WO2018058291A1

WO2018058291A1 - Applicator positioning method based on magnetic resonance imaging, and applicator

Info

Publication number: WO2018058291A1
Application number: PCT/CN2016/100308
Authority: WO
Inventors: 朱艳春; 谢耀钦; 李硕; 杨洁; 刘云
Original assignee: 深圳先进技术研究院
Priority date: 2016-09-27
Filing date: 2016-09-27
Publication date: 2018-04-05

Abstract

An applicator positioning method based on magnetic resonance imaging (MRI), and applicator. The method comprises: inserting a positioning tube (30) into an applicator vessel (20) (101); inserting the applicator vessel (20) inserted with the positioning tube (30) into a portion to which a source is to be applied, and performing three-dimensional magnetic resonance imaging (102); determining, according to an imaging agent (31) in the positioning tube (30), an application position and an application scheme, and positioning the applicator vessel (20) at the application position (103). The method of the present invention enables the position of an applicator vessel (20) to be accurately located in an MRI image, and clearly displays morphology and pathological changes of tissues and organs in a periphery of the applicator vessel (20), thus improving the precision of a treatment.

Description

Magnetic resonance imaging based source location method and applicator

Technical field

The present application relates to the field of applicator positioning technologies, and in particular, to a method and a source device for applying a position based on magnetic resonance imaging.

Background technique

Clinically, during the post-loading treatment, the positioning of the applicator is usually obtained by a positive lateral radiograph or a three-dimensional computed tomography (CT) scan. With the development of Magnetic Resonance Imaging (MRI), its advantages of no radiation, high resolution, and high soft tissue contrast make it more and more widely used.

After the 1970s, post-loading radiation therapy was developed, especially in gynecological intracavitary radiotherapy. In the late 1980s, the reactor produced a high-strength micro-铱-192 source, and the development of computer control gradually through the initial mechanical and motor stages, which made the post-loading treatment enter a new stage. Post-loading radiation therapy refers to placing a treatment container (applicator) without a radioactive source on the treatment site, and the computer remote-controlled stepper motor (post-installation machine) sends the radioactive source to the applicator for radiation therapy, so as to avoid prevention. Medical staff were injured by radiation during the treatment. Due to the advantages of accurate placement and close proximity to the body tissue, significant clinical effects have been achieved in the treatment of gynecological, nasopharyngeal, esophageal, bronchial, rectal, bladder, breast and pancreatic tumors. The function of the post-installation machine is to place the radioactive source accurately, safely and regularly into the human lesion through the application tube.

Post-loading therapy is an auxiliary treatment for external irradiation. According to the inverse square law, the dose at the near-source is much larger than the distance from the far source. Using this feature, tumor tissue can achieve an effective killing dose, while adjacent normal tissues can be protected. It can be seen that one of the quality assurances of the post-loading treatment is the accuracy of the radioactive source, which directly affects the therapeutic effect.

At present, the workflow of the post-loading treatment is to insert the disinfected application tube into the patient's treatment site according to the doctor's diagnosis result, and fix it; then, use the simulator to take a positive lateral radiograph or 3D CT image, locate the position of the application tube, formulate the optimal treatment time at each point, design the treatment plan; connect the application tube with the post-loading treatment machine, and then perform the radiotherapy plan through the operation and installation control system; After the amount of irradiation, under the control of the post-installation computer, the radioactive source automatically returns to the reservoir and completes a close-in post-loading treatment.

With the development of magnetic resonance imaging technology, magnetic resonance imaging has the advantages of no radiation, high resolution, high soft tissue contrast, etc., which makes magnetic resonance imaging more and more attention. Clinically, the positive side X-ray film is taken by the simulator, and the treatment plan is made according to the coordinate reconstruction result. Although the post-installation internal irradiation treatment can be realized, the treatment plan is simple, the dose accuracy is very low, and the lesion range and the normal tissue cannot be correctly evaluated. The situation in turn gives a personalized and precise radiotherapy dosage regimen. CT three-dimensional imaging can achieve the positioning of the applicator and develop a precise radiotherapy plan, but the soft tissue contrast of the CT image is poor, and usually the internal irradiation therapy is for the soft tissue cavity, and the CT image is not well presented. According to the principle of magnetic resonance imaging, the three-dimensional magnetic resonance image can clearly show the structure of the lesion and surrounding organs, but the current application of the polymer tube for magnetic resonance imaging is often not because of magnetic resonance imaging. The signal is reflected in black on the three-dimensional image, which results in the magnetic resonance three-dimensional image not being able to exert its original advantages to accurately locate the position of the application tube, and also affects the observability of the surrounding tissue lesions.

Summary of the invention

In order to solve the above problems in the prior art, an object of the present application is to provide a magnetic resonance imaging-based application position localization method and an applicator for accurately positioning a position of a source pipe in a magnetic resonance image, and Clearly show the shape and pathological changes of the tissues and organs around the pipe of the applicator, and effectively improve the treatment accuracy.

To achieve the above objective, the magnetic resonance imaging-based application position localization method proposed by the embodiment of the present application includes: inserting a positioning tube into the applicator tube; and inserting the applicator tube inserted with the positioning tube into the application site to be applied And performing three-dimensional magnetic resonance imaging; determining a source position and a feeding scheme according to the imaging agent in the positioning tube, and positioning the applicator tube at the application position.

In order to achieve the above object, a magnetic resonance imaging-based applicator according to an embodiment of the present application includes a post-installer and a source pipe, and the applicator further includes a positioning pipe matched with the applicator pipe, wherein The positioning tube is hollow and internally filled with an imaging agent for magnetic resonance imaging, and the positioning tube is used to be built in the applicator tube during magnetic resonance imaging, and is inserted with the applicator tube Source target location.

It can be seen from the technical solution provided by the above embodiments of the present application that by inserting a positioning tube into the applicator tube and inserting a to-be-applied portion for three-dimensional magnetic resonance scanning, the applicator tube can be highlighted in the three-dimensional magnetic resonance imaging, which can be accurately Positioning the applicator tube clearly shows the morphological structure and pathological changes of the diseased tissue and surrounding tissues and organs, providing better soft tissue contrast and better showing the tissue characteristics of the lesion, so that the position of the applicator tube can be accurately located. The location and the basis for accurate design of the radiotherapy plan, accurate control of the location and time of the radioactive source, improve treatment accuracy and safety.

The aspects and advantages of the present invention will be set forth in part in the description which follows.

DRAWINGS

In order to more clearly illustrate the embodiments of the present application or the technical solutions in the prior art, the drawings to be used in the embodiments or the prior art description will be briefly described below. Obviously, the drawings in the following description are only It is a certain embodiment of the present application, and other drawings can be obtained according to the drawings without any creative work for those skilled in the art.

1 is a schematic flow chart of a method for locating a position based on magnetic resonance imaging according to an embodiment of the present application;

2 is a schematic structural view of a magnetic resonance imaging based applicator according to an embodiment of the present application;

3 is a schematic diagram of a positioning tube of a magnetic resonance imaging based applicator according to an embodiment of the present application;

4 is a schematic diagram of a donor tube of a magnetic resonance imaging-based applicator according to an embodiment of the present application;

FIG. 5 is a schematic flow chart of a method for locating a position based on magnetic resonance imaging according to another embodiment of the present application.

detailed description

Embodiments of the present application provide a method and device for applying a position based on magnetic resonance imaging.

The technical solutions in the embodiments of the present application are clearly and completely described in the following, in which the technical solutions in the embodiments of the present application are clearly and completely described. The embodiments are only a part of the embodiments of the present application, and not all of them. All other embodiments obtained by a person of ordinary skill in the art based on the embodiments of the present application without departing from the inventive scope shall fall within the scope of the application.

1 is a schematic flow chart of a method for locating a position based on magnetic resonance imaging according to an embodiment of the present application. As shown in FIG. 1, the method includes:

In step 101, the positioning tube is inserted into the applicator tube.

Specifically, the positioning tube is matched with the applicator tube, and the differently sized applicator tubes are provided with corresponding positioning tubes, which can be highlighted in three-dimensional magnetic resonance imaging.

Step 102, inserting the applicator tube inserted with the positioning tube into the site to be applied, and performing three-dimensional magnetic resonance imaging.

Step 103: Determine a source position and a feeding scheme according to the imaging agent in the positioning tube, and position the applicator tube at the application position.

The applicator tube of the present invention is made of MRI compatible polymer material, and the positioning tube is also made of a material suitable for magnetic resonance imaging.

According to an embodiment of the present application, the positioning tube is a hollow tube internally filled with the imaging agent having a high signal to noise ratio under magnetic resonance. Among them, the developer can be oil, water or other suitable for magnetic common The contrast-enhanced contrast enhancer (or imaging agent, contrast agent, etc.) is pre-blocked and filled in the positioning tube to ensure that the position of the application tube is highlighted in the three-dimensional magnetic resonance image. The contrast enhancer is, for example, a complex of DTPA (钆-diethylenediaminepentaacetic acid) or the like.

It is to be understood that the three-dimensional magnetic resonance localization treatment has a lower radiation and provides better soft tissue contrast than existing CT-guided internal illumination treatments. Since the internal irradiation treatment is mainly for treating the cavity lesions in the human body, the better presentation of the diseased tissue and the peripheral organs is the basic condition for formulating a precise radiotherapy plan.

In this embodiment, a three-dimensional magnetic resonance scan is performed by inserting a positioning tube into the applicator tube and then inserting the site to be applied. Since the positioning tube can be highlighted in the three-dimensional magnetic resonance image, the applicator tube is in the three-dimensional magnetic resonance image. No longer black, it can clearly show the position of the applicator tube and the structure and lesions of the surrounding tissues and organs, provide better soft tissue contrast, better display the tissue characteristics of the lesion, so that the applicator tube can be accurately positioned. The location and the basis for accurate design of the radiotherapy plan, accurate control of the location and time of the radioactive source, improve treatment efficiency and safety.

Based on the same inventive concept, the embodiment of the present application further provides a magnetic resonance imaging based applicator, which can be used to implement the method described in the above embodiments, as described in the following embodiments. Since the principle of the magnetic resonance imaging-based applicator solves the problem is similar to the magnetic resonance imaging-based application position localization method, the implementation of the magnetic resonance imaging-based applicator can be referred to the magnetic resonance imaging-based application position localization method. Implementation, repetition will not be repeated. Although the apparatus described in the following embodiments is preferably implemented in software, hardware, or a combination of software and hardware, is also possible and contemplated.

2 is a schematic structural view of a magnetic resonance imaging-based applicator according to an embodiment of the present application.

As shown in FIG. 2, the magnetic resonance imaging-based applicator includes a post-installer 10 (not shown), an applicator tube 20, and a positioning tube 30 that matches the applicator tube, wherein As shown in FIG. 3, the positioning tube 30 is hollow and internally filled with a developer 31 for magnetic resonance imaging. The positioning tube 30 is used to be built into the applicator tube 20 during magnetic resonance imaging, with the applicator tube 20 being inserted into the application target position.

The applicator tube 20 of the present invention is made of an MRI compatible polymer material, and the positioning tube 30 is also made of a material suitable for magnetic resonance imaging.

In one embodiment of the invention, the positioning tube 30 is a hollow tube that is internally filled with the imaging agent that exhibits a high signal to noise ratio under magnetic resonance. Wherein, the imaging agent may be oil, water or other contrast enhancing agent (or imaging agent, contrast agent, etc.) suitable for magnetic resonance imaging, and is pre-closed and filled inside the positioning tube to ensure high in the three-dimensional magnetic resonance image. Lights up the position of the application tube. The contrast enhancer is, for example, a complex of DTPA (钆-diethylenediaminepentaacetic acid) or the like.

4 is a schematic illustration of an applicator tube of one embodiment of the present application. The source pipe 20 is closed at one end, and is a radiation therapy end 21 for placing a radiation source, and the other end has an interface 22 matching the post-installation machine 10. The inside of the pipe is a source channel 23, and during the treatment, the post-installer 10 passes through the interface 22. Connected to the applicator tube 20, the radioactive source is introduced under a computer control to a predetermined position of the radiation therapy end 21 in the source channel 23 in accordance with a radiotherapy plan.

Further, the applicator tube is made of a magnetic resonance imaging compatible polymer material, and the surface is provided with a preset precision scale. The operator can accurately determine the depth of the application tube to be placed according to the scale on the applicator tube (referred to as the application tube), and in the 3D magnetic resonance image, can also assist in locating the position of the application tube. And deviation.

According to an embodiment of the present application, the applicator includes at least one set of the applicator tube 20 and a corresponding one of the positioning tubes 30. Specifically, the number of the applicator tubes 20 is not limited to one according to the needs of the treatment, and each of the applicator tubes 20 is provided with an exact match (for example, matching of length, diameter, and interface connection). The positioning tube 30 inserts each positioning tube into a corresponding application tube in advance when performing three-dimensional magnetic resonance scanning, so that the position of each application tube can be located in the three-dimensional magnetic resonance image.

In this embodiment, a three-dimensional magnetic resonance scan is performed by inserting a positioning tube into the applicator tube and then inserting the site to be applied, since the positioning tube can be highlighted in the three-dimensional magnetic resonance image, so that the applicator tube The channel is no longer black in the 3D magnetic resonance image, which clearly shows the position of the applicator tube and the structure and lesions of the surrounding tissues and organs, provides better soft tissue contrast, and better presents the tissue characteristics of the lesion. It can precisely locate the location of the applicator tube and provide a basis for accurately designing the radiotherapy plan, accurately controlling the location and timing of the radioactive source, and improving treatment efficiency and safety.

FIG. 5 is a schematic flowchart of a magnetic resonance imaging-based application position localization method according to another embodiment of the present application. As shown in FIG. 5, the method includes:

In step 501, the positioning tube is inserted into the applicator tube.

Specifically, there may be one or more sets of positioning tubes and applicator tubes, each set of positioning tubes and the applicator tubes are matched with each other, and the differently sized applicator tubes are provided with corresponding positioning tubes. Insert the positioning tube into the corresponding applicator tube, and several applicator tubes are inserted into several positioning tubes.

Step 502, inserting the applicator tube inserted with the positioning tube into the site to be applied, and performing three-dimensional magnetic resonance imaging.

Step 503, determining a source location and a feeding scheme according to the imaging agent in the positioning tube, and positioning the applicator tube at the application position.

Specifically, the operator can estimate the position of the site to be applied according to experience or known information, insert the applicator tube inserted with the positioning tube into the estimated source to be applied, and determine by three-dimensional magnetic resonance scanning imaging. The condition of the tissue and organs around the current position of the source tube is determined, and the radiotherapy plan is determined, thereby determining the deviation of the position of the current applicator tube from the actual position to be applied, and adjusting the position of the application tube. According to the three-dimensional magnetic resonance image, the extent of the lesion and the relationship between the diseased tissue and the surrounding vital organs can be accurately evaluated, and an individualized radiation treatment plan can be formulated to determine the applicable irradiation dose in each application tube.

In step 504, the positioning tube is taken out.

After the position of the application tube is adjusted, the application tube is fixed at the position to be applied, and the positioning tube is taken out.

Step 505, connecting the post-installation machine to the applicator tube, and performing radiation source irradiation according to the application scheme.

Specifically, the application scheme may include a plurality of parameters such as a feeding position, an irradiation time, and the like, and a rear mounting interface at one end of the application tube is connected to the rear mounting machine, and the radioactive source is introduced into the application pipeline under computer control, and according to the The proposed protocol is for radiation therapy. After the quantitative irradiation (end of treatment) is completed, the radioactive source is returned to the computer under the control of the computer, and then the radiotherapy is completed.

The embodiment of the present application performs a three-dimensional magnetic resonance scan by inserting a positioning tube into the applicator tube and inserting the site to be applied. Since the positioning tube can be highlighted in the three-dimensional magnetic resonance image, the applicator tube is subjected to three-dimensional magnetic resonance. The image is no longer black, which clearly shows the position of the applicator tube and the structure and lesions of surrounding tissues and organs, provides better soft tissue contrast, better presents the tissue characteristics of the lesion, and thus can accurately locate the application. The location of the tube and the basis for accurate design of the radiotherapy plan, accurate control of the location and time of the radio source, improve treatment accuracy and safety.

It should be noted that in the description of the present application, the terms "first", "second" and the like are used for descriptive purposes only, and are not to be construed as indicating or implying relative importance. Further, in the description of the present application, the meaning of "a plurality" is two or more unless otherwise stated.

Any process or device description in the flowcharts or otherwise described herein can be understood as a module, segment or portion of code representing executable instructions including one or more steps for implementing a particular logical function or process. And the scope of the preferred embodiments of the present application includes additional implementations, in which the functions may be performed in a substantially simultaneous manner or in the reverse order depending on the functions involved, in accordance with the illustrated or discussed order. It will be understood by those skilled in the art to which the embodiments of the present application pertain.

It should be understood that portions of the application can be implemented in hardware, software, firmware, or a combination thereof. In the above-described embodiments, multiple steps or means may be implemented in software or firmware stored in a memory and executed by a suitable instruction execution system. For example, if implemented in hardware, as in another embodiment, it can be implemented by any one or combination of the following techniques well known in the art: having logic gates for implementing logic functions on data signals. Discrete logic circuit, An application specific integrated circuit with a suitable combination of logic gates, a programmable gate array (PGA), a field programmable gate array (FPGA), and the like.

One of ordinary skill in the art can understand that all or part of the steps carried by the apparatus for implementing the above embodiments can be completed by a program to instruct related hardware, and the program can be stored in a computer readable storage medium. When performed, one or a combination of the steps of the device embodiments is included.

In the description of the present specification, the description with reference to the terms "one embodiment", "some embodiments", "example", "specific example", or "some examples" and the like means a specific feature described in connection with the embodiment or example. A structure, material or feature is included in at least one embodiment or example of the application. In the present specification, the schematic representation of the above terms does not necessarily mean the same embodiment or example. Furthermore, the particular features, structures, materials, or characteristics described may be combined in a suitable manner in any one or more embodiments or examples.

While the embodiments of the present application have been shown and described above, it is understood that the above-described embodiments are illustrative and are not to be construed as limiting the scope of the present application. The embodiments are subject to variations, modifications, substitutions and variations.

Claims

A method for locating a position based on magnetic resonance imaging, characterized in that it comprises:

Insert the positioning tube into the applicator tube;

Inserting the applicator tube inserted with the positioning tube into the site to be applied, and performing three-dimensional magnetic resonance imaging;

A source location and a delivery protocol are determined based on the imaging agent in the positioning tube, and the applicator tube is positioned at the source location.
The method according to claim 1, wherein the positioning of the applicator tube after the application of the source position further comprises:

Removing the positioning tube;

A post-installation machine is coupled to the applicator tube and irradiated with the source according to the source protocol.
The method according to any one of claims 1 to 2, wherein the positioning tube is sized to match the applicator tube, the positioning tube is a hollow tube, and the interior is filled with a high magnetic resonance The imaging agent of the signal to noise ratio.
The method of claim 3 wherein the imaging agent is oil, water or a contrast enhancing agent.
The method according to claim 3, wherein the developer is pre-blocked and filled in the positioning tube.
A magnetic resonance imaging-based applicator, comprising a post-installer and a applicator tube, wherein the applicator further comprises a positioning tube matched with the applicator tube, wherein the positioning tube is Hollow, internally filled with an imaging agent for magnetic resonance imaging, which is used to be built into the applicator tube during magnetic resonance imaging, with the applicator tube being inserted into the application target position.
The applicator according to claim 6, wherein the imaging agent exhibits a high signal-to-noise ratio under magnetic resonance, and is enclosed and filled inside the positioning tube.
The applicator according to any one of claims 6 to 7, wherein the developer is oil, water or a contrast enhancer.
The applicator according to claim 6, wherein the applicator tube is made of a magnetic resonance imaging compatible polymer material, and the surface is provided with a scale of preset precision.
The applicator of claim 6 wherein said applicator comprises at least one set of said applicator tubes and corresponding said positioning tubes.