WO2020020265A1 - SYSTÈME DE RADIOTHÉRAPIE UTILISANT UN SCALPEL γ 4D À SOURCE UNIQUE - Google Patents

SYSTÈME DE RADIOTHÉRAPIE UTILISANT UN SCALPEL γ 4D À SOURCE UNIQUE Download PDF

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Publication number
WO2020020265A1
WO2020020265A1 PCT/CN2019/097602 CN2019097602W WO2020020265A1 WO 2020020265 A1 WO2020020265 A1 WO 2020020265A1 CN 2019097602 W CN2019097602 W CN 2019097602W WO 2020020265 A1 WO2020020265 A1 WO 2020020265A1
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Prior art keywords
source
grating
collimator
dimensional
radiation therapy
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PCT/CN2019/097602
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English (en)
Chinese (zh)
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王全锋
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王全锋
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Publication of WO2020020265A1 publication Critical patent/WO2020020265A1/fr

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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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/103—Treatment planning systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/1048—Monitoring, verifying, controlling systems and methods
    • A61N5/1049—Monitoring, verifying, controlling systems and methods for verifying the position of the patient with respect to the radiation beam
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/1077—Beam delivery systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/1048—Monitoring, verifying, controlling systems and methods
    • A61N5/1049—Monitoring, verifying, controlling systems and methods for verifying the position of the patient with respect to the radiation beam
    • A61N2005/105—Monitoring, verifying, controlling systems and methods for verifying the position of the patient with respect to the radiation beam using a laser alignment system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/1048—Monitoring, verifying, controlling systems and methods
    • A61N5/1049—Monitoring, verifying, controlling systems and methods for verifying the position of the patient with respect to the radiation beam
    • A61N2005/1061—Monitoring, verifying, controlling systems and methods for verifying the position of the patient with respect to the radiation beam using an x-ray imaging system having a separate imaging source

Definitions

  • the invention belongs to the field of medical radiosurgery treatment, and particularly relates to a radiation therapy system based on a four-dimensional single-source gamma knife.
  • Radiation therapy is one of the main treatments for cancer.
  • the biggest problem of the existing radiotherapy equipment is the low degree of intelligence, the low cure rate at one time, and the primary cancer and multiple metastatic cancers cannot be cured at the same time.
  • the skin focal dose ratio is large, the side effects are large, and serious complications occur frequently.
  • Radiotherapy equipment currently used in clinic medical electronic linear accelerator, proton heavy ion accelerator, after-treatment machine, X-ray treatment machine, 60 Co treatment machine, 60 Co source stereotactic treatment machine ( ⁇ knife), etc.
  • the common shortcomings of the equipment are: 1. large irradiation field, clockwise / counterclockwise rotation irradiation field in a single plane, spiral irradiation field along the longitudinal axis of the body; 2. low focal skin dose ratio, high damage to surrounding organs and tissues, and serious damage, Systemic side effects are serious; 3. Low intelligence and cumbersome operation, and its application scope and accuracy of treatment have certain defects, affecting universal use; 4. The prices are very expensive, and it also affects universal use.
  • the 60Co source stereotactic therapy machine can only treat head tumors, equipped with 201 (or 197) cobalt sources, the cost of the radiation source alone is very high. Irradiation without any difference between isocenters and iso-dose of each source, damage to tissues and organs around the focus is inevitable; 60 Co source body spiral therapy machine (spiral gamma knife): using 30 or 18 radiation sources, spiral irradiation along the center axis of the focus, Irradiation without any difference between isocenters and equal doses of various sources, and damage to tissues and organs around the focus is inevitable; 60Co treatment machine: using a radioactive source, only the frontal plane can be adjusted to adjust the nose and the direction of the incident beam to a large fixed irradiation field In order to avoid the damage to the organs and tissues outside the focus, the ratio of the focal skin dose must be less than one.
  • the purpose of the present invention is to provide a four-dimensional single-source gamma knife-based radiotherapy system.
  • the radiotherapy system focuses and projects a collimated conformal intensity-modulated gamma-ray beam from a gamma source rod provided at the arm end of a robot system.
  • the focal point receives several times the radiation dose of its surrounding tissues and organs, and the dose outside the boundary of the focal point decreases in a cliff-like manner.
  • the focal tissue cells produce a radiation biological effect and necrosis, resulting in a radiation treatment effect similar to surgical resection.
  • a radiation therapy system based on a four-dimensional single-source gamma knife, including a radiation therapy planning system, an intelligent tracking system, a three-dimensional numerical control treatment bed, a robot system, a radiation source, and auxiliary treatment System and integrated control system.
  • the radiotherapy planning system is connected to the 3D CNC treatment table, intelligent tracking system, robot system, radioactive source, auxiliary treatment system and integrated control system through the network.
  • the 3D CNC treatment table is connected to the robot system.
  • the system is connected to a radioactive source, the radioactive source is connected to a collimator system, and the three-dimensional numerical control treatment bed, robot system, intelligent tracking system, radioactive source, and auxiliary treatment system are connected to an integrated control system;
  • the radiation source includes a gamma source rod and a collimator system.
  • the collimator system includes a primary collimator, a source gate secondary collimator, and a grating collimator.
  • the bottom of the primary collimator is provided with a mounting groove I.
  • the top of the source gate secondary collimator is installed in the mounting groove I, the bottom of the source gate secondary collimator is provided with a mounting groove II, and the top of the grating collimator is installed in the mounting groove II.
  • the intelligent tracking system includes a three-dimensional double digital X-ray fluoroscopy system and a position sensor placed on the skin of the body surface, and both the position sensor and the three-dimensional double digital X-ray fluoroscopy system are directly connected to the integrated control system.
  • the three-dimensional double digital X-ray fluoroscopy system includes a C-arm frame, a pitch axis, a rotation axis, a slide rail, a slide base, and two sets of perspective mechanisms.
  • the slide base is installed in the slide rail, and the slide rail is installed on the ceiling of the treatment room.
  • the slide base, the pitch axis, the rotation axis, and the C-arm frame are connected in sequence.
  • the two sets of perspective mechanisms are installed on the C-arm frame.
  • the perspective mechanism includes an X-ray source and an X-ray dynamic flat-panel detector disposed oppositely.
  • the X-ray source is a kilovolt class, adjustable between 28-150kv, and a high-voltage generator is provided between the X-ray source and the auxiliary treatment system.
  • the auxiliary treatment system includes a human-computer interaction system and a high-voltage generation system.
  • the human-computer interaction system includes a radiotherapy physician workstation, an imaging workstation, and an operation panel.
  • the high-voltage generation system is connected to an X-ray source through a high-voltage generator.
  • the human-machine interaction system And the high voltage generation system are connected with the integrated control system.
  • the primary collimator includes a source tank shielding shell, and a ⁇ source cavity for placing a ⁇ source rod and a source tank opening fiber cone for placing a fiber cone lens are provided in the source tank shielding shell along the central axis direction.
  • the source gate secondary collimator includes a source gate shielding shell, a source gate opening lens cavity for placing a convex lens is arranged in the source gate shielding shell along the central axis direction, and the grating collimator includes a grating shield A housing, the source tank aperture fiber cone cavity is in communication with the inner cavity of the grating collimator through the source gate aperture lens cavity.
  • a plurality of mounting holes for mounting the primary collimator are provided along the circumferential direction on the top of the shielding shell of the source tank.
  • the top of the source gate shielding shell is provided with a ring-shaped protrusion I matching the installation groove I, and the ring-shaped protrusion I is integrally provided with the source gate shield shell, and the top end of the source gate shield shell is along the central axis direction
  • a ladder platform is provided, and a screw cover ring for mounting a convex lens is installed at the ladder platform.
  • the convex lens is screw-connected with the screw cover ring, and a spring ring is provided at the top of the screw cover ring. The bottom ends are in close contact.
  • the primary collimator, the source-gate secondary collimator, and the grating collimator are sequentially arranged from top to bottom, and all three are mounted on a mounting frame.
  • the inside of the source gate shielding shell is provided with a core cavity in a horizontal direction, and a core block is slidably disposed in the core cavity.
  • the core cavity is in communication with the lens cavity of the source gate opening.
  • the core block is provided with a through hole I in a vertical direction.
  • the diameter of the through hole I is the same as the diameter of the lens cavity of the source gate opening.
  • At least one brake core slide bar is fixed on one side wall of the brake core block, and the brake core main transmission bar is fixed on the other end side wall of the brake core block.
  • the free ends of the core main transmission rods pass through the source gate shielding shell, wherein the free ends of the core main transmission rods pass through the source gate shielding shell and are connected to the gate driving mechanism and the free ends of the core transmission rods are at the end positions.
  • a mechanical shutter is provided.
  • the mechanical shutter includes a limit plate I welded on the free end of the main transmission rod of the brake core, a return spring sleeved on the outside of the main transmission rod of the brake core, and a limit plate II welded on the mounting frame.
  • the two ends of the return spring are respectively connected to the limit plate I and the limit plate II.
  • the limit plate II is provided with a through hole II for the main transmission rod of the brake core to pass through.
  • the brake core driving mechanism includes a brake core servo motor provided on a mounting frame and a driving wheel connected to the brake core servo motor through a belt, and a free end of the brake core main transmission rod is provided with a mesh with the driving wheel. Toothed belt I.
  • the inner cavity of the grating collimator is provided with four groups of self-main gratings in order from top to bottom, and each group of autonomous gratings includes two grating plates arranged in parallel.
  • the four sets of autonomous gratings are 0 ° -direction autonomous gratings, 90 ° -direction autonomous gratings, 135 ° -direction autonomous gratings, and 45 ° -direction autonomous gratings.
  • Each grating plate is cylindrical and each grating plate is A grating driving mechanism for driving the grating plate is arranged at the top, wherein the center axis of any grating plate in the 0 ° direction autonomous grating is parallel to the y-axis direction of the horizontal coordinate system, and any grating plate in the 90 ° direction autonomous grating.
  • the central axis of the axis is parallel to the x-axis direction of the horizontal coordinate system.
  • the angle between the central axis of any grating plate in the 135 ° direction autonomous axis and the x-axis of the horizontal coordinate system is 135 °.
  • the angle between the central axis of the axis and the x-axis of the horizontal coordinate system is 45 °.
  • the mounting groove I is in a ring shape, and the mounting groove I is located at the center of the bottom of the shielding shell of the source tank.
  • the top of the grating shielding shell is provided with an annular protrusion II matching the mounting groove II, and the annular protrusion II is integrally provided with the grating shielding shell.
  • the present invention has the beneficial effect that the present invention provides a radiation therapy system based on a four-dimensional single-source gamma knife.
  • the radiation therapy system has high intelligence, and in most cases cures primary cancer or multiple locations at one time.
  • the present invention has the following technical effects:
  • the invention can realize the intelligent system of radiosurgery treatment by using only one gamma source, and the safety is improved;
  • the present invention is highly intelligent, and the integrated control system can intelligently analyze image data, intelligently characterize target cell and organ tissue sensitive cell characteristic data, intelligently establish a mathematical model of focus displacement tracking, intelligently formulate a radiation therapy plan, and intelligently control the spatial position and movement of a robotic arm Speed and acceleration focusing projection, intelligent adjustment of grating conformal projection, intelligent moving target focusing once and multiple target treatment, intelligent system self-test and self-assessment, and intelligent safety guarantee system;
  • Focused dose is accurate, side effects are small, primary cancer and multiple metastatic cancer are cured in one time, high safety, simple operation, suitable for popularization;
  • the tracking accuracy of the intelligent tracking system reaches micron level. There is no need to implant a gold standard, and no imaging testing assistance is required during the treatment process;
  • FIG. 1 is a principle block diagram of the present invention
  • FIG. 2 is a schematic diagram of the positional relationship between a three-dimensional double-digital X-ray fluoroscopy system, a three-dimensional numerically controlled treatment table, and a robot system in the present invention
  • FIG. 3 is a schematic structural diagram of a collimator system in the present invention.
  • FIG. 4 is a schematic structural diagram of a primary collimator in the present invention.
  • FIG. 5 is a sectional view of a primary collimator in the present invention.
  • FIG. 6 is a schematic structural diagram of a secondary collimator of a source gate in the present invention.
  • FIG. 7 is a schematic diagram of a connection relationship between a primary collimator and a source-gate secondary collimator in the present invention.
  • FIG. 8 is a schematic diagram of a connection relationship between a brake core block, a brake core slide bar, and a brake core main transmission bar in the present invention
  • FIG. 9 is a schematic structural diagram of a grating collimator in the present invention.
  • FIG. 10 is a schematic diagram of a connection relationship between a brake core main transmission rod, a mechanical shutter, and a brake core driving mechanism in the present invention.
  • FIG. 11 is a schematic diagram of a connection relationship between a grating plate and a corresponding grating driving mechanism in Embodiment 1;
  • FIG. 12 is a schematic diagram of a connection relationship between a grating plate and a corresponding grating driving mechanism in Embodiment 2;
  • FIG. 13 is a schematic diagram of a connection relationship between a grating plate and a corresponding grating driving mechanism in Embodiment 3;
  • a radiation treatment system based on a four-dimensional single-source gamma knife includes a radiation treatment planning system 11, an intelligent tracking system 12, a three-dimensional numerically controlled treatment bed 13, a robot system 14, a radiation source 15, an auxiliary treatment system 16 and Integrated control system 17, 3D CNC treatment bed 13 can automatically push the target to the origin of 3D coordinates, and can be adjusted in 6 degrees of freedom in ⁇ X, ⁇ Y, ⁇ Z coordinate directions, so that tumors in the bed and human body best meet the requirements of the projection system. Controlled by the bedside, controlled by the radiotherapy technician's console, and controlled by an integrated control system; an intelligent treatment planning system is used to provide a comprehensive treatment design and treatment plan.
  • the radiotherapy planning system 11 is respectively connected to a three-dimensional numerical control treatment bed 13, an intelligent tracking system 12, a robot system 14, a radiation source 15, an auxiliary treatment system 16 and an integrated control system 17 through a network, and the robot system 14 is a three-dimensional five-axis Intelligent robotic arm, 3D NC treatment bed 13 is connected to, robot system 14, integrated control system 17, robot system 14 is connected to radiation source 15, integrated control system 17, radiation source 15 is connected to auxiliary treatment system 16, 3D NC treatment bed 13
  • the robot system 14, the intelligent tracking system 12, the radiation source 15, and the auxiliary treatment system 16 are all connected to the integrated control system 17;
  • the radiation source 15 includes a gamma source rod 102 and a collimator system 18, and the collimator system includes a primary collimator Device, source gate secondary collimator and grating collimator, the bottom of the primary collimator is provided with a mounting slot I, the top of the source gate secondary collimator is installed in the mounting slot I, and the source gate secondary collimator The bottom of the collimator
  • the intelligent tracking system 12 includes a three-dimensional dual digital X-ray fluoroscopy system 20 and a position sensor 19 placed on the skin of the body surface.
  • the position sensor 19 is directly connected to the integrated control system 17, the three-dimensional dual digital X-ray fluoroscopy system 20 and an imaging workstation 23 The integrated control system 17 is connected.
  • the three-dimensional double digital X-ray fluoroscopy system 20 includes a C-arm frame 25, a pitch axis 26, a rotation axis 27, a slide rail 28, a slide base 29, and two sets of perspective mechanisms.
  • the slide base 29 is installed on the slide rail.
  • the slide rail 28 is installed on the ceiling of the treatment room, and the slide seat 29, the pitch axis 26, the rotation axis 27, and the C-arm frame 25 are connected in order.
  • the two sets of perspective mechanisms are installed on the C-arm frame 25.
  • the X-ray source 30 and the X-ray dynamic flat-panel detector 31 are arranged opposite to each other.
  • the X-ray source 30 is a kilovolt class and is adjustable between 28-150KV.
  • a high-voltage generator 32 is provided between the X-ray source 30 and the auxiliary treatment system 16.
  • the auxiliary treatment system 16 includes a human-computer interaction system 21 and a high-voltage generating system 22.
  • the human-computer interaction system 21 includes a radiotherapy physician workstation 9, an imaging workstation 23, and an operation panel 24.
  • the high-voltage generating system 22 is connected to an X-ray source through a high-voltage generator 32 and an X-ray source. 30 is connected, and the human-computer interaction system 21 and the high-voltage generating system 22 are connected to the integrated control system 17.
  • the radiation source 15 includes a gamma source rod 102 and a collimator system 18, as shown in FIG. 3, the collimator system includes a primary collimator 1, a source gate secondary collimator 2, and a grating collimator 3, The primary collimator 1, the source gate secondary collimator 2 and the grating collimator 3 are arranged in order from top to bottom, and the three are installed on the mounting frame 6. The bottom of the primary collimator 1 is provided with a mounting slot.
  • the mounting groove I4 has a ring shape, and the mounting groove I4 is located at the bottom center position of the source tank shielding shell 101; the top of the source gate secondary collimator 2 is installed in the mounting groove I4, and the source gate secondary collimator 2
  • a mounting groove II5 is provided at the bottom of the frame, and the top of the grating collimator 3 is installed in the mounting groove II5.
  • the primary collimator 1 includes a source tank shielding shell 101, and a gamma source cavity 103 for placing a gamma source rod 102 and a space for placing the gamma source rod 102 are provided in the source tank shielding shell 101 along the central axis direction.
  • the source tank of the optical fiber cone lens 104 has an optical fiber cone cavity 105.
  • the source gate secondary collimator 2 includes a source gate shield casing 201, and a convex lens 202 is arranged in the source gate shield casing 201 along the center axis direction.
  • the grating collimator 3 includes a grating shielding housing 301, and a top of the grating shielding housing 301 is provided with an annular protrusion II306 matching the mounting groove II5, and the annular protrusion II306 and the grating
  • the shielding shell 301 is provided integrally; the source tank aperture fiber cone cavity 105 communicates with the inner cavity of the grating collimator 3 through the source gate aperture lens cavity 203. This solution is further optimized.
  • a plurality of mounting holes 106 for mounting the primary collimator 1 are provided on the top of the source tank shielding casing 101 along the circumferential direction.
  • the top of the source gate shielding housing 201 is provided with an annular protrusion I204 matching the installation groove I4, and the annular projection I204 is integrally provided with the source gate shielding housing 201.
  • the top of the shield housing 201 is provided with a step along the center axis direction, and a screw cover ring 205 for mounting the convex lens 202 is installed at the step.
  • the convex lens 202 is screwed with the screw cover ring 205.
  • a spring coil 206 is provided at the top end, and the spring coil 206 is in close contact with the bottom end of the fiber cone lens 104.
  • the overall shape of the optical fiber cone lens is a combination of an upper cone and a lower cylinder, with a hemispherical shape of a spherical socket-shaped source rod at the top, and a cone-shaped fiber and cavity wall reflecting collimated gamma rays to the lower segment.
  • Cylindrical lens is used to emit the collimated beam to the collimating cavity of the source gate, and plays the role of primary collimator.
  • the fiber cone lens has the function of collimating ⁇ -ray treatment beam and absorbing ⁇ -ray.
  • a lock core cavity 207 is provided along the horizontal direction inside the source shield housing 201 and a lock core block 208 is slidably arranged in the lock core cavity 207.
  • the lock core cavity 207 is in communication with the optical fiber cone cavity 105 of the source tank opening.
  • the gate core block 208 is provided with a through hole I2081 in a vertical direction to further optimize this solution.
  • the diameter of the through hole I2081 is the same as the diameter of the source gate opening lens cavity 203.
  • At least one brake core slide bar 2082 is fixed on one side wall of the brake core block 208.
  • the brake core block 208 is provided with a brake core main transmission rod 2083 fixed on the other end side wall.
  • the two brake core slide rods and the brake core transmission rod jointly support the brake core block 208, and the brake core slide rod 2082 is provided.
  • the free ends of the main transmission rod 2083 and the brake core pass through the source shield housing 201.
  • the free end of the main transmission rod 2083 penetrates the source shield housing 201 and is connected to the brake core driving mechanism 8 and the main transmission shaft 2083 of the brake core.
  • the free end is provided with a mechanical shutter 7 at the end position.
  • the mechanical shutter 7 includes a limit plate 701 welded to the free end of the main transmission rod 2083 of the brake core, a return spring 702 sleeved on the outside of the main transmission rod 2083 of the brake core, and fixed to the installation.
  • the limit plate II703 on the frame 6 and the two ends of the return spring 702 are respectively connected to the limit plate I701 and the limit plate II703.
  • the limit plate II703 is provided with a through hole II704 through which the main transmission rod 2083 of the brake core passes;
  • the brake core driving mechanism 8 includes a brake core servo motor 801 provided on the mounting frame 6 and a driving wheel 802 connected to the brake core servo motor 801 through a transmission belt.
  • the free end of the brake core main transmission rod 2083 is provided with the driving wheel 802. Interlocking toothed belt I803.
  • the inner cavity of the grating collimator 3 is provided with four groups of autonomous gratings in order from top to bottom, and each group of autonomous gratings includes two grating plates arranged in parallel.
  • the four groups of autonomous gratings are 0 ° direction autonomous grating 307, 90 ° direction autonomous grating 302, 135 ° direction autonomous grating 303, and 45 ° direction autonomous grating 304, each grating plate is cylindrical and each grating plate A grating driving mechanism 305 for driving the grating plate is provided at the top end of the grating.
  • the center axis of any grating plate in the 0 ° autonomous grating 307 is parallel to the y-axis of the horizontal coordinate system.
  • the center axis of any grating plate is parallel to the x-axis direction of the horizontal coordinate system, and the angle between the central axis of any grating plate in the 135 ° direction autonomous grating 303 and the x-axis of the horizontal coordinate system is 135 °, and the autonomous grating 304 in the 45 ° direction is 304
  • the angle between the central axis of any one of the grating plates and the x-axis of the horizontal coordinate system is 45 °.
  • each group of autonomous gratings two sides of each group of autonomous gratings are provided with grating slides 3056.
  • Two grating plates in each group of autonomous gratings can slide freely within the grating slides 3056.
  • Each grating plate is cylindrical and each A grating driving mechanism 305 for driving the grating plate is provided at the top or both sides of the grating plate.
  • the grating driving mechanism 305 in this embodiment includes a traction plate 3051, a transmission belt 3052, a driving wheel I 3053, a driving wheel II 3054, and a grating servo motor 3055.
  • One of the side walls of the traction plate 3051 is connected to the transmission belt 3052 and traction
  • the bottom end of the plate 3051 is fixedly connected to the corresponding grating plate.
  • the transmission belt 3052 is arranged in parallel with the grating slide 3056.
  • the driving wheel I 3053 is connected to the grating servo motor 3055.
  • the driving wheel I 3053 and the driving wheel II 3054 are respectively arranged at both ends of the driving belt 3052.
  • the driving wheel II3054 can also be connected to a grating servo motor.
  • the two grating servo motors jointly drive the transmission belt.
  • the grating servo motor 3055, the grating slide 3056, and the driving wheel II3054 are all fixed on the inner wall of the grating shield housing 301.
  • the corresponding grating plate is driven to slide in the grating slide 3056 by the grating servo motor 3055.
  • the grating driving mechanism 305 in this embodiment includes an anchor rod, a transmission belt 3052, a driving wheel I 3053, a driving wheel II 3054, and a grating servo motor 3055.
  • the traction block is replaced
  • one of the side walls of the anchor rod is connected to the transmission belt 3052.
  • the bottom end of the anchor rod is fixedly connected to the corresponding grating plate.
  • the transmission belt 3052 and the grating slide 3056 are arranged in parallel.
  • the driving wheel I3053 and the grating The servo motor 3055 is connected, and the driving wheel I3053 and driving wheel II3054 are respectively arranged at both ends of the transmission belt 3052.
  • the driving wheel II3054 can also be connected to a grating servo motor.
  • the two grating servo motors jointly drive the belt movement.
  • 3055, the grating slide 3056, and the driving wheel II 3054 are fixed on the inner wall of the grating shield housing 301, and the corresponding grating plate is driven to slide in the grating slide 3056 by the grating servo motor 3055.
  • the grating driving mechanism 305 in this embodiment includes a driving wheel I 3053, a driving wheel II 3054, a grating slide 3056, and two grating servo motors 3055.
  • the driving wheel I 3053 is connected to one of the grating servo motors 3055.
  • the driving wheel II3054 is connected to another grating servo motor 3055.
  • the grating slide 3056 is provided on both sides of the grating plate.
  • the outer side of the grating slide 3056 is provided with a toothed belt II3057.
  • the driving wheel I3053 and the driving wheel II3054 are both gears and teeth.
  • the two grating servo motors 3055 and the grating slide 3056 are fixed on the inner wall of the grating shield housing 301, and the grating plate is driven to slide in the grating slide 3056 by the two grating servo motors 3055.
  • the four-dimensional single-source gamma knife of the present invention belongs to a four-dimensional single-source gamma knife.
  • Four-dimensional means that the target can be statically focused and irradiated from any direction of XYZ in the rectangular coordinate system, and can be used for the human chest and abdominal cavity in the time dimension. It can be used for real-time and precise displacement tracking and focus irradiation treatment with targets that are displaced with breathing or heartbeat, such as the heart, so it is called four-dimensional.
  • Single source means that the system uses only one sealed 60 cobalt source, and the beta rays are filtered by the shielded absorption structure, which can reduce the skin dose.
  • the gamma rays Only the gamma rays that have good penetrating power and good tissue energy transmission line density are used; the gamma rays pass through the primary collimation And the secondary collimator limit the maximum spot diameter, and then pass the automatic grating collimator to adjust with the target under system control to achieve conformal radiation therapy.
  • the penumbra of the collimator system is small, the robotic radiation projection system is precisely focused, and the powerful target tissue absorbed dose planning capability of the radiation treatment planning system makes the external dose edge fall down like a surgical scalpel. Called the gamma knife.
  • the robot arm adjusts the source focal length to make the incident dose rates in different directions different, and adjusts the source focal length and time integration in the incident direction to make the incident doses in different incident directions different.
  • the radiation treatment planning system individually plans the incident in all incident directions from 360 degrees Dose rate and incident dose not only ensure the absorbed dose of the target tissue, but also personalize the dose to protect sensitive cells, important tissues and organs.
  • the radiotherapy planning system includes a radiotherapy physician prescription system, a radiotherapy technician console, patient information, disease information database, medical basic database, source activity database, atomic clock synchronous timing system library, radiation dose database, coordinate database, image processing system database, angle
  • the auxiliary treatment system In addition to the human-computer interaction system and the high-pressure generation system, the auxiliary treatment system also has audio and video functions. Patients can play audio and video through this system before surgery to achieve a relaxing effect, which is helpful to rule out the patient's internal fear of surgery.
  • Radiotherapy appointment The radiotherapy is decided by an authorized senior radiotherapy physician.
  • the authorized senior radiotherapy physician enters the confirmed patient information in the 4D single-source gamma knife radiotherapy system to complete the appointment.
  • the data calculation center and treatment planning system intelligently plan a one-time or fractional static focus non-equivalence center IMRT radiation therapy plan; a senior radiation therapist reviews the treatment plan, or modifies the parameters in the treatment plan (but the reason must be described for future reference ), Confirm that the system must execute the static focus non-isocentric conformal intensity-modulated intensity-focused radiation therapy plan.
  • the video was used to simulate the radiotherapy plan execution process again, and the verification confirmed that the system must perform the static focus non-isocenter IMRT radiation therapy plan.
  • the four-dimensional single-source gamma knife uses a bone positioning coordinate system, a three-dimensional laser positioning coordinate system, and a high-performance combined MEMS position sensor for the body surface-a three-dimensional digital coordinate system for focus displacement tracking and a three-coordinate system. It cooperates with a radiosurgery treatment system that realizes patient positioning, focus positioning, focus displacement tracking, and projection robots follow the focus for laser positioning, non-isocentric conformal intensity modulation, and real-time tracking of focused irradiation.
  • the characteristic bony positioning coordinate marks of the patient's body such as the ischial tuberosity line near the midpoint mark of the midline of the bedplate, that is, near the "origin" of the three-dimensional laser positioning coordinate system.
  • the patient's body was restrained with a patient fixation system in a cooperative therapy bed.
  • Coordinate system fusion adjust the coordinated treatment bed so that the target is positioned near the "origin" of the laser positioning coordinate system; the vertical and horizontal focal points of the 3D dual digital X-ray imaging system-the intersection of the midpoint connection of the image receiver The point is also positioned near the "origin” of the laser positioning coordinate system.
  • the radiotherapy technician completes the manual positioning, leaves the machine room, closes the machine room door, and operates the three-dimensional dual digital X-ray fluoroscopy system at the radiotherapy technician's console to allow the patient to hold their breath for the first time.
  • the data calculation center directs the image processing and analysis system to analyze the typical shape and coordinate data of the target in the grab spot, and compares it with the existing target and focus data in the system. It automatically adjusts the bed to describe the "virtual target coordinate origin" of the system. (That is, the focus of radiotherapy) "to the" origin "of the device's reference positioning coordinate system to complete the fusion of the target's coordinate system with the bone positioning coordinate system and the three-dimensional laser positioning coordinate system.
  • the data and operation center obtain time-synchronized body surface high-performance combined MEMS position sensor-data of focus displacement tracking 3D digital coordinate system, data of two digital image receivers, establish a virtual target coordinate system and identify the coordinate origin (focus ), Bone positioning coordinate system, three-dimensional laser positioning coordinate system, body surface high-performance combined MEMS position sensor-focus displacement tracking three-dimensional digital coordinate system coordinate feature data correlation, complete the entire coordinate system fusion.
  • the radiotherapy technician opens a three-dimensional double digital X-ray fluoroscopy system to continuously perform a fluoroscopy examination of the target and the surrounding area, covering three calm breaths, three deep breaths, and three coughs.
  • the time-synchronized dynamic image data of the two digital image receivers are collected, transmitted, and stored.
  • the "origin" of the system that is, the focal point of the treatment
  • the characteristic data of the system is the typical data of focal displacement correlation characteristics, and the typical data of focal displacement correlation characteristics of time-synchronized MEMS position sensors are comprehensively analyzed.
  • the mathematical model of displacement tracking with breathing or heartbeat target is intelligently established.
  • the radiotherapy planning software system comprehensively analyzes the authorized senior radiotherapy physician prescription system data, coordinate system data, displacement target tracking mathematical model data, human normal organ tissue sensitive cell personalized dose protection basic data, Target tissue average absorbed dose and dose uniformity requirement data, target three-dimensional morphology and coordinate characteristic data, instantaneous activity and radiation dose rate characteristic data of radioactive sources, basic data of energy transfer line density of different tissues, non-isocentric conformal adjustment of static focus Strongly focused irradiation radiotherapy plan and other data, intelligently formulate non-isocentric conformal intensity-modulated real-time tracking focused irradiation radiosurgery treatment plan.
  • the three-dimensional five-axis laser positioning and focusing robot projection system under the command of integrated control system, intelligent tracking system and data operation center, comprehensive radiation therapy plan, mathematical model of focus displacement tracking, high-performance combined MEMS position sensor for body surface-focus Real-time data from the displacement tracking system, timely correction of operational data, and accurate laser positioning for non-isocenter conformal intensity-modulated real-time tracking focused irradiation radiosurgery treatment plan.
  • Radiotherapy is over. Program stops. The security detection and monitoring system is normal. Open the room door. The radiotherapy technician unbinds the patient from the fixed facility. The patient was returned to the ward or returned home after awakening.
  • the four-dimensional single-source gamma knife is a set of intelligent radiosurgery treatment systems for non-invasive treatment of tumors in the whole body and some benign disease indications. It provides a painless, non-surgical treatment option for patients with tumors that cannot or are difficult to remove surgically, or for patients who are looking for options other than surgery.
  • the total treatment time is affected by the patient's specific physical condition, the nature of the disease and the number and location of the target, the complexity of the treatment plan, the dose, the method of administration and the route, etc., and the time is about 30 to 180 minutes at a time, or it may take longer. Short and longer, some patients are suitable for a single radiation treatment plan, and some patients are suitable for two to five radiation treatment plans.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Pathology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Radiation-Therapy Devices (AREA)

Abstract

La présente invention concerne un système de radiothérapie utilisant un scalpel γ 4D à source unique, comprenant un système de planification de radiothérapie, un système de suivi intelligent, un lit de traitement à commande numérique tridimensionnelle, un système robotique, une source de rayonnement, un système de traitement auxiliaire, un système de commande intégré et un double système numérique tridimensionnel de fluoroscopie et de rayons X. Le lit de traitement à commande numérique tridimensionnelle, le système robotique, le système de suivi intelligent, le double système numérique tridimensionnels de fluoroscopie et de rayons X, la source de rayonnement et le système de traitement auxiliaire sont tous connectés au système de commande intégré et au système de planification de radiothérapie. Ce système de radiothérapie effectue un suivi instantané du point focal et une projection de focalisation à 360° au moyen d'un faisceau de rayons γ ajusté en intensité, conformé et collimaté émis par la source de rayonnement disposée au niveau d'une extrémité du bras du système robotique, de sorte qu'un point focal peut recevoir à plusieurs reprises la dose de rayonnement à la différence des organes tissulaires environnants, la dose au-delà de la limite du point focal chutant brutalement. Les cellules du tissu au niveau du point focal présentent un effet biologique par rayonnement et subissent une nécrose, présentant ainsi un effet radiothérapeutique similaire à une ablation chirurgicale.
PCT/CN2019/097602 2018-07-27 2019-07-25 SYSTÈME DE RADIOTHÉRAPIE UTILISANT UN SCALPEL γ 4D À SOURCE UNIQUE WO2020020265A1 (fr)

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