JP2017205482A - Support device and support method - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a support device for supporting positioning of an ultrasonic probe in radiation therapy, and to provide a supporting method.SOLUTION: A support device includes: a calculation part; and a notification control part. The calculation part calculates a recommendation degree of positioning of an ultrasonic probe for scanning a target part when it is irradiated, for each position of a treatment subject based on an irradiation plan for the target part of the treatment subject. The notification control part notifies an operator of the recommendation degree associating it with a position of the treatment subject.SELECTED DRAWING: Figure 7

Description

  Embodiments described herein relate generally to a support device and a support method.

  2. Description of the Related Art Conventionally, a guide function based on an ultrasonic image is known in a radiation treatment system that treats a target site by irradiating a target site (for example, a tumor or the like) within the body to be treated with radiation such as X-rays. For example, the radiotherapy system collects ultrasonic images of the treatment target in real time, and irradiates the target site with radiation when the target site reaches the irradiation position while confirming the position and movement of the target site within the treatment target.

  Here, the position of the ultrasonic probe arranged on the treatment target in order to collect the ultrasonic image of the target site is determined based on the experience of an operator such as a doctor. For example, the operator may consider the fact that radiation treatment efficiency decreases or the ultrasound probe deteriorates due to the radiation hitting the ultrasound probe, and the image quality of the obtained ultrasound image is considered. Based on experience, the position of the ultrasound probe on the treatment object is determined.

Special table 2015-533329 gazette Special table 2014-501143 gazette JP 2014-061061 A JP-T-2015-504690

  The problem to be solved by the present invention is to provide a support device and a support method for supporting the placement of an ultrasound probe in radiation therapy.

  The support device according to the embodiment includes a calculation unit and a notification control unit. The calculation unit calculates a recommended degree of placement of an ultrasound probe that scans the target part at the time of irradiation with the radiation on the target part of the treatment target for each position on the treatment target. . The notification control unit notifies the operator of the recommendation degree in association with the position on the treatment target.

FIG. 1 is a diagram illustrating an example of a configuration of a radiation therapy system according to the first embodiment. FIG. 2 is a diagram illustrating an example of a CT apparatus for radiotherapy planning according to the first embodiment. FIG. 3 is a diagram illustrating an example of a radiation therapy apparatus according to the first embodiment. FIG. 4 is a diagram illustrating an example of the configuration of the CT apparatus for radiotherapy planning according to the first embodiment. FIG. 5 is a diagram illustrating an example of the configuration of the radiotherapy apparatus according to the first embodiment. FIG. 6 is a diagram illustrating an example of the configuration of the ultrasonic diagnostic apparatus according to the first embodiment. FIG. 7 is a diagram illustrating an example of the configuration of the treatment planning apparatus according to the first embodiment. FIG. 8 is a flowchart illustrating an example of a processing procedure by the radiation therapy system according to the first embodiment. FIG. 9 is a flowchart illustrating an example of a processing procedure performed by the treatment planning apparatus according to the first embodiment. FIG. 10 is a diagram for explaining notification of a recommendation level according to the first embodiment. FIG. 11A is a diagram for explaining the designation operation of the position of the ultrasonic probe according to the first embodiment. FIG. 11B is a diagram for explaining the designation operation of the position of the ultrasonic probe according to the first embodiment.

  Hereinafter, an embodiment of a support device according to the present application will be described with reference to the accompanying drawings. In the following embodiment, a radiotherapy system including a treatment planning apparatus as a support apparatus will be described as an example, but the embodiment is not limited to the following contents. That is, the support apparatus according to the present application may be realized by any apparatus included in the radiation therapy system described below. Moreover, the case where the assistance apparatus which concerns on this application is implement | achieved as an apparatus different from the apparatus contained in the radiotherapy system demonstrated below may be sufficient.

(First embodiment)
First, an example of the configuration of the radiation therapy system 1 according to the first embodiment will be described. FIG. 1 is a diagram illustrating an example of a configuration of a radiation therapy system 1 according to the first embodiment. For example, as shown in FIG. 1, the radiotherapy system 1 includes a medical image diagnostic apparatus 10, a radiotherapy apparatus 20, an ultrasonic diagnostic apparatus 30, a treatment planning apparatus 40, a treatment information system 50, a PACS (Picture Archiving and Communication Systems) server 60, and each device is connected to each other. Here, in the radiotherapy system 1 according to the first embodiment, the treatment planning apparatus 40 acquires medical image data from the medical image diagnostic apparatus 10 and performs a target site (hereinafter, a target site to be treated). The radiotherapy treatment plan for the radiotherapy apparatus 20 is transmitted to the radiotherapy apparatus 20. In addition, the treatment planning device 40 supports the placement of an ultrasonic probe that scans the treatment target site on the treatment object based on the treatment plan. Furthermore, the treatment planning device 40 executes display control for displaying various information on a display arranged in a procedure room where radiation treatment is performed, or performs management of the entire radiation treatment in the radiation treatment system 1. To do. The treatment information system 50 manages patient data, treatment history, and the like. Further, the PACS server 60 stores medical image data collected by the medical image diagnostic apparatus 10 and performs various image processing on the medical image data. Note that the configuration shown in FIG. 1 is merely an example, and the embodiment is not limited to this. For example, a device that performs display control, a device that performs radiation therapy management, and the like are arranged separately. It may be.

  The medical image diagnostic apparatus 10 is an apparatus for collecting medical image data used when making a treatment plan. For example, an X-ray CT (Computed Tomography) apparatus, a magnetic resonance imaging (MRI) apparatus, An X-ray angio device, a PET (Positron Emission Tomography) device, a SPECT (Single Photon Emission Computed Tomography) device, and the like. In the following, a radiation treatment planning CT apparatus 100 shown in FIG. 2 will be described as an example of the medical image diagnostic apparatus 10. FIG. 2 is a diagram illustrating an example of the CT apparatus 100 for radiotherapy planning according to the first embodiment. As shown in FIG. 2, the CT apparatus 100 for radiation therapy planning includes a gantry 110 and a couch device having a couchtop 122, and includes CT projection data including a treatment target portion of a treatment object lying on the couchtop 122. And the reconstructed CT image data is transmitted to the treatment planning apparatus 40.

  The radiotherapy apparatus 20 is an apparatus that executes radiotherapy for a treatment target based on a treatment plan by the treatment planning apparatus 40. Here, the radiotherapy apparatus 20 will be described with reference to FIG. FIG. 3 is a diagram illustrating an example of the radiation therapy apparatus 20 according to the first embodiment. As shown in FIG. 3, the radiation therapy apparatus 20 includes a rotating table 270, a bed apparatus having a top plate 250, a radiation generator 232 for irradiating therapeutic radiation, and a radiation restrictor 233, In accordance with the treatment plan transferred from the planning device 40, the treatment target region is irradiated with radiation.

  Further, when the treatment target part is a part that moves due to breathing or the like (for example, the liver or the like), the radiation therapy apparatus 20 can emit radiation when the treatment target part comes to the radiation irradiation position. For example, the radiotherapy apparatus 20 uses the ultrasonic image collected by the ultrasonic diagnostic apparatus 30 during the radiotherapy while confirming the position and movement of the treatment target part while the treatment target part is at the irradiation position. Irradiate with radiation.

  Here, the radiotherapy apparatus 20 can also include a medical image collection apparatus that collects medical images for correcting the position of the treatment target as a preparation stage for treatment. For example, as shown in FIG. 3, the radiotherapy apparatus 20 includes an XVI (kone imaging apparatus for Cone-Beam CT) including a radiation generator 271 that emits imaging radiation and a detector 272 that detects imaging radiation. And a cone beam CT image for alignment can be generated.

  For example, in the radiotherapy apparatus 20, before the radiotherapy, the rotating base 270 is rotated once, while the radiation generator 271 continues to irradiate the object to be treated, and the radiation transmitted through the object to be detected is detected. Received by vessel 272. Thereby, the picked-up image (two-dimensional image) of the to-be-treated body from various directions is produced | generated. Then, a cone beam CT image is reconstructed based on the generated plurality of captured images and displayed on the display 220. By aligning the cone beam CT image and the CT image data for the treatment plan, and changing the treatment plan in the same manner as converting the CT image data for the treatment plan so as to coincide with the cone beam CT image, Thus, treatment targeting the position of the treatment target portion can be performed accurately.

  The ultrasonic diagnostic apparatus 30 collects an ultrasonic image including a treatment target site. For example, the ultrasonic diagnostic apparatus 30 collects ultrasonic image data including a treatment target part in real time while the radiation for treatment is being irradiated by the radiation generator 232 included in the radiotherapy apparatus 20, and the radiotherapy apparatus Or an ultrasonic image generated from the ultrasonic image data is presented to the operator.

  Here, in the radiotherapy system 1, the coordinate system in the radiotherapy planning CT apparatus 100, the coordinate system in the radiotherapy apparatus 20, and the coordinate system in the ultrasonic diagnostic apparatus 30 are aligned in advance. For example, in the radiation therapy system 1, infrared tracking devices are respectively installed in a room in which the CT apparatus 100 for radiation therapy planning is installed and a room in which the radiation therapy apparatus 20 is installed, and a laser aiming device installed in each room. A coordinate system is used to roughly align the coordinate system.

  Further, in the radiotherapy system 1, the coordinate system of the radiotherapy treatment CT apparatus 100 and the coordinate system of the radiotherapy apparatus 20 are aligned by aligning the CT image for treatment planning, the cone beam CT image, and the ultrasound image. The system and the coordinate system in the ultrasonic diagnostic apparatus 30 are associated with each other. For example, in the radiotherapy system 1, coordinates in the CT apparatus 100 for radiotherapy planning are specified by designating the same feature points as the anatomical feature points drawn in the CT image for treatment planning and the cone beam CT image. The system and the coordinate system in the radiation therapy apparatus 20 are associated with each other. Furthermore, in the radiotherapy system 1, an anatomical feature in which an ultrasonic image of the treatment target P is collected by an ultrasonic probe provided with a sensor that acquires position information and angle information, and depicted in a cone beam CT image. By designating the same feature point as the point on the ultrasound image data, the coordinate system of the ultrasound image determined by the position and angle of the sensor at that time and the coordinate system of the radiation therapy apparatus 20 are associated with each other. As a result, the radiotherapy apparatus 20 identifies the exact treatment position by associating the coordinate system of the radiotherapy planning CT apparatus 100 with the coordinate system of the radiotherapy apparatus 20. Furthermore, by associating the coordinate system in the radiotherapy apparatus 20 with the coordinate system in the ultrasonic diagnostic apparatus 30, it is possible to determine whether or not there is a target tumor at the treatment position determined by the radiotherapy apparatus 20.

  The treatment planning device 40 uses the CT image data of the treatment target collected by the radiation treatment planning CT device 100 to make a radiation treatment treatment plan by the radiation treatment device 20. For example, the treatment planning apparatus 40 specifies the position of the treatment target site in the body to be treated using the CT image data collected by the radiation treatment planning CT apparatus 100. In addition, for example, the treatment planning apparatus 40 makes a plan such as the dose, irradiation angle, and number of irradiations of the radiation irradiated by the radiation therapy apparatus 20 on a tumor or the like whose position is specified using CT image data.

  Next, the treatment planning device 40 presents the established treatment plan (radiation conditions, radiation dose map to the treatment object, etc.) to the operator. When the operator performs radiation therapy according to the treatment plan, the treatment is performed from the viewpoint of whether the exposure dose of the treatment target is within an allowable range or whether the effect of the radiation therapy can be sufficiently obtained. Determine whether the plan is appropriate. Here, when the operator determines that the treatment plan is not appropriate, the treatment planning apparatus 40 makes a treatment plan again. On the other hand, when the operator determines that the treatment plan is appropriate, the treatment plan device 40 transmits the treatment plan to the radiation treatment device 20.

  In addition, the treatment planning device 40 determines whether or not the radiotherapy by the radiotherapy device 20 is performed under the ultrasonic guide by the ultrasonic diagnostic device 30. For example, the treatment planning apparatus 40 displays buttons indicating “Yes” and “No” in a GUI dialog box presented to the operator through the display, and determines the presence or absence of the ultrasound guide in response to pressing of the button. In addition, for example, the treatment planning apparatus 40 can also determine the presence or absence of an ultrasonic guide according to whether or not a check box of a GUI presented to an operator through a display is checked.

  If the treatment planning apparatus 40 determines that radiotherapy is to be performed under an ultrasound guide, the treatment planning device 40 determines the recommended degree of placement of the ultrasound probe that scans the treatment target site during the radiotherapy based on the treatment plan. Calculation is performed for each position on the body, and the calculated recommendation degree is associated with the position on the body to be treated and notified to the operator. In other words, the treatment planning device 40 supports the placement of the ultrasonic probe on the treatment target in order to execute the ultrasonic guide. This point will be described later.

  The radiotherapy apparatus 20 performs alignment between the medical image collected by the medical image collection apparatus such as XVI provided in the radiotherapy apparatus 20 and the CT image data collected by the CT apparatus 100 for radiotherapy planning. Then, the treatment plan is corrected so that the target site can be accurately targeted. That is, the radiotherapy apparatus 20 performs radiotherapy by aligning medical images collected by a medical image collection apparatus such as XVI with CT image data collected by the CT apparatus 100 for radiotherapy planning. The exact position of the treatment target site in space is identified, and treatment is performed according to the identified position.

  The configuration of the radiation therapy system 1 shown in FIG. 1 is merely an example, and various other devices can be provided. For example, the radiotherapy system 1 may be provided with a position confirmation device that detects the movement of the position of the treatment target due to body movement, or may be various types such as RIS (Radiology Information System) and HIS (Hospital Information System). The system may be further introduced.

  Next, each device in the radiation therapy system 1 will be described. FIG. 4 is a diagram illustrating an example of a configuration of the CT apparatus 100 for radiotherapy planning according to the first embodiment. As shown in FIG. 4, the radiation therapy planning CT apparatus 100 includes a gantry 110, a couch device 120, and a console 130.

  The gantry 110 is a device that irradiates the treatment target P (patient) with X-rays, detects the X-rays that have passed through the treatment target P, and outputs the detected X-rays to the console 130. A line generator 112, a detector 113, a data acquisition circuit (DAS: Data Acquisition System) 114, a rotating frame 115, and a gantry drive circuit 116 are included.

  The rotating frame 115 supports the X-ray generator 112 and the detector 113 so as to face each other with the treatment target P interposed therebetween, and is rotated at a high speed in a circular orbit around the treatment target P by the gantry driving circuit 116. An annular frame. The X-ray irradiation control circuit 111 controls a high voltage generator (not shown) to supply a high voltage to the X-ray tube 112a. Here, the X-ray irradiation control circuit 111 adjusts the tube voltage and tube current supplied to the X-ray tube 112a under the control of the scan control circuit 133, so that the X-ray dose irradiated to the treatment object P Adjust. The X-ray irradiation control circuit 111 switches the wedge 112b. The X-ray irradiation control circuit 111 adjusts the X-ray irradiation range (fan angle and cone angle) by adjusting the aperture of the collimator 112c.

  The X-ray generator 112 is an apparatus that generates X-rays and irradiates the treatment target P with the generated X-rays, and includes an X-ray tube 112a, a wedge 112b, and a collimator 112c. The X-ray tube 112a is a vacuum tube that generates X-rays using a high voltage supplied from a high voltage generator (not shown) under the control of the X-ray irradiation control circuit 111. As the rotating frame 115 rotates, An X-ray beam is applied to the treatment target P. The wedge 112b is an X-ray filter for adjusting the X-ray dose of X-rays emitted from the X-ray tube 112a under the control of the X-ray irradiation control circuit 111. Specifically, the wedge 112b transmits the X-rays exposed from the X-ray tube 112a so that the X-rays irradiated from the X-ray tube 112a to the treatment target P have a predetermined distribution. It is a filter that attenuates. The wedge 112b is also called a wedge filter or a bow-tie filter.

  The collimator 112c is a slit for narrowing the X-ray irradiation range in which the X-ray dose is adjusted by the wedge 112b under the control of the X-ray irradiation control circuit 111. The gantry driving circuit 116 rotates the rotary frame 115 to rotate the X-ray generator 112 and the detector 113 on a circular orbit around the treatment target P. The detector 113 is a two-dimensional array type detector (surface detector) that detects X-rays that have passed through the treatment target P, and a detection element array that includes X-ray detection elements for a plurality of channels is treated. A plurality of rows are arranged along the body axis direction of the body P (Z-axis direction shown in FIG. 4).

  The data collection circuit 114 is a DAS and collects CT projection data from the X-ray detection data detected by the detector 113. For example, the data acquisition circuit 114 generates CT projection data by performing amplification processing, A / D conversion processing, inter-channel sensitivity correction processing, and the like on the X-ray intensity distribution data detected by the detector 113, The generated CT projection data is transmitted to the console 130. For example, when X-rays are continuously emitted from the X-ray tube 112a during the rotation of the rotating frame 115, the data acquisition circuit 114 collects a CT projection data group for the entire circumference (for 360 degrees). Further, the data collection circuit 114 associates the tube position with each collected CT projection data, and transmits it to the console 130. The tube position is information indicating the projection direction of the CT projection data.

  The couch device 120 is a device on which the treatment target P is placed, and includes a couch driving device 121 and a top plate 122. The bed driving device 121 moves the top plate 122 in the Z-axis direction to move the treatment target P into the rotary frame 115. The top plate 122 is a plate on which the treatment target P is placed. In addition, although the top plate for CT usually has a shape that the center is recessed so as to fit the patient's body, in the case of the CT apparatus 100 for radiation therapy planning, it is the same as the top board 250 of the radiation therapy apparatus 20. It has the shape of

  The console 130 is an apparatus that accepts an operation of the radiation treatment planning CT apparatus 100 by an operator and reconstructs CT image data (volume data) using the CT projection data collected by the gantry 110. As shown in FIG. 4, the console 130 includes an input circuit 131, a display 132, a scan control circuit 133, a preprocessing circuit 134, a storage circuit 135, an image reconstruction circuit 136, and a processing circuit 137. .

  The input circuit 131 includes a mouse, a keyboard, a trackball, a switch, a button, a joystick, and the like that are used by the operator of the radiation therapy planning CT apparatus 100 to input various instructions and settings, and instructions and settings received from the operator. Is transferred to the processing circuit 137. The display 132 is a monitor referred to by the operator, and displays a part of the CT image data to the operator under the control of the processing circuit 137, and displays various instructions and various information from the operator via the input circuit 131. A GUI (Graphical User Interface) for accepting settings and the like is displayed.

  The scan control circuit 133 controls the operations of the X-ray irradiation control circuit 111, the gantry driving circuit 116, the data acquisition circuit 114, and the bed driving device 121 under the control of the processing circuit 137, so that the CT projection data on the gantry 110 is controlled. Control the collection process. Specifically, the scan control circuit 133 controls the collection processing of CT projection data in imaging for collecting CT image data for radiation therapy planning.

  The pre-processing circuit 134 performs logarithmic conversion processing and correction processing such as offset correction, sensitivity correction, and beam hardening correction on the CT projection data generated by the data acquisition circuit 114, thereby correcting the corrected CT projection. Data is generated and stored in the storage circuit 135. The storage circuit 135 stores the CT projection data generated by the preprocessing circuit 134. Further, the storage circuit 135 stores the CT image data generated by the image reconstruction circuit 136.

  The image reconstruction circuit 136 reconstructs CT image data (volume data) using the CT projection data stored in the storage circuit 135. Here, as the reconstruction method, there are various methods, for example, back projection processing. Further, as the back projection process, for example, a back projection process by an FBP (Filtered Back Projection) method can be cited. Alternatively, the image reconstruction circuit 136 can reconstruct CT image data using a successive approximation method. Then, the image reconstruction circuit 136 stores the reconstructed CT image data in the storage circuit 135 and transmits it to the treatment planning apparatus 40.

  The processing circuit 137 performs overall control of the radiation therapy planning CT apparatus 100 by controlling the operations of the gantry 110, the bed apparatus 120, and the console 130. Specifically, the processing circuit 137 controls the CT scan performed on the gantry 110 by controlling the scan control circuit 133. Further, the processing circuit 137 controls to generate a display CT image from the CT image data stored in the storage circuit 135 and display the CT image on the display 132.

  Each processing function realized by each circuit shown in FIG. 4 is recorded in the storage circuit 135 in the form of a program executable by a computer. Each circuit is a processor that realizes a function corresponding to each program by reading each program from the storage circuit 135 and executing the program.

  FIG. 5 is a diagram illustrating an example of the configuration of the radiation therapy apparatus 20 according to the first embodiment. As shown in FIG. 5, the radiotherapy apparatus 20 includes an input circuit 210, a display 220, a radiation generation apparatus 230, a moving mechanism 240, a top plate 250, and a system control circuit 260. In addition, the radiation generator 230 includes a radiation control circuit 231, a radiation generator 232, and a radiation restrictor 233. Under the control of the system control circuit 260, the radiation control circuit 231 controls the applied voltage, the application time, and the like in the high voltage generator of the radiation generator 232 so as to irradiate the radiation dose according to the treatment plan. . The radiation generator 232 includes an electron gun and an acceleration tube (not shown). The accelerator tube accelerates the thermal electrons generated from the electron gun and radiates therapeutic radiation by colliding with the tungsten target. The radiation diaphragm 233 is, for example, an MLC (Multi-Leaf Collimator) and has a plurality of diaphragm blades that set an irradiation range of therapeutic radiation. For example, the radiation diaphragm 233 forms a radiation irradiation region having a shape corresponding to the treatment target site of the treatment target P by moving these diaphragm blades by the diaphragm movement mechanism 241.

  The moving mechanism 240 includes a diaphragm moving mechanism 241, a mechanism control circuit 242, and a top plate moving mechanism 243. The aperture moving mechanism 241 moves the aperture blades of the radiation aperture 233 under the control of the mechanism control circuit 242. The top plate moving mechanism 243 moves the top plate 250 under the control of the mechanism control circuit 242. The mechanism control circuit 242 moves the diaphragm blades by transmitting a diaphragm blade movement control signal to the diaphragm movement mechanism 241 under the control of the system control circuit 260. The mechanism control circuit 242 moves the top plate 250 by transmitting a top plate movement control signal to the top plate moving mechanism 243.

  The input circuit 210 includes a mouse, a keyboard, a trackball, a switch, a button, a joystick, and the like that are used by the operator of the radiation therapy apparatus 20 to input various instructions and settings, and receives instructions and setting information received from the operator. Then, the data is transferred to the system control circuit 260. The display 220 is a monitor that is referred to by the operator, and displays a cone beam CT image to the operator under the control of the system control circuit 260, and various instructions and various settings from the operator via the input circuit 210. Or the like for receiving a GUI or the like.

  The system control circuit 260 performs overall control of the radiation therapy apparatus 20 by controlling the operations of the rotary base 270, the radiation generation apparatus 230, and the moving mechanism 240. Specifically, the system control circuit 260 controls the radiation control circuit 231 on the basis of the treatment plan received from the treatment planning device 40, thereby controlling the irradiation of radiation to the treatment target P. In addition, the system control circuit 260 controls the position of the top plate 250 by controlling the mechanism control circuit 242 based on the treatment plan. In addition, the system control circuit 260 controls the display 220 to display the cone beam CT image and the GUI. Here, the radiotherapy apparatus 20 has a storage circuit (not shown), and stores the treatment plan transferred from the treatment planning apparatus 40 in the storage circuit. Then, the system control circuit 260 reads the treatment plan from the storage circuit and executes the above-described control.

  Each processing function realized by each circuit shown in FIG. 5 is recorded in a storage circuit (not shown) in the form of a program executable by a computer. Each circuit is a processor that realizes a function corresponding to each program by reading and executing each program from a storage circuit (not shown).

  FIG. 6 is a diagram illustrating an example of the configuration of the ultrasonic diagnostic apparatus 30 according to the first embodiment. As shown in FIG. 6, the ultrasonic diagnostic apparatus 30 according to the first embodiment includes an ultrasonic probe 310, an input circuit 320, a display 330, an apparatus body 340, a sensor 350, and a transmitter 360. .

  The ultrasonic probe 310 includes a plurality of piezoelectric vibrators, and the plurality of piezoelectric vibrators generate ultrasonic waves based on a drive signal supplied from the transmission / reception circuit 341. The ultrasonic probe 310 receives a reflected wave from the treatment target P and converts it into an electrical signal. The ultrasonic probe 310 includes a matching layer provided in the piezoelectric vibrator, a backing material that prevents propagation of ultrasonic waves from the piezoelectric vibrator to the rear, and the like.

  For example, when ultrasonic waves are transmitted from the ultrasonic probe 310 to the treatment target P, the transmitted ultrasonic waves are reflected one after another on the discontinuous surface of the acoustic impedance in the body tissue of the treatment target P, and the reflected wave signal Is received by a plurality of piezoelectric vibrators included in the ultrasonic probe 310. The amplitude of the received reflected wave signal depends on the difference in acoustic impedance at the discontinuous surface where the ultrasonic wave is reflected. Note that the reflected wave signal when the transmitted ultrasonic pulse is reflected by the moving blood flow or the surface of the heart wall depends on the velocity component of the moving object in the ultrasonic transmission direction due to the Doppler effect. And undergoes a frequency shift.

  Here, the ultrasonic probe 310 is a 2D probe capable of ultrasonically scanning the treatment target P in three dimensions by arranging a plurality of piezoelectric vibrators in a matrix. Alternatively, the ultrasonic probe 310 scans the treatment target P two-dimensionally with a plurality of piezoelectric vibrators arranged in a row and swings the plurality of piezoelectric vibrators at a predetermined angle (swing angle). Thus, it is a 3D probe that scans the treatment target P in three dimensions.

  The ultrasonic probe 310 may be realized in a wired form or may be realized in a wireless form. In the case of a wired form, the ultrasonic probe 310 includes, for example, a probe main body, a connection terminal, a connector, and a cable. The probe main body includes a plurality of piezoelectric vibrators, and transmits and receives the ultrasonic waves described above. Do. The connection terminal is a terminal for connecting a signal line for transmitting and receiving a transmission signal to the probe body and a reception signal from the probe body to the apparatus body 340. The connector accommodates the cable and secures the ultrasonic probe 310 to the apparatus main body 340 to ensure electrical connection. The cable is a cable for transmitting and receiving signals between the probe main body and the apparatus main body 340. For example, the cable has a plurality of signal lines, and each signal line is connected to the apparatus main body 340 via a connection terminal.

  In the case of a wireless form, the ultrasonic probe 310 and the apparatus main body 340 each have a wireless communication circuit that performs wireless communication, and control signals for connection between the ultrasonic probe 310 and the apparatus main body 340, and transmission / reception of ultrasonic waves The control signal etc. which relate to are exchanged by a radio signal. In this case, the ultrasonic probe 310 includes a plurality of piezoelectric vibrators and a probe main body that transmits and receives the above-described ultrasonic waves. That is, in the case of a wireless form, the ultrasonic probe 310 does not include the connection terminals, connectors, and cables described above.

  Here, as shown in FIG. 6, a sensor 350 is attached to the ultrasonic probe 310 (probe body), and a transmitter 360 is disposed at an arbitrary position near the apparatus body 340. The transmitter 360 is a device that forms a magnetic field outward from the device itself. The sensor 350 detects the strength and inclination of the three-dimensional magnetic field formed by the transmitter 360. Based on the detected magnetic field information, the sensor 350 calculates the position and angle of the device itself in the space with the transmitter 360 as the origin, and transmits the calculated position and angle to the device body 340.

  As described above, since the ultrasonic probe 310 includes the sensor 350, the radiotherapy system 1 can detect the position of the ultrasonic probe 310 in the three-dimensional coordinates of the ultrasonic image data based on the reflected wave signal received by the piezoelectric vibrator, and The angle can be uniquely identified. In addition, since the coordinate systems of the radiotherapy planning CT apparatus 100, the radiotherapy apparatus 20, and the ultrasonic diagnostic apparatus 30 are preliminarily aligned, the radiotherapy system 1 is arranged on the CT image data by the radiotherapy planning CT apparatus 100. It is possible to uniquely identify the position and angle of the ultrasonic probe 310 in FIG. 1 or the position and angle of the ultrasonic probe 310 with respect to the treatment target P in a state of receiving radiation treatment by the radiation therapy apparatus 20.

  The ultrasonic probe 310 is fixed to the treatment target P by a fixing unit (not shown). For example, the fixing unit is a holder that is stably placed on a top plate on which the treatment target P is placed, and that fixes the ultrasonic probe 310 to the treatment target P. In addition, for example, the fixing unit is an holder that includes an arm having one or a plurality of joints, and tilts and fixes the ultrasonic probe 310 at an arbitrary angle with respect to an arbitrary position of the treatment target P.

  The input circuit 320 includes a mouse, a keyboard, a button, a panel switch, a touch command screen, a foot switch, a trackball, a joystick, and the like, receives various setting requests from an operator of the ultrasonic diagnostic apparatus 30, and The various setting requests received are transferred. The display 330 displays a GUI for an operator of the ultrasound diagnostic apparatus 30 to input various setting requests using the input circuit 320, or displays various image data generated in the apparatus main body 340.

  As illustrated in FIG. 6, the apparatus main body 340 includes a transmission / reception circuit 341, a B-mode processing circuit 342, a Doppler processing circuit 343, an image memory 344, a storage circuit 345, and a processing circuit 346. The transmission / reception circuit 341 includes a pulse generator, a transmission delay circuit, a pulser, and the like, and supplies a drive signal to the piezoelectric vibrator. The pulse generator repeatedly generates rate pulses for forming transmission ultrasonic waves at a predetermined rate frequency. In addition, the transmission delay circuit focuses the ultrasonic wave generated from the piezoelectric vibrator into a beam shape, and each pulse generator generates a delay time for each piezoelectric vibrator necessary for determining the transmission directivity. Give to rate pulse. The pulser applies a drive signal (drive pulse) to the piezoelectric vibrator at a timing based on the rate pulse. That is, the transmission delay circuit arbitrarily adjusts the transmission direction of the ultrasonic wave transmitted from the piezoelectric vibrator surface by changing the delay time given to each rate pulse.

  Note that the transmission / reception circuit 341 has a function capable of instantaneously changing a transmission frequency, a transmission drive voltage, and the like in order to execute a predetermined scan sequence based on an instruction from the processing circuit 346. In particular, the change of the transmission drive voltage is realized by a linear amplifier type transmission circuit capable of instantaneously switching the value or a mechanism for electrically switching a plurality of power supply units.

  The transmission / reception circuit 341 includes a preamplifier, an A / D (Analog / Digital) converter, a reception delay circuit, an adder, and the like, and performs various processing on the reflected wave signal received by the piezoelectric vibrator to generate a reflected wave. Generate data. The preamplifier amplifies the reflected wave signal for each channel. The A / D converter A / D converts the amplified reflected wave signal. The reception delay circuit provides a delay time necessary for determining the reception directivity. The adder performs an addition process of the reflected wave signal processed by the reception delay circuit to generate reflected wave data. By the addition processing of the adder, the reflection component from the direction corresponding to the reception directivity of the reflected wave signal is emphasized, and a comprehensive beam for ultrasonic transmission / reception is formed by the reception directivity and the transmission directivity. The form of the output signal from the transmission / reception circuit 341 can be selected from various forms such as a signal including phase information called an RF (Radio Frequency) signal or amplitude information after envelope detection processing. Is possible.

  The B-mode processing circuit 342 receives the reflected wave data from the transmission / reception circuit 341, performs logarithmic amplification, envelope detection processing, etc., and generates data (B-mode data) in which the signal intensity is expressed by brightness. . The Doppler processing circuit 343 performs frequency analysis on the velocity information from the reflected wave data received from the transmission / reception circuit 341, extracts blood flow, tissue, and contrast agent echo components due to the Doppler effect, and obtains moving body information such as velocity, dispersion, and power. Data extracted for multiple points (Doppler data) is generated.

  Note that the B-mode processing circuit 342 and the Doppler processing circuit 343 can process three-dimensional reflected wave data. That is, the B mode processing circuit 342 generates three-dimensional B-mode data from the three-dimensional reflected wave data. The Doppler processing circuit 343 generates three-dimensional Doppler data from the three-dimensional reflected wave data. The three-dimensional B-mode data is data to which a luminance value corresponding to the reflection intensity of the reflection source located at each of a plurality of points (sample points) set on each scanning line in the three-dimensional scanning range is assigned. In the three-dimensional Doppler data, a luminance value corresponding to the value of blood flow information (speed, dispersion, power) is assigned to each of a plurality of points (sample points) set on each scanning line in the three-dimensional scanning range. Data.

  The image memory 344 is a memory that stores the image data generated by the processing circuit 346. The image memory 344 can also store data generated by the B-mode processing circuit 342 and the Doppler processing circuit 343. The storage circuit 345 stores various data such as a control program for performing ultrasonic transmission / reception, image processing, and display processing. The storage circuit 345 is also used for storing image data stored in the image memory 344 as necessary.

  The processing circuit 346 controls the entire processing of the ultrasonic diagnostic apparatus 30. For example, the processing circuit 346 generates ultrasonic image data from the data generated by the B mode processing circuit 342 and the Doppler processing circuit 343. That is, the processing circuit 346 generates B-mode image data in which the intensity of the reflected wave is expressed by luminance from the B-mode data generated by the B-mode processing circuit 342. The B-mode image data is data in which the tissue shape in the ultrasonically scanned region is depicted. Further, the processing circuit 346 generates Doppler image data representing moving body information from the Doppler data generated by the Doppler processing circuit 343. The Doppler image data is velocity image data, distributed image data, power image data, or image data obtained by combining these. That is, the Doppler image data is data indicating fluid information relating to the fluid flowing in the ultrasonically scanned region.

  Here, the processing circuit 346 generally converts (scan converts) a scanning line signal sequence of ultrasonic scanning into a scanning line signal sequence of a video format represented by a television or the like, and displays an ultrasonic image for display. Is generated. Specifically, the processing circuit 346 generates an ultrasound image by performing coordinate conversion in accordance with the ultrasound scanning mode by the ultrasound probe 310. The processing circuit 346 also uses, for example, image processing (smoothing processing) to regenerate an average luminance image using a plurality of image frames after scan conversion, or image processing (edge processing) using a differential filter in the image. Emphasis processing).

  Further, the processing circuit 346 performs coordinate conversion on the three-dimensional B-mode data generated by the B-mode processing circuit 342, thereby generating three-dimensional B-mode image data. Further, the processing circuit 346 generates three-dimensional Doppler image data by performing coordinate conversion on the three-dimensional Doppler data generated by the Doppler processing circuit 343. The three-dimensional B-mode data and the three-dimensional Doppler image data are volume data before the scan conversion process.

  Further, the processing circuit 346 executes various controls in the entire apparatus described above. For example, the processing circuit 346 is based on various setting requests input from the operator via the input circuit 320 and various data read from the storage circuit 345, the transmission / reception circuit 341, the B-mode processing circuit 342, and the Doppler processing circuit 343. Control the processing. In addition, the processing circuit 346 transmits the volume data to the treatment planning device 40. Further, the processing circuit 346 controls to generate an ultrasonic image for display from the volume data stored in the image memory 344 and the storage circuit 345 and to display it on the display 330.

  Each processing function realized by each circuit shown in FIG. 6 is recorded in the storage circuit 345 in the form of a program executable by a computer. Each circuit is a processor that realizes a function corresponding to each program by reading each program from the storage circuit 345 and executing the program.

  FIG. 7 is a diagram illustrating an example of the configuration of the treatment planning apparatus 40 according to the first embodiment. As illustrated in FIG. 7, the treatment planning apparatus 40 includes an input circuit 410, a display 420, a storage circuit 430, and a processing circuit 440. For example, the treatment planning device 40 is a workstation or an arbitrary personal computer.

  The input circuit 410 is a pointing device such as a mouse or an input device such as a keyboard, and accepts input of various operations on the treatment planning apparatus 40 from an operator. For example, the input circuit 410 receives an operation for designating a treatment target region for the CT image data collected by the CT apparatus 100 for radiotherapy planning. Further, for example, the input circuit 410 receives a designation operation for designating the position of the ultrasonic probe 310 on the treatment target P.

  The display 420 is a display device such as a liquid crystal display, and displays various types of information. For example, the display 420 displays a GUI for receiving various operations from the operator, a display CT image generated from CT image data for a treatment plan, and a processing result by the processing circuit 440 described later. . Here, the treatment planning apparatus 40 can include a plurality of displays 420. For example, the display 420 is arranged in a room where an operator makes a treatment plan, a room where the radiation treatment apparatus 20 is arranged, or the like. You can also.

  The storage circuit 430 is, for example, a semiconductor memory device such as a RAM (Random Access Memory) or a flash memory, or a storage device such as a hard disk or an optical disk, and is read and executed by a processing circuit 440 described later. Various programs to be stored are stored. Further, for example, the storage circuit 430 stores the treatment plan designed by the processing circuit 440. For example, the storage circuit 430 stores, for each object to be treated, information such as radiation conditions for the treatment target region, dose distribution calculated based on the irradiation conditions, and dose volume histogram. Note that the storage circuit 430 can also store exposure information for each body to be treated. Further, the storage circuit 430 stores a processing result by a processing circuit 440 described later.

  The processing circuit 440 makes a radiation treatment treatment plan by the radiation treatment apparatus 20 using the CT image data of the treatment target P collected by the radiation treatment planning CT apparatus 100. For example, the processing circuit 440 uses the CT image data collected by the radiation treatment planning CT apparatus 100 to identify the position of the treatment target site in the treatment target P. In addition, for example, the processing circuit 440 makes a plan such as the radiation dose, the irradiation angle, and the number of times of irradiation with which the radiation therapy apparatus 20 irradiates the treatment target site whose position is specified using the CT image data. Then, the processing circuit 440 stores the established treatment plan in the storage circuit 430.

  Further, the processing circuit 440 executes various processes in the treatment planning device 40. For example, the processing circuit 440 reads out the programs corresponding to the calculation function 441, the notification control function 442, the reception function 443, the determination function 444, the acquisition function 445, and the determination function 446 shown in FIG. 7 from the storage circuit 430 and executes them. Various processes are performed. Each processing function realized by each circuit shown in FIG. 7 is recorded in the storage circuit 430 in the form of a program executable by a computer. Each circuit is a processor that realizes a function corresponding to each program by reading each program from the storage circuit 430 and executing the program. Note that the calculation function 441 illustrated in FIG. 7 corresponds to the calculation unit in the claims. A notification control function 442 shown in FIG. 7 corresponds to the notification control unit in the claims.

  Then, the treatment planning apparatus 40 supports the placement of the ultrasonic probe 310 in the radiation treatment on the treatment target P based on the treatment plan. Specifically, the treatment planning device 40 calculates the recommended degree of placement of the ultrasonic probe 310 for each position on the treatment object P, and associates the calculated recommendation degree with the position on the treatment object P to the operator. By notifying, arrangement | positioning of the ultrasonic probe 310 in radiotherapy is supported.

  For example, the calculation function 441 first acquires from the storage circuit 430 a radiation irradiation plan (treatment plan) for the treatment target region of the treatment subject P. The treatment plan acquired by the calculation function 441 includes CT image data of the treatment target P collected in three dimensions by the radiation treatment plan CT apparatus 100. Here, the calculation function 441 is based on the treatment plan, the irradiation range of the radiation irradiated to the treatment target region, the distribution of the ultrasonic medium between the ultrasonic probe 310 and the treatment target region, the ultrasonic probe 310 and the treatment target. Acquire various information such as the distance between the parts, the degree of deformation of the contact surface of the treatment object P that contacts the ultrasonic probe 310, and the angle between the ultrasonic probe 310 and the contact surface in a state of scanning the treatment target part. To do. Then, the calculation function 441 calculates the recommended degree of the probe position of the ultrasonic probe 310 for each position in the treatment object P from various information based on the radiation irradiation plan. Further, the notification control function 442 notifies the operator of the recommendation level in association with the position on the treatment target P. Thereby, positioning of the ultrasonic probe 310 in radiotherapy can be supported.

  Here, first, an example of processing by the radiation therapy system 1 according to the first embodiment will be described with reference to FIG. FIG. 8 is a flowchart illustrating an example of a processing procedure performed by the radiation therapy system 1 according to the first embodiment. As shown in FIG. 8, in the radiation treatment system 1, first, the radiation treatment planning CT apparatus 100 collects CT image data (step S <b> 101), and transmits the collected CT image data to the treatment planning apparatus 40. . Then, the treatment planning device 40 makes a treatment plan (step S102) and transmits the treatment plan to the radiation treatment device 20. In addition, in the radiotherapy apparatus 20, the verification (Commission) of a treatment plan is performed. In the verification of the treatment plan, it is verified by using a phantom, a dosimeter, or the like that the radiation can be irradiated according to the treatment plan, and interference occurs in the radiation treatment apparatus 20 or between the radiation treatment apparatus 20 and the treatment target P. It is determined visually.

  Next, the treatment planning device 40 determines whether or not the radiation treatment by the radiation treatment device 20 is performed under the guidance of the ultrasound image (step S103). When the treatment is not under ultrasound guidance (No at Step S103), the radiation therapy apparatus 20 places the treatment target P on the bed and performs alignment of the treatment target P (Step S104). For example, when a CT apparatus is installed in the same room, the radiotherapy apparatus 20 captures a CT image and compares the CT image used in the treatment plan to identify the position of the treatment target P. Alternatively, the radiotherapy apparatus 20 uses the cone beam CT function to capture a cone beam CT image, and then aligns bones and organs as landmarks with the reconstructed image and the CT image used in the treatment plan. To identify the position of the body P to be treated. Alternatively, the radiotherapy apparatus 20 captures an X-ray image from two directions, performs alignment with the CT image used in the treatment plan based on the characteristic structure, and identifies the position of the treatment target P. And the radiotherapy apparatus 20 performs radiotherapy with respect to the to-be-treated body P by which alignment was performed by such a method (step S107).

  On the other hand, in the case of the treatment under the ultrasonic guide (Yes at Step S103), the treatment planning device 40 allows the operator to ultrasonically operate the treatment target P in parallel with the alignment of the treatment target P described above. The placement of the probe 310 is supported (step S105). Next, the treatment planning apparatus 40 determines whether or not the placement of the ultrasonic probe 310 is completed (step S106). Here, when it is determined that the placement of the ultrasound probe 310 is completed (Yes at Step S106), the radiation therapy apparatus 20 performs radiation therapy (Step S107). On the other hand, when it is determined that the placement of the ultrasound probe 310 has not been completed (No at Step S106), the treatment planning device 40 again places the ultrasound probe on the treatment target P by the operator. To help.

  As described above, in the radiotherapy system 1 according to the first embodiment, in step S105 of FIG. 8, the treatment planning apparatus 40 causes the operator to place the ultrasonic probe 310 on the treatment target P. By assisting, it is possible to efficiently guide radiation therapy using ultrasound images. Hereinafter, an example of processing performed by the treatment planning apparatus 40 according to the first embodiment will be described with reference to FIG. FIG. 9 is a flowchart illustrating an example of a processing procedure performed by the treatment planning apparatus 40 according to the first embodiment. Here, the process shown in FIG. 9 corresponds to the process of step S105 of FIG.

  Steps S201 and S202 illustrated in FIG. 9 are steps in which the processing circuit 440 reads a program corresponding to the calculation function 441 from the storage circuit 430 and executes it. In addition, step S203, step S209, and step S212 illustrated in FIG. 9 are steps that are executed when the processing circuit 440 reads a program corresponding to the notification control function 442 from the storage circuit 430. 9 is a step in which the processing circuit 440 reads out a program corresponding to the reception function 443 from the storage circuit 430 and executes it. 9 is a step in which the processing circuit 440 reads out a program corresponding to the determination function 444 from the storage circuit 430 and executes it. 9 is a step in which the processing circuit 440 reads out a program corresponding to the acquisition function 445 from the storage circuit 430 and executes it. Further, step S206, step S208, step S210, step S211 and step S213 shown in FIG. 9 are steps executed by the processing circuit 440 reading out a program corresponding to the determination function 446 from the storage circuit 430.

  As shown in FIG. 9, in the treatment planning apparatus 40, first, the calculation function 441 acquires a radiation irradiation plan (treatment plan) for the treatment target region of the treatment target P (step S201). Next, the calculation function 441 calculates the recommended degree of placement of the ultrasound probe 310 from the treatment plan for each position in the treatment target P (step S202). For example, the calculation function 441 uses the value “B” based on the irradiation range of the radiation irradiated to the treatment target region from the treatment plan, and the value based on the distribution of the ultrasonic medium between the ultrasonic probe 310 and the treatment target region. “A”, a value “D” based on the distance between the ultrasonic probe 310 and the treatment target site, a value “I” based on the angle between the ultrasonic probe 310 and the contact surface in a state of scanning the treatment target site, A value “S” based on the degree of deformation of the contact surface of the treatment object P in contact with the acoustic probe 310 is calculated, and the recommended degree “R” is calculated by the following equation (1) using the numerical values based on these treatment plans. Is calculated.

  Note that “a”, “b”, “c”, “d”, and “e” in the formula (1) are changed to “B”, “A”, “D”, “I”, and “S”, respectively. Such a predetermined coefficient. In addition, “B”, “A”, “D”, “I”, and “S” in Equation (1) are functions that use the coordinates of the position in the treatment target P as variables. Then, the calculation function 441 determines the recommended degree “R” at each position of the treatment object P from the values of “B”, “A”, “D”, “I”, and “S” at each position of the treatment object P. Is calculated.

  Hereinafter, a case where the calculation function 441 calculates the recommendation degree “R” as a numerical value equal to or greater than “0” for each position in the treatment target P will be described as an example. Hereinafter, a case where the calculation function 441 calculates the recommendation level “R” as an example where the value of the recommendation level “R” is smaller is more preferable as the position of the ultrasonic probe 310 will be described. Hereinafter, each of “B”, “A”, “D”, “I”, and “S” used by the calculation function 441 for calculating the recommendation degree “R” will be described.

  First, the value “B” based on the irradiation range of the radiation irradiated to the treatment target site will be described. The calculation function 441 first determines whether or not each position in the treatment target P is included in the radiation irradiation range based on the treatment plan. Here, since the treatment plan includes information on the position of the treatment target part specified using the CT image data and information on the irradiation angle of the radiation irradiated by the radiation therapy apparatus 20, the calculation function 441 includes: It can be determined whether or not each position in the treatment target P is included in the radiation irradiation range.

  Next, the calculation function 441 uses the value “B” of each position in the treatment target P so that the value “B” of the position not included in the irradiation range is smaller than the value “B” of the position included in the irradiation range. Is calculated. Then, the calculation function 441 uses the formula (1) to indicate that the recommended position “R” indicating that the position in the treatment object excluding the position included in the irradiation range is recommended over the position included in the irradiation range of radiation. Is calculated.

  That is, the calculation function 441 calculates the value “B” so that the recommended value “R” for the positions included in the irradiation range among the positions on the treatment target P is increased. For example, the calculation function 441 sets the position value “B” included in the irradiation range to a large value (for example, infinity). Here, when the value “B” is a large value, the recommendation degree “R” is also a large value according to the equation (1). Then, the calculation function 441 can calculate a recommendation level “R” indicating that each position included in the irradiation range is not recommended as a probe position.

  In addition, the calculation function 441 calculates the scattered radiation intensity based on the radiation irradiation condition for a position not included in the irradiation range, and calculates “B” according to the calculated total intensity of the scattered radiation. Then, the calculation function 441 calculates a recommendation degree “R” indicating that the position where the total intensity of scattered radiation is smaller is recommended as the probe position according to the equation (1). Note that the calculation function 441 may calculate the total scattered ray intensity from the primary scattered radiation intensity, or may calculate from the primary scattered radiation intensity and secondary or higher-order scattered radiation intensity.

  The calculation function 441 may be a case where the fixed part of the ultrasonic probe 310 is taken into account in order to calculate the value “B”. For example, the calculation function 441 first acquires information on a fixing unit used for fixing the ultrasonic probe 310 based on a treatment plan. The calculation function 441 acquires information such as the size and shape of the fixed part, the movable range of the joint in the arm, and the like as the fixed part information. In the treatment plan, a fixed portion may be selected for each treatment target site.

  Next, the calculation function 441 uses the acquired information on the fixed part to place the ultrasonic probe 310 and the fixed part within the irradiation range when the ultrasonic probe 310 is arranged at the position for each position in the treatment target P. It is determined whether or not it is included. Then, the calculation function 441 uses the value “R” so that the recommended value “R” for the position where at least one of the ultrasonic probe 310 and the fixed part is included in the irradiation range among the positions in the treatment target P is large. B "is calculated.

  For example, the calculation function 441 sets the value “B” at a position where at least one of the ultrasonic probe 310 and the fixed portion is included in the irradiation range to a large value (for example, infinity). Here, when the value “B” is a large value, the recommendation degree “R” is also a large value according to the equation (1). Then, the calculation function 441 has a position in the treatment target P excluding a position where at least one of the ultrasonic probe 310 and the fixed part is included in the irradiation range as compared with a position where the ultrasonic probe 310 and the fixed part are included in the irradiation range. A recommendation level “R” indicating that it is recommended can be calculated.

  Next, the value “A” based on the distribution of the ultrasonic medium between the ultrasonic probe 310 and the site to be treated will be described. For example, the calculation function 441 acquires the distribution of the ultrasound medium between the ultrasound probe 310 and the treatment target site from the CT image data generated by the radiation treatment planning CT apparatus 100 included in the treatment plan. Can do. Hereinafter, a region between each position on the treatment target P and the treatment target site is also simply referred to as an ultrasonic path. The ultrasonic path is an area determined for each position in the treatment target P.

  For example, the calculation function 441 first determines, for each position in the treatment target P, whether or not bone or gas is distributed as an ultrasonic medium on the ultrasonic path. Next, the calculation function 441 is configured so that the value “A” at a position where no bone or gas is distributed on the ultrasonic path is smaller than the value “A” at a position where bone or gas is distributed. The value “A” of each position at is calculated. In this case, the calculation function 441 uses the expression (1) to set the probe position as the probe position rather than the position where the bone or gas is distributed as the medium, with respect to the position in the treatment object excluding the position where the bone or gas is distributed as the ultrasonic medium. A recommendation level “R” indicating that it is recommended is calculated. Note that the gas as the ultrasonic medium is air in the lungs of the treatment target P, gas in the digestive system, or the like.

  In other words, the calculation function 441 calculates the value “A” so that the recommended degree “R” of the position where the bone or gas is distributed on the ultrasonic path among the positions on the treatment target P is increased. . For example, the calculation function 441 sets the value “A” of a position where bones and gas are distributed as an ultrasonic medium on the ultrasonic path to a large value (for example, infinity). Then, the calculation function 441 calculates the recommendation degree “R” indicating that the position where the bone and the gas are distributed on the ultrasonic path is not recommended as the probe position according to the equation (1).

  Further, the calculation function 441 evaluates the non-uniformity of the body tissue on the ultrasonic path for the position where the bone or the gas is not distributed on the ultrasonic path, and the value “A” increases as the position is non-uniform. And For example, the calculation function 441 first obtains CT image data including the body tissue on the ultrasound path from the treatment plan. Then, the calculation function 441 calculates a dispersion value for the pixel value at each position corresponding to the ultrasound path in the CT image data, and determines that the larger the dispersion value is, the more uneven the body tissue, the value “A”. Use a large value.

  The calculation function 441 may be a case where a variance value is calculated for the CT values collected by the CT apparatus 100 for radiotherapy planning, or an acoustic sound calculated based on the concept of CT values and mutual information. It may be a case where the variance value for the impedance is calculated. In the latter case, the acoustic impedance can be accurately identified by specifying the substance based on the dual energy CT. Further, the calculation function 441 can calculate the variance value from various medical image data including the body tissue on the ultrasonic path, not limited to the image data obtained by the radiation therapy planning CT apparatus 100.

  Further, the calculation function 441 may use a plurality of CT image data collected in time series when evaluating the distribution of the ultrasonic medium on the ultrasonic path. For example, when the treatment target site moves during the radiotherapy because the treatment target site is close to the lung, the radiation treatment planning CT apparatus 100 sometimes receives a plurality of CT image data including the treatment target site. Collect serially. Then, the calculation function 441 calculates information on the movement of the treatment target region based on a plurality of CT image data. Here, the movement information is, for example, the coordinates of the position of the body surface of the treatment target P where the ultrasonic probe 310 is installed, and the position of the treatment target site at the time when each of a plurality of CT image data is collected. The coordinates of

  As an example, the calculation function 441 indicates a region between the position of the treatment target site at the time when each of the plurality of CT image data is collected and the position of the moving body surface in the treatment target P. A plurality of ultrasonic paths are calculated. In other words, the calculation function 441 calculates an ultrasound path for each CT image data for each position of the treatment target P. Next, the calculation function 441 determines whether bone or gas is distributed in any of a plurality of ultrasonic paths for each position of the treatment target P. Then, the calculation function 441 sets the value “A” to a large value (for example, infinity) when bone or gas is distributed in any of the plurality of ultrasonic paths. Alternatively, the calculation function 441 calculates a dispersion value for each of the plurality of ultrasonic paths, and averages the plurality of dispersion values calculated for each ultrasonic path. Then, the calculation function 441 determines that the body tissue is more uneven as the average value of the dispersion values is larger, and sets the value “A” to a larger value.

  For example, the calculation function 441 is based on the distribution of the ultrasonic medium between the ultrasonic probe 310 and the treatment target site for each position of the treatment target P for each of a plurality of CT image data. The value “A ′” is calculated. Next, the calculation function 441 calculates an average value for each position of the treatment object P for a plurality of values “A ′” calculated for each CT image data. Then, the calculation function 441 calculates the recommendation degree “R” by substituting the average value calculated for each position of the treatment target P into “A” in Expression (1).

  Next, the value “D” based on the distance between the ultrasonic probe 310 and the treatment target site will be described. For example, the calculation function 441 firstly determines the distance (ultrasonic path length) between each position in the treatment object P and the treatment target site from the CT image data generated by the CT apparatus 100 for radiotherapy planning. To get. Then, the calculation function 441 increases the value “D” for each position in the treatment target P as the ultrasonic path becomes longer. That is, the calculation function 441 calculates the value “D” as a function of the distance between the ultrasonic probe 310 and the treatment target site.

  Here, the calculation function 441 can define a function for calculating the value “D” using the ultrasonic attenuation rate in the ultrasonic path. As an example, the calculation function 441 may make the function for calculating the value “D” include a product of the length of the ultrasonic path and the logarithmic attenuation factor of the substance in the ultrasonic path. For example, the calculation function 441 may have a function for calculating the value “D” that includes a product of the length of the ultrasonic path and the reciprocal of the attenuation ratio of the substance in the ultrasonic path. . That is, the calculation function 441 defines a function so that the value “D” is likely to increase as the ultrasonic wave is easily attenuated due to the physical property of the ultrasonic medium in the ultrasonic path. Then, the calculation function 441 can calculate the value “D” by calculating the degree of attenuation of the ultrasonic wave transmitted from the ultrasonic probe 310 in the treatment body part. Note that the calculation function 441 can calculate a value “D” by assuming a soft tissue as a tissue between the ultrasonic probe 310 and the treatment target site.

  Further, the calculation function 441 can change the function for calculating the value “D” according to the scanning condition of the scanning by the ultrasonic probe 310. For example, the calculation function 441 can make the function for calculating the value “D” include a product of the length of the ultrasonic path and the frequency of the ultrasonic wave. That is, the calculation function 441 defines a function so that the value “D” is likely to increase with respect to the scanning condition in which the ultrasonic wave is easily attenuated because the ultrasonic wave is easily attenuated as the frequency increases even at the same distance. To do. Then, the calculation function 441 calculates the value “D” as a larger value as the ultrasonic frequency is higher. Note that the calculation function 441 can acquire the scanning condition from the transmission / reception circuit 341 that adjusts the transmission frequency, the transmission drive voltage, and the like. Here, the value “D” is defined as the length of the ultrasonic path or the product of the length of the ultrasonic path and the frequency of the ultrasonic wave, but the value “D” is based on the frequency and the acoustic impedance of the ultrasonic wave. It may be calculated based on the attenuation rate up to the treatment target site calculated in (1). Specifically, for example, when the attenuation rate is “80%”, “0.8” is subtracted from “1”, and the reciprocal of the difference is calculated.

  Next, the value “I” based on the angle between the ultrasonic probe 310 and the contact surface in a state where the treatment target region is scanned will be described. Hereinafter, a case where the contact surface with the ultrasonic probe 310 is the body surface (skin) of the treatment target P will be described as an example, but the embodiment is not limited thereto. For example, the contact surface with the ultrasonic probe 310 may be a body surface tissue other than skin such as a mucous membrane. In addition, when scanning is performed from the inside (such as the esophagus) of the treatment target P by swallowing the ultrasonic probe 310 by the treatment target P, the contact surface is not limited to the body surface.

  For example, the calculation function 441 first acquires the position information of the treatment target part from the treatment plan, and acquires the direction to the treatment target part for each position in the treatment target P. Here, since the ultrasonic probe 310 disposed on the treatment target P performs scanning in a state of being directed to the treatment target site, the direction from each position on the treatment target P to the treatment target site is the treatment target. The direction of the ultrasonic probe 310 is in a state of scanning the region.

  Further, the calculation function 441 acquires the direction of the contact surface at each position in the treatment target P from the CT image data collected by the CT apparatus 100 for radiotherapy planning. For example, the calculation function 441 obtains the direction of the surface with the normal vector to the skin at each position in the treatment target P as the normal vector as the direction of the contact surface. Then, the calculation function 441 calculates an angle formed by the direction of the ultrasonic probe 310 in a state of scanning the treatment target site and the direction of the contact surface (hereinafter also simply referred to as a contact angle) in each position on the treatment target P. Is calculated.

  For example, when the ultrasonic probe 310 is disposed at a position where the contact angle is “90 °”, the ultrasonic probe 310 may be placed vertically with respect to the skin, so that it is easy to install the ultrasonic probe 310. It is. Therefore, the calculation function 441 calculates “I” as a smaller value at a position where the contact angle is closer to “90 °”. On the other hand, for example, when the ultrasonic probe 310 is disposed at a position where the contact angle is close to “0 °”, the ultrasonic probe 310 is inclined with respect to the skin. Inclining the ultrasonic probe 310 greatly may cause a gap between the ultrasonic probe 310 and the skin in addition to the difficulty of installation. When a gap is generated between the ultrasonic probe 310 and the skin, it is difficult to collect an ultrasonic image. Therefore, the calculation function 441 calculates “I” as a larger value at a position where the contact angle is closer to “0 °”.

  For example, the calculation function 441 sets the contact angle to “θ” and the square value of the cosine “cos θ” to “I”. In this case, if the contact angle is “90 °”, “I” becomes “0”, and if the contact angle is “0 °”, “I” becomes “1”. Alternatively, the calculation function 441 calculates the contact angle “θ” in the range of “0 °” to “90 °”, and sets the cosine “cos θ” to “I”.

  The calculation function 441 uses, as the direction of the ultrasonic probe 310 in the state of scanning the treatment target region, the center coordinates of the surface of the ultrasonic probe 310 in the state of scanning the treatment target region that contacts the skin of the treatment target P. The direction to the treatment target site is calculated. Then, the calculation function 441 calculates a contact angle from the direction of the ultrasonic probe 310 and the direction of the contact surface in a state of scanning the treatment target site, and calculates “I” based on the contact angle.

  Next, the value “S” based on the degree of deformation of the contact surface of the treatment target P that contacts the ultrasonic probe 310 will be described. Here, the degree of deformation is the ease of deformation of the skin in contact with the ultrasonic probe 310 in the treatment target P. For example, the calculation function 441 calculates the degree of deformation at each position of the treatment target P based on the distance to nearby tissues and bones. For example, the calculation function 441 calculates the distance to the nearest bone for each position in the treatment target P from the CT image data collected by the CT apparatus 100 for radiotherapy planning. And the calculation function 441 calculates the deformation degree of each position in the to-be-treated body P so that the value of the deformation degree becomes smaller as the distance to the bone is shorter.

  Then, the calculation function 441 calculates the value “S” as a larger value as the degree of deformation is smaller for each position in the treatment target P. For example, when the ultrasonic probe 310 is disposed at a position with a large degree of deformation, it is easy to direct the ultrasonic probe 310 toward the treatment target site in a state where the ultrasonic probe 310 is in contact with the skin of the treatment target P. Therefore, the calculation function 441 calculates the value “S” as a small value for a position where the degree of deformation is large. On the other hand, when the ultrasonic probe 310 is arranged at a position where the degree of deformation is small, if the ultrasonic probe 310 is tilted with respect to the contact surface in order to be directed toward the treatment target region, the ultrasonic probe 310 is placed between the ultrasonic probe 310 and the skin. There may be a gap. Therefore, the calculation function 441 calculates the value “S” as a large value for a position where the degree of deformation is small.

  As described above, the calculation function 441 calculates the value “B” based on the irradiation range of the radiation irradiated to the treatment target region from the treatment plan, and the distribution of the ultrasonic medium between the ultrasonic probe 310 and the treatment target region. A value “A” based on the value, a value “D” based on the distance between the ultrasonic probe 310 and the treatment target region, and a value “I” based on the angle between the ultrasonic probe 310 and the contact surface in a state of scanning the treatment target region. ”And“ S ”based on the degree of deformation of the contact surface of the treatment object P that is in contact with the ultrasonic probe 310. In addition, the calculation function 441 calculates the recommendation degree “R” according to the equation (1) using the calculated values “B”, “A”, “D”, “I”, and “S”.

  Then, the notification control function 442 notifies the operator of the recommendation degree “R” calculated by the calculation function 441 for each position of the treatment object P in association with the position on the treatment object P (step S203). Hereinafter, the notification of the recommendation level will be described with reference to FIG. FIG. 10 is a diagram for explaining notification of a recommendation level according to the first embodiment. For example, as shown in FIG. 10, the notification control function 442 displays an image with a color corresponding to the recommendation level “R” on the model representing the treatment target P on the display 420, the display 220, the display 330, or the like. By doing so, the operator is notified of the recommendation level “R”. Note that the notification control function 442 can use one of hue, saturation, and luminance, or a combination of two or more of hue, saturation, and luminance as a color corresponding to the recommendation level “R”.

  Further, the notification control function 442 can generate a model representing the treatment target P based on model data stored in advance by the storage circuit 430, for example. Here, the model data refers to a human body having a standard physique corresponding to a plurality of combinations of parameters related to physique such as age, adult / child, male / female, weight, height, etc. It is the image image | photographed with the medical image inspection apparatus.

  For example, the notification control function 442 first reads out corresponding model data from the storage circuit 430 in accordance with the treatment plan and the treatment object information read from the PACS server 60. Next, the notification control function 442 extracts anatomical feature points in the CT image data (volume data) of the treatment target P received from the CT apparatus 100 for radiotherapy planning. In addition, the notification control function 442 collates the anatomical feature points in the CT image data with the feature points in the read model data, and associates the coordinate space of the volume data with the coordinate space of the model data. The notification control function 442 acquires model data approximated to CT image data by associating feature points.

  That is, the notification control function 442 can generate a human body model that matches the body shape of the treatment target P from the model data stored in the storage circuit 430. Then, the notification control function 442 gives the recommended degree “R” calculated for each position of the treatment target P to each position on the generated human body model, one of hue, saturation, and luminance, or hue. It can be displayed by a combination of two or more of saturation and luminance. Note that the notification control function 442 may use CT image data of the treatment target P collected by the radiation treatment planning CT apparatus 100 or the like instead of the above-described human body model.

  Further, the notification control function 442 may display a MPR (Multi Planar Reconstruction) image in addition to notifying the operator of the recommendation degree “R” in association with the position on the treatment target P. . Note that the notification control function 442 can generate an MPR image from model data, CT image data transmitted from the CT apparatus 100 for radiation therapy planning and other CT apparatuses.

  For example, the notification control function 442 includes the position where the calculated recommendation level “R” is the smallest among the positions on the treatment target P and the position designated by the operator via the input circuit 410. Then, MPR images of three planes orthogonal to each other are displayed. Here, the notification control function 442 can cause the treatment target part to be included in at least two of the three-plane MPR images to be displayed. Further, for example, the notification control function 442 displays three plane MPR images that are orthogonal to each other including the treatment target region. Here, the notification control function 442 is configured such that the position where the calculated recommendation degree “R” is the smallest on the minimum two planes of the three plane MPR images to be displayed or the operator via the input circuit 410. The specified position can be included.

  In the above-described example, the case where the calculation function 441 calculates one recommended degree “R” using “B”, “A”, “D”, “I”, and “S” has been described. Here, the calculation function 441 can also calculate a plurality of recommendation degrees. For example, the calculation function 441 uses a value “B” based on the irradiation range of radiation irradiated to the treatment target region, and a value “B” based on the distribution of the ultrasonic medium between the ultrasonic probe 310 and the treatment target region. A ”, a value“ D ”based on the distance between the ultrasonic probe 310 and the site to be treated, and a value“ S ”based on the degree of deformation of the contact surface of the treatment target P in contact with the ultrasonic probe 310 Using the two values, the first recommendation degree is calculated by the following equation (2). Note that “a”, “b”, “c”, and “e” in Equation (2) are the same as in Equation (1).

  Further, the calculation function 441 multiplies the value “I” based on the angle between the ultrasonic probe 310 in a state of scanning the treatment target region and the contact surface by a predetermined coefficient “d”, thereby obtaining the second recommended degree. Is calculated. Then, the notification control function 442 notifies the operator of each of the plurality of recommended degrees in association with the position on the treatment target P. For example, the notification control function 442 represents an image of a human body model in which the first recommended degree is expressed by one of hue and saturation, or a combination of hue and saturation, and the second recommended degree is expressed by luminance. By displaying on the display 420, the display 220, the display 330, and the like, the operator is notified of the recommended degree at each position of the treatment target P.

  Alternatively, the notification control function 442 generates an image indicating the recommendation degree at each position of the treatment target P for each of the plurality of recommendation degrees calculated by the calculation function 441, and is notified according to the operation from the operator. The degree may be switched. Also, the combination of the values “B”, “A”, “D”, “I”, and “S” used for calculating the recommendation level is arbitrary. It may be.

  Next, the reception function 443 receives a designation operation for designating the position of the ultrasonic probe 310 in the treatment target P from the operator through the input circuit 410 (step S204). Here, the reception function 443 determines the position that is determined as appropriate as the position of the ultrasonic probe 310 from the operator who refers to the recommendation degree displayed in association with the position on the treatment target P by the notification control function 442. Accept the specified operation.

  Hereinafter, an example of the position specifying operation of the ultrasonic probe 310 will be described with reference to FIGS. 11A and 11B. FIG. 11A and FIG. 11B are diagrams for explaining the operation of specifying the position of the ultrasonic probe 310 according to the first embodiment. First, as shown in FIG. 11A, the notification control function 442 displays the recommended degree calculated for each position of the treatment target P at each position on the human body model with a corresponding hue. Next, the operator determines the position of the ultrasonic probe 310. For example, the operator determines, as the position of the ultrasonic probe 310, the position R1 having the smallest recommended degree value among the positions on the human body model in which the recommended degree is expressed by hue. Then, the reception function 443 receives a designation operation for designating the position R1 by a mouse operation or the like included in the input circuit 410.

  Here, the notification control function 442 can notify the angle with respect to the contact surface of the ultrasonic probe 310 in a state where the treatment target region is scanned at the position where the designation operation is received. For example, as shown in FIG. 11B, the notification control function 442 can display a graphic indicating the ultrasonic probe 310 facing the treatment target region at the position R1 where the designation operation is received. If the operator determines that the displayed angle of the ultrasonic probe 310 is inappropriate, the reception function 443 again performs a designation operation for designating the position of the ultrasonic probe 310 in the treatment target P. Can be accepted.

  Then, the determination function 444 determines the position of the ultrasonic probe 310 on the treatment target P (step S205). For example, the determination function 444 determines the position where the reception function 443 receives the designation operation from the operator in step S204 as the probe position. Note that step S204 may not be performed. In this case, the determination function 444 determines the probe position according to the recommendation value calculated by the calculation function 441. For example, the determination function 444 determines the position having the smallest recommended value as the probe position.

  As described above, the processing circuit 440 according to the embodiment supports the position determination of the ultrasonic probe 310 by calculating the recommendation degree for each position of the treatment target P. The radiotherapy apparatus 20 can place the treatment object P on the bed and perform alignment of the treatment object P in parallel with steps S201 to S205 executed by the processing circuit 440. . Here, the alignment of the treatment target P by the radiation therapy apparatus 20 is the same as the alignment in step S104 of FIG.

  Next, the determination function 446 determines whether to assist the installation of the ultrasonic probe 310 (step S206). For example, the determination function 446 displays buttons indicating “Yes” and “No” in a GUI dialog box displayed on the display 420, and sets the ultrasonic probe 310 in response to pressing of the button from the operator. It is determined whether or not to assist. Further, for example, the determination function 446 determines whether or not to assist installation depending on whether or not a check box of a GUI displayed on the display 420 is checked. If the installation of the ultrasonic probe 310 is not assisted (No at step S206), the process for assisting the placement of the ultrasonic probe 310 is terminated.

  On the other hand, when assisting the installation of the ultrasonic probe 310 (Yes in step S206), the acquisition function 445 acquires the position and angle of the ultrasonic probe 310 (step S207). Here, the ultrasonic probe 310 includes a sensor 350 for specifying a position and an angle in a three-dimensional coordinate system. The acquisition function 445 acquires the position and angle of the ultrasonic probe 310 by receiving the position information and angle information detected by the sensor 350. That is, the position and angle of the ultrasonic probe 310 acquired by the acquisition function 445 indicate the position and angle of the ultrasonic probe 310 at the current time.

  Next, the determination function 446 determines the degree of coincidence between the probe position determined by the determination function 444 and the position of the ultrasonic probe 310 acquired by the acquisition function 445 (step S208). Hereinafter, the position of the ultrasonic probe 310 determined by the determination function 444 in the treatment target P is also referred to as a recommended position. Further, the position of the ultrasonic probe 310 acquired by the acquisition function 445 in the treatment target P is also referred to as the current position.

  Here, in the radiotherapy system 1, the coordinate system in the radiotherapy planning CT apparatus 100, the coordinate system in the radiotherapy apparatus 20, and the coordinate system in the ultrasonic diagnostic apparatus 30 are aligned in advance. Therefore, the determination function 446 is, for example, the position between the recommended position determined by the determination function 444 in the coordinate system of the radiation therapy planning CT apparatus 100 and the current position acquired by the acquisition function 445 in the coordinate system of the ultrasonic diagnostic apparatus 30. Relationships can be uniquely identified. The determination function 446 calculates, for example, the distance between the coordinates of the recommended position and the coordinates of the current position, and the degree of coincidence between the recommended position and the current position (hereinafter referred to as the position of the position) so as to be inversely proportional to the calculated distance value. (Also described as the degree of coincidence).

  Next, the notification control function 442 notifies the operator of the degree of coincidence of the position determined by the determination function 446 (step S209). For example, the notification control function 442 displays the color or number corresponding to the degree of coincidence of the position on the display 420, the display 220, the display 330, or the like, or emits a sound or other sound corresponding to the degree of coincidence, thereby obtaining the degree of coincidence. Notify the operator. In other words, the notification control function 442 gives the degree of coincidence determined by the determination function 446 to the operator by hue, saturation, luminance, number, sound, or a combination of two or more of hue, saturation, luminance, number, and sound. Notice.

  Here, the determination function 446 determines whether or not a determination operation for determining the position where the ultrasonic probe 310 is installed has been received from the operator (step S210). When the installation of the ultrasonic probe 310 at the recommended position has not been completed, the determination function 446 does not accept the position determination operation (No at Step S210), and the notification control function 442 gives the operator the degree of coincidence of the position again. Notice.

  On the other hand, when the operator determines that the installation of the ultrasonic probe 310 at the recommended position is completed, the determination function 446 accepts a position determination operation (Yes in step S210), and the probe position determined by the determination function 444 ( The coincidence between the angle of the ultrasonic probe 310 acquired by the acquisition function 445 and the angle of the contact surface of the ultrasonic probe 310 in a state of scanning the treatment target region at the recommended position) and the treatment target P contacting the ultrasonic probe 310 The degree is determined (step S211).

  Here, the ultrasonic probe 310 in a state where the treatment target site is scanned at the recommended position is the ultrasonic probe 310 facing the direction from the recommended position to the treatment target site. In addition, the contact surface of the treatment object P that contacts the ultrasonic probe 310 is a surface having a normal vector as a normal line from the skin of the treatment object P at the recommended position, for example. Hereinafter, the angle of the contact surface of the ultrasonic probe 310 in a state where the treatment target site is scanned at the recommended position and the treatment target P contacting the ultrasonic probe 310 is also referred to as a recommended angle.

  The angle of the ultrasonic probe 310 acquired by the acquisition function 445 is, for example, the angle between the current direction of the ultrasonic probe 310 and the contact surface of the treatment target P at the recommended position. Hereinafter, the angle of the ultrasonic probe 310 acquired by the acquisition function 445 is also referred to as a current angle. The determination function 446 can uniquely identify the relationship between the recommended angle and the current angle because the coordinate system of each device is previously aligned in the radiation therapy system 1. Then, the determination function 446 calculates, for example, a difference between the recommended angle and the current angle, and a degree of coincidence between the recommended angle and the current angle so as to be inversely proportional to the calculated difference (hereinafter also referred to as an angle coincidence). Determine.

  Next, the notification control function 442 notifies the operator of the degree of coincidence of the angles determined by the determination function 446 (step S212). For example, the notification control function 442 displays the color or number corresponding to the degree of coincidence of the angles on the display 420, the display 220, the display 330, or the like, or emits a sound or other sound corresponding to the degree of coincidence of the angles. Is notified to the operator. That is, the notification control function 442 determines the degree of coincidence of the angles determined by the determination function 446 as one of hue, saturation, luminance, number, and sound, or 2 of hue, saturation, luminance, number, and sound. The operator is notified by the above combination.

  Here, the determination function 446 determines whether or not a determination operation for determining the angle at which the ultrasonic probe 310 is installed has been received from the operator (step S213). If the operation for adjusting the angle of the ultrasonic probe 310 to the recommended angle has not been completed, the determination function 446 does not accept the angle determination operation (No in step S213), and the notification control function 442 operates the angle coincidence again. The person in charge. On the other hand, when the operation for adjusting the angle of the ultrasonic probe 310 to the recommended angle is completed, the determination function 446 accepts an angle determination operation from the operator (Yes in step S213), and supports the placement of the ultrasonic probe 310. Terminate the process.

  The notification control function 442 can simultaneously notify the degree of coincidence of the position and angle of the ultrasonic probe 310 determined by the determination function 446. For example, the notification control function 442 includes, on the human body model, a figure indicating the ultrasonic probe 310 at the recommended position and facing the recommended angle, and an ultrasonic probe at the current position and facing the current angle. By presenting an image synthesized with the graphic representing 310 to the operator, the degree of coincidence of the position and the degree of coincidence of the angles are simultaneously notified.

  When the placement of the ultrasound probe 310 is completed, the ultrasound diagnostic apparatus 30 generates an ultrasound image including the treatment target site and presents it to the operator through the display 330 or the like. When a radiation therapy start command is input, the radiation therapy apparatus 20 irradiates the body P to be treated according to the treatment plan while confirming the position and movement of the treatment target site under the ultrasound guide. And perform radiation therapy.

  As described above, according to the first embodiment, the calculation function 441 arranges the ultrasonic probe 310 that scans the target part at the time of radiation irradiation based on the radiation irradiation plan for the target part of the treatment target P. Is calculated for each position in the treatment target P. The notification control function 442 notifies the operator of the recommendation level in association with the position on the treatment target P. Therefore, the treatment planning apparatus 40 according to the first embodiment makes it possible to support the placement of the ultrasound probe in radiotherapy.

  Further, according to the first embodiment, the calculation function 441 calculates the recommendation degree based on the value “B” based on the irradiation range of the radiation irradiated to the treatment target site. Therefore, the treatment planning apparatus 40 according to the first embodiment attenuates radiation when passing through the ultrasonic probe 310 and the fixed part, thereby reducing the efficiency of radiotherapy, or degrading the ultrasonic probe 310 itself. In order to avoid this, it is possible to assist the placement of the ultrasonic probe 310 on the treatment target P.

  Further, according to the first embodiment, the calculation function 441 calculates the value “B” based on the scattered radiation intensity of the radiation, and calculates the recommendation degree. Therefore, the treatment planning apparatus 40 according to the first embodiment reduces deterioration of the ultrasonic probe 310 due to scattered radiation when the ultrasonic probe 310 is disposed at a position not included in the radiation irradiation range. Enable.

  Further, according to the first embodiment, the calculation function 441 calculates the recommendation degree based on the value “A” based on the distribution of the ultrasonic medium between the ultrasonic probe 310 and the treatment target site. Therefore, the treatment planning apparatus 40 according to the first embodiment can avoid the deterioration of the image quality of the ultrasound image of the treatment target site due to the distribution of bones and gas as the ultrasound medium on the ultrasound path. In addition, it is possible to assist in placing the ultrasonic probe 310 on the treatment target P.

  Further, according to the first embodiment, the calculation function 441 calculates a dispersion value based on the signal value at each position on the ultrasonic path, calculates the value “A” based on the calculated dispersion value, and recommends it. Calculate the degree. Therefore, the treatment planning apparatus 40 according to the first embodiment also applies the sound wave in the ultrasonic path even when the ultrasonic probe 310 is arranged at a position where no bone or gas is distributed as the ultrasonic medium on the ultrasonic path. The ultrasound probe 310 is supported to be placed on the treatment target P so that the ultrasonic wave is attenuated due to the non-uniform distribution of the body tissue as a medium and the image quality of the ultrasonic image is deteriorated. be able to.

  Further, according to the first embodiment, the calculation function 441 calculates information on the movement of the treatment target region based on a plurality of CT image data, and changes with time of the ultrasonic medium on the ultrasonic path. A distribution is calculated, a value “A” is calculated based on the calculated distribution, and a recommendation level is calculated. Therefore, the treatment planning apparatus 40 according to the first embodiment is applied to the treatment target P even when the treatment target part moves during the radiation treatment because the treatment target part is located near the lung. Assistance in placing the ultrasound probe 310 can be provided.

  Further, according to the first embodiment, the calculation function 441 calculates the recommendation degree based on the value “D” based on the distance between the ultrasound probe 310 and the treatment target site. Therefore, the treatment planning apparatus 40 according to the first embodiment avoids that the ultrasonic wave reaching the treatment target site is attenuated due to the long ultrasonic path, and the image quality of the ultrasonic image of the treatment target site is deteriorated. As can be done, it is possible to assist the placement of the ultrasonic probe 310 on the treatment target P.

  Further, according to the first embodiment, the calculation function 441 defines a function for calculating the value “D” using the ultrasonic attenuation rate and the scanning condition in the ultrasonic path, and calculates the recommendation degree. Therefore, the treatment planning apparatus 40 according to the first embodiment can more appropriately calculate the degree of attenuation of the ultrasonic waves that reach the treatment target site.

  In addition, according to the first embodiment, the calculation function 441 calculates the recommendation degree based on the value “I” based on the angle between the ultrasonic probe 310 in a state of scanning the treatment target region and the contact surface. Therefore, the treatment planning apparatus 40 according to the first embodiment avoids the difficulty of installing the ultrasonic probe 310 with a large inclination with respect to the skin of the treatment target P, so that the ultrasonic probe is applied to the treatment target P. Assistance with placing 310 can be provided.

  Further, according to the first embodiment, the calculation function 441 calculates the recommendation degree based on the value “S” based on the degree of deformation of the contact surface of the treatment target P that contacts the ultrasonic probe 310. Therefore, the treatment planning apparatus 40 according to the first embodiment places the ultrasonic probe 310 on the treatment target P so that the treatment can be tilted in a state where the ultrasonic probe 310 is in close contact with the skin of the treatment target P. Can help.

  Further, according to the first embodiment, the determination function 446 determines the degree of coincidence between the recommended position of the ultrasonic probe 310 and the current position, and the degree of coincidence between the recommended angle and the current angle, and the notification control function 442 The determined degree of coincidence is notified to the operator. Therefore, the treatment planning apparatus 40 according to the first embodiment can assist the installation of the ultrasonic probe 310 on the treatment target P.

  Further, according to the first embodiment, the notification control function 442 notifies the operator of the degree of coincidence between the recommended position of the ultrasonic probe 310 and the current position and the degree of coincidence between the recommended angle and the current angle. Therefore, the treatment planning apparatus 40 according to the first embodiment avoids the difficulty of simultaneously adjusting the position and angle when installing the ultrasonic probe 310 on the treatment target P, and easily installs the ultrasonic probe 310. Make it possible.

(Second Embodiment)
Although the first embodiment has been described so far, the present invention may be implemented in various different forms other than the first embodiment described above.

  In the first embodiment described above, the case where the calculated recommendation degree is notified to the operator has been described. However, the embodiment is not limited to this. For example, the calculation function 441 is a case where the treatment plan is corrected based on the recommendation degree in addition to notifying the operator of the calculated recommendation degree or instead of notifying the operator of the recommendation degree. Also good.

  For example, the calculation function 441 corrects the treatment plan when it is determined that there is no appropriate position as the position of the ultrasonic probe 310 as a result of calculating the recommendation degree for each position in the treatment target P. For example, the calculation function 441 compares the minimum recommended value calculated for each position in the treatment object P with a threshold, and if the minimum recommended value is larger than the threshold, It is determined that there is no appropriate position to place.

  If it is determined that there is no appropriate position for placing the ultrasound probe 310, the calculation function 441 corrects the frequency of the ultrasound in the treatment plan, for example. Here, by correcting the treatment plan so as to reduce the frequency, the ultrasonic wave is less likely to be attenuated, and it is possible to scan the treatment target site from a more distant position. In other words, by correcting the treatment plan so as to reduce the frequency, the value “D” based on the distance between the ultrasound probe 310 and the treatment target region is reduced, and the recommended degree at each position of the treatment object P The value of becomes smaller. For example, the calculation function 441 corrects the frequency so that the minimum value of the recommendation degree at each position of the treatment target P is lower than the threshold value.

  Then, the calculation function 441 calculates the recommended degree again based on the corrected treatment plan, and the notification control function 442 notifies the operator of the recommended degree based on the corrected treatment plan. Here, since there is a position where the recommendation level is lower than the threshold after the frequency correction, the notification control function 442 can present the operator with an appropriate position where the ultrasonic probe 310 is placed.

  Further, for example, the calculation function 441 may be a case where the treatment plan is corrected when it is determined that there is an appropriate position where the ultrasound probe 310 is disposed. For example, the calculation function 441 compares the minimum recommended value calculated for each position of the treatment object P with a threshold value, and places the ultrasonic probe 310 when the minimum recommended value is smaller than the threshold value. It is determined that an appropriate position exists.

  When it is determined that there is an appropriate position for placing the ultrasound probe 310, the calculation function 441 corrects the treatment plan so that, for example, the frequency of the ultrasound is increased. In such a case, since the value “D” increases and the value of the recommendation degree at each position of the treatment target P also increases, the calculation function 441 does not have an appropriate position where the ultrasonic probe 310 is disposed. The treatment plan is corrected so that the frequency of the sound wave is increased. And the calculation function 441 makes it possible to generate a high-contrast ultrasound image based on high-frequency ultrasound by correcting the treatment plan. Further, the notification control function 442 presents an appropriate position where the ultrasonic probe 310 is disposed to the operator.

  In the above-described example, the case has been described in which the frequency of the ultrasonic wave used for scanning the treatment target region in the treatment plan is corrected. However, the embodiment is not limited to this, and the calculation function 441 may be a case where other conditions (for example, the irradiation direction of the therapeutic radiation) are corrected in the treatment plan.

  In the first embodiment described above, the calculation function 441 calculates the recommendation degree “R” as a numerical value equal to or greater than “0”, and the smaller the value, the more preferable the position of the ultrasonic probe 310 is. The case where it does is demonstrated as an example. However, the embodiment is not limited to this. For example, the calculation function 441 calculates the recommendation degree “R” as the value of the ultrasonic probe 310 is more suitable as the value is larger. Also good. In addition, the numerical value range when the calculation function 441 calculates the recommendation degree “R” as a numerical value is arbitrary. For example, the calculation function 441 may evaluate the recommendation level “R” in two or more stages. For example, the calculation function 441 may calculate whether or not each position of the treatment target P is appropriate as the position of the ultrasonic probe 310 as the recommendation degree “R”.

  In the first embodiment, the case where the recommended angle and the current angle of the ultrasonic probe 310 are calculated based on the contact surface of the treatment target P at the recommended position has been described. However, the embodiment is limited to this. is not. For example, the determination function 446 can calculate the recommended angle and the current angle of the ultrasonic probe 310 based on an arbitrary surface such as a floor or a wall of a room where the radiation therapy apparatus 20 is installed. Further, for example, the determination function 446 obtains the inner product of the direction vector of the ultrasonic probe 310 in a state where the treatment target site is scanned at the recommended position and the direction vector of the ultrasonic probe 310 acquired by the acquisition function 445, and calculates the inner product. The degree of coincidence of angles can also be determined on the assumption that the degree of coincidence increases as the value increases.

  In the first embodiment, the case where CT image data is used as volume data used for planning a treatment plan has been described as an example. However, the embodiment is not limited to this. For example, volume data collected by an MRI apparatus, a PET apparatus, a SPECT apparatus, or the like may be used.

  In the first embodiment described above, the treatment planning device 40 that executes each function by the processing circuit 440 has been described as a support device that supports the placement of the ultrasound probe 310 in radiotherapy. However, the embodiment is not limited to this, and the above-described support device may be realized by any of the devices shown in FIG. 1, or may be realized as a device separate from each device shown in FIG. May be.

  For example, the radiotherapy apparatus 20 can assist in the placement of the ultrasound probe 310 in radiotherapy. As an example, first, the system control circuit 260 of the radiotherapy apparatus 20 acquires a treatment plan for the treatment target site of the treatment target P from the treatment plan apparatus 40. Next, the system control circuit 260 calculates the recommended degree of placement of the ultrasonic probe 310 for each position in the treatment object P based on the treatment plan, and associates the calculated recommendation degree with the position in the treatment object P. By notifying the operator, it is possible to assist the placement of the ultrasound probe 310 in radiotherapy. That is, the system control circuit 260 executes each function by the processing circuit 440, whereby the above-described support device is realized in the radiation therapy apparatus 20.

  The term “processor” used in the description of the above-described CT apparatus 100 for radiotherapy planning, the radiotherapy apparatus 20, the ultrasonic diagnostic apparatus 30, and the therapy planning apparatus 40 is, for example, a CPU (Central Processing Unit), a GPU (GPU). Graphics Processing Unit), Application Specific Integrated Circuit (ASIC), Programmable Logic Device (for example, Simple Programmable Logic Device (SPLD), Complex Programmable Logic Device (Complex Programmable Logic Device) CPLD) and a field programmable gate array (FPGA)). The processor implements a function by reading and executing a program stored in the storage circuit. Instead of storing the program in the storage circuit, the program may be directly incorporated in the processor circuit. In this case, the processor realizes the function by reading and executing the program incorporated in the circuit. Note that each processor of the present embodiment is not limited to being configured as a single circuit for each processor, but may be configured as a single processor by combining a plurality of independent circuits to realize the function. Good.

  In addition, each component of each device illustrated in the first embodiment is functionally conceptual and does not necessarily need to be physically configured as illustrated. That is, the specific form of distribution / integration of each device is not limited to the one shown in the figure, and all or a part thereof may be functionally or physically distributed or arbitrarily distributed in arbitrary units according to various loads or usage conditions. Can be integrated and configured. Further, all or a part of each processing function performed in each device may be realized by a CPU and a program that is analyzed and executed by the CPU, or may be realized as hardware by wired logic.

  The support method described in the first embodiment can be realized by executing a support program prepared in advance on a computer such as a personal computer or a workstation. This support program can be distributed via a network such as the Internet. The support program can also be executed by being recorded on a computer-readable recording medium such as a hard disk, a flexible disk (FD), a CD-ROM, an MO, and a DVD, and being read from the recording medium by the computer.

  As described above, according to the first and second embodiments, it is possible to support the placement of the ultrasound probe in radiotherapy.

  Although several embodiments of the present invention have been described, these embodiments are presented by way of example and are not intended to limit the scope of the invention. These embodiments can be implemented in various other forms, and various omissions, replacements, and changes can be made without departing from the spirit of the invention. These embodiments and their modifications are included in the scope and gist of the invention, and are also included in the invention described in the claims and the equivalents thereof.

40 Treatment Planning Device 441 Calculation Function 442 Notification Control Function

Claims (19)

Based on the radiation irradiation plan for the target part of the treatment target, a calculation unit that calculates the recommended degree of placement of the ultrasonic probe that scans the target part at the time of irradiation of the radiation for each position in the treatment target;
A notification control unit that notifies the operator of the recommendation degree in association with a position on the treatment object;
A support device comprising:   The calculation unit includes an irradiation range of radiation applied to the target part, a distribution of an ultrasonic medium between the ultrasonic probe and the target part, a distance between the ultrasonic probe and the target part, The recommendation is based on at least one of a degree of deformation of a contact surface of the treatment object in contact with the ultrasonic probe and an angle between the ultrasonic probe and the contact surface in a state of scanning the target site. The support device according to claim 1, wherein the degree is calculated.   The calculation unit calculates the recommendation degree indicating that a position in the treatment object excluding a position included in the radiation irradiation range is recommended over a position included in the radiation irradiation range. 2. The support device according to 2.   The said calculation part calculates the said recommendation degree about the position in the said to-be-treated body except the position included in the irradiation range of the said radiation based on the intensity | strength of the scattered radiation of the said radiation in the said position. The support device described in 1.   The calculation unit is configured to determine a position in the treatment target excluding a position where bone or gas is distributed as an ultrasonic medium between the ultrasonic probe and the target site, from a position where bone or gas is distributed as the medium. The support device according to any one of claims 2 to 4, wherein the degree of recommendation indicating that is also recommended is calculated.   The calculation unit calculates a variance value based on a signal value at each position in a region between the ultrasound probe and the target site, and calculates the recommendation degree based on the calculated variance value. The support device according to claim 5.   The calculation unit calculates movement information of the target part based on a plurality of medical images collected in a time series including the target part, and the super image is calculated based on the plurality of medical images and the movement information. The distribution of a medium that changes with time between the acoustic probe and the target site is calculated, and the recommendation degree is calculated based on the calculated distribution of the medium. Support device.   The calculation unit calculates a degree of attenuation of the ultrasonic wave transmitted from the ultrasonic probe in the target region based on the distance and a scanning condition of scanning by the ultrasonic probe, and calculates the calculated degree of attenuation. The support device according to any one of claims 2 to 7, wherein the recommendation degree is calculated based on the value.   The support device according to any one of claims 2 to 8, wherein the calculation unit calculates the degree of deformation based on a tissue in the vicinity of the contact surface and a distance from the contact surface to a bone.   The calculation unit, as an angle between the ultrasonic probe in a state of scanning the target region and the contact surface, from the center of a surface where the ultrasonic probe in a state of scanning the target region contacts the contact surface The support device according to any one of claims 2 to 9, wherein an angle between a direction to a target site and the contact surface is calculated.   The calculation unit includes the ultrasonic probe within the radiation irradiation range with respect to a position in the treatment object excluding a position where at least one of the ultrasonic probe and the fixing unit of the ultrasonic probe is included in the radiation irradiation range. The support device according to any one of claims 2 to 10, wherein the degree of recommendation indicating that the position is recommended from a position including the fixing unit is calculated.   The notification control unit displays display information indicating the recommended degree at each position of the treatment object by one of hue, saturation, and luminance, or a combination of two or more of hue, saturation, and luminance. The support device according to any one of claims 1 to 11. The calculation unit includes an irradiation range of radiation applied to the target part, a distribution of an ultrasonic medium between the ultrasonic probe and the target part, a distance between the ultrasonic probe and the target part, And the ultrasonic probe in a state of calculating a first recommendation degree based on at least one of the deformation degrees of the contact surface of the treatment object in contact with the ultrasonic probe and scanning the target portion Based on the angle with the contact surface, a second recommendation degree is calculated,
The notification control unit represents the first recommended degree for each position of the treatment object by one of hue and saturation, or a combination of hue and saturation, and for each position of the treatment object. The support apparatus according to claim 1, wherein display information that represents the second recommendation degree of the image by brightness is displayed. A reception unit for receiving a designation operation for designating a position of the ultrasonic probe in the treatment target from an operator;
14. The notification control unit according to claim 12, wherein the notification control unit notifies a recommended angle with respect to a contact surface of the treatment target of the ultrasonic probe in a state of scanning the target portion at a position specified by the specifying operation. Support device. An acquisition unit for acquiring the position and angle of the ultrasonic probe;
A determination unit that determines a position of the ultrasonic probe in the treatment object based on an input operation by an operator or the recommended degree;
A first determination unit that determines the degree of coincidence between the position determined by the determination unit and the position of the ultrasonic probe acquired by the acquisition unit;
The ultrasonic probe in a state of scanning the target site at the position determined by the determination unit, the angle of the contact surface of the treatment target that contacts the ultrasonic probe, and the ultrasonic wave acquired by the acquisition unit A second determination unit that determines the degree of coincidence with the angle of the probe,
The support device according to any one of claims 1 to 14, wherein the notification control unit notifies an operator of the degree of coincidence determined by the first determination unit and the second determination unit.   The notification control unit may determine the degree of coincidence determined by the first determination unit and the second determination unit as one of hue, saturation, luminance, number, and sound, or hue, saturation, luminance, and number. The support device according to claim 15, wherein notification is made by a combination of two or more of sound and sound.   The support device according to claim 15 or 16, wherein the notification control unit notifies the degree of coincidence determined by the first determination unit and the degree of coincidence determined by the second determination unit, respectively.   The support device according to claim 1, wherein the calculation unit corrects the irradiation plan based on the recommendation degree. Based on the radiation irradiation plan for the target part of the treatment target, the recommended degree of placement of the ultrasonic probe that scans the target part at the time of irradiation of the radiation is calculated for each position in the treatment target,
Informing the operator of the recommended degree in association with the position on the treatment object,
Support method including that.

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