JP2013223731A - 放射線治療手順のオンラインコーンビームコンピュータ断層撮像ガイダンスの方法 - Google Patents
放射線治療手順のオンラインコーンビームコンピュータ断層撮像ガイダンスの方法 Download PDFInfo
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Abstract
【解決手段】本発明の放射線治療手順のオンラインコーンビームコンピュータ断層撮像ガイダンスの方法は、治療台の対象物のコーンビームコンピュータ断層撮像画像を取得する工程と、プラニング画像における位置と配向に関する目標量の並進及び/又は回転を識別することができるように、目標量及びその周囲の構造をコーンビームコンピュータ断層撮像画像で輪郭形成する工程と、Y方向及び/又はZ方向への治療台の対象物の並進により、且つ/又は、X軸を中心とした回転により、プラニング画像に関するコーンビームコンピュータ断層撮像画像で観察される対象物の並進を補正する工程と、目標量の測定された回転に最も緊密に対応する修正された放射線治療プランを基準プラン及び複数の追加プランから選択することにより目標量の配向を補正する工程と、を備えている。
【選択図】図26
Description
本発明は一般に、コーンビームコンピュータ断層撮像システムに関するものであり、特に、放射線治療で使用するためのアモルファスシリコン平坦パネル画像器を採用した、コーンビームに基づいてコンピュータ処理される断層撮像システムであって、患者の画像が治療台上の治療位置にある患者について得られるシステムに関連している。
放射線治療は、特定の幾何学的形状に画定された目標または目標量に対して規定の腫瘍殺傷放射線量を配給することに関与している。通例、この治療は1治療期間のうちに、または、それ以上の治療期間(期間的部分)のうちに患者に配給される。治療スケジュールが20期分から40期分を含み、その場合に、1週間あたり5期分が配給されることは珍しいことではない。放射線治療は多様なタイプの癌および多様な段階の癌を管理するのに効果的であることが分かっているが、増量線量により増大する腫瘍の制御を行う潜在性が存在する。残念ながら、増量線量の配給は隣接して正常な構造体が存在することと、ビーム配給の精度とにより制約される。或る部位では、罹病した目標は放射線に敏感な正常な構造体に直ぐ隣接している。例えば、前立腺癌の治療では、前立腺と直腸は直ぐ隣接している。この情況では、前立腺は目標量であり、最大配給線量は直腸の壁により制約される。
本発明のまた別な目的、利点、および、特徴は、添付の図面と関連づけて理解されれば、以下の説明と前掲の特許請求の範囲から明らかとなる。
図17(b)及び図18に示すように、アーム410、412及び415の他端は、プレート434の後ろ側縁部429から約20cm、かつ、プレート424の左及び右縁部の間の略中間に位置するように、プレート424に取付けられている。
〔態様1〕放射線治療システムであって、
経路を移動し且つ対象物に向かって放射線ビームを差し向ける放射線源と、
コーンビームコンピュータ断層撮像システムであって、該コーンビームコンピュータ断層撮像システムが、コーンビーム形態のX線を前記対象物に向けて放射するX線源と、前記X線が前記対象物を透過したあと該X線を受け該対象物の画像を生成するアモルファスシリコン平坦パネル画像器とを備えたコーンビームコンピュータ断層撮像システムと、
コンピュータであって、前記放射線源と前記コーンビームコンピュータ断層撮像システムとに接続されたコンピュータと、を備え、
前記コンピュータが、前記対象物の画像を受け、該画像に基づいて、放射線源に該放射線源の経路を制御する信号を送る、ことを特徴する放射線治療システム。
〔態様2〕前記X線源が、kV−X線源を備えている、上記態様1に記載の放射線治療システム。
〔態様3〕前記kV−X線源が、エネルギが約100kVのX線を照射する、上記態様1に記載の放射線治療システム。
〔態様4〕前記X線源が、直線加速器を備えている、上記態様1に記載の放射線治療システム。
〔態様5〕前記対象物を、前記X線源および前記アモルファス平坦パネル画像器に対して、移動させるステージを備えている、上記態様1に記載の放射線治療システム。
〔態様6〕前記ステージが、回転軸を中心に、前記対象物を、前記X線源およびアモルファスシリコン平坦パネル画像器に対して回転させる、上記態様5に記載の放射線治療システム。
〔態様7〕前記対象物を、前記X線源と前記アモルファスシリコン平坦パネル画像器とに対して、移動させるステージを備えている、上記態様1に記載の放射線治療システム。
〔態様8〕前記ステージが、回転軸を中心に、前記対象物を、前記X線源およびアモルファスシリコン平坦パネル画像器に対して回転させる、上記態様7に記載の放射線治療システム。
〔態様9〕前記対象物を、前記X線源と前記アモルファスシリコン平坦パネル画像器とに対して、移動させるステージを備えている、上記態様4に記載の放射線治療システム。
〔態様10〕前記ステージが、回転軸を中心に、前記対象物を、前記X線源およびアモルファスシリコン平坦パネル画像器に対して回転させる、上記態様9に記載の放射線治療システム。
〔態様11〕前記X線源の前記X線が、源平面に沿って、照射される、上記態様1に記載の放射線治療システム。
〔態様12〕前記X線源の前記X線が、前記回転軸に直交する源平面に沿って、照射される、上記態様6に記載の放射線治療システム。
〔態様13〕前記回転軸と源平面を可視化させる整列レーザ装置を備えている、上記態様10に記載の放射線治療システム。
〔態様14〕前記アモルファスシリコン平坦パネル画像器が、独立した検出素子のアレイを備えている、上記態様1に記載の放射線治療システム。
〔態様15〕前記アレイが、二次元アレイである、上記態様14に記載の放射線治療システム。
〔態様16〕前記独立した検出素子の各々が、a−Si:Hフォトダイオードを備えている、上記態様14に記載の放射線治療システム。
〔態様17〕前記独立した検出素子の各々が、a−Si:Hフォトダイオードに接続されたトランジスタを備えている、上記態様14に記載の放射線治療システム。
〔態様18〕前記コンピュータが、前記アモルファスシリコン平坦パネル画像器からの画像を受け、受けた画像に基づいて前記対象物のコンピュータ断層撮影画像を生成する、上記態様1に記載の放射線治療システム。
〔態様19〕前記画像が、二次元投影画像である、上記態様1に記載の放射線治療システム。
〔態様20〕前記コンピュータが、前記アモルファスシリコン平坦パネル画像器から二次元投影画像を受け、該二次元投影画像に基づいて前記対象物のコンピュータ断層撮影画像を生成する、上記態様19に記載の放射線治療システム。
〔態様21〕第1アームと第2アームとを備えたガントリを備え、
前記X線源が前記第1アームに取付けられ、前記アモルファスシリコン平坦パネル画像機が前記第2アームに取付けられている、上記態様1に記載の放射線治療システム。
〔態様22〕前記ガントリが回転軸を中心に回転する、上記態様21に記載の放射線治療システム。
〔態様23〕前記ガントリが前記第2回転軸を中心に回転する、上記態様22に記載の放射線治療システム。
〔態様24〕前記ガントリが部屋の壁に取付けられている、上記態様21に記載の放射線治療システム。
〔態様25〕前記ガントリが部屋の壁に取付けられている、上記態様23に記載の放射線治療システム。
〔態様26〕前記ガントリが、部屋の床を並進移動できる可動プラットフォームに取付けられている、上記態様22に記載の放射線治療システム。
〔態様27〕前記ガントリが、部屋の床を並進移動できる可動プラットフォームに取付けられている、上記態様23に記載の放射線治療システム。
〔態様28〕前記放射線源が前記X線源のパワーレベルより高いパワーレベルで作動し、
前記放射が、前記対象物の領域の放射処置に効果的な強度およびエネルギのものである、上記態様1に記載の放射線治療システム。
〔態様29〕前記放射線源が前記X線源のパワーレベルより高いパワーレベルで作動し、
前記放射が、前記対象物の領域の放射処置に効果的な強度およびエネルギのものである、上記態様1に記載の放射線治療システム。
〔態様30〕前記X線源が、前記放射源と一致する、上記態様1に記載の放射線治療システム。
〔態様31〕前記X線源が、前記放射源に対して置換されている、上記態様1に記載の放射線治療システム。
〔態様32〕前記コーンビームコンピュータ断層撮像システムの作動が、外部トリガとともに、前記対象物が配置されている患者の生物学的プロセスを制御する、上記態様1に記載の放射線治療システム。
〔態様33〕前記外部トリガが、能動呼吸制御機構を備えている、上記態様32に記載の放射線治療システム。
〔態様34〕前記外部トリガが、心臓ゲーティング機構を備えている、上記態様32に記載の放射線治療システム。
〔態様35〕前記放射源の反対に位置決めされ、前記放射源から前記対象物を透過した放射に基づいて前記対象物の画像を生成する、画像装置を備えている、上記態様1に記載の放射線治療システム。
〔態様36〕画像システムであって、
対象物に向かってX線を照射するX線源と、
前記照射されたX線に基づいて前記対象物からX線を受け、前記対象物の画像を形成する画像器と、
前記画像器を支持構造体に支持する画像器支持システムであって、前記画像器に取付けられた一端と前記支持構造体に取付けられた他端とを有する第1アームと、前記画像器に取付けられた一端と前記支持構造体に取付けられた他端とを有する第2アームとを備えた画像器支持システムとを、備えている、
ことを特徴とする画像システム。
〔態様37〕前記画像器支持システムが、前記画像器に取付けられた一端と前記支持構造体に取付けられた他端とを有する第3アームを更に備えている、上記態様36に記載の画像システム。
〔態様38〕前記第3アームが、前記第1および第2アームの一端が接合しているラインセグメントを二等分する平面内にある、上記態様37に記載の画像システム。
〔態様39〕前記画像器が前記平面に対して対称的に位置決めされている、上記態様38に記載の画像システム。
〔態様40〕前記画像器が前記平面に対して対称的に位置決めされている、上記態様38に記載の画像システム。
〔態様41〕前記画像器を、該画像器が前記平面に対して対称に位置決めされている位置から、該画像器が前記平面に対して非対称に位置決めされている位置に動かす、モータシステムを備えている、上記態様38に記載の画像システム。
〔態様42〕前記第1、第2および第3アームの前記他端のそれぞれが、前記支持構造体に取付けられたピボットに取付けられている、上記態様37に記載の画像システム。
〔態様43〕前記支持構造体が、ガントリの回転ドラムを備えている、上記態様36に記載の画像システム。
〔態様44〕前記X線源が、前記回転ドラムに取付けられている、上記態様43に記載の画像システム。
〔態様45〕前記X線源が、前記ドラムの回転軸に平行な方向に並進移動する、上記態様44に記載の画像システム。
〔態様46〕前記X線源が前記回転ドラムに取付けられている、上記態様43に記載の画像システム。
〔態様47〕前記X線源からのX線が、コーンビーム形態で照射される、上記態様36に記載の画像システム。
〔態様48〕前記画像器が、アモルファスシリコン平坦パネル画像器を備えている、上記態様36に記載の画像システム。
〔態様49〕画像システムであって、
対象物に向けてX線を照射するX線源と
前記対象物から前記照射されたX線に基づいたX線を受け前記対象物の画像を形成する画像器と、
前記画像器を支持構造体に取付ける画像器支持システムであって、前記支持構造体に取付けられた一端と前記画像器に取付けられた他端とを有する回動アームを備えた画像器支持システムと、を備えている、
ことを特徴とする画像システム。
〔態様50〕前記支持構造体がガントリの回転ドラムを備えている、上記態様49に記載の画像システム。
〔態様51〕前記X線源が、前記回転ドラムに取付けられている、上記態様50に記載の画像システム。
〔態様52〕前記X線源が、前記ドラムの回転軸に平行な方向に並進移動する、上記態様51に記載の画像システム。
〔態様53〕前記回転ドラムに取付けられた前記放射線源をさらに備えている、上記態様50に記載の画像システム。
〔態様54〕前記X線源からのX線が、コーンビーム形態で照射される、上記態様49に記載の画像システム。
〔態様55〕前記画像器が、アモルファスシリコン平坦パネル画像器を備えている、上記態様49に記載の画像システム。
〔態様56〕画像システムであって、
対象物に向けてX線を照射するX線源と
前記照射されたX線に基づいて前記対象物からX線を受け前記対象物の画像を形成する画像器と、
前記画像器を支持構造体に取付ける画像器支持システムであって、支持構造に取付けられ一端に画像器が取付けられるC型アームを備えている画像器支持システムと、を備えている、ことを特徴とする画像システム。
〔態様57〕前記C型アームが円弧に沿って動く、上記態様56に記載の画像システム。
〔態様58〕前記支持構造体がガントリの回転ドラムを備えている、上記態様56に記載の画像システム。
〔態様59〕前記X線源が、前記C型アームの他端に取付けられている、上記態様58に記載の画像システム。
〔態様60〕前記回転ドラムに取付けられた放射線源を備えている、上記態様58に記載の画像システム。
〔態様61〕前記X線源からのX線が、コーンビーム形態で照射される、上記態様56に記載の画像システム。
〔態様62〕前記画像器が、アモルファスシリコン平坦パネル画像器を備えている、上記態様56に記載の画像システム。
〔態様63〕放射線で対象物を処置する方法であって、
放射線源を経路に沿って移動させる工程と、
前記放射線源から対象物に向けて放射線ビームを差し向ける工程と、
対象物に向け、コーンビーム形態のX線ビームを照射する工程と、
前記X線ビームの照射によって前記対象物を透過したX線をアモルファスシリ
コン平坦パネル画像器で検出する工程と、
前記検出されたX線から前記対象物の画像を生成する工程と、
前記画像に基づいて前記照射源の経路を制御する工程と、を備えている、
ことと特徴とする方法。
〔態様64〕前記X線ビームが約100kVのエネルギを有する、上記態様63に記載の方法。
〔態様65〕回転軸を中心に、前記対象物を、前記X線源およびアモルファスシリコン平坦パネル画像器に対して、回転させる工程を備えている、
上記態様63に記載の方法。
〔態様66〕前記アモルファスシリコン平坦パネル画像器が独立した検出素子のアレイを備えている、上記態様63に記載の方法。
〔態様67〕前記アレイが二次元アレイである、上記態様66に記載の方法。
〔態様68〕前記独立した検出素子の各々がa−Siフォトダイオードを備えている、上記態様66に記載の方法。
〔態様69〕前記生成工程が、前記検出したX線に基づいて前記対象物のコンピュータ断層撮影画像を形成する工程を備えている、上記態様66に記載の方法。
〔態様70〕前記対象物を、第2の回転軸を中心に前記X線源および前記アモルファスシリコン平坦パネル画像器に対して、回転させる工程を備えている、上記態様65に記載の方法。
〔態様71〕前記X線源から照射されたX線とは別の、前記身体領域を処置する効果がある強度及びエネルギを有する第2組目のX線を照射する固定を備えている、上記態様63に記載の方法。
〔態様72〕前記第2組目のX線画像、前記X線源からのX線より大きな強度およびエネルギを有している、上記態様71に記載の方法。
〔態様73〕前記生成工程に先立って、オフセット及びゲインを修正する工程を備えている、上記態様69に記載の方法。
〔態様74〕前記対象物が動物である、上記態様63に記載の方法。
〔態様75〕前記画像が前記動物内の軟組織の輪郭を描く、上記態様63に記載の方法。
〔態様76〕前記軟組織が、脂肪、筋肉、腎臓、胃、腸および肝臓からなる群から選択されている、上記態様75に記載の方法。
〔態様77〕前記画像が、前記身体が前記X線源およびアモルファスシリコン平坦パネル画像器に対して一回転した後、形成される、上記態様65に記載の方法。
〔態様78〕前記X線ビームが、前記アモルファスシリコン平坦パネル画像器と独立して動き、X線源によって生成され、
前記X線源は、円筒面にされた正弦または鋸歯状経路を移動し、前記アモルファスシリコン平坦パネル画像器が円筒面上の環状経路を動く、上記態様63に記載の方法。
〔態様79〕リアルタイムで、コリメータを調整し、前記X線ビームの形状を調整して前記X線ビームの形状が前記アモルファスシリコン平坦パネル画像器の有効領域に制限されるようにする工程をさらに備えている、上記態様78に記載の方法。
〔態様80〕前記X線ビームが前記アモルファスシリコン平坦パネル画像器に従属して動くX線源によって生成され、該X線源及びアモルファスシリコン平坦パネル画像器が、球面上の正弦軌道上を動く、上記態様63に記載の方法。
〔態様81〕現存の放射線治療システムに対する補助画像システムを追加する方法であって、
支持構造対象物に支持された放射線源を備えた現存の放射線治療システムを準備する工程と、
前記構造体に前記放射線源を直接的に向けていない画像器を取付ける工程と、を備えている、
ことを特徴とする方法。
〔態様82〕前記取付け工程が、
前記画像器を画像器支持システムに取付ける工程と、
前記支持構造体に開口を形成する工程と、
前記画像器支持システムに形成された開口と前記支持構造体に形成された開口に雄部材を挿入する工程と、
前記挿入された雄部材を、前記支持構造体と前記画像器支持システムに取付ける工程と、を備えている、上記態様82に記載の方法。
〔態様83〕挿入された雄部材を取付ける工程が、ナットを前記雄部材上に締める工程を備えている、上記態様82に記載の方法。
〔態様84〕前記支持構造体が、回転ドラムを備えている、上記態様81に記載の方法。
〔態様85〕前記支持構造体が回転ドラムを備えている、上記態様82に記載の方法。
〔態様86〕X線源を前記支持構造体に取付ける工程をさらに備えている、上記態様81に記載の方法。
〔態様87〕X線源を前記回転ドラムに取付ける工程をさらに備えている、上記態様84に記載の方法。
〔態様88〕X線源を前記回転ドラムに取付ける工程をさらに備えている、上記態様85に記載の方法。
〔態様89〕身体内に位置しコンピュータ断層撮影画像で示された標的領域の輪郭を描く方法であって、
身体内の標的領域のコンピュータ断層撮影画像を形成する工程と、
前記コンピュータ断層撮影画像の切片の中で前記標的領域を手動で局部化する工程と、を備えている、
ことを特徴とする方法。
〔態様90〕前記手動で局部化する工程が、前記切片内の構造の輪郭を取る工程を備えている、上記態様89に記載の方法。
〔態様91〕前記手動で局部化する工程が、前記コンピュータ断層撮影画像内の1または2以上の異なった切片との組み合わせで、前記切片内の構造の輪郭を取る工程を備えている、上記態様89に記載の方法。
〔態様92〕身体内に位置しコンピュータ断層撮影画像で示された標的領域の輪郭を描く方法であって、
身体内の標的領域のコンピュータ断層撮影画像を形成する工程と、
前記標的領域を検出する工程と、
前記理想画像の位置及び回転に対する前記標的領域の並進及び回転を特定する工程と、 前記標的領域の位置及び向きを調整する工程と、
予め形成された放射線治療計画から、前記標的領域の検出された位置及び回転と関連して、一つの放射線治療計画を選択する工程とを備えている、
ことを特徴とする方法。
〔態様93〕身体内に位置しコンピュータ断層撮影画像で示された標的領域の輪郭を描く方法であって、
身体内の標的領域のコンピュータ断層撮影画像を形成する工程と、
前記理想画像の位置及び回転に対する、前記標的領域の並進及び回転を特定する工程と、
前記標的領域の位置及び向きを調整する工程と、
前記標的領域の調整された位置および向きに基づいて、放射線治療計画を算出する工程とを備えている、
ことを特徴とする方法。
Claims (5)
- 放射線治療手順のオンラインコーンビームコンピュータ断層撮像ガイダンスの方法であって、上記放射線治療手順が、
平坦パネル画像器と、この平坦パネル画像器に向けてコーンビーム形態のX線ビームを生成するkV−X線源と、を備えたコーンビームコンピュータ断層画像システムと、
治療用放射線を生成する放射線治療源と、コリメート構造体と、上記放射線治療源に対向して配置されたイメージャと、を備えた放射線治療源システムと、を有し、
上記方法は、オフライン治療プロセスを実施する工程を有し、この工程は、治療すべき対象物の目標量とその周囲の構造体の外形が画定されるプラニング画像を準備する工程と、上記対象物の放射線治療に必要な所定のプロトコルに従って基準プランを生成するように逆プラニングを実施する工程と、上記目標量の並進及び/又は回転の関数として複数の追加プランを生成する工程と、を備え、
上記方法は、更に、オンライン治療プロセスを実施する工程を有し、この工程は、上記対象物を治療台に位置決めする工程と、上記治療台の対象物のコーンビームコンピュータ断層撮像画像を取得する工程と、上記プラニング画像における位置と配向に関する上記目標量の並進及び/又は回転を識別することができるように、上記目標量及びその周囲の構造を上記コーンビームコンピュータ断層撮像画像で輪郭形成する工程と、Y方向及び/又はZ方向への上記治療台の上記対象物の並進により、且つ/又は、X軸を中心とした回転により、上記プラニング画像に関する上記コーンビームコンピュータ断層撮像画像で観察される上記対象物の並進を補正する工程と、上記目標量の測定された回転に最も緊密に対応する修正された放射線治療プランを上記基準プラン及び上記複数の追加プランから選択することにより上記目標量の配向を補正する工程と、を備えていることを特徴とする方法。 - 更に、上記対象物の期分内モーションをチェックするために上記対象物の放射線監視処理を実行する工程を有する請求項1記載の方法。
- 上記目標量を輪郭形成する工程は、トランス軸上、矢状、冠状、及び又は斜めスライスの組み合わせで組織の輪郭によって手で行われる請求項1記載の方法。
- 上記目標量を輪郭形成する工程は、上記プラニング画像に定められた上記目標量を所定のコーンビームコンピュータ断層撮像画像に重ね、この画像を、上記プラニング画像と比較される画素値の標準偏差を最小にするような方法で上記プラニング画像の上記目標量の輪郭を移動させたり回転させたりすることにより合わせる自動位置測定アルゴリズムによって実行される請求項1記載の方法。
- 上記放射線治療源は、MV放射線治療源である請求項1記載の方法。
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CN100448499C (zh) | 2009-01-07 |
JP5572103B2 (ja) | 2014-08-13 |
CN1424925A (zh) | 2003-06-18 |
CN101422372A (zh) | 2009-05-06 |
JP2003522576A (ja) | 2003-07-29 |
CN101422372B (zh) | 2013-06-12 |
EP3620210A1 (en) | 2020-03-11 |
US6842502B2 (en) | 2005-01-11 |
JP2013146637A (ja) | 2013-08-01 |
AU2001237051A1 (en) | 2001-08-27 |
JP5717788B2 (ja) | 2015-05-13 |
EP2311527A3 (en) | 2011-12-07 |
US7826592B2 (en) | 2010-11-02 |
US20030007601A1 (en) | 2003-01-09 |
EP1257325A2 (en) | 2002-11-20 |
EP2311527B1 (en) | 2019-08-28 |
WO2001060236A2 (en) | 2001-08-23 |
US20090074150A1 (en) | 2009-03-19 |
US20060050847A1 (en) | 2006-03-09 |
JP2011072818A (ja) | 2011-04-14 |
EP2311526A2 (en) | 2011-04-20 |
CA2400406A1 (en) | 2001-08-23 |
US7471765B2 (en) | 2008-12-30 |
CA2400406C (en) | 2012-05-08 |
EP2311526A3 (en) | 2011-12-07 |
EP1257325A4 (en) | 2006-01-04 |
US8135111B2 (en) | 2012-03-13 |
WO2001060236A3 (en) | 2002-02-07 |
US20110228906A1 (en) | 2011-09-22 |
EP2311527A2 (en) | 2011-04-20 |
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