CN102824693B - System for verifying radiotherapy plan before online therapy - Google Patents

System for verifying radiotherapy plan before online therapy Download PDF

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CN102824693B
CN102824693B CN201210272902.1A CN201210272902A CN102824693B CN 102824693 B CN102824693 B CN 102824693B CN 201210272902 A CN201210272902 A CN 201210272902A CN 102824693 B CN102824693 B CN 102824693B
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patient
radiotherapy planning
radiotherapy
image
frame
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CN102824693A (en
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李宝生
梁月强
李洪升
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Rudong Wenyuan investment and Development Co., Ltd
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李宝生
梁月强
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Abstract

The invention relates to a system for verifying a radiotherapy plan before an online therapy. The system comprises a frame, a cone-beam CT collection device, an accelerator headpiece, and a radiotherapy plan verification workstation. A two-dimensional detector is disposed under the accelerator headpiece, and an angular sensor is disposed on the frame. The system is characterized in that a movable block which can stop rays and is fixed on the accelerator headpiece is disposed under the two-dimensional detector. The method comprises: a, obtaining a positioned CT image; b, making the radiotherapy plan; c, positioning for radiotherapy; d, obtaining an online cone-beam CT image; e, blocking radiotherapy rays from radiating a patient; f, obtaining beam flux distribution information; g, generating a fusion image; h, calculating dose distribution; i, and estimating the radiotherapy plan. The verifying system and method prevent shortages of former verifying systems and methods. The system and the method prevent radiation exposure of patients, and effectively realize verification of the radiotherapy plan before the online therapy.

Description

Radiotherapy planning verification system before line treatment
Technical field
The present invention relates to radiotherapy planning verification system and method before a kind of line treatment, in particular, particularly relate to and be a kind ofly provided with the removable baffle plate avoiding irradiating patient and carry out radiotherapy planning verification system and method before the line treatment of dosage verifying by the fusion image of location CT image and online conical beam CT Computer image genration.
Background technology
It is clinical that three-dimensional conformal Intensity Modulation Radiated Therapy (IMRT) has been widely used in radiotherapy.The strong radiotherapy planning of three-dimensional suitable-shape regulating can make the dosage at edge, target area fall more " precipitous " usually, that is there is larger dose gradient, thus while Radiotherapy dosimetry being distributed in ensure that target area is in high dose area, the crucial normal organ around target area and tissue (jeopardizing organ) can also be made to be in cold spot area.But, part target area all may be made to depart from high dose area with small difference during treatment when the edge of high dose area " precipitous " also means plan, or make the organ that jeopardizes of next-door neighbour suffer excess radiation.
When causing planning and treatment time difference reason comprise tumor in therapeutic process and jeopardize the position of organ and change of shape and the error that causes in the change of relative position relation between them, the Set-up errors of patient, the kinematic error of electric multiblade collimators vanes, the dosimetric error of planning system and planned transmission process etc.Therefore, the checking of radiotherapy planning just seems especially important.Usually, the checking of radiotherapy planning is divided into two parts, one be radiotherapy planning transmission checking, another part is the dosage verifying of radiotherapy planning.At present, the dosage verifying of radiotherapy planning needs radiotherapy planning to render to include in the die body of dose measuring systems usually.The actual dosage that detects and this dosage planning at die body correspondence position calculated in planning system, to carry out dosage verifying to this plan.Above-mentioned dosage verifying based on hypothesis be that, if the dosage of this plan that planning system calculates in die body is correct, the dosage of this plan that so planning system calculates in patient body is also correct.The dose measuring systems comprised in die body can be the dose point checkout gears such as ionization chamber, also can be the two-dimentional dose measuring systems such as film.For the strong radiotherapy planning of three-dimensional suitable-shape regulating, need the dosage verifying that two dimension is even three-dimensional.For two-dimentional dose measuring systems such as films, also need analog image digitized after exposure, and according to calibration scale, digital picture is converted into absolute dosages.For every a collection of film, its calibration scale all needs to redeterminate, and this makes the dosimetry based on film very inconvenient.
Therefore, many dosage verifying systems based on ionization chamber array, quasiconductor flat panel detector are developed.These checkout gears can be arranged on dose measurement position, and the signal detected is converted into absolute dosages according to calibration scale, thus obtain detection plane two dimension dose distribution; (flat panel detector in accelerator head is such as arranged on) or after die body or patient (being such as integrated in the electronics launched field imaging device on accelerator) before these checkout gears also can be arranged on die body or patient, the signal detected first is converted into the Flux Distribution of detection plane, then recalculates the dose distribution in die body or patient body according to these Flux Distribution.Compare with film, these checkout gears and attached machinery make dosage verifying convenient.
But in the application process of reality, due to the shape of tumor in Patients During Radiotherapy and peripheral organs thereof, tissue and position relationship usually because the growth of tumor or shrink back, swallowing act, respiratory movement, heart beating, gastrointestinal tract and bladder the reason such as full and wriggling and change, and be generally fan-beam locating CT() the just location CT that considers of the upper radiotherapy planning formulated tumor and jeopardize position and the shape of organ when gathering, change when treating cannot be considered.Therefore, some radiotherapy planning system manufacturer and development in laboratory have gone out the method for the online modification radiotherapy planning based on online image, adapt to tumor and jeopardize the change of organ to make the radiotherapy planning of amendment.But for the radiotherapy planning of online modification, obtain newly planning to the process of new implementing plan from amendment, patient is fixed on therapeutic bed all the time, and this makes above-mentioned dosage verifying method all cannot implement, and namely existing equipment cannot carry out the assessment of pre-irradiation to the radiation dose of patient tumors part.How under not allowing patient be subject to the prerequisite of additional radiation, before the treatment of the radiotherapy planning produced after completing online modification, checking is a urgent problem clinically.
Summary of the invention
The present invention, in order to overcome the shortcoming of above-mentioned technical problem, provides and is a kind ofly provided with the removable baffle plate avoiding irradiating patient and carries out radiotherapy planning verification system and method before the line treatment of dosage verifying by the fusion image of location CT image and online conical beam CT Computer image genration.
Radiotherapy planning verification system before line treatment of the present invention, the frame having comprised fixing and supporting role, the conical beam CT harvester being fixed on frame middle part, be arranged at the accelerator head for generation of ray of frame top and have the radiotherapy planning checking work station of date processing and controlling functions, conical beam CT harvester is for gathering the conical beam CT image of patient; The below of described accelerator head is provided with the two-dimensional detector for detecting launched field Flux Distribution information, frame is provided with the frame angle sensor for detecting accelerator frame angle information; With radiotherapy planning, described conical beam CT harvester, two-dimensional detector, frame angle sensor all verify that work station communicates; Its special feature is: the below of described two-dimensional detector is provided with the removable block that the stopped ray be fixed in accelerator head passes, and removable block can stop that roentgenization that accelerator head sends is on patient.
Conical beam CT harvester is for gathering the conical beam CT image of patient, and accelerator head is for generation of the lonizing radiation for the treatment of patient; Two-dimensional detector can gather the Flux Distribution data in launched field, and frame angle sensor is for detecting the rotational angle of accelerator frame.Radiotherapy planning checking work station has the effect that information gathering, date processing and control signal export, to realize the communication with conical beam CT harvester, two-dimensional detector, removable baffle plate, frame angle sensor.Removable baffle plate is arranged between accelerator head and patient, can stop that radiotherapy ray passes; Like this, achieve patient not by under the prerequisite of additional radiation, complete and verify before the treatment of the radiotherapy planning of online modification.
Radiotherapy planning verification system before line treatment of the present invention, described removable block is divided into two pieces, and two pieces of removable blocks are separately fixed on different arms; The below of accelerator head is provided with slide rail, and arm is arranged on slide rail movably; Arm is provided with the arm driving device that can order about two pieces of removable blocks and move along slide rail, arm driving device and radiotherapy planning verify that work station communicates.Arm driving device can order about two pieces of removable blocks to be separated and closes, and when mobile block closes, ray can not be irradiated on patient through removable block; When to patient treatment, by two removable blocks separately, so that roentgenization is to the sufferer place of patient, patient is treated.
Radiotherapy planning verification system before line treatment of the present invention, with radiotherapy planning, described two-dimensional detector, removable block verify that work station is connected with the embedded processing unit that control signal exports by carrying out date processing with frame angle sensor; The outfan of embedded processing unit is also connected with arm driving device.By embedded processing unit, communication is carried out to two-dimensional detector, removable block, frame angle sensor, have effectively achieved the control to two-dimensional detector and information gathering, control removable baffle plate and carry out automatic shutter, to the collection of frame angle sensor output information.
Radiotherapy planning verification system before line treatment of the present invention, described two-dimensional detector is two-way detector array or the Amorphous silicon flat-panel detectors of transmissive.Amorphous silicon flat-panel detectors has higher geometric resolution.
Radiotherapy planning verification method before line treatment of the present invention, its special feature is, comprises the following steps:
A. obtaining location CT image, by scanning the sufferer place of patient, obtaining fan-beam image, as positioning image; B. formulate radiotherapy planning, according to the location CT image obtained in step a, the sufferer place for patient formulates radiotherapy planning; C. radiotherapy position, time at every turn to Patients Treated by Radiotherapy, is fixed on the therapeutic bed below radiotherapy apparatus; D. obtain online conical beam CT image, utilize conical beam CT harvester to gather the conical beam CT image in disease affected part, and image information is transferred to radiotherapy planning checking work station; E. block radiotherapy ray to the irradiation of patient, removable block is placed between accelerator head and patient, to avoid ray in proof procedure, irradiation is produced to patient; F. launched field Flux Distribution information is obtained, under corresponding frame angle, by two-dimensional detector to Flux Distribution information in launched field; The angle information of frame angle sensor acquisition, the launched field data message of two-dimensional detector collection are all sent in radiotherapy planning checking work station; G. generate fusion image, utilize location CT image and online conical beam CT Computer image genration to have the fusion image of accurate electron density information and anatomical information; H. calculated dose distribution, is applied in fusion image by the Flux Distribution in launched field under each frame angle in step f, calculates the dose distribution produced in patient body; I. according to the dose distribution calculated in step h, current online radiotherapy planning is assessed, to guarantee the correct enforcement of radiotherapy planning under patient's current state.
Obtaining location CT in step a is fan-beam image, has preferably electron density information, is suitable as radiotherapy localization CT image and calculates for Radiotherapy dosimetry; In steps d, gather when the online conical beam CT image of acquisition is and treats at every turn, provide the anatomical information in pre-irradiation patient affected part; Owing to being the checking to radiotherapy planning before line treatment, therefore set up removable baffle plate in step e, to block the irradiation of radiotherapy ray to patient.In step f, gather launched field data message, frame angle information respectively by two-dimensional detector, frame angle sensor; The fusion image generated in step g, has the electron density information of location CT and the pre-irradiation anatomical information of online conical beam CT image reflection simultaneously.Step h calculated dose distribution, to assess current radiotherapy planning.
The invention has the beneficial effects as follows: verification system of the present invention, being used for the device of online conical beam CT image acquisition, the two-dimensional detector for Flux Distribution information gathering in launched field by arranging, achieving the collection of conical beam CT image, launched field data; And by setting up removable baffle plate, blocking the irradiation of ray to patient, have effectively achieved the checking to radiotherapy planning before line treatment, being convenient to make the radiotherapy planning more meeting patient's pre-irradiation situation.Verification method of the present invention, the generation of the online conical beam CT image extracted by radiotherapy localization CT image and pre-irradiation has the fusion image of accurate electron density information and instant anatomical information, again according to dose data, frame angle information calculating place dose distribution in the launched field of online acquisition, to revise out more realistic treatment plan.
Verification system of the present invention and verification method, avoid and adopt die body to carry out the deficiency of radiotherapy planning checking in the past, have effectively achieved the checking of radiotherapy planning before line treatment; Even if in Patients During Radiotherapy the shape of tumor and peripheral organs thereof, tissue and position because of tumor growth or shrink back, the reason such as full of inflammatory reaction and bladder and changing, verification system of the present invention and verification method also can be made and verifying accurately.
Accompanying drawing explanation
Fig. 1 is the Principle of Communication figure of each several part in embodiment 1;
Fig. 2 is the structure chart that the verification system of embodiment 1 is in proofing state;
Fig. 3 is the structure chart that the verification system of embodiment 1 is in therapeutic state;
Fig. 4 is the Principle of Communication figure of each several part in embodiment 2;
Fig. 5 is the structure chart that the verification system of embodiment 2 is in proofing state;
Fig. 6 is the structure chart that the verification system of embodiment 2 is in therapeutic state.
In figure: 1 conical beam CT harvester, 2 radiotherapy planning checking work stations, the two-way detector array of 3 transmissives, 4 removable blocks, 5 frame angle sensors, 6 accelerator head, 7 slide rails, 8 arms, 9 patients, 10 therapeutic bed, 11 frames, 12 embedded processing unit, 13 Amorphous silicon flat-panel detectors.
Detailed description of the invention
Below in conjunction with accompanying drawing and embodiment, the invention will be further described.
embodiment 1as depicted in figs. 1 and 2, sets forth the Principle of Communication figure of each several part in the present embodiment, structure chart that verification system is in proofing state, it comprises frame 11, conical beam CT harvester 1, radiotherapy planning checking work station 2, the two-way detector array 3 of transmissive, removable block 4, frame angle sensor 5, accelerator head 6, slide rail 7, arm 8, therapeutic bed 10.Shown frame 11 is fixed and supporting role, and conical beam CT harvester 1 is arranged at the both sides of frame 11 middle part, realizes the collection to patient's conical beam CT image; Accelerator head 6 is arranged on the top of frame 11, the built-in radiographic source irradiated patient.The two-way detector array 3 of transmissive is positioned at the below of accelerator head 6, for gathering the dose data in launched field.
Shown slide rail 7 is arranged on the below of accelerator head 6, and arm 8 is arranged on slide rail; Under the effect of arm driving device, arm 8 can move along slide rail 7.Removable block 4 is divided into two pieces, is connected respectively from different arms 8, and like this, removable block 4 is located between the two-way detector array 3 of transmissive and patient; When arm 8 moves along different directions, two pieces of removable blocks 4 can realize separately and close.When mobile block divides closed, ray can not be irradiated on patient through removable block; When two removable blocks separate, ray can be irradiated to the sufferer place of patient, treats patient.
As shown in Figure 1, the volume images of conical beam CT harvester 1 online acquisition patient, and be transferred in radiotherapy planning checking work station 2.Radiotherapy planning checking work station 2 sends the two-way detector array 3 of acquisition controlling signal to transmissive of the two-way detector array of transmissive, and the launched field data collected are sent back radiotherapy planning checking work station 2 by the two-way detector array 3 of transmissive.Radiotherapy planning checking work station 2 sends the motion control signal of block to removable block 4, and current stop location information is sent back radiotherapy planning checking work station 2 by removable block 4.The frame angle information of collection is sent back radiotherapy planning checking work station 2 by frame angle sensor 5 simultaneously.Like this, the control of work station 2 verified by the two-way detector array 3 of conical beam CT harvester 1, transmissive, removable block 4, frame angle sensor 5 at radiotherapy planning under, achieve information gathering, control signal exports and data processing function.
In the process used, first patient 9 is fixed on therapeutic bed 10, and carries out pendulum position.Conical beam CT harvester 1 online acquisition patient volume images, and be transferred in radiotherapy planning checking work station 2.Before line treatment during plan checking, removable block 4 moves between radiographic source and patient 9 along the slide rail 7 be fixed in accelerator head 6 by arm 8 under the driving of arm driving device.Accelerator by current radiotherapy planning one by one launched field carry out Flux Distribution, frame non-rotary radiotherapy planning when radiotherapy planning in this embodiment is only limitted to those dose delivery, such as based on static intensity modulating radiotherapy planning and the dynamic intensity-modulated radiation therapy plan of electric multiblade optical grating.For each launched field calculated, the two-way detector array 3 of transmissive all gathers corresponding two-dimentional launched field data; The practical frame angle information of each launched field gathered is sent in radiotherapy planning checking work station by frame angle sensor 5, and removable block 4 then stops the ray of the two-way detector array 3 through transmissive, avoids it to be irradiated to patient 9.All gather in all launched field data in the works, run radiotherapy planning before line treatment by radiotherapy planning checking work station 2, just according to launched field data, the enforcement accuracy of multi-leaf optical grating, tungsten door or other beam limiting device can be verified.
According to location CT image, online conical beam CT image, radiotherapy planning, the launched field data of each launched field and the frame angle of its correspondence, calculate the dose distribution of this radiotherapy planning in this patient body, to carry out dosage verifying, specifically can carry out according to following steps:
A. obtaining location CT image, by scanning the sufferer place of patient, obtaining fan-beam image, as positioning image;
B. formulate radiotherapy planning, according to the location CT image obtained in step a, the sufferer place for patient formulates radiotherapy planning;
C. radiotherapy position, time at every turn to Patients Treated by Radiotherapy, is fixed on the therapeutic bed 10 below radiotherapy apparatus;
D. obtain online conical beam CT image, utilize conical beam CT harvester 1 to gather the conical beam CT image in disease affected part, and image information is transferred to radiotherapy planning checking work station;
E. block radiotherapy ray to the irradiation of patient, removable block 4 is placed between accelerator head 6 and patient 9, to avoid ray in proof procedure, irradiation is produced to patient;
F. launched field Flux Distribution information is obtained, under corresponding frame angle, by two-dimensional detector to Flux Distribution information in 3 launched fields; The angle information that frame angle sensor 5 gathers, the launched field data message of two-dimensional detector collection are all sent in radiotherapy planning checking work station;
G. generate fusion image, utilize location CT image and online conical beam CT Computer image genration to have the fusion image of accurate electron density information and anatomical information; Can adopt deformable registration in the process that fusion image generates, it can adopt the Demons algorithm of density based information, also can adopt registration Algorithm based on gradient information;
H. calculated dose distribution, is applied in fusion image by Flux Distribution in launched field under each frame angle in step f, calculates the dose distribution produced in patient body; In the computational process of dose distribution, the Monte carlo algorithm that GPU can be adopted to accelerate realizes;
I. according to the dose distribution calculated in step h, current online radiotherapy planning is assessed, to guarantee the correct enforcement of radiotherapy planning under patient's current state.
After plan checking completes, when carrying out patient treatment, as shown in Figure 3, removable block 4 along slide rail 7 to two lateral movements, shifts out between radiographic source and patient 9 by arm 8 under the driving of arm driving device, and radiotherapy is normally carried out.Because absorption and the scattering of transmissive two-dimensional detector 3 pairs of rays are very little, so can move.
embodiment 2as shown in Figure 4 and Figure 5, sets forth the Principle of Communication figure of each several part of embodiment 2, structure chart that verification system is in proofing state, except adding an embedded processing unit 12 and two-dimensional detector Amorphous silicon flat-panel detectors 13 and replacing, identical all with embodiment 1 of remaining structure.Because Amorphous silicon flat-panel detectors 13 has less geometric resolution, be beneficial to the accuracy ensureing measurement result.Embedded processing unit 12 is responsible for the moveable Amorphous silicon flat-panel detectors of unified management 13, removable block 4, frame angle sensor 5 and radiotherapy planning and is verified data transmission between work station 2.
Radiotherapy planning checking work station 2 sends to the data of embedded processing unit 12 to comprise the motion of Amorphous silicon flat-panel detectors 13 and the motion control signal of acquisition controlling signal and removable block 4, and the data that embedded processing unit 12 returns to radiotherapy planning checking work station 2 comprise the launched field image of Amorphous silicon flat-panel detectors 13 collection and the positional information of the frame angle of its correspondence, the positional information of Amorphous silicon flat-panel detectors 13 and removable block 4.Embedded processing unit 12 sends the motion of Amorphous silicon flat-panel detectors 13 and acquisition controlling signal to moveable Amorphous silicon flat-panel detectors 13, and the positional information of the launched field image collected and flat panel detector returns by moveable Amorphous silicon flat-panel detectors 13.
Before radiotherapy, identical with embodiment 1, first carry out patient and put position and online conical beam CT image acquisition.Before implementing line treatment during plan checking, Amorphous silicon flat-panel detectors 13 and removable block 4 move between radiographic source and patient 9 along the slide rail 7 be fixed in accelerator head 6 by arm 8 under the driving of arm driving device.Accelerator head 6 carries out dose delivery by current radiotherapy planning.For the plan of rotation intensity modulated radiation therapy, Amorphous silicon flat-panel detectors 13 gathers launched field image by the interval of specifying, the frame angle of its correspondence when simultaneously embedded processing unit 12 reads launched field image acquisition in real time, removable block 4 then stops the ray through Amorphous silicon flat-panel detectors 13, avoids it to be irradiated to patient 9.
After the current radiotherapy planning being used for verifying has been thrown in, radiotherapy planning verification system before line treatment before operation line treatment on radiotherapy planning checking work station 2, just according to the frame angle of the launched field image collected and correspondence thereof, the enforcement accuracy of close rate, gantry rotation rate, multi-leaf optical grating, tungsten door or other beam limiting device can be verified.Before line treatment, radiotherapy planning verifying software can also according to location CT image, online conical beam CT image, radiotherapy planning, the launched field image of each launched field and the frame angle of its correspondence, calculate the dose distribution of this radiotherapy planning in patient body, to carry out dosage verifying, its concrete steps are identical with the dosage verifying method in embodiment 1.
After plan checking completes, when carrying out patient treatment, as shown in Figure 6, removable block 4 along slide rail 7 to two lateral movements, shifts out between radiographic source and patient 9 by arm 8 under the driving of arm driving device, and radiotherapy can normally be carried out.

Claims (3)

1. radiotherapy planning verification system before a line treatment, the frame (11) having comprised fixing and supporting role, the conical beam CT harvester (1) being fixed on frame middle part, be arranged at the accelerator head for generation of ray (6) of frame top and have radiotherapy planning checking work station (2) of date processing and controlling functions, conical beam CT harvester is for gathering the conical beam CT image of patient; The below of described accelerator head is provided with the two-dimensional detector for detecting launched field Flux Distribution information, frame is provided with the frame angle sensor (5) for detecting accelerator frame angle information; With radiotherapy planning, described conical beam CT harvester, two-dimensional detector, frame angle sensor all verify that work station communicates; It is characterized in that: the below of described two-dimensional detector is provided with the removable block (4) that the stopped ray be fixed in accelerator head passes, removable block can stop that roentgenization that accelerator head sends is on patient;
Slide rail (7) is arranged on the below of accelerator head (6), and arm (8) is arranged on slide rail; Under the effect of arm driving device, arm (8) can move along slide rail (7);
Removable block (4) is divided into two pieces, is connected respectively from different arms (8), and like this, removable block (4) is located between two-dimensional detector and patient; When arm (8) moves along different directions, two pieces of removable blocks (4) can realize separately and close; When mobile block divides closed, ray can not be irradiated on patient through removable block; When two removable blocks separate, ray can be irradiated to the sufferer place of patient, treats patient; Before line treatment during plan checking, removable block (4) moves between radiographic source and patient (9) along the slide rail (7) be fixed in accelerator head (6) by arm (8) under the driving of arm driving device.
2. radiotherapy planning verification system before line treatment according to claim 1, is characterized in that: with radiotherapy planning, described two-dimensional detector, removable block (4) verify that work station (2) is connected with the embedded processing unit (12) that control signal exports by carrying out date processing with frame angle sensor (5); The outfan of embedded processing unit is also connected with arm driving device.
3. radiotherapy planning verification system before line treatment according to claim 1 and 2, is characterized in that: described two-dimensional detector is two-way detector array (3) or the Amorphous silicon flat-panel detectors (13) of transmissive.
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