JP2010227303A - Treatment table for x-ray treatment apparatus - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To suppress energy of an X-ray source by shortening the distance between the X-ray source and a treatment object part and the distance between the treatment object part and an image sensor. <P>SOLUTION: A treatment table for an X-ray treatment apparatus is provided which comprises a pair of low energy X-ray generating apparatuses 10 and 20 for detecting a position detecting marker embedded near a treatment object part of a patient and respective X-ray image sensors 11 and 21. In the treatment table, the distance between the low energy X-ray generating apparatuses and the treatment object part and the distance between the treatment object part and the X-ray image sensors are shortened. In addition, a treatment X-ray image sensor 50 is arranged on a couch to detect intensity, position and direction of an X-ray radiated from a high energy treatment X-ray generating apparatus. Data collected by the treatment X-ray image sensor 50 are used as feedback for setting next radiation condition of the treatment X-ray generating apparatus and also for verification after the treatment. An X-ray shielding plate 51 is arranged on the back surface of the treatment X-ray image sensor 50 so as to absorb transmitted X-ray and scattered X-ray of the high energy treatment X-ray and reduces scattering of the X-ray. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention relates to a treatment table of an X-ray therapy apparatus, and more particularly, to a treatment table having a position detection function for irradiating a treatment target site or marker with low energy X-rays and detecting the position.

  In X-ray therapy, it is necessary to accurately detect the position of a treatment target site in order to avoid irradiation of normal tissue with X-rays. However, since the site to be treated moves due to the patient's breathing or the like, a moving body tracking means is required for detecting the position thereof. Various proposals have been made in relation to this moving body tracking means. As shown in FIG. 4, the moving body pursuit irradiating device described in Patent Document 1 includes first X-ray fluoroscopic apparatuses 60, 61, 63, and 64 that image a tumor marker embedded in the vicinity of a tumor from a first direction, A second X-ray fluoroscope 70, 71, 73, 74 that images the tumor marker from the second direction at the same time as the first X-ray fluoroscope is provided, and image data obtained by these X-ray fluoroscopes is obtained by a computer. Image data processing and calculation processing are performed to create three-dimensional coordinate data of the tumor marker. In this moving body pursuit irradiating apparatus, the X-ray tubes 60 and 70 of the X-ray fluoroscopic apparatus are installed under the treatment room floor, and the image intensifiers 63 and 73 of the image sensor unit are installed on the ceiling of the treatment room. For this reason, the X-rays of the X-ray fluoroscopic apparatus require X-ray energy that can clearly detect X-rays transmitted through the patient by the image intensifier at a distance from the floor to the ceiling of the treatment room.

  In an apparatus for performing stereotactic radiosurgery and stereotactic radiotherapy described in Patent Document 2, an X-ray generator that irradiates first and second marker beams for detecting the position of a target region is fixed to a ceiling, An image receiver that generates image data corresponding to the first and second marker beams is attached to an operating table on which the patient is placed. Even in this case, the distance between the X-ray generator and the image receiver is long, and the X-ray generator and the image receiver are not installed on the same coordinate axis. Each time, it is necessary to adjust the positional relationship between the X-ray generator and the image receiver, and the operation becomes complicated.

Japanese Patent No. 3053389 Japanese Patent No. 3810431

In the X-ray therapy apparatus, the energy of the X-ray for detecting the position of the marker embedded in the vicinity of the site to be treated needs to be as weak as possible in order to suppress adverse effects on the patient. Since the intensity of the X-ray attenuates in inverse proportion to the square of the distance from the X-ray source to the irradiation target, the shorter the distance from the X-ray source to the treatment target site, the lower the energy of the X-ray source. Can be suppressed. In addition, in order to suppress the attenuation of X-rays transmitted through the treatment target region, it is necessary that the position where the image sensor is installed be as close as possible to the treatment target region. However, in the inventions according to Patent Document 1 and Patent Document 2 described above, the distance between the X-ray generator and the sensor that detects the X-ray is a long distance between the ceiling and the floor or between the ceiling and the treatment table. Since the X-ray intensity necessary for position detection is secured, the X-ray energy cannot be kept low.
An object of the present invention is to provide an X-ray source and a sensor in association with the couch so that the positional relationship between the X-ray source and the sensor and the treatment target part can be operated in close proximity, and irradiate the treatment target part or marker with low energy X-rays. An object of the present invention is to provide a treatment table for an X-ray treatment apparatus having a position detection function capable of detecting the position.

In order to achieve the object, the treatment table for an X-ray therapy apparatus according to claim 1 according to the present invention comprises:
A couch that supports the patient,
A couch operating robot for changing the position and posture of the couch;
Two sets of marker-detecting low-energy X-ray generators for detecting the position of a treatment target site of a patient on the couch, and corresponding marker-detecting X-ray image sensors;
A therapeutic X-ray image sensor that is mounted on the couch and detects X-rays irradiated from the therapeutic high-energy X-ray source to the site to be treated;
A treatment table for an X-ray treatment apparatus, comprising:

The treatment table for X-ray therapy apparatus according to claim 2 according to the present invention is the treatment table for X-ray therapy apparatus according to claim 1,
A therapeutic table for an X-ray therapy apparatus, wherein the therapeutic X-ray image sensor can be moved to the bottom or top of the couch by the couch operating robot.

  The X-ray therapy apparatus treatment table according to claim 3 according to the present invention is the X-ray therapy apparatus treatment table according to claim 1, wherein an X-ray shielding plate is provided on the back surface of the therapy X-ray image sensor. A therapeutic table for an X-ray therapy apparatus.

  The X-ray therapy apparatus treatment table according to claim 4 of the present invention is the X-ray therapy apparatus treatment table according to claim 1, wherein the couch operating robot moves the couch vertically and horizontally horizontally. A treatment table for an X-ray therapy apparatus, which is capable of being further rotated about the vertical direction.

  A treatment table for an X-ray therapy apparatus according to a fifth aspect of the present invention is the treatment table for the X-ray therapy apparatus according to the first aspect, wherein the pair of low energy X-ray generators for marker detection and marker detection are paired. An X-ray image sensor for an X-ray treatment apparatus characterized in that the X-ray image sensor can independently rotate with respect to the couch in the vertical direction, and can change the vertical direction with respect to the couch and the inclination with respect to the couch.

  The treatment table for an X-ray therapy apparatus according to a sixth aspect of the present invention is the treatment table for the X-ray therapy apparatus according to the first aspect, wherein the sensor for detecting the position of the treatment target site of the patient on the couch is the patient's treatment table. A therapeutic table for an X-ray therapy apparatus, which is a receiver that receives radio waves transmitted from a radio wave transmitter embedded in the vicinity of a treatment target region.

  According to the above configuration, in the X-ray therapy apparatus, the interval between the low-energy X-ray generator for detecting the position of the marker embedded in the vicinity of the treatment target site and the corresponding marker detection X-ray image sensor is set. Since it can be shortened, the energy of the marker detection X-ray can be weakened, and adverse effects on the patient can be greatly reduced. Furthermore, since the output energy of the X-ray source can be kept low, a small X-ray source is sufficient, and the marker detection X-ray apparatus itself can be downsized. As a result, an X-ray therapy apparatus having a small and light moving body tracking function can be provided. Furthermore, since an image sensor that detects high-energy X-rays for treatment is attached to the couch, information such as the intensity, position, and direction of the therapeutic X-rays is collected to set irradiation conditions for the next irradiation. It can be reflected. This makes it possible to irradiate therapeutic X-rays following the movement of the treatment target region. Furthermore, by providing an X-ray shielding plate on the back surface of the therapeutic X-ray image sensor unit, it is possible to absorb transmitted X-rays and scattered X-rays, so that the protective measures for the X-ray therapy apparatus can be reduced. .

It is a perspective view which shows embodiment of the treatment table for X-ray therapy apparatuses by this invention. It is a front view which shows embodiment of the treatment table for X-ray therapy apparatuses by this invention. It is a top view which shows embodiment of the treatment table for X-ray therapy apparatuses by this invention. It is a side view which shows embodiment of the treatment table for X-ray therapy apparatuses by this invention. It is a front view which shows other embodiment of the treatment table for X-ray therapy apparatuses by this invention. It is a side view which shows other embodiment of the treatment table for X-ray therapy apparatuses by this invention. It is a block diagram which shows the structure of the moving body tracking irradiation apparatus containing the conventional X-ray apparatus for a detection.

Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.
FIG. 1 is a perspective view showing an embodiment of a treatment table for an X-ray therapy apparatus according to the present invention.
2A is a front view showing an embodiment of a treatment table for an X-ray treatment apparatus according to the present invention, FIG. 2B is a top view thereof, and FIG. 2C is a side view thereof. FIG. 3A is a front view showing another embodiment of a treatment table for an X-ray treatment apparatus according to the present invention, and FIG. 3B is a side view thereof. The couch 40 can be moved by the couch operating robot 30 in the longitudinal direction (Y direction), the vertical direction (Z direction), and the rotation (θ direction) about the axis supporting the couch. The positions of heavy metal markers that are harmless to the human body embedded in the vicinity of the treatment target site of the patient are the first low-energy X-ray generator 10, the first X-ray image sensor 11, and the second low-energy X-ray generation. It is detected by the apparatus 20 and the second X-ray image sensor 21. The operations of the marker detection low energy X-ray generators 10 and 20 and the marker detection X-ray image sensors 11 and 21 are operated by a control device (not shown) of the X-ray therapy apparatus including the treatment table of the present invention. . Output data of the marker detection X-ray image sensors 11 and 21 are output to a storage device (not shown) and a calculation device (not shown) of the X-ray therapy apparatus, and images of the treatment target region collected in advance. The image is processed together with the data and fed back to determine the next irradiation condition of the therapeutic high energy X-ray generator 80. Based on this irradiation condition, the high energy X-ray generator 80 is moved by a robot (not shown) so that the treatment target site can be irradiated with therapeutic high energy X-rays from almost all directions.

  In FIG. 2A, FIG. 2B, and FIG. 2C, therapeutic high energy X-rays are irradiated from the patient's upper ventral side. In this case, the therapeutic X-ray image sensor 50 and the X-ray shielding plate 51 are installed on the bottom of the couch on the back side of the patient by the couch operating robot 30. The therapeutic X-ray image sensor 50 is for collecting information on the X-rays irradiated for the treatment by the therapeutic high-energy X-ray generator 80. Data such as the intensity, position, and direction of X-rays that have passed through the site to be treated are collected. The collected data is output to the storage device and the calculation device of the X-ray treatment apparatus, and is fed back to the setting of the irradiation condition of the next high-energy X-ray for treatment.

  3A and 3B show a case where the therapeutic high energy X-ray generator 80 is installed on the bottom side of the couch. In this case, the high energy X-ray for treatment is irradiated to the treatment target site from the back side of the patient. Therefore, the therapeutic X-ray image sensor 50 and the X-ray shielding plate 51 are installed on the abdominal side of the patient by the couch operating robot 30. Thus, the position of the therapeutic X-ray image sensor 50 and the X-ray shielding plate 51 can be moved by the couch operating robot 30 in conjunction with the movement of the therapeutic high-energy X-ray generator 80.

  As described above, by using the treatment table according to the present invention as a treatment table of an X-ray therapy apparatus having a moving body tracking function, the output data of the marker detection X-ray image sensor and the output data of the therapy X-ray image sensor are obtained. It is possible to feed back to the setting of the next irradiation condition, and even if the treatment target part moves, the displacement can be corrected in real time.

  According to the configuration of the present invention, the marker detection low-energy X-ray generators 10 and 20 can be installed near the treatment target site, so that the interval between the low-energy X-ray generator and the marker is shortened. Since the X-ray attenuation is small, the output energy of the marker detection low-energy X-ray generators 10 and 20 can be further reduced. Moreover, since the focus of an X-ray can be narrowed down to a marker, a patient's exposure amount can be reduced. As the low-energy X-ray image sensors 11 and 21, for example, flat panel sensors such as a flat panel sensor combining amorphous silicon and a photodiode or a flat panel sensor combining a scintillator and a CCD are suitable. Has been commercialized. These flat panel sensors are suitable for digital image processing because X-rays transmitted through the marker can be directly converted into digital signals.

  On the back surface of the therapeutic X-ray image sensor 50, a shielding plate 51 made of lead or the like having a high shielding ability against X-rays is attached to the entire surface. The shielding plate 51 shields therapeutic X-rays transmitted through the patient, and at the same time absorbs scattered X-rays generated in the human body of the patient and reduces X-ray scattering.

  The first marker detection low-energy X-ray generator 10 and the first X-ray image sensor 11 and the second marker detection low-energy X-ray generator 20 and the second X-ray image sensor 21 are respectively paired. It can be operated up and down and left and right. This operation is performed by the couch operating robot 30. Thus, according to the present invention, the marker detection low energy X-ray generators 10 and 20 and the X-ray image sensors 11 and 21 can move synchronously while maintaining the positional relationship. Even when the detection position is changed by moving, it can be processed quickly.

  In the above description of the embodiment of the present invention, as means for detecting the position of the marker, means for irradiating the marker with low energy X-rays and detecting the image data with a flat panel sensor has been disclosed. A means of using is also effective. A receiver that receives radio waves transmitted by the IC tag is attached to the couch 40 in place of the marker detection X-ray image sensors 11 and 21. In this case, the marker detection low energy X-ray generators 10 and 20 are not required. As the receiver, an apparatus in which a positioning system is mounted on an IC tag reader is suitable. It is possible to receive radio waves transmitted from a plurality of IC tags embedded in the vicinity of a treatment target region of a patient and display the position on the image data of the treatment target region collected in advance in a treatment plan. Since it can follow the movement of the patient due to respiration, the receiver data is fed back to the setting of the irradiation condition of the therapeutic X-ray generator 80 in real time as in the case of the embodiment using X-rays. Can do.

(Modification)
Various modifications can be made to the embodiment described in detail within the scope of the present invention. Although an example using an X-ray source for treatment and marker detection has been shown, other particle beam sources can also be used.
Although an example in which information is exchanged by wireless communication such as an IC tag as a marker has been shown, use of another active signal source is also conceivable.

DESCRIPTION OF SYMBOLS 10 1st marker detection low energy X-ray generator 11 1st marker detection X-ray image sensor 20 2nd marker detection low energy X-ray generator 21 21 2nd marker detection X-ray image sensor 30 Couch Operating robot 40 Couch 50 X-ray image sensor for treatment 51 X-ray shielding plate for treatment 60 First X-ray tube 61 First collimator 62 First X-ray 63 First image intensifier 64 First TV camera 70 Second X-ray tube 71 Second collimator 72 Second X-ray 73 Second image intensifier 74 Second TV camera 80 High energy X-ray generator for treatment

Claims (6)

A couch that supports the patient,
A couch operating robot for changing the position and posture of the couch;
Two sets of marker-detecting low-energy X-ray generators for detecting the position of a treatment target site of a patient on the couch, and corresponding marker-detecting X-ray image sensors;
A therapeutic X-ray image sensor that is mounted on the couch and detects X-rays irradiated from the therapeutic high-energy X-ray source to the site to be treated;
A treatment table for an X-ray treatment apparatus, comprising: The treatment table for an X-ray therapy apparatus according to claim 1,
A therapeutic table for an X-ray therapy apparatus, wherein the therapeutic X-ray image sensor can be moved to the bottom or top of the couch by the couch operating robot. The treatment table for an X-ray therapy apparatus according to claim 1,
An X-ray treatment apparatus treatment table, wherein an X-ray shielding plate is provided on the back surface of the treatment X-ray image sensor. The treatment table for an X-ray therapy apparatus according to claim 1,
The treatment table for an X-ray treatment apparatus, wherein the couch operating robot is capable of moving the couch in the vertical direction and the longitudinal horizontal direction, and further capable of rotating operation about the vertical direction. The treatment table for an X-ray therapy apparatus according to claim 1,
The two pairs of marker-detecting low-energy X-ray generators and marker-detecting X-ray image sensors independently rotate with respect to the couch in the vertical direction, the vertical direction with respect to the couch, and the inclination with respect to the couch. A treatment table for an X-ray therapy apparatus, which can be changed. The treatment table for an X-ray therapy apparatus according to claim 1,
The sensor for detecting the position of the treatment target part of the patient on the couch is a receiver for receiving a radio wave transmitted from a radio wave transmitter embedded in the vicinity of the treatment target part. Stand.