JPH07255719A - Ct system for radiation treatment plan, radiation treatment device and radiation treatment system - Google Patents

Abstract

PURPOSE:To improve the efficiency of a treatment operation and to shorten the time by forming treatment plan data after displaying the image data of the lesion on a monitor and automatically instructing the marking position of an examinee, then executing the radiation treatment in accordance with the treatment data including the shape data of a marker and irradiation field. CONSTITUTION:A control section 40 applies a command for, for example, a helical scan to execute the scan and commands the image reconstitution of an image reconstitution section 45 in accordance with the collected data of a data collecting section 22. This control section determines an isocenter by using the scannoimages and controls the positions of light projectors 27a to 27c and the position of the top plate of a bed in such a manner that the cruciform marker automatically instructs the position of the isocenter when the treatment planning method is a scanno plan. The main control section 40 calls the shape data of the irradiation field out of an image memory 46, sets the angle over the entire part of a collimator and the control mode of leaves and outputs the same to a collation recorder 4.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a radiation treatment system, and more particularly, to a CT for treatment planning, which is capable of consistently performing imaging from an image of a subject to treatment planning based on the image by incorporating an X-ray CT apparatus. The present invention relates to a radiotherapy system that includes a system and a radiotherapy device that radiates radiation to a subject to perform radiotherapy, and is effective in treating cancer and the like.

[0002]

2. Description of the Related Art Conventionally, radiotherapy for irradiating a lesion such as cancer with radiation has been performed in a clinical setting, and its effectiveness has been confirmed.

A linear accelerator is generally used as a radiation treatment apparatus for performing this radiation treatment.
This linear accelerator is for irradiating the affected area of a patient lying on a treatment table with radiation (X-rays) generated by applying an accelerated electron beam to the target from the irradiation device main body side.

In order to carry out treatment using such a radiation treatment apparatus, various preparatory work is required in advance. The first step is to acquire an image of the diseased part by, for example, an X-ray CT scanner. Then, in the second stage, the position, size, shape, number, etc. of the affected area are accurately grasped by using the image, and the position of the isocenter and the dose distribution,
After selecting the irradiation method (field of view, angle, number of portals, etc.), determine whether or not the affected area can be accurately irradiated. Furthermore, in the third stage, the isocenter, dose distribution and irradiation conditions determined by the X-ray simulator are used.
Determination, patient positioning by fluoroscopy, surface marking (isocenter, irradiation field), and simulation by the determined irradiation method.

When the simulation is completed in this way, the radiation treatment apparatus usually starts treatment after a proper period. Prior to this treatment, the irradiation field is collated with the fluoroscopic image for collation, and the patient is positioned by the isocenter mark among the body surface marks attached to the patient, and the collimator is arranged by the irradiation field mark. Set the irradiation range of. After this, the actual radiation treatment is performed according to the determined irradiation method.

[0006] In recent years, while various approaches to cancer treatment have been made, the significance of radiation therapy as a root treatment method and palliative therapy has been reconsidered, and more accurate positioning of affected areas and more detailed treatment plan. And more precise treatment is being demanded.

Under the present circumstances, the radiotherapy system has conventionally been operated by an X-ray CT scanner for taking a tomographic image or a scanogram of a subject and an operation based on those images.
Radiotherapy planning device that makes a treatment plan considering the lesion area, an X-ray simulator that performs positioning based on the created plan data assuming actual treatment, and a radiotherapy device that actually performs treatment Those with and are known. Also, among the above-mentioned four constituent devices, a system in which an X-ray CT scanner and an X-ray simulator are integrated by using a common bed is also known. As a radiation treatment planning method and positioning method, for example, one described in JP-A-3-26278 (the title of the invention is "control method of positioning apparatus for radiation treatment planning") and further one described in JP-A-3-224547. (The title of the invention is “method of setting irradiation conditions in CT device”).

Among them, in the radiation treatment planning positioning apparatus disclosed in Japanese Patent Laid-Open No. 3-26278, three pointers (arm modules) for projecting an isocenter mark with light on the body surface of the subject. Are mounted on the upper part (ceiling) and the left and right wall surfaces of the room of the positioning device, and each arm module is moved by a driving machine. Then, of these, the positional displacement due to the mechanical distortion of the left and right side pointers is corrected, and the left and right pointer cross marks are
The projection positions are matched.

Further, in the irradiation condition setting method described in Japanese Patent Laid-Open No. 3-224547, a tomographic image including an irradiation target portion of a target patient and an irradiation direction created by using this tomographic image are parallel to each other on a screen of a display device. MPR (Multi
Plane Reconstruction) image and an MPR image in a cross section about the body axis orthogonal to the irradiation direction are displayed, and irradiation conditions are determined while observing the relationship between the target site and its surrounding tissue on these images. ing.

[0010]

As seen in the above-mentioned conventional example, when a pointer for projecting a cross mark by light is attached to a wall or ceiling surface of a room, it can be transmitted through a building even for a long time. It is also assumed that the reference position of the positioning device itself, which performs the marking, with respect to the building may change due to the effects of internal and external vibrations and external disturbances such as earthquakes.If such a displacement occurs, the isocenter The accuracy of marking is decreased, and the mounting position of the pointer must be changed every time the installation location of the positioning device is changed, and the work of aligning the position of the positioning device with the pointer is required each time. , I had to spend a lot of effort and time on maintenance.

On the other hand, the above-mentioned tomographic image and two types of MP
In the method of simultaneously displaying the R images and setting the irradiation conditions, the MPR images of the parallel plane and the vertical plane that pass through the target (target) site, that is, the lesioned area, have a three-dimensional shape. If it is attempted to determine a suitable irradiation field over the entire lesion area, it is not always easy to determine the projected image of the maximum shape of the target site from the cross-sectional image, so the position of the vertical plane cannot always be indicated accurately. From this, those MPRs
It is necessary to display and observe an image, especially an MPR image on a vertical plane, by trial and error, which requires a lot of trouble and requires a long time for planning. On the other hand, if the labor for operation is simplified, there is a possibility that the accuracy of setting the irradiation conditions may be reduced.

In the conventional setting of irradiation conditions, in addition to the method based on the sectional image and the MPR image as described above,
A method is also known which is performed based on an axial image (cross-sectional image) and a scano image (perspective image). However, in this method, since it is not an image of a surface facing an arbitrary irradiation angle of radiation, it is not possible to accurately determine a collimator shape that changes for each irradiation direction during rotational irradiation, and thus high treatment plans of recent years have been encountered. It was difficult to improve accuracy.

Further, in any of the irradiation conditions set forth above, when the irradiation field is set and the line cone of the radiation path is confirmed by the axial image, the irradiation field itself is changed even if the position of the line cone is changed. The shape and size do not change. Therefore, when an inconvenience was found at the position of the line cone, the irradiation field had to be reset from the beginning.

Therefore, the present invention has been made in view of the above-mentioned various problems of the related art, and it is possible to reduce the number of devices constituting the entire radiotherapy system as compared with the related art, and the hardware of the system can be reduced. It is a main object to provide a radiotherapy system capable of simplifying and downsizing the medical treatment, improving the accuracy of the treatment plan, and shortening the planning time.

Radiation treatment capable of directly transmitting the shape data of the irradiation field created by the treatment plan to the treatment device and automatically controlling the opening of the collimator of the treatment device to improve the efficiency and shorten the time of the treatment work. It is another primary objective to provide a system.

The isocenter determined in the treatment plan
To provide a CT system for a radiation treatment plan incorporating a light projecting mechanism capable of improving a mounting position of a light projector which indicates the position on the body surface, and stabilizing and improving the marking accuracy of the flood light. The second purpose of

A third object of the present invention is to shorten the time required for treatment planning by consistently and automatically performing the processing from the position determination of the isocenter in the treatment planning to the projection of light during marking work. To do.

In the treatment plan, it is possible to make a more precise treatment plan such as setting an optimum irradiation field corresponding to an arbitrary irradiation angle, and it is possible to easily correct the treatment plan on the screen. It is another fourth object of the present invention to provide a CT system for radiation treatment planning that can be performed and facilitates planning work and improves efficiency.

[0019]

Means for Solving the Problems X-ray CT scanner means for irradiating a subject with X-rays to obtain image data of a lesion, and for displaying the image data on a monitor and performing radiotherapy for the lesion. Treatment planning means for creating treatment plan data including the position of the isocenter and the shape of the irradiation field and the positioning means for automatically indicating the marking position of the subject based on the position data of the isocenter are integrated. A radiotherapy system comprising a radiotherapy planning CT system and a radiotherapy apparatus for carrying out radiotherapy based on treatment plan data including shape data of a marker and an irradiation field attached to the marking position. The main part is to provide.

Further, a gantry for incorporating an X-ray tube and an X-ray detector into the diagnostic opening for performing X-ray exposure to the subject, and a top plate on which the subject is placed are provided in the opening. A radiotherapy plan including an X-ray CT apparatus main body having a bed that can be inserted into and retracted from the bed, and using the image acquired based on the detection data of the X-ray detector to make a radiotherapy plan for the lesion area of the subject. In the CT system for use, an optical marker for pointing to the subject is provided at three positions on the right and left side portions and the upper portion of the gantry opening and on the same plane orthogonal to the axial direction of the opening. A light projector for projecting light is separately installed, and the light emitting ends of the two light emitters on the left and right sides are moved in the vertical direction orthogonal to the axial direction, and the light emitting end of the upper light projector is moved to the axis. Movement to move in the lateral direction orthogonal to the direction While separately providing each structure, an indicating means capable of three-dimensionally indicating the position of the isocenter with respect to the lesion on the image, the position of the isocenter indicated by the indicating means and the positions of the three optical marks. And a control means for automatically controlling the positions of the projection end of the projector and the top plate so that

Further, an object is exposed to X-rays, and an image obtained on the basis of the transmitted X-rays is used to detect the data including the shape of the irradiation field on the body surface necessary for the radiotherapy of the lesion area of the object. -A CT system for radiation treatment planning for creating a data storage, and a multi-leaf structure capable of narrowing the radiation emitted from a radiation source according to the shape of the irradiation field and independently driving a plurality of leaves. In a radiotherapy system including a radiotherapy device having a collimator built-in, an opening data creating means for creating opening data by the plurality of leaves matching the shape of the irradiation field, and the opening data creating means Aperture control means for controlling the diaphragm positions of the plurality of leaves of the collimator based on the produced aperture data, and the aperture data producing means is such that the ends of the plurality of leaves are irradiated with the irradiation. field Means for selecting any one of a mode circumscribing the contour, a mode inscribed in the contour, and a mode in which the contour intersects the midpoint of the end, and a mode for selecting the mode according to the selection mode. And means for calculating aperture data.

Further, the radiation treatment in which the subject is exposed to X-rays and the treatment plan data necessary for the radiation treatment of the lesion of the subject is created on the image obtained based on the transmitted X-rays. In the planning CT system, an image obtained by processing the data of the plurality of axial images with the plurality of axial images obtained based on the transmitted X-rays and at least one scano image or an alternative image thereof is obtained. A planning means for creating the treatment planning data by using the planning means is provided, wherein the planning means is based on at least one of the plurality of axial images and a scano image or an alternative image thereof, and an isocenter of a target region surrounding the lesion. Based on the means for determining − and the plurality of axial images, it is assumed that the target region is irradiated with radiation from a virtual radiation source placed at an arbitrary radiation source position. And a means for determining the shape of the irradiation field on the subject based on the shape of the target area on the transmission image, and the virtual image based on the plurality of axial images. A means for creating a target image parallel to a cross section determined corresponding to the radiation source and the isocenter, a means for confirming the irradiation field on the target image, and a line cone of the radiation on the plurality of axial images. 14. The CT system for radiation treatment planning according to claim 13, further comprising a confirmation means.

Further, the radiation treatment in which the subject is exposed to X-rays and the treatment plan data necessary for the radiation treatment of the lesion of the subject is created on the image obtained based on the transmitted X-rays. In the planning CT system, an image obtained by processing the data of the plurality of axial images with the plurality of axial images obtained based on the transmitted X-rays and at least one scano image or an alternative image thereof is obtained. It comprises a planning means for creating the treatment plan data including the radiation field from the irradiation field on the subject and the virtual radiation source, and the planning means, means for displaying the created pyramid,
In response to a change in the displayed position of the pyramid by the manual input device, there is provided means for changing the shape of the irradiation field by an amount corresponding to the change.

Further, the radiation emitted from the radiation source is narrowed down to a desired irradiation field by a multi-leaf collimator, and the narrowed radiation is applied to a subject placed on a treatment table to perform radiation treatment. In the treatment apparatus, at least one of the collimator and the treatment table based on at least one of the control data of the opening degree of the collimator and the control data of the slew angle of the treatment table given from the outside of the radiation treatment apparatus And a control means for automatically controlling.

[0025]

The X-ray CT scanner means in the CT system for radiation treatment planning irradiates the subject with X-rays to obtain image data of the lesion, and then the treatment planning means displays the image data on the monitor. Then, the treatment plan data including the position of the isocenter and the shape of the irradiation field for radiotherapy of the lesion is created. Further, the positioning means automatically indicates the marking position of the subject based on the isocenter position data. On the other hand, in the radiation treatment apparatus, the radiation treatment is carried out based on the treatment plan data including the shape data of the marker and the irradiation field attached to the marking position.

[0026] In another aspect, for pointing to the subject, the points are pointed to three positions on the left and right side portions and the upper portion of the gantry opening on the same plane orthogonal to the axial direction of the opening. The projectors for projecting the light marks are separately installed, and the projector ends of the two projectors on the left and right sides are moved in the vertical direction orthogonal to the axial direction and the projector ends of the projectors on the upper side. Separately, a moving mechanism for moving the above in the lateral direction orthogonal to the axial direction is provided. Then, when the position of the isocenter with respect to the lesion area is instructed three-dimensionally on the image,
The positions of the projection end of the projector and the top plate are automatically controlled so that the position of the isocenter and the positions of the three light marks coincide with each other.

Further, in another aspect, aperture data is created by the plurality of leaves in accordance with the shape of the irradiation field,
The stop positions of the plurality of leaves of the collimator are controlled based on the created aperture data, and the ends of the plurality of leaves circumscribe and circumscribe the contour of the irradiation field. ,
And one of the modes in which the contour intersects the midpoint of its end is selected, and the aperture data is calculated in accordance with this selected mode.

Further, in another aspect, it is obtained by processing data of a plurality of axial images obtained based on transmitted X-rays and at least one scano image or an alternative image thereof and a plurality of axial images. Treatment planning data is created using the image and. That is, the isocenter of the target region surrounding the lesion is determined based on at least one of the plurality of axial images and the scanogram or its alternative image, and based on the plurality of axial images, the arbitrary radiation source position is determined. A transmission image is created on the assumption that the target region is irradiated with radiation from the virtual radiation source placed on the object, and the shape of the irradiation field on the subject is determined based on the shape of the target region on this transmission image. Is determined, and a target image parallel to the cross section determined corresponding to the virtual radiation source and the isocenter is created based on the plurality of axial images. The irradiation field can be confirmed on this target image, and the ray cones can be confirmed on a plurality of axial images.

Further, in another aspect, a plurality of axial images obtained based on the transmitted X-rays and at least one scano image or an alternative image thereof are obtained by processing the data of the plurality of axial images. The treatment plan data including the pyramid of the radiation from the irradiation field on the subject and the virtual radiation source is created using the image, and the pyramid is displayed. When the position of the displayed line cone is changed by the manual input device, the shape of the displayed irradiation field is automatically changed by an amount corresponding to the change.

Further, in another aspect, the collimator and the treatment table are controlled based on at least one of the control data of the opening degree of the collimator and the control data of the slew angle of the treatment table given from the outside of the radiotherapy apparatus. At least one of these is automatically controlled.

[0031]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS An embodiment of the radiotherapy system according to the present invention will be described below with reference to FIGS.

1 and 2 show the outline of the overall configuration of the radiation treatment system. This radiotherapy system is a CT system 1 for radiotherapy planning for consistently performing image acquisition, treatment planning, and alignment (simulation) during radiotherapy, and the CT system 1 for radiotherapy planning And a radiation treatment apparatus 2 for performing radiation treatment according to simulated treatment plan data, and a CT for radiation treatment plan for automatically controlling a collimator described later, which is built in the radiation treatment apparatus 2.
The system 1 and the radiotherapy apparatus 2 are connected by a coaxial cable 3 as a signal transmission line. This coaxial cable
A collation recording device 4 is inserted in the middle of the bull 3 so that the operator can finely adjust the opening of the collimator at the time of actual radiotherapy. Further, in the CT system 1 for radiation treatment planning, a dedicated processing device 5 for treatment planning, which is responsible for specialized arithmetic processing such as dose distribution calculation of radiation, and a laser printer 6 for outputting plan data, have transmission lines 7 and 8. Connected to each other.

Among these components, the CT system 1 for radiation treatment planning (hereinafter, simply referred to as "CT system") will be described first.

The CT system 1 is constructed by applying a normal X-ray CT scanner, and as shown in FIGS. 1 and 3, includes a gantry 11, a bed 12, and a control console 13. For example, it is a device driven by the RR method. On the upper surface of the bed 12, its longitudinal direction (Z axis (body axis)
The top plate 12a is disposed so as to be slidable in the direction), and the subject P is placed on the top surface of the top plate 12a. The top plate 12a is inserted into the diagnostic opening OP of the gantry 11 so as to be movable back and forth by driving a slide mechanism represented by an electric motor 12b.

As shown in FIG. 3, the gantry 11 contains an X-ray tube 20 and an X-ray detector 21 which are opposed to each other with the subject P inserted in the opening OP interposed therebetween. X-ray detector 2
The weak current signal corresponding to the transmitted X-ray detected in 1 is
The data collection unit 22 converts the digital amount to a
Sent to Le 13. In FIG. 3, reference numeral 23 indicates a collimator or filter in the gantry 11, and reference numeral 24 indicates an X-ray fan.

Further, on the front side of the gantry 11, that is, inside the front cover 11a located on the bed 12 side, 3
Light projectors 27a, 27b and 27c for positioning the table are provided. The light projectors 27a to 27c are respectively provided at a predetermined height position on the left and right of the diagnostic opening OP toward the front cover 11a and at an upper center position, and their irradiation ports are all diagnostic openings. It is directed to the subject P coming to OP.

Each of the projectors 27a to 27c adopts a laser system in this embodiment. As shown in FIG. 4, for example, a He--Ne laser light source 28 and this laser light source 28 are used.
Optical fiber 29 for guiding the output beam and the tip of the optical fiber 29 in a predetermined direction at the position where the projector is installed (that is, in the case of the left and right projectors 27a and 27c, the vertical (Y) direction, the projector 27b at the upper center). In the case of, the horizontal axis (X) direction)
It comprises a moving mechanism 30 for moving the optical fiber 29, and an illuminating section 31 for forming a cross mark using the output beam of the optical fiber 29 and irradiating the subject P toward the subject. The moving mechanism 30 has, for example, a step motor 30a and a lead screw portion 30b which is rotated by the motor 30a, and the tip end portion of the optical fiber 29, that is, the illumination, is illuminated by the forward and reverse rotations of the step motor 30a. The part 31 is movable in the vertical (Y) and horizontal (X) directions (see arrows m1 to m3 in FIG. 4). As a result, the projectors 27a to 27c can irradiate the subject P with the cross-shaped laser light from the illuminating section 31, and the shadows of the cross-shaped markers M1 to M3 on the both side surfaces and the upper surface of the body surface, respectively. Form.

The rotation of each step motor 30a of the projectors 27a to 27c and the movement of the top plate 12a of the bed 12 are automatically controlled from the console 13 side.
The markers M1 and M3 formed by the left and right projectors 27a and 27c are controlled to be at the same position in the vertical direction.

Each of the electric circuits leading to the projectors 27a to 27c is as shown in FIG. That is, 2 of alternating current
The power source voltage of 00V is stepped down to AC 100V via the transformer 33, supplied to the control unit 34 of the laser light source 28, and supplied to the laser light source 28 via the on / off switch 35. . On the other hand, the power supply voltage of AC 200V is supplied to the step motor 30a of the moving mechanism 30 as it is. Further, although not particularly shown in FIG. 4, the moving mechanism 30 and the illuminating section 31 are integrally provided with a rotating mechanism 36 (see FIG. 5) which is rotatable about the irradiation direction as a rotation axis. The rotating mechanism 36 is used when the gantry is tilted, and it includes the projectors 27a to 27a.
The marker irradiation function of 27c is installed not only for isocenter setting but also for positioning in a normal X-ray CT scanner. As a result, the CT system 1 in this embodiment can be used not only for radiation treatment planning but also as a normal X-ray CT scanner.
The rotating mechanism 36 and the on / off switch 35 are controlled by the main control unit 4 as needed.

Returning to FIG. 3, the console 13 uses this C
In addition to the main control unit 40 that controls the entire T system, the bed control unit 4 that operates by receiving a command from the main control unit 40
1. The gantry controller 42 is connected to each other via an internal bus. The main controller 40 is also provided with a high voltage generator 44 which is connected to an X-ray controller 43 outside the console and which operates in response to a drive signal from the X-ray controller 43. The high voltage generated by the high voltage generator 44 is supplied to the X-ray tube 20 to perform X-ray irradiation. Further, the console 13 receives an acquisition signal from the data acquisition unit 22 and reconstructs image data, an image reconstructing unit 45, an image memory 46 for storing the image data, and a display 47 for displaying the reconstructed image. , And the operator is provided with an input device 48 for giving a command to the main controller 40. Each of the control units and the controllers 40 to 43 is equipped with a computer, and operates based on a program stored in its memory in advance.

The internal bus of the controller 13 is further connected to an extension board 48 of the coaxial cable, and the extension board 4 is connected to the extension board 48.
8, a projector controller 49 for controlling the marker irradiation positions of the projectors 27a to 27c is connected via a coaxial cable 50, and the laser printer 6 and the collation recording device 4 are coaxial cables. It is connected through the bulls 8 and 3. The position data of the isocenter of the subject is supplied to the projector controller 49 from the main control section 40. In response to this data supply, the projector controller 49 has three projectors 27a. ~ 27c illumination unit 3
Each position of 1 is automatically controlled.

The collation recording device 4 is composed of, for example, a personal computer, and the operator is used as a radiotherapy device 2 during radiotherapy.
The collimator opening data can be reconfirmed and the opening data can be finely adjusted if necessary. Also,
Irradiation dose and irradiation information can be set and changed.

Next, the radiation treatment apparatus 2 will be described.

The radiation treatment apparatus 2 (hereinafter simply referred to as "treatment apparatus") is a treatment apparatus that uses X-rays in this embodiment, and as shown in FIGS. 1 and 6, a treatment table 50 on which a subject P is placed. And a pedestal 51 rotatable about the body axis (Z) direction of the subject P, a pedestal support 52 rotatably supporting the pedestal 51, and a console 54 (see FIG. 6). There is.

The treatment table 50 has a top plate 50a on its upper side. Since the height of the treatment table 50 can be adjusted by an internal drive mechanism, the top plate 50a can be moved up and down (Y-axis direction). In addition, the treatment table 50 can move the top plate 50a in a predetermined range in the longitudinal direction (Z direction) and the lateral direction (X direction) by driving another driving mechanism inside the treatment table 50, and another driving device. By operating the mechanism, it is possible to rotate the top support and rotate around the isocenter. The operation of these treatment tables 50 is necessary when positioning the subject P on the top plate 50a and irradiating radiation, and is controlled by a control signal from the console 54.

On the other hand, the gantry 51 is provided with an irradiation head 51a for deflecting the accelerated electrons from the Claxtron to hit the target and irradiating the subject P with the X-ray beam generated from the target. The irradiation head 51a has a target,
That is, a collimator 55 that determines the irradiation field on the body surface of the subject P is provided between the radiation source and the irradiation port. In this embodiment, the collimator 55 is a multi-leaf collimator having a multi-division conformer structure.
limator). That is, as shown in FIG. 7, two sets of leaf groups 56A and 56B (for example, 29 leaves in each group) composed of a plurality of plate-shaped tungsten leaves 56 ... 56 are provided from the radiation source S. 56 are arranged to face each other across the X-ray path, and each of the leaves 56 ... 56 is moved by a moving mechanism 57 ... 57 whose main part is a lead screw. ) Can be driven independently.
The moving mechanisms 57 ... 57 are driven in response to a control signal supplied from the console 54, and the two leaf groups 56A, 5
The size and shape of the irradiation opening formed by 6B (that is,
The size and shape of the irradiation field on the body surface) can be changed in real time.

Further, the gantry support 52 can be rotated in the clockwise direction or the counterclockwise direction of the pedestal 51 as a whole by the drive mechanism incorporated therein. The operation of this drive mechanism is performed based on a control signal from the console 54.

As shown in the figure, the console 54 has a main control unit 60 for managing the entire treatment apparatus 2 and a klystron control unit 61 for performing a process individually assigned under the instruction of the main control unit 60. , A treatment table controller 62, a gantry controller 63, a collimator controller 64, and a projector driver 65. The floodlight driving unit 65 drives three floodlights (not shown) mounted on the pedestal 51 and its related positions, walls, ceiling, or the like. By positioning the subject P on the top plate 50a so that the positions indicated by the three light projectors and the positions of the cross markers M1 to M3 on the subject P coincide with each other, the isocenter of the subject P is adjusted. − Is the treatment device 1
Will coincide with the center of rotation.

Each of the control units 60 to 64 is functionally constituted by, for example, one computer, and performs processing in accordance with a program previously stored in its memory. The main control unit 60 also
The collation recording device 4 through the interface circuit 66.
The opening data (size and shape of the opening) of the collimator 55 can be received by this. The main control unit 60 is further connected to an input device 68a such as a keyboard and a display device 68b composed of a CRT, and is also connected to a hand-held operation device 67. The handheld operation device 67 is held near the treatment table 50 to improve the convenience of operation.

Next, the operation of this embodiment will be described according to the flowchart.

FIG. 8 shows the overall flow from scanning for image acquisition of the treatment site to treatment planning.
This is a process mainly performed by the console 13 of the system 1.

First, at step 101 in FIG.
It is confirmed that the positions 7a to 27b in the respective directions are at the home position, and the process proceeds to the process for the treatment plan after step 102. First, in step 102, the main controller 40 controls the bed controller 41, the gantry controller 42, and the X-ray controller 4.
For example, a command of helical scan is given to 3 to execute scanning, and at the same time, the image reconstruction unit 45 is instructed to perform image reconstruction based on the collected data of the data collection unit 22. As a result, the image data of the three-dimensional area including the treatment site is obtained as a plurality of axial image data. It should be noted that a scanogram (transparent image) of the treatment site is obtained prior to this helical scan.

When it is determined in step 103 that this series of scans and their reconstruction have been completed, step 1
It moves to 04 and it is judged whether a dose distribution calculation is necessary.
This dose distribution calculation is often performed for confirmation when the treatment site is a new site that is not clinically routineized. Therefore, the main control unit 4
0 determines whether or not such calculation is instructed based on operator instruction information from the input device 48, and YES
In the case of, the image data is transferred online to the dedicated processing device 5 to instruct the dose distribution calculation. In this case, the dedicated processing device 5 performs the instructed dose distribution calculation, and the isocenter and the irradiation method are determined using this device 5. This decision data is used again in C at the time of laser marking described later.
It is taken into the T system 1 side.

If NO at step 104,
Enter the treatment plan without calculating the dose distribution. That is, the interactive function of the CT system is activated in step 105, and the treatment planning method is selected in step 106. In this embodiment, two types of treatment planning methods, "scan plan" and "oblique plan" are prepared.
Either 07a or 107b will be selected.

Next, the scanno plan, which is the first plan of the above-mentioned treatment plan, will be described in detail with reference to FIGS.

This scano plan is a correct scano image.
Either or both of the side images are used to determine the isocenter (in the case of one scano image, at least one axial image is required because the isocenter is vertically determined. ), This is a plan suitable for regular irradiation (1 gate or 2 opposing gates) of uterine cancer, laryngeal cancer, etc.,
The control information of the multi-leaf type collimator 55 of the treatment apparatus 2 is also output.

Specifically, first, step 110 in FIG.
Then, the patient is estimated in the patient directory for selecting an image required for planning, or the scano image and the axial image required for planning are selected and designated in the image directory. In the scano plan, one scano image is used to determine the irradiation field.

Next, at steps 111 and 112, the display of the scanogram and the setting of the number of irradiation gates are performed. That is, one scano image to be used for the scano plan is finally determined and displayed from the selected scano image group. The selected scano image is the front image (top: Top
Image) or the side view (side: Side image), the irradiation angle is determined as shown in FIGS. 10 (a) and 10 (b). Which irradiation direction is finally adopted and the irradiation gate number (Fig. (See 11)
Let me choose what to do.

Further, the irradiation field is set in step 113, and the important organ shielding block is set in step 114. That is, the irradiation field and the important organ shielding block are set on the scanogram. At the time of setting, either a polygonal ROI or a rectangular ROI is selected according to the irradiation shape and the like. 12A and 12B show an example in which an irradiation field is designated for the same lesion part. In FIG. 12A, one polygon ROI: r1 is designated, and FIG. ) Is designated by a combination of one rectangle ROI: r1 and two rectangles ROI: s1 and s2. The data of the leaves 56 ... 56 of the collimator 55 is created for the irradiation field set in this way.

In this plan, the scano image is enlarged / reduced as needed, as in the case of the scan dialogue. Also, when there are a plurality of scano images, the irradiation field shape is displayed as it is at the time of image forwarding (FWD / BWD), and it is processed so that it can be used for confirmation / correction of respiratory movement (however, The irradiation field shape can be cleared if necessary). Further, if the scanning direction of the scano is different when the image is fed, the irradiation field shape is erased.

Next, in step 115, the isocenter (center of rotation) I / C is uniquely determined at an arbitrary position. For that purpose, first, the isocenter I / C on the XZ plane is determined on the displayed scanogram. The user uses a mouse to display a cross ROI (a large, open center RO
I) is brought to the position of the desired isocenter I / C as shown in FIG. The initial value of the chrono ROI is the center of the irradiation range RD. At this time, it is possible to enlarge or reduce the scano image. Moreover, it is necessary that the correction is easy.

In the case of the top image shown in FIG. 13, X-
It is set on the Z plane, and in the case of a side image, the isocenter is set on the YZ plane.

When the center of the cross ROI is open, there is an advantage that the candidate points of the isocenter can be easily seen. Cross R
It is preferable that a scale of "mm" or "inch" is included on the OI.

Further, the isocenter on the axial image is determined. That is, an arbitrary axial image is selected from the selected image group (see FIG. 15), and the isocenter I / C on the axial image is designated by the mouse (FIG. 1).
6). Since the isocenter on the XZ (YZ) plane has already been determined, basically the remaining one point may be determined. The isocenter can be modified. As a result, the X, Y, Z coordinates of the isocenter are fixed.

When the scano image is the top (side image), the coordinates other than the Y (X) coordinates are determined, so it is convenient to fix the determined coordinates unless otherwise specified by the user. Thus, for example, when the top image is designated, the Y axis of the cross ROI is fixed and only the X axis is moved by the mouse on the axial image. The same applies to the side image.

Next, at step 116, the irradiation field and the line cone are displayed. That is, FIG. 17 shows an example of single gate irradiation. As shown in this figure, the irradiation shape RD and the isocenter I / C (marked with X) are displayed on the scanogram, and the collimator (multi-leaf collimator) is passed from the radiation source to each axial image. In this case, the outline of the radiation path (this is called the line cone LN) is displayed by the dotted line. Similarly, FIG. 18 shows a case of irradiation with two opposing gates. In FIG. 18, LN1 and LN2 are line pyramids related to two opposing gates.

It is desirable that this display is not limited to "1 image / screen" display, but multi-frame (1 × 2, 2 × 1, 2 × 2) display is possible.

In the display processing function of step 116, when the position of the displayed pyramid is changed with a pointing device (mouse or the like), the change data of the irradiation field shape corresponding to the change is calculated. The displayed irradiation field is also changed and displayed in real time. As a result, the irradiation field is automatically corrected in accordance with the fine adjustment of the line cone, so that the operability is remarkably excellent.

When the irradiation field LD and the line cone LN are thus displayed, the operator confirms them on the screen in step 117 to determine whether or not the irradiation field and the line cone need to be corrected. In this determination, if there is no correction (NO), in step 118, the data of the determined irradiation field RD and isocenter I / S and the irradiation condition data are stored. On the contrary, if you want to make corrections (YES), step 1
It returns to the required step of 12-115, and repeats the above-mentioned processing. The processes of steps 112 to 115 do not necessarily have to be performed in the illustrated order, and may be performed in any order.

Further, an oblique plan which is the second plan of the treatment planning method will be described with reference to FIGS. 19 to 31. The oblique plan is used when it is difficult to plan with the above-mentioned scano plan, and a plurality of targets and important organs can be accurately traced by ROI. In addition, a plurality of axial images are used to create and display a transmission image and a target image from a virtual radiation source (arbitrary angle, there is a radiation source rotation plane on the axial plane), and the beam irradiation and safety margin are appropriate. Whether or not it can be accurately grasped. Here, control information for multi-gate irradiation and collimator is also output.

FIG. 19 shows an outline of this oblique plan.

First, in step 120 of FIG. 19, the main controller 40 selects an image required for planning. Either specify the patient in the patient directory, or select and specify the axial and scano images required for planning in the image directory.

In such an oblique plan, the scanogram is used to specify the isocenter in the body axis direction. When there is no scano image in the designated image group, it is also possible to display a top image or a side image by using a plurality of axial images (MPR image having a thickness) and replace it with the scano image.

Next, in step 121, ROI tracing of the target and important organs is performed. That is, as shown in FIG. 20, the positions and shapes of the target and important organs are ROI traced on the selected image using the mouse. The shape of the ROI is a polygon (polyline)
ROI, rectangular (rectangular) ROI, circular ROI, free R
OI is available.

(1) Specifically, first, the selected images are sorted in ascending order (descending order) of the table positions. However, the scano image is treated separately. (2) Display the first image. (3) Set targets and important organs. At this time, each R
Each OI has a number, and grouping is performed when determining the isocenter (in the body diameter direction) by the number (see FIG. 20). The ROI number is basically an automatic number, and the user can change the number if necessary. (4) Image forwarding is possible in the selected image unless the ROI is being input (see FIG. 21). (5) If necessary, multi-frame display (if there is a fixed target or important organ, it is also displayed as a composite).

Next, at step 122, the isocenter on the (XY) plane is designated. That is, (X-
Y) In order to determine the isocenter on the plane (axial plane) (by image feed), all ROIs with the designated target number / important organ number are overlaid and displayed on the image designated by the user. The user estimates the location of the isocenter based on this superimposed ROI (see FIG. 22). The isocenter is stored in the system along with the target number.

Next, at step 123, the isocenter on the (XZ) plane is designated. That is, (X-
Z) A scanogram is displayed to determine the isocenter of the plane (plane in the body axis direction). The target and the shape of the important organ are superimposed on this scanogram. The user refers to these and sets a large cross ROI at the isocenter (see FIG. 23). It is saved with this isocenter target number.

Next, the routine proceeds to step 124, where it is judged whether or not the isocenter I / C has been determined on all the images, and if there are any remaining images, steps 123 and 124 are repeated. When all isocenter I / Cs have been determined, the process proceeds to step 125, and the beam angle is designated. As the irradiation method in this embodiment, one irradiation, two opposing irradiations, two right-angled irradiations, and multiple irradiations are supported.

The designation of the beam angle will be described for each irradiation method.

(1) Single Gate Irradiation The beam angle of the virtual radiation source is designated by the numerical input and the angle of the line ROI with the isocenter as the axis of rotation. The operation is as follows. 1) Display an image. 2) Specify the target number. 3) For example, the virtual radiation source is placed at the position shown in FIG. 4) The beam angle is specified by numerical input and the angle of the line ROI having the isocenter as the rotation axis. 5) The target number and the beam angle of the virtual radiation source are stored as a set. 6) This operation can be performed for all targets. In addition, the beam angle that has already been set can be modified.

(2) Irradiation with two opposing gates Basically, it is the same as the designation of the beam angle of the virtual radiation source of “one irradiation”. The difference is that, as shown in FIG. 25, there are two virtual radiation sources for one target, and the difference in angle is 180 °. Therefore, when storing data, two beam angles are set for one target number. Similar to the scano plan, the two irradiation gates have the same irradiation shape.

(3) Two-angle irradiation at right angles Basically, it is the same as the designation of the beam angle of the virtual radiation source of "one irradiation". The difference is that, as shown in FIG. 26, there are two virtual radiation sources for one target, and the difference in angle is 90 °. Therefore, when storing data, two beam angles are set for one target number.

(4) and Multiple Gate Irradiation There are two ways to specify the beam angle of the virtual radiation source in the case of multiple gate irradiation. One is the same as the method of specifying "1 gate irradiation", and the other is, as shown in FIG. 27, the irradiation start angle, irradiation end angle and step angle (how many times irradiation is performed) or the number of irradiation points. Is a method of specifying. For the former, "1 gate irradiation" is repeated. The latter is as follows. 1) The user displays an arbitrary axial image. 2) Enter the target number. 3) Irradiation start angle α and irradiation end angle γ with respect to the reference angle
Enter. 4) Input the step angle β or the number of irradiation points. 5) Display similar to FIG. 6) These can be set for all targets.

Next, in step 126, the data of the transmission image and the target image in an arbitrary direction is created and displayed by the cross-section conversion (MPR) from the three-dimensional tomographic image data.

An image obtained by converting a parallel beam into a beam emitted from a virtual radiation source is a transmission image (see FIG. 28).
(See (a) and (b)). By using this transmission image, an image geometrically equivalent to that at the time of treatment can be obtained. Geometric distance of treatment device, SAD (Source-to-axis-of ra
diation distance) and SID (Source-to-image-rece
The transmission image can be obtained if the ptor distance) is known (these should be set as "environmental parameters").

A transmission image from an arbitrary radiation source is created by allowing the user to select the position of the virtual radiation source. Furthermore, the trace results of the target and important organs are combined on the transmission image.

On the other hand, the target image is an image parallel to the plane containing the isocenter (see FIGS. 29 (a) and 29 (b)). This target image can accurately grasp the irradiation state in each cross section parallel to the isocenter plane. Since the target image is an image horizontal to the isocenter plane, the cross-sectional direction is determined depending on where the virtual radiation source is like the transmission image.
The user can specify a position in the depth direction by using a mouse or a numerical input (distance from the virtual radiation source, etc.) and obtain a target image at that position. Furthermore, since the trace results of the target and important organs are combined on the target image, the irradiation range can be easily confirmed.

Since the transmission image and the target image are created by cross-section conversion from the three-dimensional tomographic image data, when the position of the virtual radiation source is oblique with respect to the X, Y, and Z axes, it becomes an oblique image.

Further, in step 127, the irradiation field and the safety margin are set. That is, since the treatment device is equipped with a multi-leaf type collimator,
As shown in, the shape of the target is made the irradiation field shape as it is, and the safety margin is made to be a similar shape to the irradiation field shape. In the case of irradiation with two or more gates, the irradiation position (port number) can be selected and input, and the irradiation field shape can be confirmed on the desired transmission image.

When setting the irradiation field shape, ROI is polygonal (polyline) ROI, rectangular (rectangular) R.
OI can be used.

Next, at step 128, the irradiation field is confirmed on the transmission image and the target image, and at step 129 it is judged whether or not resetting is necessary. In case of resetting, step 127
If there is no need to go back to step 130, the process proceeds to step 130, and the line cone display on the axial image and the irradiation field display on the oblique image are performed to confirm parameters such as the irradiation field, the beam angle, and the irradiation conditions. To do. This state is shown in FIG.
In any case of the line cone and the irradiation field shape display on the axial image and the oblique image, the display can be performed by designating the target number and the virtual radiation source. This can be specified individually or multiple times.

In the process of step 130, the position of the displayed pyramid is changed by a mouse or the like as in the process of step 116 of FIG. The shape of can be corrected automatically in response to such changes.

After that, if it is necessary to redo the above-mentioned various processes, YES is returned in step 131, and the process can be restarted from step 127.

When the determination in step 132 as to whether or not the setting is completed is YES, the process proceeds to step 133 to store the set parameter data in the memory.

As described above, the position of the isocenter (three-dimensional position data) and the irradiation field shape on the body surface (two-dimensional shape data) are set by the scano plan and the oblique plan.

Therefore, returning to the processing shown in steps 108 to 110 of FIG. 8, the marking work is carried out using the laser projectors 27a to 27c. This marking is performed by the projector 27a so that the cross markers M1 to M3 automatically indicate the determined position of the isocenter I / C.
27c and the position of the top 11a of the bed 11. Therefore, the automatic positioning control for this marking does not necessarily have to be performed after the treatment planning as described above, and can be performed immediately after the position of the isocenter I / C is determined. For example, the scan plan may be performed after step 117, and the oblique plan may be performed between steps 124 and 125 or after step 133, respectively.

In step 108, the main control section 40 first determines whether or not to carry out marking based on the command from the input device 48. If YES (marking is carried out), in step 108a the left and right projectors 27a are selected. , 27b are returned to the marking angle (0 degree), and then step 109
Move to. In step 109, Isocenter I /
The position data of C is output to the projector controller 49 and the bed control unit 41. As a result, the position of the top plate 11a in the Z-axis (body axis) direction is automatically controlled, and the projectors 27a to 27a.
The marker irradiation surface position of 27c coincides with the z coordinate of the position data of the isocenter I / C, and the left and right projectors 2
The positions of 7a and 27c in the Y-axis direction are automatically controlled,
The positions of these markers M1 and M3 are isocenter I.
Corresponding to the y-coordinate of the position data of / C, and similarly, the position of the central projector 27b in the Z-axis direction is automatically controlled so that the position of the marker M2 is x of the position data of the isocenter I / C. Match the coordinates.

As described above, since the three markers M1 to M3 are irradiated on the body surface of the subject P, the operator marks these positions with a marker or the like, and is usually used for radiation therapy performed at a later date. You will be prepared.

Further, since a plurality of isocenter I / Cs may be set for a plurality of lesions, it is determined in step 110 whether or not position control has been performed for all isocenter I / Cs. However, if it still remains, the process of step 109 is repeated. Then step 11
At 1, the positions of the projectors 27a to 27c in each direction are returned to the home positions.

Subsequently, collimator control in the radiotherapy by the treatment apparatus 2 will be described with reference to FIG. In this embodiment, the CT system 1 for making a treatment plan directly controls the opening degree of the collimator 55 of the treatment device 2.

First, in step 140 of FIG. 32, the main control unit 40 of the CT system 1 determines whether or not the radiation treatment is performed based on the operation information from the input device 48, and performs the treatment (YES). , Steps 141 to 143 are sequentially performed.

That is, in step 141, the already determined irradiation field shape data is called from the image memory 46. In step 142, the angle of the entire collimator 55 and the leaf control mode are set. An appropriate value for this angle is determined according to, for example, the inclination of the irradiation field shape in the long axis direction. Further, as the leaf control mode, the system of the present embodiment is provided with three "internal contact mode", "outer contact mode", and "midpoint mode". The “inscribed mode” is the leaf 56 with respect to the contour of the irradiation field (target) RD on the body surface.
56 is a mode in which the edges of the leaves are inscribed as shown in FIG. 33 (a), and the "inscribed mode" is a mode in which the edges of the leaves 56 are inscribed as shown in FIG. 33 (b). Further, the "midpoint mode" is a mode in which the short sides of the edges of the leaves 56 ... 56 are set so as to bisect the intersection with the contour by taking the middle of the circumscribed mode and the inscribed mode. Which mode is selected can be determined in consideration of whether or not there is an important organ in the vicinity and the error rate of irradiation.

When the data for controlling the collimator 55 is determined in this way, the process proceeds to step 143 and the data is output to the collation recording device 4.

The collation recording device 4 is accompanied by a lapse of time from the time when the irradiation field is set to the time when the actual radiation treatment is performed.
The main purpose is fine adjustment of the irradiation field. For example, the treatment device 2
The fluoroscopic image obtained immediately before the treatment and the irradiation field set in the past are displayed in a superimposed manner by using the fluoroscopic mechanism added to the, and the operator's collation is opened.

Then, as a result of this collation, for example, when the lesion is small, the collation O of step 145 is performed.
It becomes NO when it is judged whether it is K or not. In this case, step 14
At 6, the positions of the leaves 56 ... 56 are finely adjusted, and new correction data is prepared in the collation recording device 4.

When the final collimator control data is established in this way, the process proceeds to step 147 and these data are transmitted to the main controller 60 of the therapeutic apparatus 2. Receiving this, the main control unit 60 passes the control data to the collimator control unit 64, and the drive mechanism 5 of each leaf 56 is in accordance with the content of the control data instructed by the collimator control unit 64.
Drive 7 independently.

As a result, two sets of leaf groups 56A and 56B are formed.
The size and shape of the opening formed in step 3 almost completely match the set irradiation field RD on the body surface, and the X-ray irradiation range to be performed later on the lesion inside is also almost completely the same. Become. Therefore, thereafter, the radiation treatment is performed by the treatment device 2 in accordance with the planned treatment method. When multiple regions to be treated (ie, isocenter and irradiation field) are set, the same collimator control data setting, collation confirmation, and collimator automatic control are performed for each treatment region.
Radiation therapy is performed.

The creation of the control data of the collimator described above (step 142) is performed by the main controller 60 of the treatment apparatus 2.
May be performed in.

As described above, in the radiotherapy system of the present embodiment, a scanner for image acquisition is used in the conventional case where a plurality of devices such as an X-ray CT device, a radiotherapy planning device, and an X-ray CT simulator are used. Due to the integration of functions, treatment planning functions, and simulator functions, a single CT system for radiation treatment planning replaces most of these functions and tasks. Therefore, compared to the conventional radiotherapy system, the hardware configuration of the entire system can be downsized and simplified, which can significantly reduce the space and facilitate the transportation due to the installation or the layout change of the room. Become.

Particularly, in the above embodiment, the position of the cross mark from the three projectors 27a to 27c in the simulator function is automatically controlled based on the position to the isocenter determined by the treatment plan. Further, the operation steps up to the marking work of the isocenter on the body surface can be omitted, whereby the marking work can be performed quickly and easily.

Further, unlike the conventional example, since the light projectors 27a to 27c are directly attached to the pedestal 11, there is no fear of the reference position shifting due to long-term external vibration transmitted to the building. Further, even when the gantry 11 has to be moved to change the layout of the radiation therapy system, the troublesome work of aligning the position of the illuminator on the wall or ceiling with the position of the gantry as in the conventional case is unnecessary.

Further, at the time of radiation treatment, the shape data of the irradiation field created in the treatment plan can be automatically sent to the radiation treatment apparatus 2 via the transmission line, and the opening degree of the multi-leaf type collimator can be automatically controlled. , The time required to set the opening of the collimator is greatly reduced compared to the case where the opening data is manually input to the treatment device or the opening is manually adjusted, which improves the overall operability. To do.

On the other hand, the treatment plan of the system of this embodiment is
Since it consists of a scano plan and an oblique plan, it is convenient because it is possible to select an appropriate plan according to the case.

The scano plan is a plan in which one irradiation and two opposite irradiations can be designated. The irradiation field and the isocenter are set on the scano image, and the irradiation field and the irradiation line cone are set on the scano image and the axial image. Can be displayed. With this display, the validity of the irradiation plan can be confirmed easily and intuitively. On the other hand, the oblique plan is a plan that can specify one irradiation, two opposed irradiations, two right-angled irradiations, rotational irradiation, and conformal irradiation, and accurately specifies a target such as a tumor on a plurality of axial images. In addition, it is possible to make a treatment plan with a transmission image and a target image of an arbitrary surface facing an arbitrary irradiation angle and direction, and quickly confirm the irradiation field shape and the irradiation line cone with the target image and the axial image, respectively. it can.

In this oblique plan, by using a transmission image that can obtain an image geometrically equivalent to that at the time of treatment, together with the target image, as compared with the case where only the target image is used,
For a three-dimensional target, a more accurate plan is created according to the irradiation angle of the treatment device.

Furthermore, in both the scan plan and the oblique plan, a fine adjustment function is provided to correct the shape of the irradiation field by correcting the position of the line cone in the middle of the plan. This is convenient because it eliminates the need to reset the shape of.

Further, at the time of the oblique plan in the CT system 1, the oblique angle information such as the set irradiation angle of the radiation is transferred from the CT system 1 to the treatment device 2 side, and at the time of the treatment, the main control unit of the treatment device 2 is performed. 60,
The treatment table controller 62 can automatically control the slew angle of the treatment table 50 according to the oblique angle information. As a result, relative to the patient, irradiation can be performed obliquely from a position other than the position in the plane orthogonal to the body axis, and the irradiation direction, that is, the slew angle can be selected according to the position and shape of the treatment site. , It becomes effective when there is a part where you want to avoid irradiation.

In the above-mentioned embodiment, the radiation plan and the CT system for radiation treatment planning are provided together with a simpler scano plan. However, only the function of the oblique plan may be provided if necessary.

Further, although the radiation treatment apparatus of the above-mentioned embodiment is assumed to use X-rays as a radiation source, it is not necessarily limited to this, and it is a treatment apparatus which uses other radiation sources such as fast neutron rays and γ rays. Good.

In the radiotherapy apparatus according to the above-mentioned embodiment and modification, the control data for the opening degree of the multileaf collimator and the control data for the slew angle of the treatment table are CT.
Although the configuration has been described in which the system is received online and controlled, the system may be operated by receiving control data created by an offline treatment planning apparatus or control data transferred from an external separate treatment planning apparatus.

[0121]

As described above, according to the radiation treatment system of the present invention, first, the X-ray CT scanner, the radiation treatment planning apparatus, and the simulator, which have been conventionally constituted by each or at least a plurality of apparatuses / systems, are integrated. Then
Since the CT system for radiation treatment planning, which can be used for multiple purposes such as a bed and a gantry, is installed, the hardware system can be significantly simplified and downsized as compared with the conventional radiation treatment system, thus saving space and transporting. Ease is achieved.

Further, in the radiation therapy system of the present invention,
Since the shape data of the irradiation field planned by the CT system for radiation therapy planning is sent to the radiation therapy apparatus and the opening degree of the collimator is automatically controlled according to the desired selection mode,
The time required for treatment is shortened and the operability is improved.

Further, according to the CT system for radiation therapy planning of the present invention, since three projectors for marking the isocenter are directly attached to the gantry, the structure for attaching to the wall surface or the ceiling as in the conventional case is adopted. Unlike the one described above, there is no concern about the shift between the position of the projector and the position of the gantry due to external vibration, and the need for alignment when transferring the gantry is eliminated, resulting in excellent maintainability.

Furthermore, according to the CT system for radiotherapy planning of the present invention, when the isocenter is marked, 3
Since the position of the floodlight of the table and the top of the bed are automatically controlled according to the determined isocenter position data, the time required for marking is shortened and the operation efficiency is improved, shortening the overall treatment time. Will greatly contribute to.

Furthermore, C for radiation treatment planning of the present invention
In the T system, it is possible to make a treatment plan by selecting either the first planning means (scan plan) or the second planning means (oblique plan) as needed, and therefore the convenience is extremely high. . In particular, since the second planning means uses the transmission image and the target image on the oblique surface that change according to the irradiation angle, it is possible to make a more detailed radiation irradiation plan for the three-dimensional target shape. As a result, it is possible to perform high-precision treatment by making a distinction between normal tissue and a lesion.

Furthermore, in the radiotherapy system of the present invention, the fine adjustment of the planned irradiation field is performed by moving the displayed line cone, so that the operability is excellent and the treatment plan can be set up more quickly. be able to.

[Brief description of drawings]

FIG. 1 is a schematic diagram of the overall configuration of a radiotherapy system according to an embodiment of the present invention.

FIG. 2 is a block diagram showing the overall electrical configuration of the embodiment.

FIG. 3 is a block diagram showing an outline of a CT system for radiation treatment planning.

FIG. 4 is a perspective view of a gantry showing a mounted state of a light projector for marking an isocenter.

FIG. 5 is a block diagram showing an electric circuit of the projector.

FIG. 6 is a block diagram showing an outline of a radiation treatment apparatus.

FIG. 7 is an explanatory diagram illustrating a multi-leaf type collimator.

FIG. 8 is a flowchart showing the overall flow of a treatment plan.

FIG. 9 is a flowchart showing the flow of a scano plan.

FIG. 10 is an explanatory diagram illustrating a scano plan.

FIG. 11 is an explanatory diagram illustrating a scano plan.

FIG. 12 is an explanatory diagram illustrating a scano plan.

FIG. 13 is an explanatory diagram illustrating a scano plan.

FIG. 14 is an explanatory diagram illustrating a scano plan.

FIG. 15 is an explanatory diagram illustrating a scano plan.

FIG. 16 is an explanatory diagram illustrating a scano plan.

FIG. 17 is an explanatory diagram illustrating a scano plan.

FIG. 18 is an explanatory diagram illustrating a scano plan.

FIG. 19 is a flowchart showing the flow of an oblique plan.

FIG. 20 is an explanatory diagram illustrating an oblique plan.

FIG. 21 is an explanatory diagram illustrating an oblique plan.

FIG. 22 is an explanatory diagram illustrating an oblique plan.

FIG. 23 is an explanatory diagram illustrating an oblique plan.

FIG. 24 is an explanatory diagram illustrating an oblique plan.

FIG. 25 is an explanatory diagram illustrating an oblique plan.

FIG. 26 is an explanatory diagram illustrating an oblique plan.

FIG. 27 is an explanatory diagram illustrating an oblique plan.

FIG. 28 is an explanatory diagram illustrating an oblique plan.

FIG. 29 is an explanatory diagram illustrating an oblique plan.

FIG. 30 is an explanatory diagram illustrating an oblique plan.

FIG. 31 is an explanatory diagram illustrating an oblique plan.

FIG. 32 is a flowchart showing the control of the collimator opening during treatment.

FIGS. 33A to 33C are explanatory views each illustrating a control mode for controlling the opening of a collimator.

[Explanation of symbols]

 1 CT system for radiation treatment planning (CT system) 2 Radiation treatment device (treatment device) 3 Transmission line 11 Gantry 12 Bed 12a Top plate 13 Console 27a, 27b, 27c Projector 28 Laser light source 29 Optical fiber 30 Moving mechanism 31 Illumination unit 40 Main control unit 41 Bed control unit 49 Projector controller 54 Consoler 55 Collimator 56 Leaf 60 Main control unit 64 Collimator control unit P Subject M1, M2, M3 Marker

Claims (16)

[Claims] 1. An X-ray CT scanner means for irradiating a subject with X-rays to obtain image data of a lesion, and an isocenter position for displaying the image data on a monitor and performing radiotherapy on the lesion. And a treatment planning means for creating treatment planning data including the shape of the irradiation field and a positioning means for automatically indicating the marking position of the subject based on the isocenter position data. C
A radiotherapy system comprising a T system and a radiotherapy apparatus for performing radiotherapy based on treatment plan data including shape data of a marker and an irradiation field attached to the marking position. 2. The X-ray CT scanner means and the positioning means share a bed on which the subject is placed, and the gantry used for X-ray exposure and transmitted X-ray detection of the X-ray scanner means is provided with the positioning means. The radiotherapy system according to claim 1, further comprising a floodlight for indicating a marking position. 3. The radiation treatment apparatus according to claim 1, wherein a pair of leaf groups, each of which comprises a plurality of leaves that can independently move forward and backward with respect to a radiation path, is arranged to face each other through the radiation path. The radiotherapy system according to claim 1, further comprising a double-sided collimator. 4. The treatment planning means makes a treatment plan including oblique angle information for irradiating a subject with radiation, and means for transferring the treatment plan including the oblique angle information to a radiation treatment apparatus. The radiotherapy system according to claim 1 or 3, further comprising means for automatically controlling the slew angle of the treatment table based on the oblique angle information. 5. A gantry for incorporating an X-ray tube and an X-ray detector into the diagnostic opening for performing X-ray irradiation on a subject, and a top plate on which the subject is placed in the opening. A radiotherapy plan including an X-ray CT apparatus main body having a bed that can be inserted into and retracted from the bed, and using the image acquired based on the detection data of the X-ray detector to make a radiotherapy plan for the lesion area of the subject. In the CT system for use, in the left and right sides and the upper part of the opening of the gantry and at three positions on the same plane orthogonal to the axial direction of the opening,
Separately, the projectors for projecting the point-marking optical marks toward the subject are installed, and the projecting ends of the two projectors on the left and right sides are moved in the vertical direction orthogonal to the axial direction. And a moving mechanism for moving the light projecting end of the upper projector in a lateral direction orthogonal to the axial direction, while indicating the position of the isocenter with respect to the lesion on the image three-dimensionally. And a control means for automatically controlling the positions of the projection end of the projector and the top plate so that the position of the isocenter designated by the designating means and the positions of the three light marks coincide with each other. A CT system for radiation treatment planning characterized by being provided. 6. The projector according to claim 5, wherein each of the projectors has a laser light source for outputting laser light and an optical fiber for guiding the laser light to the projecting end. The described CT system for radiation treatment planning. 7. The CT system for radiation treatment planning according to claim 5, wherein each of the light projectors also functions as a light projecting means when the X-ray CT apparatus main body is used as a normal X-ray CT scanner. 8. A mechanism capable of arranging each of the light projectors at a predetermined position or a predetermined height in the moving direction thereof, and the projectors installed on the left and right side portions of the gantry opening in the light projectors are arranged in the moving direction 8. The CT system for radiation treatment planning according to claim 7, further comprising a mechanism capable of rotating as a rotation axis. 9. An object obtained by irradiating a subject with X-rays, and an image obtained on the basis of the transmitted X-rays, including a shape of an irradiation field on the body surface necessary for radiotherapy of a lesion part of the subject. -A CT system for radiation treatment planning for creating a data storage, and a multi-leaf structure capable of narrowing the radiation emitted from a radiation source according to the shape of the irradiation field and independently driving a plurality of leaves. In a radiotherapy system including a radiotherapy apparatus having a collimator built-in, opening data creating means for creating opening data by the plurality of leaves matching the shape of the irradiation field, and the opening data creating means Aperture control means for controlling the diaphragm positions of the plurality of leaves of the collimator based on the produced aperture data, and the aperture data producing means is such that the ends of the plurality of leaves are irradiated with the irradiation. Outline of the field Means for selecting any one of the circumscribing mode, the inscribing mode, and the mode in which the contour intersects the midpoint of the end, and the opening data according to the selection mode. A radiation therapy system comprising: 10. The radiotherapy system according to claim 9, wherein the aperture data creating means is provided in the radiotherapy planning CT system. 11. A radiotherapy in which a subject is exposed to X-rays and treatment plan data necessary for radiotherapy of a lesion of the subject is created on an image obtained based on the transmitted X-rays. In the planning CT system, a first planning unit that creates the treatment planning data using at least one scanogram and one axial image obtained based on the transmitted X-rays, and the based on the transmitted X-rays. A second step of creating the treatment plan data by using the plurality of axial images obtained and the at least one scano image or an alternative image thereof and the image obtained by processing the data of the plurality of axial images; Planning means, and the first and second
A CT system for radiation treatment planning, comprising: a selecting unit capable of arbitrarily selecting the planning unit described above. 12. The first planning means determines a shape of an isocenter of a target region surrounding the lesion and an irradiation field on the subject based on the scanogram and the axial image, and the axial means. The CT system for radiation therapy planning according to claim 11, further comprising means for confirming a ray cone when it is assumed that radiation is emitted from a given radiation source position through the irradiation field based on an image. 13. The second planning means determines means for isocenter of a target region surrounding the lesion based on at least one of the plurality of axial images and a scano image or an alternative image thereof, A means for creating a transmission image when it is assumed that the target region is irradiated with radiation from a virtual radiation source placed at an arbitrary radiation source position based on the plurality of axial images; A means for determining the shape of the irradiation field on the subject based on the shape of the target region, and a section parallel to the virtual radiation source and the isocenter determined based on the plurality of axial images. The means for creating a target image, the means for confirming the irradiation field on the target image, and the means for confirming the ray cone of the radiation on the plurality of axial images. CT system for radiation therapy planning. 14. A radiotherapy in which a subject is exposed to X-rays, and treatment plan data necessary for radiotherapy of a lesion of the subject is created on an image obtained based on the transmitted X-rays. In the planning CT system, a plurality of axial images obtained based on the transmitted X-rays and at least one scano image or an alternative image thereof are processed by processing the data of the plurality of axial images. A planning means for creating the treatment planning data by using the planning means is provided, wherein the planning means is based on at least one of the plurality of axial images and a scano image or an alternative image thereof, and an isocenter of a target region surrounding the lesion. Based on the means for determining − and the plurality of axial images, it is assumed that the target region is irradiated with radiation from a virtual radiation source placed at an arbitrary radiation source position. Means for creating a transmission image, means for determining the shape of the irradiation field on the subject based on the shape of the target area on the transmission image, and the virtual radiation source based on the plurality of axial images And means for creating a target image parallel to the cross section determined corresponding to the isocenter, means for confirming the irradiation field on the target image, and the pyramid of the radiation for confirming the radiation cones on the plurality of axial images. The CT system for radiation treatment planning according to claim 13, further comprising means. 15. A radiotherapy in which a subject is exposed to X-rays, and treatment plan data necessary for radiotherapy of a lesion of the subject is created on an image obtained based on the transmitted X-rays. In the planning CT system, a plurality of axial images obtained based on the transmitted X-rays and at least one scano image or an alternative image thereof are processed by processing the data of the plurality of axial images. It comprises a planning means for creating the treatment plan data including the radiation field from the irradiation field on the subject and the virtual radiation source, and the planning means, means for displaying the created pyramid, In response to a change in the displayed position of the pyramid by a manual input device, there is provided a means for changing the shape of the irradiation field by an amount corresponding to the change. Temu. 16. Radiation for performing radiation treatment by narrowing radiation emitted from a radiation source to a desired irradiation field with a multileaf type collimator and irradiating the focused radiation to a subject placed on a treatment table. At least one of the collimator and the treatment table based on at least one of the control data of the opening degree of the collimator and the control data of the slew angle of the treatment table given from the outside of the radiation treatment apparatus in the treatment apparatus. A radiation treatment apparatus comprising control means for automatically controlling the radiation treatment.