein the method is performed using
(14) One or more X-ray sources arranged in space may be used to focus X-rays on a region including a point to which a measurement result belongs and a point in a patient's body that includes a malignant neoplasm. (1) and a corresponding number of X-ray lenses (2) that focus the X-rays emitted from each source to the point to which the measurement result belongs, and Delivery of the generated secondary radiation to one or more detectors (6, 20) is performed by a collimator (15, 19) oriented so that the optical axis of its central channel intersects the above point. 9. A method according to item 8, characterized in that
(15) A device for determining the position of a malignant neoplasm and for radiotherapy of the malignant neoplasm, the device comprising:
X-ray optical system (8),
Means (10) for determining the relative position of the patient's body and the x-ray optics; and
Means (12) for processing and imaging the information,
The optical system (8)
One or more X-ray sources (1),
Means (2) for focusing X-rays; and
One or more detectors (6),
The output of the detector is connected to means (12) for processing and imaging the information;
Here, the X-ray source (1) constituting the X-ray optical system (8) is realized with the ability to change the intensity of the radiation, and the X-ray optical system (8) is the radiation of the X-ray source (1). Means (9) for simultaneously controlling the intensity of the radiation, and means (2) for focusing the radiation emitted from these sources are also the result of measuring the radiation of all sources. Realized and attached to the device, with the ability to focus on the area containing and belonging to the part of the patient's body (5) containing the malignant neoplasm
Furthermore, the X-ray optical system (8) also comprises one or more means (3) for delivering secondary radiation generated in the focusing region, the secondary radiation being attached to these means and secondary radiation. Delivered to a detector (6) implemented to be sensitive to
A sensor (11) for determining the coordinates of a point to which the result being measured belongs and which is inside the part of the patient (5) that contains a malignant neoplasm is composed of the patient's body and the X-ray optics. Connected to means (10) for determining relative position and connected to means (12) for processing and imaging information by means of the output terminal of the sensor itself,
The means (12) uses means (10) for determining the relative position of the patient's body and the x-ray optics, and the radiation of the x-ray source of the patient body (5) containing the malignant neoplasm. A device characterized in that it is realized with the ability to form and image a tissue density distribution obtained as a result of scanning with a region that focuses the image.
(16) X-ray optical system
A plurality of X-ray generation sources (1, 17),
Means for focusing each radiation onto a region (16) containing a point to which the result of measuring each belongs; and
Means for delivering secondary radiation generated in said area to a detector (6, 20)
And the delivery is realized in the form of a collimator (13, 15, 18, 19) comprising a channel, the channel being realized in the form of a collimator directed to the region of the X-ray source that focuses the radiation. The device according to item 15, characterized in that the optical axis of the central channel of all collimators intersects the point to which the result being measured belongs.
(17) The X-ray sources (1) constituting the X-ray optical system can be regarded approximately as points, and the collimator (13) has channels focused on these sources, 17. Device according to item 16, characterized in that a screen (14) with an opening is placed between the outlet and the corresponding collimator inlet.
(18) The X-ray source (17) constituting the X-ray optical system has a length, and the channel of the collimator (18) extends toward the X-ray source side. apparatus.
(19) The X-ray source (1) constituting the X-ray optical system can be approximately regarded as a point, and means for focusing X-rays on a region including a point to which a measurement result belongs is as follows. Respectively realized in the form of an X-ray half-lens (21) that converts radiation emitted from the source into approximately parallel radiation, and means for delivering the generated secondary radiation to the detector comprises: Each is realized in the form of an X-ray half-lens (22) that focuses this radiation onto the detector (6), in which case the optical axis of all X-ray half-lenses depends on the result being measured. 16. The device according to item 15, characterized in that it intersects at points belonging to it.
(20) The X-ray source (1) constituting the X-ray optical system can be approximately regarded as a point, and means for focusing X-rays on a region including a point to which a measurement result belongs is as follows. Each is realized in the form of an X-ray half-lens (21) that converts the radiation emitted from the source into approximately parallel radiation and for delivering the generated secondary radiation to the detector (20). The means are each realized in the form of an X-ray half-lens (23) which forms a substantially parallel radiation and has a focal point in the region (16) for focusing the X-rays, 16. The apparatus according to item 15, characterized in that the optical axis of the half lens for use intersects at the point to which the measurement result belongs.
(21) The X-ray source (1) constituting the X-ray optical system can be approximately regarded as a point, and is used for focusing the X-ray on the region (16) including the point to which the measurement result belongs. The means are each realized in the form of an X-ray half lens (21) that converts radiation emitted from the source into approximately parallel radiation and for delivering the generated secondary radiation to the detector. The means are each realized with an X-ray lens (3) that focuses this radiation onto the detector (6) and has a second focal point in the X-ray focusing region, all X-ray half lenses and 16. The device according to item 15, characterized in that the optical axes of the lenses intersect at the point to which the measurement result belongs.
(22) The X-ray source (1) constituting the X-ray optical system can be approximately regarded as a point, and means for focusing X-rays on a region including a point to which a measurement result belongs is as follows. Respectively realized in the form of an X-ray half-lens (21) that converts radiation emitted from the source into approximately parallel radiation, and means for delivering the generated secondary radiation to the detector comprises: Each is realized in the form of a collimator (19) having a channel extending towards the corresponding detector (20) side, and the optical axes of all X-ray lenses and half lenses and the optical axis of the collimator central channel are measured. 16. The apparatus according to item 15, characterized in that the result of the intersection intersects at the point to which the result belongs.
(23) The X-ray source (1) constituting the X-ray optical system can be approximately regarded as a point, and is used to focus the X-ray on the region (16) including the point to which the measurement result belongs. The means are each realized in the form of an X-ray half lens (21) that converts the radiation emitted from the corresponding X-ray source into approximately parallel radiation and delivers the generated secondary radiation to the detector. The means for doing so are each realized in the form of a collimator (15) having a channel that converges towards the corresponding detector (6) side, and the optical axes of all X-ray half-lenses and collimator central channels are: 16. The apparatus according to item 15, characterized in that the measurement results intersect at points to which they belong.
(24) The X-ray source (1) constituting the X-ray optical system can be approximately regarded as a point, and means for focusing X-rays on a region including a point to which a measurement result belongs is as follows. Respectively realized in the form of an x-ray lens (2) for focusing the radiation emitted from the source, and means for delivering the generated secondary radiation to the detector, respectively Realized by an X-ray lens (3) focused on a vessel (6), characterized in that the optical axes of all X-ray lenses intersect at the point (4) to which the measurement result belongs. The apparatus according to item 15, wherein:
(25) The X-ray source (1) constituting the X-ray optical system can be approximately regarded as a point, and means for focusing X-rays on a region including a point to which a measurement result belongs is as follows. Respectively realized in the form of an X-ray lens (2) for focusing the radiation emitted from the X-ray source, and means for delivering the generated secondary radiation to the detector are each a corresponding detector ( 6) realized in the form of a collimator (15) with a channel converging towards the side, the optical axes of all X-ray lenses and the collimator central channel intersect at the point where the result being measured belongs. Item 16. The device according to item 15, characterized in.
(26) The X-ray source (1) constituting the X-ray optical system can be approximately regarded as a point, and is used to focus the X-ray on the region (16) including the point to which the measurement result belongs. The means are each realized in the form of an X-ray lens (2) for focusing the radiation emitted from the X-ray source, and the means for delivering the generated secondary radiation to the detector respectively Realized in the form of a collimator (19) with a channel extending towards the detector (20) side, the optical axes of all X-ray lenses and the collimator central channel intersect at the point to which the result being measured belongs. The device according to item 15, characterized in that:
(27) Items 15-26, characterized in that the device is additionally equipped with means for isolating or shielding the detector when operating the X-ray source with increasing intensity The apparatus according to any one of the above.
(Disclosure of the Invention)
Technical results provided by the present invention relating to radiation therapy for malignant neoplasms, methods for determining malignant neoplasms, and devices for performing the methods are provided for determining tissue structure and determining the location of malignant lesions. It is to eliminate the above-mentioned factors by using exactly the same beam as the original X-ray beam for radiation irradiation for an X-ray beam and a malignant lesion. Another technical result that can be achieved is that not only can the irradiation dose be reduced in the process of obtaining an image of the tissue structure used to modify the irradiation program, but also the irradiation dose of the surrounding tissue in the selected irradiation area. Can be reduced.

  The radiation therapy of malignant neoplasms using an X-ray beam according to the present invention and the known methods described above are carried out in two stages. In the first stage, based on information in the form of a spatial coordinate set of points to which the results being measured belong and the tissue density values corresponding to these coordinates, malignant neoplasms in the patient's body are identified. Images of internal structural parts including and surrounding organs and tissues are obtained. Next, using previously performed diagnostic results, identification of structural element images related to the malignant neoplasm that must be performed on various parts of the malignant neoplasm represented by the determined set of point coordinates is performed. The irradiation program is created in the form of an X-ray dose set. After this procedure, the process proceeds to the second stage, and the created irradiation program is executed.

  Unlike the known methods, in order to obtain the technical results in the above manner by the method of the present invention, in the first step, the results being measured belong to the malignant neoplasm in the patient's body. Focus the x-rays on the area containing the points inside the containing part to obtain the above information about the internal structure of the part of the patient's body. Secondary radiation generated in this area is delivered to one or more detectors to scan a portion of the patient's body containing a malignant neoplasm. For this purpose, the region where the radiation is focused and the patient's body are moved relative to each other during the scan. Based on the set of secondary radiation intensity values obtained by one or more detectors and determined simultaneously with the coordinates of the point of the x-ray focusing region to which the measurement result belongs, the tissue density at this point is determined. Is done. In order to depict an image of the tissue density distribution of a part of a patient's body containing a malignant neoplasm, a quantitative index regarded as the density of the tissue and the corresponding coordinate value are used. In the second stage, the same means as in the first stage are used to match the malignant neoplasm part represented by the coordinates of the determined point as a result of identifying the structural elements related to the malignant neoplasm in the first stage. The X-rays are focused to scan a spatial region that is considered a malignant neoplasm. The irradiation program created in the first stage is also executed by increasing the X-ray intensity from the first stage and controlling the irradiation time.

  For example, the focusing of X-rays to a region to which the result being measured belongs, which includes a point in the patient's body that is inside a portion containing a malignant neoplasm, is represented by a corresponding number of X's arranged in space. This can be done using a source and using one or more collimators. In so doing, the generated secondary radiation can be delivered to one or more detectors using one or more collimators. In this case, the orientation of all collimators is adjusted so that the axis of the central channel intersects the point where the current measurement results are relevant.

  The focusing of the X-rays to a region to which the result of the measurement belongs and which includes a point in the patient's body that is inside the portion containing the malignant neoplasm is one or more X-rays arranged in space. It is also possible to use the number of X-ray half lenses corresponding to the source. The X-ray half lens converts radiation emitted from an X-ray source into approximately parallel radiation. In this case, in order to deliver the generated secondary radiation to one or more detectors, the radiation is focused on the detector or one or more X-ray half-lenses that form approximately parallel radiation. Is used. In this case, all X-ray half-lenses are oriented so that their optical axis intersects the point where the current measurement results are relevant.

  The focusing of the X-rays to a region to which the result of the measurement belongs and which includes a point in the patient's body that is inside the portion containing the malignant neoplasm is one or more X-rays arranged in space. It is also possible to use the number of X-ray half lenses corresponding to the source. The X-ray half lens converts radiation emitted from an X-ray source into approximately parallel radiation. To deliver the generated secondary radiation to one or more detectors, one or more radiation lenses that focus the radiation onto the detector are used. In so doing, all X-ray half-lenses and lenses are oriented so that their optical axis intersects the point to which the result being measured belongs.

  In one of the specific embodiments, when carrying out the method of the present invention, the point to which the measurement result belongs, and the point within the part containing the malignant neoplasm in the patient's body is determined. The focusing of the X-rays to the region including the X-ray half-lenses is performed by using a plurality of X-ray half-lenses corresponding to a plurality of X-ray sources arranged in the space. Transforms the emitted radiation into approximately parallel radiation. One or more collimators are used to deliver the generated secondary radiation to one or more detectors. In doing so, these X-ray half-lenses and collimators are oriented so that the optical axis of the central channel of all X-ray half-lenses and all collimators intersects the point where the current measurement results are relevant. .

  In another specific embodiment, when performing the method of the present invention, to a region that includes a point to which the result being measured belongs and that is within a portion of the patient's body that includes a malignant neoplasm. X-ray focusing is performed using one or more X-ray sources arranged in space and a corresponding number of X-ray lenses, which X-rays emitted from each source. Is focused to the point to which the result being measured belongs. In order to deliver the generated secondary radiation to one or more detectors, an X-ray lens is used that focuses the radiation onto the detector and has a second focal point at the above point. In this embodiment, the radiation level for healthy tissue can be kept low, and the use of a small number of (even one) beams can limit the effects of radiation to a very small area, resulting in segmentation. Further technical results are achieved, which can avoid irradiation and in a single course the radiation treatment of small tumors in many cases.

  According to yet another specific embodiment, x-rays to an area that includes a point to which the result being measured belongs and that is within a portion of the patient's body that includes a malignant neoplasm. Focusing is performed using one or more X-ray sources arranged in space and a corresponding number of X-ray lenses, which measure the X-rays emitted from each source. Focus on the point to which the result belongs. A collimator is then used to deliver the generated secondary radiation to the one or more detectors, which collimator is oriented so that its central channel optical axis intersects the point.

  Similar to the known method described in US Pat. No. 5,207,223 [3], in the method according to the present invention for determining the position of a malignant neoplasm using an X-ray beam, the measurement result belongs. Based on information given in the form of a set of spatial coordinates and tissue density values corresponding to these coordinates, an image of the part of the patient's body containing malignant neoplasms and the surrounding organs and tissue internal structures is obtained. It is done. Thereafter, an image of the structural element related to the malignant neoplasm is identified using the diagnosis result obtained in advance.

  Unlike the above known methods, in the method of the present invention for achieving the above technical result, in order to obtain the above information on the internal structure of a part of the patient's body, X-ray focusing to an internal region is performed. Secondary radiation generated in this area is delivered to one or more detectors and a portion of the patient's body containing a malignant neoplasm is scanned. To perform the scan, the X-ray focusing area and the patient's body are moved relative to each other. This point is based on a set of simultaneously determined intensity values of the secondary radiation obtained using one or more detectors and the coordinates of the point of the region to which the radiation is to be focused, to which the measurement results belong. Determine the density of biological tissue in Quantitative indicators that are considered to be the density of the biological composition and the corresponding coordinate values are used to image an image of the density distribution of the biological tissue in the part of the patient's body containing malignant neoplasms. Subsequently, the combination of the point coordinates and the density of the biological tissue identified as belonging to the malignant neoplasm corresponding to the point coordinates is determined.

  In a specific embodiment of carrying out the method of the present invention for determining the location of a malignant neoplasm, the point to which the result being measured belongs is the point within the portion of the patient's body containing the malignant neoplasm. The focusing of the X-rays to the containing area is performed using one or more collimators. In doing so, a corresponding number of x-ray sources arranged in space are used, and one or more collimators are also used to deliver the generated secondary radiation to one or more detectors. All collimators are oriented so that the axis of their central channel intersects the point to which the result being measured belongs.

  In another specific embodiment, the focusing of X-rays to a region that includes the point to which the result being measured belongs and that is within a portion of the patient's body that includes a malignant neoplasm is located in space. One or more X-ray sources and a corresponding number of X-ray half-lenses, wherein the X-ray half-lenses convert the radiation emitted from the X-ray source into approximately parallel radiation. Convert. To deliver the generated secondary radiation to one or more detectors, one or more X-ray half lenses are used that focus the radiation onto the detector or form approximately parallel radiation. The In this case, all the X-ray half lenses are oriented so that their optical axes intersect with the point to which the measurement result belongs.

  In another specific embodiment, the focusing of X-rays to a region to which the result being measured belongs, including a point within the portion of the patient's body that includes a malignant neoplasm, This is done using one or more X-ray sources arranged in space and a corresponding number of X-ray half-lenses, which are approximately parallel to the radiation emitted from the X-ray source. Convert to radiant radiation To deliver the generated secondary radiation to one or more detectors, one or more x-ray lenses are used that focus the radiation onto the detectors. All X-ray half-lenses and lenses are then oriented so that their optical axis intersects the point to which the result being measured belongs.

  In the following specific embodiment, the focusing of the X-rays into the region to which the result being measured belongs, including the point in the patient's body that is inside the portion containing the malignant neoplasm, is in space. This is done using a plurality of arranged X-ray sources and a corresponding number of X-ray half lenses, which convert the radiation emitted from the X-ray source into approximately parallel radiation. To do. One or more collimators are used to deliver the generated secondary radiation to one or more detectors. In so doing, the X-ray half-lens and collimator should be such that the central channel optic axis of all radiation X-ray half-lenses and all collimators intersects the point to which the current measurement results pertain (belongs to). Oriented.

  Focusing X-rays into a region containing a point inside a part of a patient's body containing a malignant neoplasm includes one or more X-ray sources arranged in space and a corresponding number of X-ray lenses. This X-ray lens can be used to focus the X-rays emitted from each source to the point to which the result of measuring belongs. To deliver the generated secondary radiation to one or more detectors, an x-ray lens can be used that focuses the radiation onto the detector and has a second focal point at the above point.

  Further, the focusing of the X-rays to the area to which the results being measured belong, including the points within the portion of the patient's body that contain the malignant neoplasm, may be one or more arranged in space. It can also be performed using an X-ray source and a corresponding number of X-ray lenses, which focus the X-rays radiated from each source to the point to which the result of the measurement belongs. . In so doing, a collimator is used to deliver the generated secondary radiation to one or more detectors, which collimator is oriented so that the optical axis of the central channel intersects the point.

  The same apparatus can be used to carry out the two methods according to the invention. This device is similar to the known device according to the aforementioned US Pat. No. 5,207,223 [3] for the determination of the location of malignant neoplasms and the radiotherapy of malignant neoplasms using X-ray beams. Means for determining the relative positional relationship between the patient's body and the X-ray optical system, and means for information processing and imaging. The X-ray optics then comprises means for focusing the radiating radiation and one or more detectors, the output of the detectors being connected to means for information processing and imaging.

  In order to achieve the above technical result belonging to the invention of the present application in the above form, the X-ray source constituting the X-ray optical system changes the radiation intensity in the apparatus according to the invention of the present application, unlike the known apparatus. And the X-ray optical system includes means for simultaneously controlling the radiation intensity of the X-ray source. The means for focusing the radiation of these sources is to direct all of the source radiation to the area containing the point to which the result being measured belongs and which is inside the part of the patient's body containing the malignant neoplasm. Realized with the ability to focus and attached to the device. In addition, the x-ray optics includes one or more means for delivering secondary radiation generated in the focusing region to the detector, the detector being attached to the output of these means and sensitive to the secondary radiation. To be realized. A sensor for determining the coordinates of a point to which the result being measured belongs and which is within a portion of the patient's body containing a malignant neoplasm is a relative between the patient's body and the x-ray optics. This sensor is connected to means for information processing and imaging through its own output terminal. The information processing imaging means uses the means for determining the relative positional relationship between the patient's body and the X-ray optical system, and uses the X-ray source of the portion of the patient's body containing the malignant neoplasm. As a result of the scanning by the region where the radiation is focused, the resulting tissue density distribution is formed and realized with the ability to image.

  In one specific embodiment for realizing the apparatus of the present invention, the X-ray optical system includes a plurality of X-ray sources, and focuses the radiation on a region including a point to which a measurement result belongs. The means for delivering and the means for delivering the secondary radiation generated therein to the detector are realized in the form of a collimator having a channel directed to the X-ray focusing region of the X-ray source, wherein all collimators The central channel optical axes of the two intersect at the point to which the result being measured belongs.

  In this embodiment, for example, an X-ray optical system of an X-ray source approximately regarded as a point, and a collimator having a channel focused on these sources can be used, and the exit of each source And a screen with a hole (hole) between the corresponding collimator inlets.

  In the above embodiment, a collimator having a wide X-ray optical system as a component and a channel extending toward these radiation sources can be used.

  In another specific embodiment, the X-ray source constituting the X-ray optical system can be regarded as a point approximately, for focusing the X-ray on a region including the point to which the measurement result belongs. Each means is realized in the form of an X-ray half-lens that converts the radiation emitted from the corresponding radiation source into approximately parallel radiation, each means for delivering the generated secondary radiation to the detector. This is realized as an X-ray half lens that focuses the radiation on the detector. At that time, the optical axes of all the X-ray half lenses intersect at a point to which the measurement result belongs.

  In another specific embodiment, the X-ray sources that make up the X-ray optical system can be approximated as points, and focus the X-rays on the region containing the points to which the measurement results belong. Each means for realizing is realized in the form of an X-ray half-lens that converts radiation emitted from the corresponding radiation source into approximately parallel radiation, and each means for delivering the generated secondary radiation to the detector. The means is realized as an X-ray half-lens that forms approximately parallel radiation and has a focal point in the X-ray focusing region. At that time, the optical axes of all the X-ray half lenses intersect at a point to which the measurement result belongs.

  In the following specific embodiment, the X-ray source constituting the X-ray optical system can be regarded approximately as a point, in order to focus the X-ray on a region including the point to which the measurement result belongs. Each means is realized in the form of an X-ray half-lens that converts radiation emitted from the corresponding radiation source into approximately parallel radiation, and each means for delivering the generated secondary radiation to the detector. Is realized as an X-ray lens that focuses this radiation on a detector and has a second focal point in the X-ray focusing region. At that time, all the X-ray half lenses and the optical axes of the lenses intersect at the point to which the measurement result belongs.

  The X-ray source constituting the X-ray optical system can be approximately regarded as a point, and each means for focusing the X-ray on the region including the point to which the measurement result belongs is obtained from the corresponding source. Each means for delivering the generated secondary radiation to the detector is realized in the form of an X-ray half-lens that converts the emitted radiation into approximately parallel radiation and extends towards the corresponding detector. A device is also possible which is realized in the form of a collimator with an additional channel. In that case, the optical axes of all X-ray lenses and half lenses and the central channel of the collimator intersect at the point to which the measurement result belongs.

  Another possibility of realizing the device according to the present invention is that the X-ray source constituting the X-ray optical system can be regarded as a point approximately, and the region including the point to which the measurement result belongs is included. Each means for focusing the X-rays is realized in the form of an X-ray half-lens which converts the radiation emitted from the corresponding X-ray source into approximately parallel radiation, and the generated secondary radiation is detected by a detector. Each means for delivering to a is characterized in that it is realized in the form of a collimator with a channel that converges towards the corresponding detector. At that time, the optical axes of the central channels of all the X-ray half lenses and the collimator intersect at the point to which the measurement result belongs.

  Another embodiment for realizing the apparatus is that the X-ray source constituting the X-ray optical system can be regarded as a point approximately, and the X-ray is focused on a region including the point to which the measurement result belongs. Each means is realized in the form of an X-ray lens for focusing radiation emitted from the X-ray source, and each means for delivering the generated secondary radiation to the detector corresponds to this radiation. It is realized in the form of an X-ray lens that is focused on. At that time, the optical axes of all the X-ray lenses intersect at a point to which the measurement result belongs.

  The X-ray source constituting the X-ray optical system can be regarded approximately as a point, and each means for focusing the X-ray on the region including the point to which the measurement result belongs is emitted from the X-ray source. Each means for delivering the generated secondary radiation to the detector is in the form of a collimator with a channel that narrows towards the corresponding detector. The optic axis of the central channel of all x-ray lenses and collimators is characterized by intersecting at the point to which the result being measured belongs.

  The apparatus according to the invention of the present application can approximately regard the X-ray source constituting the X-ray optical system as a point, and each means for focusing the X-ray on the region including the point to which the measurement result belongs. Can also be embodied in such a way as to be realized in the form of an X-ray lens that focuses the radiation emitted from the X-ray source. In this case, each means for delivering the generated secondary radiation to the detector is realized in the form of a collimator with a channel extending towards the corresponding detector, the center of all X-ray lenses and collimators. The optical axes of the channels intersect at the point to which the result being measured belongs.

  In all the embodiments described here, the device can additionally be equipped with means for blocking or shielding the detector when operating the X-ray source with increased power.

(Embodiment of the Invention)
The method for determining the location of a malignant neoplasm according to the present invention is independent if no subsequent treatment of the malignant neoplasm is performed or if it does not form part of the radiation therapy for the malignant neoplasm in the first stage. It is considered a thing. In both cases, the method itself is not a diagnostic or therapeutic method.

  Radiotherapy of malignant neoplasms according to the invention of the present application always involves the implementation of a malignant neoplasm location method in the first stage.

  The apparatus according to the present invention is common to both methods.

  The method according to the present invention is carried out as follows using the apparatus according to the present invention.

  X-rays radiated from a source (pseudo-point source) 1 (FIG. 1) that is approximately regarded as a point according to a judgment made by a diagnostic examination performed in advance are transmitted through the X-ray lens 2 to the patient's body 5. Focusing on a predetermined point 4 of the part 7 containing the malignant neoplasm. The patient's body is placed in the required position by means 10 for determining the relative positional relationship between the patient's body and the x-ray optics. The radiation focused at point 4 excites secondary scattered radiation (coherent and incoherent Compton scattered radiation, fluorescent radiation) of material present in the biological tissue of patient 5. The intensity of secondary radiation that accurately reflects fluctuations due to the probabilistic nature of the secondary radiation excitation process is proportional to the density of the material it generates. The focal point of the second X-ray lens 3 is also at the same point 4. This lens focuses the scattered secondary radiation hitting it onto the detector 6. The detector converts it into an electrical signal, which is sent to the input of the means 12 for information processing and imaging. The position of the common focal point 4 of the lenses 1 and 3 is selected by moving the positional relationship between the patient body 5 and the X-ray optical system 8 by means 10 for determining the relative positional relationship. The X-ray optical system 8 includes a radiation source 1, an X-ray lens 2 and 3 and a radiation detector 6 which are realized with the ability to change the radiation intensity, and further includes means 9 for controlling by the radiation intensity. . The latter can simultaneously change the radiation intensity of all the radiation sources constituting the X-ray optical system. (FIG. 1 illustrates the principles underlying the present method, only one of which is shown).

  In the second stage of radiation therapy, the ability to change the radiation intensity and the means 9 for controlling the change are used.

  An X-ray lens (focusing of dispersive radiation, formation of an approximately parallel beam from the dispersive radiation, focusing of an approximately parallel beam, etc.) as a means for controlling X-rays is used in a radiation delivery device. It is an integral body of curved channels, and it is clear that radiation repeatedly undergoes total surface reflection within this channel (eg, VA Arkadiev, AI Kolomitsev, MA Kumakhov). Et al., Broadband X-ray optics with angular aperture.Uspecki fizzicheskikh nauk, 1989, Vol. 157, Chapter 3, pages 529-537 [4] (in which a first lens of this type is described) And US Pat. No. 5,744,813 (1998 (Published on May 28) [5] (in which more recent lenses are described)). Assuming it is used to focus dispersive radiation, the lens is barrel-shaped (ie, the surfaces at both ends are small) and the dispersive radiation is approximately parallel radiation. When it is assumed that the radiation of this kind is to be focused, or in the case where it is assumed that this type of radiation is focused, it is generally a half-barrel (half-barrel) (that is, only one end surface is small). The terms “full lens” and “half lens” are widely used to refer to the two types of lenses.

  Two types of operation and use of the device according to FIG. 1 are possible. One is to move the X-ray optics 8 relative to a fixed patient body while maintaining the relative placement of elements 1, 2, 3, and 6 (thus, lenses 1 and 3). Is the same focus). On the other hand, the X-ray optical system 8 is fixed and the patient's body 5 is moved (the movement at this time is represented by an arrow 10b in FIG. 1).

  The apparatus of the present invention is also equipped with a coordinate sensor 11 that responds to the relative movement of the X-ray optical system 8 and the patient's body 5, and determines the relative positional relationship between the X-ray optical system 8 and the patient's body 5. It is connected to means 10 for determining. This sensor 11 needs to be adjusted so that its output signal matches the coordinates of the point to which the measurement result belongs with respect to the selected reference point.

  In the specific embodiment shown in FIG. 1, the focal point 4 common to both lenses, where the optical axes of the X-ray lenses 2 and 3 intersect, emerges as the point to which the measurement result belongs.

  In another embodiment where the outline of the x-ray focusing region is not very clear, the optical axis of the means for focusing the radiation and the means for delivering the generated secondary radiation to the detector (or an optical axis that is virtually regarded as the optical axis). This is also the point where the line that is, for example, the axis of the center channel of the collimator intersects. By means 10 for determining the relative positional relationship of the X-ray optical system, within the region of the problem site in the patient's body containing (or presumed to contain) a malignant neoplasm It is necessary to confirm that this point exists.

  The X-ray focusing area is the area surrounding the above point to which the measurement result belongs, and its size depends on the focusing means used (in the second stage of performing radiation therapy, the focusing area is the radiation focusing area). It also encompasses the intersection of lines, which is the optical axis of the means and the optical axis of the means for delivering the generated secondary radiation to the detector, although it cannot be measured at this stage). The size of the focusing region of the embodiment shown in FIG. 1 is minimized.

  Similar to the output signal of detector 6, the output signal of sensor 11 is transmitted to the input of means 12 for information processing and imaging. As already mentioned above, at that time, the focus 4 is attributed to the measurement result, and (in consideration of the final size of the focal region of the X-ray lens 2), the radiation source 1 actually It is focused around it. The information processing and imaging means 12 executes a certain algorithm for rendering a two-dimensional or three-dimensional image on a screen, and reproduces the state of the density distribution of substances constituting the biological tissue of the patient 5. (See, for example: E. Lapsin, Graphics for IBM PC. Moscow, “Solon”, 1995 [6]). For example, in the simplest case where a scan (movement of the X-ray focusing area including the point 4 to which the result being measured belongs) is performed on a flat section of the patient's 5 body, afterglow on the screen of the means 12 simultaneously with the scan Long images can be developed. It is also possible to store a predetermined amount of measurement results and then periodically develop the image. Because digital techniques are possible, not necessarily the cross section in question directly, but another embodiment that scans the volume of a region containing malignant neoplasm can also obtain an image of the density distribution in a flat cross section. it can. For this purpose, the result corresponding to the cross section in question of the patient's body is selected from the obtained results (density value and corresponding coordinate value set) related to the volume including the required cross section, and It is sufficient to draw and select a dimension diagram for the coordinate axes in this section. This type of necessary conversion is performed by a program using a method similar to that described in [6].

  In order to identify the structural elements of the formed image as related to malignant neoplasm, a static image stored in digital form is developed rather than a method that performs real-time image analysis during the scanning process. The method is more suitable for the purpose.

  The principle of operation according to the invention of the present application is that the intensity of Compton scattered secondary radiation (quantum generation probability of this radiation) is different under equivalent conditions (especially when primary X-rays of a predetermined intensity act on the substance). It is based on being proportional to density (see, for example, J. Jackson, Classical electrodynamics, M., “Mir”, 1965 [7]).

  Unlike known methods and devices, the use of Compton scattered secondary radiation quanta as an information factor when they have a confusing effect represents a key feature of the present invention.

  As already pointed out, when applied to the medical field, it is an important advantage that a reasonable accuracy can be obtained even if the dose irradiated to the biological tissue is small.

  In order to estimate the expected gain, the invisible internal structures of human tissues and organs are compared with the best accuracy obtained from computer-assisted x-ray tomography, the latest method of obtaining images.

Here, the following assumptions are made: photon energy E = 50 keV; the focusing region by X-rays has a depth of 50 mm and a size of 1 mm × 1 mm × 1 mm (such values are, for example, mammography The detector senses 5% of the secondary radiation that occurs at a depth of 5 cm (this assumption is that the secondary radiation detects it) Advance the patient's body by 5 cm before hitting the entrance of the means for delivering to the lens, with the capture angle of the lens or collimator delivering the secondary radiation to the detector being 0.05 × 4πsr Means). Considering that the linear absorption coefficient when photons are absorbed by the patient's body is close to that in water and is on the order of 2 × 10 ⁻¹ / cm at an energy E = 50 keV, when entering to a depth of 5 cm The intensity of the primary beam of radiation is reduced by exp (2 × 10 ⁻¹ × 5) = e≈2.71 times. The intensity of secondary radiation emitted from the patient's body (its photon energy is very close to 50 keV) is also reduced by e≈2.71 times. Therefore, the total intensity loss due to radiation absorbed by the patient's body is e × e = 7.3 times. We underestimate the gain being evaluated and consider only the Compton component of the secondary radiation. For thickness Δx, the quantum generation probability of secondary Compton radiation is equal to ω = σ _k × N _e × Δx (where secondary Compton scattering σ _k = 6.55 × 10 ⁻²⁵ cm ² ; underwater the density ^{_{N e = 3 × 10 23 /}} cm 3 of electrons in). Therefore, when Δx = 1 mm = 10 ⁻¹ cm, the quantum generation probability is ω = 6.55 × 10 ⁻²⁵ × 3 × 10 ²³ × 10 ⁻¹ ≈2 × 10 ⁻² . In other words, an average of 1: (2 × 10 ⁻² ) = 50 primary radiation photons are required to produce one secondary photon at length Δx = 1 mm.

We want the density estimation error to be about 1% (ie, determining the number of secondary photons). Regarding the random nature of the process, given that the nature of the process is probabilistic, the root mean square of the relative error is equal to δ = 1 / (N) ^1/2 where N is the assigned The number of photons emitted). A value of δ = 0.01 corresponds to N = 10000.

Thus, the inventors have determined that N _x (the number of primary photons required to penetrate to a depth of 5 cm and generate secondary Compton radiation at this depth; and when the secondary Compton radiation travels 5 cm, N = For 10000 photons reaching the detector) a simple formula can be established:
_Nx * e- ² * 5 * 10 ^{< -2} > * 2 * 10 ^<-2 > = 10 ^{< 4} >.

Here, the coefficient 5 × 10 ⁻² means that only 5% = 10 ⁻² of photons that reach the detector and are recorded among all the generated secondary photons. From the above equation, Nx = 7.3 × 10 ⁷ is obtained.

A photon with an energy of E = 50 keV forms an irradiation dose equivalent to one roentgen if the flow of these photons is equal to 2.8 × 10 ¹⁰ / cm ² (the photon energy, its number, and the dose (See, for example, Physics of image visualization in medicine, S. Webb. M. “Mir”, 1991 [8]). Assuming that the cross-sectional area of the primary X-ray beam is 1 cm ² when entering the patient's body, the flux amount of 7.3 × 10 ⁷ pieces / cm ² is 2.6 × 10 ⁻³ within the patient's body. An irradiation dose corresponding to the X-ray is formed.

  For example, in conventional X-ray computed tomography in the examination of osteoporosis, the radiation dose is typically 100-300 milliradins (VI mazurov, EG Zotkin. Topical questions of diagnosis and treatment of osteoposis). Saint-Petersburg, IKF “Foliant”, 1998, p. 47 [9]). This is 100 times larger than the above irradiation dose.

  If the irradiation is performed using multiple sources and the radiation beam reaches the focal region in different paths and does not accumulate in the patient's body, the dose may be reduced somewhat.

  Therefore, a plurality of X-ray sources and detectors arranged in space, a corresponding number of means for focusing the radiation and a corresponding number of means for delivering secondary Compton radiation to the detector (lens Embodiments that implement the method and apparatus of the present invention using a half-lens, collimator) are most effective. On the one hand, this makes it possible to achieve a more effective focusing of the radiation (if there is only one focusing means, as shown in FIG. 1, this uses an X-ray lens. Increase the signal / noise ratio (S / N ratio) at the output of the detector. On the other hand, this has more effect on the irradiated part of the patient's body, giving the possibility of avoiding over-exposure of parts not related to the examination and organs. Simple averaging under different equivalent conditions (or more complex processing of the output signals of different detectors in the means 12 for information processing and imaging, eg taking into account the existence of density correlations at points close to each other The use of multiple detectors with load averaging enables the use of smaller output x-ray sources without loss of accuracy. In addition, the averaging mitigates the effects of other factors that reduce accuracy (eg, the radiation absorption of the source is different on the way to various points with different densities).

  In the following, such an embodiment will be considered (FIGS. 2 to 11).

  The embodiment shown in FIGS. 2 and 3 is the simplest form in terms of technical realization.

  In FIG. 2, an X-ray source 1, which can be regarded approximately as a point, and a collimator 13 in which the channel diffuses (expands) in the direction of propagation of the radiation are used to focus the radiation into the region 16. . A perforated screen 14 is provided between the source 1 and the collimator 13 to direct the radiation towards the entrance of the collimator and prevent the radiation from directly hitting the target (passing through the collimator). The secondary radiation is focused (narrowed) in the direction in which the radiation propagates, i.e. towards the detector 6, and is applied to the detector 6 using a collimator 15 with a channel that can be focused on the light receiving surface. Delivered. For example, a semiconductor detector having a small inlet opening can be used as the detector.

  In FIG. 3, the collimator is arranged in the direction opposite to the direction shown in FIG. In order to make full use of the opening at the entrance of the collimator 18 that focuses the radiation into the region 16, the use of an elongated X-ray source 17 is suitable for the purpose. For the same reason, it is desirable to use a detector (eg scintillator type) with a large opening at the inlet.

  In FIG. 4, the means for focusing the radiation of the source 1 and the means for delivering the secondary radiation, which can be regarded approximately as points, are realized in the form of X-ray half-lenses 21 and 22, respectively. In doing so, the half lens 22 focuses the scattered secondary radiation onto the detector 6.

  In FIG. 5, the means for focusing the radiation of the radiation source 1 and the means for delivering the secondary radiation, which can be regarded as points approximately, are realized in the form of X-ray half lenses 21 and 23, respectively. In doing so, the half lens 23 converts the scattered secondary radiation into approximately parallel radiation, which is directed to the detector 20 having a large opening at the entrance.

  FIG. 6 is a combination embodiment: The means for focusing the radiation of the source 1, which can be regarded approximately as points, is realized in the form of a half-lens 21 for X-rays that guides a parallel beam to the region 16.

  FIGS. 7 and 8 are other combined embodiments characterized in that the means for delivering secondary radiation is realized in the form of a collimator.

  In FIG. 7, the collimator 19 has a channel that widens towards the detector 6, which has a large opening at the inlet.

  In FIG. 8, the collimator 15 has a channel that narrows toward the detector 6, contrary to the above, and the detector has a small opening at the inlet.

  FIG. 9 shows an embodiment with the highest performance and highest resolution in terms of accuracy, and means for focusing the radiation of the source 1 that can be approximately regarded as a point and means for delivering secondary radiation to the detector 6. Are realized in the form of “perfect” lenses 2 and 3 for X-rays, respectively (see this embodiment shown in FIG. 1).

  In FIGS. 10 and 11, two additional combined embodiments are shown. One is that a “perfect” lens 2 for X-rays is used as means for focusing the radiation of the source 1 that can be regarded as a point approximately.

  FIG. 10 shows the use of a collimator 15 that is tapered towards the detector as a means for delivering secondary radiation to the detector 6 with a narrow aperture.

  FIG. 11 shows the use of a collimator 19 that spreads toward the detector as a means for delivering secondary Compton radiation to the detector 20 with a wide aperture.

  In all embodiments realizing the device of the present invention, the arrangement of the elements constituting the X-ray optical system 8 is such that the radiation of the source (1, 17) is incident directly on the detector or the patient (5) Incident in the detector (6, 20) after passing through the body must be excluded. The reason is that, as already mentioned, the secondary radiation generated in the focused region has information on the density of the biological tissue to be examined. For this purpose, any detector (and means for delivering secondary radiation to the detector) and means for focusing the radiation of the source into the focusing region intersect the X-ray beams formed by these means. It must not be on any optic axis extension to the region.

  The method for determining the position of a malignant neoplasm according to the present invention and the operation of the apparatus of the present invention to carry out this method are performed in accordance with a point coordinate and an organism corresponding to the point coordinate confirmed to belong to the malignant neoplasm. Finish by determining the combination with the density of the anatomy (eg, storing a set of digital codes corresponding to the means for processing and imaging the information). The identification can be performed, for example, by comparing the image obtained in the process of carrying out the method of the invention with the image obtained in the previous diagnosis, as in the known method [3]. In doing so, the image of the identified structural element is a means for imaging and processing information by means of an operator involved in the implementation of the method, using conventional pointing means in the field of computer technology, for example "mouse" Can be displayed on the screen.

  If a solution for practicing radiotherapy of a malignant neoplasm is acceptable, the X-ray dose to be delivered to each part of the malignant neoplasm represented by the determined set of point coordinates before further use of the device. The irradiation program to be given in the form of a set is created. The irradiation program is created using, for example, the method described in [1] in consideration of the characteristics of the organ affected by the malignant neoplasm and other factors.

  Using the same means (lenses 2, 21; collimators 13, 18) as in the first stage of performing the treatment method (for example, performing the malignant neoplasm location method), the malignant neoplasm is The irradiation program is executed in the process of scanning the occupied space area. In this case, the necessary irradiation dose is increased to an intensity level sufficient for destroying the malignant neoplastic tissue with radiation (for example, increasing the anode current of the X-ray tube). Are supplied to each of the discontinuous positions of the X-ray focusing region. In a specific embodiment, when the malignant neoplasm is small, irradiation can be performed at only one location of the X-ray irradiation focused region, that is, without scanning. When a complete lens is used to focus the radiation, it is possible to perform radiation treatment of a small tumor (eg eye).

  The X-ray source outlet can be blocked or mechanically shielded to prevent the possibility of the X-ray source leaking from the detector structure during operation at high radiation intensity (referred to here in the drawings). Means are not drawn).

  The use of the same means when accurately determining the location of a malignant neoplasm (radiotherapy in the first stage) and when carrying out an irradiation program (second stage) can reduce the aiming error of the radiation beam. It leads to minimization. Since the X-ray optics is positioned with respect to the patient's body at a location that coincides with the image of the structural element that was determined to be relevant to the malignant neoplasm at the time of identification, This is performed at the same position as that of the position determination stage. The reproducibility of the accuracy of the X-ray optical system with respect to the patient's body, which is mutually arranged at a position corresponding to the coordinates determined at the time of identification, is described in more complete relative positional determination means, for example [2] This can be enhanced by using similar means to the existing means.

  Which scheme of the embodiment of the method and apparatus configuration according to the present invention is used, and there is a possibility that an effective radiation focusing means and delivery means such as an X-ray lens or a half lens can be used, and the requirement Resolution. The latter factor also affects the selection of lens and half-lens parameters (eg, focal spot size, length of focusing area in the direction of the optical axis of the lens, etc.). In this case, when using a “perfect” lens, it takes a long time to scan the area containing the malignant neoplasm to achieve very high resolution (a fraction of mm or more). Is considered. Other circumstances are also considered, such as whether there is an X-ray source of appropriate output and size.

  In addition to the embodiments implementing the method and apparatus according to the present invention described herein, the existence of many other embodiments according to the present invention builds a means to meet the specific requirements presented herein. Offer a wide range of possibilities.

(Industrial applicability)
The method for determining the location of a malignant neoplasm according to the present invention and its radiotherapy, and the apparatus for carrying out the same are used on the condition that the diagnosis of the malignant neoplasm is performed in advance, We need sensitive data on shape, size, etc. It is also possible to carry out a direct radiation treatment even when the corresponding solution has been taken before, or as a result of obtaining the above-mentioned sensitive data, even when such a solution is taken.

  (Source of information)

The present invention will be described with reference to the drawings:
FIG. 1 explains the principle underlying the method of the present application, and schematically shows the arrangement of basic elements and their connection relationships in an apparatus for realizing the method according to the present invention. FIG. 2 is an embodiment that embodies an implementation of an apparatus that uses a collimator to focus X-rays and deliver secondary radiation to a detector. FIG. 3 is an embodiment that embodies an implementation of an apparatus that uses a collimator to focus X-rays and deliver secondary radiation to a detector. FIG. 4 is an embodiment that embodies a method for realizing an apparatus that uses an X-ray half lens. FIG. 5 shows an embodiment of a method for realizing an apparatus using an X-ray half lens. FIG. 6 illustrates an implementation of an implementation of an apparatus that uses an X-ray half lens to focus X-rays and an X-ray “perfect” lens to deliver secondary radiation to a detector. It is a form. FIG. 7 is an embodiment that embodies an implementation of an apparatus that uses an X-ray half lens to focus X-rays and uses a collimator to deliver secondary radiation to a detector. FIG. 8 is an embodiment that embodies an implementation of an apparatus that uses an X-ray half lens to focus X-rays and uses a collimator to deliver secondary radiation to a detector. FIG. 9 is an embodiment that embodies an implementation of an apparatus that uses an x-ray lens to focus x-rays and deliver secondary radiation to a detector. FIG. 10 is an embodiment that embodies an implementation of an apparatus that uses an x-ray lens to focus x-rays and uses a collimator to deliver secondary radiation to a detector. FIG. 11 is an embodiment that embodies an implementation of an apparatus that uses an X-ray lens to focus X-rays and uses a collimator to deliver secondary radiation to a detector.

Claims (1)

An x-ray device for the localization of cancer and for radiotherapy for abolishing the cancer, as described herein.