JP2015146952A - Ultrasonic treatment apparatus and ultrasonic treatment system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To perform an ultrasonic treatment while suppressing an adverse effect on a normal tissue, etc.SOLUTION: An ultrasonic treatment apparatus includes an ultrasonic treatment probe 37 for irradiating a treatment target part of a living body with a treatment ultrasonic wave, and a treatment probe control part 49 for controlling the ultrasonic treatment probe 37. The ultrasonic treatment probe 37 includes a hemispherical concave surface where a plurality of treatment vibrators 39 are disposed for converting an electric signal to an ultrasonic wave and emitting the ultrasonic wave. On the basis of determination information that determines whether or not there exists an area where irradiation of a predetermined treatment ultrasonic wave is inhibited in a treatment ultrasonic wave irradiation route 404 of each treatment vibrator 39, the treatment probe control part 49 selectively turns off the electric signal supplied to the treatment vibrator for which there exists an area where irradiation of a predetermined treatment ultrasonic wave is inhibited.

Description

  The present invention relates to an ultrasonic therapy apparatus and an ultrasonic therapy system, and more particularly to an ultrasonic therapy apparatus and an ultrasonic therapy system using high intensity focused ultrasound (HIFU) therapeutic ultrasound.

  The HIFU treatment is a less invasive treatment in which treatment is performed by heating a living tissue of a treatment target site using ultrasonic waves focused at a high density and cauterizing the site. For example, it can be treated using an ultrasonic therapy probe placed in the rectum of a living body. Moreover, the ultrasonic therapy apparatus by HIFU introduced by patent document 1 is an ultrasonic therapy provided with the several treatment vibrator | oscillator (transducer) each driven by the electrical signal of the ultrasonic wave supplied from a multichannel generator. A probe is used to independently control the amplitude and frequency of electrical signals supplied to a plurality of treatment transducers.

Special table 2007-534398

  By the way, in the HIFU treatment described in Patent Document 1, all treatment transducers constituting the ultrasonic treatment probe are driven to irradiate the treatment target site (target) with HIFU. However, no consideration is given to adverse effects on normal tissues, adverse effects on normal tissues due to reflected ultrasound from bones, etc., or damage to ultrasonic therapy probes.

  The problem to be solved by the present invention is to provide an ultrasonic therapy apparatus capable of performing ultrasonic therapy while suppressing adverse effects on normal tissues and the like, and an ultrasonic therapy system including the same.

  In order to solve the above problems, an ultrasonic therapy apparatus of the present invention includes an ultrasonic therapy probe that irradiates a therapeutic ultrasonic wave to a treatment target site of a living body, and a therapeutic probe control unit that controls the ultrasonic therapy probe. The ultrasonic treatment probe includes a hemispherical concave surface on which a plurality of treatment transducers for converting an electrical signal into an ultrasonic wave and emitting the same, and the treatment probe control unit is configured to transmit a predetermined treatment ultrasonic wave. The electrical signal supplied to the treatment transducer in which the non-irradiation region exists is based on the discrimination information that determines whether or not the non-irradiation region exists in the treatment ultrasound irradiation path of each treatment transducer. It is characterized by being selectively turned off.

  That is, according to the present invention, there is a non-irradiable region based on the determination information that determines whether or not a predetermined therapeutic ultrasonic irradiation non-existent region exists in the therapeutic ultrasonic irradiation path for each treatment transducer. The electrical signal supplied to the treatment transducer is selectively turned off. As a result, the irradiation of the therapeutic ultrasonic wave to the region where, for example, normal tissue or bone, which is set to be impossible to be irradiated with the therapeutic ultrasonic wave, is turned off. As a result, it is possible to avoid or suppress the adverse effect on the normal tissue due to the therapeutic ultrasound, or the adverse effect of damaging the ultrasound therapeutic probe due to the reflected wave of the therapeutic ultrasound. In other words, based on the position and posture of the ultrasound treatment probe at the time of treatment (hereinafter collectively referred to as a position), the treatment ultrasound irradiation non-irradiation region on the treatment ultrasound irradiation path of each treatment transducer on the three-dimensional medical image. It is determined whether or not exists. Based on the discrimination information, the treatment vibrator existing in the treatment ultrasound non-irradiation region in the treatment ultrasound irradiation path is stopped, and, for example, the invasiveness to the normal tissue is reduced to the maximum. Thereby, both the improvement of the effect of ultrasonic therapy and the reduction of side effects can be achieved.

  ADVANTAGE OF THE INVENTION According to this invention, the ultrasonic treatment system provided with the ultrasonic treatment apparatus which can suppress the bad influence to a normal tissue etc. and can perform ultrasonic treatment, and the same apparatus can be provided.

1 is a diagram illustrating an overall configuration of an ultrasonic therapy system according to an embodiment of the present invention. It is a block block diagram of the ultrasonic therapy apparatus of one Embodiment of this invention. It is a figure explaining the structure of the ultrasonic treatment probe of one Embodiment of this invention. It is a figure explaining focused ultrasound treatment. It is a figure explaining the navigation guide display function of the ultrasonic treatment system of one embodiment of the present invention. It is a flowchart which shows the process sequence of the ultrasonic treatment system of one Embodiment of this invention. It is a figure explaining the example of irradiation by the ultrasonic treatment probe of one Embodiment of this invention. It is a figure explaining irradiation control of the treatment vibrator of the ultrasonic treatment probe of one embodiment of the present invention. It is a figure explaining the irradiation method of the ultrasonic treatment probe of one Embodiment of this invention. It is a figure explaining the relationship between the number of the active treatment vibrators of the ultrasonic treatment probe of one embodiment of the present invention, and the irradiation intensity of the treatment vibrator alone. It is a figure which shows the example of a GUI display at the time of the surgical treatment of the ultrasonic treatment system of this invention.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the accompanying drawings.

  FIG. 1 shows the overall configuration of the ultrasonic therapy system of the present invention. A magnetic resonance imaging (MRI) apparatus 1 that is a medical imaging apparatus is, for example, a vertical magnetic field permanent magnet type MRI apparatus, and connects an upper magnet 3 and a lower magnet 5 that generate a vertical static magnetic field, and connects these magnets. It includes a support column 7 that supports the magnet 3, a position detection device 9, an arm 11, monitors 13, 14, a monitor support unit 15, a reference tool 17, a personal computer 19, a bed 21, an MRI control unit 23, and the like. A gradient magnetic field generator (not shown) of the MRI apparatus 1 generates a territorial magnetic field. Further, the MRI apparatus 1 includes an RF transmitter (not shown) for generating nuclear magnetic resonance in the patient 24 in a static magnetic field and an RF receiver (not shown) for receiving a nuclear magnetic resonance signal from the patient 24.

  The position detection device 9 includes two infrared cameras 25 and a light emitting diode (not shown) that emits infrared light, and the position and posture of the pointer 27 attached to the ultrasonic therapy probe 37 (hereinafter collectively referred to as a position). .) Is detected. Thereby, the pointer 27 detects the position of the ultrasonic treatment probe 37 and functions as an instruction device for an imaging tomographic plane of the ultrasonic image and the MR image. Further, the position detection device 9 is connected to the upper magnet 3 so as to be movable by an arm 11 and is formed so that the arrangement with respect to the MRI apparatus 1 can be changed as appropriate. The monitor 13 displays an image of the tomographic plane of the patient 24 indicated by the pointer 27 held by the operator 29. The monitor 13 is connected to the upper magnet 3 by the monitor support unit 15 in the same manner as the infrared camera 25. The reference tool 17 links the coordinate system of the infrared camera 25 and the coordinate system of the MRI apparatus 1, includes three reflecting spheres 35, and is provided on the side surface of the upper magnet 3.

  Information of the pointer 27 detected and calculated by the infrared camera 25 is transmitted to the personal computer 19 as position data of the ultrasonic treatment probe 37 via, for example, the RS232C cable 33. The MRI control unit 23 is configured by a workstation and controls an RF transmitter, an RF receiver, and the like (not shown). Further, the MRI control unit 23 is connected to the personal computer 19. In the personal computer 19, the position data of the pointer 27 detected and calculated by the infrared camera 25 is converted into position data of the imaging range in the MRI apparatus 1 and transmitted to the MRI control unit 23. The position data is reflected in the control of the imaging section of the imaging sequence. The MR image acquired with the new imaging section is displayed on the monitor 13. MR images are simultaneously recorded in the video recording device 34. The ultrasonic therapy apparatus 40 is connected to the personal computer 19 so that an ultrasonic image obtained by the ultrasonic therapy probe 37 to which the pointer 27 is attached is displayed on a dedicated monitor 38. The ultrasonic image is transferred to the personal computer 19 for image processing, and displayed on the operator monitors 13 and 14. The ultrasonic therapy probe 37 is formed of a non-magnetic material such as ceramic that can be operated even in the magnetic field of the MRI apparatus 1. The ultrasonic therapy probe 37 may be selectively used as 2 MHz or 1 MHz as necessary.

  FIG. 2 shows a block configuration of the main part of the ultrasonic therapy apparatus 40. The ultrasonic therapy apparatus 40 includes an ultrasonic therapy probe 37 that treats a patient 24 by irradiating therapeutic ultrasound. In addition, the ultrasonic therapy apparatus 40 forms a two-dimensional ultrasonic image or a three-dimensional ultrasonic image for a diagnostic region using a reflected echo signal obtained by transmitting / receiving ultrasonic waves from the ultrasonic therapeutic probe 37 into the patient 24. And display. That is, as will be described later, the ultrasound treatment probe 37 includes a treatment probe 37a that irradiates treatment ultrasound (HIFU) and an imaging probe 37b that acquires a diagnostic ultrasound image. The ultrasonic therapy apparatus 40 also transmits an ultrasonic transmission / reception unit 44 that transmits / receives an ultrasonic signal to / from the imaging probe 37b, and a two-dimensional ultrasonic image (for example, a B-mode image) or a three-dimensional ultrasonic image based on the received signal. The ultrasonic image forming unit 45 to be configured, the display unit 46 for displaying the ultrasonic image formed by the ultrasonic image forming unit 45, and the ultrasonic intensity supplied to the treatment probe 37a and the imaging probe 37b to be irradiated to the patient 24 are switched. The HIFU controller 49 includes an ultrasonic control unit 47 that controls each component, and a control panel 48 that gives instructions to the ultrasonic control unit 47.

  The HIFU controller 49 is a treatment probe control unit referred to in the present invention. When the ultrasonic treatment apparatus 40 is operated as a diagnostic apparatus, the imaging probe 37b is driven to irradiate the patient 24 with weak ultrasonic waves for imaging, and the treatment is performed. When operating as a device, the treatment probe 37a is driven to irradiate the patient 24 with a strong ultrasonic wave for treatment. In this example, the ultrasonic diagnostic apparatus is incorporated into the ultrasonic therapeutic apparatus 40, but the ultrasonic diagnostic apparatus and the ultrasonic therapeutic apparatus may be configured as separate apparatuses.

FIG. 3 shows a configuration diagram of an embodiment of the ultrasonic therapy probe 37 according to the feature of the present invention. 4A is a cross-sectional view of a plane passing through the central axis of the ultrasonic treatment probe 37, and FIG. 4B is a front view of the ultrasonic treatment probe 37 viewed from the ultrasonic emission surface side. As can be seen from the figure, the ultrasonic treatment probe 37 includes a treatment probe 37a for HIFU irradiation disposed on a hemispherical concave surface and an imaging probe 37b for acquiring diagnostic images disposed on the central axis of the concave surface. It is formed with. As shown in FIG. 5B, the treatment probe 37a divides the concave surface into a plurality of concentric annular regions and further divides the annular region into a plurality of regions in the radial direction. 39 is provided. In other words, the treatment probe 37a of the ultrasonic treatment probe 37 is configured as a two-dimensional matrix array transducer in which a plurality of treatment transducers 39 are arranged. Here, the number of divisions of the plurality of treatment transducers 39 is generally 2 ⁿ . For example, the imaging probe 37b in which 512 or 1024 channels are used includes the focus of the treatment target region. It is a diagnostic ultrasound probe for imaging and rendering a tomographic plane 601.

With reference to FIG. 4, the outline | summary which irradiates a focused ultrasound (HIFU) with the ultrasonic therapy apparatus 40 comprised in this way is demonstrated. As shown in FIG. 4A, the HIFU 404 from the ultrasonic treatment probe 37 is irradiated so as to be focused on a focal point 403 set in a treatment target region (target) 402. As shown in FIG.4 (b), the range cauterized by one time of HIFU irradiation is 5-10 mm in diameter (PHI), for example. Therefore, when performing treatment by HIFU irradiation, as shown in FIG. 4C, the position of the focal point 403, which is the irradiation position of the HIFU 404, is sequentially moved to irradiate the entire treatment target region (target) 402 with the HIFU 404. To do. At that time, the imaging probe 37b attached to the center of the ultrasonic therapy probe 37 monitors the state of treatment. However, if treatment and monitoring are performed simultaneously, they will appear in the image as noise. Therefore, a clear diagnostic image free from noise is acquired by operating the treatment probe 37a and the imaging probe 37b alternately. In addition, by performing focus visualization by ARFI (Acoustic Radiation Force Impulse) as shown in Non-Patent Document 1 below, an actual affected area in a living tissue is calculated with respect to an ideal ablation area, and three-dimensional measurement is performed. Can be used to calculate a three-dimensional scheduled treatment area.
Palmeri ML, Wang MH, Dahl JJ, Frinkley KD, et al. Quantifyinghepatic shear modulus in vivo using acoustic radiation force.Ultrasound inMedicine & Biology 2008; 34: 546-58.

  Next, the navigation guide display function of this embodiment will be described with reference to FIG. The surgeon 29 adjusts the focal point 403 of the ultrasonic therapy probe 37 connected to the ultrasonic therapy apparatus 40 with respect to the patient 24 to one point of the treatment target site (target). That is, the position of the ultrasonic treatment probe 37 is detected from the position of the pointer 27 with an infrared camera attached to the position detection device 9, and simulated images of the focal point 403 and the HIFU 404 of the treatment probe 37 a are respectively displayed on the navigation screen 531 to 534. Is displayed. The surgeon 29 operates the position of the ultrasonic therapy probe 37 while looking at the navigation screen 531 to 534 to adjust the focus 403 of the therapy probe 37a to the target. As the navigation screen configuration, for example, a three-dimensional volume rendering image 534 or the like can be used in addition to the three-axis cross sections (Axial, Sagittal, Coronal) 531 to 533, but can be freely customized. In addition, the operator 29 sets a treatment scheduled area 536, a warning area, a margin, and the like in advance.

  In addition to the simulated image of the ultrasound treatment probe 37, preoperative planning (surgical simulation) information 537 can be superimposed on the navigation image. In the case of the volume rendering image 534 or the like, the treatment scheduled area 536 can be displayed in a three-dimensional manner. Further, it is possible to provide a function of issuing a warning when entering the scheduled treatment area 536 or the warning area on the navigation images 531 to 534. In addition, for example, when the treatment scheduled area 536 enters the warning area, a function of automatically changing the navigation image and the treatment parameter can be provided.

  When the above-described operation is performed inside the gantry of the MRI apparatus, the above-described information is fed back continuously and in real time to the ultrasound treatment system, and the same MRI including a simulated image of the ultrasound treatment probe 37 in the treatment target region. An imaging cross-sectional image 508 and an ultrasonic image 509 can be displayed. That is, the surgeon 29 can use the two-dimensional real-time image obtained by the MRI apparatus 1 and the three-dimensional image information obtained by navigation for treatment as necessary. As one application of the high-speed imaging sequence of the MRI apparatus 1, a real-time dynamic imaging method called fluoroscopy (perspective imaging) is being clinically applied. In fluoroscopy, by repeating imaging and image reconstruction with a period of about 1 second or less, it can be used to extract the dynamics of internal tissues and to grasp the position of an instrument inserted from the outside like a fluoroscopic imaging. Generate and display dynamic images. This application is also applied to three-dimensional high-speed imaging.

  FIG. 6 shows a flowchart of a processing procedure of an embodiment of the ultrasonic therapy system of the present invention. In particular, the description will focus on performing HIFU irradiation while suppressing adverse effects on normal tissues and the like using the ultrasonic treatment probe 37 that is a feature of the present invention. First, a plurality of three-dimensional volume imaging and three-dimensional reconstruction of a three-dimensional image are performed using the MRI apparatus 1 (S101). Next, a specific region (segmentation) that requires treatment is depicted by image processing from the three-dimensionally reconstructed three-dimensional image (S102). Based on the rendered image including the specific area, the area that allows HIFU irradiation and the area that cannot be irradiated are discriminated and set (S103). Next, a treatment area and a margin area including them are set (S104). After inputting necessary parameters for HIFU irradiation (S105), the HIFU treatment plan is executed to simulate the position of the ultrasonic treatment probe 37 (S106). After the treatment plan, the operation support guidance function such as navigation is activated (S107), and the operation is started (S108).

  At the time of surgery, following the change in the position of the ultrasonic treatment probe 37, a simulated image indicating the focal position of the treatment probe 37a and the HIFU irradiation path is superimposed and displayed on the navigation image (S109). Thereby, the surgeon 29 guides the ultrasonic treatment probe 37 to the treatment plan position (target position) using the GUI and numerical information (S110). After the guidance, the position of the target is confirmed by an ultrasonic image or MR image, and then HIFU treatment is started (S111).

  Next, in step S112, with respect to the plurality of treatment transducers 39 of the HIFU treatment probe 37a of the ultrasound treatment probe 37, the HIFU irradiation that is a predetermined treatment ultrasound is applied to the HIFU irradiation path that is the respective ultrasound irradiation path. The existence of the possible area and the impossible area is determined. Specifically, the path of HIFU irradiation irradiated from each treatment transducer 39 is calculated based on the position of the ultrasonic treatment probe 37. And it is discriminate | determined whether it passes through the HIFU non-irradiation area | region preset on the navigation image. This determination can be performed by, for example, the personal computer 19 in FIG. 1, but can also be performed by the HIFU controller 49 in FIG. In short, based on the image data of the navigation images 531 to 534 reconstructed by the MRI apparatus 1, the simulated image of the ultrasonic treatment probe 37, and the shape data of the treatment probe 37 a of the ultrasonic treatment probe 37, the treatment transducers 39. The HIFU irradiation route is obtained. Then, it is determined whether or not a predetermined HIFU irradiation impossible area exists in the obtained HIFU irradiation path, and the determination information is output to the HIFU controller 49.

  When the HIFU irradiation path irradiated from a certain treatment transducer 39 passes through the HIFU non-irradiable region based on the determination information input from the outside such as the personal computer 19 or the determination information obtained by itself, the HIFU controller 49 The treatment transducer 39 is turned off (inactive), and is turned on (active) when not passing through the HIFU non-irradiable region (S112). This determination is performed by all the treatment transducers 39 and treatment is started (S113). At the time of HIFU treatment, an MR image or an ultrasonic image (for example, monitoring the state of treatment at the B image) is performed. The same treatment is performed until the brightness value of the treatment area on the ultrasound image is equal to or higher than the specified value or whether echo shadow has occurred, or until the MR measurement temperature value of the treatment area on the MR image is equal to or higher than the specified value. The sequence is repeated and the HIFU treatment sequence is immediately changed when the specified value is exceeded. These treatment sequences can be registered in advance, and can be corrected while viewing the treatment status. The HIFU treatment is repeated until the specific region (treatment essential region: segmentation) is completely treated (S114). And after implementation of step S114, the presence or absence of the remaining treatment area | region is judged, and if there is no remaining treatment area | region, HIFU treatment will be complete | finished after a treatment effect confirmation (S115).

  7A and 7B show examples of HIFU irradiation by the ultrasonic therapy probe 37. FIG. This figure shows an example in which all treatment transducers 39 of the treatment probe 37a are turned on (active). The HIFU 404 irradiated from the treatment probe 37a is focused on the focal point 403 through a prescribed HIFU irradiation path. The HIFU 404 always passes through the same HIFU irradiation path 404 a and the focal point 403 as long as the driving conditions of the treatment transducer 39 of the ultrasonic treatment probe 37 are controlled to be the same. Further, the focal point 403 can be moved back and forth and right and left by independently controlling the treatment transducers 39 of the treatment probe 37a and controlling the phase of the treatment ultrasound. As a result, the shochu range can be widened.

  FIG. 8 shows an example in which the treatment transducer 39 of the treatment probe 37a is selectively turned on (active) or turned off (inactive). FIG. 6A shows that the upper half of the plurality of treatment vibrators 39 are active treatment vibrators 39a (shaded portions in the figure), and the lower half of the plurality of treatment vibrators 39 are inactive treatment vibrations. This is an example (CASE 1) in which a child 39b (outlined portion in the figure) is used. FIG. 7B shows an example (CASE 2) in which a plurality of treatment transducers 39 are divided into four fan-shaped regions every 90 degrees, and are alternately set as active treatment transducers 39a and inactive treatment transducers 39b. . FIG. 6C shows an example (CASE 3) in which a plurality of treatment transducers 39 are divided into eight fan-shaped regions of 45 degrees and are alternately set as active treatment transducers 39a and inactive treatment transducers 39b. . These are examples of setting, and it goes without saying that ON / OFF can be set for each treatment transducer 39.

  With reference to FIG. 9, the control example which irradiates the treatment target site by avoiding the HIFU non-irradiation region by the ultrasonic therapy apparatus 40 including the ultrasonic therapy probe 37 according to the embodiment of the present invention will be described. . As shown in FIG. 6A, a volume rendering image 934 is displayed on the navigation screen in addition to the triaxial sections (Axial, Sagittal, Coronal) 931-933. The combination of display images on the navigation screen can be customized freely. In the illustrated example, the position of the ultrasonic treatment probe 37 whose position has been detected, the focal point, and the HIFU irradiation path are superimposed on the navigation screen 931 to 934, respectively. Further, a rib 936 captured in advance is superimposed on the navigation screens 931 to 934.

  In the example of FIG. 9, the rib 936 is set as an unirradiable region. That is, when the HIFU is irradiated to the rib 936, the reflected wave of the HIFU diffusely reflected by the rib 936 may be irradiated to the surrounding normal tissue or the treatment transducer 39 of the treatment probe 37a. Such a reflected wave of the HIFU may have an adverse effect that the normal tissue is damaged or the therapeutic transducer 39 is damaged. In order to avoid such adverse effects, the personal computer 19 or the HIFU controller 49 obtains the HIFU irradiation paths 404a of all the treatment transducers 39 at the position of the ultrasonic treatment probe 37 in FIG. It is determined whether or not the rib 936 set as the non-irradiation region exists in the irradiation path 404a. Then, based on the discrimination information, the treatment transducer 39 having the non-irradiable area in the HIFU irradiation path 404a is determined as the inactive 39b by the HIFU controller 49, and is determined as the active 39a when there is no non-irradiable area in the HIFU irradiation path 404a. Is done. Such discriminating information or information on the active 39a or inactive 39b of the treatment transducer 39 can be displayed as an image on the navigation image as shown in FIGS. 9B and 9C. Thereby, the operator 29 can obtain information on whether or not the position of the ultrasonic therapy probe 37 is visually appropriate.

  By the way, when the plurality of treatment transducers 39 are controlled to be turned on and off as shown in FIG. 9, the HIFU irradiation amount (treatment energy) is reduced by the amount of the treatment transducers 39 that are turned off. Thus, as the number of active treatment transducers 39a decreases, the treatment energy applied to the focal point decreases. As a result, a sufficient antitumor effect may not be obtained, or the treatment time with HIFU may be prolonged.

  Here, with reference to FIG. 10, a method of compensating for the decrease in the treatment energy of the treatment transducer 39b that has been deactivated will be described. That is, the decrease in the treatment energy of the deactivated treatment transducer 39b is compensated by the treatment energy of the HIFU of the other active treatment transducer 39a. 10A and 10B, the horizontal axis indicates the total number of active therapeutic transducers 39, and the vertical axis indicates the treatment energy (intensity) of a single therapeutic transducer 39. FIG. 6A shows a low intensity irradiation corresponding to a relatively weak intensity treatment, and FIG. 9B shows a high intensity irradiation corresponding to a high intensity treatment. That is, as shown in these figures, the basic intensity graph of the single intensity of the active treatment oscillator 39a is set in two ways, for example, when treatment is relatively weak and when treatment is performed with high intensity. Yes. These graphs are set in advance by the user, and in actual treatment, irradiation is automatically compensated according to the graph of FIG. That is, when the number of inactive therapeutic transducers 39b increases, the total number of active therapeutic transducers 39a decreases. In this case, it is possible to compensate for the decrease in the treatment energy (intensity) by increasing the single treatment energy (intensity) of the active treatment vibrator 39a according to the reduction in the total number of active treatment vibrators 39a. it can.

  In addition, when the number of active treatment transducers 39a decreases below a preset threshold value 105, the HIFU treatment may not be performed. In this case, a warning that prompts the operator 29 to move the ultrasonic treatment probe 37 is issued, the position of the ultrasonic treatment probe 37 is changed, and the HIFU irradiation path 404a of the treatment transducer 39 is set again as an unirradiable region. It is determined whether or not the rib 936 or the like is present. Based on the discrimination information, active or inactive therapeutic transducers 39a and 39b are set. As a result, it is possible to suppress a decrease in treatment efficiency (or treatment effect) due to the small number of treatment transducers 39, and to obtain an effect of reducing unnecessary treatment (intervention) for the patient. As a method of compensating for the decrease in the treatment energy of the HIFU of the deactivated treatment transducer 39b, instead of increasing the strength of the active single treatment transducer 39a, the HIFU of the active treatment transducer 39a The irradiation time can be lengthened to compensate for the HIFU energy applied to the treatment target site.

  FIG. 11 shows a GUI display example at the time of surgery / treatment by the ultrasonic therapy system of the present invention. When the three-dimensional imaging button 1101 is pressed, the axial section 1131, the sagittal section 1132, the coronal section 1133, and the volume rendering screen 1134 are reconfigured. Further, when a segmentation button 1102 is pressed, segmentation / region extraction is performed automatically (or manually). Further, by pressing the HIFU irradiation enable / disable area setting button 1103, the HIFU irradiation disabled area 1140 is identified in addition to the areas 1139 and 1119 to be treated with respect to the drawn segmentation information. In addition, by pressing the treatment plan / margin setting button 1104, the treatment route 1138 can be calculated in advance, and guidance can be provided along the treatment route. These pieces of information can be freely rotated on the volume rendering screen 1134 and can be viewed from another viewpoint / angle. Also, tumor areas (treatment areas) 1139 and 1119 and a margin area 1120 including them are set.

  Also, by pressing a treatment parameter setting button 1105, a treatment parameter for the treatment region can be input. Specific input values include the HIFU probe type, shape, output intensity, and unit output intensity for each treatment transducer. When an actual operation is performed, a navigation button 1106 is pressed to operate an operation support function such as a device necessary for treatment and navigation. The position of the ultrasonic treatment probe 37 is detected, and a simulated image of the ultrasonic treatment probe 37 is superimposed and displayed on the Axial cross section 1131, the Sagittal cross section 1132, the Coronal cross section 1133, and the volume rendering screen 1134. The surgeon 29 guides the ultrasonic therapy probe 37 with reference to the previously obtained treatment path 1138. In addition, the past path of the ultrasonic therapy probe 37 can be displayed. In addition to the treatment progress / biological information on the information screen 1125, the difference between the tumor area and the treatment area, the number of treatments, the time, the ratio, and the remaining treatment The frequency schedule can also be displayed in real time as surgery information.

  Immediately before the treatment, when the treatment oscillator calculation / setting button 1107 is pressed, the HIHU irradiation path 404 for the target 402 is depicted on the GUI. Here, when the HIHU irradiation path 404 is present in the rib 936 that is an unirradiable region, the treatment transducer 39 is automatically turned off and inactive. This calculation is performed for all the treatment transducers 39, and finally, the information is visually displayed to the operator 29 by displaying the information on the navigation image. For example, when the HIFU irradiation path 404a of the treatment transducer 39 is calculated for the ultrasonic treatment probe 37, the treatment transducers 39 that are not irradiated to the ribs 936 are determined, and active and inactive treatment transducers 39a and 39b are determined. . The information is displayed on the navigation image and transmitted to the operator 29. When the number of active and inactive therapeutic transducers 39a and 39b is determined, the output intensity of a single active therapeutic transducer 39 is automatically corrected to compensate the irradiation energy. The compensation coefficient is determined by a preset irradiation intensity. By pressing the HIFU irradiation / effect confirmation button 1108, the HIFU and imaging ultrasound are alternately irradiated, the treatment information / ultrasound image 1117 of the treatment area for the target 402 is displayed in real time, and various warning information is displayed on the treatment image. Can also be displayed. For example, there is also a function for automatically turning on / off a function for issuing a warning when a region 1118 that has been treated in the past is displayed in a superimposed manner and the planned treatment region is exceeded or an abnormality occurs in the patient. doing.

  In addition to the target 402, a remaining treatment area (= target 402-treated area 1118) and a margin 1120 are also displayed. As a result, the operator 29 can visually recognize the remaining treatment area, and if the MRI apparatus 1 is under imaging, the operator 29 also has a function of alternately imaging MRI imaging and ultrasonic imaging. . On the MR image, the specific region, the margin region, and the treatment planned region by ARFI are displayed in the same manner, and images having different tissue contrasts are displayed. The surgeon 29 determines whether or not to perform retreatment from the image information 1131 to 1134 before and after the treatment and the operation information 1125, and performs retreatment as necessary. Further, as an advantage of the MRI apparatus, it is possible to image the deep part of the body. Thus, the operator 29 can perform the movement of the surgical tool and the additional treatment while viewing the previous treatment image. For the information before and after treatment, in addition to the ultrasonic image 1117, the three-axis cross sections 1131 to 1133, the volume rendering image 1134, and the MR image, all the surgical information 1125 can be linked.

  As mentioned above, although this invention was demonstrated based on one Embodiment, this invention is not limited to these, It is possible to implement in the form deform | transformed or changed in the range of the main point of this invention. It will be obvious to those skilled in the art, and it is obvious that such modifications or alterations belong to the scope of the claims of the present application.

  That is, the ultrasonic treatment probe 37 according to the above-described embodiment includes a plurality of regions obtained by dividing the plurality of treatment transducers 39 into a plurality of concentric annular regions on the concave surface and dividing the annular region in the radial direction. Although the thing arrange | positioned to each of these was shown, it is not restricted to such an arrangement | positioning. Further, although the treatment vibrator 39 has been described as having an equal area, it can be formed with different areas. In that case, it is necessary to compensate for the HIFU irradiation energy of the treatment vibrator to be deactivated in consideration of the HIFU irradiation energy of a single treatment vibrator correlated with the area of each treatment vibrator.

  In addition, the compensation of the HIFU irradiation energy of the treatment vibrator 39b to be deactivated is performed by controlling at least one of the amplitude and the irradiation time of the HIFU of the electric signal supplied to the active treatment vibrator 39a. The energy of the therapeutic ultrasonic wave emitted from the treatment ultrasonic wave can be increased to supplement the energy of the therapeutic ultrasonic wave emitted from the deactivated therapeutic transducer 39b.

  In the above-described embodiment, an example of an MRI apparatus is shown as a medical image apparatus constituting an ultrasonic treatment system. However, the present invention is not limited to other medical image apparatuses (for example, an X-ray CT apparatus, an ultrasonic diagnostic apparatus, etc. ) Can be used. In other words, in addition to the ultrasonic therapy apparatus 40 of the above embodiment, the ultrasonic therapy system of the present invention includes a medical image apparatus that acquires three-dimensional volume image data of a living body including a treatment target site, and the position of the ultrasonic therapy probe. Based on the position detection device that detects the image in association with the coordinate system of the three-dimensional volume data and the position of the ultrasonic treatment probe detected by the position detection device, each treatment transducer irradiates the treatment target site. The ultrasonic irradiation route calculation unit for obtaining the ultrasonic irradiation route and whether or not there is a treatment ultrasonic irradiation non-predetermined region set in advance in each of the ultrasonic irradiation routes obtained by the ultrasonic irradiation route calculation unit. An irradiation non-irradiation region determination unit that outputs the determined determination information to the treatment probe control unit can be provided.

  DESCRIPTION OF SYMBOLS 1 ... MRI apparatus, 9 ... Position detection device, 13, 14 ... Monitor, 17 ... Reference tool, 19 ... Personal computer, 23 ... MRI control part, 24 ... Patient, 25 ... Infrared camera, 27 ... Pointer, 29 ... Operator 35 ... Reflective sphere, 37 ... Ultrasound treatment probe, 37a ... Treatment probe, 37b ... Imaging probe, 38 ... Ultrasonic monitor, 39, 39a, 39b ... Treatment transducer, 40 ... Ultrasound treatment device, 46 ... Display unit 47 ... Ultrasonic controller, 48 ... Control panel, 49 ... HIFU controller

Claims (5)

An ultrasound treatment probe that irradiates a treatment target region of a living body with an ultrasound treatment probe, and a treatment probe control unit that controls the ultrasound treatment probe, wherein the ultrasound treatment probe converts an electrical signal into ultrasound. A hemispherical concave surface on which a plurality of treatment vibrators to be ejected are arranged,
The treatment probe control unit includes the non-irradiation regions based on discrimination information indicating whether or not a predetermined treatment ultrasonic wave irradiation non-existence region exists in the ultrasonic irradiation path of each treatment transducer. An ultrasonic therapy apparatus that selectively turns off the electrical signal supplied to the therapy transducer.   The treatment oscillator is provided in each of a plurality of regions obtained by dividing the concave surface into a plurality of concentric annular regions and dividing the annular region in a radial direction. Item 2. The ultrasonic therapy apparatus according to Item 1.   The ultrasonic treatment apparatus according to claim 2, wherein the treatment vibrators are formed to have an equal area.   The treatment probe control unit controls at least one of an amplitude and an irradiation time of the electrical signal supplied to the treatment transducer, and increases the energy of the treatment ultrasound emitted from the treatment transducer that is turned on. The ultrasonic therapeutic apparatus according to claim 1, wherein energy of therapeutic ultrasonic waves emitted from the turned off therapeutic transducer is supplemented. The ultrasonic therapy apparatus according to any one of claims 1 to 4,
A medical image device for acquiring three-dimensional volume image data of the living body including the treatment target part;
A position detection device for detecting the position and orientation of the ultrasonic therapy probe in association with a coordinate system of three-dimensional volume data;
Based on the position and orientation of the ultrasonic treatment probe detected by the position detection device, an ultrasonic irradiation path calculation unit for obtaining an ultrasonic irradiation path to be irradiated to the treatment target site from each of the treatment transducers;
The discrimination information for discriminating whether or not there is a pre-set therapeutic ultrasound irradiation non-existence area in each of the ultrasound irradiation paths obtained by the ultrasound irradiation path calculation unit is output to the therapy probe control unit An ultrasonic therapy system comprising: an unirradiable area determination unit.

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