WO2019172373A1

WO2019172373A1 - Patient position correction method

Info

Publication number: WO2019172373A1
Application number: PCT/JP2019/009079
Authority: WO
Inventors: 秀年清水
Original assignee: 愛知県
Priority date: 2018-03-09
Filing date: 2019-03-07
Publication date: 2019-09-12
Also published as: JP6606643B2; JP2019154671A

Abstract

Provided is a patient position correction method with which it is possible to correct the position of a patient on a bed accurately. The patient position correction method of the present invention is provided with: a position-aligning step (S1); a photographing step (S2); a comparing step (S3); a calculating step (S5); and a correcting step (S6). A bed (30) is configured of a head bed (31) supporting the head of the patient, and a shoulder bed (32) supporting the shoulder of the patient. The patient position correction method is characterized in that: the calculating step (S5) calculates a movement amount of the head bed (31) and a movement amount of the shoulder bed (32); and the correcting step (S6) corrects the patient position by moving the head bed (31) and the shoulder bed (32) on the basis of the movement amounts calculated in the calculating step (S5).

Description

Patient position correction method

The present invention relates to a patient position correcting method for correcting a patient position on a bed.

As this type of patient position correction method, three-dimensional body data and a tomographic image of a patient are acquired, the three-dimensional body data and the tomographic image are aligned, and the aligned tomographic image and three-dimensional body data are used. A treatment plan that defines a posture during treatment is generated, and a treatment support process that outputs a treatment instruction based on the posture of the treatment plan is disclosed (see Patent Document 1). This treatment support processing executes alignment processing between the current patient position and the patient position on the treatment plan at the time of patient examination. Specifically, matching is performed between the three-dimensional model of the current patient position and the three-dimensional model of the patient position on the treatment plan. Based on this matching, the difference between the three-dimensional model of the current patient position and the three-dimensional model of the patient position on the treatment plan is calculated. Based on the calculated difference, the current position of the patient is corrected to match the patient position on the treatment plan.

JP 2017-93516 A

However, according to the patient position correction method described in Patent Document 1, in order to adjust the current patient position to the patient position on the treatment plan based on the calculated difference, the bed on which the patient lies is placed in the horizontal X-axis and Y-axis. Correction is performed by movement and rotation of the three axes of translation in the Z axis in the vertical direction and the three axes of rotation about the X axis, the Z axis, and the Y axis. In this correction method, when the head and shoulders of the patient lying on the bed are twisted, it is difficult to adjust the current patient position to the patient position on the treatment plan, and the correction becomes insufficient. There is a problem.

In particular, when performing intensity-modulated radiation therapy that locally administers radiation to a patient's target and allows for the reduction of the radiation dose received by surrounding normal tissue and an increase in the total dose to the target. It is necessary that the current position of the patient on the bed and the patient position on the treatment plan match as much as possible. However, in the head and neck region, which is the best indication for intensity-modulated radiation therapy, the current position of the patient cannot be matched with the patient position in the treatment plan due to the twisting of the neck with a large range of motion. In many cases, the target shape cannot be sufficiently reproduced. In consideration of such uncertainties in the position, the radiation dose to the target is guaranteed by irradiating the radiation to a wider range than the target shape in the treatment plan, and the radiation is limited to the target. There is a problem that can not be administered.

The present invention has been made to solve such a problem, and an object of the present invention is to provide a patient position correction method capable of accurately correcting the patient position on the bed.

(1) The patient position correction method according to the present invention is obtained by the position acquisition step of acquiring the patient position on the bed and the position acquisition step in the patient position correction method of correcting the patient position on the bed. The calculation step of calculating the amount of movement of the bed required for the patient position and the treatment plan position to match by collating the patient position with the treatment plan position, and the movement calculated in the calculation step A correction step of correcting the patient position by moving the position of the bed based on the amount, a head bed that supports the patient's head, and a shoulder that supports the patient's shoulder And the calculation step calculates a head movement amount of the head bed and a shoulder movement amount of the shoulder bed, and the correction step is calculated in the calculation step. Based serial head movement amount and the said shoulder movement amount, and correcting the patient position by moving the position of the shoulder bed with the head bed.

(2) The patient position correction method according to the present invention is the patient position correction method according to (1), wherein the head movement amount is a head Roll movement amount that rotates the head bed about the X axis. And a head Pitch movement amount for rotating the head couch about the Y axis, and a head Yaw movement amount for rotating the head couch about the Z axis, and the shoulder movement amount is The amount of movement of the shoulder Roll that rotates the shoulder couch about the X axis, the amount of movement of the shoulder Pitch that rotates the shoulder couch about the Y axis, and the center of the shoulder couch about the Z axis And the amount of movement of the shoulder Yaw that rotates.

(3) The patient position correction method according to the present invention is the patient position correction method according to (1) or (2), wherein the correction step moves the head couch on the X axis based on the head Roll movement amount. , The head couch is rotated about the Y axis based on the head pitch movement amount, and the head couch is rotated about the Z axis based on the head Yaw movement amount. Moving the shoulder couch about the X axis based on the amount of movement of the shoulder Roll, and rotating the couch about the Y axis based on the amount of movement of the shoulder Pitch, The patient position is corrected by rotating the shoulder couch about the Z axis based on the amount of movement of the shoulder Yaw.

(4) The patient position correction method according to the present invention is the patient position correction method according to any one of (1) to (3), wherein the head bed and the shoulder bed can be rotated separately from each other. It is connected to a universal joint.

In the patient position correction method described in (1) above, the position acquisition step of acquiring the patient position on the bed and the patient position and the treatment plan position are matched by matching the patient position and the treatment plan position. A calculation step for calculating the necessary amount of movement of the bed, and a correction step for correcting the patient position by moving the position of the bed based on the movement amount calculated in the calculation step. The bed is composed of a head bed and a shoulder bed, the calculation step calculates the head movement amount of the head bed and the shoulder movement amount of the shoulder bed, and the correction step includes the head bed. Based on the amount of movement and the amount of movement of the shoulder couch, the positions of the head couch and the shoulder couch are moved. With this configuration, the movement of the head couch and the movement of the shoulder couch are performed separately, and the patient position is finely corrected.

In the patient position correction method described in (2) above, the head movement amount includes the head Roll movement amount, the head Pitch movement amount, and the head Yaw movement amount, and the shoulder movement amount is the shoulder portion. It is composed of a Roll movement amount, a shoulder Pitch movement amount, and a shoulder Yaw movement amount. With this configuration, a finer movement with respect to the head bed and the shoulder bed can be obtained, and the patient position can be corrected more finely.

In the patient position correcting method described in (3) above, the correction step rotates the head bed based on the head Roll movement amount, rotates the head bed based on the head Pitch movement amount, The head couch is configured to rotate based on the part Yaw movement amount. Furthermore, the shoulder couch is rotated based on the amount of movement of the shoulder Roll, the shoulder couch is rotated based on the amount of movement of the shoulder Pitch, and the shoulder couch is rotated based on the amount of movement of the shoulder Yaw. It is configured. With this configuration, a finer rotation with respect to the head bed and the shoulder bed is obtained, and the patient position is corrected more finely.

In the patient position correction method described in (4) above, the head couch and the shoulder couch are connected to a universal joint that can be rotated separately from each other. With this configuration, the correction of the head couch and the correction of the shoulder couch are performed separately, and the patient position corresponding to the twisting of the patient's head and shoulder is corrected.

According to the present invention, it is possible to provide a patient position correction method capable of accurately correcting the patient position on the bed.

The perspective view of the patient position correction stand which enforces the patient position correction method which concerns on embodiment of this invention. The disassembled perspective view of the patient position correction stand which implements the patient position correction method which concerns on embodiment of this invention. It is a figure of the patient position correction stand which implements the patient position correction method which concerns on embodiment of this invention, FIG. 3 (a) shows the top view of a patient position correction stand, FIG.3 (b) is patient position correction. FIG. 3C shows a side view seen from the shoulder side of the patient position correction table, and FIG. 3D shows a side view seen from the side of the patient position correction table. A side view is shown. The perspective view of the universal joint which cut | disconnected a part of universal joint of the patient position correction stand which implements the patient position correction method which concerns on embodiment of this invention. It is a figure of the universal joint of the patient position correction stand which implements the patient position correction method which concerns on embodiment of this invention, Fig.5 (a) shows the cross-sectional view of a universal joint, FIG.5 (b) is universal. The longitudinal cross-sectional view of a coupling is shown. The side view of the raising / lowering mechanism which comprises the head raising / lowering mechanism and shoulder part raising / lowering mechanism of a patient position correction stand which implement the patient position correction method which concerns on embodiment of this invention. It is a figure of the head Yaw rotation mechanism of the patient position correction stand which performs the patient position correction method according to the embodiment of the present invention, FIG. 7 (a) is a side view seen from the head side of the patient position correction stand. FIG. 7B shows a side view of the patient position correction table viewed from the side. It is a figure of the shoulder part Yaw rotation mechanism of the patient position correction stand which implements the patient position correction method which concerns on embodiment of this invention, FIG. 8 (a) is the side view seen from the shoulder side of the patient position correction stand. FIG. 8B shows a side view of the patient position correction table viewed from the side. FIG. 9A is a plan view of a patient position correction table for performing a patient position correction method according to an embodiment of the present invention, and FIG. 9A shows a state in which the head plate is rotated clockwise and the shoulder plate is counterclockwise. FIG. 9B shows a state in which the head plate is rotated counterclockwise and a state in which the shoulder plate is rotated clockwise. It is the side view seen from the head side of the patient position correction stand which performs the patient position correction method concerning the embodiment of the present invention, and Drawing 10 (a) shows the state without the movement of the central part of head Yaw rotation mechanism FIG. 10B shows a state in which the central portion of the head Yaw rotation mechanism is moved to the left side of the paper surface, and FIG. 10C shows the central portion of the head Yaw rotation mechanism on the paper surface. The state moved to the right side is shown. It is the side view seen from the head side of the patient position correction stand which performs the patient position correction method concerning the embodiment of the present invention, and Drawing 11 (a) is adjustment of the raising / lowering mechanism which constitutes head Roll rotation mechanism. FIG. 11B shows a state in which the lifting mechanism on the right side of the paper surface constituting the head Roll rotation mechanism is raised and the lifting mechanism on the left side of the paper surface is lowered, and FIG. The state where the lifting mechanism on the left side of the paper surface constituting the head Roll rotation mechanism is raised and the lifting mechanism on the right side of the paper surface is lowered is shown. It is the side view seen from the side of the patient position correction stand which performs the patient position correction method concerning the embodiment of the present invention, and Drawing 12 (a) is in the state where there is no adjustment of the raising / lowering mechanism which constitutes the head raising / lowering mechanism FIG. 12B shows a state where the lifting mechanism constituting the head lifting mechanism is raised, and FIG. 12C shows a state where the lifting mechanism constituting the head lifting mechanism is lowered. It is the side view seen from the shoulder side of the patient position correction stand which implements the patient position correction method according to the embodiment of the present invention, FIG. 13 (a) is a state in which there is no movement of the central portion of the shoulder Yaw rotation mechanism FIG. 13B shows a state in which the central portion of the shoulder Yaw rotation mechanism is moved to the left side of the paper surface, and FIG. 13C shows the central portion of the shoulder Yaw rotation mechanism on the paper surface. The state moved to the right side is shown. It is the side view seen from the shoulder side of the patient position correction stand which carries out the patient position correction method according to the embodiment of the present invention, FIG. 14 (a) is a state where there is no adjustment of the lifting mechanism constituting the shoulder lifting mechanism FIG. 14B shows a state in which the lifting mechanism on the right side of the paper surface constituting the shoulder lifting mechanism is raised and the lifting mechanism on the left side of the paper is lowered, and FIG. 14C shows the shoulder lifting mechanism. The state where the raising / lowering mechanism on the left side of the paper constituting the mechanism is raised and the raising / lowering mechanism on the right side of the paper is lowered is shown. It is the side view seen from the side of the patient position correction stand which performs the patient position correction method concerning the embodiment of the present invention, and Drawing 15 (a) is in the state where there is no adjustment of the raising / lowering mechanism which constitutes a shoulder part raising / lowering mechanism FIG. 15B shows a state where the lifting mechanism constituting the shoulder lifting mechanism is raised, and FIG. 15C shows a state where the lifting mechanism constituting the shoulder lifting mechanism is lowered. Standard deviation and maximum of angle when head plate and shoulder plate of patient position correcting table for performing patient position correcting method according to embodiment of the present invention are rotated around X axis, Y axis and Z axis A table of deviations is shown. Process drawing of the patient position correction method which concerns on embodiment of this invention.

A patient position correction method according to an embodiment to which the patient position correction method according to the present invention is applied will be described with reference to the drawings.

First, the configuration of the patient position correction table 10 for performing the patient position correction method according to the present embodiment will be described. As shown in FIGS. 1, 2, and 3, the patient position correction table 10 includes a base plate 20, a bed 30, a universal joint 40, a head rotation device 50, and a shoulder rotation device 60. Has been.

The base plate 20 is made of a plastic or metal material having high mechanical strength, and is formed of a rectangular flat plate having a predetermined plate thickness (mm), a predetermined width (mm), and a predetermined depth (mm).

The bed 30 includes a head bed 31 and a shoulder bed 32. The head couch 31 includes a head plate 33, a hemisphere 34 that engages with a head raising / lowering mechanism 51 (described later) that constitutes the head rotation device 50, and an engagement stud 35. The head plate 33 is made of a plastic or metal material having high mechanical strength, and is formed of a rectangular flat plate having a predetermined plate thickness (mm), a predetermined width (mm), and a predetermined depth (mm). The head plate 33 is formed with four screw holes 33a.

The shoulder couch 32 includes a shoulder plate 36, a hemisphere 37 that engages with a shoulder lifting mechanism 61 (which will be described later) constituting the shoulder rotation device 60, and an engagement stud 38. The shoulder plate 36 is made of a plastic or metal material having high mechanical strength, and is formed of a rectangular flat plate having a predetermined plate thickness (mm), a predetermined width (mm), and a predetermined depth (mm). The shoulder plate 36 is formed with four screw holes 36a.

The predetermined plate thickness, the predetermined width, and the predetermined depth of the base plate 20, the head plate 33, and the shoulder plate 36 are data such as a patient's treatment method, setting parameters such as the size and structure of the bed 30, and experimental values. Is selected as appropriate.

As shown in FIGS. 4 and 5, the universal joint 40 includes a so-called ball joint, and includes a ball stud 41, a ball socket 42, a stud holder 43, a socket holder 44, a joint holder 45, and a stud bolt 46. The socket bolt 47, the mounting bolt 48, and a pair of lock bolts 49 are included. The universal joints 40 are configured so as to be rotatable with respect to each other at a tilt angle of about several degrees at the maximum within a range that does not interfere with each other with the center of the joint portion of the ball stud 41 and the ball socket 42 as a fulcrum. It is configured.

The ball stud 41 is made of a plastic or metal material having high mechanical strength, and has a ball portion 41a formed at one end portion, and a stud portion 41b formed integrally with the ball portion 41a in the same axis. ing. A screw hole 41c is formed in the stat portion 41b. A stud bolt 46 is inserted into the screw hole 41c.

The ball socket 42 is made of a plastic or metal material with high mechanical strength, and is formed at one end, and a socket 42a that accommodates the ball 41a, and a stud that is integrally formed with the socket 42a and the same axis. Part 42b, and a threaded hole 42c is formed in the stat part 42b. The socket bolt 47 is configured to be inserted into the screw hole 42c.

The stud holder 43 is made of a plastic or metal material having high mechanical strength, and has a holding portion 43a that holds the stud portion 41b, and an attachment portion 43b that is formed integrally with the holding portion 43a and is attached to the head plate 33. ing. The holding portion 43a is formed with an insertion hole 43c into which the stud portion 41b is inserted and a stepped insertion hole 43d into which the stud bolt 46 is inserted.

The stud portion 41b inserted into the insertion hole 43c is screwed by a stud bolt 46 inserted into the insertion hole 43d so that the ball stud 41 and the stud holder 43 are firmly fastened. Furthermore, a screw hole 43e is formed in the holding portion 43a. A lock bolt 49 is inserted into the screw hole 43e, and the ball stud 41 is firmly locked to the stud holder 43 by the lock bolt 49.

As shown in FIG. 2, four through holes 43 f are formed in the mounting portion 43 b, and mounting bolts 48 are inserted into the respective through holes 43 f, and the stud holder 43 is attached to the head plate 33 by the mounting bolts 48. It is comprised so that it can attach firmly to.

The socket holder 44 is made of a plastic or metal material with high mechanical strength, and has a holding portion 44a that holds the stud portion 42b, and a mounting portion 44b that is formed integrally with the holding portion 44a and is attached to the shoulder plate 36. ing. The holding portion 44a is formed with an insertion hole 44c into which the stud portion 42b is inserted and a stepped insertion hole 44d into which the socket bolt 47 is inserted.

The stud portion 42b inserted into the insertion hole 44c is screwed by a socket bolt 47 inserted into the insertion hole 44d so that the ball socket 42 and the socket holder 44 are firmly fastened. Further, a screw hole 44e is formed in the holding portion 44a, and a lock bolt 49 is inserted into the screw hole 44e, and the ball socket 42 is firmly locked to the socket holder 44 by the lock bolt 49.

As shown in FIG. 2, four through holes 44 f are formed in the mounting portion 44 b, and a mounting bolt 48 is inserted into each through hole 44 f, and the socket holder 44 is attached to the shoulder plate 36 by the mounting bolt 48. It is comprised so that it can attach firmly to.

The joint holder 45 is made of a plastic or metal material having high mechanical strength, and is positioned between the stud holder 43 and the socket holder 44 as shown in FIGS. 4 and 5, and the ball portion 41a of the ball stud 41 and the ball socket. The center of the joint part with the socket part 42a of 42 is comprised so that rotation is possible.

The joint holder 45 includes a mounting portion 45a attached to the base plate 20, a holding portion 45b that holds the socket portion 42a of the ball socket 42, and a connecting bolt 45c. The mounting portion 45a and the holding portion 45b are connected bolts. It is firmly integrated by 45c. The joint portion between the ball portion 41a of the ball stud 41 and the socket portion 42a of the ball socket 42 is located between the attachment portion 45a and the holding portion 45b.

As shown in FIG. 2, the head turning device 50 includes a head lifting mechanism 51 and a head Yaw turning mechanism 52. The head lifting mechanism 51 includes a pair of lifting mechanisms 70 as shown in FIGS. The head elevating mechanism 51 raises one elevating mechanism 70 and lowers the other elevating mechanism 70, or lowers one elevating mechanism 70 and raises the other elevating mechanism 70. The part plate 33 is configured to rotate in the Roll direction around the X axis.

On the other hand, the head elevating mechanism 51 moves the head plate 33 around the Y axis by raising both the elevating mechanisms 70 with the same dimensions or by lowering both the elevating mechanisms 70 with the same dimensions. It is configured to rotate in the pitch direction.

The elevating mechanism 70 is made of a plastic or metal material having high mechanical strength. The elevating mechanism 70 is attached to the base plate 20. The elevating mechanism 70 has one end fixed to the attaching portion 71 and a male screw formed on the stud portion 72. It is comprised by the raising / lowering part 73 which carries out screw connection and raises / lowers by rotation, and the fixing bolt 74 which fixes the attaching part 71 to the baseplate 20.

One end of the elevating part 73 is engaged with the hemisphere 34 of the head plate 33. When the elevating part 73 is raised, a part of the head plate 33 is raised via the hemisphere 34, and the elevating part 73 is lowered. Then, a part of the head plate 33 is configured to descend by gravity through the hemisphere 34.

The elevating part 73 has a screw hole 73 a in which an internal thread is formed, and is screwed to the stud part 72. The elevating part 73 is configured such that the elevating part 73 rises in the direction of arrow a by rotating counterclockwise, and the elevating part 73 descends in the direction of arrow b by rotating clockwise.

Rotation direction may be reversed. That is, the elevating unit 73 may raise the elevating unit 73 by rotating clockwise, and lower the elevating unit 73 by rotating counterclockwise.

As shown in FIG. 7, the head Yaw turning mechanism 52 includes a pair of horizontal moving mechanisms 80 facing each other. The head Yaw rotation mechanism 52 is configured to rotate the head plate 33 in the Yaw direction around the Z axis.

The horizontal movement mechanism 80 is made of a plastic or metal material having high mechanical strength, and includes a mounting portion 81 attached to the base plate 20, a stud portion 82 having one end fixed to the mounting portion 81 and formed with a male screw, and a stud portion 82. And a fixing bolt 84 for fixing the stud portion 82 to the mounting portion 81. The attachment portion 81 is fixed to the base plate 20 by a fixing bolt (not shown).

The horizontal moving portion 83 is configured so that one end is engaged with the engaging stud 35 of the head plate 33. The horizontal movement part 83 and the horizontal movement part 83 on the opposite side opposite to the horizontal movement part 83 sandwich the engagement stud 35 and move the engagement stud 35 in the arrow c direction and move in the arrow d direction. It is configured to let you.

The horizontal moving part 83 has a screw hole 83a in which a female screw is formed, and is screwed to the stud part 82. The horizontal movement unit 83 is rotated counterclockwise from the left side to the right side of the sheet of FIG. 7 to move the horizontal movement unit 83 in the direction of the arrow c, and is rotated clockwise to cause the horizontal movement unit 83 to move. It is configured to move in the direction of arrow d.

Rotation direction may be reversed. That is, the horizontal moving unit 83 rotates the horizontal moving unit 83 in the direction of the arrow c by rotating clockwise from the left side to the right side of the paper, and rotates the horizontal moving unit 83 in the direction of the arrow d by rotating counterclockwise. You may make it move to a direction.

As shown in FIG. 2, the shoulder rotation device 60 includes a shoulder lifting mechanism 61 and a shoulder Yaw rotation mechanism 62. As shown in FIGS. 2 and 6, the shoulder lifting mechanism 61 is composed of a pair of lifting mechanisms 70, similar to the head lifting mechanism 51. Similarly to the head lifting mechanism 51, the shoulder lifting mechanism 61 raises one lifting mechanism 70 and lowers the other lifting mechanism 70, or lowers one lifting mechanism 70 and lifts the other lifting mechanism 70. By raising the mechanism 70, the shoulder plate 36 is configured to rotate in the Roll direction around the X axis.

On the other hand, the shoulder lifting mechanism 61 moves the shoulder plate 36 around the Y axis by raising both lifting mechanisms 70 with the same dimensions or by lowering both lifting mechanisms 70 with the same dimensions. It is configured to rotate in the pitch direction.

As shown in FIG. 8, the shoulder Yaw rotation mechanism 62 includes a pair of horizontal movement mechanisms 90 facing each other. The shoulder Yaw rotation mechanism 62 is configured to rotate the shoulder plate 36 in the Yaw direction around the Z axis.

The horizontal movement mechanism 90 is made of a plastic or metal material having high mechanical strength, and includes a mounting portion 91 attached to the base plate 20, a stud portion 92 having one end fixed to the mounting portion 91 and formed with a male screw, and a stud portion 92. And a horizontal moving part 93 that moves horizontally by rotation, and a fixing bolt 94 that fixes the stud part 92 to the mounting part 91. The attachment portion 91 is fixed to the base plate 20 by a fixing bolt (not shown).

The horizontal moving part 93 is configured so that one end is engaged with the engaging stud 38 of the shoulder plate 36. The horizontal movement portion 93 and the horizontal movement portion 93 on the opposite side opposite to the horizontal movement portion 93 sandwich the engagement stud 38 and move the engagement stud 38 in the direction of arrow e and move in the direction of arrow f. It is configured to let you.

The horizontal moving part 93 has a screw hole 93a in which a female screw is formed, and is screwed to the stud part 92. The horizontal moving unit 93 is rotated counterclockwise from the left side to the right side of the sheet of FIG. 8 to move the horizontal moving unit 93 in the direction of arrow e, and is rotated clockwise to turn the horizontal moving unit 93 to the arrow. It is configured to move in the f direction.

Rotation direction may be reversed. That is, the horizontal moving unit 93 rotates the horizontal moving unit 93 in the direction of the arrow e by rotating clockwise from the left side to the right side of the paper surface, and rotates the horizontal moving unit 93 in the direction of the arrow f by rotating counterclockwise. You may make it move to a direction.

Next, operations of the head plate 33 and the shoulder plate 36 of the patient position correction table 10 will be described with reference to the drawings.

<Operation of head plate 33 in Yaw direction>
As shown in FIGS. 9A and 9B, the head plate 33 is centered on the Z axis in the range of angle ± θ _{Y in} the clockwise direction from the center line CL by the head Yaw turning mechanism 52. It rotates in the Yaw direction.

From the position shown in FIG. 10A, that is, the state where the angle θ _Y is 0 °, the head plate 33 moves both the horizontal movement portions 83 facing the horizontal movement mechanism 80 of the head Yaw rotation mechanism 52 from the position of the paper surface. When rotating counterclockwise from the left side to the right side, as shown in FIG. 10B, both horizontal moving parts 83 move in the direction of the arrow, and the engagement stud 35 of the head plate 33 also moves in the direction of the arrow. Moving.

When the engaging stud 35 moves in the direction of the arrow in FIG. 10B, the stud holder 43 of the universal joint 40 attached to the head plate 33 rotates in the same direction, and the ball held by the stud holder 43. The stud 41 rotates in the same direction with the center of the universal joint 40 as a fulcrum. As a result, the head plate 33, Yaw around the Z axis within the range of an angle ± theta _Y direction, i.e., rotated in the direction indicated by the arrow shown in Figure 9 (a).

Further, when both of the horizontal moving portions 83 of the horizontal moving mechanism 80 of the head Yaw turning mechanism 52 are rotated clockwise from the left side to the right side of the sheet of FIG. 83 moves in the arrow direction, and the engagement stud 35 of the head plate 33 also moves in the arrow direction.

When the engaging stud 35 moves in the direction of the arrow in FIG. 10C, the stud holder 43 of the universal joint 40 attached to the head plate 33 rotates in the same direction, and the ball held by the stud holder 43. The stud 41 rotates in the same direction with the center of the universal joint 40 as a fulcrum. As a result, the head plate 33, Yaw around the Z axis within the range of an angle ± theta _Y direction, i.e., rotated in the direction indicated by the arrow shown in Figure 9 (b).

<Operation in the Roll direction of the head plate 33>
Head plate 33, as shown in FIG. 11 (a), FIG. 11 (b), the FIG. 11 (c), the by head elevating mechanism 51, in a counterclockwise direction from the center line CL angle theta _R and clockwise around the X axis in the range of the angle theta _R rotates in the Roll direction.

As shown in FIG. 11B, the head plate 33 is lifted by rotating the lifting / lowering portion 73 of the lifting / lowering mechanism 70 constituting the head lifting / lowering mechanism 51 on the right side of the paper, The portion of the hemisphere 34 of the head plate 33 rises through the hemisphere 34 of the head plate 33. On the other hand, when the elevating unit 73 of the elevating mechanism 70 constituting the head elevating mechanism 51 on the left side of the paper surface is rotated clockwise, the elevating unit 73 descends and the head plate 33 is interposed via the hemisphere 34 of the head plate 33. The portion of the hemisphere 34 descends.

Thereby, the stud holder 43 and the ball stud 41 of the universal joint 40 attached to the head plate 33 are rotated counterclockwise with the center of the universal joint 40 as a fulcrum. As a result, the head plate 33 is counterclockwise Roll direction about the X-axis direction in a range of angle theta _R, i.e., rotates in the direction of the arrow shown in FIG. 11 (b).

In addition, as shown in FIG. 11C, the head plate 33 is lowered when the lifting / lowering portion 73 of the lifting / lowering mechanism 70 constituting the head lifting / lowering mechanism 51 on the right side of the paper is rotated clockwise. The portion of the hemisphere 34 of the head plate 33 descends via the hemisphere 34 of the head plate 33. On the other hand, when the elevating unit 73 of the elevating mechanism 70 constituting the head elevating mechanism 51 on the left side of the paper surface is rotated counterclockwise, the elevating unit 73 rises and the head plate is interposed via the hemisphere 34 of the head plate 33. The portion of the 33 hemisphere 34 rises.

Thereby, the stud holder 43 and the ball stud 41 of the universal joint 40 attached to the head plate 33 are rotated clockwise with the center of the universal joint 40 as a fulcrum. As a result, the head plate 33, Roll direction about the X axis in the range of the angle theta _R clockwise, i.e., rotates in the direction of the arrow shown in FIG. 11 (c).

<Operation of head plate 33 in the pitch direction>
Head plate 33, as shown in FIG. 12 (a), FIG. 12 (b), the FIG. 12 (c), the by head elevating mechanism 51, from the center line CL at an angle theta _P and clockwise counterclockwise in the range of the angle theta _P rotates in the Pitch direction about the Y axis.

As shown in FIG. 12B, when the head plate 33 rotates both the lifting parts 73 of the pair of lifting mechanisms 70 constituting the head lifting mechanism 51 counterclockwise, both the lifting parts 73 rise. Then, the portion of the hemisphere 34 of the head plate 33 rises through the hemisphere 34 of the head plate 33.

Thereby, the stud holder 43 and the ball stud 41 of the universal joint 40 attached to the head plate 33 are rotated clockwise with the center of the universal joint 40 as a fulcrum. As a result, the head plate 33, Pitch direction about the Y axis in the range of angle theta _P clockwise, i.e., rotates in the direction indicated by the arrow shown in Figure 12 (b).

In addition, as shown in FIG. 12C, when the head plate 33 rotates both the lifting parts 73 of the pair of lifting mechanisms 70 constituting the head lifting mechanism 51 clockwise, The hemisphere 34 of the head plate 33 is lowered through the hemisphere 34 of the head plate 33.

Thereby, the stud holder 43 and the ball stud 41 of the universal joint 40 attached to the head plate 33 are rotated counterclockwise with the center of the universal joint 40 as a fulcrum. As a result, the head plate 33, a counterclockwise direction at an angle theta Pitch direction about the Y axis in the range of _P, that is, rotated in the direction of the arrow shown in FIG. 12 (c).

<Operation of shoulder plate 36 in Yaw direction>
As shown in FIGS. 9 (a) and 9 (b), the shoulder plate 36 is rotated by the shoulder Yaw rotation mechanism 62 around the Z axis in the range of the angle θ _{Y in} the clockwise direction from the center line CL. Rotate in the direction.

From the position shown in FIG. 13A, that is, the state where the angle θ _Y is 0 °, the shoulder plate 36 moves both of the horizontal movement portions 93 facing the horizontal movement mechanism 90 of the shoulder portion Yaw rotation mechanism 62 from the paper surface. When rotating counterclockwise from the left side to the right side, as shown in FIG. 13B, both horizontal moving parts 93 move in the arrow direction, and the engagement studs 38 of the shoulder plate 36 also move in the arrow direction. Moving.

When the engagement stud 38 moves in the direction of the arrow in FIG. 13 (b), the socket holder 44 of the universal joint 40 attached to the shoulder plate 36 rotates in the same direction, and the ball held by the socket holder 44. The socket 42 rotates in the same direction with the center of the universal joint 40 as a fulcrum. As a result, the shoulder plate 36, Yaw direction about the Z axis at the range of the angle theta _Y clockwise, i.e., rotates in the direction indicated by the arrow shown in Figure 9 (b).

Further, when both the horizontal moving portions 93 of the horizontal moving mechanism 90 of the shoulder portion Yaw rotating mechanism 62 are rotated clockwise from the left side to the right side of the sheet of FIG. 93 moves in the direction of the arrow, and the engagement stud 38 of the shoulder plate 36 also moves in the direction of the arrow.

When the engagement stud 38 moves in the direction of the arrow in FIG. 13C, the socket holder 44 of the universal joint 40 attached to the shoulder plate 36 rotates in the same direction, and the ball held by the socket holder 44 The socket 42 rotates in the same direction with the center of the universal joint 40 as a fulcrum. As a result, the shoulder plate 36, counterclockwise Yaw direction direction of Z-axis in the range of the angle theta _Y around, i.e., rotates in the direction indicated by the arrow shown in Figure 9 (a).

<Operation of shoulder plate 36 in roll direction>
Shoulder plate 36, FIG. 14 (a), the as shown in FIG. 14 (b), FIG. 14 (c), the by shoulder lifting mechanism 61, in the counterclockwise direction from the center line CL angle theta _R and clockwise around the X axis in the range of the angle theta _R rotates in the Roll direction.

As shown in FIG. 14 (b), the shoulder plate 36 is lifted by rotating the lifting / lowering portion 73 of the lifting / lowering mechanism 70 that constitutes the shoulder lifting / lowering mechanism 61 on the right side of the paper, The portion of the hemisphere 37 of the shoulder plate 36 rises through the hemisphere 37 of the shoulder plate 36. On the other hand, when the elevating part 73 of the elevating mechanism 70 constituting the shoulder elevating mechanism 61 on the left side of the paper surface is rotated clockwise, the elevating part 73 descends and the shoulder plate 36 is interposed via the hemisphere 37 of the shoulder plate 36. The hemisphere 37 part of the lowering.

Thereby, the socket holder 44 and the ball socket 42 of the universal joint 40 attached to the shoulder plate 36 are rotated counterclockwise with the center of the universal joint 40 as a fulcrum. As a result, the shoulder plate 36, counter-clockwise angle θ range Roll direction about the X axis of _R, that is, rotated in the arrow direction shown in FIG. 14 (b).

Further, as shown in FIG. 14C, the shoulder plate 36 is lowered when the lifting / lowering portion 73 of the lifting / lowering mechanism 70 constituting the shoulder lifting / lowering mechanism 61 on the right side of the paper is rotated clockwise. The portion of the hemisphere 37 of the shoulder plate 36 descends via the hemisphere 37 of the shoulder plate 36. On the other hand, when the elevating part 73 of the elevating mechanism 70 constituting the shoulder elevating mechanism 61 on the left side of the paper surface is rotated counterclockwise, the elevating part 73 rises and the shoulder plate passes through the hemisphere 37 of the shoulder plate 36. The portion of 36 hemispheres 37 rises.

As a result, the socket holder 44 and the ball socket 42 of the universal joint 40 attached to the shoulder plate 36 rotate clockwise with the center of the universal joint 40 as a fulcrum. As a result, the shoulder plate 36, Roll direction about the X axis in the range of the angle theta _R clockwise, i.e., rotates in the direction of the arrow shown in FIG. 14 (c).

<Operation of shoulder plate 36 in the pitch direction>
Shoulder plate 36, as shown in FIG. 15 (a), FIG. 15 (b), the FIG. 15 (c), the by shoulder lifting mechanism 61, from the center line CL at an angle theta _P and clockwise counterclockwise in the range of the angle theta _P rotates in the Pitch direction about the Y axis.

As shown in FIG. 15 (b), when the shoulder plate 36 rotates both the lifting parts 73 of the pair of lifting mechanisms 70 constituting the shoulder lifting mechanism 61 counterclockwise, both the lifting parts 73 are lifted. Then, the portion of the hemisphere 37 of the shoulder plate 36 rises through the hemisphere 37 of the shoulder plate 36.

Thereby, the socket holder 44 and the ball socket 42 of the universal joint 40 attached to the shoulder plate 36 are rotated counterclockwise with the center of the universal joint 40 as a fulcrum. As a result, the shoulder plate 36, counterclockwise Pitch direction about the Y-axis direction in a range of angle theta _P, i.e., rotates in the direction of the arrow shown in FIG. 15 (b).

Further, as shown in FIG. 15 (c), the shoulder plate 36 is configured such that when both the lifting parts 73 of the pair of lifting mechanisms 70 constituting the shoulder lifting mechanism 61 are rotated clockwise, The hemisphere 37 of the shoulder plate 36 is lowered through the hemisphere 37 of the shoulder plate 36.

As a result, the socket holder 44 and the ball socket 42 of the universal joint 40 attached to the shoulder plate 36 rotate clockwise with the center of the universal joint 40 as a fulcrum. As a result, the shoulder plate 36, Pitch direction about the Y axis in the range of angle theta _P clockwise, i.e., rotates in the direction of the arrow shown in FIG. 15 (c).

It should be noted that in the operation of the head plate 33 and the shoulder plate 36 of the patient position correction table 10, the rotation angle θ _R of the X axis (Roll), the angle θ _P of the Y axis (Pitch), the angle of the Z axis (Yaw) θ _Y is set in a range of about −several to + several degrees.

Next, in order to confirm the operation accuracy of the patient position correction table 10 according to the present embodiment, the amount of rotation of Roll, Pitch, and Yaw calculated based on the amount of movement of each lifting mechanism 70 and measurement by a digital angle meter The values were compared. For the evaluation, 20 combinations of screw movement amounts determined using random numbers by spreadsheet software were used.

For the 20 combinations, the difference between the measured values of the X-axis (Roll), Y-axis (Pitch), and Z-axis (Yaw) on the head plate 33 and the shoulder plate 36 was calculated. As a result, as shown in FIG. 16, the mean value ± standard deviation of the head plate 33 is −0.01 ± 0.06 for the X axis (Roll) and 0.00 ± 0.06 for the Y axis (Pitch). The Z axis (Yaw) was −0.04 ± 0.04.

On the other hand, the mean value ± standard deviation of the shoulder plate 36 is −0.03 ± 0.05 for the X axis (Roll), −0.03 ± 0.04 for the Y axis (Pitch), and Y axis (Yaw). 0.02 ± 0.05.

The maximum deviation of the head plate 33 was 0.16 for the X axis (Roll), 0.12 for the Y axis (Pitch), and 0.13 for the Z axis (Yaw). The maximum deviation of the shoulder plate 36 was 0.14 for the X-axis (Roll), 0.08 for the Y-axis (Pitch), and 0.14 for the Z-axis (Yaw).

The verified angle range (°) is that the X axis (Roll) of the head plate 33 is −3.81 to 4.07, the Y axis (Pitch) is −2.00 to 2.40, and the Z axis ( Yaw) is −2.39 to 1.67, the X axis (Roll) of the shoulder plate 36 is −3.31 to 3.56, the Y axis (Pitch) is −2.26 to 2.66, The Z-axis (Yaw) is -2.39 to 2.39. As a result, it was confirmed that the operation accuracy of the patient position correction table 10 according to the present embodiment is good.

Next, a patient position correction method according to this embodiment will be described with reference to the drawings.

As shown in FIG. 17, the patient position correction method according to the present embodiment includes an alignment step, an imaging step, a verification step, a calculation step, a correction step, a corrected imaging step, and a corrected verification. And steps. The patient position on the bed 30 is corrected through each step. By this correction, radiation is locally administered to the patient's target for treatment. The imaging step (position acquisition step), the calculation step, and the correction step of the present embodiment constitute the patient position correction method according to the present invention.

In the alignment step, a mark on the surface of the patient marked when acquiring a computed tomography (CT) image for treatment planning, and an alignment laser provided in the radiotherapy room, Thus, patient positioning is performed (S1).

In the treatment plan, the optimal position of the patient's target is determined from the X-ray photograph or CT image, and how the radiation is optimal is examined by a computer, and the patient's internal anatomy is three-dimensionally analyzed. This means that the patient's posture is reconfigured and the radiation therapy method is designed so as to cause as few side effects as possible. The patient positioning may be performed by a method other than the marking on the patient body surface and laser. For example, it may be performed based on three-dimensional body data acquired from a 3D camera and tomographic images obtained from a CT apparatus.

In the imaging step, imaging of the patient on the bed 30 is performed using a CT apparatus provided in the radiation therapy room before radiation therapy (S2).

In the collation step, the CT image of the patient imaged in the imaging step and the CT image for treatment planning are collated (S3).

After the collation step, it is determined whether or not the alignment needs to be performed again (S4). If the alignment needs to be performed again, the process returns to the alignment step (S1) to perform the alignment. If it is not necessary to perform alignment again, the process proceeds to the next calculation step (S5).

In the calculation step, the head movement amount of the head couch 31 and the shoulder movement amount of the shoulder couch 32 are calculated based on the collation result in the collation step (S5). The patient position correction table 10 according to the present embodiment is placed on a treatment bed for treating a patient and used in the patient position correction method according to the present embodiment, thereby correcting the position of the patient. The treatment bed is configured such that each of the three translational axes moves to determine the position of the patient. As the treatment bed, a treatment bed in which three rotation axes move in addition to three translation axes may be used. In the calculation step, each movement amount in the treatment bed is taken into consideration, and each movement amount in the treatment bed is included in the head movement amount of the head bed 31 and the shoulder movement amount of the shoulder bed 32.

The head movement amount includes a head Roll movement amount that rotates the head bed 31 about the X axis, a head Pitch movement amount that rotates the head bed 31 about the Y axis, and a head bed 31. And the head Yaw movement amount that rotates about the Z axis.

The shoulder movement amount includes a shoulder Roll movement amount that rotates the shoulder bed 32 about the X axis, a shoulder Pitch movement amount that rotates the shoulder bed 32 about the Y axis, and a shoulder bed 32. And a shoulder Yaw movement amount that rotates about the Z axis.

In the correction step, the head couch 31 is rotated in the Roll direction around the X axis based on the head Roll movement amount calculated in the calculation step, and the head couch 31 is set to Y based on the head Pitch movement amount. The patient position is corrected by rotating in the Pitch direction about the axis and rotating the head couch in the Yaw direction about the Z axis based on the head Yaw movement amount (S6).

Further, in the correction step, the shoulder bed 32 is rotated in the Roll direction around the X axis based on the shoulder Roll movement amount calculated in the calculation step, and the shoulder bed 32 is based on the shoulder Pitch movement amount. Is rotated in the Pitch direction about the Y axis, and the patient position is corrected by rotating the shoulder couch 32 in the Yaw direction about the Z axis based on the amount of movement of the shoulder Yaw.

In the post-correction imaging step, as in the imaging step (S2), the patient on the bed 30 is imaged using the CT apparatus provided in the radiation therapy room (S7) before the radiation therapy.

In the collation step after correction, similarly to the collation step (S3), the CT image of the patient imaged in the imaging step after correction is collated with the CT image for treatment planning (S8). The corrected photographing step (S7) and the corrected collation step (S8) may not be performed.

Next, as a result of the corrected collation step, it is determined whether or not the corrected patient position is within the allowable range of the position to be irradiated with radiation on the treatment plan (S9), and the corrected patient position is the treatment plan. When it is determined that the position is within the allowable range of the position where the upper radiation should be irradiated, the patient position correction method ends. On the other hand, if it is determined that the corrected patient position is not within the allowable range of the position to be irradiated with radiation on the treatment plan, the determination step (S4) determines whether or not it is necessary to perform alignment again. Return and make a decision.

The effect of the patient position correction method and patient position correction table according to the embodiment configured as described above will be described.

The patient position correction method according to the present embodiment includes an imaging step (S2), a collation step (S3), a calculation step (S5), and a correction step (S6). In the calculation step (S5), the head Roll movement amount, the head Pitch movement amount, the head Yaw movement amount, the shoulder Roll movement amount of the shoulder bed 32, and the shoulder Pitch movement amount of the head bed 31. And the shoulder Yaw movement amount are calculated. In the correction step (S6), the head couch 31 is rotated in the Roll direction, the Pitch direction, and the Yaw direction based on each movement amount calculated in the calculation step, and the shoulder couch 32 is further moved in the Roll direction and the Pitch direction. And configured to rotate in the Yaw direction.

With this configuration, in the patient position correction method according to the present embodiment, the head couch 31 and the shoulder couch 32 are rotated about the three axes in the Roll direction, the Pitch direction, and the Yaw direction, respectively, and the patient position is finely corrected. The effect is obtained. In particular, an effect that the patient position can be accurately corrected with respect to twisting of the neck having a large range of motion is obtained. Therefore, in the head and neck region, which is the best indication for intensity-modulated radiation therapy, the current position of the patient cannot be matched with the patient position in the treatment plan due to the twisting of the neck with a large range of motion. The effect that the target shape cannot be sufficiently reproduced is obtained.

In the patient position correction table 10 according to the present embodiment, the bed 30 includes a head bed 31 and a shoulder bed 32, and the universal joint 40 rotates the head bed 31 and the shoulder bed 32 separately from each other. It is connected as possible. Further, the head lifting mechanism 51 is configured to rotate the head bed 31 in the Roll direction and in the Pitch direction, and the head Yaw rotation mechanism 52 rotates the head bed 31 in the Yaw direction. It is configured to move. Further, the shoulder lifting mechanism 61 is configured to rotate the shoulder bed 32 in the Roll direction and also in the Pitch direction, and the shoulder Yaw rotation mechanism 62 rotates the shoulder bed 32 in the Yaw direction. It is configured to move.

With this configuration, the head couch 31 and the shoulder couch 32 are rotated about the three axes of the Roll direction, the Pitch direction, and the Yaw direction, respectively, and the patient position is finely corrected.

Although the embodiments of the present invention have been described in detail above, the present invention is not limited to the above-described embodiments, and various designs can be made without departing from the spirit of the present invention described in the claims. It can be changed.

DESCRIPTION OF SYMBOLS 10 ... Patient position correction table 20 ... Base plate 30 ... Bed 31 ... Head bed 32 ... Shoulder bed 33 ...

Head plate

33a, 36a, 41c, 42c, 43e,

44e

73a, 83a, 93a ... Screw holes 34, 37 ...

Hemisphere

35, 38 ... Engagement stud 36 ... Shoulder plate 40 ... Universal joint 41 ... Ball stud 41a ...

Ball part

41b, 42b, 72, 82, 92 ...

Stud part

43f, 44f ... Through hole 42 ... Ball socket 42a ... Socket part 43 ...

Stud holder

43a, 44a, 45b ... -Holding

part

43b, 44b, 45a, 71, 81, 91 ... Mounting

part

43c, 43d, 44c, 44d ...

Insertion hole

43f, 44f ... Through hole 44 ... Socket Holder 45 ... Joint holder 45c ... Connection bolt 46 ... Stud bolt 47 ... Socket bolt 48 ... Mounting bolt 49 ... Lock bolt 50 ... Head rotation device 51 ... Head lifting mechanism 52... Head Yaw rotating mechanism 60. Shoulder rotating device 61. Shoulder lifting mechanism 62. Shoulder Yaw rotating mechanism 70. Elevating mechanism 73. -Elevating

parts

74, 94 ... Fixing

bolts

80, 90 ...

Horizontal movement mechanisms

83, 93 ... Horizontal movement parts

Claims

In the patient position correction method for correcting the patient position on the bed,
A position acquisition step of acquiring the patient position on the bed;
A calculation step for calculating the amount of movement of the bed necessary for matching the patient position and the treatment plan position by comparing the patient position obtained by the position acquisition step and the treatment plan position;
A correction step of correcting the patient position by moving the position of the bed based on the movement amount calculated in the calculation step,
The bed comprises a head bed for supporting the patient's head and a shoulder bed for supporting the patient's shoulder;
The calculation step calculates a head movement amount of the head bed and a shoulder movement amount of the shoulder bed, and the correction step calculates the head movement amount and the shoulder calculated in the calculation step. A patient position correction method, wherein the patient position is corrected by moving the positions of the head couch and the shoulder couch based on a part movement amount.
The head movement amount includes a head Roll movement amount for rotating the head bed about the X axis, a head Pitch movement amount for rotating the head bed about the Y axis, and the head The head Yaw movement amount that rotates the bed about the Z axis,
The shoulder movement amount includes a shoulder Roll movement amount that rotates the shoulder bed about the X axis, a shoulder Pitch movement amount that rotates the shoulder bed about the Y axis, and the shoulder portion. The patient position correcting method according to claim 1, comprising: a shoulder Yaw movement amount for rotating the bed about the Z axis.
The correcting step rotates the head couch around the X axis based on the head Roll movement amount, and rotates the head couch around the Y axis based on the head Pitch movement amount. The head couch is rotated about the Z axis based on the head Yaw movement amount, the shoulder couch is rotated about the X axis based on the shoulder Roll movement amount, and the shoulder portion The patient's position is corrected by rotating the shoulder couch about the Y axis based on the Pitch movement amount, and rotating the shoulder couch about the Z axis based on the shoulder Yaw movement amount. The patient position correcting method according to claim 1, wherein the patient position is corrected.
The patient position correcting method according to any one of claims 1 to 3, wherein the head couch and the shoulder couch are connected to a universal joint that can be rotated separately from each other.