KR102403650B1 - System for inducing respiration - Google Patents

Abstract

An embodiment of the present invention generates a medical image generating unit including a hollow for taking a medical image of a patient, a moving table movable into the hollow of the medical image generating unit, and a breathing image including a guide respiration signal to the patient It provides a breathing guidance system having a respiration image generating unit, a screen member disposed to be spaced apart from the hollow inner wall and a projection member for projecting the respiration image to the screen member.

Description

System for inducing respiration

Embodiments of the present invention relate to breathing guidance systems.

One of the important factors to keep in mind during 4D radiation therapy or breathing-controlled radiation therapy for a patient is that it should be done under the premise that long-term movement is constant during radiation therapy. There may be various types of exercise factors that affect the movement of organs in the human body, but among them, maintaining consistent breathing is a very important factor in radiation therapy.

Radiation therapy using a medical radiation therapy device may be the most important factor to intensively irradiate radiation to the tumor site and deliver a minimum dose to surrounding normal tissues. In particular, in radiation therapy for a moving organ, a technique for controlling a beam according to a change in the geometrical movement of an organ that occurs during radiation treatment is indispensable.

Although several devices are used to achieve the preconditions related to breathing during radiation therapy as described above, most of these devices use only guide signals so that the patient cannot check the patient's own breathing state, and breathe only as intuitively as practiced. there is a situation.

To this end, the conventional radiation therapy technology mainly uses a gating method for controlling and treating a medical radiation therapy device using a real-time position management (RPM) system. However, the success or failure of the treatment of this technology lies in the stability of the respiration of the radiation therapy patient, and there is a problem that the respiration synchronization radiation treatment of the patient with unstable respiration requires a long treatment time. In addition, since the RPM system is applied to respiration synchronization radiation therapy by setting the phase of respiration with only the respiration cycle, there is no consideration of respiration pattern or respiration volume, so the accuracy of treatment is very poor.

In particular, body stereotaxic radiation therapy for moving organs has a significantly longer treatment time compared to other radiation therapy and the risk of side effects can also be very large. things become more important.

In addition, in the case of radiation therapy patients with liver or lung-related diseases, it is actually very difficult to maintain a stable respiratory cycle and respiratory rate, so the respiratory synchronization radiation therapy technology, which requires irradiation only in a stable breathing state, can be applied to patients with liver disease or When applied to lung disease patients, the practical necessity that an auxiliary device for breathing is essential is constantly being raised.

The above-mentioned background art is technical information that the inventor possessed for the derivation of the present invention or acquired in the process of derivation of the present invention, and cannot necessarily be said to be a known technique disclosed to the general public prior to the filing of the present invention.

Embodiments of the present invention in a system for inducing regular breathing of a patient during radiation therapy, to provide a breathing induction system capable of inducing stable breathing by using a transparent screen to minimize the feeling of closure of the patient in the gantry.

An embodiment of the present invention generates a medical image generating unit including a hollow for taking a medical image of a patient, a moving table movable into the hollow of the medical image generating unit, and a breathing image including a guide respiration signal to the patient It provides a breathing guidance system having a respiration image generating unit, a screen member disposed to be spaced apart from the hollow inner wall and a projection member for projecting the respiration image to the screen member.

In one embodiment of the present invention, the screen member may be made of a transparent material.

In one embodiment of the present invention, the screen member is made of a transparent material and has a base portion having a constant first radius of curvature in a concave shape toward the moving table, and a hologram film attached to one surface of the base portion. can do.

In an embodiment of the present invention, the hollow inner wall may have a constant second radius of curvature, and the first radius of curvature may be equal to or greater than the second radius of curvature.

In an embodiment of the present invention, a fixing member connecting the screen member and the moving table may be further provided so that the screen member is fixed at a predetermined distance from the moving table.

In one embodiment of the present invention, an imaging unit for capturing a respiration image of the patient, a respiration signal conversion unit for obtaining a respiration signal of the patient by image processing and tracking analysis of the respiration image of the patient obtained from the imaging unit, and Determining at least one of whether the acquired respiration signal is respiration suitable for radiation treatment, whether the obtained respiration signal is stable, and whether the matching score between the patient's respiration signal and the guide respiration signal is greater than or equal to a predetermined reference value Further comprising a respiration determination unit, the respiration image generating unit may generate the respiration image including the respiration signal of the patient obtained from the respiration signal conversion unit, and the guide respiration signal.

In one embodiment of the present invention, the respiration determination unit, the respiration signal obtained from one or more of information of a respiration cycle (period), respiration size (amplitude), and shape of respiration (pattern) of the obtained respiration signal is radiotherapy It can be determined whether breathing is suitable for

In one embodiment of the present invention, the respiration image generation unit may generate the respiration image by obtaining the respiration signal of the patient and corresponding to the guide respiration signal in real time.

Other aspects, features and advantages other than those described above will become apparent from the following drawings, claims, and detailed description of the invention.

Respiratory induction system according to embodiments of the present invention may project a respiration image on a transparent screen member in order to minimize the feeling of closure of the patient located in the hollow. At this time, since the screen member has a hologram film attached to it even though the base part is made of a transparent material, it is possible to project the breathing image emitted from the projection member clearly. Respiratory induction system according to an embodiment of the present invention can control its own respiration through a respiration image, it is possible to secure stability in the radiation treatment process.

1 is a conceptual diagram schematically illustrating a breathing induction system according to an embodiment of the present invention.
2 and 3 are views for explaining the screen member of FIG.
FIG. 4 is a view for explaining a method for generating a breathing image by the breathing image generating unit of FIG. 1 .
5 is a view illustrating an embodiment in which a breathing image is provided to the screen member of FIG. 1 .

Since the present invention can apply various transformations and can have various embodiments, specific embodiments are illustrated in the drawings and described in detail in the detailed description. Effects and features of the present invention, and a method for achieving them will become apparent with reference to the embodiments described below in detail in conjunction with the drawings. However, the present invention is not limited to the embodiments disclosed below and may be implemented in various forms.

Hereinafter, embodiments of the present invention will be described in detail with reference to the accompanying drawings, and when described with reference to the drawings, the same or corresponding components are given the same reference numerals, and the overlapping description thereof will be omitted. .

In the following embodiments, terms such as first, second, etc. are used for the purpose of distinguishing one component from another, not in a limiting sense.

In the following examples, the singular expression includes the plural expression unless the context clearly dictates otherwise.

In the following embodiments, terms such as include or have means that the features or components described in the specification are present, and the possibility that one or more other features or components will be added is not excluded in advance.

In the following embodiments, when it is said that a part such as a film, region, or component is on or on another part, not only when it is directly on the other part, but also another film, region, component, etc. is interposed therebetween. Including cases where there is

In the drawings, the size of the components may be exaggerated or reduced for convenience of description. For example, since the size and thickness of each component shown in the drawings are arbitrarily indicated for convenience of description, the present invention is not necessarily limited to the illustrated bar.

In cases where certain embodiments may be implemented otherwise, a specific process sequence may be performed different from the described sequence. For example, two processes described in succession may be performed substantially simultaneously, or may be performed in an order opposite to the order described.

In the following embodiments, when a film, region, or component is connected, other films, regions, and components are interposed between the films, regions, and components as well as when the films, regions, and components are directly connected. and indirectly connected. For example, in the present specification, when it is said that a film, a region, a component, etc. are electrically connected, not only the case where the film, a region, a component, etc. are directly electrically connected, other films, regions, components, etc. are interposed therebetween. Indirect electrical connection is also included.

1 is a conceptual diagram schematically illustrating a breathing induction system 10 according to an embodiment of the present invention, and FIGS. 2 and 3 are views for explaining the screen member 140 of FIG. 1 . 4 is a view for explaining a method for the breathing image generating unit 130 of FIG. 1 to generate a breathing image, FIG. 5 shows an embodiment in which a breathing image is provided to the screen member 140 of FIG. It is a drawing.

1 to 3 , the respiratory induction system 10 according to an embodiment of the present invention includes a medical image generating unit 110 , a moving table 120 , a breathing image generating unit 130 , and a screen member 140 . ) and a projection member 150 may be provided. This will be described in more detail as follows.

In detail, with the development of radiation therapy technologies such as radiosurgery, intensity-controlled radiation therapy, and image-guided radiation therapy, it is possible to deliver a minimal dose to normal tissues around the target and to intensively irradiate most of the dose to the tumor site. it was done On the other hand, radiation therapy for tumors in the lungs, liver, and abdomen affected by respiratory movements is also continuously increasing.

However, in radiation therapy of organs that have movement due to respiration, such as the lungs and liver, precision and accuracy in terms of radiation delivery technology are deteriorated due to movement of the treated organ, so it is not possible to concentrate the radiation dose to a desired place, or the radiation dose to an unwanted place There are limitations to the investigation. To overcome this, in the field of radiation therapy, radiation therapy is performed using a four-dimensional breathing synchronization method.

The success or failure of breathing-tuned radiation therapy lies in controlling the beam according to the change in the geometrical movement of the organ during or between treatments. In particular, in the case of particle beam radiation therapy, which has recently been in the spotlight, the introduction of breathing-controlled radiation therapy is indispensable because it is greatly affected by the change in radiation dose due to the movement of the treatment organ compared to conventional therapy. For this purpose, the conventional radiation therapy technology uses a gating method that tracks only the movement of an in vitro marker based on a linear accelerator, and in this method, breathing is synchronized using a Real-time Position Management (RPM) system.

However, the success or failure of the treatment of this technology lies in the breathing stability of the radiation therapy patient, and there is a problem that the respiratory synchronization radiation therapy of the patient with breathing unstable takes longer treatment time. In particular, since body stereotaxic radiotherapy and body radiosurgery have a very long treatment time, it is very important to educate the patient and practice breathing so as to have a regular and stable respiration cycle and respiration volume during radiotherapy.

In addition, when establishing a treatment plan for conventional radiation therapy, a still image is used. However, due to the movement of internal organs by breathing in the patient during radiation therapy, the planned three-dimensional dose distribution is distributed differently from the plan, and this is partially offset by the conventional breathing synchronization method. However, if the breathing regularity of a patient who is to be treated with respiratory radiation therapy is not good, radiation therapy for organs due to movement has a worse effect.

In order to solve this problem, in the respiratory induction system according to an embodiment of the present invention, radiation therapy is performed while acquiring an image of a region of interest in real time using medical imaging equipment, and regular breathing of the patient during radiation treatment A system for inducing

In this case, the medical image generating unit 110 may include a hollow (A) for taking a medical image of the patient. Here, the medical images are magnetic resonance imaging (MRI), positron emission tomography (PET), computed tomography (CT), linear accelerator (LINAC), and tomotherapy (Tomo). It may be an image acquired through medical equipment such as therapy).

The above-described medical equipment is further provided with a display device in the hollow (A) in order to provide a breathing image to the patient in a state in which the patient enters a certain hollow (A) for imaging. However, when such a display device is additionally disposed within the hollow (A), the patient may feel more closed to the narrow space, which may cause anxiety, which may make it difficult to breathe stably. Respiratory induction system according to an embodiment of the present invention uses a transparent screen member 140 to be described later to minimize the feeling of closure in the patient entering the hollow (A) of the medical image generating unit 110, inducing stable breathing function can be performed. Hereinafter, for convenience of explanation, a case where the medical image is a magnetic resonance image (MRI) will be mainly described.

The medical image generator 110 may include a hollow A to which a magnetic field for magnetic resonance imaging (MRI) imaging is applied. The hollow (A) may have a cylindrical shape with an empty inner space. The medical image generator 110 may include a gantry surrounding the hollow A, and may include a static magnetic field coil and a gradient coil disposed to surround the hollow A inside the gantry. .

The movement table 120 may be movable into the hollow A of the medical image generating unit 110 . The moving table 120 may include a treatment table 123 on which the patient is placed and a guide stand 121 for guiding the treatment table 123 into or out of the hollow (A).

Meanwhile, referring to FIGS. 1 and 4 , the breathing image generating unit 130 may generate a breathing image including a guide breathing signal to the patient.

As an embodiment, the respiration image generator 130 may generate a respiration image used for simulation treatment performed before respiration tuning radiation therapy. Respiratory image generating unit 130 provides a general guide signal in the form of a sine to the patient for breathing training of the patient during simulated treatment. Based on this, basic elements related to respiration, such as the patient's respiration cycle and respiration size, are measured. At this time, since the breathing pattern is different for each patient, the optimal breathing pattern for each patient is found by analyzing the measured breathing data. In addition, self-breathing practice will be performed with the elements of the measured and analyzed respiration. After breathing practice using the guide signal obtained using the patient's individual breathing elements, it is determined whether the patient is breathing stably through comparative analysis with the measured patient's breathing signal. At this time, when the matching score between the guide breathing and the actual patient's breathing is less than or equal to the reference value, the breathing element of the individual patient is analyzed again to determine an appropriate breathing induction signal again.

At this time, when it is determined that the patient is breathing stably, the patient is provided with an interface showing the guide signal and the currently acquired breathing signal of the patient. At this time, a guide signal similar to that of the initial patient is provided as much as possible so that the patient can breathe regularly while keeping an eye on the eye tracking point displayed on the monitor. In this way, the patient's breathing signal and guide signal acquired through image processing and tracking analysis are provided to the patient in real time. The patient's respiratory signal obtained at this time is used as basic data to determine whether breathing is suitable for breathing-tuned radiation therapy when establishing a respiratory-tuned radiation treatment plan. If, when establishing a treatment plan, it is judged that it is not suitable for respiratory synchronization radiation therapy due to the geometric structure with other organs, the patient re-establishes appropriate respiratory factors through respiratory synchronization simulation therapy. On the contrary, when it is determined as an appropriate therapeutic respiration factor, the operator determines the optimal respiration synchronization gating window based on the patient's respiration factor provided during simulation.

As another embodiment, the respiration image generating unit 130 provides a patient-specific guide signal and the current respiration state to the patient in real time even during respiration tuning radiation therapy, and through this, regular breathing of the radiation therapy patient is induced. In addition, during respiratory synchronization radiation therapy, matching with breathing during simulation is analyzed in real time through the present invention during simulated treatment, and it is possible to continuously observe in real time whether the patient's breathing is made within the gating window. If the patient's breathing during simulated treatment is different from the actual treatment, or if the patient does not breathe within the gating window, the beam off alarm is turned on for the worker and the treatment patient, so it is not an appropriate situation. will inform In this case, the beam is automatically terminated or the beam is manually terminated by an operator.

Respiratory induction system 10 according to an embodiment of the present invention may further include an imaging unit 183, a respiration signal conversion unit 185, a respiration determination unit 187 to perform such a role. Hereinafter, each component performing such a role will be described in more detail.

First, the respiration signal conversion unit 185 acquires a respiration signal by image processing and tracking analysis of the respiration image of the patient acquired by the imaging unit 183 . To this end, a predetermined marker 181 may be disposed on the chest or abdomen of the patient, and the movement of the marker 181 among the breathing images of the patient acquired by the imaging unit 183 is image-processed and traced to analyze the breathing signal. can be obtained At this time, the patient's respiration signal (patient signal) obtained by the respiration signal conversion unit 185 may be displayed on the screen member 140 to be described later in the form of a sine wave.

The respiration determination unit 187 serves to determine whether the patient's respiration signal is respiration suitable for radiation treatment, whether the respiration of the patient is stable, and whether the matching score between respiration and guide respiration of the patient is greater than or equal to a predetermined reference value. .

First, the respiration determination unit 187 may determine whether the respiration signal obtained from the respiration signal conversion unit 185 is respiration suitable for radiation therapy. In detail, the respiration determination unit 187 is the obtained respiration cycle (period), respiration size (amplitude), shape (pattern) of respiration, etc., the regularity of respiration and the obtained respiration signal to the radiation treatment. Determine whether breathing is adequate. That is, if the patient's breathing cycle is too long or short, the patient's breathing size is too large or too small, or the shape of the breathing is irregular, it can be determined that the acquired breathing signal is not suitable for radiation therapy. .

Next, the respiration determination unit 187 may determine whether the matching score between the respiration signal and the guide respiration obtained from the respiration signal conversion unit 185 is greater than or equal to a predetermined reference value. That is, if the difference between the guide breathing and the patient's breathing for a certain period of time is within a certain standard, even if the patient's breathing is not stable for a while, it is determined that the patient's breathing is being made stably when viewed as a whole. You can have the patient perform self-breathing exercises according to the guided breathing pattern of On the other hand, if the difference between the guide breathing and the patient's breathing for a certain period of time deviates from a certain standard, it is determined that the stored guide breathing and the patient's breathing do not match, and a new breathing pattern suitable for the individual patient can be provided as a guide breathing. have.

In addition, the respiration determination unit 187 may determine whether the acquired patient's respiration signal is stable. That is, the respiration determination unit 187 determines whether the initially measured respiration of the patient is maintained stably. And, when the acquired breathing signal is maintained stably, the current breathing pattern is stored as the patient's breathing pattern, whereas, when the acquired breathing signal is not stable, the new breathing pattern can be stored as the patient's breathing pattern.

Thereafter, the respiration image generating unit 130 may serve to generate a respiration image including a guide respiration signal to the patient and provide it to the projection member 150 so that the patient can maintain stable respiration. In addition, the respiration image generating unit 130 may generate a respiration image including the respiration signal and the guide respiration signal of the patient acquired by the respiration signal conversion unit 185. As an embodiment, the respiration image generating unit 130 may generate a respiration image by acquiring the patient's respiration signal and matching it with the guide respiration signal in real time. In other words, the respiration image generating unit 130 is a predetermined guide respiration signal in the form of a sine wave to the patient through the projection member 150 and the screen member 140 and the respiration signal of the patient obtained from the respiration signal conversion unit 185 By providing it together, it can serve to guide the patient so that he or she can control his or her breathing according to the guide signal.

Hereinafter, the projection member 150 and the screen member 140 for providing the respiration image to the patient will be described in detail.

Referring back to FIGS. 1 to 3 , the screen member 140 may be disposed to be spaced apart from the hollow inner wall PA. As shown in FIG. 2 , the screen member 140 may be made of a transparent material. Specifically, the screen member 140 is made of a transparent material and has a base portion 141 concave toward the moving table 120 and a hologram film 143 attached to one surface of the base portion 141 . can be provided. For example, the base part 141 may be made of an acrylic material, a polyethylene terephthalate (PET) material, or a polypropylene (PP) material.

Here, the hologram film 143 may be a film for projecting the breathing image emitted from the projection member 150 can be visually recognized from the outside. The hologram film 143 may be formed by being attached to or coated on one surface of the base part 141 . The hologram film 143, like the base part 141, may be made of a transparent material. Respiratory induction system 10 according to an embodiment of the present invention by providing a breathing image to the patient through the screen member 140 of a transparent material, while minimizing the feeling of closure of the patient located in the hollow (A) induces stable breathing can do.

As shown in FIG. 3 , the base part 141 may have a first radius of curvature R1 that is constant in a concave shape toward the moving table 120 . Since the screen member 140 is formed in a concave shape toward the patient positioned on the moving table 120 , the patient can easily view the respiration image. On the other hand, the hollow (A) is formed in a cylindrical shape, the inner wall of the hollow (A) may have a constant second radius of curvature (R2) in a concave shape toward the center (O2) of the hollow.

In this case, the first radius of curvature R1 may be equal to or greater than the second radius of curvature R2 . Through this, the screen member 140 has a smoother curved surface than the inner wall PA of the hollow (A). Since the patient looks at the breathing image through the screen member 140 having a smoother curved surface than the hollow (A), the patient who enters the hollow (A) for radiation treatment is projected on the inner wall (PA) of the hollow (A) It is possible to secure a more open view than looking at the breathing image.

Meanwhile, the screen member 140 may be fixed to one side of the moving table 120 through the fixing member 160 . The fixing member 160 may connect the screen member 140 and the moving table 120 to be fixed by being spaced apart from the moving table 120 by a predetermined distance. The fixing member 160 is formed to adjust the position of the screen member 140 . For example, although not shown, the fixing member 160 may be formed of a female member connected to a plurality of joints.

The optimal viewing distance for a breathing image varies for each patient depending on the patient's visual acuity or body structure. can be formed, which can cause discomfort to the patient. Respiratory induction system 10 according to an embodiment of the present invention by adjusting the position of the screen member 140, that is, the height or angle of the screen member 140 to suit the characteristics of the patient through the fixing member 160, hollow In (A), it allows the patient to more comfortably check the breathing image.

The projection member 150 may project a breathing image to the screen member 140 described above. The projection member 150 may be a beam projector, for example, a hologram projector for emitting a holographic image. As shown in FIG. 1 , the projection member 150 is fixed to the other side of the moving table 120 and can move into the hollow A together with the moving table 120 . However, the present invention is not limited thereto, and the projection member 150 may be fixedly disposed in the hollow A of the medical image generating unit 100 rather than the moving table 120 .

The projection member 150 may project the respiration image generated from the respiration image generating unit 130 together with a preset background image. The background image may be an image having a sense of perspective. In other words, the projection member 150 provides a background image with perspective when the patient looks at the breathing image in the hollow (A), thereby making the space of the hollow (A) feel more expanded than it actually is. can Through this, the patient can minimize the feeling of closure felt when positioned in the hollow (A).

Referring to FIG. 5 , the respiratory induction system 10 according to an embodiment of the present invention may project a respiration image on the transparent screen member 140 in order to minimize the feeling of closure of the patient located in the hollow. At this time, the screen member 140 has a hologram film attached to it even though the base part 141 is made of a transparent material, so that it is possible to project the breathing image emitted from the projection member 150 clearly. Respiratory induction system according to an embodiment of the present invention can control its own respiration through a respiration image, it is possible to secure stability in the radiation treatment process.

In addition, the respiratory induction system 10 according to an embodiment of the present invention enables the construction of a patient education system for inducing stable and regular respiration during respiratory tuning radiation simulation treatment or actual treatment. In addition, by displaying a feedback signal using the screen member to the patient, it is possible to obtain the effect of more stable and regular breathing induction.

Therefore, the spirit of the present invention should not be limited to the above-described embodiments, and the scope of the spirit of the present invention is not limited to the scope of the scope of the present invention. will be said to belong to

10: Respiratory guidance system
110: medical image generation unit
120: moving table
130: breathing image generation unit
140: screen member
150: projection member
160: fixing member

Claims (8)

A medical image generating unit including a hollow for taking a medical image of a patient;
a movable table movable into the hollow of the medical image generating unit;
Respiratory image generation unit for generating a respiration image including a guide respiration signal to the patient;
a screen member spaced apart from the hollow inner wall; and
and a projection member for projecting the breathing image to the screen member;
The screen member is a breathing induction system made of a transparent material.
delete According to claim 1,
The screen member is made of a transparent material and having a base portion having a constant first radius of curvature in a concave shape toward the moving table, and a hologram film attached to one surface of the base portion, the breathing induction system. 4. The method of claim 3,
The hollow inner wall has a constant second radius of curvature,
The first radius of curvature is equal to or greater than the second radius of curvature, breathing guidance system. According to claim 1,
Further comprising; a fixing member connecting the screen member and the moving table so that the screen member is fixed at a predetermined distance from the moving table. According to claim 1,
an imaging unit for taking a breathing image of the patient;
Respiratory signal conversion unit for obtaining the patient's respiration signal by image processing and tracking analysis of the respiration image of the patient obtained from the imaging unit; and
Determining at least one of whether the acquired respiration signal is respiration suitable for radiation treatment, whether the obtained respiration signal is stable, and whether the matching score between the patient's respiration signal and the guide respiration signal is greater than or equal to a predetermined reference value Respiratory determination unit; further comprising,
The respiration image generation unit for generating the respiration image including the respiration signal of the patient and the guide respiration signal obtained from the respiration signal conversion unit, a respiration induction system. 7. The method of claim 6,
The respiration determination unit,
Respiratory induction system that determines whether the acquired respiratory signal is respiration suitable for radiation therapy from one or more of the information of the respiratory cycle (period), respiration amplitude (amplitude), and shape of respiration (pattern) of the acquired respiration signal. 7. The method of claim 6,
The breathing image generating unit,
Respiratory induction system for generating the respiration image by acquiring the patient's respiration signal and corresponding to the guide respiration signal in real time.

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