WO2015189943A1 - Fluoroscope à rayons x - Google Patents

Fluoroscope à rayons x Download PDF

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Publication number
WO2015189943A1
WO2015189943A1 PCT/JP2014/065544 JP2014065544W WO2015189943A1 WO 2015189943 A1 WO2015189943 A1 WO 2015189943A1 JP 2014065544 W JP2014065544 W JP 2014065544W WO 2015189943 A1 WO2015189943 A1 WO 2015189943A1
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WO
WIPO (PCT)
Prior art keywords
ray
subject
ray detector
detector
fluoroscopic
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PCT/JP2014/065544
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English (en)
Japanese (ja)
Inventor
唯 鳥越
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株式会社島津製作所
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Priority to PCT/JP2014/065544 priority Critical patent/WO2015189943A1/fr
Publication of WO2015189943A1 publication Critical patent/WO2015189943A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/08—Auxiliary means for directing the radiation beam to a particular spot, e.g. using light beams

Definitions

  • This invention relates to an X-ray fluoroscope.
  • Radiation that includes a head that irradiates a therapeutic beam and a gantry that rotates the head about the subject, and performs radiation therapy by irradiating the affected area such as a tumor with a therapeutic beam such as an X-ray or an electron beam
  • a therapeutic beam such as an X-ray or an electron beam
  • the subject may move the body, but the affected part itself may move.
  • a tumor near the lung moves greatly based on respiration.
  • a radiotherapy apparatus having a configuration in which a gold marker is arranged near a tumor, the position of the marker is detected by an X-ray fluoroscope, and irradiation of therapeutic radiation is controlled (Patent Document). 1).
  • an X-ray fluoroscopy device is used to identify the position of the marker by seeing through an image including the marker placed in the body of the subject.
  • a first X-ray fluoroscopic mechanism comprising a first X-ray tube that irradiates X-rays from the floor side and a first X-ray detector that detects X-rays passing through the subject from the ceiling side.
  • a second X-ray fluoroscopy mechanism comprising a second X-ray tube for irradiating X-rays from the floor side and a second X-ray detector for detecting X-rays passing through the subject from the ceiling side. The detected marker is detected.
  • three-dimensional position information is obtained using a two-dimensional fluoroscopic image by the first X-ray fluoroscopic mechanism and a two-dimensional fluoroscopic image by the second X-ray fluoroscopic mechanism.
  • the present invention has been made to solve the above-described problems, and an object thereof is to provide an X-ray fluoroscopy device that can easily recognize an X-ray fluoroscopic region.
  • a table on which the subject is placed an X-ray tube that emits X-rays from below toward the subject on the table, and the subject that is irradiated from the X-ray tube
  • An X-ray detector that detects X-rays that have passed, a moving mechanism that moves the X-ray tube and the X-ray detector in a state of facing each other via the subject, and the X-ray detector side To the X-ray tube direction, and a light source that emits visible light for displaying an X-ray fluoroscopic region.
  • the light source is attached to the X-ray detector.
  • the light source is disposed on the outer peripheral portion of the X-ray detector, and displays the outer peripheral region of the X-ray irradiation field by irradiating visible light toward the focal point of the X-ray tube. .
  • the X-ray detector is a flat panel detector or an image intensifier, and the light source is disposed on the outer periphery of the X-ray detector.
  • a radiation treatment is performed by irradiating a therapeutic beam to the subject, comprising a head that irradiates a therapeutic beam, and a gantry that rotates the head around the subject. It is used together with a radiotherapy apparatus and sees through an area including an irradiation area of the treatment beam with respect to the subject.
  • a template matching unit that specifies the position of the marker or the specific part in the continuously collected images
  • the X-ray fluoroscopic region can be easily understood based on the visible light emitted from the light source. If the X-ray axis from the X-ray tube to the X-ray detector interferes with the head for irradiating the treatment beam, this can be easily recognized, and X-ray fluoroscopy is performed appropriately. It becomes possible to do.
  • FIG. 1 is a perspective view of a radiotherapy apparatus to which an X-ray fluoroscopic apparatus according to the present invention is applied. It is explanatory drawing which shows rocking
  • FIG. 3 is a side view showing a state in which an X-ray fluoroscopic region E is displayed by a laser light source 5.
  • FIG. It is a perspective view which shows the state which displays X-ray fluoroscopic area
  • FIG. It is explanatory drawing which shows the state which performs the irradiation of the treatment beam B with respect to the subject 57, and X-ray fluoroscopy simultaneously.
  • FIG. 3 is a perspective view showing a state in which an X-ray fluoroscopic region E is displayed by a laser light source 7.
  • FIG. 3 is a perspective view showing a state in which an X-ray fluoroscopic region E is displayed by a laser light source 8 attached to a ceiling 100.
  • FIG. 1 is a perspective view of a radiotherapy apparatus to which an X-ray fluoroscopic apparatus according to the present invention is applied.
  • FIG. 2 is an explanatory diagram showing the swinging operation of the head 55 and the head support portion 54 in the radiotherapy apparatus.
  • This radiotherapy apparatus is for performing radiotherapy by irradiating the affected part of a subject 57 lying on a table 56 with radiation such as X-rays or electron beams, and on the floor surface 51 of the treatment room.
  • a gantry 53 installed on the head, a head support 54 that swings about an axis that faces the gantry 53 in the horizontal direction, and a head support 54 that is supported by the head support 54 to irradiate the subject 57 with radiation.
  • the head 55 is provided. The head 55 can irradiate the affected part of the subject 57 with radiation from various angles by the swinging motion of the head support part 54.
  • the two-dimensional fluoroscopy obtained by the first X-ray fluoroscopy mechanism and the second X-ray fluoroscopy mechanism is obtained by continuously fluoroscopying the marker embedded in the body using the first X-ray fluoroscopy mechanism and the second X-ray fluoroscopy mechanism.
  • the marker is detected with high accuracy by calculating the three-dimensional position information of the marker from the image. Note that markerless tracking that uses an image instead of a marker at a specific site such as a tumor in the subject may be employed instead of placing a marker near the affected area in the subject.
  • An X-ray fluoroscopic apparatus for performing such fluoroscopy includes a first X-ray fluoroscopic mechanism including a first X-ray tube 1a and a first X-ray detector 2a, a second X-ray tube 1b, and a second X-ray.
  • the second X-ray fluoroscopic mechanism comprising the detector 2b, and the first X-ray tube 1a and the first X-ray detector 2a are moved to a first fluoroscopic position and a second fluoroscopic position, which will be described later, arranged opposite to each other, And a moving mechanism for moving the second X-ray tube 1b and the second X-ray detector 2b to a first fluoroscopic position and a second fluoroscopic position that are arranged to face each other.
  • a flat panel detector (FPD) is used as the first X-ray detector 2a and the second X-ray detector 2b.
  • the first X-ray tube 1a is supported by the first pedestal 3a for the X-ray tube.
  • the second X-ray tube 1b is supported by the second pedestal 3b for X-ray tubes.
  • a first rail 21 for a substantially U-shaped X-ray tube in which two linear portions are connected by a connecting portion including an arc portion, and for this X-ray tube Similar to the first rail 21, a substantially U-shaped second rail 22 for an X-ray tube is provided in which two straight portions are connected by a connecting portion including an arc portion.
  • the first rail 21 for X-ray tube and the second rail 22 for X-ray tube are arranged in parallel to each other.
  • the X-ray tube first pedestal 3a and the X-ray tube second pedestal 3b are guided by the first rail 21 and the second rail 22 for the X-ray tube, and will be described later in a first see-through position and a second see-through position. Move to.
  • first X-ray detector 2a is supported by the first pedestal 4a for X-ray detectors.
  • the second X-ray detector 2b is supported by the second pedestal 4b for X-ray detectors.
  • a first rail 11 for a substantially U-shaped X-ray detector in which two linear portions are connected by a connecting portion including an arc portion, and two similar to the first rail 11 for the X-ray detector.
  • the first rail 11 for the X-ray detector and the second rail 12 for the X-ray detector are arranged in parallel to each other.
  • first pedestal 4a for X-ray detectors and the second pedestal 4b for X-ray detectors are guided by the first rail 11 and the second rail 12 for these X-ray detectors, and a first see-through position and a first position described later. 2 Move to the fluoroscopic position.
  • the recess formed in the floor 51 is covered with a lid member that constitutes a part of the floor. For this reason, the 1st X-ray detector 2a and the 2nd X-ray detector 2b will be arrange
  • the first X-ray tube 1 a, the second X-ray tube 1 b, the first X-ray detector 2 a, and the second X-ray detector 2 b are disposed at the first fluoroscopic position and the second fluoroscopic position, respectively. It is explanatory drawing which shows the state made.
  • This X-ray fluoroscopic apparatus has a configuration in which the subject 57 is seen through from two different directions at three preset positions.
  • FIG. 3 shows a state in which the first X-ray tube 1a, the second X-ray tube 1b, the first X-ray detector 2a, and the second X-ray detector 2b see through the subject 57 from two different directions at the first position.
  • FIG. 4 shows that the first X-ray tube 1a, the second X-ray tube 1b, the first X-ray detector 2a, and the second X-ray detector 2b move the subject 57 from two different directions in the second position.
  • FIG. 5 shows a state of seeing through, and FIG.
  • FIG. 5 shows that the first X-ray tube 1a, the second X-ray tube 1b, the first X-ray detector 2a, and the second X-ray detector 2b are different from each other in the subject 57 at the third position. The state seen through from two directions is shown.
  • the X-ray fluoroscopic apparatus has a configuration in which the subject 57 is seen through from two different directions at three positions, and therefore, as shown in FIG. Even when the person 57 is irradiated with radiation from various angles, X-ray fluoroscopy can be performed without hindering the movement of the head 55.
  • the first X-ray tube 1a and the second X-ray tube 1b, and the first X-ray detector 2a and the second X-ray detector 2b It will be arranged at one of the two perspective positions.
  • the first X-ray tube 1a is at the first fluoroscopic position
  • the second X-ray tube 1b is at the first fluoroscopic position
  • the first X-ray detector 2a is at the first fluoroscopic position.
  • the second X-ray detectors 2b are respectively disposed at the first fluoroscopic positions.
  • the first X-ray tube 1a is in the second fluoroscopic position
  • the second X-ray tube 1b is in the first fluoroscopic position
  • the first X-ray detector 2a is in the second fluoroscopic position
  • the line detectors 2b are respectively arranged at the first see-through positions.
  • the first X-ray tube 1a is in the second fluoroscopic position
  • the second X-ray tube 1b is in the second fluoroscopic position
  • the first X-ray detector 2a is in the second fluoroscopic position
  • the line detectors 2b are respectively arranged at the second see-through positions.
  • the X-ray tube first pedestal 3a and the X-ray tube second pedestal 3b move along the moving path 20 constituted by the X-ray tube first rail 21 and the second rail 22, whereby the first X-ray tube 1a.
  • the 2nd X-ray tube 1b is each arrange
  • the first rail 11 for the X-ray detector, the second rail 12 for the X-ray detector, the first rail 21 for the X-ray tube, and the second rail 22 for the X-ray tube are all included.
  • the two straight portions have a substantially U-shape connected by a connecting portion including an arc portion. Therefore, from the first position shown in FIG. 3, the second position shown in FIG. 4, and the third position shown in FIG. 5, the first X-ray tube 1a, the second X-ray tube 1b, the first X-ray detector 2a, and the second X-ray.
  • the fluoroscopic position can be moved in the horizontal direction.
  • the first X-ray tube 1a, the second X-ray tube 1b, the first X-ray detector 2a, and the second X-ray detector 2b are mutually connected. It is possible to track a marker or the like by moving in the horizontal direction in synchronization.
  • FIG. 6 is a block diagram showing the main control system of the X-ray fluoroscopic apparatus according to the present invention.
  • This X-ray fluoroscopic apparatus has a control unit 61 that controls the entire apparatus.
  • the control unit 61 performs template matching on the image of the subject 57 photographed at regular time intervals using a template image, whereby the image of the subject 57 photographed at regular time intervals is obtained.
  • a template matching unit 62 that specifies the position of a specific part such as a marker or a tumor in real time is provided.
  • the control unit 61 is connected to a display unit 65 including a liquid crystal display panel for displaying a fluoroscopic image.
  • the control unit 61 is also connected to the storage unit 63.
  • the storage unit 63 includes a template image storage unit 64 that stores a template image.
  • the controller 61 is connected to the above-described first X-ray tube 1a, second X-ray tube 1b, first X-ray detector 2a, and second X-ray detector 2b.
  • the controller 61 is not shown for driving the first X-ray tube pedestal 3a, the second X-ray tube pedestal 3b, the first X-ray detector pedestal 4a, and the second X-ray detector pedestal 4b. It is connected to the drive unit.
  • the control unit 61 is also connected to a light source driving unit 66 for controlling lighting of laser light sources 5, 6, 7, and 8, which will be described later. Further, the control unit 61 is also connected to the radiotherapy apparatus shown in FIG.
  • a template corresponding to a specific part such as a marker or a tumor is first created.
  • the first X-ray tube 1a, the second X-ray tube 1b, the first X-ray detector 2a, and the second X-ray detector 2b are arranged at any of the positions shown in FIGS.
  • an image including a marker or a specific part is captured.
  • the position of the marker or the specific part is detected by the X-ray fluoroscopic apparatus according to the present invention.
  • the region including the marker or the specific part is seen through at a frame rate of about 30 fps.
  • the template matching unit 62 shown in FIG. 6 uses the template image stored in the template image storage unit 64 for the region including the marker or the specific part in the image photographed every predetermined time. I do. That is, the template image is matched with a region including a marker or a specific part in an image photographed every predetermined time.
  • the matching result exceeds a preset threshold for matching, it is determined that the matching is successful. Thereby, the position of a marker or a specific part is specified. And the position of the radiation irradiated with respect to the affected part of the subject 57 is adjusted based on the position of this marker or a specific part.
  • the first X-ray detector 2a and the second X-ray detector 2b are arranged under the floor and it is impossible to visually confirm the position thereof. It is difficult to understand which region of the subject 57 on the table is being subjected to fluoroscopy. Therefore, the X-ray axis extending from the first X-ray tube 1a to the first X-ray detector 2a or the X-ray axis extending from the second X-ray tube 1b X-ray tube to the second X-ray detector 2b and the treatment beam are irradiated. Even if the head 55 and the head support 54 interfere with each other, the operator may not notice it.
  • the X-ray fluoroscopic apparatus As described above, when the X-ray axis interferes with the head 55 or the head support portion 54, the subject 57 cannot be irradiated with X-rays, and proper X-ray fluoroscopy cannot be performed. . For this reason, in the X-ray fluoroscopic apparatus according to the present invention, such a problem is prevented by using a light source that emits visible light for displaying the X-ray fluoroscopic region.
  • FIG. 7 is a front view showing the laser light source 5 attached to the first X-ray detector 2a or the second X-ray detector 2b.
  • the first X-ray detector 2a or the second X-ray detector 2b is composed of a rectangular flat panel detector. And four laser light sources which irradiate the laser beam of the visible region as visible light in the four corners of the outer periphery frame part used as the outer peripheral part of the 1st X-ray detector 2a which consists of a flat panel detector, or the 2nd X-ray detector 2b. 5 is disposed.
  • FIG. 8 is a side view showing a state in which the X-ray fluoroscopic region E is displayed by the laser light source 5
  • FIG. 9 is a perspective view showing a state in which the X-ray fluoroscopic region E is displayed by the laser light source 5.
  • the first X-ray detector 2 a When performing X-ray fluoroscopy, the first X-ray detector 2 a is disposed opposite to the first X-ray tube 1 a via the subject 57, and the second X-ray detector 2 b is provided via the subject 57 as the second X-ray tube. 1b is arranged oppositely.
  • the four laser light sources 5 arranged in the first X-ray detector 2a irradiate the laser beam L toward the focal point of the first X-ray tube 1a.
  • the four laser light sources 5 disposed in the second X-ray detector 2b irradiate the laser beam L toward the second X-ray tube 1b.
  • the laser beams L emitted from the four laser light sources 5 arranged at the four corners of the outer peripheral frame portion of the first X-ray detector 2a or the second X-ray detector 2b are irradiated on the body surface of the subject 57.
  • 4 points indicating the X-ray fluoroscopic region E are displayed. Therefore, the operator can easily recognize the X-ray fluoroscopic region E.
  • an X-ray irradiation region irradiated from the first X-ray tube 1a or the second X-ray tube 1b toward the first X-ray detector 2a or the second X-ray detector 2b is indicated by a broken line.
  • FIG. 10 is an explanatory diagram showing a state in which irradiation of the treatment beam B and X-ray fluoroscopy on the subject 57 are simultaneously performed. Also in this figure, X-rays emitted from the first X-ray tube 1a toward the first X-ray detector 2a, and X-rays emitted from the second X-ray tube 1b toward the second X-ray detector 2b The irradiation area is indicated by a broken line.
  • the treatment beam B is irradiated from the head 55 toward the affected area C of the subject 57 with the head support portion 54 and the head 55 being swung with respect to the gantry 53 shown in FIG.
  • the first X-ray fluoroscopic mechanism including the first X-ray tube 1a and the first X-ray detector 2a and the second X-ray fluoroscopic mechanism including the second X-ray tube 1b and the second X-ray detector 2b are utilized.
  • the subject 57 is seen through from two different directions.
  • the second X-ray fluoroscopic mechanism including the second X-ray tube 1b and the second X-ray detector 2b can appropriately perform X-ray fluoroscopy.
  • the first X-ray fluoroscopic mechanism composed of 1a and the first X-ray detector 2a
  • a part of the X-rays that have passed through the subject 57 are blocked by the head support portion 54 and the head 55 and are blocked by the first X-ray detector 2a. Since it does not reach, proper X-ray fluoroscopy cannot be performed.
  • the laser light source 5 attached to the first X-ray detector 2a is irradiated toward the focal point of the first X-ray tube 1a. Since the laser beam L is blocked by the head support portion 54, four points indicating the X-ray fluoroscopic region E are not displayed on the body surface of the subject 57. For this reason, the operator can easily understand that X-ray fluoroscopy is not correctly executed.
  • the operator has a first X-ray fluoroscopic mechanism composed of the first X-ray tube 1a and the first X-ray detector 2a, and a second X-ray fluoroscopic mechanism composed of the second X-ray tube 1b and the second X-ray detector 2b.
  • the head support portion 54 is moved together with the head 55.
  • the X-ray fluoroscopic apparatus As described above, according to the X-ray fluoroscopic apparatus according to the present invention, not only the X-ray fluoroscopic region E can be easily understood based on the laser beam L emitted from the laser light source 5, but also the If the axis line interferes with the head 55 or the like, this can be easily recognized, and X-ray fluoroscopy can be appropriately executed.
  • FIG. 11 is a front view showing the laser light source 6 attached to the first X-ray detector 2a or the second X-ray detector 2b.
  • first X-ray detector 2a and the second X-ray detector 2b rectangular flat panel detectors are used as the first X-ray detector 2a and the second X-ray detector 2b.
  • circular image intensifiers (II) are used as the first X-ray detector 2a and the second X-ray detector 2b in front view.
  • eight laser light sources 6 that irradiate laser beams in the visible region are arranged on the circumferences of the outer peripheral portions of the first X-ray detector 2a and the second X-ray detector 2b.
  • Eight laser light sources 5 disposed in the first X-ray detector 2a irradiate laser beams toward the focal point of the first X-ray tube 1a, and eight laser light sources 5 disposed in the second X-ray detector 2b.
  • the laser light source 6 emits a laser beam toward the second X-ray tube 1b.
  • the circular X-ray fluoroscopic region E can be easily understood based on the laser beam emitted from the laser light source 6, but also the X-ray axis interferes with the head 55 and the like. This can be easily recognized and X-ray fluoroscopy can be appropriately executed.
  • FIG. 12 is a front view showing the laser light source 7 attached to the first X-ray detector 2a or the second X-ray detector 2b.
  • FIG. 13 is a perspective view showing a state in which the X-ray fluoroscopic region E is displayed by the laser light source 7.
  • a single laser beam in the visible region is irradiated on the upper part of the outer peripheral frame portion of the first X-ray detector 2a or the second X-ray detector 2b composed of a rectangular flat panel detector.
  • a laser light source 7 is provided. As shown in FIG. 13, the laser light source 7 has a configuration in which four laser beams L indicating the four corners of the X-ray fluoroscopic region E are irradiated on the body surface of the subject 57.
  • FIG. 14 is a perspective view showing a state in which the X-ray fluoroscopic region E is displayed by the laser light source 8 attached to the ceiling 100.
  • four laser light sources 8 for irradiating a laser beam in the visible region are arranged on the ceiling 100 of the examination room where X-ray fluoroscopy is performed. These four laser light sources 8 are configured to irradiate four laser beams L indicating the four corners of the X-ray fluoroscopic region E on the body surface of the subject 57.
  • the region showing the X-ray fluoroscopic region E cannot be moved along with the movement of the first X-ray detector 2a or the second X-ray detector 2b.
  • such a configuration can be adopted when the number of regions where X-ray fluoroscopy is performed is limited.
  • each of the laser light sources 5, 6, 7, and 8 emits a dotted laser beam
  • the end of the X-ray fluoroscopic region E is on the body surface of the subject 57.
  • a dot indicating is displayed.
  • the X-ray fluoroscopic region E may be displayed using a laser light source that can irradiate a linear region.
  • a light source having an optical system capable of irradiating a certain region may be used to irradiate the entire surface of the X-ray fluoroscopic region E.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
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Abstract

　Quatre sources (5) de lumière laser équipant un premier détecteur (2a) de rayons X émettent des faisceaux laser (L) vers le foyer d'un premier tube (1a) à rayons X. Quatre sources (5) de lumière laser équipant un second détecteur (2b) de rayons X émettent des faisceaux laser (L) vers un second tube (1b) à rayons X. Par conséquent, les faisceaux laser émis par les quatre sources (5) de lumière laser disposées aux quatre coins du cadre périphérique externe du premier détecteur (2a) de rayons X ou du second détecteur (2b) de rayons X produisent un affichage de quatre points, indiquant une zone (E) d'éclairage par rayons X, sur une surface corporelle d'un patient (57). L'opérateur peut ainsi facilement discerner la zone (E) d'éclairage par rayons X.
PCT/JP2014/065544 2014-06-12 2014-06-12 Fluoroscope à rayons x WO2015189943A1 (fr)

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2000167072A (ja) * 1998-12-03 2000-06-20 Mitsubishi Electric Corp 動体追跡照射装置
JP2001112750A (ja) * 1999-09-14 2001-04-24 Koninkl Philips Electronics Nv Ｘ線装置
WO2012127865A1 (fr) * 2011-03-22 2012-09-27 国立大学法人北海道大学 Dispositif de suivi d'un corps en mouvement pour la radiothérapie
WO2013019665A1 (fr) * 2011-07-29 2013-02-07 Gammex, Inc. Système laser informatique amovible pour positionnement radiographique d'un patient

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2000167072A (ja) * 1998-12-03 2000-06-20 Mitsubishi Electric Corp 動体追跡照射装置
JP2001112750A (ja) * 1999-09-14 2001-04-24 Koninkl Philips Electronics Nv Ｘ線装置
WO2012127865A1 (fr) * 2011-03-22 2012-09-27 国立大学法人北海道大学 Dispositif de suivi d'un corps en mouvement pour la radiothérapie
WO2013019665A1 (fr) * 2011-07-29 2013-02-07 Gammex, Inc. Système laser informatique amovible pour positionnement radiographique d'un patient

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