WO2021087681A1 - Dispositif de radiothérapie à modulation volumétrique hélicoïdale à base de faisceau conique et système d'image - Google Patents

Dispositif de radiothérapie à modulation volumétrique hélicoïdale à base de faisceau conique et système d'image Download PDF

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WO2021087681A1
WO2021087681A1 PCT/CN2019/115404 CN2019115404W WO2021087681A1 WO 2021087681 A1 WO2021087681 A1 WO 2021087681A1 CN 2019115404 W CN2019115404 W CN 2019115404W WO 2021087681 A1 WO2021087681 A1 WO 2021087681A1
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treatment
cone
collimator
rotating gantry
radiotherapy device
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PCT/CN2019/115404
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English (en)
Chinese (zh)
Inventor
田新智
陈亮
金铁
陈忠平
吴修东
赵晓峰
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新里程医用加速器(无锡)有限公司
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Priority to CN201980011708.8A priority Critical patent/CN112055602B/zh
Priority to PCT/CN2019/115404 priority patent/WO2021087681A1/fr
Publication of WO2021087681A1 publication Critical patent/WO2021087681A1/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
    • A61N5/1042—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy with spatial modulation of the radiation beam within the treatment head
    • A61N5/1045—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy with spatial modulation of the radiation beam within the treatment head using a multi-leaf collimator, e.g. for intensity modulated radiation therapy or IMRT
    • 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
    • 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
    • A61N5/1048—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
    • 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
    • A61N2005/1092—Details
    • 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
    • A61N2005/1092—Details
    • A61N2005/1094—Shielding, protecting against radiation

Definitions

  • the invention relates to a radiotherapy device, in particular to a spiral volume intensity modulated radiotherapy device based on a cone beam, and also relates to an imaging system including the radiotherapy device.
  • the radiotherapy device is a large-scale long-distance radiotherapy equipment used for cancer treatment. It generates X-rays and electronic rays to directly irradiate the tumor in the patient's body outside the body, thereby achieving the purpose of eliminating or reducing the tumor.
  • C-arm and O-arm there are two types of common radiotherapy devices: C-arm and O-arm. Relatively speaking, the structure of O-arm device is more compact and closed. It has more advantages in the implementation of more and more automation and intelligent radiotherapy technology. It also has higher security.
  • Commonly used radiotherapy techniques include Intensity Modulated Radiation Therapy (IMRT), Volumetric Modulated Arc Therapy (VMAT) and helical tomotherapy (HT).
  • IMRT Intensity Modulated Radiation Therapy
  • VMAT Volumetric Modulated Arc Therapy
  • HT helical tomotherapy
  • Intensity Modulated Radiation Therapy has several fixed radiation fields.
  • the position of the grating blades can be changed during each radiation field treatment process.
  • the dose distribution of a single fixed field is better, but due to the radiation field direction It is a limited number of directions.
  • the overall dose distribution is rougher than the gantry rotation intensity adjustment.
  • the time utilization rate is not high, and the treatment time is longer. long.
  • VMAT Volumetric Modulated Arc Therapy
  • VMAT Volumetric Modulated Arc Therapy
  • the frame speed, MLC blade speed, dosage and other parameters are adjustable.
  • the main models on the market are all ⁇ 180°rotation methods.
  • the basic principle is to form one or more arcs by rotating the frame angle for continuous irradiation.
  • the multi-leaf grating MLC irradiates the conformal subfields generated by each angle through integration
  • the superposition forms a dose distribution with good dose, volume, conformity and high precision.
  • the accelerator of Volumetric Modulated Arc Therapy is basically the same as the IMRT accelerator, including the upper collimator 1', the lower collimator 2'and the multi-collimator 3' (Including the blade drive motor 31' and the blade 32' moving under the blade drive motor), there is no difference in structure except for the higher requirements for the blade speed and system control ability of the multi-element collimator.
  • VMAT Volumetric Modulated Arc Therapy
  • Helical tomotherapy (helical tomotherapy, HT) is a CT scan with 360° continuous rotation and a narrow fan beam for spiral irradiation to achieve intensity-modulated radiotherapy.
  • a long and narrow collimator (binary pneumatic collimator) is installed on the traditional machine to obtain a fan beam with a width of about 20 cm and a layer thickness of 1-4 cm.
  • the fan beam can form a strip-shaped irradiation field on the cross section of the patient.
  • the blades of the collimator enter and exit under the control of the computer to adjust the opening or closing time of each sector to achieve the purpose of strengthening.
  • the stepping movement of the treatment bed it can cover the treatment of super-large tumors.
  • This kind of equipment adopting spiral stepping intensity modulation method can treat multiple lesions at the same time in the same positioning interval. And for longer radiation fields (such as total central irradiation, large-area irregular lymphatic drainage area irradiation and spinal tumors, etc.), there is no need to separate fields and complete them at one time, avoiding the appearance of cold spots or hot spots, improving tumor control rate and reducing Damage to normal tissues.
  • the use of fan beam spiral intensity modulation equipment has a low utilization rate of radiation. To treat the entire target area, it is necessary to irradiate several narrow fields in sequence, so it is relatively The treatment time of VMAT is relatively long, and the treatment efficiency is reduced. In terms of time, a VMAT treatment takes about 2-3 minutes, and to complete the same treatment, it takes 15-30 minutes to use fan beam treatment.
  • the present invention provides a cone beam-based spiral volume intensity modulated radiotherapy device, including:
  • a microwave system for generating rays arranged on the rotating gantry
  • the rotating frame
  • the cone-beam-based spiral volume-modulated radiotherapy device can combine the stepping of the cone beam and the treatment bed to implement different doses to different target areas, high-dose tumor target areas, low-dose surrounding normal tissues, and irradiate
  • the range is more suitable for the shape of the tumor, which improves the tumor control rate, improves the protection of risk organs, reduces the side effects of radiotherapy, and improves the survival time of patients.
  • the radiotherapy device has higher target area accuracy and achieves sub-millimeter target area accuracy errors. It can complete extremely complex intensity modulation planning schemes that cannot be completed by traditional radiotherapy devices, improve work efficiency, and allow more patients to perform radiation Treatment reduces the labor intensity of doctors who perform radiotherapy work and reduces the requirements of radiological physicists.
  • the cone beam-based spiral volume-modulated radiotherapy device includes a first solenoid valve arranged on the rotating gantry or the fixed gantry, so that both can pass through the first solenoid valve. A solenoid valve is locked.
  • the rotating frame has a cantilever extending parallel to the B axis;
  • the microwave system includes a modulator, a magnetron, a circulator, a grid-controlled gun power supply, a grid-controlled gun, and an acceleration
  • the modulation modulator controls the magnetron
  • the magnetron is connected to the acceleration tube through a circulator
  • the grid control gun power supply is used to control the grid control gun injection voltage and Electric current to make the grid control gun output an electron beam
  • the accelerator tube accelerates the electron beam and makes it hit the accelerator tube target to generate an X-ray beam
  • the central axis of the X-ray generated by the microwave system coincides with the A axis , And the A axis and the B axis intersect at the isocenter point I.
  • the treatment head and the rotating gantry are connected by a cantilever and are located below the accelerating tube target, and the treatment head includes:
  • An ionization chamber fixedly arranged on the cantilever and located below the primary collimator for ionizing inert gas to generate an output electrical signal;
  • a secondary collimator fixedly arranged on the cantilever and located below the ionization chamber;
  • the treatment head of the cone beam-based spiral volume intensity modulated radiotherapy device adopts a combination of a primary collimator, a secondary collimator, and a rotating double-layer multi-leaf grating to modulate the rays emitted by the microwave system into a cone Beam, and then coordinate with the movement of the treatment bed to achieve precise radiotherapy of the target area.
  • the treatment head includes a homogenizer that is fixedly disposed on the primary collimator and can filter low-energy X-rays to form evenly distributed high-energy X-rays.
  • the double-layer multi-leaf grating includes:
  • the cone beam-based spiral volume-modulated radiotherapy device includes a second solenoid valve disposed on the double-layer multi-leaf grating or the cantilever, so that the two can Locked by the second solenoid valve.
  • the treatment bed includes:
  • a single scissors support structure provided on the bottom plate and a first driving device for driving the single scissors support mechanism to complete the Z-direction movement;
  • a second supporting plate capable of moving along the X-direction unit and a second driving device for driving the second supporting plate to move along the X-direction unit provided on the first supporting plate, the second supporting plate With Y-direction unit;
  • a third supporting plate capable of moving along the Y-direction unit and a third driving device for driving the third supporting plate to move along the Y-direction unit are arranged on the second supporting plate.
  • the rotation speed of the rotating gantry, the number of machine hops of the radiotherapy device, the movement speed of the blades of the double-layer multi-leaf grating, and the movement speed of the treatment bed satisfy the following conditions:
  • ⁇ , MU, x, and y respectively represent the rotation speed of the rotating gantry, the number of machine hops of the radiotherapy device, the movement displacement of the double-layer multi-leaf grating, and the movement displacement of the treatment bed;
  • (d ⁇ /dt) max , (dMU/dt) max , (dx/dt) max , (dy/dt) max respectively represent the maximum speed of the rotating frame, the maximum dose rate of the accelerator, and the maximum speed of the double-layer multi-leaf grating And the maximum speed of the treatment bed.
  • the control algorithm can plan the motion control of the accelerator's spiral VMAT treatment mode, that is, every time the rotating gantry rotates one degree, the grating position of the treatment head changes in real time to conform to the shape of the target area of the treatment field.
  • the dose rate is also changing to ensure the accuracy of the radiation therapy dose.
  • the treatment bed runs at a uniform speed. When the treatment bed covers the entire tumor area, the patient's treatment is completed.
  • the present invention also provides a cone beam-based spiral volume intensity modulation imaging system, including:
  • the MV imaging system includes:
  • An MV detector arranged on the rotating gantry for collecting X-rays penetrating the treatment bed
  • the main beam shielding assembly arranged on the rotating gantry and located under the MV detector;
  • the MV detector and the beam main shielding assembly are both located on the opposite side of the treatment head.
  • the MV imaging system and the treatment head 300 provided by the present invention work at the same time, so that the MV imaging system can complete the quality assurance (QA) function of the radiotherapy device, such as the verification of the center position of the radiotherapy device, and the positioning of the double-layer multi-leaf grating 305 Accuracy verification and dose verification of accelerator treatment field, etc.
  • QA quality assurance
  • the cone-beam-based spiral volume modulation imaging system further includes a KV-level energy X-ray-based CBCT imaging system
  • the CBCT imaging system includes:
  • a CBCT tube capable of generating KV-level X-rays with corresponding energy under the control of the CBCT high-voltage generator and arranged on the rotating gantry;
  • a KV beam limiting device arranged on the rotating gantry and located at the front end of the CBCT tube;
  • a KV detector arranged on the rotating gantry and located on the opposite side of the CBCT tube;
  • the center line of the KV class X-ray generated by the CBCT tube and the B axis intersect at the isocenter point I.
  • the KV ray-based CBCT system has multiple applications, such as monitoring of the patient's position during treatment, and patient's position verification before treatment.
  • the high-voltage generator, CBCT tube, and image detector form an image acquisition system.
  • the acquisition system collects and transmits the projection data sequence to the CBCT workstation for 3D reconstruction, and then the reconstructed CBCT volume data and the radiotherapy planning system CT image are used for 3D volume registration , And finally get the patient's positioning error. If the error exceeds the specified positioning deviation requirement, the imaging system will transmit the deviation to the motion control system.
  • the motion control system controls the movement of the treatment bed to eliminate the artificial positioning error, and finally performs accurate positioning on the patient. Radiation Therapy.
  • Fig. 1 is a schematic diagram of the structure of a multi-element collimator 3'in the prior art
  • Figure 2 shows the formation of a cone beam conformal field in the prior art
  • Figure 3 shows the formation of a fan beam conformal field in the prior art
  • FIG. 4 is a schematic diagram of the overall structure of a spiral volume-modulated radiotherapy device based on a cone beam according to an embodiment of the present invention
  • FIG. 5 is a schematic structural diagram of a microwave system 200 in an embodiment of the present invention.
  • FIG. 6 is a schematic diagram of the structure of the treatment head 300 in an embodiment of the present invention.
  • FIG. 7 is a schematic structural diagram of a treatment bed 400 in an embodiment of the present invention.
  • FIG. 8 is a working flow chart of an MV imaging system application in an embodiment of the present invention.
  • FIG. 9 is a working flow chart of a CBCT imaging system based on KV energy X-rays in an embodiment of the present invention.
  • Fig. 10 is a schematic diagram of a spiral volume-modulated radiotherapy device based on a cone beam provided by the present invention that generates spiral rays surrounding the human body.
  • Microwave system 200 modulator 201; magnetron 202; circulator 203; grid control gun power supply 204; grid control gun 205; acceleration tube 206; acceleration tube target 207;
  • Treatment head 300 primary collimator 301; homogenizer 302; ionization chamber 303; secondary collimator 304; double-layer multi-leaf grating 305; upper independent collimator or upper multi-element collimator 305-1; lower independent collimator Straightener or lower multi-element collimator 305-2;
  • the treatment bed 400 a bottom plate 401, a single scissors support structure 402, a first driving device 403, a first supporting board 404, a second supporting board 405, a second driving device 406, a third supporting board 407, and a third driving device 408.
  • the cone beam-based spiral volume-modulated radiotherapy apparatus includes a fixed gantry 100, a rotating gantry 101, a microwave system 200, a treatment head 300, and a treatment bed 400.
  • the above-mentioned rotating frame 101 is arranged on the fixed frame 100, and the rotating frame 101 can rotate 360° along the horizontal axis B in FIG. 4 relative to the fixed frame 100 (the rotating frame 101 can be mounted on the fixed frame in a shaft connection manner). 100 on the shelf).
  • the rotating gantry 101 is roughly cylindrical, with a hollow channel in the middle, which can allow the treatment bed 400 carrying the patient to pass through (enter or leave).
  • the microwave system 200 is installed on the rotating gantry 101 and can control and generate X-rays.
  • the treatment head 300 is disposed on the rotating machine 101, and the treatment head 200 can rotate 360° along the vertical axis A in FIG. 4 relative to the rotating frame 101.
  • the treatment head 300 can modulate the X-rays generated by the microwave system 200 into a cone beam.
  • the treatment bed 400 is arranged on one side of the rotating gantry 101 (shown as the left side in FIG. 4), which can move relative to the rotating gantry 101 in the three-dimensional space coordinate system X, Y, and Z shown in the figure, so that It can enter or leave the rotating frame 101 via the middle passage.
  • the rotating frame 101 has a cantilever 102 extending in a direction parallel to the B axis, and the microwave system 200 is fixedly arranged on the cantilever 102.
  • the microwave system 200 includes a modulator 201, a magnetron 202, a circulator 203, a grid control gun power supply 204, a grid control gun 205, an acceleration tube 206 and an acceleration tube target 207. All components are arranged on the rotating frame 101 of the accelerator. The relationship between the components is shown in FIG. 5, the modulator 201 controls the magnetron 202, and the magnetron 202 is connected to the acceleration tube 206 through the circulator 203.
  • the grid control gun power supply 204 is used to control the injection voltage and current of the grid control gun 205, and the grid control gun 205 outputs an electron beam.
  • the electron beam is accelerated by the acceleration tube 206 and hits the acceleration tube target 207 to generate an X-ray beam.
  • the central axis of the X-ray generated by the microwave system 200 coincides with the A-axis, and the A-axis and the B-axis intersect at the isocenter I
  • the treatment head 300 includes a primary collimator 301, a homogenizer 302, an ionization chamber 303, a secondary collimator 304 and a double-layer multi-leaf grating 305 arranged in sequence.
  • the treatment head 300 is located under the accelerating tube target 207 of the microwave system 200, and the primary collimator 301 is fixedly nested on the cantilever 102.
  • the homogenizer 302 is fixedly arranged on the primary collimator 301, and is used to filter out low-energy rays to form evenly distributed high-energy rays.
  • the ionization chamber 303 is fixedly arranged on the cantilever 102 and located under the primary collimator 301, and is used to ionize the inert gas to generate an output electrical signal, and to perform statistics on the dose emitted by the accelerator.
  • the secondary collimator 304 is fixedly arranged on the cantilever 102 and located under the ionization chamber 303, and is used to collimate the X-ray into a cone beam with a square cross-section.
  • the double-layer multi-leaf grating 305 is located below the secondary collimator 304, and the double-layer multi-leaf grating 305 is axially connected to the cantilever 102, so that the double-layer multi-leaf grating 305 can rotate 360° along the vertical A axis. It is mainly used to provide conformal positioning of the irradiation field during treatment or plan verification, and to provide support for precise treatment.
  • the radiotherapy device also supports a flattening filter free (FFF) treatment mode.
  • FFF flattening filter free
  • the flattening filter 302 can be moved out of the radiation irradiation area, and the radiation without flattening becomes softer than the radiation quality, and the photon flux increases.
  • the double-layer multi-leaf grating 305 includes an upper independent collimator or an upper multi-element collimator 305-1 and a lower multi-element collimator 305-2 that are fixedly connected to each other.
  • the upper layer multi-element collimator 305-1, the lower layer independent collimator or the lower layer multi-element collimator 305-2 fixedly connected to each other. That is, the above-mentioned double-layer multi-leaf grating 305 does not use a combination of an upper-layer independent collimator and a lower-layer independent collimator.
  • the cone beam-based spiral volume modulated radiotherapy device includes a first solenoid valve (not shown) arranged on the rotating gantry 101 or the fixed gantry 100, so that the two can be locked by the first solenoid valve .
  • the control system controls the operation of the first solenoid valve.
  • the rotating gantry 101 rotates to a predetermined angle relative to the fixed gantry 100 during treatment
  • the two are locked by the first solenoid valve
  • the treatment head 300 modulates the cone beam radiation treatment
  • the cone beam-based spiral volume modulation radiotherapy device includes a second solenoid valve (not shown) provided on the double-layer multi-leaf grating 305 or the cantilever 102, so that the two can pass through the second solenoid valve.
  • the valve is locked.
  • the function of the second solenoid valve is similar to that of the first solenoid valve, and is used to ensure that the double-layer multi-leaf grating 305 will not rotate relative to the cantilever 102 during the treatment process.
  • the above-mentioned treatment bed 400 includes a bottom plate 401, a single scissors support structure 402, a first driving device 403, a first supporting board 404, a second supporting board 405, a second driving device 406, and a third Carrying board 407, third driving device 408.
  • the single scissors supporting structure 402 and the first driving device 403 are both arranged on the bottom plate 401, and the bottom of the X-shaped single scissors supporting structure 402 and the bottom plate 401 are slidably arranged, so that it can be realized under the driving of the first driving device 403.
  • Z-direction movement (such as the Z-direction in Figure 4), that is, to achieve raising and lowering.
  • the first bearing plate 404 is arranged on the single scissors support structure 402 so that it can follow the single scissors support structure 402 to move in the Z direction.
  • the first supporting board 404 has an X-direction unit (the X-direction as shown in FIG. 4, and the X-direction unit in this embodiment is represented as a slide rail).
  • the second bearing plate 405 and the second driving device 406 are both arranged on the first bearing plate 404, and the lower part of the second bearing plate 405 has a structure that matches the X-direction unit (in this embodiment, a slider moving along a guide rail can be used). ), so that under the driving of the second driving device 406, the second bearing plate 405 realizes the X-direction movement along the first bearing plate 404.
  • a Y-direction unit (the Y-direction as shown in FIG. 1, and the Y-direction unit in this embodiment is represented by a screw) is provided on the second bearing plate 405.
  • the third bearing plate 407 and the third driving device 408 are arranged on the second bearing plate 405, and the lower part of the third bearing plate 407 is provided with a structure matching the above-mentioned Y-direction unit (in this embodiment, the movement along the lead screw can be used). Screw nut), so that under the driving of the third driving device 408, the third bearing plate 407 realizes the Y-direction movement along the second bearing plate 405.
  • the cone-beam-based helical volume-modulated radiotherapy device has a more advanced imaging system configuration, and this part of the components can be selected according to economic conditions.
  • the imaging system includes MV imaging system and CBCT imaging system based on KV energy X-ray.
  • the MV imaging system includes the above-mentioned cone beam-based spiral volume modulation radiotherapy device, an MV detector 107, and a beam main shielding assembly 108.
  • the MV detector 107 and the beam main shielding assembly 108 are both installed on the rotating gantry 101, and they are directly below the treatment head 300 (located on the opposite side of the treatment head 300), and the beam main shielding assembly 108 is located at the MV detection Below the device 107.
  • the CBCT imaging system based on KV energy X-rays includes a KV beam limiting device 103, a CBCT tube 104, a CBCT high-voltage generator 105, and a KV detector 106.
  • the components of the CBCT imaging system are all arranged on the rotating gantry 101, wherein the KV beam limiting device 103 and the CBCT tube 104 are installed together, and the KV detector 106 is arranged on the rotating gantry opposite to the CBCT tube 104.
  • the working principle is that when the CBCT high-voltage generator 105 outputs high voltage to the CBCT tube 104, the CBCT tube 104 can be controlled to generate KV-level X-rays with corresponding energy, and the X-rays are transmitted to the KV detector 106 through the KV beam limiting device 103.
  • the generated X-ray centerline and the B axis intersect at the isocenter point I.
  • the MV imaging system has many applications. In the absence of a CBCT imaging system based on KV-level energy X-rays, the MV imaging system can collect the projection of the angular position of the two rotating gantry 101 to achieve the patient before treatment. Placement verification. At the same time, because the MV imaging system and the treatment head 300 work at the same time, the MV imaging system can complete the quality assurance (QA) function of the radiotherapy device, such as the verification of the central position of the radiotherapy device, and the verification of the positioning accuracy of the double-layer multi-leaf grating 305 And the dose verification of the treatment field of the radiotherapy device.
  • QA quality assurance
  • Figure 8 shows the workflow of the MV imaging system application, where the MV imaging detector 107 and the treatment head 300 form an image acquisition system.
  • the acquisition system collects projection data.
  • the collected data can be used for two-dimensional registration or a radiotherapy device.
  • QA function If the registration function is performed, the data is transmitted to the MV two-dimensional registration system, and then the projection data is collected and the digitally reconstructed radiograph (DRR) in the radiotherapy planning system is used for two-dimensional registration, and finally the patient's Set-up error, if the error exceeds the specified set-up deviation requirements, the imaging system will transmit the deviation to the motion control system.
  • the motion control system controls the movement of the treatment bed 400 to eliminate man-made positioning errors, and finally perform accurate radiotherapy on the patient.
  • the collected projection data will be transmitted to the MV QA system, and then the system will analyze the projection data to obtain relevant machine QA or radiation field-related information, such as dose flatness, symmetry, and dose
  • relevant machine QA or radiation field-related information such as dose flatness, symmetry, and dose
  • the QA analysis report can be printed out at the end.
  • the CBCT system based on KV rays has many applications, such as monitoring the patient's position during treatment, and verifying the patient's position before treatment.
  • Figure 9 shows an application process of the CBCT imaging system in patient positioning verification.
  • the high-voltage generator 105, the CBCT tube 104, and the image detector 106 constitute an image acquisition system.
  • the acquisition system collects and transmits the projection data sequence to the CBCT workstation for 3D reconstruction, and then the reconstructed CBCT volume data and radiotherapy planning system CT images are used for 3D reconstruction. Volume registration, and finally get the patient's positioning error. If the error exceeds the specified positioning deviation requirements, the imaging system will transmit the deviation to the motion control system.
  • the motion control system controls the movement of the treatment bed 400 to eliminate the artificial positioning error.
  • the patient undergoes precise radiotherapy.
  • the cone beam-based spiral volume-modulated radiotherapy device has a spiral VMAT-based treatment method.
  • the existing VMAT treatment technology is suitable for relatively small tumor target areas and can complete irradiation treatment at one time.
  • This technology is also a relatively mature technology. In summary, it can be considered as a subset of spiral VMAT.
  • This device also supports VMAT treatment. Because of the more mature technology, I won't repeat it here.
  • the spiral VMAT treatment method is suitable for the treatment of large tumors, and has higher efficiency, smoother dose distribution, higher conformity, and more accurate dose distribution. Spiral VMAT can complete the treatment of all the lesions after a patient is placed, without the need for traditional technology to switch to multi-center treatment.
  • the spiral VMAT takes less time.
  • this treatment method is safer, because the treatment process can be fully automated without manual intervention in the middle process, which reduces the possibility of human error. Since the entire target area is treated by moving the bed at a uniform speed during the whole process, this method can ensure the accuracy of the modulation of the dose intensity through exercise, and ensure that the dose conformity of the target area is better.
  • the spiral VMAT treatment technology needs to be used.
  • the key is to control the movement of the moving parts of the accelerator and the X-ray beam to achieve the coordinated and precise work of the parts.
  • the component parameters that need to be controlled include the speed of the rotating gantry 101, the number of machine hops of the radiotherapy device, the motion speed of the blades of the double-layer multi-leaf grating 305, and the motion speed of the treatment bed 400.
  • the parameter restriction conditions of each component are as follows:
  • ⁇ , MU, x, and y respectively represent the rotation speed of the rotating gantry 101, the number of machine hops of the radiotherapy device (dose monitoring uses the number of machine hops MU as the display unit), the movement displacement of the double-layer multi-leaf grating 305, and the treatment bed 400
  • (d ⁇ /dt) max , (dMU/dt) max , (dx/dt) max , (dy/dt) max represent the maximum speed of the rotating gantry 101, the maximum dose rate of the accelerator, and the double-layer multi-leaf grating 305 The maximum speed and the maximum speed of the treatment couch.
  • each device When executing the patient's treatment plan, each device must not exceed the maximum speed of its own machine, otherwise the accelerator's interlocking system will report interlocking, and the interlocking interface will give corresponding prompt information and methods to remove interlocking.
  • the rotating gantry 101 of the accelerator is designed to support a speed of 6 revolutions per minute. If the speed used during treatment is one revolution per minute, in order to ensure safety during treatment, the running speed of the gantry may be reduced, and the high-speed gantry rotates Modes are more used in imaging and verification functions.
  • the rotating gantry 101 can be obtained.
  • the displacement of the largest double-layer multi-leaf grating 305 corresponding to each rotation is 1 cm, namely:
  • the maximum dose rate of the accelerator in this embodiment is supported to 1200 MU/min.
  • the movement speed of the treatment bed 400 of the radiotherapy device in this embodiment is set as an unchangeable parameter.
  • the grating position of the treatment head 300 changes in real time to conform to the shape of the target area of the treatment field, and the dose rate is also changing to ensure radiotherapy
  • the accuracy of the dose while the treatment bed 400 runs at a uniform speed, when the treatment bed 400 covers the entire tumor area, the treatment of the patient is completed.
  • the radiotherapy device provides a real-time dose statistics function.
  • the BGM (Beam Generator Module) system of the radiotherapy device can be within the allowable range of the deviation of the rotating gantry 101 and the dose. Adjust the dose rate to compensate.
  • the dose is under-dose, increase the dose rate, but the dose rate cannot exceed the range of the dose rate supported by the machine itself, otherwise the system will report the chain of under-dose.
  • the dose is too large, lower the dose rate, and the same dose rate cannot exceed the range of the dose rate supported by the machine, otherwise the system will report a chain of excessive dose.
  • the BGM (Beam Generator Module) system of the radiotherapy device can adjust the speed of the rotating gantry 101 to compensate within the allowable range of the deviation between the deflection of the rotating gantry 101 and the dose.
  • the dose is under-dose, reduce the speed of the rotating frame 101.
  • the dose is too large, increase the speed of the rotating frame 101, but the rotating speed cannot exceed the maximum value of the rotating speed supported by the machine itself, otherwise the system will report an overdose chain.

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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

L'invention concerne un dispositif de radiothérapie à modulation volumétrique hélicoïdale à base de faisceau conique, comprenant un bâti fixe (100) ; un bâti rotatif (101) disposé sur le bâti fixe (100), le bâti rotatif (101) comportant un canal central ; un système à micro-ondes (200) disposé sur le bâti rotatif (101) et utilisé pour générer des rayons ; une tête (300) de thérapie disposée sur le bâti rotatif (101) et utilisée pour moduler les rayons générés par le système à micro-ondes (200) de façon à former un faisceau conique ; et un lit (400) de thérapie disposé sur un côté du bâti rotatif (101), le lit (400) de thérapie pouvant se déplacer selon X, Y et Z dans un système de coordonnées spatiales tridimensionnelles par rapport au bâti rotatif (101). En outre, un système d'image à modulation volumétrique hélicoïdale à base de faisceau conique est fourni. Le dispositif de radiothérapie peut être associé à la mise en marche du faisceau conique et du lit (400) de thérapie, de façon à ce que différentes doses soient appliquées en différentes zones cibles, et à ce que la plage d'exposition aux rayonnements s'ajuste mieux à la forme d'une tumeur, ce qui permet d'améliorer le taux de suppression des tumeurs, de réduire les effets secondaires de la radiothérapie et de prolonger la durée de survie du patient.
PCT/CN2019/115404 2019-11-04 2019-11-04 Dispositif de radiothérapie à modulation volumétrique hélicoïdale à base de faisceau conique et système d'image WO2021087681A1 (fr)

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CN201980011708.8A CN112055602B (zh) 2019-11-04 2019-11-04 基于锥形束的螺旋容积调强放疗装置及影像系统
PCT/CN2019/115404 WO2021087681A1 (fr) 2019-11-04 2019-11-04 Dispositif de radiothérapie à modulation volumétrique hélicoïdale à base de faisceau conique et système d'image

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WO2023134741A1 (fr) * 2022-01-17 2023-07-20 江苏瑞尔医疗科技有限公司 Dispositif collimateur et procédé de commande de mouvement associé

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WO2023134741A1 (fr) * 2022-01-17 2023-07-20 江苏瑞尔医疗科技有限公司 Dispositif collimateur et procédé de commande de mouvement associé

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