WO2019008793A1 - Appareil d'irradiation de faisceau de particules - Google Patents

Appareil d'irradiation de faisceau de particules Download PDF

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Publication number
WO2019008793A1
WO2019008793A1 PCT/JP2017/043812 JP2017043812W WO2019008793A1 WO 2019008793 A1 WO2019008793 A1 WO 2019008793A1 JP 2017043812 W JP2017043812 W JP 2017043812W WO 2019008793 A1 WO2019008793 A1 WO 2019008793A1
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Prior art keywords
irradiation
particle beam
image acquisition
particle
rotation
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PCT/JP2017/043812
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English (en)
Japanese (ja)
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原田　久
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三菱電機株式会社
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    • 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

  • the present invention is directed to particle beam therapy for treating cancer and the like by irradiating particle beams, by moving a plurality of devices targeting an irradiation area to be irradiated with particle beams to an angle required for each operation, for imaging and irradiation.
  • the present invention relates to a particle beam irradiation apparatus that switches the function of
  • JP-A-11-146874 (paragraphs 0017 to 0028, FIGS. 1 to 5) JP, 2002-306617, A (paragraphs 0013 to 0017, FIG. 1, FIG. 2) JP 2008-522677 A (paragraphs 0024 to 0026, FIGS. 2 to 4b) JP, 2011-505191, A (paragraphs 0054-0058, FIG. 12) JP, 2015-500719, A (paragraph 0043-0051, FIG. 2)
  • the number of support structures supporting the respective devices increases to complicate the device arrangement around the irradiation area, it becomes difficult to avoid collision between the devices, or it becomes difficult to secure the safety of patients and technicians. And had many challenges. Further, for example, there is also a problem that an imaging device and an irradiation device interfere with each other to make desired imaging and accurate irradiation difficult.
  • a particle beam diagnostic device for diagnosing particle beams and a medical image acquisition device for acquiring a medical image may be concentrated in a narrow space around the irradiation position. desirable.
  • these equipments use equipment used for positioning of the affected area, and computed tomography (CT) techniques that rotate around the patient for imaging during the patient setup stage before irradiation.
  • CT computed tomography
  • an apparatus for example, a cone beam CT apparatus.
  • imaging is performed while rotating an imaging device around a patient, so it was difficult to secure a space around the patient so that the apparatus would not interfere.
  • the present invention has been made to solve the above problems, and enables various imaging and particle beam diagnostic equipment arrangements without moving the patient from the irradiation position, and the efficiency without impairing the imaging accuracy.
  • An object of the present invention is to provide a particle beam irradiation apparatus that enables well accurate irradiation.
  • the particle beam irradiation apparatus is provided independently of the irradiation port for irradiating the particle beam accelerated by the accelerator toward the patient and the irradiation port, and passes the particle beam irradiated from the irradiation port.
  • a control unit is provided, which controls the emission of the particle beam from the irradiation port and controls the operation of the rotary drive unit.
  • efficient and accurate irradiation can be realized without impairing the imaging and irradiation accuracy, by providing the rotating stand provided with the support device independently from the irradiation port for irradiating the particle beam to the affected part of the patient. can do.
  • FIG. 1 It is a schematic diagram when the particle beam irradiation apparatus regarding Embodiment 1 of this invention is seen from a rotating shaft direction. It is the cross-sectional schematic diagram which cut
  • FIG. 1 shows the particle beam irradiation apparatus 800 in the rotational axis direction of the rotating gantry.
  • FIG. 2 is a schematic cross-sectional view of the particle beam irradiation apparatus 800 taken along a plane including the rotation axis and the vertical line of the rotating gantry, and
  • FIG. 3 is a particle beam therapy apparatus 900 including the particle beam irradiation apparatus 800.
  • FIG. 4 is a block diagram showing the configuration of a control unit that controls the single operation of the particle beam irradiation apparatus 800 and the cooperative operation with the particle beam therapy apparatus 900.
  • the present invention is most characterized in the configuration of a particle beam irradiation apparatus 800 for easily switching between irradiation devices and imaging modalities, and efficiently and accurately achieving irradiation without impairing the imaging and irradiation accuracy.
  • the configuration of the particle beam therapy system 900 for irradiating the particle beam to the irradiation target will be described.
  • the particle beam treatment apparatus 900 provided with the particle beam irradiation apparatus 800 according to the first embodiment of the present invention is, as shown in FIG. 3, an accelerator 500 which is a synchrotron as a source (particle source) of particle beams.
  • An irradiation unit 200 which shapes and irradiates the particle beam supplied from 500 according to an affected area (irradiation target), connects an accelerator 500 and one or more irradiation units 200 (including a portion not shown) And a transport system 400 for transporting the particle beam emitted from the accelerator 500 to the selected irradiation unit 200.
  • the accelerator 500 may be an accelerator of a system other than a synchrotron such as a cyclotron or a synchrocyclotron, but, for example, in the case of a synchrotron as described above, a vacuum duct serving as an orbital path for circulating charged particles, An incidence device for injecting charged particles supplied from an accelerator into a vacuum duct, a deflection electromagnet for deflecting a charged particle trajectory so that the charged particles orbit along the orbit in the vacuum duct, on the orbit A focusing electromagnet for focusing the charged particles so as not to diverge, a high frequency accelerating cavity for accelerating by applying a high frequency voltage synchronized to the circulating charged particles, a charged particle accelerated in the circulating orbit as a particle beam having a predetermined energy Extraction device for taking out out of orbit and emitting to particle beam transport part, particle beam is emitted from the emission device And a sextupole electromagnet for exciting the resonance in circulation orbit in order to. Then, the charged particles in the orbit are accelerated
  • the transport system 400 is referred to as a HEBT (High Energy Beam Transport) system, and includes a vacuum duct 410 serving as a particle beam transport path, a switching electromagnet 420 for switching the particle beam trajectory, and the particle beam at a predetermined angle. And a deflection electromagnet for deflecting the light.
  • HEBT High Energy Beam Transport
  • description is abbreviate
  • the irradiation unit 200 is installed in each irradiation chamber 300 for performing particle beam therapy on the patient K, and shapes the particle beam supplied from the transport system 400 into an irradiation field according to the size and depth of the irradiation target To the
  • the particle beam supplied to the irradiation unit 200 is a so-called pencil-like thin beam. Therefore, the irradiation unit 200 includes an irradiation field forming member (not shown) for controlling the shape of the particle beam irradiation field in the lateral direction (that is, the plane perpendicular to the beam traveling direction) and the depth direction (i.e., the beam). An irradiation field forming member for controlling the traveling direction). Further, the irradiation room 300 is provided with a treatment table 320 and the like for positioning and fixing the patient K being irradiated with reference to the irradiation area.
  • a ridge filter also referred to as a ripple filter
  • Range shifters etc. can be considered.
  • a scanning electromagnet (not shown) that deflects the particle beam in a direction perpendicular to the beam traveling direction can be considered.
  • detectors (a beam position monitor, a dose monitor, etc.) for measuring the beam position and beam fluence of the deflected particle beam are provided.
  • a control unit for example, control units 610, 620, 630,..., 6 **
  • a cooperation control unit for example, , And the control unit 600
  • the irradiation unit 200 has a function to form an irradiation field suitable for irradiating a particle beam to a patient, and the treatment planning apparatus 700 irradiates a desired dose distribution. It has a function of determining the parameters of each device of the accelerator 500 to appropriate values. Then, when confirming the treatment plan or changing the treatment plan according to the situation, an imaging device for specifying the position, fluctuation, etc. of the patient's tumor, and a device for measuring the irradiation beam during treatment It will be necessary.
  • a portion of the irradiation unit 200 that emits the particle beam is referred to as an irradiation port (for example, an irradiation port 220 r, an irradiation port 220 A, and the like described later).
  • the rotation angle of the rotating gantry is not approximately 360 degrees, but approximately 220 degrees Limited examples are also known.
  • the embodiment of the present invention can be implemented regardless of the type of gantry or the number of treatment rooms.
  • An example in which an accelerator is combined with a rotating gantry to reduce the size of the rotating gantry irradiation chamber in a single-chamber type particle beam therapy system is shown in FIG.
  • the accelerator is fixed and does not rotate with the rotating gantry.
  • FIG. 6 shows an example where the accelerator rotates with the gantry. Further, FIG.
  • Patent Document 4 discloses a method of rotating an accelerator around a patient.
  • a deflection electromagnet 430 and a quadrupole electromagnet 440 are provided in the beam transport part between the accelerator and the irradiation point to bend the trajectory of the particle beam or to converge the beam.
  • the beam emitted from the accelerator is directly sent to the irradiation system.
  • the beam spreads when passing through the range adjusting device in the irradiation device 210 or the nozzle tip device 220r, and the spot size irradiated to the affected area tends to be large.
  • rotation apparatus 100 is provided in irradiation chamber 300.
  • the particle beam irradiation apparatus 800 includes a rotary device 100 including a rotary gantry 110 and a rotary drive unit 121 that rotationally drives the rotary gantry 110, a rotary gantry 350 having the same center of rotation as the rotary device 100, a rotary drive unit 121 and a rotary gantry 350.
  • a rotary drive unit 121 that controls the operation of the drive unit (not shown), a treatment table 320 on which the patient is placed, and an irradiation unit 200 that irradiates the patient with particle beams.
  • the particle beam irradiation apparatus 800 is provided with a rotating apparatus 100 that is rotationally driven so as to share the rotation axis Xr with the rotating gantry 350.
  • the treatment table 320 is not fixed to the rotation device 100, and is installed to rotate around the patient K placed thereon, like the rotation gantry 350.
  • the details will be described below.
  • the rotating gantry 350 originally requires a large-scale rotation of a duct portion, a deflection electromagnet, and the like, only a ring-shaped portion (referred to as a ring portion) is shown in the figure for the sake of simplicity.
  • a point Ic (corresponding to the isocenter) in the irradiation area is set on the rotation axis Xr of the rotation gantry 350, and the irradiation port 220r installed in the ring part of the rotation gantry 350 in the irradiation unit 200 has an emission direction. Is directed to a point Ic in the irradiation area, and is rotationally driven about the point Ic in the irradiation area.
  • the portion on which the patient K is placed floats from the floor 310 It is stretched to a position beyond the irradiation range in the state.
  • irradiation angle rotation plane a plane perpendicular to rotation axis Xr
  • the rotating device 100 includes a rotating gantry 110 that rotates around the same rotation axis Xr as the rotating gantry 350, and a plurality of devices such as an imaging device or a radiation detector disposed along the circumferential direction of the rotating gantry 110. ing.
  • the drive range of the rotating stand can bring all the devices arranged along the circumferential direction to the use position. That is, if the drive range is from 0 degrees to 360 degrees, all use angles can be covered, but if the drive range is from 0 degrees to 540 degrees, that is, 1.5 laps, up to the next use angle in all states
  • the movement angle of can be 180 degrees or less, and device setting can be performed in a shorter time.
  • the rotation base 110 is provided with a rotation drive unit 121 for adjusting the rotation angle of the rotation base 110 to a desired angle, and a wheel 122 w that rolls on the rail 122 r fixed to the floor surface 310. And a linear drive unit 122 which drives in a direction.
  • the translation platform 110 is moved to a predetermined position and positioned by translating the rotation platform 110 along the rotation axis Xr in a plane parallel to the floor surface 310 of the irradiation chamber 300 by the straight drive unit 122.
  • the imaging device and the irradiation device do not interfere with each other by operating in cooperation with the irradiation unit 200 (in particular, the position of the irradiation port 220r) in a state where each of the devices is arranged in the irradiation angle rotation plane And accurate irradiation can be done.
  • the rotation device 100 has a rotation / operation structure different from that of the rotation gantry 350, and the setting angle can also be set separately from the rotation gantry.
  • a radiation detector is a detector that detects primary radiation that is a particle beam used for treatment, or secondary radiation (X-rays, gamma rays, charged particles, etc.) generated by the reaction of primary radiation with atoms or nuclei. It refers to a detector to detect.
  • a plurality of devices including radiation detectors were installed on the particle beam passage devices installed on the passage where the particle beam passes at the time of treatment irradiation and its extension, and at other places along the circumferential direction. It can be roughly classified into two of particle beam passage outside equipment.
  • particle beam passage part (duct part) 130 which becomes a passage route when particle beam emitted from irradiation port 220r goes to the affected part including point Ic in the irradiation area is irradiation port at the time of irradiation Aligned to the same angle as 220r.
  • the rotating device is rotated 180 degrees from the position shown in FIG. 1 and disposed immediately downstream of the irradiation port 220r.
  • the downstream particle beam detection unit 141 that detects the particle beam transmitted through the affected area is disposed diagonally of the irradiation unit 200 with the point Ic in the irradiation area.
  • the beam stopper 111 which stops particle beam is arrange
  • the irradiation boat 220 r is at the 12 o'clock position in FIG. 1, actual irradiation is performed from various angles. Also in this case, the above-described operation is the same, and the particle beam passage (duct) and the downstream particle beam detector are set with respect to the angle of the irradiation port 220r.
  • an X-ray generator such as an X-ray tube, a flat panel detector (FPD) or an image intensifier tube as an image acquisition device used for positioning a patient or an affected part called digital radiography Combinations of x-ray imaging devices are conceivable.
  • the X-ray generators 152 s and 153 s are disposed as X-ray generators, and the FPDs 152 m and 153 m are disposed opposite to each other with the point Ic in the irradiation area facing the X-ray tubes 152 s and 153 s. Then, X-ray image acquisition devices 152 and 153 are configured.
  • a PET (Positron Emission Tomography) detector a PET (Positron Emission Tomography) detector, a SPECT (Single Photon Emission Computed Tomography) detector, or a scintillation detector for detecting gamma rays called prompt gamma rays may be considered.
  • two PET detectors 151a and 151b are opposed to each other across a point Ic in the irradiation area. An example is shown in FIG.
  • the rotating device 100 is provided with protective covers on the inside and the outside of the circumferential portion.
  • the protective cover is also used to protect the device mounted on the rotating device, to protect the patient when the rotating device is rotated, and to prevent collision with devices other than the rotating device.
  • the inner protective cover since X-ray imaging is performed through this cover, it is made sufficiently thin using a material with a low atomic number such as polyimide.
  • the particle beam passage portion (duct portion) 130 omits the protective cover for the portion where particle beam scattering is concerned.
  • the inner and outer covers of the rotating portion be circular in order to avoid interference during rotation, it is not circular but is polygonal such as octagonal or hexagonal or partially straight It is also good.
  • the configuration of the particle beam diagnostic apparatus 142 of the on-particle beam passage devices will be described in more detail.
  • a detector provided as the particle beam diagnostic apparatus 142 is a multilayer Faraday cup, a radiation film loaded in a radiation film holder, a fluorescent screen beam monitor and a video camera, or a two-dimensional semiconductor detector called a 2D array or the like. It is an apparatus.
  • a multilayer Faraday cup is a device in which a normal Faraday cup is multilayered in the depth direction, and the range (energy) of a particle beam can be confirmed in real time by reading out these layers independently.
  • the radiation film holder may be loaded with a radiation film and irradiated with a pencil beam in a test pattern such as a grid or may be irradiated to form a two-dimensional uniform distribution.
  • the beam size and shape of the pencil beam can also be confirmed in detail. Although analysis of the film takes time, it may be performed as needed.
  • the position, size, shape, uniformity of dose distribution, etc. of the pencil beam can be easily confirmed in a shorter time by using a fluorescent screen beam monitor and a video camera. Even if it is impossible to carry out verification of absolute accuracy using these verification methods, it is sufficiently worthwhile to check only the reproducibility.
  • the above specific confirmation items may be determined according to the concept of each treatment facility. Items to be confirmed may be determined appropriately so that the irradiation accuracy can be secured, for example, for each patient, every irradiation session, every day, every week, or the like.
  • the particle beam passage portion (duct portion) 130 and the particle beam diagnostic device 142 used in the quality assurance check are arranged along the circumferential direction of the rotating device 100. Lined up. Therefore, it is possible to switch between treatment and quality assurance confirmation only by setting the rotation angle to a desired value, so troublesome installation work is unnecessary, daily work is facilitated, and confirmation is made without lowering work efficiency.
  • the frequency can also be increased.
  • the particle beam diagnostic apparatus 142 is disposed on the opposite side of the irradiation nozzle (irradiation unit 200), and the rotating apparatus 100 is rotated 180 degrees to use the particle beam diagnostic apparatus 142 as the particle beam incident direction. Is assumed to be close to the irradiation nozzle. However, for example, when the medical image acquisition apparatus 151 is not provided, the particle beam diagnostic apparatus can be disposed in the space there, and if it does not rotate by 180 degrees, it may be shortened by only rotating by 90 degrees. You can switch between quality assurance confirmation and treatment irradiation on time. However, if the arrangement shown in FIG. 1 is to be used for the transmission type irradiation described later, the beam stopper 111 is opened to allow the particle beam diagnostic apparatus 142 to generate a point Ic in the irradiation area. It can be used even downstream.
  • downstream particle beam detection unit 141 which is a device on the particle beam passage, will be described.
  • treatment planning is usually made so that the depth of the Bragg peak is near the affected area as described above.
  • transmission irradiation which is another use of particle beam irradiation described below, the energy of the particle beam emitted from the irradiation unit 200 is set high, and irradiation is performed so that the particle beam passes through the patient K's body.
  • the radiation as the downstream particle beam detection unit 141 in the direction opposite to the irradiation nozzle (irradiation unit 200) across the point Ic in the irradiation region that is, the downstream side of the point Ic in the irradiation region as viewed from the particle beam
  • a detector is placed to measure particle beams penetrating through the body by transmission radiation.
  • various radiation detectors can be considered as an apparatus used for the downstream particle beam detection unit 141, specifically, positions of particle beams such as a multi-wire chamber, a multi-strip chamber, a semiconductor position detector, an FPD, and a radiation film There are conceivable known devices which can be detected.
  • the transmission irradiation confirmation of the irradiation site as described below, acquisition of a particle beam radiography image, acquisition of a particle beam tomographic image, and the like can be considered.
  • Permeable irradiation can be performed as preparatory irradiation immediately before therapeutic irradiation, or can be performed with temporary interruption of therapeutic irradiation.
  • the downstream particle beam detection unit 141 by performing preparation irradiation using the downstream particle beam detection unit 141, normally, it can be confirmed while irradiating whether the particle beam performed in advance is in contact with an appropriate location.
  • the location information two-dimensional coordinates in the lateral direction of the particle beam
  • the position information of particle beam irradiation obtained by the downstream particle beam detection unit 141 Check to make sure that it falls within the preset tolerance range.
  • the values projected to the downstream particle beam detection unit 141 in consideration of the divergence of the scanned beam Use If the difference between the projected coordinates and the measured coordinates is out of the range of the allowable accuracy, the irradiation of the particle beam is immediately interrupted as an irradiation position abnormality, and the particle beam therapy system 900 is suspended.
  • the center position of the particle beam is suitable as the position information, the beam size of the particle beam (second moment of beam profile) may be confirmed as additional information.
  • the particle beam emitted from the irradiation unit 200 has a sufficiently high energy and can be transmitted through the patient's body.
  • the intensity (beam current) of the particle beam emitted from the irradiation unit 200 is controlled so that the dose used is sufficiently smaller than the treatment dose, and is included in the treatment dose in the treatment plan. Keep it.
  • downstream particle beam detection unit 141 is an imaging device such as an FPD or a radiation film
  • particle beam radiography can be acquired by measuring the transmitted particle beam. By comparing this image with the reference image, it is possible to directly confirm that the positional deviation is within the allowable range in the treatment irradiation. This confirmation is done just prior to therapeutic irradiation.
  • X-ray image acquisition devices 152 and 153 which are devices outside the particle beam passage will be described.
  • particle beam therapy it is necessary to accurately position the affected area before irradiating the affected area with a treatment line.
  • X-ray images are acquired from two directions using an X-ray tube and FPD, etc., and alignment and confirmation of the affected area are performed.
  • the rotation device 100 a positioning image can be acquired in a short time by rotating the device to a desired angle.
  • the target area is moved by respiration and blood flow, so in order to perform accurate irradiation, it is desirable to perform irradiation while confirming the movement of the affected area with X-rays. If the displacement due to the movement exceeds the desired range, the control unit of the X-ray image acquisition apparatus determines it, and the irradiation is immediately interrupted via the control unit of the irradiation unit 200, and the displacement is within the desired range. Resume when it comes to The particle beam for treatment and the X-ray for imaging may be irradiated simultaneously or alternately. When alternately irradiating, it is necessary to switch between X-ray imaging and particle beam irradiation at high speed within one second.
  • the X-ray image acquisition device since the X-ray image acquisition device is installed around the irradiation point in advance, it becomes easy to perform X-ray imaging while irradiating the particle beam. Since the X-ray image acquisition apparatus can be placed near the patient, a wide imaging field can be taken without being disturbed by other devices. In order to confirm the movement, not only the affected area but also the surrounding area, such as the movement of the diaphragm deviated from the irradiation target, may be used, and the wide X-ray imaging range enables such peripheral information to be utilized. The irradiation accuracy can be secured for more parts.
  • the setting angle of the X-ray image acquisition apparatus is often acquired at an angle on the positive side with respect to the irradiation chamber, regardless of the angle of the irradiation port 220r.
  • positioning may be performed from the irradiation angle, which is also referred to as “beams eye view”, but in the present invention, it is possible to easily cope with such other imaging conditions simply by bringing the rotation device to a desired angle. can do.
  • CBCT cone beam tomographic
  • the prior art discloses an example in which a mechanism that rotates independently of the rotating gantry is provided.
  • the irradiation nozzle and the rotation mechanism interfere with each other, it is difficult to obtain a CBCT image when the patient is at the treatment position (that is, when the reference point of the affected area is positioned within the irradiation area).
  • Patent Document 3 since the X-ray generation apparatus and the X-ray imaging apparatus are protruded, it is difficult to increase the rotational speed in consideration of safety against the collision with the patient and peripheral devices.
  • the patient can be positioned without moving from the treatment position, and an image can be acquired in a short time, thereby shortening the working time and preventing displacement of the patient's posture due to movement after positioning. Both advantages of accuracy are obtained.
  • the rotating apparatus 100 since the X-ray tubes 152s, 153s and the FPDs 152m, 153m can be installed in the covered case, the rotational speed can be increased. it can. This enables high-speed imaging of the part moving by breathing. Furthermore, the combination of the X-ray generator and the X-ray imaging apparatus (X-ray tube 152s and FPD 152m, or X-ray tube 153s and FPD 153m) which are devices outside the particle beam passage, and the particle beam passage portion (duct portion) 130 rotate They are aligned along the circumferential direction of the device 100.
  • the rotation drive unit 121 is rotated by at least 180 degrees + ⁇ degrees.
  • ⁇ corresponds to an angle range which can be imaged at one time by the X-ray tube 153s and the FPD 153m.
  • the rotational angular range may be 90 ° C. + ⁇ degrees or more if imaging data acquired from these two pairs is used comprehensively.
  • 4D-CBCT four-dimensional cone beam CT
  • the PET apparatus PET detectors 151a and 151b
  • PET detectors 151a and 151b a method of viewing at a place other than the point Ic in the irradiation area (that is, in a state where the treatment table is slightly away from the treatment position)
  • measurement can be performed in the state of irradiation without moving the patient.
  • not only positioning of the patient is required only once, but also positioning accuracy at the time of treatment can be confirmed, and as described above, there is an advantage that confirmation can be performed even during preparatory irradiation and treatment irradiation.
  • the irradiation unit 200 can perform preparation irradiation with characteristics of preparation irradiation performed in a short time as compared with treatment irradiation, or preparation irradiation performed by reducing the irradiation beam current, or both, and may be performed just before the start of treatment irradiation. It is possible to make a preparation irradiation.
  • preparatory irradiation refers to irradiation using a part of the dose specified in the treatment plan.
  • the irradiation is temporarily stopped, the information from the equipment mounted on the rotating device 100 is collected and processed by the irradiation control unit, displayed to the operator, and whether to continue the irradiation based on the information It may be possible for the operator to make a decision.
  • the dose used for confirmation can be suppressed by using preparatory irradiation.
  • a control system for controlling the operation of the rotation device 100 and the cooperative operation with the particle beam therapy device 900 is configured by a plurality of controllers. For example, it is desirable from the viewpoint of operability that the display of the rotation angle, the display of the operation, the display of the mounted detector, and the operation can be performed on the control screen installed in the irradiation chamber 300 including the rotating device 100.
  • the control screen of the rotating device 100 and the control function have the same display and operation on the control terminal installed outside the irradiation chamber 300. It is desirable to be possible.
  • the rotation device 100 (rotation drive unit 121) includes a rotation angle detector (not shown), and confirms that the rotation angle of the rotation device 100 matches the angle of the irradiation port 220r required for the treatment at that time. It is conceivable that this confirmation is performed by either the control computer (control unit 610) of the rotating device 100 or the control computer (control units 600 and 620) of the irradiation unit 200.
  • control computer reads the rotation angle from the rotation angle detector attached to the rotating device 100, and is matched with the desired rotation angle transmitted from the irradiation unit 200. Only when the "rotation angle OK" enable signal is turned ON. It is conceivable to use this enable signal for the "irradiable" interlock of the irradiation unit 200. In addition, it is desirable to double confirmation means from the safety of treatment.
  • the rotation angle detector a rotary encoder attached to the rotation drive unit 121 of the rotation device 100 can be considered. An indicator for displaying the rotation angle, the state of the rotation device 100, and the state of the mounted device may be attached near the rotation device 100, or the rotation angle may be displayed on the operation screen of the irradiation unit 200.
  • the irradiation unit 200 in particular, the irradiation port 220r or the accelerator 500, it is ensured that the respective coordinate systems match within sufficient accuracy.
  • the radiation detector the particle beam diagnostic device 142 or the nozzle tip device 210) of the rotation device 100.
  • This beam position detector is a device that can detect the beam position in a plane perpendicular to the beam axis, and uses a known fluorescent plate and a CCD camera, multi-wire chamber, multi-strip chamber, multi-electrode semiconductor detection Bowl etc. can be considered.
  • the particle beam is irradiated with the rotation angle of the rotation device 100 at a desired position, and it is confirmed that the particle beam in the beam position detector comes to a desired position with a desired accuracy.
  • the trajectory of the particle beam can be corrected by one or more sets of horizontal and vertical steering electromagnets (not shown) installed in the upstream device (for example, the transport system 400) or the scanning electromagnet described above.
  • the upstream device for example, the transport system 400
  • the scanning electromagnet described above.
  • beam trajectory correction can be performed in real time by providing a feedback circuit that enables dynamic excitation and change of the steering electromagnet or the above-mentioned scanning electromagnet, and can calculate the beam position detection and correction amount at high speed. Is also possible. Also, as a safety consideration, when the beam trajectory correction amount exceeds a certain value, it is conceivable that the rotation angle of the rotating device 100 is incorrect or there is an abnormality in the upstream device, so interlocking is performed. You should do it.
  • the apparatus outside the particle beam passage (medical image acquisition device 151, X-ray image acquisition device 152, 153), the nozzle tip device 210 (irradiation field forming member, beam position monitor) which is the device above the particle beam passage. , A dose monitor), a particle beam diagnostic apparatus 142, a downstream particle beam detection unit 141, and a beam stopper 111, which are provided to support irradiation of particle beams, and are referred to as a support device.
  • each supporting device on the circumference in FIG. 1 is determined in consideration of the interference of the imaging range, the interference of the device and the wiring, etc. The same function can be obtained except for the arrangement example described here.
  • the FPD 153 m is located closer to the particle beam passage portion 130 than the X-ray tube 153 s in FIG. 1, this arrangement may be reversed.
  • the X-ray image acquisition devices 152 and 153 are illustrated in a positional relationship of approximately 45 degrees with the particle beam passage portion 130 interposed therebetween, the same function can be obtained by arranging them at angles other than this.
  • the irradiation port 220 r for irradiating the particle beam accelerated by the accelerator toward the patient K and the irradiation port 220 r are provided independently.
  • a control unit 610 is provided to control the emission of particle beam from the port 220 r and to control the operation of the rotational drive unit 121.
  • the equipment whose usable position is determined in the irradiation direction of the particle beam for example, the downstream particle beam detection unit 141, the medical image acquisition device 151 Since the position in the circumferential direction is fixed on the basis of the position, the device can be used simply by adjusting the position of the particle beam passage (duct) 130 according to the irradiation direction of the particle beam. It can be switched.
  • the inspection apparatus includes an apparatus (for example, the X-ray image acquisition devices 152 and 153) that operates while rotating around the rotation center (rotation axis Xr), imaging and treatment are performed without extra work. Can be performed continuously.
  • an apparatus for example, the X-ray image acquisition devices 152 and 153 that operates while rotating around the rotation center (rotation axis Xr)
  • imaging and treatment are performed without extra work. Can be performed continuously.
  • the rotating frame 110 is provided so as to be movable in translation along the rotation axis Xr, the rotating frame is driven to a predetermined position and positioned, and each of the plurality of devices is disposed within the irradiation angle rotation plane
  • the irradiation unit 200 in particular, the position of the irradiation port 220r
  • imaging and accurate irradiation can be performed without interference between the imaging device and the irradiation device.
  • FIG. 7 is a view for explaining the particle beam irradiation apparatus 800 according to the second embodiment, and is a schematic view when a rotating device in which a rotating gantry and a rotating shaft are aligned is viewed from the rotating shaft direction. Note that the configuration used in the first embodiment is used for the configuration relating to the particle beam therapy apparatus 900 and the control, and the description of the same parts is omitted.
  • the rotating device 100 rotatably supports the nozzle tip device 210 in the rotating frame 110.
  • the nozzle tip device 210 is basically the irradiation field forming member described in the irradiation unit 200 of the first embodiment.
  • the irradiation field forming member refers to a range shifter, (or offset range shifter), ridge filter, (or ripple filter), compensation filter (also called bolus) holder, patient collimator, multileaf collimator, and the like.
  • the range shifter is a device for controlling the range of particle beam
  • the ridge filter is a device for intentionally broadening the Bragg peak
  • the compensation filter is a filter manufactured according to the shape of the rear end side of the target (tumor). It forms the radiation field in the depth direction.
  • the patient collimator is a collimator manufactured to the shape of the particle beam in the lateral direction (direction perpendicular to the beam irradiation direction) with respect to the target.
  • a multileaf collimator is a computer-controllable movable collimator. The use of these radiation field forming members is determined by the medical staff depending on the case, and is not necessarily used.
  • a beam position monitor and a dose monitor may be provided. These are all known in particle beam therapy, and in scanning radiation etc., the tip of an irradiation nozzle (irradiation port) is a valid device as an installation place.
  • a beam position monitor a multi-wire chamber, a multi-strip chamber, etc., and as a dose monitor, an ion chamber, a secondary electron emission monitor, etc. can be used, both of which are known techniques in conventional particle beam therapy. It is desirable to arrange the nozzle tip device 210 as downstream as possible in order to suppress beam size expansion due to scattering.
  • one rotational structure of an apparatus to be disposed near the point Ic in the irradiation area by installing a part of the apparatus of the irradiation unit, which is usually installed at the tip of the irradiation unit 200, on the rotating device 100 side. It is possible to concentrate on objects and secure a rotational space within a constant radius from the point Ic in the irradiation area. That is, interference between the image acquisition device and the irradiation unit when acquiring a tomographic image such as CBCT can be avoided by suppressing the unevenness of the irradiation unit tip on the irradiation port side. At the same time, the device at the tip of the nozzle can be installed as close as possible to the patient, and the beam diameter can be suppressed from expanding.
  • a vacuum duct for passing the particle beam is also provided in the irradiation unit 200.
  • the vacuum duct and the vacuum duct 410 of the transport system 400 from the accelerator 500 be integrated via a shutoff valve, and the vacuum window at the beam outlet be installed as downstream as possible.
  • the beam diameter of the particle beam is expanded by the scattering generated at the vacuum window, so that the beam diameter at a point in the irradiation area can be kept smaller when the vacuum window is as downstream as possible.
  • a vacuum window at the beam outlet may be provided immediately upstream of the rotating device 100.
  • the beam position monitor is normally provided with two units, primary and secondary, to obtain redundancy, and one of the two units is installed as the nozzle tip device of the rotating device, and the other is Installed on the upstream irradiation unit 200 side and comparing the measurement values of the two beam position monitors, it is confirmed that the rotation angle at which the rotating device is set is a desired value, and the safety of the irradiation device It can be enhanced.
  • the cover of the rotating portion be substantially circular in consideration of interference during rotation, since it is desirable that the irradiation nozzle tip device 210 be as close as possible to the irradiation area, as shown in FIG. A protrusion may be provided on the nozzle cover to make it close, or only this portion may be straight.
  • the rotating device 100 includes the irradiation field forming member that forms the irradiation field of the particle beam in the particle beam passage portion (duct portion) 130.
  • the irradiation field forming member that forms the irradiation field of the particle beam in the particle beam passage portion (duct portion) 130.
  • the radiation detector (beam position monitor, dose monitor) is installed in the particle beam passage (duct) of the rotating frame 110, the measurement of the radiation detector installed on the upstream irradiation unit side By comparing with the value, it is possible to confirm that the rotation angle set by the rotation device is a desired value and to enhance the safety of the irradiation device.
  • FIG. 9 is a view for explaining the particle beam irradiation apparatus 800 according to the third embodiment, and is a schematic view when a rotation device in which a rotation gantry and a rotation axis are aligned are viewed from the rotation axis direction. Also in the third embodiment, the configuration used in the first embodiment is used for the configuration relating to the particle beam therapy apparatus 900 and the control, and the description of the same parts is omitted.
  • the rotating device 100 is provided with either the range telescope or the split calorimeter as the downstream particle beam detection unit 141. .
  • particle beam CT particle beam tomographic images
  • a range telescope is a measurement device for measuring the remaining range of transmitted particle beams, and the remaining range is the remaining range of particle beams that have lost some of their kinetic energy in the body. It is.
  • the beam position detector measures the passing position of the particle beam
  • the multilayer detector measures the remaining range of the particle beam. At this time, a method of individually measuring one particle of the particle beam and a method of measuring as a pencil beam in which the particle beam is finely narrowed can be considered.
  • the remaining energy of the particle beam may be measured using a split energy meter (split calorimeter).
  • a radiation detector such as CsI, BaF, LaBr 3 or the like, which has a sufficient thickness to absorb all the remaining energy, is used. These detectors may be finely divided and arranged in the lateral direction of the particle beam, and the particle beam may be used to guide light generated in the detector by an optical fiber to a photomultiplier or the like.
  • the residual energy is directly measured, and if it is measured as a pencil beam finely narrowed particle beam, particles counted by the upstream dose monitor etc.
  • the prompt gamma ray detector is mounted on the rotation apparatus 100 as the medical image acquisition apparatus 151.
  • a detector there are known methods such as a slit gamma camera and a Compton camera.
  • the slitted gamma camera the position and direction of the detected gamma ray are limited by providing a slit in front of the divided gamma ray detector.
  • the Compton camera can identify the gamma ray generation position by measuring the scatterers that scatter gamma rays and the scattered photons.
  • preparatory irradiation can be performed in prompt gamma ray detection as in the case of PET detection.
  • the prompt gamma ray detector or the like can be visualized and displayed on the screen, the information obtained by these devices may not necessarily represent the range of the particle beam directly. That is, the generation probability of prompt gamma rays depends on the energy of the particle beam and the material of the target. In order to take account of this dependency, it is desirable to compare the calculation and the measurement in the analysis result calculated in advance by a known calculation code capable of particle beam transport simulation. However, it is not necessary to compare the reproducibility with the previous irradiation result using only the measurement result.
  • FIG. 10 is a view for explaining the particle beam irradiation apparatus 800 according to the fourth embodiment, and is a schematic view when the rotation apparatus is viewed from the rotation axis direction.
  • the diagram used in the first embodiment is used for the basic configuration and the configuration relating to control of the particle beam therapy system 900, and the description of the same parts is omitted. Further, since the devices in the rotating device are the same as those described in the first to third embodiments, the description will be omitted.
  • the particle beam is directed from the 12 o'clock direction and the 3 o'clock direction toward the point Ic in the irradiation area.
  • the center (reference axis) serving as the reference of the change of the angle corresponds to the rotation axis Xr of the rotating gantry described above, and the rotation device 100 in the fourth embodiment also causes the reference axis to coincide with the rotation axis.
  • angle of the irradiation port is not limited to horizontal and vertical but may be another angle as long as it is in the same plane as the rotation surface of the rotating gantry 110, such as 45 degrees diagonally or 45 degrees horizontally and 45 degrees vertically .
  • the irradiation chamber 300 receives an irradiation port (for example, 220A) for irradiating particle beams from an angle fixed to the point Ic in the irradiation area.
  • an irradiation port for example, 220A
  • the rotation center (rotation axis Xr) of the rotating gantry 110 is perpendicular to the line connecting the point Ic in the irradiation area and the fixed irradiation port, the irradiation direction of the particle beam is Imaging and treatment of a patient's condition centering on a point in the irradiation area can be performed without interruption in a plane including the inside of the irradiation area.
  • the irradiation chamber 300 is provided with a plurality of the above-described fixed irradiation ports so as to irradiate particle beams from different angles in the plane set with respect to the point Ic in the irradiation area, the imaging accuracy And accurate illumination can be realized efficiently.
  • Embodiment 5 an example of non-coplanar irradiation using a rotating gantry will be described based on FIGS. 11 and 12.
  • Coplanar irradiation is irradiation performed with the patient's body axis, that is, the long axis of the treatment table substantially parallel to the rotation axis of the gantry, and the particle beam is irradiated in a plane substantially perpendicular to the body axis. In the plane, it says to irradiate from a desired angle in 360 degrees.
  • non-coplanar irradiation irradiation is performed from a direction other than a plane substantially perpendicular to the body axis.
  • FIG. 11 is a view showing the state of the treatment table and the rotating device at the time of coplanar irradiation
  • FIG. 12 is an example of the state of the treatment table and the rotating device at the time of non-coplanar irradiation.
  • the rotational axes of the rotating gantry and the rotating device are kept parallel.
  • the treatment table is in a state of being rotated by an angle ⁇ around the illustrated z-axis. If the angle ⁇ becomes too large, the inner diameter 102 of the treatment table or patient interferes with the inner diameter 102 of the rotation device, but a smaller range of the rotation angle of the treatment table can cope with non-coplanar irradiation.
  • Embodiments 1 to 5 of the present invention although the case where the shape of the rotating portion of the rotating device is a ring shape, that is, the case of an approximately O shape, has been described, Similar functions can be realized.
  • the rotation can be selected either clockwise or counterclockwise, the drive range for setting to a desired angle, that is, the setting time can be shortened.
  • the degree of freedom in selecting the rotation area is increased. It is also advantageous in terms of mechanical balance and strength.
  • the workability of the medical staff may be improved when setting the treatment table and the patient at the irradiation position.
  • FIG. 13 shows an example of a C-shaped rotating device.
  • the device is not arranged over 360 degrees in the circumferential direction of the rotating device, but a part where the device is not arranged is provided in a part of the circumferential direction.
  • the devices described in the first to fifth embodiments are miniaturized or some of the devices are reduced.
  • the X-ray imaging apparatus 153 is not provided in two pairs, but only on one side, and the medical image acquisition apparatus 151 is also provided on only one side.
  • the workability can be improved by setting the notch 101 to a desired angle as necessary.

Abstract

Cet appareil d'irradiation de faisceau de particules comprend : un orifice d'irradiation 220r pour émettre des faisceaux de particules accélérés par un accélérateur au niveau d'un patient K; un cadre rotatif 110 disposé indépendamment de l'orifice d'irradiation 220r et sur lequel sont disposés de manière circonférentielle un trajet de faisceau de particules (partie de conduit) 130 pour laisser passer les faisceaux de particules émis par l'orifice d'irradiation 220r et des dispositifs de support pour supporter une irradiation avec les faisceaux de particules (un dispositif d'acquisition d'image médicale 151, des dispositifs d'acquisition d'image radiologique 152, 153, un dispositif de pointe de buse 210, un dispositif de diagnostic par faisceau de particules 142, une unité de détection de faisceau de particules en aval 141, et un élément d'arrêt de faisceau 111); une unité d'entraînement en rotation 121 pour entraîner la rotation du cadre rotatif 110; et une unité de commande 610 pour commander l'émission de faisceaux de particules à partir de l'orifice d'irradiation 220r et commander le fonctionnement de l'unité d'entraînement en rotation 121.
PCT/JP2017/043812 2017-07-03 2017-12-06 Appareil d'irradiation de faisceau de particules WO2019008793A1 (fr)

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CN109613606A (zh) * 2019-01-25 2019-04-12 上海理工大学 一种目标粒子运动轨迹的x射线检测方法
JP2020192085A (ja) * 2019-05-28 2020-12-03 株式会社日立製作所 粒子線治療システムおよび粒子線治療システムの操作画面更新方法

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JP2016120282A (ja) * 2014-12-19 2016-07-07 イオンビーム アプリケーションズ， エス．エー． 放射線治療で用いられる基準放射線画像を決定する方法及び撮影システム

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US20140066755A1 (en) * 2012-08-29 2014-03-06 ProNova Solutions, LLC Simultaneous Imaging and Particle Therapy Treatment system and Method
US20140288348A1 (en) * 2013-03-25 2014-09-25 Siemens Aktiengesellschaft Radiotherapy treatment device comprising image acquisition device and irradiation device, and radiotherapy method
JP2016120282A (ja) * 2014-12-19 2016-07-07 イオンビーム アプリケーションズ， エス．エー． 放射線治療で用いられる基準放射線画像を決定する方法及び撮影システム

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109613606A (zh) * 2019-01-25 2019-04-12 上海理工大学 一种目标粒子运动轨迹的x射线检测方法
JP2020192085A (ja) * 2019-05-28 2020-12-03 株式会社日立製作所 粒子線治療システムおよび粒子線治療システムの操作画面更新方法
WO2020241311A1 (fr) * 2019-05-28 2020-12-03 株式会社日立製作所 Système de radiothérapie à particules et procédé de mise à jour d'écran de fonctionnement d'un système de radiothérapie à particules
JP7146695B2 (ja) 2019-05-28 2022-10-04 株式会社日立製作所 粒子線治療システムおよび粒子線治療システムの操作画面更新方法

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