WO2020124583A1

WO2020124583A1 - Real-time tumor position monitoring system and monitoring method thereof

Info

Publication number: WO2020124583A1
Application number: PCT/CN2018/122782
Authority: WO
Inventors: 李林涛; 郎锦义; 秦远; 王培�; 黎杰; 康盛伟; 唐斌; 吴凡; 黄娜
Original assignee: 四川省肿瘤医院
Priority date: 2018-12-21
Filing date: 2018-12-21
Publication date: 2020-06-25

Abstract

Disclosed is a real-time tumor position monitoring system, comprising a pneumotachometer, a handpiece MLC driving mechanism and a PLC controller. The pneumotachometer comprises a pneumotachometer body (1), the left side and the right side of the pneumotachometer body (1) are provided with a trumpet-shaped tube (4) and an exhaling tube (5) respectively, a flowmeter (6) is provided on the exhaling tube (5), and the end portion of the exhaling tube (5) is hinged to a first open/close valve (7). The handpiece MLC driving mechanism comprises two longitudinal guide rails (10), the longitudinal guide rails (10) are each provided with two sliders (11) capable of sliding along the longitudinal guide rails (10), the sliders (11) are each provided with a guide sleeve (12), a horizontal guide rail (17) is provided between two opposite guide sleeves (12), and an MLC is provided between the two horizontal guide rails (17). Further disclosed is a tracking method. The system can more accurately track tumor motions caused by respiratory motions, provides favorable conditions for subsequent tumor treatment, and enables a simple tracking method.

Description

Tumor position real-time monitoring system and monitoring method

Technical field

The invention relates to the technical field of lung tumor tracking, in particular to a real-time tumor position monitoring system and monitoring method thereof.

Background technique

At present, the respiratory gating system is mainly controlled by foreign manufacturers, mainly including the infrared binocular method respiratory gating system from GE, the abdominal pressure-sensitive respiratory gating system from Philips, and an active breathing called ABC Gating system and medical Keda's pre-judgment breathing gating system. To put it simply, GE uses two infrared cameras to sense the surface of the patient's body (mainly the chest and abdomen) and the body surface driven by breathing motion. Movement, and then through a series of algorithms to simulate the image movement caused by breathing movement.

The difference between Philips' abdominal belt pressure-sensitive breathing gating system and GE's is the front-end measurement method. Philips uses an abdominal belt that can sense pressure changes and is tied to the chest and abdomen of the person being measured. The movement of the watch to drive the girth leads to the pressure change and the measurement. The difference in the backhaul lies in the algorithm.

Among all the current respiratory gating technologies, the most obvious shortcoming lies in the measurement of breathing movement by "indirect induction". In other words, almost all methods are to estimate the movement of the lungs in the body by measuring the data of body surface, ECG, etc. . ABC active breathing gating is mainly used in radiotherapy. Its principle is to pause breathing movement through passive apnea, and at the same time, the accelerator emits radiation to start treatment, to achieve the purpose of precise treatment. This method often requires the patient to be treated to apnea for up to 40~ 60s, which is very, very difficult for patients with diseases in their lungs. There is also a medical Kodak 4D system, which is also used in accelerator treatment. The principle is to improve the beam output of the accelerator through a computer algorithm. The disadvantage is that there is no measurement, but an implementation of calculation by algorithm.

Summary of the invention

The purpose of the present invention is to overcome the shortcomings of the prior art, provide a compact, more accurate tracking of tumor movement caused by respiratory movement, provide favorable conditions for subsequent tumor treatment, a simple tracking method, a real-time tumor position monitoring system and its monitoring method.

The object of the present invention is achieved by the following technical solution: a real-time tumor position monitoring system, which includes a respiratory velocimeter, a nose MLC drive mechanism and a PLC controller, the respiratory velocimeter includes a velocimeter body, the velocimeter body A cavity is opened, an air inlet pipe is provided on the top of the rheometer body, and a horn tube and an air outlet pipe are respectively provided on the left and right sides of the rheometer body. The horn tube, the air outlet pipe and the air inlet pipe are all in communication with the cavity. A flow meter is arranged on the air outlet pipe, a first opening and closing door is hinged at the end of the air outlet pipe, a fan is arranged in the air inlet pipe, and a second opening and closing door is hinged in the cavity and located on the top wall of the cavity , The second opening and closing door is located under the air intake pipe, the machine head MLC drive mechanism includes two longitudinal guide rails, the longitudinal guide rail is provided with two sliders that can slide along the longitudinal guide rail, and the slider is provided with a guide sleeve A horizontal guide rail is provided between the two opposite guide sleeves, and an MLC is provided between the two horizontal guide rails. The PLC controller is electrically connected to the flow meter and the fan.

A cover plate is provided on the top of the intake pipe.

The cover plate is provided with a through hole communicating with the intake pipe.

The rotating shaft of the fan is rotatably installed on the cover plate.

A strap is provided outside the body of the flow meter.

The MLC is composed of each pair of lead blades that can move independently.

The method for monitoring the tumor position in real time by the system includes the following steps:

S1, the patient is strapped to the head, the horn tube is facing the mouth and the contact is strict;

S2. During exhalation, the gas enters the cavity through the horn tube, and the airflow blows towards the second opening and closing door. The second opening and closing door rotates to the right around the hinge point under the action of air pressure, and the second opening and closing door closes the intake pipe; then the gas Entering the air outlet pipe, the first opening and closing door rotates to the right around the hinge point under the action of air pressure, and the gas exhaled by the human body can be discharged. During the exhaust process, the flow meter measures the flow rate and converts the flow signal into an electrical signal and transmits it to the PLC control devices, PLC controller calculates the amount of expiratory patient X _1; CX while using lung of a patient image scanning, when the detected expiratory volume of X _1, Y ₁ in the longitudinal position of the tumor in the lung;

S3. When inhaling, a negative pressure is formed in the cavity. The first opening and closing door rotates to the left around the hinge point and buckles on the air outlet pipe, and the outside air enters the intake pipe, and the second opening and closing door is hinged around the air pressure The point rotates to the left, the second opening and closing door opens, and the external air flow enters the cavity and the horn tube in sequence; during the inhalation process, the fan rotates, and the fan converts the rotation signal into telecommunications for transmission to the PLC controller, which is controlled by the PLC patients calculates the intake air amount X _2; CX while using lung of a patient image scanning, when the detected intake air amount is X _2, the longitudinal position of the tumor in the lung Y _2;

S4. Repeat steps S2 to S3 repeatedly to detect the longitudinal position Y of the tumor in the lung at different respiratory volumes X, and draw a graph of X and Y;

S5. When tracking the tumor, put the patient on his back and make his lungs face MLC; bring the patient with the respiratory velocimeter for breathing, at this time the instantaneous respiratory volume is detected, combined with the curve in step S4 to find the instantaneous respiratory volume The longitudinal position of the tumor under the same breathing volume, thus tracking the lung tumor; after finding the tumor position, adjust the MLC position and adjust the position of each multi-leaf grating, so that the contour formed by the multi-leaf grating is the same as the outer contour of the tumor.

The invention has the following advantages: the invention more accurately tracks the tumor movement caused by respiratory movement, provides favorable conditions for subsequent tumor treatment, and the tracking method is simple.

BRIEF DESCRIPTION

Figure 1 is a schematic diagram of the structure of the respiratory velocimeter;

Figure 2 is a schematic diagram of the structure of the head MLC drive mechanism;

Figure 3 is a front view of Figure 2;

FIG. 4 is an operation flowchart of the present invention;

In the picture, 1-flow meter body, 2-cavity, 3-intake pipe, 4-horn tube, 5-outlet pipe, 6-flow meter, 7-first opening and closing door, 8-fan, 9-second Opening and closing doors, 10-longitudinal guide, 11-slider, 12-guide sleeve, 13-MLC, 14-cover plate, 15-bandage, 16-leaf grating, 17-transverse guide.

detailed description

The present invention will be further described below in conjunction with the drawings. The scope of protection of the present invention is not limited to the following:

As shown in FIGS. 1 to 3, a real-time tumor position monitoring system includes a respiratory velocimeter, a nose MLC drive mechanism and a PLC controller. The respiratory velocimeter includes a velocimeter body 1 and an external portion of the velocimeter body 1 A strap 15 is provided, a cavity 2 is opened in the flow meter body 1, an intake pipe 3 is provided on the top of the flow meter body 1, a horn tube 4 and an air outlet pipe 5 are respectively provided on the left and right sides of the flow meter body 1, a horn The tube 4 is made of rubber material and can be closely attached to the mouth. The horn tube 4, the air outlet tube 5 and the air inlet tube 3 are all in communication with the cavity 2. The air outlet tube 5 is provided with a flow meter 6 A first opening and closing door 7 is hinged at the end of the air pipe 5, a fan 8 is provided in the intake pipe 3, and a second opening and closing door 9 is hinged in the cavity 2 and located on the top wall of the cavity 2 The opening and closing door 9 is located below the intake pipe 3.

As shown in FIGS. 2 to 3, the MLC driving mechanism of the machine head includes two longitudinal guide rails 10, and two sliders 11 that can slide along the longitudinal guide rails 10 are provided on the longitudinal guide rails 10, and a guide sleeve is provided on the slider 11 12. A horizontal guide rail 17 is provided between the two opposing guide sleeves 12, the horizontal guide rail 17 can move left and right along the guide sleeve 12, and an MLC 13 is provided between the two horizontal guide rails 17, the MLC 13 is independently movable by each pair The lead blade 16 is configured, and the PLC controller is electrically connected to the flow meter 6 and the fan 8. The MLC 13 can move back and forth along the longitudinal rail 10, and can also move left and right along the lateral rail 17, to ensure that the MLC can move in real time with the movement of the tumor.

A cover plate 14 is provided on the top of the intake pipe 3, and the cover plate 14 is provided with a through hole communicating with the intake pipe 3, so that outside air can enter the intake pipe 3 through the through hole. The rotating shaft of the fan 8 is rotatably installed on the cover plate 14.

S1. The patient is brought to the head via the strap 15 and the horn tube 4 is facing the mouth and the contact is strict;

S2. During exhalation, the gas enters the cavity 2 through the trumpet tube 4, the airflow blows towards the second opening and closing door 9, the second opening and closing door 9 rotates to the right around the hinge point under the action of air pressure, and the second opening and closing door 9 Close the air intake pipe 3 to prevent the exhaled gas from running out of the air intake pipe 3, and the flow rate of the exhaled gas is read by the 6 flow meter; then the gas enters the air outlet pipe 5, and the first opening and closing door 7 is hinged around under the action of air pressure The point rotates to the right, the gas exhaled by the human body can be discharged. During the exhaust process, the flow meter 6 measures the flow rate and converts the flow signal into an electrical signal to the PLC controller. The PLC controller calculates the patient's exhaled volume as X ₁ ; CX while using lung of a patient image scanning, when the detected expiratory volume of X _1, Y ₁ in the longitudinal position of the tumor in the lung;

S3. When inhaling, a negative pressure is formed in the cavity 2. The first opening and closing door 7 rotates to the left around the hinge point and buckles on the air outlet pipe 5 to prevent outside air from entering the air outlet pipe 5 while outside air enters the air inlet pipe Within 3, the second opening and closing door 9 rotates to the left around the hinge point under the action of air pressure, the second opening and closing door opens, and the external air flow enters the cavity through the cavity 2 and the trumpet tube 4 in sequence; during the suction process, the fan 8 Turning, the fan 8 converts the rotation signal into telecommunications and transmits it to the PLC controller. The PLC controller calculates the patient's inspiratory volume X ₂ ; at the same time, the CX is used to scan the patient's lungs and the inspiratory volume is detected as X ₂ When, the longitudinal position of the tumor in the lung is Y ₂ ;

S5. When tracking the tumor, put the patient on his back and make his lungs face MLC13; bring the patient with the respiratory velocimeter for breathing, at this time instantaneous respiratory volume is detected, combined with the curve in step S4 to find the instantaneous respiratory volume The longitudinal position of the tumor under the same breathing volume, thereby realizing the tracking of the lung tumor. Therefore, the monitoring method can more accurately track the tumor movement caused by the respiratory movement and provide favorable conditions for subsequent tumor treatment. After finding the position of the tumor, adjust the position of the MLC 13 and adjust the position of each multi-leaf grating 16 so that the contour formed by the multi-leaf grating 16 is the same as the outer contour of the tumor.

Claims

A real-time tumor position monitoring system, which is characterized in that it includes a respiratory velocimeter, a machine head MLC drive mechanism and a PLC controller. The respiratory velocimeter includes a velocimeter body (1), which is opened in the velocimeter body (1) There is a cavity (2), an air inlet pipe (3) is provided on the top of the tachometer body (1), a horn tube (4) and an air outlet pipe (5) are respectively provided on the left and right sides of the tachometer body (1). The horn tube (4), the air outlet tube (5) and the air inlet tube (3) are all in communication with the cavity (2), the air outlet tube (5) is provided with a flow meter (6), and the air outlet tube (5) The end of the door is hinged with a first opening and closing door (7). The intake pipe (3) is provided with a fan (8). The cavity (2) is located on the top wall of the cavity (2). Two opening and closing doors (9), the second opening and closing door (9) is located below the intake pipe (3), the machine head MLC drive mechanism includes two longitudinal guide rails (10), and two longitudinal guide rails (10) are provided on the longitudinal guide rail (10) A slider (11) that can slide along the longitudinal guide rail (10), a guide sleeve (12) is provided on the slider (11), and a transverse guide rail (17) is provided between two opposite guide sleeves (12), An MLC (13) is arranged between the two lateral guide rails (17), and the PLC controller is electrically connected to the flow meter (6) and the fan (8).
The tumor position real-time position monitoring system according to claim 1, characterized in that a cover plate (14) is provided on the top of the air intake pipe (3).
A real-time tumor position monitoring system according to claim 2, characterized in that: the cover plate (14) is provided with a through hole communicating with the intake pipe (3).
A real-time tumor position monitoring system according to claim 1, characterized in that the rotating shaft of the fan (8) is rotatably mounted on the cover plate (14).
A real-time tumor position monitoring system according to claim 1, characterized in that a strap (15) is provided outside the body of the flow meter (1).
A real-time tumor position monitoring system according to claim 1, characterized in that the MLC (13) is composed of each pair of lead blades (16) that can move independently.
The method for monitoring the position of a tumor in real time according to any one of claims 1 to 6, characterized in that it includes the following steps:

S1. The patient is brought to the head through the strap (15), the horn tube (4) is facing the mouth and the contact is tight;

S2. During exhalation, the gas enters the cavity (2) through the trumpet tube (4), and the airflow blows towards the second opening/closing door (9). The second opening/closing door (9) moves to the right around the hinge point under the action of air pressure Rotate, the second opening and closing door (9) closes the intake pipe (3); then the gas enters the outlet pipe (5), the first opening and closing door (7) rotates to the right around the hinge point under the action of air pressure, the body exhales the gas It can be discharged. During the exhaust process, the flow meter (6) measures the flow rate and converts the flow signal into an electrical signal to the PLC controller. The PLC controller calculates the patient's expiratory volume as X 1 ; lung image scanning, when the detected expiratory volume of X 1, Y 1 in the longitudinal position of the tumor in the lung;

S3. During inhalation, negative pressure is formed in the cavity (2), the first opening and closing door (7) rotates to the left around the hinge point and snaps on the air outlet pipe (5), and the outside air enters the air inlet pipe (3) Inside, the second opening and closing door (9) rotates to the left around the hinge point under the action of air pressure, the second opening and closing door opens, and the external air flow enters the mouth through the cavity (2) and the horn tube (4) in sequence; During the process, the fan (8) rotates, and the fan (8) converts the rotation signal into telecommunications and transmits it to the PLC controller. The PLC controller calculates the patient's inspiratory volume X 2 ; at the same time, CX is used to scan the patient's lungs. in the intake amount detected is X 2, Y 2 in the longitudinal position of the tumor in the lung;

S4. Repeat steps S2 to S3 repeatedly to detect the longitudinal position Y of the tumor in the lung at different respiratory volumes X, and draw a graph of X and Y;

S5. When tracking the tumor, put the patient on his back and make his lungs face MLC (13); bring the patient with the respiratory velocimeter for breathing, at this time the instantaneous breathing volume is detected, combined with the curve in step S4 to find and The longitudinal position of the tumor under the same instantaneous respiration volume realizes the tracking of the lung tumor; after finding the tumor position, adjust the position of the MLC (13) and adjust the position of each multi-leaf grating (16) so that the multi-leaf grating ( 16) The formed contour is the same as the outer contour of the tumor.