JP3785136B2 - Radiotherapy apparatus and method of operating radiotherapy apparatus - Google Patents

Radiotherapy apparatus and method of operating radiotherapy apparatus Download PDF

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JP3785136B2
JP3785136B2 JP2002336528A JP2002336528A JP3785136B2 JP 3785136 B2 JP3785136 B2 JP 3785136B2 JP 2002336528 A JP2002336528 A JP 2002336528A JP 2002336528 A JP2002336528 A JP 2002336528A JP 3785136 B2 JP3785136 B2 JP 3785136B2
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irradiation
image
treatment
radiation
ray
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JP2004166975A (en
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謙治 原
則幸 川田
真 赤津
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三菱重工業株式会社
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Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a radiotherapy apparatus and a method for operating the radiotherapy apparatus, and more particularly to a technique for recording a treatment history during radiotherapy.
[0002]
[Prior art]
Conventionally, a radiotherapy apparatus for treating cancer or tumor using radiation has been known. Radiosurgery treatment devices, linac treatment devices, and the like are known as three-dimensional irradiation radiation treatment devices that emit radiation in a stereotactic orbit. Stereotaxic multi-orbital irradiation is a radiotherapy method in which radiation is concentrated on a small lesion from multiple directions to increase the therapeutic effect and minimize the exposure dose of surrounding tissues.
[0003]
A conventional radiosurgery treatment apparatus irradiates a narrow radiation beam intensively to a specific small area with high accuracy from a radiation irradiation unit fixed to the treatment apparatus. A gamma ray source or a linac is used as the radiation irradiation unit. In the radiosurgery treatment device, an affected part such as a patient's skull or the peripheral part thereof is mechanically fixed using a fixture for precise positioning of the affected part called a frame. Using this frame as a coordinate reference jig for positioning, diagnostic imaging such as X-ray CT (Computed Tomography), MRI, and DAS (Digital Subtraction Angiography) is performed to determine the exact position and shape of the affected area. Then, the patient is mechanically fixed in this frame as it is to an irradiation apparatus including a radiation irradiation unit and a collimating mechanism that collimates the radiation irradiation unit and concentrates therapeutic radiation in a small area of the space. As a result, the irradiation field is mechanically precisely matched to the small area, and precise localization irradiation is performed. When the affected area is spherical, it is possible to irradiate a required therapeutic dose with a single irradiation. When the affected part is indefinite, positioning is repeated several times according to the shape of the treatment field. At the same time, the diameter of the collimator is selected again and irradiation treatment is performed.
[0004]
In the radiosurgery treatment device, the device and procedure are extremely simple, and high reliability can be obtained. At the same time, when the irradiation object does not move with respect to the skull like the head, extremely precise positioning and irradiation are possible. However, because the irradiation field of the radiation irradiation unit is fixed, the body to which the irradiation object such as tumor moves due to the influence of organ movement and condition such as breathing and heartbeat below the neck, peristalsis and urine volume in the bladder The current situation is that stereotactic radiation therapy cannot be performed on the department. Strictly speaking, radiation is not irradiated while observing the affected area in real time.
[0005]
Further, in the conventional linac treatment apparatus, the large gantry rotates 360 degrees around one axis parallel to the installation surface, so that isocentric irradiation treatment is performed. Furthermore, various irradiations are possible by adding a two-dimensional movement in the top and bottom of the treatment bed and in a horizontal plane and a rotation in the horizontal plane. In addition, MLC (Multi Leaf Collimator) can deal with irradiation objects with complicated shapes, and the irradiation dose distribution is controlled to enable precise irradiation therapy (IMRT: Intensity Modulated Radio Therapy).
[0006]
This linac treatment apparatus cannot perform high-speed position control. Therefore, real-time follow-up irradiation to a therapeutic field that moves at high speed, such as movement by heartbeat, is not possible. Further, as a means for monitoring the irradiation field during irradiation, linacography using therapeutic X-ray transmission rays is used. Since therapeutic X-rays are highly transmissive and have many scattered rays, they are inappropriate for use as a real-time monitor of an irradiation target.
[0007]
Synchronous irradiation is performed by a respiratory synchronizer only for respiratory motion. In this case, since the affected part image cannot be imaged in real time, the affected part position is estimated by a predetermined method. Then, at the time when it is estimated that the affected part has reached the determined irradiation position, the irradiation apparatus is triggered to perform treatment irradiation. As the estimation method, the marker attached to the affected part is optically tracked, or the movement of the affected part is estimated by grasping the respiratory state of the patient by directly measuring the flow rate of exhaled air. However, synchronous irradiation estimates the affected part position and irradiates the radiation toward the estimated position, and does not irradiate the patient while tracking the affected part in real time.
[0008]
As other three-dimensional irradiation radiotherapy apparatuses, there are known an apparatus that drives an electronic linac in an isocentric manner and an apparatus that drives an electronic linac along a gantry having a predetermined shape.
[0009]
As an apparatus for driving an electronic linac in an isocentric manner, there is a device equipped with a small electronic linac at the tip of an industrial general-purpose robot arm. The exact shape and position of the affected area are determined by X-ray CT, MRI, or the like in association with landmark body tissue such as a skull or chest or a marker such as a small gold plate embedded as a marker near the affected area. At the time of treatment irradiation, two X-ray cameras having different lines of sight perform precise irradiation while monitoring the movement of the landmark and correcting the aim. This device is capable of essentially non-isocentric irradiation treatment due to the free movement capability of the 6-DOF robot arm.
[0010]
In the case of head treatment, this device uses a fixing tool for fixing the head, but does not irradiate while directly viewing the image of the affected area. That is, imaging with an X-ray camera is not performed during irradiation of the treatment beam. Therefore, a method is adopted in which the imaging is completed before the irradiation is started and the irradiation is started after the irradiation position is confirmed. Therefore, in this case, the irradiation field is not monitored in real time. In addition, because the electronic linac is heavy, it is necessary to solve problems such as inertia in order to perform precise follow-up irradiation in real time for fast movements such as heartbeats while holding it at the tip of a cantilevered robot arm. is required.
[0011]
In addition, the industrial robot arm does not guarantee absolute accuracy with respect to the designated spatial coordinates, but only guarantees repeatability by teaching. Therefore, teaching and related work are required prior to actual treatment.
[0012]
As a device for driving an electronic linac along a gantry having a predetermined shape, for example, Japanese Patent Application Laid-Open No. 8-504347 (see International Application No. PCT / US93 / 11872: Patent Document 1) and Japanese Patent Application Laid-Open No. 6-502330. (International Application No .: PCT / US91 / 07696: Patent Document 2). The stereotactic radiotherapy apparatus of this technology includes a C-arm type X-ray camera having two rotation axes, and a medical electronic linac having two rotation axes. Three-dimensional irradiation can be performed by adding another rotating shaft to the conventional electronic linac that can only rotate in one axis direction. However, the irradiation method is isocentric and is the same as that of the radiosurgery treatment device in that the head needs to be fixed with a frame. Moreover, it differs from the case of the radiosurgery treatment device in that the large gantry is driven in two axes.
[0013]
The patient's affected area is also moving during treatment. In particular, the irradiation target such as a tumor is constantly moving from the neck to the bottom under the influence of organ movement and state such as breathing, heartbeat, peristalsis, and urine volume in the bladder. For example, just by lying down, the body gradually flattens. In addition, although periodic movements such as breathing and heartbeat are periodic, the movement of each organ accompanying the movement does not always follow the same path. On the other hand, if the movement of the irradiation target is to be accurately captured in real time, the heartbeat, which is one of the fastest movements, is 1 to 2 times / second, so an image capturing technique of about 30 images / second is required. It is said that. If the irradiation target is accurately tracked in real time and radiation is to be irradiated, it is necessary to accurately direct the radiation irradiation head to the irradiation target every 1/30 seconds.
[0014]
By the way, when a radiotherapy is performed using the radiotherapy apparatus as described above, it is obliged to leave a treatment history by law. In order to cope with this, in the treatment using the conventional radiotherapy apparatus, a fluoroscopic image of the irradiation unit is taken and recorded immediately after the treatment in order to confirm the irradiation position of the therapeutic radiation. This recorded fluoroscopic image is submitted to the Ministry of Health, Labor and Welfare upon request and provided to the doctor. However, since irradiation information during treatment is not recorded, the site where treatment radiation is actually irradiated is unknown. Therefore, it cannot be said that it is sufficient as a record of the treatment history, and there arises a problem that the subsequent treatment plan is hindered. Therefore, it is desired to clarify the site irradiated with therapeutic radiation during treatment.
[0015]
Moreover, in the treatment using the conventional radiotherapy apparatus, a planned dose is irradiated from a previously planned direction, the total irradiated dose is recorded on a medical record or the like, and a fluoroscopic image of the irradiation unit is taken immediately after the treatment. The recorded fluoroscopic image is provided to the doctor and submitted to the Ministry of Health, Labor and Welfare upon request. Therefore, since there is no information indicating the irradiation state during treatment, the site irradiated with the treatment radiation and the dose at that time are unknown, the doctor confirms the treatment status, plans the next treatment action, whether the current treatment is good or bad There is a problem that judgment is difficult. Therefore, it is desired to develop a method capable of easily confirming the treatment status by a doctor, determining whether the current treatment is good, and planning the next treatment action.
[0016]
Moreover, in the treatment using the conventional radiotherapy apparatus, the state in the treatment room is monitored with a television camera, the irradiation dose is displayed, and if there is a malfunction, the doctor stops the treatment. However, the quality of treatment cannot be judged, and the quality of treatment is unclear. Therefore, it is desired to develop a method capable of judging the quality of treatment with comprehensive information including the situation of the treatment department.
[0017]
Furthermore, in the treatment using the conventional radiation therapy apparatus, the radiation dose for treatment is measured by a radiation dosimeter attached to the radiation head, and this is recorded together with the head position space coordinates of the radiation head. However, this method has a problem that the coordinate information of the affected part of the patient is not known, the direction of radiation is unknown, and it is difficult to collate with the treatment plan.
[Patent Document 1]
JP-T 8-504347
[Patent Document 2]
Japanese Patent Publication No. 6-502330
[0018]
[Problems to be solved by the invention]
An object of the present invention is to provide a radiotherapy apparatus and an operation method of the radiotherapy apparatus that can facilitate a treatment plan after radiotherapy is performed on a subject.
[0019]
[Means for Solving the Problems]
Hereinafter, means for solving the problem will be described using the numbers and symbols used in the embodiments of the present invention. These numbers and symbols are added to clarify the correspondence between the description of [Claims] and [Embodiments of the Invention]. However, these numbers and symbols should not be used for the interpretation of the technical scope of the invention described in [Claims].
[0020]
In order to solve the above-mentioned problems, a radiation therapy apparatus according to the first aspect of the present invention includes a radiation irradiation head (10) for irradiating therapeutic radiation, and therapeutic radiation from the radiation irradiation head (10). An image processing unit (30, 31) for generating an image of the affected part while tracking the affected part of the subject, and a recording unit (80) for sequentially recording the image of the affected part generated by the image processing unit (30, 31) , And.
[0021]
According to the radiotherapy apparatus according to the first aspect, since an image of the affected area under treatment is recorded, it is possible to easily know the site where the therapeutic radiation is actually irradiated. Therefore, it is sufficient as a record of treatment history, and a treatment plan after radiation treatment can be easily made.
[0022]
The radiotherapy apparatus according to the first aspect further includes a calculation unit (80) that calculates a treatment history with therapeutic radiation based on the operating state of the radiation irradiation head (10), and the recording unit (80) The treatment history calculated by the unit (80) can be sequentially recorded in association with the image of the affected part. In this case, the calculation unit (80) calculates, as the treatment history, the treatment dose to which the therapeutic radiation is input and the estimated absorbed dose estimated to have been absorbed by the subject for each irradiation direction of the therapeutic radiation. Can be configured. The irradiation direction can be determined from the source coordinates representing the radiation source of the radiation irradiation head (10) and the target coordinates representing the coordinates of the affected part of the subject. According to this configuration, it is possible to easily confirm the treatment status by the doctor, determine the quality of the current treatment, and plan the next treatment action.
[0023]
In addition, the radiotherapy apparatus according to the first aspect can further include a display (81) for displaying the image of the affected area and the treatment history recorded in the recording section (80). According to this configuration, the doctor can quickly make an accurate judgment by looking at the display (81).
[0024]
In the radiotherapy apparatus according to the first aspect, the display (81) can be configured to further display the instantaneous value and the integrated value of the irradiation dose of the therapeutic radiation. According to this configuration, in addition to the information indicating the irradiation state during treatment, the site irradiated with the therapeutic radiation and the dose at that time are displayed on the display (81). It is easy to plan actions and judge the quality of current treatment.
[0025]
Further, in the radiotherapy apparatus according to the first aspect, the display (81) can be configured to further display information indicating suitability of the treatment position. According to this configuration, since the information indicating the suitability of the treatment position is displayed, the quality of treatment can be determined from the comprehensive information including the situation of the treatment unit.
[0026]
Furthermore, in the radiotherapy apparatus according to the first aspect, the recording unit (80) can be configured to further record the spatial coordinates of the affected area irradiated with the therapeutic radiation from the radiation irradiation head (10). According to this configuration, the irradiation direction of the radiation is clarified, so that the comparison with the treatment plan is facilitated.
[0027]
The operation method of the radiotherapy apparatus according to the second aspect of the present invention is an image generation step of generating an image of an affected area while tracking the affected area of a subject irradiated with therapeutic radiation from the radiation irradiation head (10). And a recording step for sequentially recording the generated images of the affected area.
[0028]
The operation method of the radiotherapy apparatus according to the second aspect further includes a calculation step of calculating a treatment history by the therapeutic radiation based on the operating state of the radiation irradiation head (10), and the recording step is a calculation step. The calculated treatment history can be sequentially recorded in association with the image of the affected area. In this case, the calculation step is configured to calculate, as the treatment history, the treatment dose to which the treatment radiation is input and the estimated absorbed dose estimated to have been absorbed by the subject for each irradiation direction of the treatment radiation. . The irradiation direction can be determined from the source coordinates representing the radiation source of the radiation irradiation head (10) and the target coordinates representing the coordinates of the affected part of the subject.
[0029]
The operation method of the radiotherapy apparatus according to the second aspect may further include a display step for displaying the image of the affected part and the treatment history recorded in the recording step. Further, the display step can be configured to further display an instantaneous value and an integrated value of the irradiation dose of therapeutic radiation. Further, the display step can be configured to further display information indicating the suitability of the treatment position. Furthermore, the recording step can be configured to further record the spatial coordinates of the affected area irradiated with therapeutic radiation from the radiation irradiation head (10).
[0030]
DETAILED DESCRIPTION OF THE INVENTION
Hereinafter, the radiation therapy apparatus of this invention is demonstrated in detail, referring an accompanying drawing.
[0031]
1 is a side view of a radiotherapy apparatus according to an embodiment of the present invention, FIG. 2 is a front view thereof, and FIG. 3 is a perspective view thereof. A part of the drawing is omitted. A coordinate 200 indicates a three-dimensional orthogonal coordinate having the X axis, the Y axis, and the Z axis in FIGS.
[0032]
The radiotherapy apparatus 6 includes a treatment bed system 7, an X-ray head 10, a first swing mechanism 131, a second swing mechanism 132, an arc guide rail 9, a microwave generator 70, a driven waveguide system 11, and A real-time imager 30 is provided.
[0033]
The therapeutic bed system 7 includes a bed driving system 7-1, a therapeutic bed 7-2, and a patient fixing device 7-3. The treatment bed 7-2 is configured to be movable with the patient 4 to be subjected to radiation therapy, and is mounted on the XY table of the bed drive system 7-1. The patient fixing device 7-3 fixes the patient 4 to the treatment bed 7-2. The bed drive system 7-1 moves the treatment bed 7-2 in the two-axis directions of the longitudinal direction (X-axis direction) and the width direction (Y-axis direction) by a built-in drive mechanism (not shown). The bed drive system 7-1 is configured so that the affected area 5 serving as the irradiation field 5 ′ is isocentered based on diagnostic image data photographed by the real-time imager 30 (X-ray CT inspection apparatus) under the control of the system controller 80 described later. The position of the treatment bed 7-2 is adjusted so as to be positioned at 5a. The treatment bed 7-2 and the patient fixing device 7-3 include materials suitable for image processing in diagnostic imaging equipment such as a real-time imager 30, a solid-state imaging device for X-rays (X-ray CCD), and PET (Positron Emission Tomography). And the shape is selected.
[0034]
The X-ray head 10 irradiates the therapeutic field X ′ 3a to the irradiation field 5 ′ (affected area 5). The X-ray head 10 includes a small electronic linac that generates a therapeutic X-ray 3a having an energy of 4 MeV to 10 MeV. The X-ray head 10 is movably attached to the arc guide rail 9 via a circular movement mechanism 68. Further, the X-ray head 10 includes a first swing mechanism 131 and a second swing mechanism 132.
[0035]
The first swing mechanism 131 swings (rotates) the X-ray head 10 on the arc guide rail 9 as shown by an arrow R1 in FIG. 2 around the first swing axis S1. The first swing axis S1 is provided on or in the vicinity of an axis that substantially passes through the center of inertia of the X-ray head 10 so that the inertia when the X-ray head 10 swings becomes small.
[0036]
The second swing mechanism 132 swings (rotates) the X-ray head 10 on the arc guide rail 9 as shown by an arrow R2 in FIG. 1 around the second swing axis S2. The second swing axis S2 is provided on or near an axis that substantially passes through the center of inertia of the X-ray head 10 so that the inertia when the X-ray head 10 swings becomes small.
[0037]
The arc guide rail 9 includes a guide rail tilting mechanism 28 and a circular movement mechanism 68. The arc guide rail 9 is formed of a semicircular ring having an arc shape that is an upper half of the therapeutic bed 7-2, and is provided so as to straddle the therapeutic bed 7-2. The guide rail tilting shaft 26 is an axis in the Y-axis direction connecting both ends and the center of the semicircle, and the center of the circle coincides with the isocenter 5a. The arc guide rail 9 is supported by a guide rail tilting mechanism 28 so as to be tiltable. The guide rail tilt mechanism 28 moves the arc guide rail 9 around the guide rail tilt axis 26 within a range of 0 degrees (position standing upright in the Z-axis positive direction) to 90 degrees (position lying sideways in the X-axis positive direction). Tilt as shown by arrow G1 in FIG. That is, the arc guide rail 9 moves so as to draw a quarter sphere (1/4 spherical shell) centering on the isocenter 5a. The arc guide rail 9 is made of a material having high rigidity such as stainless steel.
[0038]
Further, as shown by an arrow H <b> 1 in FIG. 2, the circling movement mechanism 68 circulates the X-ray head 10 around the semicircular arc of the arc guide rail 9 along the arc guide rail 9. As the circular movement mechanism 68, a rack and opinion method or a belt method can be adopted.
[0039]
By the above three-axis drive (G1, H1), the X-ray head 10 can move in an isocentric manner on the ¼ spherical shell centered on the isocenter 5a (the X-ray head 10 faces the isocenter 5a). become. Further, by the above-described two-axis drive (R1, R2), the X-ray head 10 moves in a pseudo non-isocentric manner on the ¼ spherical shell (the X-ray head 10 is three-dimensional in the vicinity of the isocenter 5a. Can be directed to a desired point in the region 5b (see FIG. 2). Since this pseudo non-isocentric motion is a swing motion around the center of inertia of the X-ray head 10, it is possible to perform a quick motion at each stage as compared with the isocentric motion. With the pseudo non-isocentric high-response quick tracking motion, the head sight can be followed with high response and precision even for fast movement such as heartbeat.
[0040]
The microwave generator 70 includes a klystron, has a circulator 21 and a dummy load 22 related to a waveguide, and supplies microwaves for electron acceleration to the X-ray head 10 through the driven waveguide system 11. . Here, a microwave of C band (for example, 5.6 GHz) is supplied.
[0041]
The driven waveguide system 11 is a waveguide that supplies the microwave generated by the microwave generator 70 to the X-ray head 10. The joint part 14a, the link arm 12, the joint part 14b, the link arm 13, the joint part 14c, the link arm 15, the joint part 16, and the X-ray head 10 are connected to each other to form a link mechanism. Only the joint part 14a can rotate around the axis in the Y-axis direction, and the joint part 14b, the joint part 14c, and the joint part 16 can rotate around the axis in the X-axis direction. The X-ray head 10 at the end of the link slides along the arc guide rail 9 by the circular movement mechanism 68 and is swung around the joint portion 16 by the first swing mechanism 131.
[0042]
Each of the joint portions 14a, 14b, 14c, and 16 includes a rotary RF coupler (not shown) that transmits microwaves by axial rotation. The link arms 12, 13, and 15 are made of a waveguide, and are electromagnetically communicated with each other through the joint portions 14 a to 14 c and 16. The microwave generated by the microwave generator 70 is supplied to the X-ray head 10 via the joint portion 14 a, the link arm 12, the joint portion 14 b, the link arm 13, the joint portion 14 c, the link arm 15, and the joint portion 16. Is done.
[0043]
The real-time imager 30 is an X-ray CT inspection apparatus. The X-ray CT examination apparatus irradiates the affected part (treatment field) 5 of the patient 4 as a subject with diagnostic X-rays 3b, which are weak fan beam X-rays, one after another from various directions over 360 degrees, and transmits them. Detect the image. The detected diagnostic image data is displayed as a three-dimensional tomographic diagnostic image of the affected area 5 on the display 81 by image processing. The real-time imager 30 is controlled by the system controller 80.
[0044]
The real-time imager 30 is supported in a posture tilted at a predetermined angle (for example, tilted by 20 degrees to 30 degrees with respect to the vertical axis) by the imager tilting mechanism 20 shown in FIG. When the imager tilting mechanism 20 is driven, the real-time imager 30 tilts around the axis (indicated by an arrow K1 in FIG. 1), thereby changing the irradiation angle of the diagnostic X-ray 3b. Note that the real-time imager 30 and the arc guide rail 9 are mechanically closely coupled and have a common coordinate reference.
[0045]
The real-time imager 30 is controlled so that the arc guide rail 9 and the X-ray head 10 do not interfere with each other. When a normal X-ray camera is used as an imager, if necessary, a small gold plate is embedded in the vicinity of the irradiation field, and the irradiation field is labeled as a marker.
[0046]
The real-time imager 30 includes a donut-shaped vacuum chamber having a central opening as a diagnostic space, and a patient 4 as a subject is taken in and out of the diagnostic space together with a treatment bed 7-2. The inside of the vacuum chamber is evacuated by a vacuum pump through an exhaust port (not shown).
[0047]
In the vacuum chamber, a number of diagnostic X-ray generation units arranged on concentric circles near the outer periphery and a number of sensor arrays arranged on concentric circles closer to the inner periphery are provided. ing. The diagnostic X-ray generation unit and the sensor array are arranged while being shifted in the X-axis direction, and the diagnostic X-ray 3b is irradiated in a fan shape in a direction inclined forward with respect to the radius of the vacuum chamber. For this reason, the fan-shaped diagnostic X-ray 3b passes through the patient 4 in the diagnostic space without being blocked by the X-ray irradiation side (upper) sensor array, and is detected by the opposite (lower) sensor array. it can.
[0048]
Further, in the vacuum chamber, a beam limiter, an electron gun drive circuit, an image signal digitizer, and the like are arranged at appropriate positions. The fan-shaped diagnostic X-ray 3b radiated from the diagnostic X-ray generation unit is narrowed by a collimator (not shown), further defined by the width at the irradiation position by a beam limiter, and detected by the sensor array after passing through the patient 4. The
[0049]
The sensor array receives (receives light) the diagnostic X-ray 3 b that has passed through the patient 4. It is densely arranged on the circumference surrounding the diagnostic space in which the patient 4 is arranged, has a number of ultra-sensitive CdTe sensors, and has a resolution of 0.5 mm. The imaging width of one shot at the time of inspection is 80 mm. The X-ray irradiation time is 0.01 seconds per shot.
[0050]
X-ray transmission data detected by the sensor array is converted into a current signal proportional to the transmitted X-ray dose, sent to the image signal digitizer and data recording device via the preamplifier and main amplifier, and recorded as diagnostic image data. . Imaging, data recording, and the like by the diagnostic X-ray 3b are controlled by the system controller 80. The recorded diagnostic image data is output from the data recording device to the imager signal processing device 31 (see FIG. 5), and data processing is performed by the imager signal processing device 31. The processed data is reproduced and displayed on the display 81 of the system controller 80 as an X-ray CT diagnosis image of the affected part 5.
[0051]
On the other hand, the output side of the X-ray generation control device of the real-time imager 30 is connected to the power source and the grid electrodes of the anode, cathode and gate array in the diagnostic X-ray generation unit. When an X-ray generation command signal is output from the system control device 80 to the X-ray generation control device, the X-ray generation control device controls the power feeding operation from the power source to the electron gun drive circuit based on the command. At the same time, a grid electrode suitable for the imaging region is selected from the gate array. In response, an electron beam is emitted from one of the cathodes in the diagnostic X-ray generation unit, the negative bias voltage applied to the selected grit electrode is released to zero potential, and the electron beam passes through the hole of the grit electrode. Passes through and enters the anode. When an electron beam enters the anode, secondary X-rays are generated from the anode, and fan-shaped therapeutic X-rays 3b are emitted toward the patient 4 via a collimator attached to the window.
[0052]
The real-time imager 30 does not have to be an X-ray CT inspection apparatus, and may be a set of an X-ray source and a sensor array facing the X-ray source. FIG. 4 is a perspective view of a radiotherapy apparatus that employs another real-time imager 30.
[0053]
The real-time imager 30 includes a rotary drive mechanism 95, holding frames 96A and 96B, two sets of X-ray sources 97A and 97B, and sensor arrays 98A and 98B that constitute a normal X-ray camera. An X-ray source 97A is provided at one end of the holding frame 96A, and a sensor array 98A is provided at the other end. An X-ray source 97B is provided at one end of the holding frame 96B, and a sensor array 98B is provided at the other end. The central portions of the holding frames 96 </ b> A and 96 </ b> B are attached to the rotation drive mechanism 95.
[0054]
The sensor array 98A is disposed in the vicinity of one side of the X-ray head 10 in the Y-axis direction. The perpendicular from the center of the sensor side plane faces the isocenter 5a, and the X-ray source 97A is arranged on the extended line. Similarly, the sensor array 98B is disposed near the other side of the X-ray head 10 in the Y-axis direction. The perpendicular from the center of the sensor side plane faces the isocenter 5a, and the X-ray source 97B is disposed on the extended line. The rotary drive mechanism 95 is configured to hold the holding frame 96A around the rotation axis Q of the real-time imager passing through the isocenter 5a and parallel to the X axis so that the two sets of X-ray sources 97A, 97B and 98B are at a desired position. And 96B are rotated.
[0055]
The two sets of X-ray source and sensor array 97A and 98A, and 97B and 98B are controlled to maintain a predetermined angle with respect to each other. The angle formed by the sensor array 98A or the sensor array 98B-isocenter 5a-X-ray head 10 is 60 degrees to 20 degrees. More preferably, it is 45 to 30 degrees. This is set based on the condition that the X-ray head 10, the X-ray source 97A, and the X-ray source 97B operate accurately without mutual influence and a diagnostic image having sufficient accuracy can be obtained. Is done. However, the two sets of X-ray source and sensor array 97A and 98A, and 97B and 98B can be controlled independently if the lines of sight of the X-ray source-sensor array set do not coincide with each other. You can do it.
[0056]
In the case of the radiotherapy apparatus shown in FIG. 4, the power source and the anodes, cathodes, and grid electrodes in the X-ray sources 97A and 97B are connected to the output side of the X-ray generation control apparatus of the real-time imager 30, respectively. When an X-ray generation command signal is output from the system control device 80 to the X-ray generation control device, the X-ray generation control device controls the power feeding operation from the power source to the electron gun drive circuit based on the command. At the same time, the rotational drive mechanism 95 is differentiated to move the two sets of the X-ray source-sensor array from the positional relationship with the X-ray head 10 to the optimum place. In response to this, an electron beam is emitted from the cathodes in the X-ray sources 97A and 97B, the negative bias voltage applied to the grit electrode is released and becomes zero potential, and the electron beam passes through the hole of the grit electrode and reaches the anode. Incident. When an electron beam enters the anode, secondary X-rays are generated from the anode, and fan-shaped therapeutic X-rays 3b are emitted toward the patient 4 via a collimator attached to the window.
[0057]
The X-ray source 97A and the X-ray source 97B are surely on opposite sides with respect to a straight line connecting the X-ray head 10 and the isocenter 5a in FIG. The same applies to the sensor array 98A and the isocenter 98B. Thereby, the movement of each part in the body of the patient 4 can be grasped quickly and accurately. In addition, since the sensor arrays 98A and 98B are attached to the X-ray head 10 side, the therapeutic X-ray 3a, which is a very strong X-ray, does not enter the sensor arrays 98A and 98B.
[0058]
The SAD (Source Axis Distance) shown in FIG. 1 corresponds to the distance from the isocenter 5a to the X-ray target (not shown) in the X-ray head 10. In this embodiment, the standard SAD is set to 80 to 100 cm.
[0059]
Next, a control system for the above-described radiotherapy apparatus will be described. FIG. 5 is a block diagram showing the configuration of this control system. This control system includes a treatment bed system 7, an X-ray head system 8, a real-time imager 30, an imager signal processing device 31, a microwave generation device 70, a system control device 80, and a system utility 90.
[0060]
The system controller 80 controls the radiotherapy apparatus as a whole. The system controller 80 includes a system control computer, and includes a “system management algorithm”, an “image tracking algorithm”, a “treatment planning algorithm”, a “treatment management algorithm”, a “graphical user interface (GUI)” as a computer program, It includes an “interlock algorithm” and includes a “treatment plan database”, a “trend record database”, and a “treatment database”. The system control device 80 includes a system monitor (display 81) and a BIT, and other blocks are connected to each other to exchange input / output signals.
[0061]
The “treatment plan database” stores treatment plan information as information on treatment plans established by doctors. The treatment plan information is based on various examinations performed before surgery. The treatment plan information associates patient attribute information, patient image information, estimated absorbed dose information, treatment dose information, affected area position information, and the like.
[0062]
The patient attribute information includes the name and date of birth of the patient 4. The patient image information includes an X-ray tomographic image of the patient 4. The estimated absorbed dose information is information relating to the estimated absorbed dose setting indicating the estimated absorbed dose of radiation (X-rays) to the affected part 5, the irradiation method (number of times, one estimated absorbed dose, irradiation direction (route)), and the like. The treatment dose information is information relating to treatment dose setting indicating a treatment dose of radiation (X-rays) to the affected part 5, an irradiation method (number of times, one treatment dose, an irradiation direction (route)), and the like. The affected part position information is information relating to the position of the affected part 5. The position of the affected part 5 may be a definition area 5-1 described later.
[0063]
The “trend record database” stores irradiation result information related to the results of irradiation treatment. The irradiation result information relates to radiation (X-rays) actually irradiated at the time of treatment. The irradiation result information includes patient attribute information, ring image information, accumulated treatment dose, accumulated estimated absorbed dose, treatment dose for each irradiation direction (number of portals), estimated absorbed dose, target coordinates (coordinates of irradiation targets in the affected area 5) and Machine coordinates (coordinates of the irradiation field 5 ′ where irradiation is actually performed) and the like are associated with each other. The affected area image information is an X-ray tomographic image of the patient 4 obtained in real time from the real-time imager 30 during treatment. A part of the affected part image information is reflected in the treatment plan database as patient image information. This irradiation result information is presented to the doctor as a record of treatment history and is submitted to the Ministry of Health, Labor and Welfare upon request.
[0064]
The “treatment database” stores the type of substance, the radiation absorption amount curve indicating the relationship between the thickness of the substance and the absorption amount of radiation (X-rays), and the like in association with each other.
[0065]
The “system management algorithm” controls the entire system controller 80 such as each algorithm, GUI, system monitor (display 81), and BIT.
[0066]
The “treatment plan algorithm” is based on the treatment plan database (X-ray tomographic image of patient 4 and estimated absorbed dose information) and the treatment database (radiation absorption curve for each substance), and the treatment dose information (irradiation direction (route)). X-ray treatment dose for each, cumulative treatment dose) and the like are calculated. And it displays on the display 81 and receives a doctor's confirmation. The doctor changes the irradiation direction, the estimated absorbed dose of X-rays, and the like as necessary to obtain desired treatment dose information. After confirmation by the doctor, store in the treatment plan database.
[0067]
The “treatment management algorithm” is an X-ray head system in which the X-ray head 10 is directed in a predetermined direction based on the treatment plan information in the treatment plan database and / or the swing amount of the X-ray head 10 from the image tracking algorithm. 8 is controlled. In addition, irradiation result information obtained from the imager signal processing device 31, the X-ray head system 8, the image tracking algorithm, and the like during treatment is stored in a trend recording database.
[0068]
The “image tracking algorithm” calculates the coordinates of the affected part 5 based on the tracking image data obtained from the imager signal processing device 31. Further, the coordinates of the irradiation field 5 ′ of the X-ray head 10 are obtained based on various data obtained from the X-ray head system 8. Then, based on the coordinates of the affected area 5 and the coordinates of the irradiation field 5 ′, the swing amount of the X-ray head 10 is calculated.
[0069]
The “interlock algorithm” urgently stops the therapeutic X-ray 3a and the diagnostic X-ray 3b when a predetermined condition is satisfied. The predetermined condition is that when the emergency stop button is pressed, when the irradiation field 5 ′ and the affected part 5 are separated by a predetermined distance or more, at least one of the therapeutic dose and the estimated absorbed dose for the patient 4 is On the other hand, when the preset allowable value is exceeded, when the diagnostic X-ray 3b is stopped when the therapeutic X-ray 3a is irradiated, the therapeutic X-ray 3a is stopped when the diagnostic X-ray 3b is irradiated. If so, etc.
[0070]
The X-ray transmission data detected by the real-time imager 30 is reconstructed into a diagnostic image by an image reconstruction algorithm in the imager signal processing device 31 and transmitted to the system control device 80. As a result, a diagnostic image is generated in real time during treatment, and the doctor can perform treatment while viewing the diagnostic image displayed on the display 81 of the system control device 80.
[0071]
The microwave generator 70 includes a klystron modulator and linac system controller, a klystron and an RF driver. The klystron is connected to the X-ray head 10 via the driven waveguide system 11 and is a supply source for supplying microwaves to the internal acceleration tube.
[0072]
The X-ray head system 8 includes an X-ray head 10, an isocentric drive mechanism (including an arc guide rail 9, a guide rail tilting mechanism 28, and a head circumferential movement mechanism 68), and a swing drive mechanism (first swing mechanism). 131, a second swing mechanism 132, and a rotary RF coupler). The isocentric drive mechanism and the swing drive mechanism are connected to the system control device 80 via their corresponding drivers (isocentric drive driver and swing drive driver), and X-rays during isocentric irradiation The head rotation driving mechanism 68 of the head 10 and the biaxial swing driving of the X-ray head 10 during pseudo-isocentric irradiation are controlled.
[0073]
Next, the operation of the radiation therapy apparatus according to the embodiment of the present invention configured as described above will be described with reference to the accompanying drawings.
[0074]
First, position calibration will be described. 6A and 6B are diagrams for explaining the calibration of the position of the radiation therapy apparatus 6, FIG. 6A is a front view of the radiation therapy apparatus 6, and FIG. 6B is a side view. In addition to the configuration shown in FIGS. 1 to 3, a CCD camera 60 is disposed on the treatment bed 7-2.
[0075]
The CCD camera 60 is installed such that the center of the light receiving surface overlaps the isocenter 5a and the light receiving surface is horizontal. The CCD camera 60 is connected to a laser intensity analyzer (not shown). In the X-ray head 10, a laser transmitter (not shown) such as a low-power small He-Ne laser is installed in place of the acceleration tube or the like so as to be coaxial with the emitted X-ray.
[0076]
Next, the position calibration procedure will be described.
(1) Step S1-1
In the state shown in FIG. 6, the laser transmitter of the X-ray head 10 outputs a laser to the CCD camera 60.
(2) Step S1-2
The CCD camera 60 receives a laser. Then, the light reception result is output to a laser intensity analyzer (not shown).
(3) Step S1-3
The laser intensity analyzer detects the intensity distribution of the laser. Then, the displacement (X axis direction, Y axis direction, Z axis direction) between the isocenter 5a (= the center of the light receiving surface of the CCD camera 60) and the peak position of the laser intensity is calculated.
(4) Step S1-4
The calculated displacement is stored in a storage unit (not shown) of the system control device 80 as a correction value.
[0077]
By the above-described position calibration method, a large machine workpiece such as the arc guide rail 9 can be accurately displaced in a short time with a high degree of accuracy due to distortion during work, deflection due to its own weight, stress due to stress during installation, etc. It is possible to correct the positional accuracy. In the case of this embodiment, it is possible to make the position resolution about 20 μm.
[0078]
This position calibration is performed at the time of installation of the radiotherapy apparatus 6 and at a periodic inspection. Note that the position calibration may be performed every predetermined number of uses and every radiotherapy.
[0079]
Next, the operation of the radiotherapy apparatus according to the embodiment of the present invention will be described with reference to the timing chart shown in FIG.
[0080]
FIG. 7A is a timing for processing a diagnostic image, FIG. 7B is a timing for image tracking calculation based on the processed diagnostic image and a swing operation of the X-ray head 10, and FIG. 7C. Respectively show the timing of irradiation of therapeutic X-rays.
[0081]
First, when the main switch of the radiotherapy apparatus 6 is turned on, the power of the treatment bed system 7, the X-ray head system 8, the real-time imager 30, the microwave generator 70, the system controller 80, and the system utility 90 is turned on. Each is in a standby state. Then, the treatment bed system 7 is activated, the patient 4 moves into the treatment area together with the treatment bed 7-2, and the real-time imager 30 is activated to treat the affected area 5 so as to coincide with the isocenter 5a of the treatment apparatus. Move the bed 7-2 for alignment. After the completion of this isocentric alignment, real-time image diagnosis by the real-time imager 30 and radiation therapy by the X-ray head 10 are performed in the following procedure.
[0082]
(1) Step S2-1: Time t0 to t1
The normal X-ray camera (real-time imager 30) irradiates the irradiation field 5 'with the diagnostic X-ray 3b from the diagnostic X-ray generation unit. Then, the sensor array detects the X-ray transmission data as diagnostic image data. In order to minimize the exposure, the irradiation time of the diagnostic X-ray 3b is limited to t0 to t1.
[0083]
(2) Step S2-2: Time t1 to t2
The detected diagnostic image data is converted into a current signal proportional to the transmitted X-ray dose, and is taken into the image signal digitizer and the data recording device via the preamplifier and the main amplifier.
[0084]
(3) Step S2-3: Time t2 to t3
The recorded diagnostic image data is sent from the data recording device to the imager signal processing device 31. Then, the imager signal processing device 31 performs arithmetic processing on the diagnostic image data using an image reconstruction algorithm, and converts the diagnostic image data into tracking image data. The image data for tracking is data indicating a diagnostic image at each coordinate point (Xi, Yi, Zi) (i = 1 to n: n is the number of data) of the coordinate system of the radiation therapy apparatus 6. This tracking image data is sent to the system control device 80.
[0085]
The system control device 80 reproduces and displays the tracking image data on the display 81 as an (X-ray CT) diagnostic image of the affected part 5, and stores it in the trend recording database as affected part image information. On the display 81, as shown in FIG. 15, an irradiation dose and an integrated dose are displayed in addition to the (X-ray CT) diagnostic image. Thereby, confirmation of the treatment status by the doctor, determination of the quality of the current treatment, planning of the next treatment action, and the like can be easily performed. The display on the display 81 can be configured to display the estimated absorbed dose and the accumulated estimated absorbed dose in addition to the irradiation dose and the accumulated dose. Further, the picture on the right side in FIG. 15 indicates that radiation is irradiated in the direction of the current dose (shown by a solid line) with respect to the planned dose (shown by a broken line).
[0086]
The real-time imager 30 and the imager signal processor 31 repeat the process from time t0 to t3 again after time t3. In FIG. 7, time t3 = time t10, process at time t0 to t3 = time t10 to t13, time t20 to t23...
[0087]
In order to prevent direct rays, leakage rays, and scattered rays of the therapeutic X-ray 3a from affecting the sensor array (detector) of the real-time imager 30, at least a time t0 when the diagnostic X-ray 3b is irradiated. In -t1, the X-ray head 10 is interlocked so that the therapeutic X-ray 3a is not irradiated.
[0088]
The total time t0 to t3 required for these diagnostic image processes (steps S2-1 to S2-3) is 0.01 seconds. That is, one cycle time of diagnostic image processing is 0.01 seconds. This is a sufficient sample rate to follow a fast movement such as a heartbeat.
[0089]
(4) Step S2-4: Time t3 to t4
The system control device 80 performs the following image tracking calculation using an image tracking algorithm. That is, based on the image data for tracking, the coordinates of the affected area 5 (coordinate points (X, Y, Z) in the coordinate system of the radiation therapy apparatus 6) are extracted. On the other hand, the irradiation field 5 of the current X-ray head 10 is determined based on the position (coordinates), rotation angle, and the like of the guide rail tilting mechanism 28, the head circling mechanism 68, the first swing mechanism 131, and the second swing mechanism 132. 'Coordinates (coordinate points (x, y, z) in the coordinate system of the radiation therapy apparatus 6) are calculated. (1) When the distance L = | (X, Y, Z) − (x, y, z) | between two points is less than or equal to a preset value L02, the swing control is not performed, and 2) If the distance L is greater than or equal to the preset value L01, the swing amount is θ0. (3) If L02 <distance L <L01, then based on the coordinates of the affected area 5 and the coordinates of the irradiation field 5 ′ Then, the swing amounts (θ1, θ2) of the X-ray head 10 are calculated.
[0090]
However, the amount of swing (θ1, θ2) of the X-ray head 10 is a minute displacement angle (swing angle) θ1 (rotation direction, magnitude of rotation angle) around the S1 swing drive axis and around the S2 swing drive axis. Is a minute displacement angle (swing angle) θ2 (rotation direction, magnitude of rotation angle). L01 is the maximum distance that the X-ray head 10 can swing between times t4 and t5. L02 is a value of an error expected when calculating the coordinate point (X, Y, Z) of the affected part 5 and the coordinate point (x, y, z) of the irradiation field 5 ′.
[0091]
The movement (movement) state (coordinate points (X, Y, Z)) of the affected part 5 is displayed on the display 81 of the system controller 80 as shown in FIG. However, not only the affected part 5 but also the surrounding area (example: contour line 5-2 including the affected part 5 (described later)) may be indicated in the same manner. At this time, as shown in the picture on the right side of FIG. 16, when the direction of the current dose (shown by a solid line) deviates greatly from the planned dose (shown by a broken line), a message “large treatment line deviation” is displayed. And an interlock is applied. Thereby, the doctor can judge the quality of treatment with comprehensive information including the situation of the treatment department.
[0092]
(5) Step S2-5: Time t4 to t5
Based on the calculated swing amounts (θ1, θ2) of the X-ray head 10, the system control device 80 swings the swing amounts (θ1, θ2) of the X-ray head 10 using a treatment management algorithm. A drive signal is sent to the X-ray head system 8. Based on the swing drive signal, the X-ray head swing drive driver of the X-ray head system 8 drives the first swing mechanism 131 and the second swing mechanism 132 so that the X-ray head 10 faces in a desired direction. . The system controller 80 repeats the process from time t3 to time t5 again from time t13 after time t5. In FIG. 7, the process at time t3 to t5 = time t13 to t15, time t23 to t25...
[0093]
The total time t3 to t5 required for the image tracking calculation and the X-ray head swing (steps S2-4 to S2-5) is 0.01 seconds. That is, one cycle time of image tracking calculation and X-ray head swing is 0.01 seconds. This is a sufficient rate for following a fast movement such as a heartbeat.
[0094]
During the time t4 to t5 during which the S1 swing drive servomotor of the first swing mechanism 131 and the S2 swing drive servomotor of the second swing mechanism 132 (both not shown) are driven, the swing angle Therefore, the X-ray head 10 is interlocked to ensure safety so that the therapeutic X-ray 3a is not irradiated.
[0095]
(6) Step S2-6: Time t5 to t6
The system control device 80 sends a therapeutic X-ray irradiation signal to the X-ray head 10 as a signal for instructing the irradiation of the therapeutic X-ray 3a at time t5 using the system management algorithm. Thereby, the interlock of the X-ray head 10 is released, and irradiation of the therapeutic X-ray 3a to the affected part 5 is started. The irradiation time t5 to t6 of the therapeutic X-ray 3a is about 50 milliseconds. The duty of irradiation is about 50%. The system controller 80 repeats the process from time t5 to time t6 again from time t15 after time t6. In FIG. 7, the process at time t5 to t6 = the process at time t15 to t16, time t25 to t26.
[0096]
The total time t5 to t6 required for this therapeutic X-ray irradiation (step S2-6) is 0.01 seconds. That is, one cycle time of therapeutic X-ray irradiation is 0.01 seconds. This is a sufficient rate for following a fast movement such as a heartbeat.
[0097]
Here, how the therapeutic X-ray 3a is irradiated while swinging the X-ray head 10 will be further described with reference to the drawings. FIG. 8 is a perspective view showing a state of radiation therapy by the X-ray head 10. The X-ray head 10 irradiates the affected part 5 with X-rays.
[0098]
FIG. 9 and FIG. 10 are diagrams for explaining how the therapeutic X-ray 3 a is irradiated while swinging the X-ray head 10. 9 is an AA cross section in FIG. 8, and FIG. 10 is a BB cross section in FIG.
[0099]
In order to irradiate following the movement of the irradiation field, the system control apparatus 80 calculates the position (coordinates (X, Y, Z)) of the affected part 5 and the current X-ray head at the time t3 to t4. Based on the coordinates (x, y, z) of the ten irradiation fields 5 ′, shift amounts DV1 and DV2 from the irradiation field 5 ′ of the affected area 5 in the X-axis direction and the Y-axis direction are calculated. Then, based on the shift amounts DV1 and DV2, the displacement angles θ1 and θ2 due to the movements around the first swing drive shaft S1 and the second swing drive shaft S2 are obtained using a predetermined calculation formula, respectively.
[0100]
At the time t5 to t6, the X-ray head 10 is swung at high speed by the displacement angle θ1 around the first swing drive axis S1 and by the displacement angle θ2 around the second swing drive axis S2. Then, simultaneously with stopping the swing, the therapeutic X-ray 3a is emitted from the X-ray head 10.
[0101]
By the above steps S2-1 to S2-6, the affected part 5 such as a tumor moving under the influence of the movement and state of the organ, such as breathing and heartbeat below the cervix, peristalsis and urine volume in the bladder, The aim of the X-ray head 10 follows quickly and with high response, and radiation (X-rays) can be irradiated with high accuracy. In other words, the X-ray head 10 can be swung at a high speed within 0.03 seconds including the processing time of the diagnostic image, and radiation (X-rays) can be generated. Can be followed.
[0102]
In the above-described process, at step S2-4: at times t3 to t4, the angle at which the X-ray head 10 is swung in step S2-5 is limited to a predetermined size. This is because as the swing angle increases, the time required for swinging becomes longer, and the affected part 5 further moves during that time. As a result, the coordinate point (x, y, z) of the irradiation field 5 ′ of the X-ray head 10 is greatly deviated from the position of the coordinate point (X, Y, Z) of the affected part 5.
[0103]
The fast movement of the affected part 5 tracked by the X-ray head 10 is due to breathing and heartbeat. In this case, the affected part 5 is moving in substantially the same region (however, the route is not necessarily the same). Therefore, once the coordinate point (x, y, z) of the irradiation field 5 ′ of the X-ray head 10 and the coordinate point (X, Y, Z) of the affected area 5 may not completely match, they will match thereafter. It is possible to make it.
[0104]
If an abnormality occurs in the acquisition of diagnostic image data or image tracking calculation, the irradiation of the therapeutic X-ray 3a is interlocked at that time to stop the irradiation, thereby ensuring safety. This apparatus is designed to irradiate the therapeutic X-ray 3a after confirming that the X-ray head 10 has been swung and positioned normally. If the deviation between the coordinate point (x, y, z) of the irradiation field 5 ′ and the coordinate point (X, Y, Z) of the affected part 5 is equal to or larger than a preset allowable value, step S2 is performed in the cycle. The irradiation of the therapeutic X-ray 3a at -6 (time t5 to t6) is not performed.
[0105]
Further, the system control device 80 can also move the head circling mechanism 68, the tilt mechanism 28, and the treatment bed system 7 so that the X-ray head 10 is aimed at the affected area 5 as necessary. It is. In this case, the system controller 80 determines the amount of swing of the X-ray head 10 (the first swing mechanism 131 and the second swing mechanism based on the coordinates of the affected part 5 and the coordinates of the irradiation field 5 ′ at time t3 to t4). (For the swing mechanism 132) and the movement amount (for the head circling mechanism 68, the tilt mechanism 28, and the treatment bed system 7) are calculated. Next, the amount of swing and the amount of movement of the X-ray head 10 are output to the X-ray head system 8 from time t4 to t5. Then, the first swing mechanism 131, the second swing mechanism 132, the head circling mechanism 68, the tilt mechanism 28, and the treatment bed system 7 are moved so that the X-ray head 10 is aimed at the affected area 5.
[0106]
After the irradiation of the therapeutic X-ray 3a is stopped, irradiation of the diagnostic beam 3b is started at timing t5, and the process proceeds to the next diagnostic image processing cycles t5 to t8. Next, the interlock of the X-ray head 10 is released at timing t3 after the diagnostic image processing, and the irradiation of the treatment beam 3a is resumed.
[0107]
Thus, diagnostic image processing cycle (0 to T1 in FIG. 7): 0.01 second, image tracking calculation cycle and X-ray head swing cycle (T1 to T2 in FIG. 7): 0.01 second, And a treatment X-ray irradiation cycle (in FIG. 7, T2 to T3): A cycle of 0.03 seconds in total of 0.01 seconds is repeated. In other words, the irradiation head can be accurately directed to the irradiation target approximately every 1/30 seconds, and the irradiation target can be accurately detected in real time even if the affected area (the treatment field) has the fastest movement such as a heartbeat. Can be tracked and irradiated.
[0108]
Further, since diagnostic image data of the affected part 5 which is image data for tracking during treatment is sequentially stored in the trend recording database as affected part image information, therapeutic radiation is actually irradiated by referring to the trend recording database later. The site can be clearly identified. Therefore, it is sufficient as a record of treatment history, and subsequent treatment planning can be easily made.
[0109]
Next, a pseudo non-isocentric treatment procedure will be described. FIG. 11 is a flowchart showing a pseudo non-isocentric treatment procedure on the display 81. In the example shown in FIG. 11, an example is shown in which a diagnostic image of the affected part from the three directions X, Y, and Z is displayed on the display 81.
[0110]
(1) Step S3-1
In radiation therapy, a doctor makes a treatment plan. The treatment plan is based on various tests performed before surgery. Those treatment plans are stored in a treatment plan database. Furthermore, since the doctor can directly perform real-time image diagnosis of the lesion in the affected area by using the radiotherapy device during the operation, the radiotherapy can be performed with high accuracy and high reliability.
[0111]
(2) Step S3-2
As shown in FIG. 11A, the diagnostic image of the affected area 5 and its vicinity is reconstructed using only the real-time imager 30 and the imager signal processing device 31, and is reproduced and displayed on the display 81 of the system control device 80. The In this case, as shown in FIG. 15, the irradiation dose and the accumulated dose, as well as the estimated absorbed dose and the accumulated estimated absorbed dose are displayed on the display 81, but are omitted in FIGS. 11 (a) to 11 (f). It is. The reconstruction of the diagnostic image is performed by the above steps S2-1 to S2-3. However, step S2-4 to step S2-6 are not performed at this stage.
[0112]
(3) Step S3-3
As shown in FIG. 11 (b), the doctor confirms each sectional view of the affected part 5 on the display 81 and defines the outline of the irradiation field 5 ′ for image tracking. Here, prior to the start of treatment, the mapping of the irradiation field 5 ′ has been completed (treatment plan database), and the contour of the irradiation field 5 ′ is defined by a plurality of slices with reference to this. The region defined by the contour is the definition region 5-1, and the definition region 5-1 includes the affected part 5. The definition area 5-1 is stored in the treatment plan database.
[0113]
The treatment plan algorithm calculates treatment dose information (X-ray treatment dose for each irradiation direction (route), integrated treatment dose) and the like based on the treatment plan database (including the definition area 5-1) and the treatment database. To do. And it displays on the display 81 and receives a doctor's confirmation. The doctor changes the irradiation direction, the estimated absorbed dose of X-rays, and the like as necessary to obtain desired treatment dose information. After the doctor confirms, the treatment dose information is stored in the treatment plan database.
[0114]
(4) Step S3-4
As shown in FIG. 11C, image contour extraction is performed by the image tracking algorithm of the system control device 80. That is, pattern matching is performed between the actual diagnostic image of the affected area 5 and the outline of the defined area 5-1 defined and displayed as the outline 5-2 (described later). Then, image tracking is started, and the moving state of the affected area 5 is displayed on the display 81 as shown in FIG. The doctor visually confirms the image tracking status. Image tracking is performed in step S2-4. Therefore, step S2-1 to step S2-4 are repeated. However, step S2-5 to step S2-6 are not performed at this stage.
[0115]
(5) Step S3-5
As shown in FIG. 11D, after the image tracking is stabilized, the doctor operates the master arm switch (Master Arm SW) to place the X-ray head system 8 in the ARMED state. The X-ray head system 8 displays the aim on the display 81 in cross hairline and the irradiation volume in red. Simultaneously with image tracking, tracking (swinging) of the X-ray head 10 is also performed. Since tracking by the image and the X-ray head 10 continues, the aim and the irradiation volume automatically follow as the irradiation field 5 ′ moves. Tracking (swinging) of the X-ray head 10 is performed by the above step S2-5. Therefore, step S2-1 to step S2-5 are repeated. However, since the therapeutic X-ray 3a is not released at this stage, step S2-6 is not performed.
[0116]
(6) Step S3-6
As shown in FIG. 11E, irradiation of the therapeutic X-ray 3a is started by a trigger operation of a doctor. The scheduled irradiation time is determined at the stage of treatment planning, and a countdown is started on the display 81. On the other hand, the irradiation time of one irradiation (step S2-6: time t5 to t6) is also determined. Therefore, the count decreases while repeating the irradiation for a short time (time t5 to t6). And when it finally becomes zero, the therapeutic X-ray 3a automatically stops. The therapeutic dose of the therapeutic X-ray 3a is detected by an ionization chamber (not shown) in the X-ray head 10 and is output to the treatment management algorithm. The irradiation with the therapeutic X-ray 3a is performed by the above step S2-6. Therefore, step S2-1 to step S2-6 are repeated.
[0117]
Further, irradiation treatment information (all or a part thereof) obtained from the imager signal processing device 31, the X-ray head system 8, the image tracking algorithm, etc. during treatment is continuously displayed on the display 81 by the treatment management algorithm. The The doctor continues the irradiation by continuing the trigger while confirming the irradiation result information (all or a part thereof). Irradiation result information is stored in a trend recording database.
[0118]
The system control device 80 continues sampling of the diagnostic image (tracking) and irradiation of the therapeutic X-ray 3a alternately at high speed, and continues image tracking and irradiation of the therapeutic X-ray in real time. Even before the countdown reaches zero, if the doctor releases the trigger, the therapeutic X-ray 3a immediately stops at that timing, so safety is sufficiently ensured.
[0119]
(7) Step S3-7
As shown in FIG. 11F, the doctor sets the master arm switch to the SAFE position, puts the system in a safe state, and moves the X-ray head 10 to the next irradiation position. At this stage, the above steps S2-1 to S2-3 are performed. And step S2-4-step S2-6 are not performed.
[0120]
The above steps S3-1 to S3-7 are performed for a plurality of irradiation directions (coordinates), and irradiation result information for each irradiation direction obtained from two diagnostic images is stored in the trend recording database. More specifically, as conceptually shown in FIG. 17A, the XY axis direction is determined by the direction of radiation from the X-ray head 10 as the irradiation direction, and the Z axis direction is determined by the inclination of the arc guide rail 9. A fixed three-dimensional coordinate is obtained. FIG. 17B shows an example in which the planned dose, the irradiation dose, and the integrated dose are stored in the trend recording database for the six irradiation directions. With this configuration, coordinate information of the affected area of the patient can be obtained, so that the direction of the radiation becomes clear, and collation with the treatment plan is facilitated.
[0121]
Before the end of the series of irradiation, the doctor confirms the total dose, which is the total accumulated daily dose. That is, the treatment management algorithm reads data from the trend record database, and displays the cumulative dose of the day and the cumulative dose distribution within one course on the screen. Data relating to treatment is stored in a treatment file (including irradiation result information) created for each patient 4 in the trend record database.
[0122]
Here, the method of pattern matching between the actual diagnostic image of the affected area 5 and the outline of the definition area 5-1 in step S3-4 will be further described.
[0123]
FIG. 12 is a diagram showing the relationship between the affected part 5, the definition area 5-1, and the contour line 5-2 by pattern matching. 12A shows the relationship between the affected area 5 and the definition area 5-1, and FIGS. 12B to 12E show the relationship between the affected area 5 and the contour line 5-2.
[0124]
(1) Step S4-1
As shown in FIG. 12A, the doctor shows the definition area 5-1 on the display 81 in the manner of a drawing tool with a touch pen that can draw on the display 81 or a pointer such as a mouse.
(2) Step S4-2
The treatment planning algorithm extracts a diagnostic image in the definition area 5-1 based on the definition area 5-1 drawn on the display 81 and the diagnostic image on the display 81. Then, the shape, coordinates, and brightness distribution of the diagnostic image are grasped. Alternatively, the shape, coordinates, and lightness distribution of the diagnostic image are grasped by extracting the shape of the lightness range that occupies a predetermined ratio (example 90%) of the definition area 5-1 as shown in FIG. .
(3) Step S4-3
The treatment planning algorithm obtains the center of gravity of the shape in the range of the definition area 5-1 or the shape of the lightness range indicating a predetermined ratio. Then, “+” is displayed on the display 81. For example, the center of gravity of the definition area 5-1 (FIG. 12A) is as shown in FIG. The center of gravity of the lightness range (FIG. 12B) showing a predetermined ratio is as shown in FIG. Note that only the center of gravity may be shown as shown in FIG. Thus, the pattern matching is finished.
[0125]
On the display 81, a binarized display is performed in which the range of the definition area 5-1 or the brightness range indicating the brightness range indicating a predetermined ratio is displayed in a specific color, and the others are displayed in other colors. Is also possible. The definition area 5-1 and the like can be easily distinguished.
[0126]
However, the lightness distribution is grasped as follows. FIG. 13 is a graph showing an example of brightness distribution in a diagnostic image. The vertical axis is the brightness, and the horizontal axis is the position of the diagnostic image. It can be seen from the graph that the brightness in the diagnostic image definition area 5-1 is in the range of L1 to L2. Therefore, the brightness range of the definition area 5-1 is L1 to L2.
[0127]
Further, the lightness range occupying a predetermined ratio (example 90%) of the definition area 5-1 occupies an area of a predetermined ratio (example 90%) of the definition area 5-1 in the lightness ranges L1 to L2. Is a continuous lightness range L3 to L4. In this case, L2 = L4. In addition, since the other position which shows the same brightness is away from the definition area 5-1, it is not recognized.
[0128]
As described above, according to the radiotherapy apparatus according to the embodiment of the present invention, the radiation irradiation head (X-ray head 10) is swung at a high speed within 0.02 seconds including image processing, and the irradiation field Since it is possible to follow the movement of the affected area, radiation can be irradiated with high accuracy (irradiation time 0.01 seconds). In this way, it is possible to perform non-isocentric irradiation with high response and high accuracy in response to the movement of the affected area, so organ movement such as breathing and heartbeat, peristalsis and urine volume in the bladder, etc. It is possible to treat a site where an irradiation target such as a tumor moves under the influence of the condition or the state of treatment.
[0129]
In the above-described example, the case where the real-time imager 30 is combined with the radiotherapy apparatus as an inspection apparatus has been described. However, the present invention is not limited to this, and a normal X-ray camera is not used for special applications. Other non-magnetic type inspection devices such as PET (Positron Emission Tomography) can be combined with the radiation therapy device.
[0130]
In the case of a normal type X-ray camera, two or more cameras having different lines of sight are required. In addition, since soft tissues with low contrast cannot be imaged, the irradiation field can be positioned in advance by X-ray CT, MRI or the like based on landmarks with high contrast such as bone tissue. Alternatively, a small gold plate or the like is embedded in the vicinity of the irradiation field to be used as a marker, or a device such as DSA (Digital Subtraction Angiography) is used to enhance the image by contrast medium or differential image processing. In X-ray CT and PET, high-speed real-time image reconstruction calculation is performed for real-time imaging.
[0131]
Next, with reference to FIG.18 and FIG.19, the 1st modification of the radiotherapy apparatus which concerns on embodiment of this invention is demonstrated. In addition, the description of the part which overlaps with description of the radiotherapy apparatus which concerns on embodiment mentioned above is abbreviate | omitted.
[0132]
FIG. 18 is a side view showing the configuration of the first modification of the radiotherapy apparatus according to the embodiment of the present invention, and FIG. 19 is a front view showing the configuration of the rotating drum (treatment gantry). .
[0133]
In this radiotherapy apparatus 6A, a therapeutic X-ray head 10, a therapeutic X-ray source (CT X-ray tube) 97, and a sensor array 98 are mounted on a rotating drum (treatment gantry) 99. That is, the overall structure of the apparatus is a structure in which the X-ray head 10 is mounted on the upper part of the drum portion of the rotary X-ray CT inspection apparatus which is the real-time imager 30 of the above embodiment. The rotation center of the rotary drum (therapeutic gantry) 99 is the isocenter 5a. The X-ray head 10 is composed of an electronic linac of 4 MeV to 10 MeV, and can swing around two axes (first swing axis S1 and second swing axis S2) as shown in the figure. That is, by these swinging operations, non-isocentric irradiation with two axes is possible in addition to the isocentric irradiation around the rotation axis of the rotating drum. The swing of the second swing axis S2 includes aiming angle correction accompanying the rotation of the rotary drum. On the other hand, the aiming angle correction for the swing of the first swing axis S1 is not necessary.
[0134]
The diagnostic X-ray source (CT X-ray tube) 97 and the sensor array 98 are respectively attached to locations that do not interfere with the therapeutic X-ray head 10, and the diagnostic X-ray source (CT X-ray tube) 97. And the sensor array 98 face each other. The sensor array 98 for detection is for X-rays, and is a multi-array type multi-row sensor. In X-ray CT and PET, high-speed real-time image reconstruction calculation processing is performed for real-time imaging.
[0135]
Next, with reference to FIG. 20, the 2nd modification of the radiotherapy apparatus which concerns on embodiment of this invention is demonstrated. In addition, description of the part which overlaps with radiotherapy apparatus description which concerns on embodiment mentioned above and its 1st modification is abbreviate | omitted.
[0136]
FIG. 20 is a front view showing a configuration of a rotating drum (treatment gantry) in the second modification of the radiotherapy apparatus according to the embodiment of the present invention. In this radiotherapy apparatus 6B, a set of a therapeutic X-ray head 10, a pair of X-ray sources 97A and 97B and sensor arrays 98A and 98B constituting a normal X-ray camera on a rotating drum (treatment gantry) 99. It is equipped with. Their relative positions are fixed within a predetermined range. In the predetermined range, the angle formed by the sensor array 98A or the sensor array 98B-isocenter 5a-X-ray head 10 is 60 degrees to 20 degrees. More preferably, it is 45 to 30 degrees. This is set based on the condition that the X-ray head 10, the X-ray source 97A, and the X-ray source 97B operate accurately without mutual influence and a diagnostic image having sufficient accuracy can be obtained. Is done.
[0137]
Unlike the radiotherapy apparatus according to the first modification equipped with a diagnostic X-ray source (CT X-ray tube) and a sensor array, the rotating drum 99 includes two sets constituting a normal X-ray camera. X-ray sources 97A and 97B and sensor arrays 98A and 98B are set, and the visual lines of the X-ray source-sensor array set do not coincide with each other. The X-ray source 97A and the X-ray source 97B are on opposite sides of a straight line connecting the X-ray head 10 and the isocenter 5a in FIG. The same applies to the sensor array 98A and the isocenter 98B.
[0138]
Thereby, X-ray fluoroscopic images of the affected part 5, landmark, minute gold plate, etc. in the body of the patient 4 can be acquired in two axes, and the movement of each part in the body of the patient 4 can be grasped quickly and accurately. As an image enhancement method for a fluoroscopic image, a method of performing image processing such as DSA using a contrast agent is also conceivable. In addition, since the sensor arrays 98A and 98B are attached to the X-ray head 10 side, the therapeutic X-ray 3a, which is a very powerful X-ray, does not enter the sensor arrays 98A and 98B.
[0139]
The X-ray head 10 is composed of an electronic linac of 4 MeV to 10 MeV, and can swing around two axes (first swing axis S1 and second swing axis S2) as shown. That is, by these swinging operations, non-isocentric irradiation with two axes is possible in addition to the isocentric irradiation around the rotation axis of the rotating drum. The swing of the second swing axis S2 includes aiming angle correction accompanying the rotation of the rotary drum. On the other hand, the aiming angle correction for the swing of the first swing axis S1 is not necessary.
[0140]
Next, with reference to FIG. 21, the 3rd modification of the radiotherapy apparatus which concerns on embodiment of this invention is demonstrated. In addition, description of the part which overlaps with description of the radiotherapy apparatus which concerns on embodiment mentioned above and its 1st and 2nd modification is abbreviate | omitted.
[0141]
FIG. 21 is a perspective view showing a configuration of a radiation therapy apparatus according to a third modification of the embodiment of the radiation therapy apparatus of the present invention. This radiotherapy apparatus 6C includes an X-ray head 10, X-ray sources 97A and 97B, and sensor arrays 98A and 98B as a real-time imager (30).
[0142]
The X-ray head 10 is movably provided on the arc guide rail 9. The X-ray sources 97A and 97B are respectively fixed to different one sides of the X-ray head 10 in the Y-axis direction. The sensor arrays 98A and 98B are provided at fixed positions relative to the X-ray sources 97A and 97B at positions facing the X-ray sources 97A and 97B via the isocenter 5a, respectively. The X-ray source 97A and the X-ray source 97B are on opposite sides of a straight line connecting the X-ray head 10 and the isocenter 5a in FIG. The same applies to the sensor array 98A and the isocenter 98B.
[0143]
The X-ray head 10 for treatment is mounted on the arc guide rail 9 and is the same as the radiotherapy apparatus according to the embodiment. The second modification is the same as the second modification in that a set of two sets of X-ray sources 97A and 97B and sensor arrays 98A and 98B constituting an ordinary X-ray camera is fixed to the X-ray head 10. . It is installed. Their relative positions are fixed within a predetermined range. In the predetermined range, the angle formed by the sensor array 98A or the sensor array 98B-isocenter 5a-X-ray head 10 is 60 degrees to 20 degrees. More preferably, it is 45 to 30 degrees. This is set based on the condition that the X-ray head 10, the X-ray source 97A, and the X-ray source 97B operate accurately without mutual influence and a diagnostic image having sufficient accuracy can be obtained. Is done.
[0144]
The above-described embodiment equipped with an X-ray CT inspection apparatus, the above-described first modification in which a rotating drum 99 is equipped with a diagnostic X-ray source (CT X-ray tube) and a sensor array, two sets in the rotating drum 99 Unlike the second variant, in which the X-ray source and sensor array set is provided, the X-ray source-sensor array set is connected to the X-ray head 10 in any irradiation situation, Operates to have a fixed positional relationship with respect to the head 10
[0145]
Thereby, in addition to the effects of the operations of the above-described embodiments, the X-ray source-sensor array set has a fixed positional relationship with respect to the X-ray head 10, so that a diagnostic image is obtained. The load on the control to acquire the image and the load on the operation of the real-time imager can be greatly reduced. In addition, since the sensor arrays 98A and 98B are attached to the X-ray head 10 side, the therapeutic X-ray 3a, which is a very powerful X-ray, does not enter the sensor arrays 98A and 98B.
[0146]
The X-ray head 10 is composed of an electronic linac of 4 MeV to 10 MeV, and can swing around two axes (first swing axis S1 and second swing axis S2) as shown. That is, by these swinging operations, non-isocentric irradiation with two axes is possible in addition to the isocentric irradiation around the rotation axis of the rotating drum.
[0147]
【The invention's effect】
As described above in detail, according to the present invention, it is possible to provide a radiotherapy apparatus and an operation method of the radiotherapy apparatus that can facilitate a treatment plan after radiotherapy is performed on a subject. More specifically, since an image of the affected area under treatment is recorded, it is possible to easily know a site where treatment radiation is actually irradiated. Therefore, it is sufficient as a record of treatment history, and a treatment plan after radiation treatment can be easily made.
[0148]
In addition, according to the present invention, the image processing apparatus further includes a calculation unit that calculates a treatment history with the therapeutic radiation based on the operating state of the radiation irradiation head, and the recording unit corresponds to the treatment history calculated by the calculation unit with the image of the affected part. In addition, the calculation unit is configured to record, as the treatment history, the treatment dose to which the therapeutic radiation has been injected and the estimated absorbed dose that is estimated to have been absorbed by the subject. In addition, the irradiation direction is determined from the source coordinates representing the radiation source of the radiation irradiation head and the target coordinates representing the coordinates of the affected part of the subject. It is possible to easily determine the quality of treatment and to plan the next treatment.
[0149]
Further, according to the present invention, since the display further displays the image of the affected part and the treatment history recorded in the recording unit, the doctor can quickly make an accurate judgment by looking at the display. . Further, according to the present invention, the display further displays an instantaneous value and an integrated value of the irradiation dose of the therapeutic radiation, so that in addition to the information indicating the irradiation state during the treatment, the region irradiated with the therapeutic radiation and the time Thus, it is easy for the doctor to check the treatment status, plan the next treatment, determine the quality of the current treatment, and the like.
[0150]
Further, according to the present invention, since the display further displays information indicating the suitability of the treatment position, the information indicating the suitability of the treatment position is displayed. You can judge good or bad.
[0151]
Furthermore, according to the present invention, since the recording unit further records the spatial coordinates of the affected part to which the therapeutic radiation from the radiation irradiation head is irradiated, the irradiation direction of the radiation becomes clear, so that it can be easily compared with the treatment plan. become. In addition, it is possible to easily check the treatment status by the doctor, determine the quality of the current treatment, and plan the next treatment action.
[Brief description of the drawings]
FIG. 1 is a side view showing a configuration of a radiotherapy apparatus according to an embodiment of the present invention.
FIG. 2 is a front view showing the configuration of the radiotherapy apparatus according to the embodiment of the present invention.
FIG. 3 is a perspective view showing the configuration of the radiotherapy apparatus according to the embodiment of the present invention.
FIG. 4 is a perspective view showing another configuration of the radiation therapy apparatus according to the embodiment of the present invention.
FIG. 5 is a block diagram showing a configuration of a control system of the radiotherapy apparatus according to the embodiment of the present invention.
6A and 6B are diagrams for explaining position calibration of the radiotherapy apparatus according to the embodiment of the present invention, where FIG. 6A is a front view, and FIG. 6B is a side view.
7A and 7B are timing charts showing the operation of the radiotherapy apparatus according to the embodiment of the present invention, where FIG. 7A is a timing of an operation for processing a diagnostic image, and FIG. 7B is an image tracking based on the processed diagnostic image. The timing of the calculation and the swing motion of the X-ray head, (c) shows the timing of treatment X-ray irradiation.
FIG. 8 is a perspective view showing a state of radiotherapy using an X-ray head of the radiotherapy apparatus according to the embodiment of the present invention.
FIG. 9 is a view for explaining the state of irradiation with therapeutic X-rays while swinging the X-ray head of the radiotherapy apparatus according to the embodiment of the present invention, and shows a cross section taken along the line AA in FIG.
FIG. 10 is a view for explaining the state of irradiation with therapeutic X-rays while swinging the X-ray head of the radiotherapy apparatus according to the embodiment of the present invention, and shows a cross section taken along line BB in FIG.
FIG. 11 is a flowchart showing a pseudo non-isocentric treatment procedure of the radiotherapy apparatus according to the embodiment of the present invention on a display.
12A and 12B are diagrams showing a relationship between an affected area, a definition area, and a contour line by pattern matching in the radiotherapy apparatus according to the embodiment of the present invention, wherein FIG. 12A is a relationship between the affected area and the definition area; -(E) shows the relationship between an affected part and an outline.
FIG. 13 is a graph showing an example of lightness distribution in a diagnostic image of the radiation therapy apparatus according to the embodiment of the present invention.
FIG. 14 is a diagram showing an example of a tracking state monitor of the radiotherapy apparatus according to the embodiment of the present invention.
FIG. 15 is a diagram showing a display example on the display of the radiotherapy apparatus according to the embodiment of the present invention.
FIG. 16 is a diagram showing another display example on the display of the radiation therapy apparatus according to the embodiment of the present invention.
FIG. 17 is a view for explaining the radiation direction of the radiation therapy apparatus according to the embodiment of the present invention.
FIG. 18 is a side view showing the configuration of the first modification of the radiotherapy apparatus according to the embodiment of the present invention.
FIG. 19 is a front view showing a configuration of a rotating drum (treatment gantry) of a second modified example of the radiotherapy apparatus according to the embodiment of the present invention.
FIG. 20 is a front view showing a configuration of a rotating drum (treatment gantry) of a second modified example of the radiation therapy apparatus according to the embodiment of the present invention.
FIG. 21 is a perspective view showing a configuration of a third modification of the radiotherapy apparatus according to the embodiment of the present invention.
[Explanation of symbols]
3a X-ray for treatment
3b X-ray for diagnosis
4 patients
5 affected area
5 'Irradiation field
5a Isocenter
5b Swing area
6, 6A, 6B, 6C Radiation therapy equipment
7 Treatment bed system
7-1 Bed drive system
7-2 Treatment bed
7-3 Patient fixation device
8 X-ray head system
9 Arc guide rail
10 X-ray head
11 Driven waveguide system
12, 13, 15 Link arm
14a, 14b, 14c, 16 joint
20 Imager tilt mechanism
21 Circulator
22 Dummy load
26 Guide rail tilt axis
28 Guide rail tilt mechanism
30 Real-time imager
31 Imager signal processor
60 CCD camera
68 Head rotation mechanism
70 Microwave generator
80 System controller
90 System Utilities
95 Rotation drive mechanism
96, 96A, 96B Holding frame
97, 97A, 97B X-ray source
98, 98A, 98B sensor array
99 Rotating drum (Gantry for treatment)
131 First swing mechanism
132 Second swing mechanism
S1 First swing axis
S2 Second swing axis
R1 First swing direction
R2 Second swing direction
G1 Arc guide rail moving direction
H1 X-ray head moving direction
K1 Real-time imager moving direction
Q Real-time imager rotation axis

Claims (16)

  1. A radiation irradiation head for irradiating therapeutic radiation;
    An image processing unit that generates an image of an affected area of the subject irradiated with the therapeutic radiation from the radiation irradiation head;
    Repeat the cycle including the generation of the image and the irradiation of the therapeutic radiation, and before the irradiation of the therapeutic radiation of the first cycle, the diagnostic X-rays in the second cycle following the first cycle The imaging of the image to be used is completed, and processing of the captured image is completed and the image of the affected area is generated during the irradiation of the therapeutic radiation in the first period, and the radiation irradiation head and the A radiotherapy apparatus comprising a control unit that controls an image processing unit.
  2. The radiotherapy apparatus according to claim 1 , further comprising a recording unit that sequentially records images of the affected area generated by the image processing unit.
  3. A calculation unit for calculating a treatment history by the treatment radiation based on an operating state of the radiation irradiation head;
    The treatment history includes a treatment dose irradiated with the therapeutic radiation and an estimated absorbed dose estimated to have been absorbed by the subject,
    The radiotherapy apparatus according to claim 2, wherein the recording unit sequentially records the treatment history calculated by the calculation unit in association with an image of the affected part.
  4. The radiotherapy apparatus according to claim 3, wherein the calculation unit calculates the treatment history for each irradiation direction of the therapeutic radiation.
  5. The radiotherapy apparatus according to any one of claims 2 to 4, further comprising a display for displaying an image of the affected part recorded in the recording unit and the treatment history.
  6. The radiotherapy apparatus according to claim 5, wherein the display further displays an instantaneous value and an integrated value of an irradiation dose of the therapeutic radiation.
  7. The radiotherapy apparatus according to claim 6, wherein the display further displays information indicating suitability of an irradiation position of the therapeutic radiation.
  8. The radiotherapy apparatus according to any one of claims 2 to 7, wherein the recording unit further records data indicating the position of the affected part with respect to the radiotherapy apparatus in association with the image.
  9. The control unit performs the processing for tracking the affected part of the radiation irradiation head in the second cycle , and the irradiation of the therapeutic radiation in the first cycle is performed after the imaging of the image in the second cycle. any but to so that is started prior to completion of the irradiation of the radiation for the treatment of the first period based on the generated image, of claims 1 to 8 for controlling said image processing unit and said radiation irradiating head The radiotherapy apparatus of Claim 1.
  10. And repeating the cycle comprising irradiation period of the therapeutic radiation with the generation period of the image,
    And controlling so as before the irradiation of the therapeutic radiation from the radiation irradiation head of the first cycle, the imaging of the image using the diagnostic X-ray in the next second period of the first cycle is completed,
    An image generation step of generating an image of the subject of the affected area from the captured image while the therapeutic radiation from the front Kiho ray emitting head is irradiated in the first period,
    And a recording step of sequentially recording the generated images of the affected area.
  11. A calculation step of calculating a treatment history by the therapeutic radiation based on an operating state of the radiation irradiation head;
    The treatment history includes a treatment dose irradiated with the therapeutic radiation and an estimated absorbed dose estimated to have been absorbed by the subject,
    The operation method of the radiotherapy apparatus according to claim 10, wherein the recording step sequentially records the treatment history calculated in the calculation step in association with an image of the affected part.
  12. The operation method of the radiotherapy apparatus according to claim 11, wherein the calculating step calculates the treatment history for each irradiation direction of the therapeutic radiation.
  13. The operation method of the radiotherapy apparatus according to claim 11 or 12, further comprising a display step of displaying the image of the affected part recorded in the recording step and the treatment history.
  14. The operation method of the radiotherapy apparatus according to claim 13, wherein the display step further displays an instantaneous value and an integrated value of an irradiation dose of the therapeutic radiation.
  15. The display step further displays information indicating the appropriateness of irradiation good location of the therapeutic radiation,
    The operation method of the radiotherapy apparatus according to any one of claims 10 to 14, wherein the recording step further records data indicating a position of an affected part with respect to the radiotherapy apparatus.
  16. The controlling step includes tracking the affected part of the radiation irradiation head in the second period so that the therapeutic radiation in the first period is performed after the imaging of the image in the second period. 16. The process according to any one of claims 10 to 15, including a step of controlling so that processing for starting is started before completion of the irradiation of the therapeutic radiation in the first period based on the generated image. Method of radiation therapy apparatus of the present invention.
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