JP2011234932A - Focal tissue real-time position identification device and x-ray treatment device using the same - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a small position identification device, capable of identifying the position of a focal tissue that is a treatment object while following up the movement of the focal tissue for miniaturizing and speeding up an X-ray treatment device, a maker to be embedded in the vicinity of the tissue, which is low in invasiveness and suitable for X-ray imaging, and a high-speed and accurate X-ray treatment method using them.SOLUTION: The focal tissue real-time position identification device includes one or two or more X-ray sources arranged on a plane or a circular curved surface, and an X-ray sensor arranged oppositely to the X-ray sources, and the device is attached to a couch on which a patient lies or to a head of a 6-axis or 7-axis robot. The X-ray source is a microfocus X-ray source, and can be combined with a flat panel sensor or the like to perform high-speed X-ray imaging. The marker to be embedded to the vicinity of the focal tissue is made of shape storage alloy or super-elastic alloy and low in invasiveness to the patient. These are used to attain a real-time and accurate X-ray treatment.

Description

  The present invention relates to a position identification device that identifies the position of a marker tissue or a marker embedded in the vicinity of the lesion tissue in X-ray therapy, and an X-ray therapy method using the same. More specifically, a position identification apparatus capable of performing real-time position identification of a lesion tissue or using a special marker to perform marker position identification, and X-ray therapy is performed based on the position identification result of the position identification apparatus. The present invention relates to an X-ray therapy method.

  In X-ray treatment, in order to avoid the irradiation of therapeutic X-rays to focus tissue and to irradiate healthy tissue, the position of the marker embedded in or near the lesion tissue to be treated is accurately determined. Need to be identified. However, since the lesion tissue to be treated moves due to the patient's breathing or the like, the moving body tracking means is required for the position identification. Various proposals have been made in relation to this moving body tracking means.

  The moving body pursuit irradiating device described in Patent Document 1 includes a first X-ray fluoroscopic device that images a spherical tumor marker such as Au embedded in the vicinity of a tumor from a first direction, and a tumor marker that is first from a second direction. A second X-ray fluoroscopic apparatus that simultaneously images the X-ray fluoroscopic apparatus, and image data processing and arithmetic processing are performed on the image data acquired by these X-ray fluoroscopic apparatuses by a computer, and three-dimensional coordinate data of the tumor marker is obtained. create. In this moving body pursuit irradiating apparatus, the X-ray tube of the X-ray fluoroscopic apparatus is installed below the treatment room floor, and the image intensifier of the image sensor unit is installed on the ceiling of the treatment room. Treatment X-rays are irradiated only when the three-dimensional coordinates of the obtained tumor marker are within a predetermined range. According to the invention described in Patent Document 1, since X-rays for treatment are irradiated only when the identified three-dimensional coordinates of the tumor marker are within an allowable range, there is a limit to shortening the total treatment time. Furthermore, since the apparatus is large, it becomes an obstacle to spread it in many medical facilities. Moreover, the diameter of the tumor marker is 1 mm to 2 mm, and in order to embed it in the vicinity of the tumor, an incision operation is necessary, and the burden on the patient is great.

  The X-ray CT apparatus described in Patent Document 2 is provided with a large number of small X-ray tubes and a large number of X-ray sensors that detect X-rays transmitted through the subject by removing the rotating mechanism of the gantry. According to the present invention, it is possible to acquire image data instantaneously by simultaneously operating a small X-ray tube and an X-ray sensor around a subject. For this reason, since imaging is performed at a higher speed than the movement of the organ, continuous imaging of the organ such as the movement of the heart is possible. According to the invention described in Patent Document 2, an X-ray sensor corresponding to an X-ray tube is required to perform irradiation by a large number of X-ray tubes and detection by an X-ray sensor corresponding to the irradiation simultaneously, and an acquired image Processing takes time due to the large amount of data. Therefore, since it takes time to identify the three-dimensional position in addition to the reconstruction of the organ image, it is difficult to perform X-ray therapy in real time even if it is used as a position identification device of the X-ray therapy device. Furthermore, the apparatus becomes large.

  FIG. 9 shows a configuration diagram of a conventional X-ray CT apparatus. As shown in FIG. 9, the continuous processing X-ray CT apparatus without a rotation mechanism described in Patent Document 3 is rotated by a combination of a large number of high-speed switching micro X-ray sources 101 and a semiconductor X-ray detector array 104. The mechanism can be eliminated and the X-ray CT apparatus can be miniaturized. Further, since the generation order of X-rays can be set arbitrarily, it is possible to increase the speed by finely imaging at a specific part or a specific angle and scanning coarsely at other parts or angles. According to the invention described in Patent Document 3, a plurality of X-ray sources are selectively irradiated sequentially, but an X-ray detector array corresponding to each of them is required. Furthermore, since the X-ray source and the X-ray detector array are annularly arranged so as to surround the patient, the structure becomes large.

  The patient monitor described in Patent Document 4 captures a patient lying on a couch with a stereoscopic camera, and processes the video image with a computer to generate a model of patient movement and respiration. Thereafter, the motion and respiration of the patient being treated is monitored and compared to the previously generated model, and if abnormal motion and respiration are detected, treatment is performed such as interrupting the therapeutic device. According to the invention described in Patent Document 4, detection of patient movement and abnormal breathing is performed by observation data on the body surface, but does not represent actual movement of the lesion tissue.

Japanese Patent No. 3053389 Japanese Patent No. 4002984 JP 2007-267980 A Special table 2010-502244 gazette

  In order to carry out accurate X-ray treatment, it is necessary to accurately grasp the shape and position of the lesion tissue so that the treatment X-ray is irradiated only to the lesion tissue in accordance with the treatment plan data prepared in advance. There is. However, because the lesion tissue is constantly moving due to the patient's breathing, etc., the moving body is tracked and X-rays are irradiated at an appropriate timing, or the movement of the lesion tissue can be followed in real time. It is necessary to perform position identification and X-ray irradiation. The conventional techniques disclosed in Patent Documents 1 to 4 as lesion tissue position identification devices are large in size, and in order to be widely used in many medical facilities, the size and size of the device can be reduced. Costing is necessary. In addition, as in the invention disclosed in Patent Document 4, even if the patient's movement or breathing motion is monitored on the body surface, an error occurs with the movement of the lesion tissue that is actually treated. Therefore, it is necessary to directly and quickly identify the marker embedded in the vicinity of the lesion tissue and the position of the lesion tissue. Furthermore, it is necessary to improve the image resolution in order to identify the accurate shape and position of the marker or lesion tissue. Furthermore, as disclosed in Patent Document 1, the conventional marker is a spherical marker having a diameter of 1 to 2 mm, and in order to embed it in the vicinity of a lesion tissue, a procedure such as an open surgery is necessary. The burden on the patient is large. Even when a marker is implanted, a method that is less invasive to the patient is desired. Therefore, a minimally invasive marker can be used, or the position of a lesion tissue can be directly detected and tracked without using a marker, and without using a large device such as a conventional CT device. Therefore, a small device capable of identifying the position of a lesion tissue in real time is desired.

  An object of the present invention is to provide a small lesion tissue position identification apparatus capable of performing lesion tissue position identification in real time and with high accuracy in X-ray therapy. Another object of the present invention is to provide the position identification. Based on this, it is an object to provide an X-ray therapy method that performs high-speed and accurate X-ray therapy. A more specific object is to provide a minimally invasive marker capable of reducing the burden on the patient in the lesion tissue position identification device.

  In order to achieve the object, a lesion tissue real-time position identification device according to claim 1 according to the present invention is provided with an X-ray source and an X-ray sensor arranged opposite to the X-ray source and supine on a couch. For irradiating X-rays from the X-ray source toward a marker or lesion tissue embedded in the vicinity of the lesion tissue and identifying the position of the marker or lesion tissue by detecting the irradiated X-ray with the X-ray sensor 1 or 2 or more X-ray sources are arranged on a plane or arcuate curved surface, and the plane or arcuate curved surface shape is composed of 1 or 2 or more facing the X-ray source group The X-ray sensor is arranged, a marker embedded near the lesion tissue of the patient, an X-ray source control device that controls the irradiation timing of the X-ray source group, and an X that controls the position, angle, etc. of the X-ray sensor Line sensor control device An image processing device that performs image processing on output data of the X-ray sensor to create a reconstructed image, a central processing device that controls the X-ray source control device, the X-ray sensor control device, and the image processing device; An image display device that displays a captured image of a marker or lesion tissue, and the X-ray source group and the X-ray sensor are attached to the couch, and are provided from the X-ray source control device and the X-ray sensor control device. The position and orientation of each of the X-ray source groups can be controlled by signals, and the X-ray sources of the X-ray source group sequentially irradiate one by one according to the signal of the X-ray source control device, and the X-ray sensor and the image processing The apparatus sequentially detects X-rays emitted from the X-ray source, and identifies a three-dimensional position of the marker or the lesion tissue in real time. It is the identification apparatus.

  The lesion tissue real-time position identification device according to claim 2 according to the present invention is the lesion tissue real-time position identification device according to claim 1, wherein the X-ray source group includes one or more unencapsulated X-ray sources, The lesion tissue real-time position identification device is characterized in that it is arranged on a flat surface or an arcuate curved surface, and all the X-ray sources are enclosed in one vacuum vessel.

  The lesion tissue real-time position identification device according to claim 3 according to the present invention is the lesion tissue real-time position identification device according to claim 1, wherein the X-ray source is a microfocus X having an X-ray beam focal spot diameter of 100 μm or less. A lesion tissue real-time position identification device characterized by being a radiation source.

  The lesion tissue real-time position identification device according to claim 4 according to the present invention is the lesion tissue real-time position identification device according to claim 1, in which the X-ray sensor and the image processing device are three-dimensional of the marker or the lesion tissue. A lesion tissue real-time position identification apparatus characterized by identifying a position in 5 ms or less.

  The lesion tissue real-time position identification device according to claim 5 according to the present invention is the lesion tissue real-time position identification device according to claim 1, wherein the X-ray source group and the X-ray sensor are arranged on a 6-axis or 7-axis robot arm. A lesion tissue real-time position identification device, which is attached while maintaining a facing relationship, and can control the position and posture thereof by signals from the X-ray source control device and the X-ray sensor control device, respectively. .

  The lesion tissue real-time position identification device according to claim 6 according to the present invention is the lesion tissue real-time position identification device according to claim 1, wherein the marker is made of a shape memory alloy or a superelastic alloy, and the lesion tissue It is a lesion tissue real-time position identification device characterized by being deformed into a coil shape or a barbed shape by being embedded in the vicinity.

  The lesion tissue real-time position identification device according to claim 7 according to the present invention is the lesion tissue real-time position identification device according to claim 1, wherein the X-ray source selectively switches at least two kinds of output energy, and alternately A lesion tissue real-time position identification device characterized by being capable of being irradiated.

  An X-ray treatment method using the lesion tissue real-time position identification device according to claim 8 according to the present invention is based on a treatment plan formulated prior to X-ray treatment and irradiates the lesion tissue with a therapeutic X-ray source. In the X-ray therapy to be performed, one or two or more X-ray sources are arranged in a plane or an arcuate curved surface, and the position detection X-ray source group is opposed to the position detection X-ray source group. X-ray source control for controlling the irradiation timing of the position detection X-ray source group and a marker embedded in the vicinity of the patient's lesion tissue, in which a planar or arcuate curved surface position detection X-ray sensor composed of An apparatus, an X-ray sensor control device that controls the position, angle, and the like of the position detection X-ray sensor, and an image processing device that generates a reconstructed image by performing image processing on output data of the position detection X-ray sensor , X-ray source control device, front An X-ray sensor control device and a central processing unit that controls the image processing device; and an image display device that displays a captured image of the marker or lesion tissue, and the X-ray sources of the position detection X-ray source group include: The position detection X-ray sensor and the image processing apparatus sequentially detect the X-rays irradiated from the position detection X-ray source group in accordance with a signal from the X-ray source control device. The output data of the lesion tissue real-time position identification device characterized by identifying the marker or the three-dimensional position of the lesion tissue in real time and the treatment plan data are sequentially compared and collated. The irradiation condition of the therapeutic X-ray source is corrected so as to match the treatment plan data, irradiation is performed toward the lesion tissue, and the irradiated X-ray of the therapeutic X-ray source is detected by the therapeutic X-ray detection sensor. If there is a difference between the detected data and the treatment plan data, the treatment X-ray source is repeatedly irradiated while correcting the irradiation conditions of the treatment X-ray source so as to match the treatment plan data. This is an X-ray therapy method.

  The X-ray therapy method according to claim 9 of the present invention is the X-ray therapy method using the lesion tissue real-time position identification device according to claim 8, wherein the patient is supine on the couch for X-ray therapy after the treatment plan is formulated. In contrast, the three-dimensional position of the marker or lesion tissue is identified using the lesion tissue real-time position identification device, the output data of the lesion tissue real-time position identification device and the treatment plan data are compared and collated, If there is a difference between the data, the X-ray treatment is performed after correcting the position or posture of the couch and matching the position and posture of the marker or lesion tissue with the treatment plan data. X-ray therapy method.

  According to the present invention having the above-described configuration, it is possible to provide a small lesion tissue position identification apparatus capable of performing lesion tissue position identification in real time and with high accuracy in X-ray therapy. By incorporating the lesion tissue position identification apparatus according to the present invention into an X-ray therapy apparatus, a high-speed, high-accuracy and small-sized X-ray therapy apparatus can be configured, and the spread to many medical institutions is expected. Furthermore, since the marker used in the position identification device according to the present invention and embedded in the vicinity of the lesion tissue is a linear shape having a diameter of 10 μm or less until it is embedded, it can be easily embedded without burdening the patient by an injector such as a syringe. Can do. Moreover, after the implantation, the shape changes to a coil shape or the like, so that it does not easily move in the tissue and can be clearly recognized by X-ray imaging. Furthermore, according to the X-ray treatment method using the lesion tissue position identification device according to the present invention, the treatment plan data is verified immediately before the start of the X-ray treatment, and the marker or lesion tissue is acquired from the acquisition of the treatment plan data. Since it is possible to verify the treatment plan data for a change in the state, the accuracy of the X-ray treatment is improved. In addition, since the movement of the marker or lesion tissue can be detected in real time and the position thereof can be identified, X-ray therapy can be performed at high speed without selecting the timing of X-ray irradiation.

It is a block diagram which shows embodiment of the lesion tissue real-time position identification apparatus by this invention. It is a block diagram which shows the Example of the X-ray source group of the lesion tissue real-time position identification apparatus by this invention. It is a block diagram which shows the other Example of the X-ray source group of the lesion tissue real-time position identification apparatus by this invention. It is explanatory drawing of the marker used with the lesion tissue real-time position identification apparatus by this invention, (a) is the shape memory alloy marker (martensitic transformation state) and the schematic of the injector, (b) is shape memory alloy Schematic diagram of a marker (reverse transformation state) made from a metal, (c) is a schematic diagram of a marker (unloading state) made of a superelastic alloy. It is a block diagram which shows other embodiment which mounts the lesion tissue real-time position identification apparatus by this invention in the 6-axis or 7-axis robot. It is a block diagram of the Example of the X-ray therapy apparatus for demonstrating the X-ray therapy method using the lesion tissue real-time position identification apparatus by this invention. FIG. 3 is a process flow diagram of an X-ray therapy method using a lesion tissue real-time position identification device according to the present invention. It is a timing diagram which shows the irradiation timing of the X-ray source for position detection of a X-ray therapy apparatus and the X-ray source for therapy for demonstrating the X-ray therapy method using the lesion tissue real-time position identification apparatus by this invention. It is a block diagram which shows the structure of the conventional X-ray CT apparatus.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. In the drawings, the same reference numerals are used for portions showing equivalent or equivalent functions.

  FIG. 1 is a block diagram showing an embodiment of a real-time position identification apparatus for lesion tissue according to the present invention. FIG. 2 is a block diagram showing an embodiment of the X-ray source group of the lesion tissue real-time position identification device according to the present invention. FIG. 3 is a block diagram showing another embodiment of the X-ray source group of the lesion tissue real-time position identification apparatus according to the present invention. The X-ray source group 1 and the X-ray sensor 2 are attached to the couch 9 while maintaining an opposing relationship, and the position and posture can be freely controlled by the X-ray source control device 5 and the X-ray sensor control device 6, respectively. Can do.

  [Position Identification X-ray Source] The X-ray source 20 includes an electron source 21, a grid 22, an anode 23, an electron lens 25, and a target 26. The electron beam 24 radiated from the electron source 21 is focused on the central axis by the grid 22, accelerated by the anode 23, further focused by the electron lens 25, and forms a micro focus having a diameter of 100 μm or less on the target 26. X-rays 27 are generated by the electron beam 24 colliding with the target 26. The irradiation field of the X-ray 27 is narrowed by a collimator 28. The X-ray source 20 is a microfocus X-ray source having an X-ray beam focal spot diameter of 100 μm or less. By using the microfocus X-ray source, the image resolution is improved and a clear fluoroscopic image can be obtained. Furthermore, since a refraction contrast imaging method can be applied by using a microfocus X-ray source, a clearer image can be obtained. Further, the energy subtraction method can be applied by switching the output energy of the X-ray source 20 to two types. This is because two X-ray images are acquired by irradiating the same subject with X-rays having two types of energy distributions, and each pixel of these two X-ray images is associated with each other. This is a method of generating a difference signal representing an image of a specific substance by multiplying an appropriate weighting coefficient between signals and then performing subtraction. By using this method, the marker and the lesion tissue can be imaged more clearly. X-rays having two types of energy distribution are generated by controlling the voltage between the cathode and anode of the X-ray source. By using the imaging technique as described above, the lesion tissue itself can be X-ray imaged.

FIG. 2A shows an embodiment in which X-ray sources 20 sealed in a vacuum vessel 29 made of steel, ceramic, or glass are arranged side by side in a plane, and FIG. In this embodiment, the X-ray sources 20 are arranged in an arc. The X-ray source 20 shown in FIG. 2 is sealed in a vacuum container 29 as a single unit.
On the other hand, the X-ray source group 1 shown in FIGS. 3A and 3B has a plurality of X-ray sources 20 sealed in one vacuum vessel 29. The plurality of X-ray sources 20 are positioned and fixed in a vacuum vessel 29 made of steel, ceramic or glass.
The X-ray source group 1 shown in FIG. 2 is easy to handle such as changing or replacing the number of X-ray sources 20 because the X-ray source 20 is sealed in a vacuum vessel. On the other hand, it becomes larger and heavier than the embodiment shown in FIG. On the other hand, the X-ray source group 1 shown in FIG. 3 can be made smaller and lighter than the X-ray source group 1 shown in FIG. On the other hand, since it is not easy to change or replace the number of X-ray sources 20, it is necessary to prepare the X-ray source group 1 according to the application.

  [X-ray sensor for position identification] In FIG. 1, a flat panel sensor can be suitably used as the X-ray sensor 2. Flat panel sensors are commercially available and popular because of high-speed operation and high-resolution products. If a photon sensor is used, higher speed and higher accuracy can be realized. The purpose of the lesion tissue real-time position identification device according to the present invention is to identify the position of the lesion tissue or marker, so that it is not necessary to scan all the pixels of the flat panel sensor, and the lesion tissue according to the present invention is reduced by thinning out the scan pixels. It is possible to secure the frame rate required by the real-time position identification device. Two or more X-ray sensors 2 may be arranged. Projection data from two or more directions of the marker or lesion tissue detected by the X-ray sensor 2 is sent to the image processing device 7. The image processing device 7 obtains three-dimensional coordinates from the two-dimensional coordinates of the marker or the lesion tissue using a DLT (Direct Linear Transformation) method or the like. Further, the projection data is reconstructed and converted into a three-dimensional image. The practitioner can perform X-ray treatment while confirming a three-dimensional image of the marker or lesion tissue with the image display device 8.

  [Central processing unit and the like] The central processing unit 4, the X-ray source control unit 5, the X-ray sensor control unit 6 and the image processing unit 7 are preferably housed in a pedestal that supports the couch 9. As a result, the lesion tissue real-time position identification device can be further miniaturized.

  FIG. 4 is an outline view of a marker that is used together with the lesion tissue real-time position identification device according to the present invention and is embedded in the vicinity of the lesion tissue. The marker buried in the vicinity of the lesion tissue has hitherto been a heavy metal that does not adversely affect the human body and absorbs X-rays well, for example, a sphere having a diameter of 1 to 2 mm or a coil having a diameter of 0.3 mm or more made of Au or Pt. Since this type of marker is embedded in the vicinity of the lesion tissue using an open operation or a dedicated needle, the burden on the patient is great.

  The marker used in the lesion tissue real-time position identification device according to the present invention is made of a shape memory alloy or a superelastic alloy composed of a metal harmless to the human body such as Pd, Au, Pt, and Ti. FIG. 4A shows a wire 31 having a diameter of several μm. This is a marker linearly stretched below the martensite transformation temperature below the memory-treated marker. When this linearized marker is embedded in the body, it rises above the martensitic transformation temperature due to body temperature, reversely transforms into a coiled shape, and has a diameter of 10 μm to 100 μm and a length of 0, as shown in FIG. .It changes to a coil shape of 1 mm to 1 mm. The marker used in the apparatus according to the present invention is embedded in the vicinity of the lesion tissue by an injector 32 as shown in FIG. Since the tip of the injector 32 is the same as a thin injection needle, the burden on the patient can be greatly reduced. Further, by manufacturing the marker with a superelastic alloy, after being embedded in the body, as shown in FIG. 4C, the marker spreads into the barbed shape 34 and is reliably placed in the vicinity of the lesion tissue.

  FIG. 5 is a block diagram showing another embodiment in which a lesion tissue real-time position identification device according to the present invention is mounted on a 6-axis or 7-axis robot. By mounting the lesion tissue real-time position identification device on the 6-axis or 7-axis robot 30, it is possible to take various irradiation postures compared to the case where the device is attached to the couch, so that the marker or lesion tissue can be more accurately detected. Position information and reconstructed images can be acquired. Further, by integrating with a robot equipped with a therapeutic X-ray source, the X-ray therapy apparatus can be further miniaturized.

  [X-ray Treatment Method] FIG. 6 shows a block diagram of an embodiment of an X-ray treatment apparatus for explaining an X-ray treatment method using a lesion tissue real-time position identification apparatus according to the present invention. The therapeutic X-ray source 10 and the therapeutic X-ray detection sensor 11 are added to the block diagram showing the embodiment of the lesion tissue real-time position identification device according to the present invention in FIG. FIG. 7 is a flowchart showing the steps of an X-ray treatment method using the lesion tissue real-time position identification device according to the present invention. FIG. 8 is a timing chart showing the irradiation timing of the position detection X-ray source and the therapeutic X-ray source in the X-ray therapy apparatus including the lesion tissue real-time position identification apparatus according to the present invention. An X-ray treatment method using the lesion tissue real-time position identification device according to the present invention will be described with reference to FIGS.

  Prior to the X-ray treatment, the treatment site, that is, the target volume, is determined by using an apparatus such as CT or MRI, and an irradiation method, an irradiation field, an X-ray beam quality, and a dose division method for the X-ray treatment. An appropriate treatment plan including the above is formulated (step 40). In a general X-ray treatment procedure, after a treatment plan is established, the process proceeds to a specific X-ray treatment step. However, the X-ray treatment method according to the present invention is roughly divided into three steps. In FIG. 7, the first step is a step of verifying treatment plan data using the lesion tissue real-time position identification device according to the present invention immediately before the X-ray treatment (step 50). The purpose of this verification is to confirm whether the condition of the target lesion tissue (hereinafter referred to as the treatment target) or the marker 3 embedded in the vicinity thereof has not changed after the treatment plan is formulated. A treatment target or marker is irradiated with low-energy X-rays from the position detection X-ray source (step 51), and the position information and shape information of the treatment target or marker immediately before the start of the X-ray treatment are acquired, and the treatment plan is obtained. The data is compared and collated (step 52). As a result of this verification, if there is a difference between the treatment plan data and the data immediately before the start of X-ray treatment, the position and posture of the couch 9 are corrected so as to match the treatment plan data, and if necessary, treatment The setting conditions of the X-ray source 10 are corrected (step 54).

After the verification of the treatment plan data is completed, the procedure proceeds to a specific X-ray treatment step composed of the second step (step 60) and the third step (step 70). A series of steps from step 62 to step 76 is executed at a repetition period of 200 pps or more (5 ms or less) in order to secure a dose necessary for treatment of the lesion tissue. This is because the irradiation time of the therapeutic X-ray source 10 is limited to about 4 μs due to the restriction of the microwave source constituting the X-ray source. First, each device constituting the treatment planning apparatus is set to an initial value (step 61). At this time, the verification result of the treatment plan data is reflected in the initial value. Step 60 is a step of tracking the movement of the treatment target or marker moving during the X-ray treatment in real time and identifying the position thereof. First, the position detection X-ray source group 1 emits X-rays toward the treatment target or marker (step 62). Since the position detection X-ray has low energy, it takes time until the position detection X-ray sensor 2 fully recognizes, for example, 3 ms. After the position detection X-ray irradiation is completed, the position of the treatment target or marker is detected within the position identification time (T _SHX ) of the treatment target or marker shown in FIG. 8 (step 63), and the data and treatment The position information of the plan data and the image data are compared and collated to identify the treatment target or marker (step 64). This position identification time (T _SHX ) is set to 2 ms or less. Thus, the position identification of the treatment target or marker can be executed in 5 ms or less.
If there is a difference between the treatment plan data and the data detected by the position detection X-ray source, the irradiation condition of the treatment X-ray source 10 is corrected (step 66).

Next, the process proceeds to a specific X-ray treatment step of Step 70. High-energy therapeutic X-rays are irradiated from the therapeutic X-ray source 10 toward the target to be treated (step 71). As shown in FIG. 8, the irradiation timing is irradiated after the position identification time (T _SHX ) of the treatment target or marker. The treatment X-ray irradiation time (T _WHX ) is set sufficiently shorter than the position detection X-ray source irradiation time (T _WLX ) and is about 4 _μs . The irradiated therapeutic X-ray passes through the treatment target and is detected by the therapeutic X-ray detection sensor 11 (step 72). This detected data is compared with the treatment plan data, and it is verified whether or not irradiation has been performed according to the treatment plan data (step 73). If there is a difference as a result of the verification, the irradiation condition of the therapeutic X-ray source is corrected (step 75) and reflected in the next irradiation. The series of X-ray treatment steps from Step 62 to Step 76 described above are repeatedly executed until the end of the X-ray treatment based on the treatment plan data.

  As described above, various modifications can be made to the embodiment described in detail within the scope of the present invention. A variety of position identification X-ray sources suitable for various affected areas can be prepared by combining any arrangement and number of the position detection X-ray sources 20.

DESCRIPTION OF SYMBOLS 1 X-ray source group 2 X-ray sensor 3 Marker or lesion tissue 4 Central processing unit 5 X-ray source control unit 6 X-ray sensor control unit 7 Image processing unit 8 Image display unit 9 Couch 10 Therapeutic X-ray source 11 Therapeutic X Line detection sensor 20 X-ray source 21 Electron source 22 Grid 23 Anode 24 Electron beam 25 Electron lens 26 Target 27 X-ray 28 Collimator 29 Vacuum container 30 6-axis or 7-axis robot 31 Shape memory alloy marker in martensitic transformation state 32 Marker Injector 33 Reverse-transformed shape memory alloy marker 34 Unloaded superelastic alloy marker 40 Treatment plan formulation step 50 Treatment plan data verification step 60 Marker or lesion tissue position identification step 70 X-ray treatment step 100 Imaging ring 101 X-ray source 102 X-ray 103 Subject 104 X-ray detector Lee 105 control circuit 106 a signal processing circuit

The present invention relates to a position identification device for identifying a position of a marker tissue or a marker embedded in the vicinity of the lesion tissue in X-ray therapy, and an X-ray therapy device using the position identification device. More specifically, a position identification apparatus capable of performing real-time position identification of a lesion tissue or using a special marker to perform marker position identification, and X-ray therapy is performed based on the position identification result of the position identification apparatus. The present invention relates to an X-ray therapy apparatus .

An object of the present invention is to provide a small lesion tissue position identification apparatus capable of performing lesion tissue position identification in real time and with high accuracy in X-ray therapy. Another object of the present invention is to provide the position identification. Based on this, an X-ray therapy apparatus that performs high-speed and accurate X-ray therapy is provided. A more specific object is to provide a minimally invasive marker capable of reducing the burden on the patient in the lesion tissue position identification device.

In order to achieve the object, a lesion tissue real-time position identification device according to claim 1 according to the present invention is provided with an X-ray source and an X-ray sensor arranged opposite to the X-ray source and supine on a couch. For irradiating X-rays from the X-ray source toward a marker or lesion tissue embedded in the vicinity of the lesion tissue and identifying the position of the marker or lesion tissue by detecting the irradiated X-ray with the X-ray sensor 1 or 2 or more X-ray sources are arranged on a plane or arcuate curved surface, and the plane or arcuate curved surface shape is composed of 1 or 2 or more facing the X-ray source group The X-ray sensor is arranged, a marker embedded near the lesion tissue of the patient, an X-ray source control device that controls the irradiation timing of the X-ray source group, and an X that controls the position, angle, etc. of the X-ray sensor Line sensor control device An image processing device that performs image processing on output data of the X-ray sensor to create a reconstructed image, a central processing device that controls the X-ray source control device, the X-ray sensor control device, and the image processing device; An image display device that displays a captured image of a marker or lesion tissue, and the X-ray source group and the X-ray sensor are attached to the couch, and are provided from the X-ray source control device and the X-ray sensor control device. Each position and posture can be controlled by a signal, and the marker is made of a shape memory alloy or a superelastic alloy, and is deformed into a coiled shape or a barbed shape by being embedded in the vicinity of the lesion tissue. it can, X-ray source of the X-ray source group irradiates sequentially one by one in accordance with signals of the X-ray source control unit, the X-ray sensor and the image processing apparatus, patients Contour, the shape is compared against the treatment planning data lowers the resolution to a level no trouble in determining its integrity, and can be skipped scan pixel, X-rays irradiated from the X-ray source Is a lesion tissue real-time position identification device characterized in that the three-dimensional position of the marker or lesion tissue is identified in real time.

The lesion tissue real-time position identification device according to claim 6 according to the present invention is the lesion tissue real-time position identification device according to claim 1, wherein the X-ray source selectively switches at least two kinds of output energy, and alternately A lesion tissue real-time position identification device characterized by being capable of being irradiated.

An X-ray treatment apparatus using the lesion tissue real-time position identification device according to claim 7 according to the present invention irradiates the lesion tissue with a therapeutic X-ray source based on a treatment plan set prior to the X-ray treatment. In the X-ray therapy to be performed, the position detection X-ray source group in which one or two or more X-ray sources are arranged on a plane or an arcuate curved surface, and one or two or more facing the position detection X-ray source group An X-ray source control apparatus for controlling the irradiation timing of the position detection X-ray source group and a marker embedded in the vicinity of a patient's lesion tissue, in which a configured planar or arcuate curved surface position detection X-ray sensor is arranged An X-ray sensor control device that controls the position, angle, and the like of the position detection X-ray sensor, an image processing device that performs image processing on output data of the position detection X-ray sensor, and creates a reconstructed image; The X-ray source control device; Comprising a central processing unit that controls the line sensor control apparatus and the image processing apparatus, an image display apparatus for displaying a captured image of the marker or lesion tissue, the marker is a made of a shape memory alloy or a superelastic alloy Then, it can be transformed into a coiled shape or a barbed shape by being embedded in the vicinity of the lesion tissue , and one X-ray source of the position detecting X-ray source group is sequentially set in accordance with a signal from the X-ray source control device. The position detection X-ray sensor and the image processing apparatus sequentially detect X-rays irradiated from the position detection X-ray source group, and the three-dimensional position of the marker or lesion tissue in real time. If the difference between the output data and the treatment plan data of the lesion tissue real-time position identification device characterized in that The irradiation condition of the therapeutic X-ray source is corrected so as to match the data, the irradiation is directed toward the lesion tissue, and the X-ray of the irradiated therapeutic X-ray source is detected by the therapeutic X-ray detection sensor and detected. If there is a difference between the measured data and the treatment plan data, the treatment X-ray source is repeatedly irradiated while correcting the irradiation condition of the treatment X-ray source so as to match the treatment plan data. X-ray therapy apparatus .

X-ray therapy device of claim 8, according to the present invention provides an X-ray treatment apparatus using a lesion tissue real-time location identification apparatus according to claim 7, after treatment planning, and supine on the couch for X-ray therapy A patient is identified with a three-dimensional position of the marker or lesion tissue using the lesion tissue real-time position identification device, and the output data of the lesion tissue real-time position identification device is compared with the treatment plan data. If there is a difference between the data, the position or posture of the couch is corrected, the position and posture of the marker or lesion tissue are matched with the treatment plan data, and then X-ray treatment is performed. X-ray therapy apparatus .

According to the present invention having the above-described configuration, it is possible to provide a small lesion tissue position identification apparatus capable of performing lesion tissue position identification in real time and with high accuracy in X-ray therapy. By incorporating the lesion tissue position identification apparatus according to the present invention into an X-ray therapy apparatus, a high-speed, high-accuracy and small-sized X-ray therapy apparatus can be configured, and the spread to many medical institutions is expected. Furthermore, since the marker used in the position identification device according to the present invention and embedded in the vicinity of the lesion tissue is a linear shape having a diameter of 10 μm or less until it is embedded, it can be easily embedded without burdening the patient by an injector such as a syringe. Can do. Moreover, after the implantation, the shape changes to a coil shape or the like, so that it does not easily move in the tissue and can be clearly recognized by X-ray imaging. Furthermore, according to the X-ray treatment apparatus using the lesion tissue position identification device according to the present invention, the treatment plan data is verified immediately before starting the X-ray treatment, and the marker and the lesion tissue are acquired from the time when the treatment plan data is acquired. Since it is possible to verify the treatment plan data for a change in the state, the accuracy of the X-ray treatment is improved. In addition, since the movement of the marker or lesion tissue can be detected in real time and the position thereof can be identified, X-ray therapy can be performed at high speed without selecting the timing of X-ray irradiation.

In order to achieve the object, a lesion tissue real-time position identification device according to claim 1 according to the present invention is provided with an X-ray source and an X-ray sensor arranged opposite to the X-ray source and supine on a couch. For irradiating X-rays from the X-ray source toward a marker or lesion tissue embedded in the vicinity of the lesion tissue and identifying the position of the marker or lesion tissue by detecting the irradiated X-ray with the X-ray sensor , An X-ray source group in which two or more X-ray sources are arranged on an arcuate curved surface , a robot arm that supports the X-ray source group and faces the affected area, and 1 or 2 facing the X-ray source group The X-ray sensor having a flat or arcuate curved shape configured as described above is arranged, a marker embedded near the lesion tissue of a patient, an X-ray source control device for controlling the irradiation timing of the X-ray source group, and the X Line sensor position and angle An X-ray sensor control device for controlling the image, an image processing device for image processing the output data of the X-ray sensor to create a reconstructed image, the X-ray source control device, the X-ray sensor control device, and the image A central processing unit that controls a processing unit; and an image display unit that displays a captured image of the marker or lesion tissue, wherein the X-ray source group and the X-ray sensor are attached to the couch, and the X-ray source The position and posture can be controlled by signals from the control device and the X-ray sensor control device, respectively, and the marker is made of a shape memory alloy or a superelastic alloy and is embedded in the vicinity of the lesion tissue. Therefore, the X-ray sources of the X-ray source group sequentially irradiate one by one according to the signal of the X-ray source control device, and the X-ray source can be deformed. The image processing apparatus and the image processing apparatus reduce the resolution to a level at which there is no problem in determining the consistency of the contour and shape of the affected area by comparing and comparing with the treatment plan data. A lesion tissue real-time position identification apparatus characterized by sequentially detecting X-rays emitted from an X-ray source and identifying a three-dimensional position of the marker or lesion tissue in real time.

The lesion tissue real-time position identification device according to claim 2 according to the present invention is the lesion tissue real-time position identification device according to claim 1, wherein the X-ray source group includes two or more unencapsulated X-ray sources having an arcuate curved surface. The lesion tissue real-time position identification apparatus is characterized in that all the X-ray sources are enclosed in a single vacuum vessel.

The lesion tissue real-time position identification device according to claim 5 according to the present invention is the lesion tissue real-time position identification device according to claim 1, wherein the X-ray source selectively switches at least two kinds of output energy, and alternately A lesion tissue real-time position identification device characterized by being capable of being irradiated.

An X-ray treatment apparatus using the lesion tissue real-time position identification device according to claim 6 according to the present invention irradiates the lesion tissue with a therapeutic X-ray source based on a treatment plan set prior to the X-ray treatment. In the X-ray therapy to be performed, a position detection X-ray source group in which two or more X-ray sources are arranged on an arcuate curved surface , a robot arm that supports the position detection X-ray source group and faces the affected area, and the position A position detection X-ray sensor having a planar or arcuate curved surface shape composed of one or two or more facing the detection X-ray source group is disposed, and a marker embedded in the vicinity of a patient's lesion tissue, and the position detection X-ray source control device for controlling the irradiation timing of the X-ray source group, X-ray sensor control device for controlling the position, angle, etc. of the position detection X-ray sensor, and output data of the position detection X-ray sensor Create reconstructed image by image processing An image processing device, a central processing device that controls the X-ray source control device, the X-ray sensor control device, and the image processing device, and an image display device that displays a captured image of the marker or lesion tissue, The marker is made of a shape memory alloy or a superelastic alloy, and can be transformed into a coiled shape or a barbed shape by being embedded in the vicinity of the lesion tissue, and the X-ray of the position detecting X-ray source group The source sequentially radiates one by one according to the signal from the X-ray source control device, and the position detection X-ray sensor and the image processing device sequentially detect X-rays emitted from the position detection X-ray source group. to, treated target or Ma in the position detecting X-ray source of the lesion tissue real-time location identification apparatus characterized by identifying the three-dimensional position of the marker or lesion tissue in real time After irradiating X-rays toward the mosquito and ending the X-ray irradiation, the position of the treatment target or marker is detected, and the position information and image data of this treatment data and treatment plan data are compared and collated. When a target or marker is identified and there is a difference between the data detected by the position detection X-ray source and the treatment plan data, the irradiation condition of the treatment X-ray source is set so as to match the treatment plan data. The X-ray of the therapeutic X-ray source is corrected and irradiated to the lesion tissue, and the irradiated X-ray of the therapeutic X-ray source is detected by the therapeutic X-ray detection sensor, and the detected data and the treatment plan are detected. If there is a difference between data, X-rays therapy apparatus characterized by repeatedly irradiating the irradiation condition of the treatment X-ray source in the treatment X-ray source while correcting to match the treatment plan data Is

The X-ray therapy apparatus according to claim 7 according to the present invention is an X-ray therapy apparatus using the lesion tissue real-time position identification apparatus according to claim 6 and is supine on the couch for X-ray therapy after the treatment plan is formulated. A patient is identified with a three-dimensional position of the marker or lesion tissue using the lesion tissue real-time position identification device, and the output data of the lesion tissue real-time position identification device is compared with the treatment plan data. If there is a difference between the data, the position or posture of the couch is corrected, the position and posture of the marker or lesion tissue are matched with the treatment plan data, and then X-ray treatment is performed. X-ray therapy apparatus.

Claims (9)

An X-ray source and an X-ray sensor arranged opposite to the X-ray source are provided, and X-rays are emitted from the X-ray source toward a marker or lesion tissue embedded in the vicinity of the lesion tissue of a patient lying on the couch In the apparatus for detecting the irradiated X-ray by the X-ray sensor and identifying the position of the marker or the lesion tissue,
An X-ray source group in which one or more X-ray sources are arranged on a plane or an arcuate curved surface;
A flat or arcuate curved X-ray sensor composed of 1 or 2 or more is arranged facing the X-ray source group,
A marker embedded in the vicinity of the patient's focal tissue;
An X-ray source control device for controlling the irradiation timing of the X-ray source group;
An X-ray sensor control device for controlling the position, angle, etc. of the X-ray sensor;
An image processing apparatus for processing the output data of the X-ray sensor to create a reconstructed image;
A central processing unit for controlling the X-ray source control device, the X-ray sensor control device and the image processing device;
An image display device for displaying a captured image of the marker or lesion tissue;
With
The X-ray source group and the X-ray sensor are attached to the couch, and their positions and postures can be controlled by signals from the X-ray source control device and the X-ray sensor control device,
The X-ray sources of the X-ray source group sequentially irradiate one by one according to the signal of the X-ray source control device, and the X-ray sensor and the image processing device sequentially apply the X-rays irradiated from the X-ray source. A lesion tissue real-time position identification device that detects and identifies a three-dimensional position of the marker or lesion tissue in real time.   2. The lesion tissue real-time position identification device according to claim 1, wherein the X-ray source group includes one or two or more unencapsulated X-ray sources arranged on a plane or an arcuate curved surface, and all the X-ray sources are A lesion tissue real-time position identification device characterized by being enclosed in a vacuum container.   The lesion tissue real-time position identification device according to claim 1, wherein the X-ray source is a microfocus X-ray source having an X-ray beam focal spot diameter of 100 µm or less.   The lesion tissue real-time position identification device according to claim 1, wherein the X-ray sensor and the image processing device identify a three-dimensional position of the marker or the lesion tissue in 5 ms or less. Identification device.   2. The lesion tissue real-time position identification device according to claim 1, wherein the X-ray source group and the X-ray sensor are attached to a 6-axis or 7-axis robot arm while maintaining an opposing relationship, and the X-ray source control device and A lesion tissue real-time position identification device characterized in that the position and orientation of each can be controlled by a signal from the X-ray sensor control device.   The lesion tissue real-time position identification device according to claim 1, wherein the marker is made of a shape memory alloy or a superelastic alloy, and is deformed into a coiled shape or a barbed shape by being embedded in the vicinity of the lesion tissue. A lesion tissue real-time position identification device characterized by the above.   The lesion tissue real-time position identification device according to claim 1, wherein the X-ray source can selectively switch at least two kinds of output energy and can alternately irradiate. In the X-ray treatment performed by irradiating the lesion tissue with a therapeutic X-ray source based on the treatment plan established prior to the X-ray treatment,
A position detection X-ray source group in which one or more X-ray sources are arranged on a flat surface or an arcuate curved surface;
A position detection X-ray sensor having a flat or arcuate curved surface shape constituted by one or two or more is arranged opposite to the position detection X-ray source group,
A marker embedded in the vicinity of the patient's focal tissue;
An X-ray source control device for controlling the irradiation timing of the position detection X-ray source group;
An X-ray sensor control device for controlling the position, angle, etc. of the position detection X-ray sensor;
An image processing device for processing the output data of the position detection X-ray sensor to create a reconstructed image;
A central processing unit for controlling the X-ray source control device, the X-ray sensor control device and the image processing device;
An image display device for displaying a captured image of the marker or lesion tissue;
X-ray sources of the position detection X-ray source group sequentially radiate one by one according to the signal of the X-ray source control device, and the position detection X-ray sensor and the image processing device Output data and treatment plan data of a lesion tissue real-time position identification apparatus characterized by sequentially detecting X-rays irradiated from a group of X-ray sources and identifying a three-dimensional position of the marker or lesion tissue in real time If there is a difference between the data, the irradiation condition of the therapeutic X-ray source is corrected so as to match the treatment plan data, and irradiation is performed toward the lesion tissue. When the X-ray of the medical X-ray source is detected by a therapeutic X-ray detection sensor and there is a difference between the detected data and the treatment plan data, the irradiation condition of the treatment X-ray source is set as the treatment plan data. To match X-ray therapy method characterized by repeatedly irradiating the treatment X-ray source with correct.   9. The X-ray treatment method according to claim 8, wherein a three-dimensional marker or lesion tissue is used for a patient who is supine on the couch for X-ray treatment after the treatment plan is formulated, using the lesion tissue real-time position identification device. The position data of the lesion tissue is compared with the treatment plan data, and if there is a difference between the data, the position or posture of the couch is corrected, and the marker Alternatively, the X-ray treatment method is characterized in that the X-ray treatment is performed after the position and posture of the lesion tissue are matched with the treatment plan data.

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