WO2018024630A1 - Device for positioning patients in radiotherapy treatments - Google Patents
Device for positioning patients in radiotherapy treatments Download PDFInfo
- Publication number
- WO2018024630A1 WO2018024630A1 PCT/EP2017/069158 EP2017069158W WO2018024630A1 WO 2018024630 A1 WO2018024630 A1 WO 2018024630A1 EP 2017069158 W EP2017069158 W EP 2017069158W WO 2018024630 A1 WO2018024630 A1 WO 2018024630A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- support base
- contact sensor
- patient
- positioning arm
- fixed bar
- Prior art date
Links
Classifications
-
- 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
- A61N5/1048—Monitoring, verifying, controlling systems and methods
- A61N5/1049—Monitoring, verifying, controlling systems and methods for verifying the position of the patient with respect to the radiation beam
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G13/00—Operating tables; Auxiliary appliances therefor
- A61G13/10—Parts, details or accessories
-
- 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
- A61N5/1048—Monitoring, verifying, controlling systems and methods
- A61N5/1064—Monitoring, verifying, controlling systems and methods for adjusting radiation treatment in response to monitoring
- A61N5/1069—Target adjustment, e.g. moving the patient support
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/06—Measuring instruments not otherwise provided for
- A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
- A61B2090/065—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension for measuring contact or contact pressure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/397—Markers, e.g. radio-opaque or breast lesions markers electromagnetic other than visible, e.g. microwave
- A61B2090/3975—Markers, e.g. radio-opaque or breast lesions markers electromagnetic other than visible, e.g. microwave active
- A61B2090/3979—Markers, e.g. radio-opaque or breast lesions markers electromagnetic other than visible, e.g. microwave active infrared
-
- 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
- A61N2005/1092—Details
- A61N2005/1097—Means for immobilizing the patient
Definitions
- the present invention relates to a device for positioning patients in radiotherapy treatments in general, and especially in treatments in which patients must be irradiated in a deep inspiration breath hold position, maintaining said position during the irradiation process, such as in the treatment for left breast cancer or supradiaphragmatic Hodgkin lymphoma, among others.
- radiotherapy techniques that reduce the dose the heart receives is highly important.
- the doses received by the lung and the contralateral breast should not be ignored because patient monitoring shows that there is a risk of pulmonary fibrosis, as well as lung cancer and contralateral breast cancer.
- the present invention consists of a simple and affordable device which enables reliably reproducing the positioning of a patient and deep inspiration breath hold on a daily basis, the aim of the invention being to direct the irradiation exclusively at the target volume, avoiding that other risk organs may be damaged by said radiation, and thereby minimizing the cardiotoxicity caused by radiotherapy treatments.
- the device of the present invention accelerates radiotherapy treatment with maximum reliability and comfort, both for the nursing and technical staff, as well as for the patients, it being easier to adjust on the patient, providing contact and visual reference of the amplitude of the deep inspiration breath hold, quickly detecting situations in which patients do not have a proper position or deep inspiration breath hold, as well as stopping the irradiation the moment this occurs.
- the device for positioning patients in radiotherapy treatments of the present invention comprises a positioning arm capable of varying the distance thereof with respect to a support base configured to receive a patient.
- said positioning arm has at least one contact sensor which allows generating one or more control signals upon contact with a patient arranged between the support base and the positioning arm, and maintaining said control signal or signals activated while in contact with the patient.
- the control signals are mainly luminous, acoustic and/or electric, controlled by an electric circuit associated with the contact sensor. They preferably serve to warn and/or inform both the staff and the patient with regard to whether the deep inspiration breath-hold technique is being performed correctly or not. Specifically, a correct inspiration occurs when the patient's chest is kept in contact with the sensor during the time established by the specialist, having previously adjusted the positioning arm, with the patient arranged on the support base (stretcher, treatment table, etc.). According to a preferred operating mode, once the patient is in the correct position, the device begins to emit a luminous signal and an acoustic signal, which serve as a reference for the patient and the radiotherapy technicians to know that the patient is in the correct position.
- Said signals remain active while the sensor detects contact with the patient. Each time said contact is lost, the device ceases to emit signals, so that the patient can correct their position, and/or so that the expert may act as they feel is most appropriate.
- this operating mode for example, inversely to the case previously described, combining the signals in a different way, using different colors and/or sound tones as reference for each of the positions, etc.
- the signals can also be used, either independently or in combination, to activate or deactivate other complementary safety devices.
- a force sensor is preferably used with a long and thin configuration in the form of a strip, which is capable of adhering to the lower face of the positioning arm by adhesive means. Nevertheless, it is also possible to use contact sensors such as limit switches conveniently arranged on said positioning arm.
- radiolucent materials such as carbon fiber, fiberglass, quartz, or other equivalent radiolucent materials.
- the positioning arm comprises:
- a movable bar in which is a contact sensor is arranged, joined to the fixed bar and configured to move along the same, maintaining a position parallel to the support base.
- the positioning arm has an L-shaped configuration, wherein the fixed bar is arranged in a vertical position, while the movable bar is arranged in a horizontal position, forming a 90° angle with respect to the fixed bar and parallel to the support base.
- the bar comprises a sliding carriage configured to move along a longitudinal rail, arranged on the fixed bar.
- said carriage allows maintaining the movable bar secured to the fixed bar, preventing them from separating from one another.
- the positioning arm comprises a retaining element, which enables fixing the vertical position of the movable bar with respect to the fixed bar once the desired distance is reached.
- said retaining element preferably has a threaded pin with a knob at the end thereof, which facilitates handling with the hand, such that the action of screwing/unscrewing allows joining or releasing the movable bar with respect to the fixed bar.
- the fixed bar comprises a graded length scale arranged according to the direction of the movement of the movable bar, and that allows choosing the fastening point with a margin of less than 1 mm.
- the device for the positioning of patients in radiotherapy treatments of the present invention allows an operation based exclusively on the supervision of an expert, guided in turn by luminous and/or acoustic control signals.
- said device may work in conjunction with other complementary safety systems or devices.
- the movable bar comprises an auxiliary mechanism configured to couple an infrared reflective device, synchronized with an electron accelerator.
- said auxiliary mechanism comprises:
- ⁇ a mounting base configured to be secured to the movable bar above the contact sensor, with the aim of ensuring that it is not placed between the patient's chest and said contact sensor;
- a positioning guide having an upper end joined to the infrared reflective device and a lower end, configured to move vertically with respect to the mounting base, so as to enable the lower end to be brought from a lower position located below the contact sensor to an upper position located at the height of the contact sensor;
- a guiding groove configured to receive a guiding pivot joined to the positioning guide, which enables delimiting the vertical displacement of the positioning guide and prevents the rotation thereof.
- the positioning arm can be directly coupled to a support base, formed by a stretcher, treatment table, etc. or indirectly through a support base integrated in the device itself and configured to be coupled to said stretcher or treatment table.
- the support base must be made of materials that provide the necessary resistance, preferably radiolucent materials, such as carbon fiber.
- the positioning arm has the particular feature of being removable with respect to the support base. In other words, it may be easily mounted on the support base and subsequently removed.
- the device can easily be coupled to any type of stretcher or treatment table. This is especially practical for significantly reducing preparation time prior to starting treatment.
- images are usually taken by means of computerized axial tomography (CAT) during said planning session in order to obtain an anatomical record of the patient, and a tattoo is also made to mark the horizontal position of the positioning arm.
- CAT computerized axial tomography
- Said tattoo is carried out with the movable bar in contact with the patient on the cranial side and without inspiration. Subsequently, the value of the vertical distance of said arm with respect to the support base is noted, with the patient in a deep inspiration breath hold position. In subsequent treatment sessions, the technical staff only has to follow these indications to reproduce the exact position between the patient and the device.
- the fixed bar comprises a coupling element which allows said fixed bar to be coupled to a fixed position of the support base, as well as the subsequent decoupling thereof.
- the support base comprises a receiving element, which allows fitting the coupling element and the subsequent removal thereof.
- the support base preferably comprises an anchoring mechanism that can be easily manipulated without using tools.
- the anchoring mechanism comprises:
- a second lateral stop located at a second end of the support base, wherein said second lateral stop forms a cam, configured to rotate with respect to a rotation axis by means of the rotation of a handle joined thereto.
- the rotation of the cam allows increasing or reducing the horizontal distance between the first lateral stop and the second lateral stop, depending on the direction of rotation of the handle.
- the stops move toward one another to fasten the support base to the stretcher or treatment table, while in the opposite direction they move away from one another in order to release the same. This makes the use of the device compatible with stretchers or treatment tables of different widths.
- Figure 1 shows a perspective view of the device of the present invention.
- Figure 2 shows a first elevation view of Figure 1 , with the positioning arm arranged in an upper position.
- Figure 3 shows a second elevation view of Figure 1 , with the positioning arm arranged in a lower position.
- Figure 4 shows a partial bottom view of the movable bar.
- Figure 5 shows a cross-section view along line A-A of Figure 6.
- Figure 6 shows a plan view of Figure 5.
- Figure 7 shows a rear view of Figure 2.
- Figure 8 shows a cross-section view along line B-B of Figure 7.
- Figures 9a and 9b show an example of application of the device of the present invention.
- the device of the present invention comprises a positioning arm (2) capable of varying the distance (D) thereof with respect to a support base (3) configured to receive a patient (P), wherein said positioning arm (2) has at least one contact sensor (4), as shown in Figures 2-4, which enables generating one or more control signals (S1 , S2, S3) upon contact with a patient (P), arranged between the support base (3) and the positioning arm (2), and maintaining said control signal or signals (S1 , S2, S3) activated while in contact with the patient (P).
- a positioning arm (2) capable of varying the distance (D) thereof with respect to a support base (3) configured to receive a patient (P)
- said positioning arm (2) has at least one contact sensor (4), as shown in Figures 2-4, which enables generating one or more control signals (S1 , S2, S3) upon contact with a patient (P), arranged between the support base (3) and the positioning arm (2), and maintaining said control signal or signals (S1 , S2, S3) activated while in contact with the patient (P
- the contact sensor (4) allows generating a luminous control signal (S1 ) through a luminous indicator (5) arranged on the device (1 ) itself. Said luminous indicator (5) turns on or off depending on whether the position of the patient (P) is correct or not.
- the contact sensor (4) also allows generating an acoustic control signal (S2) through an acoustic indicator (6), which produces a sound when the position of the patient (P) is correct.
- the acoustic indicator (6) is also located in the device (1 ) so that it is more compact, autonomous and functional.
- said indicators (5, 6) may be separate from the device (1 ), forming part of a fixed installation of the treatment facility, conveniently located to allow their correct visualization and/or perception, and receiving the signals (S1 , S2, S3) wirelessly or by means of wiring from the device (1 ).
- the contact sensor (4) is configured to generate an electric control signal (S3) through an electric contact, in this case located in the control box and/or power supply unit (7) of the device (1 ), and which may be integrated into an electric control and/or power circuit.
- This electric contact can be used in many different ways, such as: to activate or deactivate other devices and/or indicators, or as an electrical safety interlock, etc.
- the constructive configuration of the device (1 ), which allows varying the distance (D) is based on a positioning arm (2) made from carbon fiber, comprising:
- the positioning arm (2) has an L-shaped configuration, wherein the fixed bar (21 ) is arranged in a vertical position, while the movable bar (22) is arranged in a horizontal position, forming a 90° angle with respect to the fixed bar (21 ) and parallel to the support base (3).
- the positioning arm (2) is removable with respect to the support base (3). In other words, it may be easily mounted on the support base (3) and subsequently removed.
- the fixed bar (21 ) comprises a coupling element (28) which allows said fixed bar (21 ) to be coupled to a pre-established position (XYREF) of the support base (3), as well as to allow for the subsequent decoupling thereof.
- the support base (3) comprises a receiving element (31 ), which allows fitting the coupling element (28) and the subsequent removal thereof.
- the coupling element (28) and the receiving element (31 ) are joined by means of screws or pins (29), which can be manipulated without tools.
- the device (1 ) is adapted to work in conjunction with a complementary safety device.
- the movable bar (22) comprises an auxiliary mechanism (27) configured to couple an infrared reflective device (100) synchronized with the electron accelerator of the radiotherapy device to emit radiation only when the patient (P) is in the correct position.
- Figures 2 and 3 show two elevation views with the positioning arm (2) arranged in different vertical positions, in order to show how the distance (D) thereof varies with respect to the support base (3).
- the positioning arm (2) is located at a first distance (Di) further away from the support base (3) while in Figure 3 it is located at a second distance (D2) closer thereto.
- Figure 4 shows the arrangement of the contact sensor (4) in greater detail.
- a force sensor with a long and thin configuration in the form of a strip is used, which is capable of adhering to the lower face of the positioning arm (2) by adhesive means.
- the bar comprises a sliding carriage (24) configured to move along a longitudinal rail (23), arranged on the fixed bar (21 ).
- said carriage (24) allows maintaining the movable bar (22) secured to the fixed bar (21 ), preventing them from separating from one another.
- the positioning arm (2) comprises a retaining element (25), which enables fixing the vertical position of the movable bar (22) with respect to the fixed bar (21 ) once the desired distance (D) is reached.
- Said retaining element (25) preferably has a threaded pin (251 ) with a knob (252) at the end thereof, such that the screwing/unscrewing thereof allows joining or releasing the movable bar (22) with respect to the fixed bar (21 ).
- the support base (3) preferably comprises an anchoring mechanism (32) that can be easily manipulated without using tools.
- the anchoring mechanism (32) comprises:
- a second lateral stop (34) located at a second end (3b) of the support base (3), wherein said second lateral stop (34) forms a cam (35), configured to rotate with respect to a rotation axis (Z34) by means of the rotation of a handle (36) joined thereto.
- the rotation of the cam (35) allows increasing or reducing the horizontal distance between the first lateral stop (33) and the second lateral stop (34), depending on the direction of rotation of the handle (36).
- the stops (33, 34) move toward one another to fasten the support base (3) to the stretcher or treatment table (M), while in the opposite direction they move away from one another in order to release the same.
- the handle (36) comprises a push button (37), which allows decoupling the rotation of the handle (36) from the cam (35), in order to avoid interference with a possible electron accelerator or (CAT) scanner.
- the push button (37) can be pressed so that the handle (36) rotates freely with respect to the cam (35), gathering it within the area defined by the stretcher or treatment table (M), as shown in Figure 9b.
- the fixed bar (21 ) comprises a graded length scale (26) arranged according to the direction of the movement of the movable bar (22), which interacts with a pointer (261 ) joined to the same.
- FIG. 8 shows the auxiliary mechanism (27) in greater detail, allowing the integration of the infrared reflective device (100).
- Said auxiliary mechanism (27) comprises:
- a mounting base (271 ) configured to be secured to the movable bar (22) above the contact sensor (4) with the aim of ensuring that it is not placed between the patient's (P) chest and said contact sensor (4);
- a positioning guide (272) having an upper end (2721 ) joined to the infrared reflective device (100) and a lower end (2722), configured to move vertically with respect to the mounting base (271 ), so as to enable the lower end (2722) to be brought from a lower position (Yi) located below the contact sensor (4) to an upper position (Ys) located at the height of the contact sensor (4); and
- a guiding groove (273) configured to receive a guiding pivot (2723) joined to the positioning guide (272), which enables delimiting the vertical displacement of the positioning guide (272) and prevents the rotation thereof.
- the auxiliary mechanism (27) is completed with a separator (274), which allows limiting the downward movement of the positioning guide (272), preventing the guiding pivot (2723) from coming out of the guiding groove (273).
- a separator (274) which allows limiting the downward movement of the positioning guide (272), preventing the guiding pivot (2723) from coming out of the guiding groove (273).
- the auxiliary mechanism (27) can be mounted in a symmetrical arrangement to that shown in Figure 8. To this end, simply loosen the screw (275), remove the auxiliary mechanism (27) completely, rotate it 180° and mount it once again on the movable bar (22).
- Figures 9a and 9b show the operating mode of the device (1 ) of the present invention, comprising the following steps:
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Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
ESU201630997 | 2016-08-03 | ||
ES201630997U ES1165083Y (es) | 2016-08-03 | 2016-08-03 | Dispositivo para el posicionamiento de pacientes en tratamientos de radioterapia |
Publications (1)
Publication Number | Publication Date |
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WO2018024630A1 true WO2018024630A1 (en) | 2018-02-08 |
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Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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PCT/EP2017/069158 WO2018024630A1 (en) | 2016-08-03 | 2017-07-28 | Device for positioning patients in radiotherapy treatments |
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ES (1) | ES1165083Y (es) |
WO (1) | WO2018024630A1 (es) |
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE202019107134U1 (de) * | 2019-12-19 | 2021-03-22 | Unger Medizintechnik Gmbh & Co. Kg | Vorrichtung zur Atemüberwachung eines Patienten |
EP4169574A1 (en) | 2021-10-20 | 2023-04-26 | Fundació Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI) | Patient positioning system for radiation emission treatment and/or diagnosis equipment |
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Cited By (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE202019107134U1 (de) * | 2019-12-19 | 2021-03-22 | Unger Medizintechnik Gmbh & Co. Kg | Vorrichtung zur Atemüberwachung eines Patienten |
EP4169574A1 (en) | 2021-10-20 | 2023-04-26 | Fundació Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI) | Patient positioning system for radiation emission treatment and/or diagnosis equipment |
WO2023067006A1 (en) | 2021-10-20 | 2023-04-27 | Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI) | Patient positioning system for radiation emission treatment and/or diagnosis equipment |
Also Published As
Publication number | Publication date |
---|---|
ES1165083Y (es) | 2016-12-14 |
ES1165083U (es) | 2016-09-21 |
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