WO2000071205A2 - Radiotherapy device - Google Patents
Radiotherapy device Download PDFInfo
- Publication number
- WO2000071205A2 WO2000071205A2 PCT/EP2000/004341 EP0004341W WO0071205A2 WO 2000071205 A2 WO2000071205 A2 WO 2000071205A2 EP 0004341 W EP0004341 W EP 0004341W WO 0071205 A2 WO0071205 A2 WO 0071205A2
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- radiation
- arrangement according
- metal complex
- designed
- target tissue
- Prior art date
Links
Classifications
-
- 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
- A61N5/1001—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy using radiation sources introduced into or applied onto the body; brachytherapy
- A61N5/1027—Interstitial radiation therapy
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
- A61N2005/1092—Details
- A61N2005/1098—Enhancing the effect of the particle by an injected agent or implanted device
-
- 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
- A61N5/1001—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy using radiation sources introduced into or applied onto the body; brachytherapy
- A61N5/1002—Intraluminal radiation therapy
Definitions
- the invention relates to an arrangement for radiation therapy of a limited target tissue area, with a radiation source which is designed to emit ionizing radiation, and an emplacement which is arranged within the target tissue area or adjacent to it and which is designed for backscattering ionizing radiation .
- Such an arrangement is known from the applicant's document DE 199 22 991 A1.
- this known arrangement has an embedding which consists of micropellets or nanoparticles.
- the particles consist of a titanium alloy and are embedded in a carrier emulsion.
- the emulsion is introduced into the target tissue area using a catheter device.
- a disadvantage of this arrangement is that the particles embedded in the emulsion are complex and expensive to produce. This results in correspondingly high operating costs for this known arrangement.
- the technical problem underlying the invention is therefore to develop an arrangement of the type mentioned at the outset in such a way that it can be operated more cost-effectively.
- incorporation comprises a metal complex compound in a liquid solution or in an emulsion.
- the technical teaching on which the invention is based is that the effect of increasing the dose in the immediate vicinity of metallic surfaces also occurs when the metallic surfaces are not solid but are in the liquid phase.
- the inclusion contains a metal complex compound in a liquid solution or in an emulsion. It has been shown that the effect of increasing the dose can be achieved both with complex compounds of the common metals in the classic sense, i.e. the metals of the 3rd to 6th main group and the transition metals, as well as with alkaline earth metals and with internal transition metals, i.e. rare earth metals .
- Biocompatible metal complex solutions or emulsions are preferably used. In this way, undesirable side effects, for example in the form of allergic reactions, are excluded as far as possible.
- the choice of the metal complex compound to be used also depends on the scattering coefficient of the respective metal element for the radiation used.
- the scattering coefficient should be as high as possible in the area of the energy spectrum used for the therapy, in order to be able to keep the irradiated intensity low and to protect unaffected, irradiated body sections.
- X-rays or y-rays can be used.
- the complex salt compounds used in practice should be able to be transferred to the target tissue area in a biocompatible, soluble form - be it as an emulsion or as a direct solution. This can be done with the help of an injection or infusion or, under suitable conditions, by iontophoresis.
- the metal complex is an alkaline earth metal complex salt compound.
- Barium sulfate is used in an embodiment of the invention designed in particular for an X-ray radiation therapy. Barium sulfate is already widely used in X-ray diagnostics as a positive contrast medium.
- the metal complex compound is a rare earth complex salt compound.
- Metal complexes containing gadolinium are particularly suitable for X-ray radiation.
- the gadolinium DTPA used as a contrast agent in magnetic resonance imaging can be used.
- This spreading agent is already medically approved as biocompatible and has the advantageous property of accumulating in particular in hypervascularized peripheral zones of tumors. This is exactly the area where the excessive dose effect is to be used to optimize radiation therapy.
- the inclusion is preferably formed entirely from the metal complex compound in liquid solution or in emulsion. It goes without saying that a liquid solution or an emulsion which contains two or more different metal complexes can also be used. Alternatively, the arrangement according to the invention can also have an inclusion which is formed partly from conventional metal particles in emulsion and partly from a solution or emulsion containing metal complex.
- the arrangement for the radiation therapy preferably has a backscatter geometry. That is, at least a portion of the storage is related to the Radiation source positioned behind the target tissue area or in its rear section. Appropriate positioning and expansion of the embedding can ensure that the entire target tissue area is exposed to radiation backscattered by the embedding.
- the radiation geometry is optimized by a positioning device to which the radiation source is attached and which is designed to perform defined positioning movements for positioning the radiation source relative to the target tissue area.
- the radiation detector should, as far as possible, not require any additional space beyond the volume occupied by a catheter device used to introduce the scattering agent, ie the metal complex-containing solution or emulsion. It is therefore preferably designed as a miniature dosimeter.
- Another exemplary embodiment of the arrangement according to the invention has a radiation detector which is designed as a probe which can be displaced in the target tissue area.
- the radiation intensity can be controlled over long distances of the target tissue area.
- the radiation geometry can be adapted to the specific conditions of the respectively irradiated target tissue area.
- a further exemplary embodiment of the arrangement according to the invention has a control device which is connected to the radiation detector and to the radiation source and which controls the power and / or the emission duration of the radiation emitted by the radiation source as a function of the measurement signal of the Radiation detector is formed.
- the control device is preferably additionally connected to the positioning device and is designed to control an actuating movement of the positioning device, by means of which the radiation source is moved into a position in which the measurement signal assumes a maximum value.
- Figure 1 shows an embodiment of the radiation therapy arrangement according to the invention in a schematic diagram
- FIG. 2 shows a functional block diagram of a processing and control device of the arrangement according to FIG. 1.
- FIG. 1 shows schematically a radiation therapy arrangement 1 00.
- a tissue section 1 02 is shown in a schematic sectional view.
- a tumor T is represented by coarse hatching and a dashed outline.
- a fluid applicator 104 for the afterloading technique is inserted interstitially into the tissue section 102 and extends with its distal end into the tumor T.
- the fluid applicator 1 04 is connected via a connecting piece 1 06 to a container (not shown) via which a liquid scattering agent 1 08 is supplied under pressure.
- a liquid scattering agent 1 08 is supplied under pressure.
- gadolinium-DTPA is used as the scattering agent.
- the present arrangement is not limited to the use of gadolinium DTPA.
- a liquid Solution of all metal complex compounds mentioned above, also in the form of an emulsion, are used.
- the scattering agent 1 08 exits through a plurality of openings 1 1 0 in the wall of the applicator 1 04 in the surrounding target tissue area T and forms a liquid reservoir 1 1 2 there, which due to its metal content is a "multiple scattering body" for X-ray or -Radiation forms.
- a radiation detector 11 8 is arranged on an axially displaceable carrier rod 11 4, which carries a scale 11 6 in the proximal region.
- the radiation detector 1 1 8 generates a measurement signal corresponding to the dose rate.
- the scale is used to determine the position of the radiation detector relative to the longitudinal extent of the distal end region of the fluid applicator 1 04.
- automatically working arrangements for determining the position of the radiation detector 1 1 8 can also be provided.
- the radiation detected by the detector 11 8 is generated with the aid of an irradiation device 120.
- the irradiation device 1 20 has an X-ray device 1 22, which is constructed so that it can be pivoted by a motor on a swivel device 1 24.
- the x-ray device 1 22 is assigned an imaging device 1 26 with an image processing unit 1 27 beyond the irradiated body section, by means of which the position of the fluid applicator 104 and of the radiation detector 1 1 8 relative to the target tissue area can be determined.
- the same design can be used instead of an X-ray device to provide a radiation source for rays, for example using 60 Co.
- the radiation detector 1 1 8 is designed as a miniature X-ray dosimeter.
- the measurement signal generated by it is fed via a cable 1 28 to the input of a detector signal processing unit 1 30. This is on the output side with a tion control unit 1 32 connected.
- the irradiation control unit 1 32 is connected to the X-ray device 1 22 and the swivel device 1 24 via control outputs. On the one hand, it controls the power of the radiation emitted by the X-ray device 1 22 and, on the other hand, the positioning of the X-ray device 1 22 using the swivel device 1 24.
- the structure and function of the detector signal processing unit 1 30 are described in more detail below.
- the x-ray device 1 22 is operated with a radiation output that is substantially reduced compared to comparable radiation therapies, since there is a greatly increased effective dose of the x-radiation in the target tissue area T as a result of multiple scattering effects in the liquid reservoir 1 1 2.
- the exact dose rate is set with the help of the radiation control unit above an experimentally predetermined effect threshold for the proliferation inhibition.
- the effect threshold can be determined, for example, by radiation tests on a tissue of the type of tissue section 102.
- the dose rate profile of the radiation along the axis of the applicator 1 04 can be determined by moving the carrier rod 1 14.
- the radiation power and / or direction of the radiation source 1 22 can be controlled on the basis of this profile.
- the effective dose in the target tissue area T can also be controlled by additional supply or by suction of scattering material 1 08 during the treatment.
- FIG. 2 schematically shows, in the form of a functional block diagram, a simple embodiment of the detector signal processing unit 1 30 and the irradiation control unit 1 22 of the arrangement according to FIG. 1.
- the functions mentioned below will largely be implemented using software.
- the detector signal processing unit 1 30 connected on the input side to the radiation detector 1 1 8 (FIG. 1) comprises an amplifier stage 1 30.1 and one of these subordinate correction stages 1 30.3, which is also connected to a correction table memory 1 30.2, in which the dose rate values recorded in the longitudinal axis of the fluid applicator 1 04 are extrapolated to the therapy-relevant circumferential dose rate values on the basis of a correction table predetermined for the special fluid applicator in vitro.
- the irradiation control unit 1 32 comprises a subtraction stage 1 32.2 connected to the output of the detector signal processing unit 1 30 and to an internal setpoint memory 1 32.1, in which the current setpoint / actual value deviation of the dose rate is determined for each detector position and which in turn contains a control table memory 1 32.3 addressed.
- a primary control signal for the power supply 1 32.4 of the X-ray source 1 22 is read from these as a function of the difference value obtained.
- the primary control signals for various detector positions are generally fed to a subordinate averaging stage 1 32.5, which they store in an internal (not shown separately) buffer memory and, after completion of a measurement, carries out an averaging, the result of which represents a secondary control signal that is used by the power supply 1 32.4 is supplied.
- the x-ray source can also be readjusted (represented by a dashed line) when a single primary control signal is present. This will be particularly useful in the event of large deviations at the start of treatment.
- the control unit 1 32 further comprises - in a manner known per se - a sequence control stage 1 32.6 (with timer, working and program memory, which are not shown separately here) and a display unit 132.7 as well as an input unit 1 32.8 via which the essential treatment parameters are given to the operator are displayed and with the help of which the operator is given the opportunity to intervene manually.
- the sequence control stage 1 32.6 receives detector position signals from the image processing unit 1 27 (FIG. 1) and, depending on this, controls the acquisition of the secondary control signal mentioned above and also a representation of the detector position together with the local dose rate on the display unit 1 32.7.
- the swiveling device 1 24 (FIG.
Landscapes
- 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
Description
Claims
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP00958278A EP1180055A2 (en) | 1999-05-12 | 2000-05-12 | Radiotherapy device |
AU69854/00A AU6985400A (en) | 1999-05-12 | 2000-05-12 | Radiotherapy device |
JP2000619505A JP2003500125A (en) | 1999-05-12 | 2000-05-12 | Radiation therapy equipment |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE19922991.0 | 1999-05-12 | ||
DE19922991A DE19922991A1 (en) | 1998-09-22 | 1999-05-12 | Apparatus for radiation therapy has insert to reflect controlled ionized radiation back into target tissue zone without effects on neighboring tissue |
Publications (2)
Publication Number | Publication Date |
---|---|
WO2000071205A2 true WO2000071205A2 (en) | 2000-11-30 |
WO2000071205A3 WO2000071205A3 (en) | 2001-06-28 |
Family
ID=7908530
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/EP2000/004341 WO2000071205A2 (en) | 1999-05-12 | 2000-05-12 | Radiotherapy device |
Country Status (4)
Country | Link |
---|---|
EP (1) | EP1180055A2 (en) |
JP (1) | JP2003500125A (en) |
AU (1) | AU6985400A (en) |
WO (1) | WO2000071205A2 (en) |
Citations (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE19922991A1 (en) | 1998-09-22 | 2000-03-23 | Laser & Med Tech Gmbh | Apparatus for radiation therapy has insert to reflect controlled ionized radiation back into target tissue zone without effects on neighboring tissue |
Family Cites Families (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4310507A (en) * | 1978-08-02 | 1982-01-12 | Eastman Kodak Company | Contrast agent for radiography |
US4976266A (en) * | 1986-08-29 | 1990-12-11 | United States Department Of Energy | Methods of in vivo radiation measurement |
DE3640708C2 (en) * | 1986-11-28 | 1995-05-18 | Schering Ag | Improved pharmaceuticals containing metals |
US4998268A (en) * | 1989-02-09 | 1991-03-05 | James Winter | Apparatus and method for therapeutically irradiating a chosen area using a diagnostic computer tomography scanner |
US5813985A (en) * | 1995-07-31 | 1998-09-29 | Care Wise Medical Products Corporation | Apparatus and methods for providing attenuation guidance and tumor targeting for external beam radiation therapy administration |
US6125295A (en) * | 1997-08-27 | 2000-09-26 | Cash, Jr.; Webster C. | Pharmaceutically enhanced low-energy radiosurgery |
US6001054A (en) * | 1998-05-19 | 1999-12-14 | Regulla; D. F. | Method and apparatus for differential energy application for local dose enhancement of ionizing radiation |
-
2000
- 2000-05-12 JP JP2000619505A patent/JP2003500125A/en active Pending
- 2000-05-12 WO PCT/EP2000/004341 patent/WO2000071205A2/en not_active Application Discontinuation
- 2000-05-12 EP EP00958278A patent/EP1180055A2/en not_active Withdrawn
- 2000-05-12 AU AU69854/00A patent/AU6985400A/en not_active Abandoned
Patent Citations (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE19922991A1 (en) | 1998-09-22 | 2000-03-23 | Laser & Med Tech Gmbh | Apparatus for radiation therapy has insert to reflect controlled ionized radiation back into target tissue zone without effects on neighboring tissue |
Also Published As
Publication number | Publication date |
---|---|
JP2003500125A (en) | 2003-01-07 |
EP1180055A2 (en) | 2002-02-20 |
AU6985400A (en) | 2000-12-12 |
WO2000071205A3 (en) | 2001-06-28 |
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