JP2002017748A - Diagnostic-therapeutic device - Google Patents
Diagnostic-therapeutic deviceInfo
- Publication number
- JP2002017748A JP2002017748A JP2000205235A JP2000205235A JP2002017748A JP 2002017748 A JP2002017748 A JP 2002017748A JP 2000205235 A JP2000205235 A JP 2000205235A JP 2000205235 A JP2000205235 A JP 2000205235A JP 2002017748 A JP2002017748 A JP 2002017748A
- Authority
- JP
- Japan
- Prior art keywords
- tumor
- light
- photosensitizer
- diagnostic
- light irradiation
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
- 206010028980 Neoplasm Diseases 0.000 claims abstract description 83
- 238000003745 diagnosis Methods 0.000 claims abstract description 12
- 238000002560 therapeutic procedure Methods 0.000 claims abstract description 3
- 239000003504 photosensitizing agent Substances 0.000 claims description 32
- 238000001126 phototherapy Methods 0.000 claims description 14
- 230000001678 irradiating effect Effects 0.000 claims description 12
- 230000001225 therapeutic effect Effects 0.000 claims description 9
- 238000010521 absorption reaction Methods 0.000 claims description 5
- 239000000700 radioactive tracer Substances 0.000 claims description 5
- 238000002372 labelling Methods 0.000 claims description 4
- 238000003325 tomography Methods 0.000 claims description 3
- 206010034972 Photosensitivity reaction Diseases 0.000 claims description 2
- 238000000034 method Methods 0.000 claims description 2
- 230000036211 photosensitivity Effects 0.000 claims description 2
- 239000000126 substance Substances 0.000 abstract description 6
- 239000000523 sample Substances 0.000 description 15
- GYHNNYVSQQEPJS-YPZZEJLDSA-N Gallium-68 Chemical compound [68Ga] GYHNNYVSQQEPJS-YPZZEJLDSA-N 0.000 description 5
- 229940079593 drug Drugs 0.000 description 4
- 239000003814 drug Substances 0.000 description 4
- 230000005251 gamma ray Effects 0.000 description 4
- 238000010586 diagram Methods 0.000 description 3
- 229940109328 photofrin Drugs 0.000 description 3
- ZGXJTSGNIOSYLO-UHFFFAOYSA-N 88755TAZ87 Chemical compound NCC(=O)CCC(O)=O ZGXJTSGNIOSYLO-UHFFFAOYSA-N 0.000 description 2
- OKTJSMMVPCPJKN-OUBTZVSYSA-N Carbon-13 Chemical group [13C] OKTJSMMVPCPJKN-OUBTZVSYSA-N 0.000 description 2
- 102100034323 Disintegrin and metalloproteinase domain-containing protein 2 Human genes 0.000 description 2
- 101000780288 Homo sapiens Disintegrin and metalloproteinase domain-containing protein 2 Proteins 0.000 description 2
- 229960002749 aminolevulinic acid Drugs 0.000 description 2
- QVGXLLKOCUKJST-UHFFFAOYSA-N atomic oxygen Chemical compound [O] QVGXLLKOCUKJST-UHFFFAOYSA-N 0.000 description 2
- 238000013480 data collection Methods 0.000 description 2
- 238000003384 imaging method Methods 0.000 description 2
- 229910052760 oxygen Inorganic materials 0.000 description 2
- 239000001301 oxygen Substances 0.000 description 2
- QGZKDVFQNNGYKY-OUBTZVSYSA-N Ammonia-15N Chemical compound [15NH3] QGZKDVFQNNGYKY-OUBTZVSYSA-N 0.000 description 1
- KSFOVUSSGSKXFI-GAQDCDSVSA-N CC1=C/2NC(\C=C3/N=C(/C=C4\N\C(=C/C5=N/C(=C\2)/C(C=C)=C5C)C(C=C)=C4C)C(C)=C3CCC(O)=O)=C1CCC(O)=O Chemical compound CC1=C/2NC(\C=C3/N=C(/C=C4\N\C(=C/C5=N/C(=C\2)/C(C=C)=C5C)C(C=C)=C4C)C(C)=C3CCC(O)=O)=C1CCC(O)=O KSFOVUSSGSKXFI-GAQDCDSVSA-N 0.000 description 1
- 206010009944 Colon cancer Diseases 0.000 description 1
- 206010061902 Pancreatic neoplasm Diseases 0.000 description 1
- 208000005718 Stomach Neoplasms Diseases 0.000 description 1
- 241000906446 Theraps Species 0.000 description 1
- 125000004429 atom Chemical group 0.000 description 1
- 210000004027 cell Anatomy 0.000 description 1
- 239000003795 chemical substances by application Substances 0.000 description 1
- 208000029742 colonic neoplasm Diseases 0.000 description 1
- RYGMFSIKBFXOCR-IGMARMGPSA-N copper-64 Chemical compound [64Cu] RYGMFSIKBFXOCR-IGMARMGPSA-N 0.000 description 1
- 239000013078 crystal Substances 0.000 description 1
- 230000005284 excitation Effects 0.000 description 1
- GYHNNYVSQQEPJS-BJUDXGSMSA-N gallium-69 Chemical compound [69Ga] GYHNNYVSQQEPJS-BJUDXGSMSA-N 0.000 description 1
- 206010017758 gastric cancer Diseases 0.000 description 1
- 201000007270 liver cancer Diseases 0.000 description 1
- 208000014018 liver neoplasm Diseases 0.000 description 1
- 208000015486 malignant pancreatic neoplasm Diseases 0.000 description 1
- 238000005259 measurement Methods 0.000 description 1
- 229910052751 metal Inorganic materials 0.000 description 1
- 239000002184 metal Substances 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 229910052757 nitrogen Inorganic materials 0.000 description 1
- 125000004433 nitrogen atom Chemical group N* 0.000 description 1
- 239000013307 optical fiber Substances 0.000 description 1
- 230000001590 oxidative effect Effects 0.000 description 1
- 201000002528 pancreatic cancer Diseases 0.000 description 1
- 208000008443 pancreatic carcinoma Diseases 0.000 description 1
- 150000004033 porphyrin derivatives Chemical class 0.000 description 1
- 150000004032 porphyrins Chemical class 0.000 description 1
- 238000002600 positron emission tomography Methods 0.000 description 1
- 238000012545 processing Methods 0.000 description 1
- 229950003776 protoporphyrin Drugs 0.000 description 1
- 230000005855 radiation Effects 0.000 description 1
- 238000001959 radiotherapy Methods 0.000 description 1
- KEAYESYHFKHZAL-BJUDXGSMSA-N sodium-22 Chemical compound [22Na] KEAYESYHFKHZAL-BJUDXGSMSA-N 0.000 description 1
- 201000011549 stomach cancer Diseases 0.000 description 1
- 230000002194 synthesizing effect Effects 0.000 description 1
- 229910052714 tellurium Inorganic materials 0.000 description 1
- PORWMNRCUJJQNO-UHFFFAOYSA-N tellurium atom Chemical compound [Te] PORWMNRCUJJQNO-UHFFFAOYSA-N 0.000 description 1
- 210000004881 tumor cell Anatomy 0.000 description 1
Abstract
Description
【０００１】[0001]
【発明の属する技術分野】本発明は、被検体の腫瘍を診
断・治療する診断・治療装置に関する。The present invention relates to a diagnostic / therapeutic apparatus for diagnosing / treating a tumor in a subject.
【０００２】[0002]
【従来の技術】光線力学治療法（Photodynamic Therap
y、以下ＰＤＴと記す）は、腫瘍部に特異的に集積する
性質をもつポルフィリン類等の光感受性物質を体内に投
与して腫瘍部に集積させ、そこに光感受性物質の吸収波
長の光を照射することによりその光感受性物質を励起し
て活性酸素を放出させ、腫瘍部の細胞を破壊する治療方
法である。このＰＤＴの従来の手順は、まずＸ線ＣＴや
ＭＲＩ−ＣＴ等により大まかな腫瘍部の位置を把握した
後に、光感受性物質を投与してそれを腫瘍部に集積さ
せ、光照射部を有する内視鏡等を体内に挿入して腫瘍部
近傍に腫瘍部確認用のレーザ光を入射し、光感受性物質
から放出される励起蛍光により腫瘍部における光感受性
物質の所在を確認した後、治療用のレーザ光を腫瘍部に
照射していた。このため、手間が掛かって効率が悪く、
光感受性物質が集積している腫瘍部の位置・分布を画像
診断装置により外部から直接診断することにより手間を
省くことのできる、診断から治療までを一貫して迅速に
行える診断・治療装置が求められていた。2. Description of the Related Art Photodynamic Therap
y, hereinafter referred to as PDT) is to administer a photosensitizer such as porphyrins having a property of specifically accumulating in a tumor part into the body and accumulate in the tumor part, and to emit light having an absorption wavelength of the photosensitizer there. Irradiation excites the photosensitizer to release active oxygen, thereby destroying tumor cells. In the conventional procedure of PDT, first, after roughly grasping the position of a tumor part by X-ray CT, MRI-CT, or the like, a photosensitizer is administered, and the photosensitizer is accumulated in the tumor part. Inserting an endoscope etc. into the body, irradiating the tumor part with laser light near the tumor part, confirming the location of the photosensitizer in the tumor part by excitation fluorescence emitted from the photosensitizer, The laser beam was applied to the tumor. Therefore, it takes time and inefficiency,
There is a need for a diagnostic / therapeutic device that can save time and effort by directly diagnosing the location and distribution of the tumor site where photosensitizers are accumulated from outside using an image diagnostic device, and that can perform consistently and quickly from diagnosis to treatment. Had been.
【０００３】これに関して、最近、光感受性物質の体内
での位置や分布を外部から容易に診断することを可能と
すべく、標識を有する光感受性物質が開発され、たとえ
ば、特開平１１−１２１９７号公報には光感受性物質中
の原子を同位体に置換してＭＲＩ−ＣＴにより画像診断
する薬剤が、また、特開平１１−１３０４３１号公報に
は光感受性物質をポジトロン放出金属核種で標識してポ
ジトロン放出トモグラフィー（ＰＥＴ）により画像診断
する薬剤が、各々開示されている。これらの薬剤を用い
れば、標識物質を検出する画像診断装置により光感受性
物質が集積した腫瘍部の位置や分布が外部から容易に診
断できる。[0003] In this regard, in recent years, a photosensitizer having a label has been developed so that the position and distribution of the photosensitizer in the body can be easily diagnosed from the outside. For example, Japanese Patent Application Laid-Open No. H11-12197 has been developed. JP-A-11-130431 discloses a drug for imaging diagnosis by MRI-CT by substituting an atom in a photosensitizer with an isotope, and JP-A-11-130431 discloses a photosensitizer labeled with a positron-emitting metal nuclide. Drugs for imaging by emission tomography (PET) have each been disclosed. If these agents are used, the position and distribution of the tumor site where the photosensitizer has accumulated can be easily diagnosed from the outside by an image diagnostic apparatus that detects the labeling substance.
【０００４】[0004]
【発明が解決しようとする課題】しかし、上記の公報に
は実際にこれらの薬剤を用いて腫瘍部の診断・治療を行
うための具体的な装置構成については記載されておら
ず、実際にこれらの薬剤を用いて診断・治療を行った場
合、つぎのような問題点が生じる。すなわち、画像診断
装置により光感受性物質が集積した腫瘍部の位置や分布
を診断し、ＰＤＴを行うため光照射部を体内に挿入する
場合、その光照射部が体内のどの位置にあるか正確に把
握できず、腫瘍部に光照射部を迅速に導いて適切にレー
ザ光を照射することができない。However, the above-mentioned publication does not disclose a specific device configuration for actually diagnosing and treating a tumor using these drugs. When the diagnosis and treatment are performed using the above-mentioned drug, the following problems occur. In other words, the position and distribution of the tumor site on which the photosensitizer has accumulated are diagnosed by an image diagnostic device, and when the light irradiation unit is inserted into the body to perform PDT, the position of the light irradiation unit in the body is accurately determined. It cannot be grasped, and the light irradiation part cannot be quickly guided to the tumor part to properly irradiate the laser light.
【０００５】本発明は、上記課題に鑑みてなされたもの
であり、腫瘍部の診断と治療を一貫して迅速に行うこと
が可能な診断・治療装置を提供することを目的とする。[0005] The present invention has been made in view of the above problems, and has as its object to provide a diagnostic / therapeutic apparatus capable of consistently and promptly diagnosing and treating a tumor.
【０００６】[0006]
【課題を解決するための手段】本発明に係る診断・治療
装置は、光を被検体に照射する光照射部を有し、光によ
って被検体の腫瘍部を治療する光治療器と、光治療器の
光照射部の位置を検出する位置検出器と、腫瘍部を検出
するための腫瘍部検出器とを備えることを特徴とする。A diagnostic / therapeutic apparatus according to the present invention has a light irradiator for irradiating light to a subject, and a phototherapy device for treating a tumor portion of the subject with light; And a position detector for detecting the position of the light irradiating part of the vessel and a tumor part detector for detecting a tumor part.
【０００７】腫瘍部検出器を備えることにより腫瘍部の
位置や分布が把握され、また、光治療器の光照射部の位
置を検出する位置検出器を備えることにより、光治療器
の光照射部の体内における位置が精度よく把握される。The position and distribution of the tumor part can be grasped by providing a tumor part detector, and the position of the light irradiation part of the phototherapy device can be detected by providing the light irradiation part of the phototherapy device. The position of the person in the body is accurately grasped.
【０００８】また、光治療器は、トレーサで標識され腫
瘍部親和性を有する光感受性物質が集積した前記腫瘍部
に、その光感受性物質の吸収波長の光を照射可能である
ことが好ましい。これにより、腫瘍部の位置や分布がト
レーサを検出する腫瘍部検出器により外部より容易に把
握される。また、腫瘍部に集積された光感受性物質が光
により励起されて腫瘍部が治療される。It is preferable that the phototherapy device is capable of irradiating the tumor portion on which the photosensitizer labeled with a tracer and having photosensitivity having an affinity for the tumor portion is accumulated, with light having an absorption wavelength of the photosensitizer. Thereby, the position and distribution of the tumor part can be easily grasped from the outside by the tumor part detector for detecting the tracer. Further, the photosensitizer accumulated in the tumor is excited by light to treat the tumor.
【０００９】また、光感受性物質を標識するトレーサは
ポジトロン放出核種であり、腫瘍部検出器はポジトロン
放出トモグラフィーであることが好ましい。これによ
り、分解能の高いＰＥＴにより腫瘍部の位置や分布がさ
らに精度よく把握される。Preferably, the tracer for labeling the photosensitizer is a positron emitting nuclide, and the tumor site detector is a positron emitting tomography. As a result, the position and distribution of the tumor part can be grasped more accurately by PET having a high resolution.
【００１０】また、光治療器は、光を出力する針状の光
出力部を有し、光照射部は光出力部の先端に位置してい
ることが好ましい。これにより、光出力部が体内に穿刺
され、光出力部の先端の光照射部から体組織内の腫瘍部
に光が照射される。Preferably, the phototherapy device has a needle-shaped light output section for outputting light, and the light irradiation section is located at the tip of the light output section. Thereby, the light output unit is punctured into the body, and light is irradiated from the light irradiation unit at the tip of the light output unit to the tumor part in the body tissue.
【００１１】また、位置検出器は、Ｘ線ＣＴであること
が好ましい。これにより、光照射部先端の位置が精度よ
く把握される。Preferably, the position detector is an X-ray CT. As a result, the position of the tip of the light irradiation unit can be accurately grasped.
【００１２】[0012]
【発明の実施の形態】以下、添付図面を参照しながら、
本発明に係る診断・治療装置の好適な実施形態について
詳細に説明する。なお、図面の説明において、同一又は
相当要素には同一の符号を付し、重複する説明は省略す
る。BRIEF DESCRIPTION OF THE DRAWINGS FIG.
A preferred embodiment of the diagnosis / treatment device according to the present invention will be described in detail. In the description of the drawings, the same or corresponding elements will be denoted by the same reference characters, without redundant description.
【００１３】図１は、本実施形態の診断・治療装置の構
成図である。診断・治療装置１０は、被検体１７の腫瘍
部を診断・治療するものであり、光感受性物質の集積し
た腫瘍部にレーザ光を照射して腫瘍部を治療するＰＤＴ
機器（光治療器）１１、Ｘ線ＣＴ１５とポジトロン放出
トモグラフィー（以下、ＰＥＴと記す）２０とを有し被
検体１７の画像診断データの取得を行う円筒状のガント
リ２７と、Ｘ線ＣＴ１５とＰＥＴ２０等を制御する制御
部２３と、被検体１７が横臥されガントリ２７内をガン
トリ２７の軸方向に移動するベッド１８とを備えてい
る。FIG. 1 is a configuration diagram of the diagnosis / treatment device of the present embodiment. The diagnostic / therapy device 10 is for diagnosing / treating a tumor portion of a subject 17 and irradiating a tumor portion on which a photosensitizer is accumulated with laser light to treat the tumor portion.
A cylindrical gantry 27 having an apparatus (phototherapy device) 11, an X-ray CT 15, and a positron emission tomography (hereinafter, referred to as PET) 20 for acquiring image diagnostic data of the subject 17, an X-ray CT 15 and a PET 20 And a bed 18 on which the subject 17 lies and which moves in the axial direction of the gantry 27 within the gantry 27.
【００１４】ＰＤＴ機器１１は、被検体１７に投与され
る光感受性物質の吸収波長光を放出するレーザ光源１３
と、針状で体内に穿刺挿入して体組織内の腫瘍部に直接
レーザ光を出力可能なプローブ（光出力部）１６と、プ
ローブ１６にレーザ光源１３からのレーザ光を誘導する
光ファイバーよりなる導光部２５とを有している。ま
た、プローブ１６の先端に、導光部２５によって誘導さ
れたレーザ光を腫瘍部に照射する光照射部１２を有して
いる。The PDT device 11 includes a laser light source 13 that emits light having an absorption wavelength of a photosensitive substance to be administered to a subject 17.
A probe (light output section) 16 capable of directly outputting a laser beam to a tumor portion in a body tissue by inserting the needle into the body in a needle shape, and an optical fiber for guiding the laser beam from the laser light source 13 to the probe 16. And a light guide 25. The tip of the probe 16 has a light irradiator 12 for irradiating the tumor with laser light guided by the light guide 25.
【００１５】ガントリ２７内のＸ線ＣＴ１５は、位置検
出器として体内に穿刺挿入されるプローブ１６先端の光
照射部１２の位置測定と、生体の内部構造の診断を行う
ものであり、Ｘ線源およびＸ線検出器を有している。ま
た、ガントリ２７内のＰＥＴ２０は、ポジトロン放出核
種により標識された腫瘍親和性を有する光感受性物質が
集積している位置や分布を測定する腫瘍部検出器であ
り、放出ポジトロンが体内の電子と結合した際に正反対
方向に一対放出される消滅ガンマ線を検出する検出器を
有する。The X-ray CT 15 in the gantry 27 measures the position of the light irradiating section 12 at the tip of the probe 16 inserted into the body as a position detector and diagnoses the internal structure of the living body. And an X-ray detector. The PET 20 in the gantry 27 is a tumor detector that measures the location and distribution of the photosensitizer having a tumor affinity labeled with a positron emitting nuclide, and the emitted positron binds to electrons in the body. And a detector for detecting a pair of annihilated gamma rays emitted in a diametrically opposite direction.
【００１６】制御部２３は、Ｘ線ＣＴ１５とＰＥＴ２０
から得られたデータを収集するデータ収集バッファ３
６、収集された各々のデータに基づいてＸ線ＣＴ画像と
ＰＥＴ画像を再構成処理するＣＰＵ３３、ＣＰＵ３３に
よって得られた画像を合成して表示するＣＲＴ３０、画
像を記憶する記憶装置３７、オペレータの指示を受け付
ける入力装置３２、および、制御信号をガントリ２７、
ベッド１８およびＰＤＴ機器１１へ送信するためのイン
ターフェース３４を備えている。ＣＰＵ３３は、インタ
ーフェース３４を介して、ガントリ２７、ベッド１８お
よびＰＤＴ機器１１に制御信号を送信する。The control unit 23 includes an X-ray CT 15 and a PET 20
Data collection buffer 3 for collecting data obtained from
6. CPU 33 for reconstructing an X-ray CT image and PET image based on each collected data, CRT 30 for synthesizing and displaying images obtained by CPU 33, storage device 37 for storing images, instructions from operator An input device 32 for receiving the gantry 27;
An interface 34 for transmitting to the bed 18 and the PDT device 11 is provided. The CPU 33 transmits a control signal to the gantry 27, the bed 18, and the PDT device 11 via the interface 34.
【００１７】続いて、本実施形態の診断・治療装置１０
の動作を説明する。まず、ポジトロン放出核種で標識さ
れた腫瘍親和性を有する光感受性物質であるフォトフリ
ンＩＩのガリウム６８錯体を、被検体１７に経口または
注射器等により投与する。投与後所定時間経過すると、
この光感受性物質は体内の腫瘍部に選択的に集積され
る。一方、レーザ光源１３のレーザ光の波長を、入力装
置３２によりこの光感受性物質の波長に設定する。Subsequently, the diagnosis / treatment device 10 of the present embodiment
Will be described. First, a gallium 68 complex of photofrin II, which is a photosensitizer having a tumor affinity and labeled with a positron-emitting nuclide, is administered to the subject 17 orally or by a syringe or the like. After a predetermined time after administration,
This photosensitizer is selectively accumulated in the tumor site in the body. On the other hand, the wavelength of the laser light of the laser light source 13 is set by the input device 32 to the wavelength of the photosensitive substance.
【００１８】つぎに、オペレーターは、入力装置３２を
操作して被検体１７が横臥されたベッド１８をガントリ
２７の軸方向に移動させ、ＰＥＴ２０により体内のガリ
ウム６８の分布測定を行い全身のスライスデータを取得
する。このデータは、データ収集バッファ３６を経由し
てＣＰＵ３３に送られて画像の再構成処理が行われ、Ｐ
ＥＴ画像としてＣＲＴ３０に表示される。このガリウム
６８の分布像は、ポジトロン放出核種で標識された光感
受性物質が集積しているところ、すなわち、被検体１７
の腫瘍部の分布画像である。このように、内視鏡等の装
置を用いずに外部から容易に、解像度の高いＰＥＴ２０
により腫瘍部の位置・分布を迅速に把握することができ
る。Next, the operator operates the input device 32 to move the bed 18 on which the subject 17 lies down in the axial direction of the gantry 27, measures the distribution of gallium 68 in the body by using the PET 20, and performs slice data of the whole body. To get. This data is sent to the CPU 33 via the data collection buffer 36 to perform image reconstruction processing.
It is displayed on the CRT 30 as an ET image. This distribution image of gallium 68 shows that the photosensitizer labeled with the positron emitting nuclide is accumulated, that is, the specimen 17
5 is a distribution image of a tumor part. As described above, a high-resolution PET 20 can be easily provided from outside without using an endoscope or the like.
Thereby, the position and distribution of the tumor can be quickly grasped.
【００１９】つぎに、オペレータは、このＰＥＴ画像を
基にして被検体１７の腫瘍部がＸ線ＣＴ１５の計測視野
に収まるように、入力装置３２を操作してベッド１８を
移動させ、Ｘ線ＣＴ１５により被検体１７の腫瘍部近傍
のＸ線ＣＴデータを取得する。このデータはＰＥＴデー
タと同様にデータ処理されて生体の内部構造を示すＸ線
ＣＴ画像とし、既にＰＥＴ２０により取得された腫瘍部
の分布画像であるＰＥＴ画像と重ね合わせてＣＲＴ３０
に表示する。Next, the operator operates the input device 32 to move the bed 18 on the basis of the PET image so that the tumor portion of the subject 17 falls within the measurement field of view of the X-ray CT 15. As a result, X-ray CT data near the tumor of the subject 17 is obtained. This data is processed in the same manner as the PET data to form an X-ray CT image showing the internal structure of the living body, and is superimposed on a PET image which is a distribution image of a tumor part already acquired by the PET 20, and the CRT 30
To be displayed.
【００２０】つぎに、このＣＲＴ３０上の重ね合わせ画
像で腫瘍部の位置を確認しながら、ＰＤＴ機器１１のプ
ローブ１６を被検体１７に穿刺挿入する。このとき、Ｘ
線ＣＴ１５ではプローブ１６の位置も観察可能であり、
プローブ１６先端の光照射部１２の位置をＣＲＴ３０で
確認しながら被検体１７の体内に穿刺挿入し、光照射部
１２を腫瘍部に到達させる。光照射部１２が腫瘍部に到
達したことをＣＲＴ３０の画像により確認した後、レー
ザ光源１３から光感受性物質の吸収波長のレーザ光を導
光部２５とプローブ１６を介して、光照射部１２から腫
瘍部に照射する。この照射により、光感受性物質が励起
されて活性酸素が放出され、その強い酸化作用により腫
瘍部の細胞が破壊される。Next, the probe 16 of the PDT device 11 is punctured into the subject 17 while confirming the position of the tumor part on the superimposed image on the CRT 30. At this time, X
In the line CT15, the position of the probe 16 can also be observed,
While confirming the position of the light irradiation unit 12 at the tip of the probe 16 on the CRT 30, the light irradiation unit 12 is inserted into the body of the subject 17 by puncture and the light irradiation unit 12 reaches the tumor. After confirming from the image of the CRT 30 that the light irradiating section 12 has reached the tumor, the laser light having the absorption wavelength of the photosensitive substance is emitted from the laser light source 13 via the light guide section 25 and the probe 16 to the laser irradiation section 12. Irradiate the tumor. This irradiation excites the photosensitizer, releases active oxygen, and destroys cells in the tumor by its strong oxidizing action.
【００２１】このように、本実施形態の診断・治療装置
１０は、光照射により腫瘍部を治療するＰＤＴ機器１１
と、ＰＤＴ機器１１の光照射部１２の位置を検出するＸ
線ＣＴ１５と、光感受性物質が集積した腫瘍部の位置や
分布を把握するＰＥＴ２０とを備えることにより、腫瘍
部の位置や分布とＰＤＴ機器１１の光照射部１２の位置
とがＣＲＴ３０上に合成されて容易に精度よく把握さ
れ、ＰＤＴ機器１１の光照射部１２を容易に腫瘍部に誘
導することが可能とされ、一貫して迅速に腫瘍部の診断
・治療をすることが可能となる。As described above, the diagnostic / therapeutic apparatus 10 of the present embodiment is a PDT device 11 for treating a tumor by light irradiation.
And X for detecting the position of the light irradiation unit 12 of the PDT device 11
By providing the line CT15 and the PET 20 for grasping the position and distribution of the tumor part on which the photosensitizer is accumulated, the position and distribution of the tumor part and the position of the light irradiation part 12 of the PDT device 11 are synthesized on the CRT 30. The light irradiation unit 12 of the PDT device 11 can be easily guided to the tumor part, and the tumor part can be diagnosed and treated consistently and quickly.
【００２２】また、ＰＤＴ機器１１の光照射部１２は、
針状のプローブ１６の先端に位置しているので、このプ
ローブ１６が被検体１７の体内に穿刺挿入されることに
より体組織内の腫瘍部に光照射部１２からレーザ光を照
射することが可能とされ、たとえば、膵臓ガン、肝臓ガ
ン等、体組織内の腫瘍部の治療が可能とされる。The light irradiation unit 12 of the PDT device 11
Since the probe 16 is located at the distal end of the needle-shaped probe 16, the probe 16 can be punctured and inserted into the body of the subject 17 to irradiate the tumor portion in the body tissue with laser light from the light irradiating section 12. Thus, for example, it is possible to treat a tumor site in a body tissue such as a pancreatic cancer or a liver cancer.
【００２３】なお、本発明の診断・治療装置は、上記実
施形態に限定されるものではなく、他の条件等に応じて
種々の変形態様をとることが可能である。例えば、本実
施形態では、プローブ１６の光照射部１２の位置検出器
として、好適に、Ｘ線ＣＴ１５を採用しているが、プロ
ーブ１６と生体の内部構造を認識できるものなら他の機
器でも構わず、例えば、超音波診断機器でもよい。It should be noted that the diagnosis and treatment apparatus of the present invention is not limited to the above-described embodiment, but can take various modifications in accordance with other conditions and the like. For example, in the present embodiment, the X-ray CT 15 is preferably used as the position detector of the light irradiation unit 12 of the probe 16, but other devices may be used as long as they can recognize the probe 16 and the internal structure of the living body. Instead, for example, an ultrasonic diagnostic device may be used.
【００２４】また、本実施形態では、ポジトロン放出核
種で標識された光感受性物質としてフォトフリンＩＩの
ガリウム６８錯体を採用しているが、これに限られるも
のではない。例えば、標識としてはポジトロン放出核種
であれば種々の元素が採用でき、ガリウム６８以外に銅
６４、ナトリウム２２等でもよい。また、光感受性物質
としては、フォトフリンＩＩ以外の他のポルフィリン誘
導体でもよく、また、プロトポルフィリンＩＸを誘導す
る５−アミノレブリン酸等でも構わない。In this embodiment, the gallium-68 complex of photofrin II is employed as the photosensitizer labeled with a positron-emitting nuclide, but the present invention is not limited to this. For example, as the label, various elements can be adopted as long as they are positron-emitting nuclides. In addition to gallium 68, copper 64, sodium 22, or the like may be used. The photosensitizer may be a porphyrin derivative other than photofrin II, or 5-aminolevulinic acid which induces protoporphyrin IX.
【００２５】また、本実施形態では、光感受性物質の標
識として、好適に、ポジトロン放出核種を採用している
が、他の標識元素を採用することもできる。例えば、ガ
リウム６９やテルル１２０等のガンマ線放出核種を採用
してもよく、この場合、腫瘍部を認識するための腫瘍部
検出器として、ＰＥＴ２０に代えて、図２に示すガンマ
カメラ４５を採用することができる。このガンマカメラ
４５は、ガンマ線放出核種から放出されるガンマ線５３
をコリメータ５０を介してＮａＩ結晶シンチレータ５１
と光電子増倍管５２の組み合わせで検出し、ガンマ線放
出源、すなわち腫瘍部の位置や分布を外部から診断する
ことができる。In the present embodiment, a positron-emitting nuclide is preferably used as a label for a photosensitive substance, but other labeling elements can be used. For example, a gamma-ray emitting nuclide such as gallium 69 or tellurium 120 may be employed. In this case, a gamma camera 45 shown in FIG. 2 is employed instead of the PET 20 as a tumor detector for recognizing a tumor. be able to. The gamma camera 45 includes a gamma ray 53 emitted from a gamma ray emitting nuclide.
To the NaI crystal scintillator 51 via the collimator 50
And the photomultiplier tube 52, the gamma ray emission source, that is, the position and distribution of the tumor part can be diagnosed from outside.
【００２６】さらに、光感受性物質の標識として、ポジ
トロン放出核種に代えて安定同位体を採用することも可
能であり、例えば、５−アミノレブリン酸の炭素原子を
置換して炭素１３としたものや、窒素原子を置換して窒
素１５としたものを採用することができる。この場合、
腫瘍部を認識するための腫瘍部検出器として、ＰＥＴ２
０に代えて、ＭＲＩ−ＣＴを採用すれば腫瘍部の位置や
分布を外部から診断することができる。Further, a stable isotope can be employed as a label for the photosensitizer in place of the positron-emitting nuclide. For example, 5-aminolevulinic acid can be substituted with carbon-13 to give carbon-13, What substituted the nitrogen atom and made it into nitrogen 15 can be employ | adopted. in this case,
PET2 as a tumor part detector to recognize the tumor part
If MRI-CT is used instead of 0, the position and distribution of the tumor can be diagnosed from outside.
【００２７】また、本実施形態では、体組織内の腫瘍部
を治療するために光照射部１２を針状のプローブ１６の
先端に設置して体内に穿刺挿入しているが、光照射部１
２を内視鏡等の先端に設置して体腔内に挿入しても構わ
ない。この場合は、体表面の腫瘍部、例えば、胃ガンや
大腸ガン等、をレーザ照射により治療することができ
る。In this embodiment, the light irradiating section 12 is set at the tip of the needle-like probe 16 and is punctured into the body in order to treat a tumor in the body tissue.
2 may be installed at the tip of an endoscope or the like and inserted into a body cavity. In this case, a tumor on the body surface, such as a stomach cancer or a colon cancer, can be treated by laser irradiation.
【００２８】なお、特開２０００−１０５２７９には、
放射線治療に際して、ＰＥＴ画像とＸ線ＣＴ画像を重ね
合わせて腫瘍部の位置や分布を特定することが記載され
ているが、これらの公報には、ＰＤＴ治療や、放射線照
射部の位置検出器に関しては一切記載されていない。Note that Japanese Patent Application Laid-Open No. 2000-105279 discloses that
In radiotherapy, it is described that a PET image and an X-ray CT image are superimposed to specify the position and distribution of a tumor part. However, these publications disclose PDT treatment and a position detector of a radiation irradiation part. Is not listed at all.
【００２９】[0029]
【発明の効果】以上説明したように、本発明に係る診断
・治療装置によれば、光照射により腫瘍部を治療する光
治療器と、光治療器の光照射部の位置を検出する位置検
出器と、光感受性物質が集積した腫瘍部の位置や分布を
把握する腫瘍部検出器とを備えることにより、腫瘍部の
位置や分布と光治療器の光照射部の位置とが容易に精度
よく把握され、光治療器の光照射部を容易に腫瘍部に誘
導することが可能とされ、一貫して迅速に腫瘍部の診断
・治療をすることが可能となる。As described above, according to the diagnostic / therapeutic apparatus of the present invention, a phototherapy device for treating a tumor by light irradiation, and a position detecting device for detecting the position of the light irradiation portion of the phototherapy device. Device and a tumor part detector that grasps the position and distribution of the tumor part where the photosensitizer has accumulated, so that the position and distribution of the tumor part and the position of the light irradiation part of the phototherapy device can be easily and accurately determined. As a result, the light irradiation part of the phototherapy device can be easily guided to the tumor part, and the diagnosis and treatment of the tumor part can be performed consistently and quickly.
【図１】本実施形態の診断・治療装置の構成図である。FIG. 1 is a configuration diagram of a diagnosis / treatment device of the present embodiment.
【図２】図１のＰＥＴと代替可能なガンマカメラの原理
を示す模式図である。FIG. 2 is a schematic diagram illustrating the principle of a gamma camera that can be substituted for the PET of FIG.
１０…診断・治療装置、１１…ＰＤＴ機器（光治療
器）、１２…光照射部、１５…Ｘ線ＣＴ（位置検出
器）、１６…プローブ（光出力部）、１７…被検体、２
０…ＰＥＴ（腫瘍部検出器）。DESCRIPTION OF SYMBOLS 10 ... Diagnosis / therapeutic apparatus, 11 ... PDT equipment (phototherapy device), 12 ... Light irradiation part, 15 ... X-ray CT (Position detector), 16 ... Probe (light output part), 17 ... Subject, 2
0: PET (tumor site detector).
Claims (5)
前記光によって前記被検体内の腫瘍部を治療する光治療
器と、 前記光治療器の光照射部の位置を検出する位置検出器
と、 前記腫瘍部を検出するための腫瘍部検出器と、 を備えることを特徴とする、診断・治療装置。A light irradiation unit for irradiating the object with light;
A phototherapy device that treats a tumor part in the subject with the light, a position detector that detects a position of a light irradiation part of the phototherapy device, and a tumor part detector that detects the tumor part, A diagnostic / therapeutic device comprising:
瘍部親和性を有する光感受性物質が集積した前記腫瘍部
に、その光感受性物質の吸収波長の光を照射可能である
ことを特徴とする、請求項１に記載の診断・治療装置。2. The phototherapy device is capable of irradiating the tumor portion on which a photosensitizer labeled with a tracer and having photosensitivity having an affinity for a tumor portion is accumulated with light having an absorption wavelength of the photosensitizer. The diagnostic / therapy device according to claim 1, wherein
サはポジトロン放出核種であり、前記腫瘍部検出器はポ
ジトロン放出トモグラフィーであることを特徴とする、
請求項２に記載の診断・治療装置。3. The method according to claim 2, wherein the tracer for labeling the photosensitizer is a positron emitting nuclide, and the tumor site detector is a positron emitting tomography.
The diagnosis / treatment device according to claim 2.
の光出力部を有し、前記光照射部は前記光出力部の先端
に位置していることを特徴とする、請求項１〜３に記載
の診断・治療装置。4. The light treatment device according to claim 1, further comprising a needle-shaped light output unit for outputting the light, wherein the light irradiation unit is located at a tip of the light output unit. The diagnostic / treatment device according to any one of claims 1 to 3.
を特徴とする、請求項１〜４の何れか１項に記載の診断
・治療装置。5. The diagnostic / therapeutic apparatus according to claim 1, wherein the position detector is an X-ray CT.
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Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP2008173299A (en) * | 2007-01-18 | 2008-07-31 | National Cancer Center-Japan | Charged particle beam irradiation device and charged particle beam irradiation method |
| JP2011194243A (en) * | 2011-05-02 | 2011-10-06 | National Cancer Center | Charged particle beam irradiation apparatus |
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|---|---|---|---|---|
| JPH02239856A (en) * | 1989-03-13 | 1990-09-21 | Olympus Optical Co Ltd | Tumor treatment device |
| JPH10216252A (en) * | 1997-02-07 | 1998-08-18 | Hamamatsu Photonics Kk | Cancer medical treatment device |
| WO2000016684A1 (en) * | 1998-09-24 | 2000-03-30 | Super Dimension Ltd. | System and method for determining the location of a catheter during an intra-body medical procedure |
-
2000
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|---|---|---|---|---|
| JPH02239856A (en) * | 1989-03-13 | 1990-09-21 | Olympus Optical Co Ltd | Tumor treatment device |
| JPH10216252A (en) * | 1997-02-07 | 1998-08-18 | Hamamatsu Photonics Kk | Cancer medical treatment device |
| WO2000016684A1 (en) * | 1998-09-24 | 2000-03-30 | Super Dimension Ltd. | System and method for determining the location of a catheter during an intra-body medical procedure |
| JP2002526188A (en) * | 1998-09-24 | 2002-08-20 | スーパー ディメンション リミテッド | System and method for determining the position of a catheter during a medical procedure inside the body |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP2008173299A (en) * | 2007-01-18 | 2008-07-31 | National Cancer Center-Japan | Charged particle beam irradiation device and charged particle beam irradiation method |
| JP2011194243A (en) * | 2011-05-02 | 2011-10-06 | National Cancer Center | Charged particle beam irradiation apparatus |
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