WO2017188345A1 - Dispositif de traitement d'image et procédé de traitement d'image - Google Patents

Dispositif de traitement d'image et procédé de traitement d'image Download PDF

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Publication number
WO2017188345A1
WO2017188345A1 PCT/JP2017/016622 JP2017016622W WO2017188345A1 WO 2017188345 A1 WO2017188345 A1 WO 2017188345A1 JP 2017016622 W JP2017016622 W JP 2017016622W WO 2017188345 A1 WO2017188345 A1 WO 2017188345A1
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Prior art keywords
radiation
image
image processing
imaging
reprojection
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PCT/JP2017/016622
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English (en)
Japanese (ja)
Inventor
芳賀　昭弘
要武 名和
恵一 中川
チャタクリ リトゥ ブーサル
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国立大学法人東京大学
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Publication of WO2017188345A1 publication Critical patent/WO2017188345A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/02—Devices for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis
    • A61B6/03—Computerised tomographs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy

Definitions

  • Some embodiments according to the present invention relate to an image processing apparatus and an image processing method for processing a tomographic image of a human body, for example.
  • Patent Document 1 discloses a method for accurately confirming the position of a target in the body during preparation for radiation therapy and during radiation therapy.
  • a plurality of markers that emit marker signals are embedded in a patient's body at a certain position with respect to a target. By measuring this marker signal with a sensor, the position of the target is determined.
  • Patent Document 1 it is necessary to embed a marker in the patient's body, which places a heavy physical burden on the patient.
  • an object of the present invention is to provide an image processing apparatus and an image processing method capable of suitably specifying a patient's tumor position.
  • the information processing apparatus includes at least one reprojection corresponding to irradiation of radiation for imaging from each angle generated using CT imaging information obtained by computer tomography of a subject.
  • Means for managing images input means for receiving an input of a projection image obtained by irradiating imaging radiation to a subject on which therapeutic radiation is rotated, and the projection image and one or more projection images Collating means for collating the reprojected image, and output means for outputting a control signal for controlling the irradiation of the therapeutic radiation according to the collation result.
  • the information processing method includes at least one reprojection corresponding to irradiation of radiation for imaging from each angle generated using CT imaging information obtained by computer tomography of a subject.
  • a step of managing an image a step of receiving an input of a projection image obtained by irradiating a subject irradiated with therapeutic radiation with imaging radiation, and the projection image and one or more of the projection image
  • the image processing apparatus performs a step of collating the reprojection image and a step of outputting a control signal for controlling the irradiation of the therapeutic radiation in accordance with the collation result.
  • “part”, “means”, “apparatus”, and “system” do not simply mean physical means, but “part”, “means”, “apparatus”, “system”. This includes the case where the functions possessed by "are realized by software. Further, even if the functions of one “unit”, “means”, “apparatus”, and “system” are realized by two or more physical means or devices, two or more “parts” or “means”, The functions of “device” and “system” may be realized by a single physical means or device.
  • FIG. 3 is a flowchart illustrating a processing flow of the image processing apparatus illustrated in FIG. 1. It is a block diagram which shows the specific example of the hardware constitutions which can mount the image processing apparatus shown in FIG.
  • FIGS. 1 to 3 are diagrams for explaining the embodiment. Hereinafter, embodiments will be described along the following flow with reference to these drawings.
  • “2” describes the functional configuration of the image processing apparatus
  • “3” describes the processing flow of the image processing apparatus.
  • 4 a specific example of a hardware configuration capable of realizing the image processing apparatus will be described.
  • 5 effects and the like according to the embodiment will be described.
  • a patient is fixed on a couch of a CT (Computed Tomography) apparatus, and then a doctor uses a CT apparatus to perform a tomography. Take a picture.
  • a doctor identifies an affected part such as a tumor by observing and diagnosing the tomographic image, and formulates a treatment plan including a radiation dose to be irradiated.
  • a radiator that emits radiation toward the center of the ring and a detector that detects the emitted radiation can travel in a ring shape in a ring-like gantry. It is like that.
  • a couch with a subject moves around the center of the ring. As a result, the radiation is rotated and applied to the subject.
  • the radiation that has passed through the subject is detected by a detector on the opposite side of the radiator with the couch interposed therebetween, and CT imaging information is generated. Based on the CT imaging information, the CT apparatus generates a tomographic image of the subject.
  • the doctor fixes the patient to the couch of the radiation therapy apparatus and treats the affected area (hereinafter also referred to as target) of the patient. Irradiation for the purpose.
  • the radiation used for the treatment is generally narrower in irradiation width and stronger than the radiation used in the CT apparatus for diagnosis. Therefore, in order to reliably irradiate the target with the therapeutic radiation to be irradiated in the radiotherapy and to avoid applying the therapeutic radiation to other parts of the patient (healthy tissue) as much as possible, Prior to irradiation, it is important to suitably perform registration on the patient's couch.
  • the target is brought to a position where therapeutic radiation can be irradiated, and the patient is couched by positioning so that the posture of the patient is almost the same as when taking a tomographic image for diagnosis. It is necessary to fix to. For this reason, the latest radiotherapy apparatuses often include an X-ray imaging apparatus for position verification for use in alignment or the like.
  • the target moves within a certain range within the patient's body according to the patient's breathing and the like. Therefore, after irradiating the patient's body surface with laser, infrared rays, etc. and measuring the reflection, the patient's respiratory condition etc. is detected, and the presence or absence of irradiation of therapeutic radiation to the target according to the respiratory condition Switching is also considered.
  • the interrelationship between body surface movement and internal organs is disrupted by changes in the respiratory state, particularly for lung cancer and liver cancer, where respiratory movement is a problem.
  • CT imaging information captured in advance for formulation and positioning of a treatment plan is used as prior information, and the CT imaging information captured in advance and radiation treatment are performed.
  • a target position is identified in real time using a photographed X-ray projection image without using a marker.
  • FIG. 1 is a functional block diagram illustrating a specific example of a functional configuration of the image processing system 1.
  • the image processing system 1 includes an image processing apparatus 100 and a radiation therapy apparatus 200.
  • the image processing apparatus 100 and the radiotherapy apparatus 200 are described as physically different apparatuses.
  • the present invention is not limited to this, and for example, a radiotherapy apparatus including the functions of the image processing apparatus 100 Implementation as 200 is also conceivable.
  • the function of the image processing apparatus 100 may be realized by dividing it into a plurality of information processing apparatuses.
  • the radiotherapy apparatus 200 is an apparatus for treating cancer or the like by irradiating a therapeutic radiation to a patient's tumor or the like.
  • the radiation therapy apparatus 200 includes a radiation irradiation unit 210 and an X-ray imaging apparatus 220.
  • the radiation irradiation unit 210 irradiates therapeutic radiation to a target that is an affected part of a patient fixed to the couch. At this time, the radiation irradiating unit 210 can rotate and irradiate therapeutic radiation to the target by moving in a circumferential shape with the target as a substantially center. By rotating and irradiating radiation, it is possible to irradiate the target such as a tumor from various angles and reduce the amount of radiation irradiated to the healthy tissue around the target.
  • the radiation irradiation unit 210 can control the irradiation of therapeutic radiation according to a control signal output from the image processing apparatus 100. More specifically, for example, when a control signal for stopping irradiation (BEAM OFF) is output from the control signal output unit 160, the radiation irradiation unit 210 stops the irradiation of therapeutic radiation.
  • the control of the radiation irradiation unit 210 by the control signal is not limited to this. For example, the start of irradiation and the control of the irradiation intensity may be performed based on the control signal from the image processing apparatus 100.
  • the X-ray imaging apparatus 220 is an apparatus for capturing a projection image for patient alignment and target position identification during treatment.
  • the X-ray imaging apparatus 220 includes a radiator that emits imaging radiation (X-rays) toward a couch direction where a patient is fixed, and a detector that detects the emitted radiation. The radiation emitted from the radiator and passed through the patient as the subject is detected by the detector, and the X-ray imaging apparatus 220 creates a projection image according to the detected radiation intensity.
  • the X-ray imaging apparatus 220 moves in accordance with the movement of the radiation irradiation unit 210. More specifically, if the radiation irradiation unit 210 moves on a circumference with the target as a substantially center, the radiator and the detector constituting the X-ray imaging device 220 on the circumference are irradiated with radiation. It moves so as to be at a position shifted by about ⁇ 90 degrees from the position of the portion 210. As a result, the X-ray imaging apparatus 220 can image the target substantially horizontally with respect to the irradiation direction of the therapeutic radiation.
  • the radiation irradiation unit 210 irradiates the patient's target with the therapeutic radiation, and the X-ray imaging apparatus 220 captures a projection image around the target, so that the real-time around the target being treated is obtained. It is possible to output a projection image.
  • the real-time X-ray projection image is output to the input unit 140 of the image processing apparatus 100.
  • the imaging angle of the target imaged as an X-ray projection image changes according to the imaging time.
  • the image processing apparatus 100 uses the imaging information captured in advance as the prior information and the real-time projection image captured during the radiotherapy by the radiotherapy apparatus 200 to determine whether the target is in a normal position (the therapeutic radiation is It is a device for determining whether or not it is at an irradiation position. Further, the image processing apparatus 100 outputs a control signal for controlling the radiation irradiation unit 210 according to the determination result.
  • the image processing apparatus 100 according to the present embodiment includes an input unit 110, a reprojection image generation unit 120, a database (DB) 130, an input unit 140, a collation unit 150, and a control signal output unit 160.
  • the input unit 110 receives CT imaging information as prior information.
  • This CT imaging information can be obtained by CT imaging performed in advance for formulation of a treatment plan and / or by CT imaging by the X-ray imaging apparatus 220 immediately before starting radiotherapy for position verification. it can.
  • CT imaging information is obtained by rotating and irradiating radiation while moving the radiator around the subject, and includes voxel data.
  • the reprojection image generation unit 120 obtains one or more reprojection images (Re-projection image) 131 (also referred to as DDR (Digitally Reconstructed Radiography) images) from the CT imaging information input as prior information from the input unit 110. Generate.
  • the one or more reprojection images 131 generated by the reprojection image generation unit 120 are pseudo projection images obtained as a result of irradiating imaging radiation to the patient as the subject from each angle. Equivalent to. For example, a reprojected image 131 corresponding to a projected image captured from a plurality of angles, such as a projected image captured from an angle of 30 degrees, a projected image captured from an angle of 40 degrees, etc. Obtained from shooting information.
  • the reprojection image 131 is collated with a real-time X-ray projection image as described later. As described above, since the imaging angle of the X-ray projection image changes according to the time, an X-ray projection image of an arbitrary imaging angle can be input by preparing a reprojection image 131 corresponding to various imaging angles. Even in this case, it is possible to collate using the reprojection image 131 having an approximate angle.
  • the reprojection image 131 generated by the reprojection image generation unit 120 is stored in the DB 130.
  • the CT image information is input from the input unit 110 and the reprojection image generation unit 120 generates the reprojection image 131.
  • the present invention is not limited to this.
  • a reprojection image 131 is generated from CT imaging information by a CT apparatus or other information processing apparatus that has performed CT imaging, and the input unit 110 receives the reprojected image 131.
  • the input unit 140 receives an input of a real-time X-ray projection image captured by the X-ray imaging apparatus 220 of the radiotherapy apparatus 200 as needed during radiotherapy.
  • the collation unit 150 collates the X-ray projection image input from the input unit 140 with one or more reprojection images 131 stored in the DB 130.
  • the collation unit 150 includes a correlation calculation unit 151, an irradiation angle identification unit 153, and a position abnormality detection unit 155.
  • the correlation calculation unit 151 calculates a correlation value between the X-ray projection image input from the input unit 140 and one or more reprojection images 131 stored in the DB 130. At this time, before calculating the correlation value, the registration between both images may be performed using an existing method. If the correlation value is high, it can be seen that the similarity between the X-ray projection image and the reprojection image 131 is high.
  • the reprojection image 131 used for collation with the real-time X-ray projection image is created from CT imaging information photographed for the treatment plan formulation as described above, It may be taken immediately before starting radiotherapy. However, it is considered that using the reprojection image 131 generated from CT imaging information taken for position matching immediately before treatment is closer to the state of the patient or target in the real-time X-ray projection image. In particular, when performing radiation therapy for several months, it may be several months ago that CT imaging for treatment planning was performed. In such a case, in particular, it is considered that better prior information can be obtained by using the reprojection image 131 generated from the CT imaging information imaged for position verification.
  • the irradiation angle specifying unit 153 specifies the reprojection image 131 corresponding to the imaging angle of the input real-time projection image. Specifically, for example, among the correlation values for each reprojection image 131 calculated by the correlation calculation unit 151, the one having the highest correlation value is the reprojection image 131 corresponding to the imaging angle of the X-ray projection image. Can be specified. Note that the method of specifying the reprojection image 131 corresponding to the imaging angle is not necessarily limited to the method using the correlation value, and for example, it is conceivable that the imaging angle information is directly acquired from the radiation therapy apparatus 200.
  • the position abnormality detection unit 155 determines whether or not the correlation between the X-ray projection image corresponding to the imaging angle identified by the irradiation angle identification unit 153 and the reprojection image 131 is within the reference range. Between the X-ray projection image corresponding to the imaging angle and the reprojection image 131, the correlation between the images is within a reference range, for example, if the correlation value between the two is equal to or greater than a threshold value, It can be considered that the positional deviation from the current target position is within an allowable range. This means that the target position based on the radiation treatment plan, that is, the distance from the position emitting radiation based on the treatment plan to the current target position is within an allowable range. If the correlation value between the two is less than the threshold value, the distance between the current target position and the position where radiation is applied based on the treatment plan is beyond an acceptable range, that is, an abnormal state. it is conceivable that.
  • the reference range (for example, a threshold value that defines the reference range) detected by the position abnormality detection unit 155 as an abnormality in the target position can be statistically calculated, for example. For example, statistical processing of a huge number of captured images taken in the past during radiation therapy and the recovery status of those patients after treatment and the presence or absence of complications can be used to detect abnormalities in the target position. It is possible to define a reference range for detection. For example, various existing machine learning methods can be applied to the statistical processing.
  • the control signal output unit 160 outputs a control signal to the radiation therapy apparatus 200 according to the collation result by the collation unit 150. More specifically, for example, if an abnormality with respect to the current target position is detected by the position abnormality detection unit 155, the control signal output unit 160 outputs a control signal for stopping radiation irradiation. Thereafter, for example, if an abnormality relating to the target position is not detected again, the control signal output unit 160 may output a control signal for resuming irradiation. Alternatively, the doctor may restart the radiotherapy after aligning the patient (re-setup) or the like as necessary.
  • FIG. 2 is a flowchart illustrating a processing flow of the image processing apparatus 100 according to the present embodiment.
  • Each processing step to be described later can be executed in any order or in parallel as long as there is no contradiction in processing contents, and other steps can be added between the processing steps. good. Further, a step described as a single step for convenience can be executed by being divided into a plurality of steps, and a step described as being divided into a plurality of steps for convenience can be executed as one step.
  • the input unit 110 receives CT imaging information taken for the formulation of a treatment plan and / or CT imaging information taken immediately before the start of radiation treatment for position verification from the CT apparatus or the radiotherapy apparatus 200.
  • An input is received (S201).
  • the reprojection image generation unit 120 generates one or more reprojection images 131 that are pseudo projection images obtained when the patient is imaged from each angle from the input CT imaging information (S203).
  • the generated one or more reprojection images 131 are stored in the DB 130.
  • the input unit 140 receives an input of a projection image captured in real time by the X-ray imaging apparatus 220 (S205). As described above, the imaging angle of the projected image captured in real time changes from time to time.
  • the collation unit 150 performs collation between the projection image input from the input unit 140 and one or more reprojection images 131 stored in the DB 130 (S207).
  • the correlation calculation unit 151 can calculate correlation values between the real-time projection image and one or more reprojection images 131, respectively.
  • the irradiation angle identification unit 153 identifies the real-time projection image and the reprojection image 131 corresponding to the imaging angle (S209). As this technique, for example, among the one or more reprojected images 131, the irradiation angle specifying unit 153 can specify the image having the highest correlation with the real-time projected image as the reprojected image 131 corresponding to the imaging angle. Is possible.
  • the position abnormality detection unit 155 determines whether or not the deviation of the target position is within the allowable range between the reprojection image 131 corresponding to the imaging angle and the real time projection image (S211). This can be determined, for example, based on whether or not the correlation value of the image calculated by the correlation calculation unit 151 is within a predetermined reference range. When the reference range is exceeded, that is, when an abnormality of the target position is detected (YES in S211), the control signal output unit 160 sends a control signal for stopping the radiation output to the radiation therapy apparatus 200. Output (S213).
  • control signal output unit 160 continues to output a control signal for continuing the radiation output to the radiation therapy apparatus 200 (S215).
  • the process returns to S205, and the same processing is performed on the newly input real-time projection image.
  • the image processing apparatus 100 includes a control unit 301, a communication interface (I / F) unit 305, a storage unit 307, a display unit 311 and an input unit 313, each of which is a bus line. 315 is connected.
  • the control unit 301 includes a CPU (Central Processing Unit, not shown), a ROM (Read Only Memory, not shown), a RAM (Random Access Memory) 303, and the like.
  • the control unit 301 is configured to execute the above-described image processing in addition to a general computer by executing a control program 309 stored in the storage unit 307.
  • a control program 309 stored in the storage unit 307.
  • the input unit 110, the reprojection image generation unit 120, the input unit 140, the collation unit 150, and the control signal output unit 160 described with reference to FIG. 1 operate on the CPU after being temporarily stored in the RAM 303.
  • the control program 309 can be realized.
  • the RAM 303 temporarily holds part or all of the input CT difference information, the real-time projection image, the reprojection image 131 stored in the DB 130, and the like, in addition to the code included in the control program 309.
  • the RAM 303 is also used as a work area when the CPU executes various processes.
  • the communication I / F unit 305 is a device for performing data communication by wire or wireless with, for example, the radiation therapy apparatus 200, a storage apparatus that stores CT image information that has been imaged in advance, or another information processing apparatus. is there.
  • the input units 110 and 140 receive input of projection images and CT imaging information, for example, the communication I / F unit 305 can be used.
  • the storage unit 307 is a non-volatile storage medium such as an HDD (Hard Disk Drive) or a flash memory.
  • the storage unit 307 stores an operating system (OS), applications, and data (not shown) for realizing functions as a general computer.
  • the storage unit 307 stores a control program 309. As described above, the input unit 110, the reprojection image generation unit 120, the input unit 140, the collation unit 150, and the control signal output unit 160 illustrated in FIG. 1 can be realized by the control program 309.
  • the display unit 311 is a display device for presenting various information, for example, the result of collation by the collation unit 150.
  • Specific examples of the display unit 311 include a liquid crystal display and an organic EL (Electro-Luminescence) display.
  • the input unit 313 is a device for receiving an operation input. Specific examples of the input unit 313 include a keyboard, a mouse, and a touch panel.
  • the image processing apparatus 100 does not necessarily include the display unit 311 and the input unit 313.
  • the display unit 311 and the input unit 313 may be connected to the image processing apparatus 100 from the outside via various interfaces such as a USB (Universal Serial Bus) and a display port.
  • USB Universal Serial Bus
  • the reprojection image 131 generated from the CT imaging information obtained in advance by CT imaging is used as the prior information.
  • the image is collated with a real-time projection image that is captured.
  • the image processing apparatus 100 outputs a control signal for controlling radiation irradiation by the radiation therapy apparatus 200. As a result, it is possible to automatically detect an abnormality in the treatment area in real time only by collating the images.
  • CT information taken for treatment planning CT information taken immediately before treatment can be used as advance information, so it is possible to cope with changes in patient system and organ position over a long period of time. It is. Furthermore, it is possible to improve the accuracy of abnormality detection by preparing prior information in the same imaging system (for example, imaging angle) as the X-ray projection image acquired during treatment.
  • Image processing system 100 Image processing device 110: Input unit 120: Reprojection image generation unit 131: Reprojection image 140: Input unit 150: Verification unit 151: Correlation calculation unit 153: Irradiation angle specification unit 155: Position abnormality detection Unit 160: Control signal output unit 200: Radiotherapy device 210: Radiation irradiation unit 220: X-ray imaging device 301: Control unit 303: RAM 305: Communication interface (I / F) unit 307: Storage unit 309: Control program 311: Display unit 313: Input unit 315: Bus line

Abstract

Le problème décrit par la présente invention est de fournir un dispositif de traitement d'image et un procédé de traitement d'image permettant de spécifier de manière appropriée la position d'une tumeur chez un patient. La solution selon la présente invention porte sur un moyen de gestion d'une ou de plusieurs images de reprojection correspondant à l'émission de rayonnement d'imagerie à partir de chaque angle, générées à l'aide d'informations d'imagerie de tomographie assistée par ordinateur (CT) obtenues par CT d'un sujet, d'un moyen d'entrée pour recevoir l'entrée d'une image de projection obtenue par rayonnement d'un rayonnement d'imagerie vers un sujet soumis à une irradiation rotative avec un rayonnement de traitement, d'un moyen de collecte pour collecter l'image de projection et lesdites images de reprojection, et d'un moyen de sortie pour émettre un signal de commande pour commander l'irradiation avec le rayonnement de traitement selon les résultats de collecte.
PCT/JP2017/016622 2016-04-26 2017-04-26 Dispositif de traitement d'image et procédé de traitement d'image WO2017188345A1 (fr)

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JP7279336B2 (ja) * 2018-10-26 2023-05-23 株式会社島津製作所 Ｘ線撮影装置

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2004136021A (ja) * 2002-10-21 2004-05-13 Toshiba Corp 集中照射型放射線治療装置
JP2008029887A (ja) * 1996-06-11 2008-02-14 Wisconsin Alumni Res Found 放射線治療用ｃｔ装置

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2008029887A (ja) * 1996-06-11 2008-02-14 Wisconsin Alumni Res Found 放射線治療用ｃｔ装置
JP2004136021A (ja) * 2002-10-21 2004-05-13 Toshiba Corp 集中照射型放射線治療装置

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