WO2013060220A1

WO2013060220A1 - 4d stereo positioning radiation therapy device

Info

Publication number: WO2013060220A1
Application number: PCT/CN2012/082348
Authority: WO
Inventors: 姚毅
Original assignee: 苏州雷泰医疗科技有限公司
Priority date: 2011-10-25
Filing date: 2012-09-28
Publication date: 2013-05-02
Also published as: CN103071241A; CN103071241B

Abstract

A stereo positioning radiation therapy device comprises: an accelerator (21), an accelerator bracket, an X-axis rotation device (13) for driving the accelerator bracket to rotate about an X-axis and a frame (1), and an adapter disposed on the accelerator bracket. The accelerator (21) is installed above the adapter, and the accelerator bracket and the frame (1) are in a transmission connection through the X-axis rotation device (13), so that the accelerator (21) can perform nodding and looking-upward actions following the accelerator bracket, thereby changing the irradiation angle of a ray emitted by the accelerator (21) with respect to a Z-axis. As a result, the irradiation angle can be adjusted in the three-dimensional space, instead of merely being changed in the two-dimensional plane originally, thereby significantly improving the degree of freedom of adjustment, which provides greater supports for accurate detection and treatment.

Description

说明书 Description

4D立体定位放射治疗装置技术领域 4D stereotactic radiotherapy device

本发明涉及一种医疗设备，特别涉及与加速器治疗仪配合使用的一种 4D立体定位放射治疗装置。背景技术 The present invention relates to a medical device, and more particularly to a 4D stereotactic radiotherapy apparatus for use with an accelerator treatment device. Background technique

在对肿瘤（靶区）进行放射治疗时，需要给肿瘤的精确定位。在 3D 空间中，医生或物理师首先在 CT室扫描病人的 CT图像，通过算法将一系列 CT图像重建成三维图像，此时，可定位三维图象中肿瘤的三维坐标。然后医生或物理师将病人放置到加速器室进行复位，将肿瘤的三维坐标与加速器的治疗等中心（ i socenter )精确重合。最后开始治疗。目前的放射治疗设备的加速器只能绕 Z轴旋转，加速器发射的射线也只能限定在垂直于 Z轴的面上，不能自由选择入射角度，对疾病的检查和定向照射治疗带来很大约束。 When radiotherapy is performed on a tumor (target area), precise positioning of the tumor is required. In the 3D space, the doctor or physicist first scans the patient's CT image in the CT room and reconstructs a series of CT images into a three-dimensional image by algorithm. At this time, the three-dimensional coordinates of the tumor in the three-dimensional image can be located. The doctor or physicist then places the patient in the accelerator chamber for a reset, precisely matching the three-dimensional coordinates of the tumor to the accelerator's treatment center (i socenter). Finally start treatment. The accelerator of the current radiotherapy equipment can only rotate around the Z axis, and the radiation emitted by the accelerator can only be limited to the plane perpendicular to the Z axis, and the angle of incidence cannot be freely selected, which greatly restricts the examination of the disease and the treatment of the directional irradiation. .

针对上述问题，现有技术提出了一种解决方案，即将加速器悬挂于平行于 Z轴的滑轨上，可来回滑动，其加速器头可在 YZ面上摆动，加速器随加速器支架在 XY平面内转动，配合在 YZ平面的摆动，实现了三维多角度的照射，但由于加速器较重，因此其悬挂和驱动结构非常复杂，成本较高，另外加速器摆动造成射线不稳定，加速器传动***与加速器连接紧密，也可能对治疗***产生干扰，使制造难度和成本提高，另夕卜，加速器在摆动过程中无法与数字图像探测平板保持对应工作状态，因此无法随时检测治疗效果，并进行进一步的纠正与治疗。发明内容 In view of the above problems, the prior art proposes a solution in which the accelerator is suspended on a slide rail parallel to the Z-axis and can slide back and forth. The accelerator head can swing on the YZ plane, and the accelerator rotates in the XY plane with the accelerator bracket. With the oscillation of the YZ plane, three-dimensional multi-angle illumination is realized. However, due to the heavy weight of the accelerator, the suspension and drive structure are very complicated and costly. In addition, the accelerator swing causes the radiation to be unstable, and the accelerator transmission system is closely connected with the accelerator. It may also cause interference to the treatment system, making the manufacturing difficulty and cost increase. In addition, the accelerator cannot maintain the corresponding working state with the digital image detecting plate during the swinging process, so the treatment effect cannot be detected at any time, and further correction and treatment are performed. . Summary of the invention

为解决上述问题，本发明的目的在于提供一种通过 4D空间的跟踪，使剂量跟随肿瘤的时间轴运动轨迹，达到精确治疗，结构简单，制造难度低，同时节省时间和成本的 4D立体定位放射治疗装置。 In order to solve the above problems, an object of the present invention is to provide a 4D stereotactic radiography that can track the time axis of a tumor by tracking in a 4D space, achieve accurate treatment, has a simple structure, is difficult to manufacture, and saves time and cost. Therapeutic device.

为达到上述目的，本发明的技氺女案是：一种 4D立体定位放射治疗装置，包括加速器，还包括：加速器支架、驱动所述加速器支架绕 X轴旋转的 X轴旋转装置和机木， In order to achieve the above object, the technical female case of the present invention is: A 4D stereotactic radiotherapy apparatus, including an accelerator, further comprising: an accelerator bracket, an X-axis rotating device for driving the accelerator bracket to rotate around the X-axis, and a machine wood,

所述加速器支架包括 X轴旋转支架和 Z轴旋转支架，所述 Z轴旋转支架传动设置于所述 X轴旋转支架上并可绕其中心轴即 Z轴往返旋转；所述 X轴旋转支架与所述机架通过所述 X轴旋转装置传动连接，或 X轴旋转支架与所述机架直接活动连接； The accelerator bracket includes an X-axis rotating bracket and a Z-axis rotating bracket, and the Z-axis rotating bracket is disposed on the X-axis rotating bracket and rotatable around a central axis thereof, that is, a Z-axis; the X-axis rotating bracket and the The frame is connected by the X-axis rotating device, or the X-axis rotating bracket is directly movably connected to the frame;

以及设置于 Z轴旋转支架上的适配器，所述加速器安装于所述适配器上面。 And an adapter disposed on the Z-axis rotating bracket, the accelerator being mounted on the adapter.

优选的，所述加速器为至少一个； Preferably, the accelerator is at least one;

所述加速器安装于所述 X轴旋转支架上，所述 Z轴旋转支架传动设置于所述 X轴旋转支架上并可绕其中心轴即 Z轴往返旋转； The accelerator is mounted on the X-axis rotating bracket, and the Z-axis rotating bracket transmission is disposed on the X-axis rotating bracket and can rotate around the central axis, that is, the Z-axis;

所述 X轴旋转支架与所述机架通过所述 X轴旋转装置传动连接；或 X轴旋转支架与所述机架直接活动连接，并与所述 X轴旋转装置传动连接，所述机架包括底座和两个固定于所述底座上的支柱，或所述机架为直接固定于地面的两个支柱，所述加速器支架悬挂于所述两个支柱上。 The X-axis rotating bracket is drivingly connected to the frame through the X-axis rotating device; or the X-axis rotating bracket is directly movably connected to the frame, and is drivingly connected with the X-axis rotating device, the frame The base and two struts fixed to the base are included, or the frame is two struts directly fixed to the ground, and the accelerator bracket is suspended from the two struts.

优选的，所述 X轴旋转装置包括两组齿轮变速箱和驱动所述齿轮变速箱运转的 X轴驱动部件，所述 X轴旋转装置固定连接于所述机架的支柱上，所述 X轴旋转支架固定连接于所述齿轮变速箱的输出轴上。 Preferably, the X-axis rotating device comprises two sets of gear transmissions and an X-axis driving component for driving the gear transmission, the X-axis rotating device is fixedly connected to the pillar of the frame, the X-axis A rotating bracket is fixedly coupled to the output shaft of the gearbox.

优选的，所述 X轴旋转装置包括液压装置、螺杆推动装置或气动装置，所述液压装置、螺杆推动装置或气动装置一端铰连接于所述机架底座或地面上，另一端铰连接于所述 X轴旋转支架上。 Preferably, the X-axis rotating device comprises a hydraulic device, a screw pushing device or a pneumatic device, and the hydraulic device, the screw pushing device or the pneumatic device is hingedly connected to the frame base or the ground at one end, and the other end is hingedly connected to the Said on the X-axis rotating bracket.

优选的，所述 X轴旋转装置包括固定设于所述机架底座或直接设于地面上的弧形齿条、设于所述 X轴旋转支架上并与所述弧形齿条啮合的齿轮。 Preferably, the X-axis rotating device includes an arc-shaped rack fixedly disposed on the base of the frame or directly disposed on the ground, and a gear disposed on the X-axis rotating bracket and meshing with the curved rack .

优选的，所述加速器为至少一个 KV级加速器，所述的 4D立体定位放射治疗装置还包括至少一个探测 KV级能量并成像的 KV级数字图像探测平板； Preferably, the accelerator is at least one KV level accelerator, and the 4D stereotactic radiotherapy apparatus further comprises at least one KV level digital image detecting plate for detecting KV level energy and imaging;

所述 Z轴旋转支架上设有一等中心环形导轨，所述环形导轨为两段对称的圆弧形导轨组成，或为一连续的圆弧； The Z-axis rotating bracket is provided with an isocenter annular rail, and the annular rail is two segments a symmetrical arc-shaped guide rail, or a continuous arc;

所述 KV级加速器和 KV级数字图像探测平板安装于所述环形导轨并可沿其往返滑动。 The KV-class accelerator and the KV-class digital image detecting plate are mounted on the annular guide rail and slidable along the same.

优选的，所述加速器为至少 1个 MV级加速器，所述的 4D立体定位放射治疗装置还包括至少 1个 MV级数字图像探测平板，所述 MV级加速器固定安装于所述 Z轴旋转支架上，并随其转动； Preferably, the accelerator is at least one MV-level accelerator, and the 4D stereotactic radiotherapy apparatus further includes at least one MV-level digital image detecting plate, and the MV-level accelerator is fixedly mounted on the Z-axis rotating bracket. And rotate with it;

所述 MV级数字图像探测平板安装于所述 τ轴旋转支架上，并随其转动，或所述 MV级数字图像探测平板安装于所述 Ζ轴旋转支架上设有的等中心导轨或导槽上，并能随 Ζ轴旋转支架转动的同时沿所述等中心导轨或导槽来回移动。 The MV-level digital image detecting plate is mounted on the τ-axis rotating bracket and rotates therewith, or the MV-level digital image detecting plate is mounted on the isometric guide rail or the guiding groove provided on the cymbal rotating bracket And can move back and forth along the isometric guide rail or the guide groove while rotating the bracket with the rotation of the shaft.

优选的，所述加速器为至少 1个 MV级加速器，所述的 4D立体定位放射治疗装置还包括至少 1个 MV级数字图像探测平板，所述 MV级加速器固定安装于所述 Ζ轴旋转支架上，并随其转动； Preferably, the accelerator is at least one MV-level accelerator, and the 4D stereotactic radiotherapy apparatus further includes at least one MV-level digital image detecting plate, and the MV-level accelerator is fixedly mounted on the x-axis rotating bracket. And rotate with it;

所述 MV级数字图像探测平板安装于所述 Ζ轴旋转支架上，并随其转动，或所述 MV级数字图像探测平板安装于所述 1轴旋转支架上设有的等中心导轨或导槽上，并能随 Ζ轴旋转支架转动的同时沿所述等中心导轨或导槽来回移动。 The MV-level digital image detecting plate is mounted on the yoke rotating bracket and rotates therewith, or the MV-level digital image detecting plate is mounted on the isocenter guide or guide groove provided on the 1-axis rotating bracket And can move back and forth along the isometric guide rail or the guide groove while rotating the bracket with the rotation of the shaft.

优选的，所述 KV级加速器为 3个。 Preferably, the KV level accelerators are three.

优选的，所述 MV级数字图像探测平板为固定式、折叠式或伸缩式。优选的，所述 MV级加速器下面还装设有控制射线通过的面积和形状的光栅。 Preferably, the MV level digital image detecting tablet is fixed, folded or telescopic. Preferably, the MV-level accelerator is further provided with a grating for controlling the area and shape through which the rays pass.

本发明内容涉及的相关技术内容，阐述如下： The related technical content related to the present invention is as follows:

锥形束 CT技术： Cone beam CT technology:

近年发展起来的基于大面积非晶硅数字化 X 射线探测板的锥形束 CT (cone beam CT , CBCT)，具有体积小、重量轻、开放式架构的特点，可以直接整合到直线加速器上。机架旋转一周就能获取和重建一个体积范围内的 CT图像。这个体积内的 CT影像重建后的三维患者模型，可以与治疗计划的患者模型匹配比较，并得到治疗床需要调节的参数。根据采用放射线能量的不同分为两种，即：采用 kV级 X射线的 kV. CBCT和采用 MV级 x射线的 MV. CBCT Cone beam CT (CBCT) based on large-area amorphous silicon digital X-ray detector plate developed in recent years has the characteristics of small size, light weight and open architecture, which can be directly integrated into the linear accelerator. The CT image can be acquired and reconstructed within one volume by rotating the rack for one revolution. The reconstructed 3D patient model of the CT image within this volume can be compared to the patient model of the treatment plan and the parameters to be adjusted for the treatment bed are obtained. According to the difference in the amount of radiation energy, there are two types, namely: kV. CBCT and kV-level X-rays. MV. CBCT with MV-level x-ray

(1) KV-CBCT: 平板探测器的读数装置和探测器结合在一起，本身就具有提高空间分辨率的优势，因此， kV-CBCT可以达到比传统 CT更高的空间分辨率，密度分辨率也足以分辨软组织结构，可以通过肿瘤本身成像引导放疗。而且该***的射线利用效率高，患者接受的射线剂量少，使它可以作为一种实时监测手段。因此， CBCT具有在治疗位置进行 X线透视、摄片和容积成像的多重功能，对在线复位很有价值，成为目前 IGRT 开发和应用的热点。但其密度分辨率，尤其是低对比度密度分辨率与先进的 CT比，还有差距。 (1) KV-CBCT: The combination of the reading device and the detector of the flat panel detector has the advantage of improving the spatial resolution. Therefore, the kV-CBCT can achieve higher spatial resolution than the conventional CT, and the density resolution. It is also sufficient to distinguish the soft tissue structure, which can be guided by the tumor itself to guide radiotherapy. Moreover, the system has high radiation utilization efficiency and the patient receives a small dose of radiation, making it a real-time monitoring tool. Therefore, CBCT has multiple functions for X-ray fluoroscopy, radiography and volume imaging at the treatment site, which is valuable for online reset and has become a hot spot for IGRT development and application. However, the density resolution, especially the low contrast density resolution, is different from the advanced CT ratio.

(2) MV-CBCT: Poul iot等用低剂量 MV. CBCT获得无脉冲伪影的三维图像，融合计划 kV CT图像，并进行位置校正，推管和鼻咽融合精确到 1 Nakagawa等也应用 MV- CBCT进行在线校正。 MV. CBCT的 x线源和治疗束同源是其优点。而且 MVx线具有旁向散射少的特点，适用于评估精确电子密度，故可以同时作为剂量学监测设备。但与 kv. CBCT相比，它在图像分辨率、信噪比和成像剂量上处于明显劣势。 (2) MV-CBCT: Poul iot uses low-dose MV. CBCT to obtain three-dimensional images without pulse artifacts, fusion plan kV CT images, and position correction, push tube and nasopharyngeal fusion to 1 Nakagawa, etc. - CBCT performs online calibration. The x-ray source of MV. CBCT and the therapeutic beam homolog are its advantages. Moreover, the MVx line has the characteristics of less side scatter and is suitable for evaluating accurate electron density, so it can be used as a dosimetry monitoring device at the same time. However, compared with kv. CBCT, it is at a significant disadvantage in image resolution, signal-to-noise ratio, and imaging dose.

无论采用何种 CT技术，如果在 CT扫描和加速器照射时加进了时间变量因素，就称为四维放射（four dimens iona l rad iotherapy, 4DRT) , 相应的加进了时间变量因素的 CT扫描，称之为四维 CT (four dimens i ona 1 computed tomography, 4DCT) 4DCT扫描截取患者在某一时段内不同时刻的 CT 扫描序列，图像按相位重建，得到该时段内肿瘤和重要器官的 3D图像随时间变化的序列。应用 4DCT模拟定位，治疗时再应用 CBCT获得的肿瘤或重要器官的 3D图像与 4DCT序列的 3D图像比较后的结果，控制加速器进行实时照射，完成 4DRT Regardless of the CT technique used, if the time-variation factor is added to the CT scan and the accelerator, it is called four dimens iona radiotherapy (4DRT), and the CT scan with the time variable factor is added. Four-dimensional CT (four dimens i ona 1 computed tomography, 4DCT) 4DCT scan captures CT scan sequences of patients at different times in a certain period of time, and the images are reconstructed by phase to obtain 3D images of tumors and vital organs over time. The sequence of changes. 4DCT was used to simulate the localization, and the 3D image of the tumor or vital organ obtained by CBCT was compared with the 3D image of the 4DCT sequence, and the accelerator was controlled for real-time illumination to complete 4DRT.

动态螺旋断层放疗技术： Dynamic spiral tomography:

动态螺旋断层放射治疗（he l i ca l tomotherapy)***是一个将治疗计划、剂量计算、兆伏级 CT扫描、定位和螺旋照射治疗功能集为一体的调强放疗***。采用类似 CT的模式，从 360度聚焦断层照射肿瘤，靶区适形性佳，剂量分布均匀，使正常组织及器官得到最大限度的保护；具有图像引导放射治疗功能，每次放疗前在治疗机上进行 CT扫描，确认治疗***在三维空间上与治疗计划一致后再行放疗，从而保证了治疗的精确性；可在每次治疗后推算出肿瘤接收到的剂量，从而可以及时调整后续的治疗剂量，从而保证了治疗剂量的准确性。 The dynamic spiral tomography (hei ca l tomotherapy) system is an intensity-modulated radiotherapy system that combines treatment planning, dose calculation, mega-level CT scan, localization and spiral irradiation treatment functions. Using CT-like mode, the tumor is irradiated from a 360-degree focusing tomography, the target area is well-formed, the dose distribution is uniform, and the normal tissues and organs are protected to the maximum extent; the image-guided radiotherapy function is used, and the treatment machine is used before each radiotherapy. CT scan, confirmation The treatment position is consistent with the treatment plan in three dimensions, and then the radiotherapy is performed to ensure the accuracy of the treatment; the dose received by the tumor can be calculated after each treatment, so that the subsequent treatment dose can be adjusted in time, thereby ensuring the treatment. The accuracy of the dose.

图像引导放射治疗技术： Image guided radiotherapy technology:

图像引导放射治疗（IGRT )是一种四维的放射治疗技术，它在三维放疗技术的基础上加入了时间因数的概念，充分考虑了解剖组织在治疗过程中的运动和分次治疗间的位移误差，如呼吸和蠕动运动、日常摆位误差、靶区收缩等引起放疗剂量分布的变化和对治疗计划的影响等方面的情况，在患者进行治疗前、治疗中利用各种先进的影像设备对肿瘤及正常器官进行实时的监控，并能根据器官位置的变化调整治疗条件使照射野紧紧 "追随" 靶区，使之能做到真正意义上的精确治疗。 Image Guided Radiation Therapy (IGRT) is a four-dimensional radiotherapy technique that incorporates the concept of time factor based on three-dimensional radiotherapy technology, taking into account the movement of anatomical tissue during treatment and the displacement error between fractionated treatments. , such as respiratory and peristaltic movements, daily placement error, target area contraction, etc., which cause changes in the distribution of radiation doses and effects on treatment plans, etc., using advanced imaging equipment to treat tumors before and during treatment. Real-time monitoring of normal organs, and adjustment of treatment conditions according to changes in organ position, so that the irradiation field closely follows the target area, so that it can achieve precise treatment in the true sense.

4D概念： 4D concept:

3D就是空间的概念也就是由 X、 Y、 Ζ三个轴组成的空间.而 4D根据爱因斯坦的理论就是加上了时间的概念。从而时间与空间相结合就成了所谓的 4D空间。 3D is the concept of space, which is the space consisting of three axes: X, Y, and .. 4D According to Einstein's theory, the concept of time is added. Thus, the combination of time and space becomes the so-called 4D space.

放射治疗计划***（TPS ) ： Radiation Therapy Planning System (TPS):

基本流程：导入 CT图像，在每一层 CT图像上勾画肿瘤（靶区 )轮廓，勾画受保护器官的轮廓，添加机器数据，添加照射野（决定机架旋转角度，即照射方向），添加适形（如利用光栅叶片形成该射野下靶区的照射形状），计算照射剂量，导出计划文件。其中，需要软件来制作放射治疗计划。 Basic process: Import CT images, outline the tumor (target area) on each CT image, outline the protected organs, add machine data, add irradiation field (determine the rotation angle of the gantry, ie the direction of irradiation), add appropriate Shape (such as the use of grating blades to form the illumination shape of the target area under the field), calculate the irradiation dose, and export the plan file. Among them, software is needed to make a radiotherapy plan.

后续工作：将该计划文件传输到光栅或加速器进行治疗。 Follow-up: Transfer the plan file to a raster or accelerator for treatment.

光栅叶片的动态运动（S l iding ) ： Dynamic motion of the grating blade (S l iding ):

在加速器发射射线的过程中，叶片从一端向另一端不间断的运动，以控制加速器发射的射线通过的形状及面积大小。 During the emission of the illuminator, the blades move uninterrupted from one end to the other to control the shape and size of the rays emitted by the accelerator.

采用本技术方案的有益效果是：包括至少一个加速器、加速器支架、驱动所述加速器支架绕 X轴旋转的 X轴旋转装置和机架；所述加速器支架包括用于安装所述加速器的 X轴旋转支架和 Z轴旋转支架，所述 Z轴旋转支架传动设置于所述 X轴旋转支架上并可绕其中心轴即 Z轴往返旋转；所述 X轴旋转支架与所述机架通过所述 X轴旋转装置传动连接；或 X轴旋转支架与所述机架直接活动连接，并与所述 X轴旋转装置传动连接。这样，使加速器可以跟随加速器支架进行点头和仰头动作，即可以改变加速器所发射的射线相对于 z轴的照射角度，使照射角度由原来的只能在二维平面上变动，改为可以在三维空间上调节，大大增加了调节的自由度，对精确检测和治疗提供了更大的支持。 Advantageous effects of the present technical solution are: comprising at least one accelerator, an accelerator bracket, an X-axis rotating device and a frame that drives the accelerator bracket to rotate about the X-axis; the accelerator bracket includes an X-axis rotation for mounting the accelerator a bracket and a Z-axis rotating bracket, wherein the Z-axis rotating bracket is disposed on the X-axis rotating bracket and rotatable around a central axis thereof, that is, a Z-axis; The X-axis rotating bracket is drivingly connected to the frame through the X-axis rotating device; or the X-axis rotating bracket is directly movably connected to the frame and is drivingly connected to the X-axis rotating device. In this way, the accelerator can follow the accelerator bracket to perform the nodding and tilting movements, that is, the irradiation angle of the ray emitted by the accelerator relative to the z-axis can be changed, so that the illumination angle can only be changed in the two-dimensional plane, and can be changed in The three-dimensional adjustment greatly increases the degree of freedom of adjustment and provides greater support for accurate detection and treatment.

另外，所述机架包括底座和两个固定于所述底座上的支柱，或所述机架为直接固定于地面的两个支柱，所述加速器支架悬挂于所述两个支柱上，两个支柱的方案使得加速器支架的仰头、点头（即绕 X轴转动）得以更加方便的实现。本方案使纯 KV级放射治疗设备实现了 4D动态治疗的功能，并且成本得到有效控制，为无力购买昂贵 MV级设备的中小医院提供理想的医疗设备。进一步的，本方案可以集成 MV级加速器，并且在三维空间运转中，随时可保持与数字图像检测平板保持对应的工作姿态，可以随时进行治疗效果检测跟踪，并进行实时修正、验证和治疗。附图说明 In addition, the frame includes a base and two pillars fixed to the base, or the frame is two pillars directly fixed to the ground, and the accelerator bracket is suspended from the two pillars, two The struts are designed to make the accelerator head's head and nodding (ie, rotating around the X axis) more convenient. This program enables pure KV-class radiotherapy equipment to achieve 4D dynamic treatment, and the cost is effectively controlled, providing ideal medical equipment for small and medium-sized hospitals that cannot afford expensive MV-class equipment. Further, the solution can integrate the MV-level accelerator, and maintain the working posture corresponding to the digital image detecting tablet at any time in the three-dimensional operation, and can perform the detection and tracking of the therapeutic effect at any time, and perform real-time correction, verification and treatment. DRAWINGS

图 1是本发明一种 4D立体定位放射治疗装置实施例 1的示意图；图 2是本发明一种 4D立体定位放射治疗装置实施例 2、 3的示意图；图 3是本发明一种 4D立体定位放射治疗装置实施例 2的示意图；图 4是本发明一种 4D立体定位放射治疗装置实施例 3的示意图；图 5是本发明一种 4D立体定位放射治疗装置一种实施例的示意图；图 6是本发明一种 4D立体定位放射治疗装置实施例 4的示意图。图中数字和字母所表示的相应部件名称： 1 is a schematic view of Embodiment 1 of a 4D stereotactic radiotherapy apparatus according to the present invention; FIG. 2 is a schematic view of Embodiments 2 and 3 of a 4D stereotactic radiotherapy apparatus according to the present invention; FIG. 3 is a 4D stereoscopic positioning of the present invention. Figure 4 is a schematic view of a third embodiment of a 4D stereotactic radiotherapy apparatus according to the present invention; and Figure 5 is a schematic view of an embodiment of a 4D stereotactic radiotherapy apparatus according to the present invention; It is a schematic diagram of Embodiment 4 of a 4D stereotactic radiotherapy apparatus according to the present invention. The names of the corresponding parts represented by numbers and letters in the figure:

1.机架 11. X轴旋转支架 12.环形导轨 13. X轴旋转装置 14. Z 轴旋转支架 21. MV级加速器 22. MV级数字图像探测平板 31. KV 级加速器 32. KV级数字图像探测平板具体实施方式 1. Rack 11. X-axis swivel bracket 12. Ring guide 13. X-axis swivel device 14. Z-axis swivel bracket 21. MV-level accelerator 22. MV-level digital image detection tablet 31. KV-class accelerator 32. KV-level digital image Detection plate specific implementation

下面结合附图和具体实施方式对本发明作进一步详细的说明。实施例 1 , The present invention will be further described in detail below in conjunction with the drawings and specific embodiments. Example 1,

如图 1所示，一种 4D立体定位放射治疗装置，包括 MV级加速器 21，还包括：加速器支架、驱动所述加速器支架绕 X轴旋转的 X轴旋转装置 13和机架 1 ; 以及设置于 Ζ轴旋转支架 14上的适配器（也可集成于加速器上），所述 MV级加速器 21安装于所述适配器上面。适配器在图中未示出，它固定安装（或可拆卸的活动安装、或传动安装）于所述 Ζ轴旋转支架 14上，它也可以和 MV级加速器 21—体成型，或装配为一整体。 As shown in FIG. 1, a 4D stereotactic radiotherapy apparatus includes an MV-level accelerator 21, and further includes: an accelerator bracket, an X-axis rotating device 13 that drives the accelerator bracket to rotate about the X-axis, and a frame 1; An adapter on the cymbal rotating bracket 14 (which may also be integrated on the accelerator), the MV stage accelerator 21 is mounted on the adapter. The adapter is not shown in the drawings, it is fixedly mounted (or detachably movable, or drive mounted) on the cymbal swivel bracket 14, which can also be integrally formed with the MV-level accelerator 21, or assembled as a whole. .

所述加速器支架包括 X轴旋转支架 11和 Ζ轴旋转支架 14，所述 Ζ 轴旋转支架 14传动设置于所述 X轴旋转支架 11上并可绕其中心轴即 1 轴往返旋转；所述 4D立体定位放射治疗装置还包括探测 MV级能量并成像的 MV级数字图像探测平板 22，所述 MV级数字图像探测平板 11安装于所述 Ζ轴旋转支架 14上，所述 MV级数字图像探测平板 22为固定式、折叠式或伸缩式。 The accelerator bracket includes an X-axis rotating bracket 11 and a cymbal rotating bracket 14 . The cymbal rotating bracket 14 is disposed on the X-axis rotating bracket 11 and can rotate around a central axis thereof, that is, 1 axis; the 4D The stereotactic radiotherapy apparatus further includes a MV level digital image detecting plate 22 for detecting MV level energy and imaging, the MV level digital image detecting plate 11 being mounted on the x-axis rotating bracket 14, the MV level digital image detecting tablet 22 is fixed, folded or telescopic.

所述 Ζ轴旋转支架 14上设有一环形导轨 12，所述环形导轨为两段对称的圓弧形导轨组成； The cymbal rotating bracket 14 is provided with an annular guide rail 12, which is composed of two symmetrical circular arc guide rails;

所述 4D 立体定位放射治疗装置还包括两个分别安装于所述环形导轨 12不同圓弧形导轨上并可沿其滑动的探测 KV级能量并成像的 KV级数字图像探测平板 32，以及两个安装于所述环形导轨 12 不同圆弧形导轨上并可沿其滑动的的 KV级加速器 31 (这里为 X射线发射装置）。 The 4D stereotactic radiotherapy apparatus further includes two KV-level digital image detecting plates 32 that are respectively mounted on the circular arc-shaped guide rails of the annular guide rail 12 and can be scanned along the KV-level energy and imaged, and two A KV-class accelerator 31 (here, an X-ray emitting device) mounted on and slidable on the different arc-shaped guide rails of the annular guide 12.

实际上， X轴旋转支架 11和 Ζ轴旋转支架 14之间由环形导轨或环形滑槽滑动连接，并在 X轴旋转支架 11或 Ζ轴旋转支架 14上设有环形平面齿轮，在 Ζ轴旋转支架 14或 X轴旋转支架 11上设置伺服电机和与所述环形平面齿轮匹配的传动齿轮，当电机运行时， Ζ轴旋转支架 14则绕其中心纵轴（ Ζ轴）旋转，达到使 MV级加速器 21、 MV级数值图像探测平板 22、以及环形导轨 12及安装于其上的 KV级加速器 31和 KV级数字图像探测平板 32—起绕 Ζ轴等中心旋转的目的。 In fact, the X-axis rotating bracket 11 and the cymbal rotating bracket 14 are slidably connected by an annular guide rail or an annular sliding groove, and an annular face gear is arranged on the X-axis rotating bracket 11 or the cymbal rotating bracket 14 to rotate on the y-axis. A servo motor and a transmission gear matched with the annular face gear are disposed on the bracket 14 or the X-axis rotating bracket 11. When the motor is running, the cymbal rotating bracket 14 rotates about its central longitudinal axis (Ζ axis) to achieve the MV level. The accelerator 21, the MV-level numerical image detecting plate 22, and the annular guide 12 and the KV-class accelerator 31 and the KV-class digital image detecting plate 32 mounted thereon are used for the purpose of center-rotation around the yoke.

所述 X轴旋转支架 11与所述机架 1通过所述 X轴旋转装置 13传动连接，以及设置于 Ζ轴旋转支架 14上的适配器，所述 MV级加速器 21安装于所述适配器上面。所述 X轴旋转装置 13包括齿轮变速箱和驱动所述齿轮变速箱运转的 X轴驱动部件，所述 X轴旋转装置固定连接于所述机架 1上如图 1所示，即固定连接于两个支柱上，所述 X轴旋转支架 11固定连接于所述齿轮变速箱的输出轴上，因此整个加速器支架是悬空悬挂于两个支柱上的，这样为整个加速器支架实现点头和仰头功能（即绕 X轴旋转）奠定了基础。 The X-axis rotating bracket 11 is drivingly coupled to the frame 1 through the X-axis rotating device 13, and an adapter disposed on the cymbal rotating bracket 14, and the MV-level accelerator 21 is mounted on the adapter. The X-axis rotating device 13 includes a gear transmission and an X-axis driving component that drives the gear transmission, and the X-axis rotating device is fixedly coupled to the frame 1 as shown in FIG. On the two pillars, the X-axis rotating bracket 11 is fixedly coupled to the output shaft of the gearbox, so that the entire accelerator bracket is suspended from the two pillars, thereby implementing the nodding and tilting functions for the entire accelerator bracket. (that is, rotating around the X axis) laid the foundation.

当 X轴旋转装置 1 3正传或反转的时候，可以驱动加速器支架（ X轴旋转支架 11 ) 绕 X轴往复转动，即带动加速器支架连同 MV级加速器 21 完成仰头或点头的动作，使加速器可以跟随加速器支架进行点头和仰头动作，即可以改变加速器所发射的射线相对于 Z轴的照射角度，使照射角度由原来的只能在二维平面上变动，改为可以在三维空间上调节，大大增加了调节的自由度，对精确检测和治疗提供了更大的支持。 When the X-axis rotating device 13 is forwarded or reversed, the accelerator bracket (the X-axis rotating bracket 11) can be driven to reciprocate around the X-axis, that is, the accelerator bracket and the MV-level accelerator 21 are actuated to complete the upward or nod movement. The accelerator can follow the accelerator bracket for nodding and upward movement, that is, the angle of illumination of the ray emitted by the accelerator relative to the Z axis can be changed, so that the illumination angle can be changed only in the two-dimensional plane, and can be changed in three-dimensional space. Adjustments greatly increase the freedom of adjustment and provide greater support for accurate detection and treatment.

两个 KV级加速器 31分别与两个 KV级数字图像探测平板 32对应使用， MV级加速器 21与所述 MV级数字图像检测板 22对应使用，位置关系如图 1所示。 Two KV level accelerators 31 are respectively used corresponding to the two KV level digital image detecting plates 32, and the MV level accelerator 21 is used correspondingly to the MV level digital image detecting board 22, and the positional relationship is as shown in Fig. 1.

所述适配器下面还装设有控制加速器射线通过的面积和形状的光栅。所述光栅为电动多叶片光栅。所述光栅上还设有至少一个摄像头。图中均未示出。 Also mounted below the adapter is a grating that controls the area and shape through which the accelerator rays pass. The grating is an electric multi-blade grating. At least one camera is also disposed on the grating. Neither is shown in the figure.

本实施例可实现两种工况，其一，两个 KV级加速器 31和两个 KV级数字图像探测平板 32位置分别对应位于环形导轨 12的同一直径的两端，利用 KV级加速器 31和 KV级数字图像探测平板 32配合，可实现 KV能量级 4D CBCT功能。 KV级加速器 31和 KV级数字图像探测平板 32始终保持相对正交的摆放位置，且沿环形导轨 12绕等中心旋转，同时 KV级加速器 31对靶区（肿瘤）进行 KV级能量照射， KV级数字图像探测平板 32 接收照射剂量并按照捕获间隔（capture int erva l ) 生成一系列图像，这些图像通过软件计算，可生成病人病患部位的立体图像，利于对病情的精确诊断。其二，使 MV级数字图像探测平板 22和 MV级加速器 2 1位置分别位于环形导轨 12的同一直径的两端，利用 MV级数字图像探测平板 11与 MV级加速器 21的 MV级能量的配合使用，可以替代目前市面上昂贵的专用剂量验证产品，实现放射治疗剂量验证 ( Dos ime t ry ) 功能。当 MV级数字图像探测平板 22捕获 MV级加速器 21的 MV级能量照射的图像后，软件根据图像记录的灰度值，将其转换为剂量值，并于设计计划中的剂量进行对比和验证。可做 MV级加速器 21、 TPS (放射治疗计划***）、电动多叶光栅的定期验证。 In this embodiment, two working conditions can be realized. First, two KV-level accelerators 31 and two KV-level digital image detecting plates 32 respectively correspond to the two ends of the same diameter of the annular guide 12, and the KV-level accelerator 31 and KV are utilized. The level digital image detecting plate 32 cooperates to realize the KV energy level 4D CBCT function. The KV-class accelerator 31 and the KV-class digital image detecting plate 32 are always maintained in a relatively orthogonal position and are rotated around the circular guide 12 in an isocenter, while the KV-level accelerator 31 performs KV-level energy irradiation on the target region (tumor), KV The level digital image detecting plate 32 receives the irradiation dose and generates a series of images according to the capture interval (capture int erva l), which are calculated by software to generate a stereoscopic image of the patient's patient part, which is convenient for accurate diagnosis of the condition. Secondly, the MV-level digital image detecting plate 22 and the MV-level accelerator 2 1 are respectively located at the same diameter of both ends of the annular guide 12, and the MV-level digital image detecting plate 11 is used together with the MV-level energy of the MV-level accelerator 21. It can replace the expensive special dose verification products currently available on the market and realize the radiation therapy dose verification (Dos ime t ry ) function. When the MV-level digital image detecting panel 22 captures the MV-level energy-irradiated image of the MV-level accelerator 21, the software converts the image-recorded grayscale value into a dose value and compares and verifies the dose in the design plan. Regular verification of MV-level accelerator 21, TPS (radiation therapy planning system), and electric multi-leaf grating can be performed.

两个摄像头被安装在电动多叶光栅上，从 BEV视角望向靶区（肿瘤）方向，实时监控及记录靶区的呼吸运动（速率、轨迹、位置）蠕动运动、日常摆位误差、靶区收缩等信息，通过软件处理将信息进行反馈，实现 4D Track i ng功能。 Two cameras are mounted on the electric multi-leaf grating, looking at the target area (tumor) from the BEV perspective, real-time monitoring and recording of the respiratory motion (rate, trajectory, position) of the target area, peristaltic motion, daily placement error, target area Information such as shrinkage, feedback through software processing, and 4D Track i ng function.

同时结合 MV级数字图像探测平板 22与 MV级加速器 2 1保持正交的摆放位置，在 MV级加速器 21 出束治疗过程中，摄像头一边监控及记录以上信息并进行反馈， MV级数字图像探测平板 22则不断拍摄一系列的 MV级图像，并同样将靶区的位置信息反馈给软件***，与摄像头记录信息进行比对、配准和校正，然后通过软件控制电动多叶光栅叶片的运动，使其与靶区的运动相吻合，从而实现 I GRT功能。 At the same time, the MV-level digital image detecting plate 22 and the MV-level accelerator 2 1 are placed in an orthogonal position. During the MV-level accelerator 21 beam-out treatment, the camera monitors and records the above information and performs feedback, and the MV-level digital image detection is performed. The tablet 22 continuously captures a series of MV-level images, and also feeds the position information of the target area to the software system, compares, registers and corrects the information recorded by the camera, and then controls the movement of the electric multi-blade grating blades through software. It is matched with the motion of the target zone to achieve the I GRT function.

本实施例上集成 KV级加速器 31和 KV级数字图像探测平板 32 , 通过 CBCT功能迅速得到病人的三维图象，在得到三维图象后，软件通过算法将该组数据中的肿瘤坐标快速定位在等中心上；由于 CBCT只需要旋转 120度即可迅速得到病人的三维图象，所耗时间非常短，因此可在一个时间周期中，得到病人的多组三维图像，在这几组图像中，肿瘤由于呼吸运动所造成的位置的变化就被记录了下来，通过算法比对多组三维图像的肿瘤位置（配准），根据图像组之间的位移差，在放射治疗计划系统（TPS ) 中来设计 4D计划，并因此可以对病情进行快速诊断。在计算出照射剂量后将此 4D计划传输给设备的控制***，控制光栅及 MV级加速器 21进行治疗。在 MV级加速器 21进行照射的过程中，光栅叶片根据计划给定的位置，在时间周期中，不断地做规律的往返滑动 ( s l id ing ) , 以跟随肿瘤的呼吸运动。同时主数字图像探测平板 22与 MV级加速器 21正交摆放，通过治疗 4D计划， MV级加速器 21将精确的照射肿瘤，在治疗过程中， MV级数字图像探测平板 22 以一个固定的频率获取一系列包含剂量 -灰度值的数字图像（如每 2s获取一张图像），并将这些图像传输到验证软件中，通过与 4D计划计算的理想剂量进行比对，得到更精确的剂量验证结果。 In this embodiment, a KV-level accelerator 31 and a KV-level digital image detecting tablet 32 are integrated, and a three-dimensional image of the patient is quickly obtained by the CBCT function. After obtaining the three-dimensional image, the software quickly locates the tumor coordinates in the set of data by an algorithm. On the isocenter; because CBCT only needs to rotate 120 degrees to get the patient's three-dimensional image quickly, the time is very short, so it can be in one During the time period, multiple sets of three-dimensional images of the patient are obtained. In these sets of images, the changes in the position of the tumor due to respiratory motion are recorded, and the tumor positions (registration) of multiple sets of three-dimensional images are compared by an algorithm. According to the displacement difference between the image groups, the 4D plan is designed in the Radiotherapy Planning System (TPS), and thus the condition can be quickly diagnosed. The 4D plan is transmitted to the control system of the device after the irradiation dose is calculated, and the control grating and the MV level accelerator 21 are treated. During the illumination of the MV-level accelerator 21, the grating blade continuously performs regular round-trip sliding (sl id ing) in the time period according to the planned given position to follow the respiratory motion of the tumor. At the same time, the main digital image detecting plate 22 is placed orthogonally with the MV level accelerator 21. By treating the 4D plan, the MV level accelerator 21 will accurately illuminate the tumor, and during the treatment, the MV level digital image detecting plate 22 is acquired at a fixed frequency. A series of digital images containing dose-gray values (eg, one image per 2 s) and transmitted to the validation software for comparison with the ideal dose calculated by the 4D program for more accurate dose verification results .

本实施例的一些基本参数如下： Some basic parameters of this embodiment are as follows:

(1) 平板探测精度： 1024* 1024*8bi t以上； (1) Flat panel detection accuracy: 1024* 1024*8bi t or more;

(2) 创建图像：及时迅速的自动显示并存储图像； (2) Create an image: Automatically display and store images in a timely and timely manner;

(3) 定位 /配准精度：平移 <0. 5腿，旋转 <0. 5度； (3) Positioning / registration accuracy: translation <0. 5 legs, rotation <0. 5 degrees;

(4) 效率：以每秒一幅的速率获取图像； (4) Efficiency: Acquire images at a rate of one per second;

(5) 计算时间： 15s ; (5) Calculation time: 15s;

(6) 剂量精确度：〉95%; (6) Dose accuracy: 〉95%;

(7) 探测模式：单曝光、双曝光、以及治疗序列曝光模式。 (7) Detection mode: single exposure, double exposure, and treatment sequence exposure mode.

本实施例中， KV级数字图像探测平板 32和 KV级加速器 31可以只有一对，另外 MV级数字图像探测平板 11也可以用同一块 KV级数字图像探测平板 32兼任，由控制电路控制该 KV级数字图像探测平板 32在需要的时候分别与 KV级加速器 31或 MV级加速器 11对应，以完成相应的工作。上述装置的数量也可以根据需要来灵活配置。 In this embodiment, the KV level digital image detecting plate 32 and the KV level accelerator 31 may have only one pair, and the MV level digital image detecting plate 11 may also use the same KV level digital image. The detecting plate 32 is concurrently controlled, and the KV-level digital image detecting plate 32 is controlled by the control circuit to correspond to the KV-level accelerator 31 or the MV-level accelerator 11 respectively when necessary to complete the corresponding work. The number of the above devices can also be flexibly configured as needed.

本实施例中，所述 MV级数字图像探测平板还可以安装于所述 1轴旋转支架上设有的等中心导轨或导槽上，并能随 Z轴旋转支架转动的同时沿所述等中心导轨或导槽来回移动，以使其也可以进行控制和移动位置，可以避免各装置之间的干涉或获得更多的可操控性能。 In this embodiment, the MV-level digital image detecting plate can also be mounted on the isocenter guide rail or the guide groove provided on the 1-axis rotating bracket, and can rotate along the center along with the Z-axis rotating bracket. The rails or guides are moved back and forth so that they can also be controlled and moved to avoid interference between the devices or to achieve more maneuverability.

实施例 2， Embodiment 2,

如图 2、图 3所示，其余与实施例 1相同，不同之处在于，所述 X 轴旋转装置为液压装置，所述液压装置一端铰连接于所述机架 1的底座上（当机架只有两个直接固定于地面的支柱时，液压装置就直接安装于地面上），另一端铰连接于所述加速器支架上。加速器支架及加速器 22 的仰头和点头的动作由该液压装置的活塞杆来推动，而加速器支架（实质上是 X轴旋转支架 11 )和机架 1之间通过转轴和轴承来活动连接，也可以用轴及轴套的方式活动连接。上述液压装置也可以由螺杆推动装置或气动装置代替。 As shown in FIG. 2 and FIG. 3, the rest is the same as Embodiment 1, except that the X-axis rotating device is a hydraulic device, and one end of the hydraulic device is hingedly connected to the base of the frame 1 (when the machine is When the rack has only two pillars fixed directly to the ground, the hydraulic device is directly mounted on the ground, and the other end is hingedly connected to the accelerator bracket. The action of the accelerator head and the head 22 of the accelerator bracket and the accelerator 22 are pushed by the piston rod of the hydraulic device, and the accelerator bracket (essentially the X-axis rotating bracket 11) and the frame 1 are movably connected by the rotating shaft and the bearing, also The connection can be made by means of a shaft and a bushing. The above hydraulic device can also be replaced by a screw pushing device or a pneumatic device.

实施例 3 , Example 3,

如图 1、图 4所示，其余与实施例 1相同，不同之处在于，所述 X 轴旋转装置包括固定设于所述机架的底座上的弧形齿条（当机架只有两个直接固定于地面的支柱时，直接设置于地面上）、设于所述加速器支架上并与所述弧形齿条啮合的齿轮。通过控制设于加速器支架上的齿轮 (可由伺服电机驱动）旋转，使该齿轮沿弧形词条上下运动，带动加速器支架及加速器完成仰头和点头的动作。 As shown in FIG. 1 and FIG. 4, the rest is the same as Embodiment 1, except that the X-axis rotating device includes an arc-shaped rack fixed to the base of the frame (when the frame has only two When the struts are directly fixed to the ground, they are directly disposed on the ground, and the gears are disposed on the accelerator bracket and mesh with the curved rack. By controlling the gear (which can be driven by the servo motor) provided on the accelerator bracket, the gear moves up and down along the curved entry, and the accelerator bracket and the accelerator are driven to complete the movement of the head and the nod.

采用本技术方案的有益效果是：加速器支架、驱动所述加速器支架分别绕 Z轴和 X轴旋转的 X轴旋转装置和机架，以及设置于加速器支架上的适配器，所述加速器安装于所述适配器上面，所述加速器支架与所述机架通过所述 X轴旋转装置传动连接。这样，使加速器可以跟随加速器支架进行点头和仰头动作，即可以改变加速器所发射的射线相对于 1 轴的照射角度，使照射角度由原来的只能在二维平面上变动，改为可以在三维空间上调节，大大增加了调节的自由度，对精确检测和治疗提供了更大的支持。 Advantageous effects of the present technical solution are: an accelerator bracket, an X-axis rotating device and a frame that drive the accelerator bracket to rotate around the Z-axis and the X-axis, respectively, and an adapter disposed on the accelerator bracket, the accelerator being mounted on the Above the adapter, the accelerator bracket is drivingly coupled to the frame by the X-axis rotating device. In this way, the accelerator can follow the accelerator bracket for nodding and tilting, that is, the angle of the radiation emitted by the accelerator relative to the 1 axis can be changed, so that the illumination angle can be changed only in the two-dimensional plane, and can be changed to Adjustment in three-dimensional space greatly increases the degree of freedom of adjustment, providing greater support for accurate detection and treatment.

上述实施例中， 1轴旋转支架 14上的环形导轨也可以是一连续的圆弧形导轨，如图 5所示，可以根据需要来设定。 In the above embodiment, the annular guide rail on the 1-axis rotating bracket 14 may also be a continuous circular arc-shaped guide rail, as shown in Fig. 5, which can be set as needed.

实施例 4， Embodiment 4,

如图 6所示，其余与实施例 1相同，不同之处在于，本实施例的加速器为 3个 KV级的 X射线发射装置（即 KV级加速器 31 ) , 并配合 3个 KV级数字图像探测平板 32 (或 1个或 2个），均安装在等中心环形滑轨上，并可受控自由滑动，本方案使纯 KV级放射治疗设备实现了 4D动态治疗的功能，并且成本得到有效控制，为无力购买昂贵 MV级设备的中小医院提供理想的医疗设备。本实施例中， KV级加速器的数量还可以是两个、 4个等需要的数量， KV级的数字图像检测平板的数量可以是 1个、两个等需要的数量。 As shown in FIG. 6, the rest is the same as Embodiment 1, except that the accelerator of this embodiment is three KV-level X-ray emitting devices (ie, KV-level accelerator 31), and is combined with three KV-level digital image detection. The flat plates 32 (or 1 or 2) are mounted on the isocenter circular slide rails and can be controlled to slide freely. This solution enables the pure KV-class radiotherapy equipment to realize the function of 4D dynamic therapy, and the cost is effectively controlled. , providing ideal medical equipment for small and medium-sized hospitals that cannot afford to buy expensive MV-class equipment. In this embodiment, the number of KV-level accelerators may also be two, four, etc., and the number of digital image detecting plates of the KV level may be one, two, and the like.

上述实施例中， KV级数字图像探测平板 32、 KV级数字图像探测平板 32既可以在所述环形导轨 12上受控滑动，也可以 ^^随 Z轴旋转支架 14一起旋转。控制非常灵活方便。 In the above embodiment, the KV level digital image detecting plate 32 and the KV level digital image detecting plate 32 can be controlled to slide on the annular guide 12 or rotate together with the Z-axis rotating bracket 14. Control is very flexible and convenient.

上述实施例中， KV级数字图像探测平板 32、 KV级数字图像探测平板 32、摄像头均可根据需要来确定为采用一个、两个或是三个或其他数量。 In the above embodiment, the KV level digital image detecting plate 32, the KV level digital image detecting plate 32, and the camera can be determined to adopt one, two or three or other numbers as needed.

另外，在设备上集成 X射线发射装置（即 KV级加速器）和 KV级数字图像探测平板，通过 CBCT功能迅速得到病人的三维图象，在得到三维图象后，软件通过算法将该组数据中的肿瘤坐标快速定位在等中心上；由于本技术方案的独有结构， CBCT只需要旋转 120度即可迅速得到病人的三维图象，所耗时间非常短，因此可在一个时间周期中，得到病人的多组三维图像，在这几组图像中，肿瘤由于呼吸运动所造成的位置的变化就被记录了下来，通过算法比对多组三维图像的肿瘤位置（配准），根据图像组之间的位移差，在放射治疗计划***（TPS ) 中来设计 4D计划。此后计算出照射剂量后将此 4D计划传输到光栅及加速器进行治疗。在加速器进行照射的过程中，光栅叶片根据计划给定的位置，在时间周期中，不断地做规律的往返滑动（s l i d ing ) , 以跟随肿瘤的呼吸运动。使得治疗精度大大提高，降低了对正常组织的伤害。 In addition, an X-ray emitting device (ie, a KV-level accelerator) and a KV-level digital image detecting tablet are integrated on the device, and a three-dimensional image of the patient is quickly obtained by the CBCT function. After obtaining the three-dimensional image, the software uses the algorithm to group the data. The tumor coordinates are quickly located at the isocenter; due to the unique structure of the technical solution, CBCT only needs to rotate 120 degrees to quickly obtain the patient's three-dimensional image, which takes a very short time, so it can be obtained in a time period. Multiple sets of three-dimensional images of the patient. In these sets of images, changes in the position of the tumor due to respiratory motion are recorded. The tumor position (registration) of multiple sets of three-dimensional images is compared by an algorithm, according to the image group. The difference in displacement is designed in the Radiation Therapy Planning System (TPS) to design a 4D plan. Thereafter, the 4D plan is transmitted to the grating and the accelerator for treatment after the irradiation dose is calculated. During the illumination of the accelerator, the grating blades are given according to the planned position, in the time week During the period, regular regular sliding is performed to follow the respiratory movement of the tumor. The treatment accuracy is greatly improved, and the damage to normal tissues is reduced.

上述实施例中，可以仅由单纯的一个或多个 MV级加速器或 KV级加速器构成，组成单纯的 MV级或 KV级治疗***，也可以两者任一数量进行搭配，满足不同的需要。 In the above embodiment, only one or more MV-level accelerators or KV-level accelerators may be used to form a simple MV-level or KV-level treatment system, or any number of the two may be matched to meet different needs.

采用本技术方案的有益效果是：包括至少一个加速器、加速器支架、驱动所述加速器支架绕 X轴旋转的 X轴旋转装置和机架；所述加速器支架包括用于安装所述加速器的 X轴旋转支架和 Ζ轴旋转支架，所述 Ζ轴旋转支架传动设置于所述 X轴旋转支架上并可绕其中心轴即 Ζ轴往返旋转；所述 X轴旋转支架与所述机架通过所述 X轴旋转装置传动连接；或 X轴旋转支架与所述机架直接活动连接，并与所述 X轴旋转装置传动连接，所述机架包括底座和两个固定于所述底座上的支柱，或所述机架为直接固定于地面的两个支柱，所述加速器支架悬挂于所述两个支柱上。这样，使加速器可以跟随加速器支架进行点头和仰头动作，即可以改变加速器所发射的射线相对于 Ζ轴的照射角度，使照射角度由原来的只能在二维平面上变动，改为可以在三维空间上调节，大大增加了调节的自由度，对精确检测和治疗提供了更大的支持，两个支柱的方案使得加速器支架的仰头、点头（即绕 X轴转动）得以方便的实现。本方案使纯 KV级放射治疗设备实现了 4D 动态诊断和辅助治疗的功能，并且成本得到有效控制，为无力购买昂贵 MV级设备的中小医院提供理想的医疗设备。进一步的，本方案可以集成 MV级加速器，并且在三维空间运转中，随时可保持与数字图像检测平板保持对应的工作姿态，可以随时进行治疗效果检测跟踪，并进行实时修正、验证和治疗。 Advantageous effects of the present technical solution are: comprising at least one accelerator, an accelerator bracket, an X-axis rotating device and a frame that drives the accelerator bracket to rotate about the X-axis; the accelerator bracket includes an X-axis rotation for mounting the accelerator a bracket and a cymbal rotating bracket, wherein the cymbal rotating bracket is disposed on the X-axis rotating bracket and rotatable around a central axis thereof, that is, a cymbal; the X-axis rotating bracket and the rack pass the X a shaft rotation device drive connection; or an X-axis rotation bracket directly movably coupled to the frame and drivingly coupled to the X-axis rotation device, the frame including a base and two pillars fixed to the base, or The frame is two pillars directly fixed to the ground, and the accelerator bracket is suspended from the two pillars. In this way, the accelerator can follow the accelerator bracket to perform the nodding and tilting movements, that is, the angle of the radiation emitted by the accelerator relative to the x-axis can be changed, so that the illumination angle can only be changed in the two-dimensional plane, and can be changed in The three-dimensional adjustment greatly increases the degree of freedom of adjustment, and provides greater support for accurate detection and treatment. The two-pillar scheme makes the elevation and nodding of the accelerator bracket (ie, rotating around the X-axis) convenient. This program enables pure KV-class radiotherapy equipment to achieve 4D dynamic diagnosis and auxiliary treatment functions, and the cost is effectively controlled, providing ideal medical equipment for small and medium-sized hospitals that cannot afford expensive MV-class equipment. Further, the solution can integrate the MV-level accelerator, and maintain the working posture corresponding to the digital image detecting tablet at any time during the three-dimensional operation, and can perform the detection and tracking of the therapeutic effect at any time, and perform real-time correction, verification and treatment.

以上所述的仅是本发明的优选实施方式，应当指出，对于本领域的普通技术人员来说，在不脱离本发明创造构思的前提下，还可以做出若干变形和改进，这些都属于本发明的保护范围。 The above is only a preferred embodiment of the present invention, and it should be noted that those skilled in the art can make various modifications and improvements without departing from the inventive concept. The scope of protection of the invention.

Claims

权利要求书 Claim

1.一种 4D立体定位放射治疗装置，包括加速器，其特征在于，还包括： A 4D stereotactic radiotherapy apparatus, comprising an accelerator, further comprising:

加速器支架、驱动所述加速器支架绕 X轴旋转的 X轴旋转装置和机木, An accelerator bracket, an X-axis rotating device and a machine that drives the accelerator bracket to rotate about the X-axis,

所述加速器支架包括 X轴旋转支架和 1轴旋转支架，所述 Ζ轴旋转支架传动设置于所述 X轴旋转支架上并可绕其中心轴即 Ζ轴往返旋转；所述 X轴旋转支架与所述机架通过所述 X轴旋转装置传动连接，或 X 轴旋转支架与所述机架直接活动连接； The accelerator bracket includes an X-axis rotating bracket and a 1-axis rotating bracket. The cymbal rotating bracket is disposed on the X-axis rotating bracket and rotatable around a central axis thereof, that is, a cymbal; the X-axis rotating bracket and the The frame is drivenly connected by the X-axis rotating device, or the X-axis rotating bracket is directly movably connected to the frame;

以及设置于 Ζ轴旋转支架上的适配器，所述加速器安装于所述适配器上面。 And an adapter disposed on the x-axis rotating bracket, the accelerator being mounted on the adapter.

2. 根据权利要求 1所述的 4D立体定位放射治疗装置，其特征在于，所述加速器为至少一个； 2. The 4D stereotactic radiotherapy apparatus according to claim 1, wherein the accelerator is at least one;

所述加速器安装于所述 X轴旋转支架上，所述 Ζ轴旋转支架传动设置于所述 X轴旋转支架上并可绕其中心轴即 Ζ轴往返旋转； The accelerator is mounted on the X-axis rotating bracket, and the cymbal rotating bracket transmission is disposed on the X-axis rotating bracket and can rotate around the central axis, that is, the Ζ axis;

所述 X轴旋转支架与所述机架通过所述 X轴旋转装置传动连接；或 X 轴旋转支架与所述机架直接活动连接，并与所述 X轴旋转装置传动连接，所述机架包括底座和两个固定于所述底座上的支柱，或所述机架为直接固定于地面的两个支柱，所述加速器支架悬挂于所述两个支柱上。 The X-axis rotating bracket is drivingly connected to the frame through the X-axis rotating device; or the X-axis rotating bracket is directly movably connected to the frame, and is drivingly connected to the X-axis rotating device, the frame The base and two struts fixed to the base are included, or the frame is two struts directly fixed to the ground, and the accelerator bracket is suspended from the two struts.

3.根据权利要求 2所述的 4D立体定位放射治疗装置，其特征在于，所述 X轴旋转装置包括两组齿轮变速箱和驱动所述齿轮变速箱运转的 X 轴驱动部件，所述 X轴旋转装置固定连接于所述机架的支柱上，所述 X 轴旋转支架固定连接于所述齿轮变速箱的输出轴上。 The 4D stereotactic radiotherapy apparatus according to claim 2, wherein the X-axis rotation device includes two sets of gear transmissions and an X-axis driving member that drives the operation of the gear transmission, the X-axis The rotating device is fixedly coupled to the pillar of the frame, and the X-axis rotating bracket is fixedly coupled to the output shaft of the gear transmission.

4.根据权利要求 2所述的 4D立体定位放射治疗装置，其特征在于，所述 X轴旋转装置包括液压装置、螺杆推动装置或气动装置，所述液压装置、螺杆推动装置或气动装置一端铰连接于所述机架底座或地面上，另一端铰连接于所述 X轴旋转支架上。 The 4D stereotactic radiotherapy apparatus according to claim 2, wherein the X-axis rotating device comprises a hydraulic device, a screw pushing device or a pneumatic device, and the hydraulic device, the screw pushing device or the pneumatic device has one end hinge Attached to the base of the frame or the ground, and the other end is hingedly connected to the X-axis rotating bracket.

5.根据权利要求 2所述的 4D立体定位放射治疗装置，其特征在于，所述 X轴旋转装置包括固定设于所述机架底座或直接设于地面上的弧形齿条、设于所述 X轴旋转支架上并与所述弧形齿条啮合的齿轮。 The 4D stereotactic radiotherapy apparatus according to claim 2, wherein the X-axis rotating device comprises a curved rack fixedly disposed on the base of the frame or directly disposed on the ground, and is disposed at the A gear on the X-axis rotating bracket that meshes with the curved rack.

6.根据权利要求 1到 5任一所述的 4D立体定位放射治疗装置，其特征在于，所述加速器为至少一个 KV级加速器，所述的 4D立体定位放射治疗装置还包括至少一个探测 KV级能量并成像的 KV级数字图像探测平板； The 4D stereotactic radiotherapy apparatus according to any one of claims 1 to 5, wherein the accelerator is at least one KV-level accelerator, and the 4D stereotactic radiotherapy apparatus further comprises at least one detecting KV level. Energy and imaging KV level digital image detection plate;

所述 Z轴旋转支架上设有一等中心环形导轨，所述环形导轨为两段对称的圓弧形导轨组成，或为一连续的圆弧； The Z-axis rotating bracket is provided with an equal-center annular guide rail, and the annular guide rail is composed of two symmetrical circular arc-shaped guide rails, or is a continuous arc;

7.根据权利要求 1到 5任一所述的 4D立体定位放射治疗装置，其特征在于，所述加速器为至少 1个 MV级加速器，所述的 4D立体定位放射治疗装置还包括至少 1个 MV级数字图像探测平板，所述 MV级加速器固定安装于所述 Z轴旋转支架上，并随其转动； The 4D stereotactic radiotherapy apparatus according to any one of claims 1 to 5, wherein the accelerator is at least one MV-level accelerator, and the 4D stereotactic radiotherapy apparatus further comprises at least one MV. a digital image detecting plate, the MV level accelerator is fixedly mounted on the Z-axis rotating bracket, and rotates with the same;

所述 MV级数字图像探测平板安装于所述 Z轴旋转支架上，并随其转动，或所述 MV级数字图像探测平板安装于所述 Z轴旋转支架上设有的等中心导轨或导槽上，并能随 Z轴旋转支架转动的同时沿所述等中心导轨或导槽来回移动。 The MV level digital image detecting plate is mounted on the Z-axis rotating bracket and rotates therewith, or the MV-level digital image detecting plate is mounted on the isocenter rail or the guiding groove provided on the Z-axis rotating bracket Above, and can move back and forth along the isometric guide rail or guide groove while rotating the Z-axis rotating bracket.

8.根据权利要求 6所述的 4D立体定位放射治疗装置，其特征在于，所述加速器为至少 1个 MV级加速器，所述的 4D立体定位放射治疗装置还包括至少 1个 MV级数字图像探测平板，所述 MV级加速器固定安装于所述 Z轴旋转支架上，并随其转动； The 4D stereotactic radiotherapy apparatus according to claim 6, wherein the accelerator is at least one MV level accelerator, and the 4D stereotactic radiotherapy apparatus further comprises at least one MV level digital image detection. a slab, the MV-level accelerator is fixedly mounted on the Z-axis rotating bracket and rotates therewith;

所述 MV级数字图像探测平板安装于所述 Z轴旋转支架上，并随其转动，或所述 MV级数字图像探测平板安装于所述 1轴旋转支架上设有的等中心导轨或导槽上，并能随 Z轴旋转支架转动的同时沿所述等中心导轨或导槽来回移动。 The MV level digital image detecting plate is mounted on the Z-axis rotating bracket and rotates therewith, or the MV-level digital image detecting plate is mounted on the isocenter rail or the guiding groove provided on the 1-axis rotating bracket Above, and can move back and forth along the isometric guide rail or guide groove while rotating the Z-axis rotating bracket.

9.根据权利要求 6所述的 4D立体定位放射治疗装置，其特征在于，所述 KV级加速器为 3个。 The 4D stereotactic radiotherapy apparatus according to claim 6, wherein the KV-level accelerators are three.

10.根据权利要求 7所述的 4D立体定位放射治疗装置，其特征在于，所述 MV级数字图像探测平板为固定式、折叠式或伸缩式。 The 4D stereotactic radiotherapy apparatus according to claim 7, wherein the MV-level digital image detecting tablet is of a fixed type, a folding type or a telescopic type.