JP2019010508A - Radiotherapy system and therapy support device - Google Patents

Abstract

To perform first positioning of a patient in radiotherapy accurately and easily.SOLUTION: A radiotherapy system includes a medical image collection device, a first body surface data collection device, and an arithmetic circuit. The medical image collection device collects medical three-dimensional image data on a patient in therapeutic planning. The first body surface data collection device collects first body surface data indicating a three-dimensional body surface on the patient in therapeutic planning. The arithmetic circuit creates integrated data in which at least one of the medical three-dimensional image data and therapeutic site data included in the medical three-dimensional image data, and the first body surface data are integrated in the same three-dimensional coordinate system.SELECTED DRAWING: Figure 7

Description

  Embodiments described herein relate generally to a radiation treatment system and a treatment support apparatus.

  At the time of radiotherapy, it is necessary to align the tumor roughly at the isocenter (hereinafter referred to as the first alignment) in order to accurately irradiate the tumor position with radiation. In the first alignment, a mark indicating the tumor position is drawn on the front or side of the patient's body surface while referring to the planning CT image, and the patient and the irradiation position of the laser from the laser sighting device coincide with each other. This is done by manually aligning the bed or the bed. This task is cumbersome and inaccurate. Although radiation therapy is performed for a plurality of days, the mark may disappear if the patient enters a bath or the like. If the mark disappears, it is redrawn again, but this is also cumbersome and inaccurate.

JP 2008-022896 JP 2011-200542 A JP 2005-514969 A JP2015-019693A

  The problem to be solved by the present invention is to accurately and simply perform the first alignment of a patient during radiation therapy.

  The radiation therapy system according to the embodiment includes a medical image collection device, a first body surface data collection device, and an arithmetic circuit. The medical image collection apparatus collects medical three-dimensional image data of a patient at the time of treatment planning. The first body surface data collection device collects first body surface data representing the three-dimensional body surface of the patient at the time of treatment planning. The arithmetic circuit outputs integrated data in which at least one of the medical 3D image data and the treatment site data included in the medical 3D image data and the first body surface data are integrated in the same 3D coordinate system. Generate.

FIG. 1 is a diagram illustrating a configuration of a radiation therapy system according to the first embodiment. FIG. 2 is a diagram showing an installation environment of the treatment planning CT apparatus of FIG. 1 and the first surface shape measurement apparatus. FIG. 3 is a diagram illustrating an example of three-dimensional patient body surface data collected by the first surface shape measurement apparatus of FIG. FIG. 4 is a diagram showing an installation environment of the radiotherapy apparatus and the second surface shape measurement apparatus of FIG. FIG. 5 is a diagram showing a configuration of the radiotherapy apparatus of FIG. FIG. 6 is a diagram showing a configuration of the treatment support apparatus of FIG. FIG. 7 is a diagram showing a typical flow of operation of the radiation therapy system of FIG. FIG. 8 is a diagram showing an example of planned integration data generated in step SA4 of FIG. FIG. 9 is a view showing a 9-9 'cross section of FIG. FIG. 10 is a diagram schematically showing the flow of position comparison and tumor position estimation processing executed by the arithmetic operation circuit of the treatment support apparatus in step SA6 of FIG. FIG. 11 is a diagram illustrating a typical flow of the operation of the radiation therapy system according to the second embodiment. FIG. 12 is a diagram showing an example of a superimposed image of the planned integrated image and the treatment body surface image displayed in step SB6 of FIG. FIG. 13 is a diagram illustrating a configuration of a treatment support apparatus according to the third embodiment. FIG. 14 is a diagram illustrating a typical flow of the operation of the radiation therapy system according to the third embodiment. FIG. 15 is a continuation of the flow of FIG. FIG. 16 is a diagram illustrating a configuration of a treatment support apparatus according to the fourth embodiment. FIG. 17 is a diagram schematically showing processing by the body type comparison function of the arithmetic circuit according to the fourth embodiment. FIG. 18 is a diagram illustrating a configuration of an information display system according to an application example.

  Hereinafter, a radiotherapy system and a treatment support apparatus according to the present embodiment will be described with reference to the drawings.

(First embodiment)
FIG. 1 is a diagram showing a configuration of a radiation therapy system 1 according to the first embodiment. As shown in FIG. 1, a radiation treatment system 1 includes a treatment planning CT (Computed Tomography) device 2, a first surface shape measurement device 3, a radiation treatment device 4, a second surface shape measurement device 5, and a treatment plan device. 6. It has a PACS (Picture Archiving and Communication System) system 7 and a treatment support apparatus 8. The treatment planning CT device 2, the first surface shape measuring device 3, the radiation treatment device 4, the second surface shape measuring device 5, the treatment planning device 6, the PACS system 7, and the treatment support device 8 are mutually connected via a network. It is connected so that it can communicate.

  FIG. 2 is a diagram illustrating an installation environment of the treatment planning CT apparatus 2 and the first surface shape measurement apparatus 3. As shown in FIG. 2, the treatment planning CT apparatus 2 and the first surface shape measurement apparatus 3 are installed in the planning CT room. The treatment planning CT apparatus 2 includes an imaging stand 21 and an imaging bed 22. The treatment planning CT apparatus 2 has a console (not shown) installed in an operation room adjacent to the planning CT room. The imaging gantry 21 has an opening 211 into which a patient is inserted, and an X-ray tube (not shown) and an X-ray detector (not shown) are rotated around the rotation axis Z1 inside the gantry 21. A support mechanism (not shown) that supports the load is mounted. The imaging bed 22 includes an imaging top plate 23 on which a patient is placed, and a base 24 that supports the imaging top plate 23 movably. The imaging top plate 23 has a planar shape like a treatment top plate 44 described later. In order to improve patient positioning accuracy, the imaging top plate 23 preferably has the same shape as the treatment top plate 44.

  At the time of CT imaging, the imaging gantry 21 performs X-ray irradiation by the X-ray tube and X-ray detection by the X-ray detector while rotating the X-ray tube and the X-ray detector at a high speed. Raw data indicating X-ray attenuation by the patient is collected by an X-ray detector. The raw data is transmitted to a console (not shown). The console reconstructs 3D CT image data based on the raw data. The console may generate, as CT image data, image data indicating a spatial distribution of CT values according to the X-ray attenuation coefficient, calculate an X-ray attenuation coefficient from the CT value, and spatial distribution of the X-ray attenuation coefficient May be generated. The CT image data is transmitted to the treatment planning device 6, the PACS system 7, and the treatment support device 8.

  Although the radiotherapy system 1 has the CT device 2 for treatment planning, the present embodiment is not limited to this. That is, if the radiotherapy system 1 is a medical image diagnostic apparatus capable of generating three-dimensional medical image data for a patient treatment plan, a cone beam CT apparatus, a magnetic resonance imaging apparatus, You may have a nuclear medicine diagnostic device etc. However, in order to perform the following description specifically, it is assumed that the radiation treatment system 1 includes a treatment planning CT apparatus 2 as a medical image diagnostic apparatus capable of generating three-dimensional medical image data for a patient treatment plan.

  The first surface shape measuring device 3 is provided on the wall surface of the planning CT room. For example, the first surface shape measuring device 3 is suspended from the ceiling. The first surface shape measuring device 3 measures the body surface of the patient placed on the imaging top plate 23 and collects three-dimensional patient body surface data related to the patient's body surface.

  FIG. 3 is a diagram showing an example of the three-dimensional patient body surface data D1 collected by the first surface shape measuring device 3. As shown in FIG. As shown in FIG. 3, the patient body surface data D <b> 1 has a patient body surface region RP related to the body surface of the patient P and a top plate surface region RT related to the surface of the imaging top plate 23. The patient body surface data D1 is data in which forms such as the shape, position and size of the body surface of the patient measured according to a predetermined measurement principle are recorded. The patient body surface data D1 is defined by an XYZ orthogonal coordinate system. The Y axis is defined as the vertical axis, the Z axis is defined as the central axis R1 of the imaging stand 21, and the X axis is defined as an axis orthogonal to the Y axis and the Z axis. Hereinafter, the three-dimensional body surface data collected by the first surface shape measurement device 3 and related to the body surface of the patient placed on the imaging top plate of the treatment planning CT device 2 is referred to as planned body surface data. I will decide. The planned body surface data is transmitted to the treatment support apparatus 8. Note that the planned body surface data shown in FIG. 3 includes the patient body surface region RP related to the whole patient body, but may include only the patient body surface region RP related to the partial body surface of the patient. That is, the first surface shape measurement apparatus 3 may optically scan only a part of the patient's body surface.

  There are several measurement principles by the first surface shape measurement device 3. For example, there is an optical scanning method as a measurement principle. In this case, the first surface shape measurement apparatus 3 includes a light projecting unit, a photographing unit, and a three-dimensional coordinate identification unit. The light projecting unit scans the patient placed on the imaging top plate 23 in a line with a laser. The imaging unit captures the laser light on and around the patient as an image in synchronization with the laser projection. The three-dimensional coordinate identification unit calculates three-dimensional coordinates from the position of the laser projector light source of the light projecting unit and the laser position on the image. By this operation, one section of the patient surface shape is obtained. By repeatedly identifying this while changing the projection angle of the laser, the patient surface shape can be obtained three-dimensionally.

  Another measurement principle is epipolar geometry. In this case, the first surface shape measurement apparatus 3 includes an image collection unit and an image processing unit. The image collection unit has two cameras. The image collecting unit photographs the patient placed on the imaging top plate 23 with two cameras having different observation angles, and collects two image data having different observation angles. The image processing unit has a processor and a memory. The image processing unit sets one pixel (point of interest) of the image data relating to the first observation angle, and identifies a corresponding point in the image data relating to the second observation angle corresponding to the point of interest. Note that the point of interest may be a small region including the pixel as a center. As an identification method, correlation calculation is generally used. When the corresponding point is identified, the image processing unit includes an imaging trajectory (ray) connecting the point of interest included in the first image data and the first camera that has collected the first image data, and the second The three-dimensional coordinates of the intersection of the corresponding point included in the image data and the imaging trajectory connecting the second camera that has collected the second image data are identified based on the principle of epipolar geometry. The image processing unit identifies the three-dimensional coordinates of the intersection for all the pixels, and identifies a set of intersections as the three-dimensional patient body surface data of the patient.

  Although two examples have been described as the measurement principle, the measurement principle of the first surface shape measurement apparatus 3 according to the present embodiment is not limited to this, and any method may be used as long as the patient's body surface can be measured. In order to specifically describe the following, it is assumed that the measurement principle of the first surface shape measurement apparatus 3 is an optical scanning method.

  FIG. 4 is a diagram illustrating an installation environment of the radiation therapy apparatus 4 and the second surface shape measurement apparatus 5. As shown in FIG. 4, the radiotherapy apparatus 4 and the second surface shape measurement apparatus 5 are installed in a treatment room. The radiotherapy apparatus 4 includes a treatment stand 41 and a treatment bed 42. The radiation therapy apparatus 4 has a console (not shown) installed in an operation room adjacent to the treatment room. The treatment gantry 41 includes a gantry body 411 installed on the wall surface of the treatment room. The gantry body 411 supports the irradiation head unit 412 so as to be rotatable around the rotation axis Z2. The treatment bed 42 includes a treatment top plate 44 on which a patient is placed and a base 45 that movably supports the treatment top plate 44. The therapeutic top plate 44 has a planar shape like the imaging top plate 23.

  The second surface shape measuring device 5 is provided on the wall surface of the treatment room. For example, the second surface shape measuring device 5 is suspended from the ceiling. The second surface shape measuring device 5 measures the body surface of the patient placed on the treatment top plate 44 and collects three-dimensional patient body surface data relating to the patient's body surface. Hereinafter, the three-dimensional patient surface data collected by the second surface shape measuring device 5 and related to the body surface of the patient placed on the treatment top plate of the radiation therapy device 4 is referred to as treatment body surface data. To. The second surface shape measuring device 5 collects body surface data during treatment based on the same principle as that of the first surface shape measuring device 3. The body surface data at the time of treatment is transmitted to the treatment support device 8.

  FIG. 5 is a diagram showing a configuration of the radiation therapy apparatus 4. As shown in FIG. 5, the radiation therapy apparatus 4 includes a treatment base 41, a treatment bed 42, and a console 46.

  The treatment frame 41 includes a frame body 411 and an irradiation head part 412. The gantry body 411 is installed on the floor and supports the irradiation head unit 412 so as to be rotatable about the rotation axis Z2. An irradiation head unit 412 is attached to the gantry body 411. An irradiation unit 413 is built in the irradiation head unit 412. The irradiator 413 includes an acceleration tube (not shown) that accelerates electrons generated by an electron gun or the like, and a metal target (not shown) that collides with electrons accelerated by the acceleration tube. When electrons collide with the metal target, X-rays that are radiation are generated. The irradiator 413 emits radiation upon receiving a control signal from the irradiation control circuit 461 of the console 46. The point where the beam axis of the irradiation head portion 412 and the rotation axis Z2 intersect is spatially immobile and is called an iso-center.

  The irradiation head unit 412 is provided with a multi-leaf collimator (MLC) not shown. The multi-leaf collimator supports a plurality of leaves formed of an X-ray shielding material so as to be individually movable. By moving a plurality of leaves, an irradiation field having an arbitrary shape can be formed.

  A gantry driving device 994 is built in the gantry body 411. The gantry driving device 994 receives the control signal from the gantry control circuit 462 of the console 46 and rotates the irradiation head unit 412 around the rotation axis Z2.

  A bed driving device 451 is built in the treatment bed 42. The couch driving device 451 moves the treatment top plate 44 in response to the supply of the control signal from the couch control circuit 463 of the console 46.

  As shown in FIG. 5, the console 46 includes an irradiation control circuit 461, a gantry control circuit 462, a bed control circuit 463, an arithmetic circuit 464, a communication circuit 465, a display circuit 466, an input circuit 467, and a storage circuit 468.

  The irradiation control circuit 461 controls the irradiator 413 to irradiate the radiation according to the irradiation condition based on the treatment plan transmitted from the treatment planning device 6. The irradiation conditions may be input by a user such as a radiation therapy worker via the input circuit 467. The irradiation control circuit 461 includes, as hardware resources, a processor such as a CPU (Central Processing Unit) and a memory such as a ROM (Read Only Memory) and a RAM (Random Access Memory).

  The gantry control circuit 462 controls the gantry driving device 994 to emit radiation from an irradiation angle based on the treatment plan transmitted from the treatment planning device 6. The irradiation angle may be input by the user via the input circuit 467. The gantry control circuit 462 includes a processor such as a CPU and a memory such as a ROM and a RAM as hardware resources.

  The bed control circuit 463 transmits a control signal to the bed driving device 451 in order to move the treatment top plate 44 to an arbitrary position. The position of the treatment top plate 44 may be input by the user via the input circuit 467. The bed control circuit 463 controls the bed driving device 451 in order to make the position of the treatment site of the patient coincide with the iso-center. The bed control circuit 463 includes a processor such as a CPU and a memory such as a ROM and a RAM as hardware resources.

  The arithmetic circuit 464 functions as the center of the radiation therapy apparatus 4. The arithmetic circuit 464 executes the radiotherapy according to the present embodiment by executing the operation program according to the present embodiment stored in the storage circuit 468 and controlling each unit according to the operation program. The arithmetic circuit 464 includes a processor such as a CPU and a memory such as a ROM and a RAM as hardware resources.

  The communication circuit 465 performs data communication with the treatment planning device 6, the PACS system 7, and the treatment support device 8 that configure the radiation treatment system 1 via a wired or wireless communication (not shown).

  The display circuit 466 displays various information. Specifically, the display circuit 466 includes a display interface and a display device. The display interface converts data representing a display target into a video signal. The video signal is supplied to the display device. The display device displays a video signal representing a display target. As the display device, for example, a CRT display, a liquid crystal display, an organic EL display, an LED display, a plasma display, or any other display known in the art can be used as appropriate. The display device may be provided on the gantry body 411 or may be provided on the wall surface of the treatment room. The display device may be a projector.

  Specifically, the input circuit 467 includes an input device and an input interface. The input device accepts various commands from the user. As an input device, a keyboard, a mouse, various switches, and the like can be used. The input interface supplies an output signal from the input device to the arithmetic circuit 464 via the bus.

  The storage circuit 468 is a storage device such as a hard disk drive (HDD), a solid state drive (SSD), or an integrated circuit storage device that stores various information. For example, the storage circuit 468 stores a radiation treatment plan and the like. As the hardware, the storage circuit 468 may be a drive device that reads and writes various information with a portable storage medium such as a CD-ROM drive, a DVD drive, or a flash memory.

  As shown in FIG. 1, the treatment planning device 6 is a computer that makes a treatment plan based on the CT image transmitted from the treatment planning CT device 2. The radiotherapy plan created in this way is sent to the radiotherapy apparatus 4 and the treatment support apparatus 8.

  The PACS system 7 includes an image server that manages medical image data such as CT image data generated by the treatment planning CT apparatus 2.

  The treatment support apparatus 8 is a computer for supporting radiation therapy by the radiation therapy apparatus 4. FIG. 6 is a diagram illustrating a configuration of the treatment support apparatus 8 according to the first embodiment. As illustrated in FIG. 6, the treatment support apparatus 8 includes an arithmetic circuit 81, a communication circuit 83, a display circuit 85, an input circuit 87, and a storage circuit 89. The arithmetic circuit 81, the communication circuit 83, the display circuit 85, the input circuit 87, and the storage circuit 89 are connected to each other via a bus so that they can communicate with each other.

  The arithmetic circuit 81 includes, as hardware resources, a processor such as a CPU and a GPU (Graphics Processing Unit) and a memory such as a ROM and a RAM. The arithmetic circuit 81 executes a program related to radiation therapy support (hereinafter referred to as a radiation therapy support program), and performs radiation therapy support by the radiation therapy apparatus 4. The arithmetic circuit 81 according to the first embodiment executes a position comparison function 811, an integration function 812, and a rendering function 813 during radiation therapy support.

  In the position comparison function 811, the arithmetic circuit 81 compares the positions of the planned body surface data collected by the first surface shape measuring device 3 and the treatment time body surface data collected by the second surface shape measuring device 5. To do.

  In the integration function 812, the arithmetic circuit 81 generates integrated data of the planned body surface data collected by the first surface shape measurement device 3 and at least one of the CT image data and the treatment site data included in the CT image data. To do. The integrated data is used for positioning in patient radiotherapy.

  In the rendering function 813, the arithmetic circuit 81 performs volume rendering, surface volume rendering, pixel value projection processing, MPR (Multi-multiple) on 3D CT image data, planning integrated data, planning body surface data, and treatment body surface data. A two-dimensional image for display is generated by performing three-dimensional image processing such as Planer Reconstruction (CPR) processing and CPR (Curved MPR) processing.

  The communication circuit 83 includes a CT device 2 for treatment planning, a first surface shape measuring device 3, a radiation treatment device 4, and a second surface shape measuring device 5 that constitute the radiation treatment system 1 via wired or wireless (not shown). Data communication is performed between the treatment planning device 6 and the PACS system 7.

  The display circuit 85 displays various information. Specifically, the display circuit 85 includes a display interface and a display device. The display interface converts data representing a display target into a video signal. The display signal is supplied to the display device. The display device displays a video signal representing a display target. As the display device, for example, a CRT display, a liquid crystal display, an organic EL display, an LED display, a plasma display, or any other display known in the art can be used as appropriate.

  Specifically, the input circuit 87 includes an input device and an input interface. The input device accepts various commands from the user. As an input device, a keyboard, a mouse, various switches, and the like can be used. The input interface supplies an output signal from the input device to the arithmetic circuit 81 via the bus.

  The storage circuit 89 is a storage device such as a hard disk drive (HDD), a solid state drive (SSD), or an integrated circuit storage device that stores various information. In addition, the storage circuit 89 may be a drive device that reads and writes various information with a portable storage medium such as a CD-ROM drive, a DVD drive, or a flash memory.

  The radiotherapy system 1 includes a single treatment support device 8. However, this embodiment is not limited to this. For example, it may be provided in each of an operation room adjacent to the planning CT room and an operation room adjacent to the treatment room. In the following description, it is assumed that the radiation therapy system 1 has one treatment support apparatus 8 provided in an operation room adjacent to the treatment room.

  Next, an operation example of the radiation therapy system 1 according to the first embodiment will be described. FIG. 7 is a diagram illustrating a typical flow of the operation of the radiation therapy system 1 according to the first embodiment. As shown in FIG. 7, the operation of the radiation therapy system 1 is divided into a planning stage and a treatment stage. The planning stage process is Step SA1-SA4, and the treatment stage process is Step SA5-SA8. The planning stage is a stage for formulating a radiation treatment plan for a patient to be treated prior to radiation treatment. The treatment stage is a stage in which radiotherapy is performed according to a radiotherapy plan. The planning and treatment phases are typically performed on different days. Radiotherapy is usually performed over multiple days. Treatment in the treatment stage is repeated every day when radiation therapy is performed.

  In the planning stage, first, step SA1 by the treatment planning CT apparatus 2 and step SA2 by the first surface shape measuring apparatus 3 are performed in parallel or sequentially. In step SA1, the treatment planning CT apparatus 2 performs CT imaging on a patient placed on the imaging top plate 23 and collects CT image data of the patient. In step SA <b> 2, the first surface shape measuring apparatus 3 collects the planned body surface data of the patient placed on the imaging top plate 23 of the treatment planning CT apparatus 2.

  Detailed processing in steps SA1 and SA2 will be described. First, the radiotherapy worker lays the patient on the imaging top plate 23 of the treatment planning CT apparatus 2 and puts a fixture on the patient in the same way as during radiation therapy. For example, the fixture may be installed between the patient and the imaging top plate 23 and shaped according to the patient's physique, or may cover the patient's surface from above to prevent the patient's movement. good. In particular, the fixing device for the head is formed of a mesh-like member, and can be respired even when the patient's head is covered.

  When the imaging top plate 23 is disposed at the initial position, the first surface shape measuring device 3 optically scans the patient placed on the imaging top plate 23 to obtain three-dimensional planned body surface data. collect. The initial position is the position of the imaging top plate 23 before the start of movement for inserting the imaging top plate 23 into the opening 211 of the imaging platform 21. The collected planning body surface data is transmitted to the treatment support apparatus 8. Next, the planning CT apparatus 2 inserts the imaging top plate 23 on which the patient is placed into the opening 211 of the imaging platform 21, performs CT imaging, and collects CT image data. The CT image data is transmitted from the treatment planning CT apparatus 2 to the treatment planning apparatus 6 and the PACS system 7.

  After the CT imaging is completed, the planning CT apparatus 2 returns the imaging top plate 23 to the initial position. The first surface shape measuring apparatus 3 collects three-dimensional planned body surface data by optically scanning again the patient placed on the imaging top plate 23 arranged at the initial position. The collected planning body surface data is transmitted to the treatment support apparatus 8.

  The arithmetic circuit 81 of the treatment support apparatus 8 executes a position comparison function 811. In the position comparison function 811, the arithmetic circuit 81 calculates a positional deviation amount between the body surface area of the first planned body table data and the body surface area of the last planned body table data, and the positional deviation amount is determined in advance. Determine whether it is within the allowable range. When it is determined that the amount of displacement is within the allowable range, either the first planned body table data or the last planned body table data is selected as the planned time table data used for future processing. . When it is outside the allowable range, the arithmetic circuit 81 calculates the amount of positional deviation between the patient body surface area identified from the CT image data and the patient body surface area of the first planned body surface data, and is included in the CT image data. Calculates the amount of positional deviation between the patient body surface area and the patient body surface area of the last planned body surface data, and selects the planned body surface data with a small amount of positional deviation as planned body surface data used for future processing. To do.

  When Steps SA1 and SA2 are performed, the treatment planning device 6 creates a radiation treatment plan based on the CT image data collected in Step SA1 (Step SA3). Specifically, in step SA3, the treatment planning apparatus 6 receives CT image data directly from the treatment planning CT apparatus 2 or via the PACS system 7. The treatment planning device 6 creates a radiation treatment plan based on the CT image data.

  There are two types of methods for creating a radiation treatment plan: Forward Planning and Inverse Planning. Forward planning sets the radiation treatment conditions such as the number and direction of radiation treatment, each radiation angle, the radiation intensity of each radiation, the collimator opening of each radiation, and the wedge filter in detail, and finally those conditions. The radiotherapy conditions are evaluated by looking at the obtained radiation distribution. When changing the radiation distribution, a part or all of the radiation treatment conditions are changed and the radiation distribution is obtained again. Thus, in the forward planning, the radiation distribution is changed little by little while changing the radiation treatment conditions, and the radiation conditions are repeatedly changed until a desired radiation distribution is realized. Inverse planning sets the tumor area and appropriate margins, and sets the radiation dose and tolerance for the area. Further, a risk region such as a dangerous organ is extracted from the CT image data, and the radiation dose to the risk region is set to a safe level that does not become a radiation dose higher than a predetermined level. The radiotherapy apparatus 4 sequentially formulates radiotherapy plans that satisfy the requirements for the radiation distribution while changing the radiotherapy conditions. The radiation treatment plan and the position of the tumor area are transmitted to the treatment support apparatus 8.

  When step SA3 is performed, the arithmetic circuit 81 of the treatment support apparatus 8 executes the integration function 812 (step SA4). In step SA4, the arithmetic circuit 81 generates planned time integrated data based on the CT image data, the tumor region data, and the planned body table data.

  For the integration, it is necessary to register individual three-dimensional coordinate systems of the first surface shape measuring device 3 and the treatment planning CT device 2. This is done using a dedicated calibration phantom. The calibration phantom has a plurality of markers with unevenness on the surface. The number of markers is 3 or more. The first surface shape measuring apparatus 3 collects surface shape data related to the calibration phantom by optically scanning the calibration phantom, like the patient. The treatment planning CT apparatus 2 performs CT imaging of the calibration phantom and collects CT image data. The surface shape data and CT image data related to the calibration phantom are transmitted from the treatment planning CT apparatus 2 to the treatment support apparatus 8.

  The arithmetic operation circuit 81 of the treatment support apparatus 8 identifies markers for each of the surface shape data and CT image data related to the calibration phantom by image processing, and calculates correction parameters for matching the three-dimensional coordinate systems of both markers. . The arithmetic circuit 81 integrates the CT image data related to the patient and the planned body surface data in the same three-dimensional coordinate system based on the correction parameter to generate integrated data. In addition, the arithmetic circuit 81 extracts a tumor region from the CT image data regarding the patient, and identifies the position of the extracted tumor region in the CT image data. The arithmetic circuit 81 attaches a mark indicating the position of the tumor region to the integrated data in a position-matched manner based on the correction parameter. Hereinafter, the integrated data of the CT image data related to the patient, the planned body surface data, and the tumor position will be referred to as planned integrated data. The planned integrated data is transferred to the radiation therapy apparatus 4 and other apparatuses. Thus, the process in the planning stage is completed.

  FIG. 8 is a diagram illustrating an example of the planned integration data D2 generated in step SA4. FIG. 9 is a view showing a 9-9 'cross section of FIG. As shown in FIGS. 8 and 9, the planned integrated data D2 includes a patient body surface region RP and a top surface region RT derived from the planned body surface data, CT image data IC, and a tumor position RC. . The tumor position RC is designated at the time of treatment planning using the CT image data IC.

  As described above, the planned integration data is a data set obtained by spatially integrating planned body surface data, CT image data, and tumor position regarding the patient's body surface at the time of CT imaging in the planning stage. The radiotherapy system 1 according to the present embodiment can easily and accurately match the tumor position at the time of treatment to the isocenter by using the planned integration data. For this reason, marking of the tumor position with respect to the patient conventionally required in the planning stage is unnecessary in this embodiment.

  For example, the planned time integration data is used in the treatment stage as follows. In the treatment stage, the second surface shape measurement device 5 collects body surface data during treatment relating to the patient placed on the treatment top plate 44 of the radiation treatment device 4 (step SA5). Specifically, first, the radiotherapy worker lays the patient in the treatment room on the treatment top plate 44 and installs the fixture on the patient in the same manner as CT imaging at the planning stage. At the stage where the treatment top plate 44 is placed at the initial position, the second surface shape measuring device 5 optically scans the patient and collects three-dimensional body surface data during treatment. The initial position is the position of the treatment top plate before the treatment top plate 44 starts to move to the isocenter of the treatment mount 41. The body table data at the time of treatment is similar to the body table data at the time of planning, and includes a patient body surface area relating to the body surface of the patient placed on the treatment top board 44 and a top plate surface area relating to the surface of the treatment top board 44. Have. The body surface data at the time of treatment is transmitted to the treatment support device 8. In addition, after step SA5, the 2nd surface shape measuring apparatus 5 shall repeat the optical scanning of the patient mounted on the treatment top plate 44, and is collecting the body surface data at the time of treatment repeatedly.

  When step SA5 is performed, the arithmetic operation circuit 81 of the treatment support apparatus executes the position comparison function 811 (step SA6). In step SA6, the arithmetic circuit 81 performs position comparison between the planned body surface data included in the planned time integrated data and the treated body surface data collected by the second surface shape measuring device 5, and the current (treatment stage) The patient's tumor location at is estimated.

  Hereinafter, specific examples of position comparison and tumor position estimation will be described.

  FIG. 10 is a diagram schematically showing the flow of position comparison and tumor position estimation processing executed by the arithmetic circuit 81 of the treatment support apparatus 8 in step SA6. In FIG. 10, the patient body surface data D2, D3, and D4 are shown in a plan view, not a three-dimensional view, for clarity of explanation. As shown in FIG. 10, the arithmetic circuit 81 first reads the planned integrated data D2 and the treatment body surface data D3. The planned integrated data D2 includes at least a patient body surface region RP2 and a tumor position RC2. The body surface data D3 at the time of treatment has a patient body surface region RP3. A tumor position is not attached to the patient body surface region RP3.

  The arithmetic circuit 81 compares the positions of the patient body surface area RP2 of the planning integrated data D2 and the patient body surface area RP3 of the treatment body surface data D3, and positions of the patient body surface area RP2 and the patient body surface area RP3. A deviation amount is calculated (step SA61). The displacement amount is defined by the difference between the reference point of the patient body surface region RP2 and the corresponding point of the patient body surface region RP3. Typically, within the top plate surface of the imaging top plate 23 or the therapeutic top plate 44 under the condition that the imaging top plate 23 or the therapeutic top plate 44 is located at the same height. The difference between the reference point of the patient body surface region RP2 and the corresponding point of the patient body surface region RP3 is defined as the positional deviation amount. The reference point and the corresponding point are set at a plurality of locations. In addition, when performing a position comparison with the patient body surface area | region RP2 of the plan integrated data D2 and the patient body surface area | region RP3 of the treatment body surface data D3, it may not be desirable to compare all the areas. For example, when treating liver tumors, if the angles of the neck, shoulders, and hip joints are shifted between the planned CT imaging and the radiation therapy, the body part may be shifted by matching them together. End up. In order to solve such a problem, the arithmetic circuit 81 roughly recognizes the head, torso, hands, and feet from each of the patient body surface region RP2 and the patient body surface region RP3, and only the region including the tumor is recognized. Use for position comparison. In this way, by performing the position comparison only on the part including the tumor, the body part is not displaced, so that the accuracy of the position comparison is improved.

  Next, as shown in FIG. 10, the arithmetic circuit 81 converts the planned integrated data D2 into an image according to the amount of positional deviation, and determines the position of the patient body surface region RP2 included in the planned integrated data D2 as the treatment body table. The position is matched with the position of the patient body surface region RP3 included in the data D3 (step SA62). Image conversion may be linear conversion such as movement, rotation, enlargement, and reduction, or non-linear conversion. It is assumed that the image deformation by the position comparison function 811 is typically a linear transformation such as movement or rotation. That is, it is assumed that the shapes of the patient body surface region RP2 and the patient body surface region RP3 are not deformed in the image deformation by the position comparison function 811.

  Next, as shown in FIG. 10, the arithmetic circuit 81 estimates the tumor position of the patient at the present time (at the time of collecting body table data at the time of treatment) based on the planned integration data D4 after image conversion (step SA63). Specifically, the arithmetic circuit 81 identifies the tumor position RC4 included in the planned integration data D4. Then, the arithmetic circuit 81 specifies the three-dimensional coordinates of the position of the tumor region RT4 included in the CT image data IC4 of the axial section AX4. The position of the identified tumor region RC4 is estimated to be the tumor position of the patient at the time when the body surface data at the time of treatment is collected by the second surface shape measuring device 5. Data of the three-dimensional coordinates of the tumor position is transmitted to the radiation therapy apparatus 4.

  When step SA6 is performed, the bed control circuit 463 of the radiation therapy apparatus 4 moves the treatment table 44 so that the tumor position specified in step SA6 coincides with the isocenter of the treatment table 41 (step SA7). ). The couch control circuit 463 first determines the control parameters of the treatment couch 42 such that the tumor position matches the isocenter of the treatment couch. Specifically, the bed control circuit 463 calculates the distance and direction from the three-dimensional coordinates of the tumor position to the three-dimensional coordinates of the isocenter of the treatment platform 41, and the control parameter corresponding to the calculated distance and direction And a drive signal corresponding to the determined control parameter is supplied to the bed driving device 451. The bed driving device 451 moves the treatment top plate 44 in response to the supplied driving signal. Thereby, the tumor position specified in step SA6 coincides with the iso-center of the treatment base 41. That is, the patient's tumor position can be made to coincide with the isocenter without manually adjusting the position of the patient placed on the treatment top plate 44. As described above, according to the present embodiment, the first alignment of the patient can be performed accurately and easily without using the marker, the laser sighting device, or the like by using the integrated data at the time of planning.

When step SA7 is performed, the radiotherapy apparatus 4 performs second alignment (step SA8). The second alignment has a role of complementing the first alignment, and is a finer alignment than the first alignment. In the second alignment, the arithmetic circuit 464 of the radiotherapy apparatus 4 performs, for example, an X-ray image captured by a bi-directional X-ray image capturing system attached to the radiotherapy apparatus 4 and a CT image for treatment planning as if they were in two directions. A DRR (Digitally Reconstructed Radiography) image projected as if captured by an X-ray imaging system is generated. The arithmetic circuit 464 compares the tumor region and anatomical feature points included in the DRR image with the corresponding points (the same tumor region and anatomical feature points) included in the X-ray image, and calculates the amount of displacement. .
Then, the bed control circuit 463 moves the treatment top plate 44 according to the amount of displacement. Thereby, the tumor region specified in the CT image for treatment planning can be precisely matched with the iso-center. Note that the patient himself may move so that the tumor region specified in the CT image for treatment planning coincides with the isocenter, or the patient may be moved by a radiotherapy worker.

  As another method of the second alignment, the arithmetic circuit 464 is used for the tumor region and anatomical feature points included in the cone beam CT image captured by the cone beam CT imaging system attached to the radiation therapy apparatus 4 and for treatment planning. The amount of displacement may be calculated by comparing corresponding points (the same tumor region and anatomical feature points) included in the CT image. The couch control circuit 463 moves the treatment top 44 according to the amount of displacement. Thereby, it is possible to precisely match the tumor region specified in the CT image for treatment planning with the iso-center. Also in this other method, the patient himself / herself may be moved so that the tumor area specified in the CT image for treatment planning coincides with the isocenter, or the patient may be moved by a radiotherapy worker. Accurate alignment is performed by the second alignment.

  If step SA8 is performed, the radiotherapy apparatus 4 will irradiate the patient's tumor with radiation (step SA9). For example, in the case of planning to irradiate X-rays from the patient front direction and the patient left side surface, the gantry control circuit 462 arranges the irradiation head unit 412 in front of the patient. Next, the irradiation control circuit 461 adjusts the opening of the multi-leaf collimator so that the X-ray irradiation field shape matches the tumor shape. In addition to adjusting the opening of the multi-leaf collimator, a wedge filter or the like for removing low energy components of X-rays may be inserted. The irradiation control circuit 461 further irradiates X-rays after setting the X-ray intensity (tube voltage, tube current, etc.) to an appropriate level.

  When the irradiation from one direction is completed, the gantry control circuit 462 rotates the irradiation head unit 412 to the next angle, in this case, the left side of the patient. The irradiation control circuit 461 adjusts the opening of the multi-leaf collimator again in order to match the X-ray irradiation field shape with the tumor shape. Further, if necessary, a wedge filter or the like for removing low energy components of X-rays is inserted. The irradiation control circuit 461 irradiates X-rays after setting the X-ray intensity to an appropriate level. This completes one treatment. Treatment is performed several times. The number of times is generally 5 to 30 times.

  In addition, since very powerful X-rays are irradiated in radiotherapy, if the tumor position deviates from the X-ray irradiation field, it has a great adverse effect on normal tissues. Therefore, the second alignment confirms whether the tumor is at the iso-center position. There are two confirmation methods. One is a method using X-ray images from two directions, and the other is a method using CBCT (cone beam CT).

  In the former, first, the arithmetic circuit 464 generates a DRR image based on the CT image for treatment planning, compares the DRR image with the X-ray image, and corrects the deviation. The DRR image is a pseudo X-ray image generated using a CT image and an X-ray optical system as if a patient imaged with a CT image was captured by an X-ray imaging system. In the latter, CBCT imaging is performed by a CBCT apparatus to generate a CBCT image. The CBCT apparatus may be a single apparatus or may be incorporated in the radiation therapy apparatus 4. The arithmetic circuit 464 compares the CBCT image with the CT image for treatment planning and corrects the positional deviation. Since the former only has to be positioned mainly based on bones and easy-to-understand organs, it is often displaced when aligned with bones. Further, when positioning is performed based on an easy-to-understand organ, the organ may contain a tumor or be close to the organ, but if the organ is away from the organ, a positional shift is likely to occur. On the other hand, in CBCT, since the organ shape can be clearly depicted, there is an advantage that the positional deviation hardly occurs. However, since CBCT imaging takes 30 seconds to 1 minute, the CBCT image may include motion artifacts, and the organ shapes may become unclear or shift due to the motion artifacts.

  Thus, when radiation therapy is performed, typical operation | movement of the radiation therapy system 1 which concerns on 1st Embodiment is complete | finished.

  Here, the alignment of the existing routine will be briefly described. In the existing routine, at the treatment planning stage, a reference point at the time of CT imaging is identified on the patient's body surface, and the position deviation from the reference point to the tumor is measured, and the position deviation on the body surface is determined based on the position deviation. A marker indicating the tumor position is drawn from the front and side. In the treatment stage, the marker is aligned with a laser sighting device installed in the treatment room, so that coarse alignment is performed so that the tumor position coincides with the isocenter. The marker drawn on the body surface is thinned and disappears when the patient takes a bath, so it is necessary to rewrite several times in the existing routine. This is a troublesome work as well as causing errors.

  However, according to the first embodiment, the arithmetic operation circuit 81 of the treatment support apparatus 8 performs position comparison between the body table data at the time of treatment and the body table data at the time of planning included in the integrated data at the time of planning, and the position comparison result Based on the integrated data at the time of planning, the tumor position of the patient at the time of collecting body surface data at the time of treatment (that is, at the radiation treatment stage) is estimated. Then, the bed control circuit 463 of the radiotherapy apparatus 4 moves the treatment top plate 44 in order to make the estimated tumor position coincide with the isocenter.

  According to the first embodiment, it is not necessary to draw a marker on the body surface, which is necessary in the existing routine. Accordingly, there is no need to provide a laser sighting device in the treatment room. Therefore, according to the first embodiment, it is possible to easily align the patient at the time of radiation therapy as compared with the existing routine. Further, according to the first embodiment, unlike the manual alignment by the sighting device or the like, it is based on the position comparison between the planned body table data and the treatment body table data by the arithmetic circuit 81. In comparison, the first alignment of the patient during radiotherapy can be performed more accurately. According to the first embodiment, the body table data at the time of planning is collected only once in the planning stage, so that the body table data at the time of treatment is collected every day in the radiotherapy over a plurality of days, and the body table at the time of treatment is collected. Compare the position of the data with the planned body surface data. Since the planned body surface data, which is a reference for alignment, is not inaccurate like a marker, the reproducibility of alignment can be improved even in radiotherapy over a plurality of days.

  In the above-described embodiment, the planned time integrated data including the planned body table data is image-converted so that the patient body surface area of the planned body table data matches the patient body surface area of the treated body table data. It was supposed to be. However, this embodiment is not limited to this. For example, the bed control circuit 463 of the radiotherapy apparatus 4 may use the treatment table so that the patient body surface area of the planned body surface data matches the patient body surface area of the treatment body surface data collected in real time. 44 may be moved and rotated about 6 axes (X, Y, Z, θx, θy, θz) to match. Here, θx, θy, and θz indicate rotations about the X, Y, and Z axes, respectively. Thereby, the position of the patient's body surface actually mounted on the treatment top plate 44 can be matched with the position of the patient's body surface at the time of planning. After that, the current position of the treatment top 44 is shifted from the isocenter, and further, the difference between the reference point of the treatment top 44 and the CT reference point, and the difference between the CT reference point and the tumor position are comprehensively corrected. By moving the treatment top plate 44 in such a manner, the tumor position and the iso-center can be matched.

  In the above embodiment, the planned integrated data includes planned body surface data, medical image data, and a tumor region. However, this embodiment is not limited to this. For example, the planned integrated data may be integrated data of planned body chart data and medical image data, or may be integrated data of planned body chart data and tumor area data.

  For example, there is medical image data that can recognize a tumor region such as MR diffusion weighted image data. In this case, the planned integrated data may be integrated data of the planned body surface data and the diffusion weighted image data. Tumor region data can be generated by performing image processing on the diffusion weighted image data to recognize or identify the tumor region data.

  In the above-described embodiment, the therapeutic table 33 is automatically moved by the bed control circuit 463 based on the amount of displacement, so that the tumor position is automatically matched to the iso-center. However, this embodiment is not limited to this. For example, the positional deviation amount between the body surface area of the planned body surface data and the body surface area of the treatment body surface data may be displayed on the display circuit 85 of the treatment support apparatus 8 or the display circuit 466 of the radiation therapy apparatus 4. good. For example, the positional deviation amount is displayed as a numerical value indicating the distance between the body surface area of the planned body surface data and the body surface area of the treatment body surface data. Further, the misregistration amount may be displayed as characters or figures indicating the direction of misregistration. Alternatively, the positional deviation amount may be displayed as both the numerical value and the direction.

  The display circuit 85 and the display circuit 466 are displays provided in a treatment room, for example. Thereby, the user can confirm the amount of positional deviation visually. The user gives an instruction to move the treatment top 33 via the input circuit 467 while grasping the amount of displacement. The bed control circuit 463 can match the tumor position with the isocenter by moving the treatment top plate 33 in accordance with a movement instruction via the input circuit 467 by the user.

  At this time, the amount of displacement is not limited to the display provided in the treatment room. For example, the position shift amount may be a projector as the display circuit 85 or the display circuit 466. The projector projects the amount of positional deviation onto the patient placed on the treatment top board 33. Thereby, the user can put both the patient and the positional deviation amount in the field of view. Therefore, the relationship between the patient and the positional deviation amount can be grasped more easily.

(Second Embodiment)
In the first embodiment, the plan-time integrated data is image-converted or the treatment top plate 44 is moved so that the patient body surface area of the planning body surface data matches the patient body surface area of the treatment body surface data. It was. However, this embodiment is not limited to this. In the second embodiment, the position of the patient placed on the treatment top 44 is adjusted so that the patient surface area of the planned body surface data matches the patient body surface area of the treatment body surface data. Shall. Hereinafter, the radiation therapy system 1 according to the second embodiment will be described. In the following description, components having substantially the same functions as those in the first embodiment are denoted by the same reference numerals, and redundant description is provided only when necessary.

  FIG. 11 is a diagram illustrating a typical flow of the operation of the radiation therapy system 1 according to the second embodiment. Note that steps SB1 to SB5 in FIG. 11 are the same as steps SA1 to SA5 in FIG.

  When step SB5 is performed, the display circuit 85 of the treatment support apparatus 8 displays the planned integration data and the treatment body surface data (step SB6). More specifically, in step SB6, the arithmetic circuit 81 executes the rendering function 813. In the rendering function 813, the arithmetic circuit 81 renders the planned time integrated data to generate a two-dimensional image (hereinafter referred to as the planned time integrated image), and renders the treatment body surface data to render the two-dimensional image (hereinafter referred to as the “planned time integrated image”). The body surface image at the time of treatment). The planned integrated image and the treatment body surface image are generated based on the same viewpoint and line of sight. The arithmetic circuit 81 superimposes the generated planned integrated image and treatment body surface image on the display device of the display circuit 85.

  FIG. 12 is a diagram illustrating an example of a superimposed image IO of the planned integrated image I2 and the treatment body surface image I3. As shown in FIG. 12, the superimposed image IO includes a planned integrated image I2 and a treatment body surface image I3 that are superimposed in alignment with each other. The planning time integrated image I2 may be displayed superimposed on the treatment time body surface image I3, or the treatment time body surface image I3 may be displayed superimposed on the planning time integrated image I2. In order to improve the visibility, it is preferable that the superimposed image is displayed translucently and the superimposed image is displayed opaquely. By superimposing and displaying the planning integrated image I2 and the treatment body surface image I3, the positional deviation amount between the patient body surface region of the planning body surface data and the patient body surface region of the treatment body surface data can be simplified. And it can grasp correctly.

  The display device may be a display provided in a treatment room, for example. As a result, a radiotherapy worker working in the treatment room can easily observe the planned integrated image I2 and the treatment body surface image I3. The display device may be a projector provided on a wall surface such as a ceiling of a treatment room. In the case of a projector, the planned integrated image I2 and the treatment body surface image I3 are superimposed or arranged and projected onto the body surface of the patient placed on the treatment top plate 44. As a result, a radiotherapy worker working in the treatment room can easily observe the planned integrated image I2 and the treatment body surface image I3.

  For example, the arithmetic circuit 81 generates a wire frame model of the patient surface region of the integrated data at the time of planning, generates a solid model of the patient surface region of the body surface data at the time of treatment, and superimposes the wire frame model on the solid model to display the circuit 85 may be displayed. Thereby, the display circuit 85 can clearly distinguish and display the patient position in the planning stage and the real-time patient position in the treatment stage. Since the patient or the radiotherapy worker can clearly distinguish and grasp the patient position at the planning stage and the real-time patient position at the treatment stage, the patient position can be adjusted easily and accurately. Therefore, the plan integrated data and the treatment body surface data can be accurately matched.

  The arithmetic circuit 81 converts both the patient surface area of the planning integrated data and the patient surface area of the treatment body surface data into a semi-transparent solid model, and the display circuit 85 displays both in different colors. May be. For example, the display circuit 85 may display the patient surface area of the planning integrated data in blue and the patient surface area of the treatment body surface data in red. Further, for easy understanding, the display circuit 85 may display an overlapping area between the patient surface area of the integrated data at the time of planning and the patient surface area of the body surface data at the time of treatment in green. The display circuit 85 may display a non-overlapping area between the patient surface area of the planning integrated data and the patient surface area of the treatment body surface data with emphasis in red.

  Further, the display circuit 85 displays the patient surface area of the integrated data at the planning time and the patient surface area of the body surface data at the time of treatment in different colors, and then displays the patient surface area of the integrated data at the time of planning and the body surface data at the time of treatment. The display mode of the integrated data at the time of planning or the body surface data at the time of treatment may be variously changed according to the degree of coincidence with the patient surface area. The degree of match is calculated by the position comparison function 811 of the arithmetic circuit 81. For example, the arithmetic circuit 81 counts the number of pixels or the number of voxels in the overlapping region of the patient surface area of the planning integrated data and the patient surface area of the treatment body surface data as the degree of coincidence. For example, when the matching degree is lower than the threshold value, the display circuit 85 may display the patient body surface area of the planned integrated data in a blinking manner. Further, the display circuit 85 may blink faster as the matching degree is lower, and may be slower as the matching degree is higher. In this case, when the patient surface area of the planning integrated data and the patient surface area of the treatment body surface data completely match, the display circuit 85 ends blinking. Alternatively, the display circuit 85 may display the degree of coincidence with a number or a graph by arranging the superimposed images of the planned integrated image I2 and the treatment body surface image I3.

  In this way, various display methods are possible in order to match the patient surface area of the planning integrated data and the patient surface area of the treatment body surface data. For example, the radiotherapy worker observes the image displayed on the display circuit 85, and the patient should move to match the patient surface area of the integrated data at the time of planning and the patient surface area of the body surface data at the time of treatment. Know the direction and distance and instruct the patient to “slightly shift to the right”, “rotate the whole body to the right so that the feet are straight”, etc. Adjust. Alternatively, the patient may observe the image displayed on the display circuit 85, grasp how much the patient himself is, and correct the shift by actively moving the patient. In this case, the burden on the radiotherapy worker is reduced, which is efficient.

  When step SB6 is performed, the arithmetic circuit 81 waits for a move button provided in the input circuit 87 or the like to be pressed (step SB7). The patient or radiotherapy worker confirms the planned integrated data (or planned integrated image) displayed in step SB6, changes the patient position and body position based on it, and changes the patient body of the planned body table data. The positions of the surface area and the patient body surface area of the body surface data during treatment collected in real time are matched. Thereby, the position of the tumor area included in the integrated data at the time of planning substantially matches the actual tumor position of the patient.

  When the positions of the patient body surface area of the planned body surface data and the patient body surface area of the treatment body surface data coincide with each other, the radiotherapy worker depresses a movement button provided in the input circuit 87 or the like (step) SB7: YES). When the move button is pressed, the arithmetic circuit 81 supplies a signal indicating that the press button has been pressed (hereinafter, referred to as a press signal) to the radiation therapy apparatus 4.

  When receiving the pressing signal, the radiotherapy apparatus 4 moves the treatment top plate 44 so that the tumor position coincides with the iso-center of the treatment mount 41 (step SB8). Specifically, the couch control circuit 463 calculates the distance and direction from the three-dimensional coordinates of the tumor region included in the planning integrated data to the three-dimensional coordinates of the isocenter of the treatment platform 41, and the calculated distance Then, a driving signal corresponding to the direction is supplied to the bed driving device 451. The bed driving device 451 moves the treatment top plate 44 in response to the supplied driving signal. Thereby, the tumor position coincides with the iso-center. It should be noted that X-ray imaging images may be acquired from two directions, or a CBCT image may be generated, for example, so that the position of the treatment top plate 44 may be further corrected.

  When step SB8 is performed, the radiotherapy apparatus 4 performs the second alignment (step SB9). Since the process of step SB9 is the same as that of step SA8, description is abbreviate | omitted. More accurate alignment is performed by the second alignment.

  If step SB9 is performed, the radiotherapy apparatus 4 will irradiate a patient's tumor according to a radiotherapy plan (step SB10). Since the process of step SB10 is the same as that of step SA8, description is abbreviate | omitted.

  When radiation therapy is performed, typical operations of the radiation therapy system 1 according to the second embodiment are completed.

  As described above, unlike the treatment support apparatus 8 according to the first embodiment, the treatment support apparatus 8 according to the second embodiment does not perform position comparison between the planned body surface data and the treatment body surface data. By manually adjusting the position of the patient placed on the treatment top plate 44, the patient body surface area of the planned body surface data and the patient body surface area of the treatment body surface data are indirectly matched. . Thereby, even when the accuracy of the position comparison is not good, the patient body surface area of the body table data at the time of planning can be matched with the patient body surface area of the body table data at the time of treatment. As a result, the first alignment of the patient at the time of radiotherapy can be performed easily and accurately compared to the existing routine.

(Third embodiment)
In radiotherapy, an interference check that simulates the presence or absence of interference between the treatment platform 41, the treatment bed 42, and the patient is performed. The interference check is performed using a virtual patient model. The body type of the virtual patient model is selected from 50 standard body types prepared in advance, such as a standard body type, a fat body type, a lean body type, or an intermediate between them. Therefore, the actual patient's body shape may not match the virtual patient model's body shape. In some cases, the position at which the patient is actually sleeping on the treatment top 44 does not match the position on the virtual top model of the virtual patient model. Furthermore, when the patient sleeps on the treatment top plate 44, the treatment top plate 44 may bend due to the influence of the weight of the patient, but it is difficult to reflect this deflection in the simulation. Due to errors between these actual and simulations, it is difficult to correctly evaluate the interference risk.

  Hereinafter, the radiation therapy system 1 according to the third embodiment will be described. In the following description, components having substantially the same functions as those in the first and second embodiments are denoted by the same reference numerals, and redundant description is provided only when necessary.

  FIG. 13 is a diagram illustrating a configuration of the treatment support apparatus 8 according to the third embodiment. As shown in FIG. 13, the arithmetic operation circuit 81 of the treatment support apparatus 8 according to the third embodiment has a position comparison function 811, an integration function 812, a rendering function 813, an interference check function 814, and a warning function 815 during radiation treatment support. Execute.

  In the interference check function 814, the arithmetic circuit 81 determines whether or not there is interference between the treatment platform 41, the treatment table 44, and the patient based on the simulation of the treatment platform 41, the treatment table 44, and the position and operation of the patient. judge.

  In the warning function 815, the arithmetic circuit 81 issues a warning when the interference check function 814 determines that there is interference. The warning is performed, for example, by displaying an error message or the like via the display circuit 85 or outputting a warning sound or the like via a speaker (not shown).

  Next, an operation example of the radiation therapy system 1 according to the third embodiment will be described.

  FIG.14 and FIG.15 is a figure which shows the typical flow of operation | movement of the radiotherapy system 1 which concerns on 3rd Embodiment. Steps SC1-SC4 in FIG. 14 are the same as steps SB1-SB4 in FIG.

  When step SC4 is performed, the arithmetic circuit 81 of the treatment support apparatus 8 executes the interference check function 814 (step SC5). In step S5, the arithmetic circuit 81 performs interference check according to the radiation treatment plan created in step SC3, using the planned body table data collected in step SC2. For example, the arithmetic circuit 81 stores in advance information related to the structure of the treatment platform 41 and the treatment bed 42 and information related to the movable range of the structure in the storage device or the like. Hereinafter, information on the structure and information on the movable range of the structure will be referred to as mechanism information. The mechanism information can be obtained from mechanism design data (CAD: Computer-Aided Design) regarding the radiation therapy apparatus 4.

  The arithmetic circuit 81 generates a patient model imitating the patient's body shape based on the patient body surface area included in the planned body surface data collected by the first surface shape measuring device 3. That is, in the third embodiment, the patient model is generated based on the patient body surface area of the planned body surface data, not the patient model prepared as a template in advance, so that the patient model imitating the actual patient body shape Can be used. In addition, the arithmetic circuit 81 generates a top board model imitating the treatment top board 44 based on the top board surface area included in the planned body surface data. The top surface area included in the planned body surface data is a top surface area related to the imaging top plate 23, but the imaging top plate 23 and the treatment top plate 44 have substantially the same shape and material. Therefore, a top plate model imitating the treatment top plate 44 can be generated based on the top plate surface area included in the planned body surface data.

  Next, the arithmetic circuit 81 arranges the patient model generated based on the planned body surface data at an appropriate position of the top board model under the assumption that the patient is sleeping at an appropriate position. When the radiotherapy apparatus 4 is moved according to the radiotherapy plan, the arithmetic circuit 81 moves between the patient and the units of the radiotherapy apparatus 4 (specifically, the irradiation head unit 412, the therapeutic bed 42, or the X-ray imaging unit). FPD (Flat Panel Detector), X-ray tube, etc.) are judged as to whether or not there is a risk of interference due to interference.

  According to step SC5, an interference check can be performed using an accurate patient body shape using the planned body surface data collected by the first surface shape measuring apparatus 3. In addition, the correct patient position can be identified by matching the position where the patient is sleeping on the treatment top plate 44 with the treatment planning CT apparatus 2 and the radiation treatment apparatus 4. Furthermore, the deflection due to the patient sleeping on the treatment top plate 44 can be correctly identified by using the top surface area included in the planned body surface data. By using such an accurate patient model and top plate model, the interference check can be performed almost accurately.

  In the treatment stage, the second surface shape measurement apparatus 5 collects body surface data during treatment of the patient (step SC6). Since step SC6 is the same as step SB5, the description thereof is omitted.

  When step SC6 is performed, the display circuit 85 of the treatment support apparatus 8 displays the planned integration data and the treatment body surface data (step SC7). Since step SC7 is the same as step SB6, the description thereof is omitted. The patient or the radiotherapy worker confirms the planned integrated data displayed in step SC7, changes the position and position of the patient, and changes the patient body area of the planned integrated data and the patient body of the treated body surface data. Match the position with the table area.

  At this time, the arithmetic circuit 81 executes the position comparison function 811 (step SC6). In step SC6, the arithmetic circuit 81 determines that the positional relationship between the patient body surface area and the top surface area included in the treatment body surface data is the difference between the patient body surface area and the top surface area included in the planned body surface data. It is determined whether or not the positional relationship deviates by more than a threshold value. The positional relationship is defined by, for example, a vector that connects the reference point of the patient body surface area and the reference point of the top surface area. The reference point of the patient surface area and the reference point of the top surface area may be set at arbitrary positions.

  Specifically, the arithmetic circuit 81 calculates a vector (hereinafter referred to as a treatment vector) that connects the reference point of the patient body surface area and the reference point of the top surface area included in the treatment body surface data. A vector connecting the reference point of the patient body surface area and the reference point of the top surface area included in the planned body surface data (hereinafter referred to as the planning time vector) is calculated, and the length of the treatment time vector and the planning time vector is calculated. A difference in height and a difference in angle are calculated. The arithmetic circuit 81 compares the difference in length against the threshold for length, compares the difference in angle against the threshold for angle, and at least one of the difference in length and the difference in angle is equal to or greater than the threshold. It is determined whether or not. When at least one of the difference in length and the difference in angle is equal to or greater than the threshold value, the arithmetic circuit 81 determines that the positional relationship between the patient and the treatment top 44 is shifted (step SC8: YES), and the length If both the difference and the angle difference are not equal to or greater than the threshold value, the arithmetic circuit 81 determines that the positional relationship between the patient and the treatment top 44 is not shifted (step SC8: NO).

  Note that the determination criteria for the positional relationship deviation are merely examples, and are not limited to the above. For example, when both the length difference and the angle difference are equal to or greater than the threshold value, the arithmetic circuit 81 determines that the positional relationship is shifted (step SC8: YES), and the length difference and If at least one of the angle differences is not greater than or equal to the threshold value, it may be determined that the positional relationship is not shifted (step SC8: NO). The arithmetic circuit 81 may calculate only one of the difference in length and the difference in angle between the treatment time vector and the planning time vector. When calculating only the difference in length, the arithmetic circuit 81 compares the difference in length against a threshold for length, and if the difference in length is equal to or greater than the threshold, the positional relationship is shifted. If it is determined (step SC8: YES) and the difference in length is not equal to or greater than the threshold value, it may be determined that the positional relationship is not shifted (step SC8: NO). The same determination can be made when only the angle difference is calculated.

  When it is determined in step SC8 that the positional relationship between the patient and the treatment top 44 is shifted (step SC8: YES), the arithmetic operation circuit 81 of the treatment support apparatus executes the interference check function 814 (step SC9). . In step SC9, the arithmetic circuit 81 performs an interference check again based on the positional relationship deviation amount (that is, the difference in length and the difference in angle).

  When step SC9 is performed, the arithmetic circuit 81 displays the result of the interference check on the display circuit 85 (step SC10). In step SC10, the arithmetic circuit 81 executes the warning function 815. When the warning function 815 determines that the risk of interference is high, the arithmetic circuit 81 issues a warning for prompting the radiotherapy worker to correct the deviation.

  When step SC10 is performed or when it is determined in step SC8 that the positional relationship between the patient and the treatment top plate 44 is not shifted (step SC8: NO), the arithmetic circuit 81 has the movement button pressed. (Step SC11). The patient or the radiotherapy worker confirms the planned integrated data displayed in step SC7, changes the patient position and position based on the data, and matches the planned body table data with the treated body table data. . By matching the body data at the time of treatment collected in real time with the body data at the time of planning included in the integrated data at the time of planning, the location of the tumor area included in the integrated data at the time of planning is abbreviated to the actual tumor location of the patient. Will match.

  When the body table data at the time of treatment is matched with the body table data at the time of planning included in the integrated data at the time of planning, the radiotherapy worker presses a movement button provided on the input circuit 87 or the like (step SC11: YES). When the movement button is pressed, the arithmetic circuit 81 supplies a press signal to the radiation therapy apparatus 4. When receiving the pressing signal, the radiotherapy apparatus 4 moves the treatment top plate 44 so that the tumor position coincides with the iso-center of the treatment mount 41 (step SC12). When step SC12 is performed, the radiotherapy apparatus 4 performs the second alignment (step SC13). If step SC13 is performed, the radiotherapy apparatus 4 will irradiate a patient's tumor according to a radiotherapy plan (step SC14). Since the process of step SC12-SC14 is the same as that of step SB8-SB10, description is abbreviate | omitted.

  When radiation therapy is performed, typical operations of the radiation therapy system 1 according to the third embodiment are finished.

  As described above, in step SC8, the arithmetic circuit 81 accurately reproduces the positional relationship between the patient and the imaging top board 44 at the time of treatment as the positional relationship between the patient and the imaging top board 23 at the time of planning. It can be determined whether or not. If the positional relationship cannot be accurately reproduced, the interference check is performed again at the previous stage of radiation therapy as in step SC9. By performing the interference check again, it is possible to reduce the risk of stopping radiotherapy due to the occurrence of interference during radiotherapy and correcting the treatment plan.

  If the positional relationship between the patient and the imaging top plate 23 at the time of treatment planning can accurately reproduce the positional relationship between the patient and the therapeutic top plate 44 at the time of treatment, steps SC8 to SC10 are performed. It does not necessarily have to be done.

  The interference check function may be improved to shorten the time required for alignment. Specifically, the arithmetic circuit 81 generates an enlarged top panel model by expanding the top panel model by a predetermined margin. The top plate allowable margin is set to an allowable deviation amount of the actual treatment top plate 44 with respect to the imaging top plate 23 in the treatment planning stage. Similarly, the arithmetic circuit 81 enlarges the patient model by a predetermined margin and generates an enlarged patient model. The patient tolerance margin is set to the patient's allowable deviation during the actual treatment with respect to the patient in the treatment planning stage.

  The arithmetic circuit 81 performs an interference check based on the enlarged top panel model and the enlarged patient model according to the radiation treatment plan. That is, the arithmetic circuit 81 determines whether or not the treatment gantry model, the magnifying table model, and the magnifying patient model interfere with each other, and determines that the alignment is completed when it is determined that there is no interference. When it is determined that there is no interference by the interference check based on such an enlarged model, it means that there is a considerable space between the treatment platform 41, the treatment bed 42, and the patient. Therefore, since very fine alignment is not necessary, the time required for alignment can be greatly shortened.

  On the other hand, if the arithmetic circuit 81 determines that the treatment gantry model, the enlarged couchtop model, and the enlarged patient model interfere, it determines that alignment is necessary. At this time, the arithmetic circuit 81 may reduce the margin of the enlarged top panel model or the enlarged patient model determined to cause interference automatically or in accordance with an instruction via the input circuit 87 by the radiotherapy worker. The arithmetic circuit 81 may reduce only the portion of the omnidirectional margins of the magnifying table model and the magnifying patient model where the interference is determined, or the entire margin of the magnifying table model and the magnifying patient model may be reduced. You may reduce over an azimuth | direction. At this time, the arithmetic circuit 81 may reduce both the margin of the enlarged top panel model and the margin of the enlarged patient model, or may reduce only one of them. The arithmetic circuit 81 performs interference check again using the enlarged top plate model or the enlarged patient model after reduction. Even when it is determined that there is no interference in the second interference check, the radiotherapy worker can recognize the danger of interference. When it is determined that there is interference by the interference check again, the radiotherapy worker re-aligns or redoes the radiotherapy plan. In this case, when comparing the patient position in the radiation therapy apparatus 4, it is determined within these allowable margins, but is determined using the reduced margin.

(Fourth embodiment)
Since radiation therapy is performed over a long period of time such as 5 weeks or 6 weeks, it is assumed that the patient's body shape changes due to the influence of anticancer agents and the like. If the body shape changes greatly, it is necessary to re-create the radiation treatment plan. Further, in the third embodiment, in step SC8, it is determined whether or not to perform the interference check again according to the positional relationship between the patient and the treatment top plate 44. However, since the change in the patient's body shape is not reflected in the positional relationship between the patient and the treatment top plate 44, the interference check may not be performed again even if the body shape has changed greatly.

  Hereinafter, the radiation therapy system 1 which concerns on 4th Embodiment is demonstrated. In the following description, components having substantially the same functions as those of the first, second, and third embodiments are denoted by the same reference numerals, and redundant description is provided only when necessary.

  FIG. 16 is a diagram illustrating a configuration of a treatment support apparatus according to the fourth embodiment. As shown in FIG. 16, the arithmetic operation circuit 81 of the treatment support apparatus according to the fourth embodiment includes a position comparison function 811, an integration function 812, a rendering function 813, an interference check function 814, a warning function 815, and a radiotherapy support. The figure comparison function 816 is executed.

  In the body shape comparison function 816, the arithmetic circuit 81 compares the body shape of the patient in the planning stage with the body shape of the patient in the treatment stage. In the present embodiment, the distance interval in the vertical direction of the patient surface area included in the planned body surface data and the treatment body surface data is regarded as a body shape. That is, the arithmetic circuit 81 compares the distance interval in the vertical direction of the patient body surface area of the planned body surface data with the distance interval in the vertical direction of the patient body surface area of the treatment body surface data. The arithmetic circuit 81 may compare the weight of the patient measured by the weight sensor or the like at the planning stage with the weight of the patient measured by the weight sensor or the like at the treatment stage. The weight sensors are provided on the imaging bed 22 and the treatment bed 42, respectively. The weight data measured by the weight sensor is transmitted to the treatment support apparatus 8.

  Next, an operation example of the radiation therapy system 1 according to the fourth embodiment will be described. Since the flow of operation of the radiotherapy system 1 according to the third embodiment is substantially the same as the flow of operation of the radiotherapy system 1 according to the third embodiment, description will be made with reference to FIGS. 14 and 15.

  In step SC <b> 2 in the planning stage, the first surface shape measuring device 3 collects the planned body surface data of the patient placed on the imaging top plate 23 of the treatment planning CT device 2. At this time, the weight of the patient at the time of collecting the body data at the time of planning is measured by the weight sensor provided on the imaging bed 22. The weight measurement value data is supplied to the treatment support apparatus 8.

  In step SC <b> 6 in the treatment stage, the second surface shape measuring device 5 collects body surface data during treatment of the patient placed on the treatment top plate 44 of the radiation treatment device 4. At this time, the weight of the patient at the time of collecting body surface data during treatment is measured by a weight sensor provided on the treatment bed 42. The weight measurement value data is supplied to the treatment support apparatus 8.

  Although the weight sensor is provided on the imaging bed 22 and the treatment bed 42, the present embodiment is not limited to this. For example, a weight sensor may be provided at the entrance of the planning room and the treatment room, or a weight sensor may be provided in the changing room or at the entrance.

  When step SC6 is performed, the display circuit 85 of the treatment support apparatus 8 displays the planned integration data and the treatment body surface data (step SC7). Since step SC7 is the same as step SB6, the description thereof is omitted. The patient or the radiotherapy worker confirms the planned integrated data displayed in step SC7, changes the position and position of the patient, and changes the patient body area of the planned integrated data and the patient body of the treated body surface data. Match the position with the table area.

  At this time, the arithmetic circuit 81 executes the position comparison function 811 (step SC6). In step SC6, the arithmetic circuit 81 determines that the positional relationship between the patient body surface area and the top surface area included in the treatment body surface data is the difference between the patient body surface area and the top surface area included in the planned body surface data. It is determined whether or not the positional relationship deviates by more than a threshold value.

  In step SC <b> 6, the arithmetic circuit 81 executes the body shape comparison function 816 in parallel with the execution of the position comparison function 811.

  FIG. 17 is a diagram schematically showing processing by the body type comparison function 816 of the arithmetic circuit 81. As shown in FIG. 17, the arithmetic circuit 81 first reads the planned integrated data D2 and the treatment body surface data D3 related to a predetermined axial section. The planned integrated data D2 includes a patient body surface region RP2 included in the planned body surface data, a top surface area RT2 included in the planned body surface data, and a tumor region RC2 included in the CT image data ICT2. The body table data D3 at the time of treatment includes a patient body surface region RP3 included in the body surface data at the time of treatment and a top surface area RT3 included in the body surface data at the time of treatment.

  As shown in FIG. 16, the arithmetic circuit 81 executes a body thickness measurement process on the planned integrated data D2 (step SC61). In step SC61, the arithmetic circuit 81 measures the distance interval V2 in the vertical direction of the patient body surface region RP2 as the body thickness. The vertical direction refers to a direction perpendicular to the surface of the imaging top plate 23. Similarly, the arithmetic circuit 81 executes a body thickness measurement process on the treatment body surface data D3 (step SC62). In step SC62, the arithmetic circuit 81 measures the distance interval V3 in the vertical direction of the patient body surface region RP3 as the body thickness.

  When Steps SC61 and SC62 are performed, the arithmetic circuit 81 performs body thickness comparison processing (Step SC63). In step SC63, the arithmetic circuit 81 compares the planned body thickness value V2 measured in step SC61 with the therapeutic body thickness value V3 measured in step SC62. More specifically, the arithmetic circuit 81 calculates a difference between the body thickness value V2 at the time of planning and the body thickness value V3 at the time of treatment, and whether or not the difference is within a predetermined allowable range, Determine whether planning is necessary. If the difference is not within the allowable range, the patient's physique has changed greatly between the planning time and the treatment time, so it is better to repeat the radiation therapy planning. When the difference is within the allowable range, the patient's physique has not changed much between the planning time and the treatment time, and therefore the radiation therapy planning need not be performed again.

  When step SC63 is performed, the arithmetic circuit 81 displays the result of the body thickness comparison in step SC63 on the display circuit 85 (step SC64). Here, the arithmetic circuit 81 executes the warning function 815 when the difference between the body thickness value V2 at the time of planning and the body thickness value V3 at the time of treatment is not within the allowable range. In the warning function 815, the arithmetic circuit 81 issues a warning that the patient's physique has changed greatly between planning and treatment. For example, the arithmetic circuit 81 transmits a warning signal to the radiation therapy apparatus 4. The arithmetic circuit 464 of the radiotherapy apparatus 4 that has received the warning signal indicates to the radiotherapy worker that the display 466 provided in the treatment room says "The patient's body shape has changed significantly. Replanning may be necessary. "" Is displayed.

  Further, the arithmetic circuit 464 displays a confirmation button together with a warning message. The radiotherapy worker will press the confirmation button after re-planning. Preferably, the radiotherapy is temporarily stopped, and after re-imaging of the radiotherapy CT, re-execution of the radiotherapy plan, etc., the radiotherapy is resumed. In this case, the confirmation button is pressed. When the confirmation button is pressed, the arithmetic circuit 464 notifies the irradiation control circuit 461 that radiation (X-ray) irradiation is permitted. When an irradiation instruction is given when irradiation permission is notified, the irradiation control circuit 461 can irradiate radiation. In other words, the arithmetic circuit 464 restricts radiation irradiation unless the confirmation button is pressed.

  The arithmetic circuit 81 may compare the weight measured by the weight sensor instead of the body thickness. Specifically, the arithmetic circuit 81 calculates a difference between the weight at the time of planning and the weight at the time of treatment, and determines whether or not the difference is within a predetermined allowable range, that is, whether or not replanning is necessary. judge. As in the case where the body thickness is compared, the arithmetic circuit 81 issues a warning when the difference in weight is not within the allowable range, because the patient's physique has changed greatly between planning and treatment. When the difference is within the allowable range, the patient's physique has not changed much between the planning time and the treatment time, and therefore the radiation therapy planning need not be performed again.

  Note that the arithmetic circuit 81 may determine whether or not replanning is necessary by using both the difference regarding the body thickness and the difference regarding the weight. For example, when any one of the difference regarding the body thickness and the difference regarding the body weight is not within the allowable range, the arithmetic circuit 81 may determine that replanning is necessary and issue a warning. On the other hand, the arithmetic circuit 81 determines that re-planning is not necessary when the difference between the difference regarding the body thickness and the difference regarding the weight is within the allowable range. Thus, by using both the difference regarding the body thickness and the difference regarding the weight, it is possible to accurately determine whether or not the re-planning is necessary.

  When it is determined that replanning is necessary, the arithmetic circuit 81 performs steps SC9 and SC10. When it is determined that re-planning is not necessary or when step SC10 is performed, the arithmetic circuit 81 performs steps SC11, SC12, SC13, and SC14.

  When radiation therapy is performed in step SC13, the typical operation of the radiation therapy system 1 according to the fourth embodiment ends.

  In step SC63, the difference regarding the body thickness is calculated using the body table data at the time of planning and the body surface data at the time of treatment. However, this embodiment is not limited to this. For example, the arithmetic circuit 81 uses the position comparison function 811 to convert the planned body table data into the treatment body table data under the condition that the imaging top plate 23 or the treatment top plate 44 is positioned at the same height. Align with. Specifically, the planned time integrated body data or the planned time body surface data is image-converted so that the patient body surface area of the planned body table data matches the patient body surface area of the treated body surface data. Then, the arithmetic circuit 81 calculates a positional deviation amount in the vertical direction between the planned body surface data after the alignment and the treated body surface data as a difference regarding the body thickness by the body shape comparison function 816. Thereby, the difference regarding more exact body thickness is computable. Also in this case, as in step SC64, if the difference regarding the body thickness is not within the allowable range, the arithmetic circuit 81 may issue a warning that the patient's physique has changed greatly between the planning time and the treatment time. Thereby, a warning can be issued based on more accurate information, the reliability with respect to the warning can be improved, and the efficiency of radiation therapy can be improved.

(Application examples)
In the above embodiment, information such as planning integration data and positional deviation amount is displayed by the display circuit 85 of the treatment support apparatus 8. However, information such as planned integration data and positional deviation amount according to the present embodiment may be displayed on a head mounted display mounted on a user such as a radiotherapy worker.

  FIG. 18 is a diagram illustrating a configuration of an information display system according to an application example. The information display system is incorporated in the radiation therapy system 1. As shown in FIG. 18, the head mounted display 9 is a display device that is worn on the user's head. For example, the head mounted display 9 is a glasses-type display device as shown in FIG.

  The head-mounted display 9 includes a left-eye lens 91 and a right-eye lens 92. The left-eye lens 91 and the right-eye lens 92 are supported by a frame 93 such as a temple. The frame 93 is provided with a display 94, a position detector 95, and a communication interface 96.

  For example, the display 94 is provided on the frame 93 so as to be positioned in front of the lens 91 for the left eye. The display 94 is realized by, for example, a combination of a translucent screen and a projector that projects an image on the screen.

  The position detector 95 may be any position sensor such as a GPS (Global Positioning System) sensor, a magnetic sensor, or an electric sensor. When detecting only the position of the head mounted display 9, the position detector 95 may be one and may be provided at any position. However, when detecting the position and direction of the head mounted display 9, it is provided on each of the left side and the right side of the head mounted display 9. The direction is calculated based on the relative relationship between the positions of the position detectors 9. The direction substantially coincides with the direction of the line of sight of the user wearing the head mounted display 9. The calculation of the line-of-sight direction may be performed by a processor such as a CPU (not shown) provided in the head mounted display 9 or may be performed by the arithmetic circuit 81 of the treatment support apparatus 8. Hereinafter, the position and the line-of-sight direction are collectively referred to as position information.

  The communication interface 96 communicates information with the treatment support apparatus 8. For example, the communication interface 96 transmits position information to the treatment support apparatus 8 and receives display integrated data from the treatment support apparatus 8.

  For example, the user is wearing the head mounted display 9 at the time of alignment in the treatment stage. The position detector 9 of the head mounted display 9 repeatedly detects the position and line-of-sight direction of the position detector 9 and repeatedly transmits position information to the treatment support apparatus 8. In the rendering function 813, the arithmetic operation circuit 81 of the treatment support apparatus 8 converts the planned integrated data into display integrated data having a format for displaying on the head mounted display 9. Specifically, the arithmetic circuit 81 generates rendering image data (integrated data for display) of the planned integrated data with the head mounted display 9 as a viewpoint based on the planned integrated data and the position information. More specifically, the planned integration data is arranged in the three-dimensional image space, and the viewpoint is set at the position of the head mounted display 9 in the three-dimensional image space. For example, the planned integration data is arranged at the treatment position defined in the three-dimensional image space. The treatment position is defined in an area including at least the tumor position. A ray passing through the planning integrated data along the line-of-sight direction from the viewpoint is set, and volume rendering based on the ray is performed. As a result, rendering image data (integrated data for display) related to the integrated data with the viewpoint set on the head mounted display 9 is generated. The display integrated data is displayed in a translucent manner, for example. Thereby, it becomes possible to visually recognize the actual patient, the treatment top plate 44 and the like superimposed on the display integrated data.

  As described above, according to the application example, it is possible to provide a system as if the patient represented by the planned integration data is lying on the treatment top 44. Since the integrated data for display is based on the integrated data at the time of planning, the tumor position is also drawn in addition to the patient body surface data. The user can move the treatment top plate 44 so that the translucent display integrated data and the patient body surface observed through the display integrated data match. Thereby, a patient's 1st position alignment can be performed correctly and simply.

  The head-mounted display 9 may display planned integrated data. That is, the arithmetic operation circuit 81 of the treatment support apparatus 8 may transmit the planned integrated data to the head mounted display 9 in the treatment stage, and the head mounted display 9 may display the received planned integrated data. In this case, the position detector 95 does not need to be provided in the head mounted display 9.

  Thus, according to at least one embodiment described above, the first alignment of the patient at the time of radiation therapy is performed accurately and simply.

  The combination of the processor and the memory according to the present embodiment may be realized by an application specific integrated circuit (ASIC), a field programmable gate array (FPGA), a complex programmable logic device (CPLD), or a simple programmable logic device (SPLD). .

  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.

  DESCRIPTION OF SYMBOLS 1 ... Radiation treatment system, 2 ... CT apparatus for treatment planning, 3 ... 1st surface shape measuring device, 4 ... Radiation treatment device, 5 ... 2nd surface shape measuring device, 6 ... Treatment planning device, 7 ... PACS system 8 ... Treatment support device, 21 ... Imaging platform, 22 ... Imaging bed, 23 ... Imaging platform, 24 ... Base, 41 ... Treatment platform, 42 ... Treatment platform, 44 ... Treatment platform, 45 ... Base, 46 ... Console, 81 ... Arithmetic circuit, 83 ... Communication circuit, 85 ... Display circuit, 87 ... Input circuit, 89 ... Memory circuit, 211 ... Opening, 411 ... Base body, 412 ... Irradiation head unit, 413 Irradiator, 451 ... bed driving device, 461 ... irradiation control circuit, 462 ... gantry control circuit, 463 ... bed control circuit, 464 ... arithmetic circuit, 465 ... communication circuit, 466 ... display circuit, 467 ... input circuit, 468 ... Memory circuit 811 Position comparison function 812 ... integration function, 813 ... rendering, 814 ... interference check function, 815 ... warning function, 816 ... integrated compare function 994 ... gantry driving device.

Claims (18)

A medical image collection unit for collecting medical three-dimensional image data of a patient at the time of treatment planning;
A first body surface data collection unit for collecting first body surface data representing a three-dimensional body surface of the patient at the time of treatment planning;
An arithmetic circuit that generates integrated data in which at least one of the medical 3D image data and treatment site data included in the medical 3D image data and the first body surface data are integrated in the same 3D coordinate system When,
A radiation therapy system comprising: A therapeutic bed that movably supports a therapeutic table on which the patient is placed;
A radiation treatment stand for irradiating the patient with radiation, and
The arithmetic circuit arranges the integrated data at a treatment position, and displays the integrated data arranged at the treatment position on a display device.
The radiation therapy system according to claim 1. The display device is a head-mounted display,
It further comprises a position detector provided in the head mounted display,
The arithmetic circuit sets a viewpoint on the head-mounted display based on the position detected by the position detector, generates integrated data for display arranged at the treatment position,
The head mounted display displays the integrated data for display.
The radiation therapy system according to claim 2. A second body surface data collection unit for collecting second body surface data representing a three-dimensional body surface of the patient placed on the treatment top;
The arithmetic circuit generates combined data of the integrated data arranged at the treatment position and the second body surface data, and displays the combined data on the display device.
The radiation therapy system according to claim 2.   The radiotherapy according to claim 4, further comprising a bed control circuit that controls movement of the treatment table so that a position of treatment site data included in the integrated data coincides with an iso center of the radiotherapy stand. system.   The bed control circuit determines a bed control parameter so that the first body surface data and the second body surface data included in the integrated data match, and based on the control parameter, the treatment table The radiation therapy system of Claim 5 which controls the movement of a top plate.   The arithmetic circuit includes: a patient body surface at the time of the treatment plan represented by the first body surface data included in the integrated data; and a patient body at the time of the treatment represented by the second body surface data. The radiotherapy system according to claim 6, wherein a positional deviation amount with respect to a body surface is calculated, and information representing the positional deviation amount is displayed on the display device.   The radiotherapy system according to claim 7, wherein the display device includes a projector that projects the information representing the amount of displacement to the treatment top plate or the patient placed on the treatment top plate.   The radiotherapy system according to claim 7, wherein the display device includes a display provided at a position visible to the patient placed on the treatment top in a room where the treatment bed is installed. .   In the plane parallel to the imaging top plate and the treatment top plate when the height of the imaging top plate and the treatment top plate is the same as the amount of displacement, the arithmetic circuit The radiotherapy system according to claim 7, wherein a first shift amount relating to a position between the first body surface data and the second body surface data is calculated.   The said arithmetic circuit calculates the 2nd deviation | shift amount of the said patient's body type regarding the collection time of the said patient's body type regarding the collection time of the said 1st body surface data, and the 2nd body surface data. Radiation therapy system. The arithmetic circuit is:
In the case where the height of the imaging top plate and the treatment top plate are the same, the first body surface data is aligned with the second body surface data,
A positional shift between the first body surface data and the second body surface data after the alignment in a direction perpendicular to the imaging top plate and the treatment top plate is defined as the second shift. As a quantity,
The radiotherapy system according to claim 11.   The radiotherapy system according to claim 11, wherein the arithmetic circuit issues a warning when the second deviation amount exceeds a threshold value.   The radiation according to claim 7, wherein the arithmetic circuit performs an interference check under a calculation condition that a patient model imitating the patient is sleeping at an appropriate position of the couch model imitating the treatment couch. Treatment system.   The radiotherapy system according to claim 14, wherein the arithmetic circuit checks the presence or absence of mechanical interference between the patient model, the top plate model, and a radiotherapy frame model simulating the radiotherapy frame.   The radiotherapy system according to claim 14, wherein the arithmetic circuit uses an enlarged patient model larger than the patient as the patient model, and uses an enlarged top plate model larger than the treatment top plate as the top model. .   When the positional deviation between the first body surface data and the second body surface data is larger than a predetermined value, the arithmetic circuit interferes based on the second body surface data and the positional deviation amount. The radiation therapy system according to claim 14, wherein the check is performed again. At least one of the medical three-dimensional image data of the patient at the time of treatment planning and the treatment site data included in the medical three-dimensional image data; and first body surface data representing the three-dimensional body surface of the patient at the time of treatment planning; An arithmetic circuit that generates integrated data integrated in the same three-dimensional coordinate system,
A treatment support apparatus comprising: