JP2015533581A - 放射線療法に対する生理学的反応の画像化を用いる治療の評価及び改善 - Google Patents
放射線療法に対する生理学的反応の画像化を用いる治療の評価及び改善 Download PDFInfo
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- A61B5/0033—Features or image-related aspects of imaging apparatus classified in A61B5/00, e.g. for MRI, optical tomography or impedance tomography apparatus; arrangements of imaging apparatus in a room
- A61B5/0036—Features or image-related aspects of imaging apparatus classified in A61B5/00, e.g. for MRI, optical tomography or impedance tomography apparatus; arrangements of imaging apparatus in a room including treatment, e.g., using an implantable medical device, ablating, ventilating
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- A61N5/00—Radiation therapy
- A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
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- A61N5/00—Radiation therapy
- A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
- A61N5/1048—Monitoring, verifying, controlling systems and methods
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
- A61N5/1048—Monitoring, verifying, controlling systems and methods
- A61N5/1071—Monitoring, verifying, controlling systems and methods for verifying the dose delivered by the treatment plan
Abstract
Description
本出願は、2012年10月26日に提出された米国仮特許出願第61/719,337に対する35USC§119(e)の優先権を主張するものであり、その開示はその全体が参考として援用される。
Claims (22)
- 放射線治療のコースの少なくとも一部の間又は後に行われる後続の浮腫分析と、基準浮腫分析(前記放射線治療のコースから得られる患者の組織における浮腫の変化を評価するために前記後続の浮腫分析の前に行われる)とを比較し、
前記放射線治療のコース中に放射線の照射線量と相関関係がある患者の組織の浮腫の変化の少なくとも一部に基づき浮腫の照射線量相関を導出し、
前記浮腫の放射線量相関に基づいて1以上の臨床行動を行う、
ことを含む方法。 - 前記後続の浮腫分析及び基準浮腫分析は、MRIスキャン、T1強調MRIスキャン、T2強調MRIスキャン、T1強調MRIスキャン結果に対するT1強調MRIの比率、及びMRI反応率の少なくとも1つを含む、請求項1に記載の方法。
- 前記比較は、前記浮腫の変化のプロキシとして前記患者の組織における遊離水素の含有量の変化を定量化することを含み、前記定量化は、前記患者の組織の位置の関数として遊離水素の相対量を導出するために前記後続の浮腫分析及び前記基準浮腫分析の差次的分析を行うことを含む、請求項1〜2のいずれか1つに記載の方法。
- 前記浮腫の照射線量相関の導出は、前記患者の組織に実際に照射された放射線の量及び前記患者の組織に照射される放射線の期待量の1以上を導出するために、物理的な線量照射の推定又はモデルの1以上を適用することを含む、請求項1〜3のいずれか1つに記載の方法。
- 前記患者の組織に実際に照射された又は照射されるべきと期待される放射線の導出量は、1以上の入力の少なくとも一部に基づいており、前記少なくとも1つの入力は、事前の放射線治療計画、及び前記患者の組織のイントラ・フラクション動作に基づき放射線の受信線量を推定するMRI及び放射線照射アプローチの組合せの少なくとも1つを含む、請求項4に記載の方法。
- 更に、前記照射線量と前記患者の組織における浮腫の変化とを関連付けることを含み、前記関連付けは、前記浮腫の変化が、期待値と比較して前記疾患組織及び周囲組織の期待される治療効果にどの程度対応するかを定量化することを含む、請求項1〜5のいずれか1つに記載の方法。
- 前記浮腫の照射線量相関に基づく前記1以上の臨床行動は、更なる分析のための前記治療のコースを停止すること、臨床医に警告すること、前記治療のコースの後期のフラクションで照射される放射線量を増加すること、及び前記治療のコースの後期のフラクションで照射される放射線の量を減少させることの少なくとも1つを含む、請求項1〜6のいずれか1つに記載の方法。
- オペレーションを行うように構成されたハードウェアを備えるシステムであって、前記オペレーションは、
放射線治療のコースの少なくとも一部の間又は後に行われる後続の浮腫分析と、基準浮腫分析(前記放射線治療のコースから得られる患者の組織における浮腫の変化を評価するために前記後続の浮腫分析の前に行われる)とを比較し、
前記放射線治療のコース中に放射線の照射線量と相関関係がある患者の組織の浮腫の変化の少なくとも一部に基づき浮腫の照射線量相関を導出し、
前記浮腫の放射線量相関に基づいて1以上の臨床行動を行う、
ことを含む方法。 - 前記後続の浮腫分析及び基準浮腫分析は、MRIスキャン、T1強調MRIスキャン、T2強調MRIスキャン、T1強調MRIスキャン結果に対するT1強調MRIの比率、及びMRI反応率の少なくとも1つを含む、請求項8に記載のシステム。
- 前記比較は、前記浮腫の変化のプロキシとして前記患者の組織における遊離水素の含有量の変化を定量化することを含み、前記定量化は、前記患者の組織の位置の関数として遊離水素の相対量を導出するために前記後続の浮腫分析及び前記基準浮腫分析の差次的分析を行うことを含む、請求項8〜9のいずれか1つに記載のシステム。
- 前記浮腫の照射線量相関の導出は、前記患者の組織に実際に照射された放射線の量及び前記患者の組織に照射される放射線の期待量の1以上を導出するために、物理的な線量照射の推定又はモデルの1以上を適用することを含む、請求項8〜10のいずれか1つに記載のシステム。
- 前記患者の組織に実際に照射された又は照射されるべきと期待される放射線の導出量は、1以上の入力の少なくとも一部に基づいており、前記少なくとも1つの入力は、事前の放射線治療計画、及び前記患者の組織のイントラ・フラクション動作に基づき放射線の受信線量を推定するMRI及び放射線照射アプローチの組合せの少なくとも1つを含む、請求項11に記載のシステム。
- 前記オペレーションは、更に、前記照射線量と前記患者の組織における浮腫の変化とを関連付けることを含み、前記関連付けは、前記浮腫の変化が、期待値と比較して前記疾患組織及び周囲組織の期待される治療効果にどの程度対応するかを定量化することを含む、請求項8〜12のいずれか1つに記載のシステム。
- 前記浮腫の照射線量相関に基づく前記1以上の臨床行動は、更なる分析のための前記治療のコースを停止すること、臨床医に警告すること、前記治療のコースの後期のフラクションで照射される放射線量を増加すること、及び前記治療のコースの後期のフラクションで照射される放射線の量を減少させることの少なくとも1つを含む、請求項8〜13のいずれか1つに記載のシステム。
- 前記放射線治療に使用するための1以上の治療ビームを生成する放射線源であって、前記1以上の治療ビームは、陽子ビーム、重イオンビーム、中性子ビーム、ガンマ放射線ビーム、ベータ放射線ビーム、アルファ放射線ビーム、電離放射線ビーム、及びX線ビームの1以上を含む、放射線源、及び
前記ハードウェアと通信し、前記後続の浮腫分析及び前記基準浮腫分析に使用されるMRIスキャンを生成するMRI装置、
の少なくとも1つを更に含む、請求項8〜14のいずれか1つに記載のシステム。 - 少なくとも1つのプロセッサで実行されたとき、少なくとも1つのプログラマブル・
プロセッサにオペレーションを行わせる命令を記憶する機械可読媒体を備えるコンピュータプラグラムであって、前記オペレーションは、
放射線治療のコースの少なくとも一部の間又は後に行われる後続の浮腫分析と、基準浮腫分析(前記放射線治療のコースから得られる患者の組織における浮腫の変化を評価するために前記後続の浮腫分析の前に行われる)とを比較し、
前記放射線治療のコース中に放射線の照射線量と相関関係がある患者の組織の浮腫の変化の少なくとも一部に基づき浮腫の照射線量相関(edema to delivered dose correlation)を導出し、
前記浮腫の放射線量相関に基づいて1以上の臨床行動を行う、
ことを含む、コンピュータプログラム。 - 前記後続の浮腫分析及び基準浮腫分析は、MRIスキャン、T1強調MRIスキャン、T2強調MRIスキャン、T1強調MRIスキャン結果に対するT1強調MRIの比率、及びMRI反応率の少なくとも1つを含む、請求項16に記載のコンピュータプログラム。
- 前記比較は、前記浮腫の変化のプロキシとして前記患者の組織における遊離水素の含有量の変化を定量化することを含み、前記定量化は、前記患者の組織の位置の関数として遊離水素の相対量を導出するために前記後続の浮腫分析及び前記基準浮腫分析の差次的分析を行うことを含む、請求項16〜17のいずれか1つに記載のコンピュータプログラム。
- 前記浮腫の照射線量相関の導出は、前記患者の組織に実際に照射された放射線の量及び前記患者の組織に照射される放射線の期待量の1以上を導出するために、物理的な線量照射の推定又はモデルの1以上を適用することを含む、請求項16〜18のいずれか1つに記載のコンピュータプログラム。
- 前記患者の組織に実際に照射された又は照射されるべきと期待される放射線の導出量は、1以上の入力の少なくとも一部に基づいており、前記少なくとも1つの入力は、事前の放射線治療計画、及び前記患者の組織のイントラ・フラクション動作に基づき放射線の受信線量を推定するMRI及び放射線照射アプローチの組合せの少なくとも1つを含む、請求項19に記載のコンピュータプログラム。
- 更に、前記照射線量と前記患者の組織における浮腫の変化とを関連付けることを含み、前記関連付けは、前記浮腫の変化が、期待値と比較して前記疾患組織及び周囲組織の期待される治療効果にどの程度対応するかを定量化することを含む、請求項16〜20のいずれか1つに記載のコンピュータプログラム。
- 前記浮腫の照射線量相関に基づく前記1以上の臨床行動は、更なる分析のための前記治療のコースを停止すること、臨床医に警告すること、前記治療のコースの後期のフラクションで照射される放射線量を増加すること、及び前記治療のコースの後期のフラクションで照射される放射線の量を減少させることの少なくとも1つを含む、請求項16〜21のいずれか1つに記載のコンピュータプログラム。
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WO2014066853A1 (en) | 2014-05-01 |
US10835763B2 (en) | 2020-11-17 |
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US20190022413A1 (en) | 2019-01-24 |
JP6791915B2 (ja) | 2020-11-25 |
EP2911745A1 (en) | 2015-09-02 |
JP2018192281A (ja) | 2018-12-06 |
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CN108452443B (zh) | 2021-05-18 |
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EP3628370A1 (en) | 2020-04-01 |
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CN104902956A (zh) | 2015-09-09 |
AU2013334064A1 (en) | 2015-05-14 |
CA2888993A1 (en) | 2014-05-01 |
US20140121495A1 (en) | 2014-05-01 |
EP2911745B1 (en) | 2019-08-07 |
CN108452443A (zh) | 2018-08-28 |
US20210308488A1 (en) | 2021-10-07 |
AU2018203000A1 (en) | 2018-05-17 |
AU2018203000B2 (en) | 2020-09-17 |
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US20180133511A1 (en) | 2018-05-17 |
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