Patient alignment method and system using light field and light reflector during radiation therapy
11065474 · 2021-07-20
Assignee
Inventors
- Tae-Ho KIM (Gyeonggi-do, KR)
- Seong-Hee Kang (Gyeonggi-do, KR)
- Dong-Su Kim (Gyeonggi-do, KR)
- Min-Seok Cho (Gyeonggi-do, KR)
- Dong-Seok SHIN (Incheon, KR)
- TAE-SUK SUH (Seoul, KR)
- Kyeong-Hyeon Kim (Gyeonggi-do, KR)
Cpc classification
A61N5/1049
HUMAN NECESSITIES
A61B5/0077
HUMAN NECESSITIES
A61N2005/1074
HUMAN NECESSITIES
A61B5/721
HUMAN NECESSITIES
A61N5/1068
HUMAN NECESSITIES
International classification
A61B5/00
HUMAN NECESSITIES
A61N5/10
HUMAN NECESSITIES
Abstract
A system to align an object using a light reflector, including: an input unit for pre-setting a first region in which radiation is to be emitted to the object; a display unit for displaying information on the first region; a radiation unit for emitting radiation to the first region; a reflector formed to correspond to the shape of the first region and configured to be attached to the first region; a light unit for emitting light in the same direction as the radiation to the first region; a camera for photographing a region of the reflector when the reflector reflects light emitted by the light unit; and a control unit for controlling the display unit to display the region of the light reflector which reflects light photographed by the camera, and determining whether the radiation is aligned to the first region of the object based on whether the region of the light reflector is included in the shape of the first region.
Claims
1. A system to align an object using a light reflector, the system comprising: a user input unit which pre-sets a first region in which radiation is to be emitted to the object; a display unit which displays information on the first region; a radiation emitting unit which emits the radiation to the first region; a light reflector which is formed to correspond to a shape of the first region is configured to be attached to the first region of the object; a light emitting unit which emits light in the same direction as the radiation to the first region; a camera which photographs a region of the light reflector which reflects light when the light reflector reflects light emitted by the light emitting unit; and a control unit which controls the display unit to display the region of the light reflector which reflects light photographed by the camera, and determines whether the radiation is aligned to the first region of the object based on whether the region of the light reflector is included in the shape of the first region.
2. The system of claim 1, wherein the control unit double-checks whether the radiation is emitted to the first region in a step of aligning the object to establish a plan for emitting the radiation and a step of aligning the object to perform treatment by emitting the radiation to the object.
3. The system of claim 1, wherein when the region of the light reflector deviates from the shape of the first region by at least a predetermined percentage, the control unit stops the radiation emitting unit from emitting the radiation.
4. The system of claim 1, wherein the camera is attached to the radiation emitting unit and the control unit determines whether the radiation is emitted to the first region using a change in an area of the region of the light reflector included in the shape of the first region.
5. The system of claim 1, wherein the system comprises a plurality of cameras, the control unit determines changes in three-dimensional translation and rotation of the region of the light reflector with respect to the shape of the first region by a plurality images acquired using the plurality of cameras, and the control unit determines whether the radiation is emitted to the first region based on the changes.
6. The system of claim 1, further comprising a sensor which senses a respiratory signal related to breath of the object, wherein when a change in the respiratory signal deviates from a predetermined range, the control unit stops radiation emitting unit from emitting the radiation.
7. The system of claim 1, wherein the radiation and the light are simultaneously emitted.
8. A method of aligning an object using a light reflector, the method comprising: setting a first region which radiation is to be emitted to the object; displaying information on the first region; attaching a light reflector to the first region of the object, the light reflector formed to correspond to a shape of the first region; emitting light in the same direction as a direction of the radiation to be emitted to the first region; displaying a region of the light reflector which reflects light using the light emitted, as photographed by a camera; and establishing a radiation emitting plan for alignment of the object to the radiation to be emitted using whether the region of the light reflector is included in the shape of the first region.
9. The method of claim 8, wherein after establishing the radiation emitting plan for alignment of the object to the radiation to be emitted using whether the region of the light reflector is included in the shape of the first region, the method further comprising: emitting the radiation to the first region; emitting further light to the first region in the same direction as the radiation; displaying a further region of the light reflector which reflects light using the further light emitted, as photographed by the camera; and determining whether the radiation is aligned to the first region of the object based on whether the further region of the light reflector is included in the shape of the first region.
10. The method of claim 9, wherein after determining whether the radiation is aligned to the first region of the object based on whether the further region of the light reflector is included in the shape of the first region, the method further comprising stopping emission of the radiation when the further region of the light reflector deviates from the shape of the first region by at least predetermined percentage.
11. The method of claim 9, wherein in determining whether the radiation is aligned to the first region of the object based on whether the further region of the light reflector is included in the shape of the first region, it is determined whether the radiation is aligned to the first region of the object based on at least one of a change in an area of the region of the light reflector included in the shape of the first region, and changes in three-dimensional translation and rotation of the region of the light reflector with respect to the shape of the first region.
12. The method of claim 9, wherein after determining whether the radiation is aligned to the first region of the object based on whether the further region of the light reflector is included in the shape of the first region, the method further comprising: sensing a respiratory signal related to the breath of the object; and stopping emission of the radiation when a change in the respiratory signal deviates from a predetermined range.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
DETAILED DESCRIPTION OF THE EMBODIMENTS
(10)
(11) Referring to
(12) Referring to
(13) The image augmentation device 10 may further include a bed unit 101 on which a patient is located, a control unit 102, and a reading unit 103.
(14) First, the body unit 11 provides a mechanical balance and support to the image augmentation device 10, and also provides a transport path of electromagnetic energy and high energy particles to the outside, which is required for individual units 13, 14, and 15. Specifically, the body unit 11 is erected from a floor on which the image augmentation device 10 is disposed at least to a plane in which an isocenter is located to support a weight of the C-arm gantry 12 of the image augmentation device 10. Further, in order to reduce risks of twisting, errors, and rollover due to the movement of the center of gravity during an operation, for example, various known support structures such as a counter-balancing structure may be adapted. The isocenter is a position in which radiations emitted from various positions are intensively transmitted so as to be selected to coincide with a specific portion of the body which requires the therapy or diagnosis. Therefore, a plane in which the isocenter is located may refer to a conceptual plane which is determined depending on a position of the lesion of the patient located or laying on the bed unit 101. The body unit 11 may have a base 111 which has wheels to move the image augmentation device 10 in a desired position or is movable on a predetermined track provided on the floor. Further, the body unit 11 may be mechanically fastened with a fixing unit 122 of the C-arm gantry 12 by a fixing unit 112 installed in a position which is in contact with a center of curvature of a circular arc of a C-arm 121 of the C-arm gantry 12. In this case, the fixing unit 122 of the C-arm gantry 12 may be fixed rotatably around the fixing unit 112 of the body unit 11. To this end, the body unit 11 may further include a rotary driving unit 113 such as a motor and a gear.
(15) The C-arm gantry 12 may include the C-arm 121 and the fixing unit 122. The C-arm 121 has a curved C-shaped arc shape with one side opened and specifically, when the C-arm 121 is vertically erected and radiates heat, the C-arm is symmetrical with a plane where the isocenter is located and is open toward the isocenter. The fixing unit 122 of the C-arm gantry 12 mechanically couples at least a part of an outer surface of the C-arm 121 to the fixing unit 112 of the body unit 11. Desirably, the fixing unit 122 of the C-arm gantry 12 may be coupled to the fixing unit 112 of the body unit 11 on the outer surface of the center position of the curvature of the arc of the C-arm 121. Moreover, the fixing unit 122 of the C-arm gantry 12 may be pivotably and rotatably fastened with the fixing unit 112 of the body unit 11. In this case, the fixing unit 122 of the C-arm gantry 12 may be rotatably fastened with the body unit 11 with respect to an axis connecting a portion which is fixed to the body unit 11 and the isocenter.
(16) The therapeutic radiation unit 13 may support a therapeutic radiation emitting head 132 which emits therapeutic radiation from a head support 131. In this case, the therapeutic radiation unit 13 may determine a position of the therapeutic radiation emitting head 131 in a specific position and at a specific angle on an inner surface of the C-arm 121 such that a dose of the therapeutic radiation emitted from the therapeutic radiation emitting head 132 is effectively applied to a target tissue at the isocenter, as indicated by the control unit 102 according to a predetermined dose plan.
(17) According to an example embodiment, the therapeutic radiation emitting head 132 may emit X-rays, gamma rays, high-energy electrons, high-energy protons, or other high energy fine particles.
(18) According to an example embodiment, the therapeutic radiation emitting head 132 may include any one of an X-ray generating device, a radioisotope source, and a linear accelerator. According to another example embodiment, the therapeutic radiation emitting head 132 receives high energy fine particle beam generated by being accelerated in the particle accelerator installed outside the image augmentation device 10 to emit the high energy fine particle beam. Further, according to an example embodiment, the therapeutic radiation emitting head 132 may be implemented by a multi-leaf collimator (MLC). When the multi-leaf collimator is used, the therapeutic radiation emitting head 132 may internally form the beam so that the radiation energy may be more efficiently transmitted.
(19) The image augmentation device 10 may further include a therapeutic radiation source unit 14 and a therapeutic radiation detecting unit 15, which are mounted on the inner surface of the C-arm 121 to be opposite to each other with the isocenter therebetween. According to an example embodiment, the therapeutic radiation source unit 14 may include an X-ray source and the therapeutic radiation detecting unit 15 may include an X-ray detecting sensor. The therapeutic radiation source unit 14, the therapeutic radiation detecting unit 15, and the reading unit 103 may configure a computed tomographic imaging device (CT).
(20) Even though not illustrated, the therapeutic radiation source unit 14 may include at least one camera.
(21) Here, the camera may be used to monitor the change in an area of the reflection region to compare the reflection region of the body surface adhering light reflector and the designed beam field region.
(22) Further, a plurality of cameras may be used to monitor the changes in the three-dimensional translation and rotation of the patient's body surface to which the light reflector is attached.
(23) The bed unit 101 is configured so that the patient may lay thereon, and may include wheels or a track on a portion which is in contact with the floor according to an example embodiment.
(24) The control unit 102 may control the driving of the fixing unit 112 and the rotating unit 113 of the body unit 11, and a therapeutic radiation emitting direction and intensity of the therapeutic radiation source unit 14 in accordance with a diagnosis plan input in advance and control the driving of the fixing unit 112 and the rotating unit 113 of the body unit 11, and a position, an angle, a direction, and beam formation of the therapeutic radiation unit 13 in accordance with a dose plan input in advance.
(25) The reading unit 103 may analyze a signal detected by the therapeutic radiation detecting unit 15 to reconstruct the signal as a CT image.
(26) In the meantime, the maintaining of accurate pretreatment setup prior to the radiation therapy and the accuracy of the intra-fraction patient setup during the radiation therapy are very important factors which determine the results of the radiation therapy.
(27) In order to satisfy the above-mentioned requirements, various monitoring methods such as a patient alignment method using a laser system and a patient alignment method using a stereovision technology are proposed.
(28) However, the methods are not very helpful to improve the accuracy due to technical limitations and lack of verification.
(29) In order to transmit an accurate dose to the tumor, it is ideal to perform the setup based on the position of the tumor.
(30) However, when real-time monitoring is performed using radiations such as X-ray or CT for the above-mentioned purpose, an imaging dose more than necessary may be transmitted to the patient, which may cause problems.
(31) Currently, even though in clinical practices, a beam field-based patient setup is performed as an alternative, it is unreliable to ensure the accuracy because the patient setup is performed depending on the user's experience (visually confirmed by human) without performing quantitative verification.
(32) That is, there are no quantitative evaluation method and no commercially available monitoring device for the beam field based patient setup which is clinically used, but the beam field based patient setup is performed only depending on the experience and knowhow of radiographers.
(33) Further, only one checking process is provided before the radiation therapy, but appropriate preparations for changes during the treatment are not proposed.
(34) Therefore, in order to solve the above-mentioned problems, the present disclosure is to provide a beam-field based patient setup method and system using a light field and a body surface adhering light reflector.
(35) Specifically, according to the present invention, it is possible to provide a method and a device in which a light field reflector, having the same size and the same shape as a beam field set at the time of establishing a treatment plan, is attached to a body surface of a patient and then a light field is emitted from a gantry head onto a region of the light field reflector attached to the body surface of the patient, a reflected light field is acquired using a camera based imaging device, and quantitative analysis is performed to analyze whether a radiation therapy beam that is incapable of visual observation is precisely incident on the body surface of the patient through real-time comparison of the reflected light field with the beam field as set at the time of establishing a treatment plan.
(36) Prior to specific description of the present invention, a light reflector which is applied to the present invention will be described.
(37) The light reflector may include an object which emits (reflects) light based on light incident on the light reflector.
(38) Here, light which is provided to the light reflector may be separately provided in the radiation emitting head 14 or may be provided in at least one camera 33.
(39) Specifically, in the present invention, a light reflector which is attached to a body surface of a patient to be treated may be desirably used.
(40)
(41) Referring to
(42) Referring to
(43) Referring to
(44) Referring to
(45) Referring to
(46) In the present invention, a method which identifies an emission region of invisible radiation in real time through use of a light reflector is described with reference to
(47) That is, a region to which radiation is emitted is set in advance and a light reflector having a shape corresponding to the set region is attached to the patient's body.
(48) Thereafter, light is projected in the same direction as radiation emitted by the emitting head (gantry head) 14 onto the set region and thus the light reflector emits (reflects) light.
(49) Whether the region to which radiation is emitted and a region of the light reflector which emits (reflects) light coincide with each other may be identified by the display device 20 in real time.
(50) When the regions do not slightly coincide with each other, it is possible make an adjustment such that the region of the light reflector to which light is projected coincides with the region to which the radiation is emitted by changing a fixed position of the patient.
(51) Further, when the region to which the radiation is emitted and a region of the light reflector which emits (reflects) light are significantly different, the radiation therapy may be stopped.
(52) The determination of whether the region to which radiation is emitted and the region of the light reflector which emits (reflects) light coincide with each other may also be double-checked before the radiation therapy and during the radiation therapy.
(53) Accurate pretreatment setup prior to the radiation therapy and the maintaining of the accuracy of the intra-fraction patient setup during the radiation therapy are very important factors which determine the results of the radiation therapy. There is an advantage in that the setup of the patient in a planning step and a treatment step may be accurately performed according to the method proposed by the present invention.
(54)
(55)
(56) Further,
(57) Further,
(58) Further,
(59) Specifically,
(60) Hereinafter, for the convenience of description, the region to which the radiation is emitted is referred to as a radiation therapy region 31 and the region of the light reflector which emits (reflects) light using the emitted light is referred to as a light reflector region 32.
(61) Referring to
(62) The light reflector region 32 may be formed to have completely the same area as the radiation therapy region 31 or to be smaller than the radiation therapy region 31.
(63)
(64) Further,
(65) Further,
(66) However, when the light reflector region 32 coincides with 80% or more of the radiation therapy region 31, it is possible to adjust the light reflector region 32 to be included in the radiation therapy region 31 by adjusting the patient or the equipment.
(67) How much the light reflector region 32 is included in the radiation therapy region 31 may be determined by the following Equation 1.
(68)
(69) Further, a specific method of determining whether the light reflector region 32 is included in the radiation therapy region 31 according to the present invention will be described with reference to the above description.
(70)
(71) Referring to
(72) The camera 33 of
(73) Further, using the camera 33 attached to the radiation emitting unit (gantry head) 14 as illustrated in
(74)
(75) Further, a plurality of cameras may be used to monitor changes in the three-dimensional translation and rotation of the patient's body surface to which the light reflector is attached.
(76)
(77) Referring to
(78) The two cameras 33a and 33b do not need to be attached to the radiation emitting unit (gantry head) 14, which is different from the one camera 33 of
(79) Referring to
(80)
(81)
(82)
(83) Further, according to the example embodiment of the present invention, a respirational therapy may also be performed by monitoring the light reflection region.
(84)
(85) Referring to
(86) Referring to (a), (b), and (c) regions of
(87) Therefore, when the breath of the patient is monitored and a respiratory signal deviates from the specific setup range, a method of concluding that the light reflector region 32 leaves the radiation therapy region 31 and stopping the radiation therapy may be additionally used.
(88) In the meantime, a method for maintaining the accurate patient setup prior to the radiation therapy and the accuracy of the patient setup during the radiation therapy will be described in detail based on the above-mentioned method for determining whether the light reflector region 32 deviates from the radiation therapy region 31.
(89)
(90) Referring to
(91) In both the steps of aligning a patient prior to the treatment and the steps of monitoring patient setup during the therapy, the method for determining whether the light reflector region 32 deviates from the radiation therapy region 31 may be applied.
(92) Referring to
(93) Next, after checking translation or rotation of a patient's body surface, a correction related to the treatment plan field is performed in step S100.
(94) That is, it is confirmed whether the light reflector region 32 is mapped to the radiation therapy region 31 by the method described with reference to
(95) Moreover, a step of further checking whether the reflection region (light field region) is included in 100% of the planned radiation region (beam field region) is performed in step S130.
(96) When the reflection region (light field region) is included in 100% of the planned radiation region (beam field region) in step S130, the patient setup before treatment is completed and the radiation therapy starts in step S150.
(97) Otherwise, a step of checking the accuracy of the patient setup and modifying the patient setup is performed in step S140 and step S130 is performed again.
(98) When the steps of aligning a patient prior to the treatment above the line S3 are completed, the steps of monitoring the patient setup during the treatment below the line S3 may be performed.
(99) In the steps of monitoring patient setup during the treatment, first, it is determined whether the reflection region (light field region) is included in 100% of the planned radiation region (beam field region) in step S200.
(100) When the reflection region (light field region) is included in 100% of the planned radiation region (beam field region) in step S200, the radiation is emitted in step S210, otherwise, a step of stopping the radiation therapy and modifying the patient setup in real time is performed in step S220.
(101) After step S210, a step S230 of determining whether all therapeutic dose is emitted is performed in step S230 and when all therapeutic dose is emitted, the reflection region monitoring is completed in step S240, otherwise, the step S200 is performed again.
(102) Therefore, when the alignment method and system using a light field and a body surface adhering light reflector according to the present invention as above mentioned are applied, it is possible to attach a light reflector having the same size and the same shape as a beam field set at the time of establishing a treatment plan to a body surface of a patient and then emit a light field from a gantry head onto a light field reflector attached to the body surface of the patient, continuously acquire the reflected light field using a camera based imaging device, and quantitatively compare and analyze whether a radiation therapy beam that is incapable of visual observation is precisely incident on the body surface of the patient through real-time comparison of the reflected light field with the beam field set at the time of establishing a treatment plan for the patient.
(103) Further, according to the present invention, quantitative evaluation may be provided by a real-time analysis system and an error caused by a human may be prevented.
(104) Further, according to the present invention, it is possible to identify not only setup errors prior to the radiation therapy, but also errors generated during the therapy in real time, so that it is very helpful to improve the results of the radiation therapy.
(105) When the method and the monitoring system proposed by the present invention are used, quantitative analysis which was not possible by the human-dependent methods of the related art is possible and the monitoring is allowed even during the radiation therapy, so that it may be very helpful to improve the results of the radiation therapy.
(106) Further, according to the present invention, in addition to the clinical advantages, a cost for the development is very small and in actual clinical application, there is no increase in an amount of work given to the user and increase in the treatment time, so that it may be very advantageous for commercialization.
(107) As described above, the detailed description of the example embodiments of the disclosed present invention is provided such that those skilled in the art implement and carry out the present invention.
(108) While the invention has been described with reference to the preferred embodiments, it will be understood by those skilled in the art that various changes and modifications of the present invention may be made without departing from the spirit and scope of the invention. For example, those skilled in the art may use configurations disclosed in the above-described example embodiments by combining them with each other. Therefore, the present invention is not intended to be limited to the above-described example embodiments but to assign the widest scope consistent with disclosed principles and novel features.
(109) The present invention may be implemented in another specific form within the scope without departing from the essential feature of the present invention. Therefore, the detailed description should not be analyzed in a limited fashion but should be considered as providing examples of the present invention. The scope of the present invention should be determined by rational interpretation of the appended claims and all changes are included in the scope of the present invention within the equivalent scope of the present invention. The present invention is not intended to be limited to the above-described example embodiments but to assign the widest scope consistent with disclosed principles and novel features. Further, claims having no clear quoting relation in the claims are combined to configure the embodiment or may be included as new claims by correction after application.