1. Field of the Invention
The present invention relates to an apparatus for X-ray treatment and a treatment method using the apparatus. More particularly, the present invention relates to an apparatus and a method which can prevent the destruction of the normal tissue with a new technique called MMRT (Microbeam Modulated Radiation Therapy).
2. Description of the Related Art
Disadvantageously, X-rays in an X-ray treatment are irradiated to any normal tissue other than a lesion because the X-rays are irradiated to the lesion through the normal tissues and the lesion moves by the breathing and other motion of the patient also. Various kinds of measures are effected for this problem.
Japanese Patent No. 3,790,481 discloses a radiation treatment apparatus which comprises a radiation generator irradiating X-rays for treatment, two radiation sources irradiating X-rays for inspecting, two or more detectors, an image forming apparatus and an analyzer. In the radiation treatment apparatus, the aperture shape of the collimator is adjusted according to the consequence of calculating the three-dimensional position and shape of the pursuit object part from the three-dimensional image of the inspection object part. The apparatus pursuits the radiation field for treatment like statement above corresponding to the treatment object part. The apparatus cannot irradiate the X-ray until the setting of the aperture shape of the collimator is completed because it makes pursuit the moving treatment object part by changing the aperture shape of the collimator. In this apparatus, because the geometric accuracy to the radiation field depends on the setting accuracy of the aperture shape of the collimator, it is difficult to realize rapidity and high resolution together.
Japanese Patent No. 3,881,199 discloses the radiation treatment apparatus and the radiodiagnosis apparatus which can efficiently treat and diagnose with the radiation generator which can lead the breathing of the patient to be easy to take the timing and synchronization of the radiation. However, the apparatus cannot pursue the moving treatment object part in real time.
Japanese Patent No. 3,748,531 discloses the radiation therapy apparatus which can reduce the exposure dose to normal tissues by irradiating selectively to a tumor in the soma with large dosage. In the patent, the three tumor markers embedded in the vicinity of the tumor are captured by the fluoroscope from two directions. The captured two-dimensional transillumination images are digitized, and are performed template matching by the gray-level normalization cross correlation method between the digitized images and the template images of tumor markers registered beforehand for the predetermined frame in real time to calculate the two-dimensional coordinate of three tumor markers with higher correlation degree on digitized fluoroscopy images. The position of the isocenter and the three-dimensional coordinate of three tumor markers at least are calculated based on the calculated two-dimensional coordinate of three tumor markers, compensating for the difference from the position of isocenter in the original planning. However, it is difficult to improve the rapidity any further in this radiation therapy apparatus, because the rapidity of the continuous radiation is limited by the place recognition of the tumor markers and the settling time of the collimator. Even more particularly, in the case of radiation to the edge part of the tumor, it is difficult to avoid the normal tissues because the collimator is used, and the normal tissues are damaged.
Japanese Patent No. 3,053,389 discloses the moving body pursuit irradiating apparatus which is composed of a first X-ray fluoroscope, a second X-ray fluoroscope, a first and a second recognition processing sections, a central arithmetic processing section and an irradiating control section. The first X-ray fluoroscope captures the images of a tumor marker embedded in the vicinity of the tumor from a first direction, and the second X-ray fluoroscope captures the images of the tumor marker from a second direction, and the captured two-dimensional transillumination images are digitized. The first and second recognition processing sections calculate the first and the second two-dimensional coordinate of the tumor marker by the gray-level normalization cross correlation method. The central arithmetic processing section calculates the three-dimensional coordinate of the tumor marker from two-dimensional coordinate calculated by the first and second recognition processing sections. The irradiating control section controls the radiation of the treatment beam by the Linac based on the three-dimensional coordinate of the tumor marker. Thus this apparatus can reduce the exposure dose to normal tissues by irradiating selectively to the moving tumor in the soma with large dosage. However, it is difficult to improve the rapidity any further in this radiation therapy apparatus, because the rapidity of the continuous radiation is limited by the position recognition of the tumor markers and the settling time of the collimator. Even more particularly, in the case of radiation to the edge part of the tumor, it is difficult to avoid the normal tissues because the collimator is used, and the normal tissues are damaged.
Japanese Unexamined Patent Application Publication No. 2003-523220 (U.S. Pat. No. 6,144,875) discloses an apparatus and method for performing treatment on an internal target region while compensating for breathing and other motion of the patient. The apparatus comprises a first imaging device for periodically generating positional data about the internal target region and a second imaging device for continuously generating position data about one or more external markers adapted to be attached to the patient's body or any external sensor. The apparatus further comprises a processor that receives the positional data about the internal target region and the external markers in order to generate a correspondence between the position of the internal target region and the external markers and a treatment apparatus that directs the treatment towards the position of the target region of the patient based on the positional data of the external markers. However, it is difficult to improve the rapidity any further in this radiation therapy apparatus, because the rapidity of the continuous radiation is limited by the position recognition of the tumor markers and the settling time of the collimator. Even more particularly, in the case of radiation to the edge part of the tumor, it is difficult to avoid the normal tissues because the collimator is used, and the normal tissues are damaged.
Each previously described apparatus includes the following problems. The patient's mental and physical burdens are heavy because it is not possible to irradiate continuously and it takes time for the treatment. The accuracy of verification to the consequence of the X-ray treatment is inferior, and the proceeding of verification is complicated. Because the diameter of the X-ray beam cannot be thin, it is difficult to completely remove tumors without damaging the normal tissues. As for the radiation direction of the apparatus, the gantry type cannot irradiate to the tumor from the arbitrary direction and the optimum angle.
It is an object of the present invention to provide the X-ray treatment apparatus which can pursue the moving tumor in real time, and can perform rapidly X-ray treatment along the shape of the object tumor with high accuracy without damage to the normal tissues by the high power and thin X-ray beam.
In a first aspect in accordance with the present invention, an X-ray treatment apparatus irradiates X-rays which intersect and penetrate a lesion from different directions to a patient who lies on a couch. The X-ray treatment apparatus includes a low energy X-ray generator and a marker sensor which detect a position of a marker fixed in the patient to the couch while keeping the predetermined position, the marker sensor is composed of an image sensor corresponding to the low energy X-ray generator, a couch operative means to make change the position and posture of the couch, an X-ray source for treatment controlling the profile and the dosage of the X-ray beam by deflecting the electron beam, an X-ray sensor for treatment detecting the X-ray which is irradiated from the X-ray source for treatment and penetrates the lesion, an X-ray source operative means to support the X-ray source and to control the position and posture of the X-ray source for treatment, a central processing unit which outputs the control signal to the X-ray source for treatment and other operative means after calculating the profile and the dosage of the X-ray source for treatment according to the position of the lesion specified by the output of the marker sensor based on the treatment planning, moreover the central processing unit modifies the treatment planning according to the output data of the X-ray sensor for treatment and outputs the next control signal to the X-ray source for treatment and other operative means. According to this X-ray treatment apparatus, because the marker is fixed in the patient while keeping the predetermined position to the lesion, the position of the lesion is specified by detecting the marker, the X-ray source for treatment can accurately irradiate to the lesion.
In a second aspect in accordance with the present invention, an X-ray treatment apparatus includes preferably an X-ray source operative means which supports an X-ray source for treatment in a head of six axis or seven axis robot arm. By this, the X-ray treatment from a wide solid angle toward the lesion is enabled.
In a third aspect in accordance with the present invention, an X-ray treatment apparatus includes preferably an X-ray source operative means which is a gantry or a toroidal rotational structure such as Calculated Tomography, supporting an X-ray source for treatment, deciding freely the direction of the radiation cooperating with the motion of the couch.
In a fourth aspect in accordance with the present invention, an X-ray treatment apparatus includes preferably an X-ray source for treatment comprising an X-ray target tube array which is composed of a plurality of the target tubes generating a thin beam of the diameter from 1 mm to 10 mm, and the accurate treatment is possible by using the X-ray treatment apparatus.
In a fifth aspect in accordance with the present invention, an X-ray treatment apparatus includes preferably an X-ray source for treatment which the activity of an X-ray target tube in the X-ray source is selected according to a treatment planning. The accurate treatment to the complicated shaped lesion is enabled by the X-ray treatment apparatus because a profile and condition of the X-ray for treatment which can be freely changed in real time by selecting the condition of the activity of each the X-ray target tube. Moreover, the X-ray treatment apparatus can improve the quality of treatment and shorten the treatment time.
In a sixth aspect in accordance with the present invention, an X-ray treatment apparatus includes preferably marker sensors which are composed of two low energy X-ray generators and image sensors corresponding to the low energy X-ray generators, and outputs the image data of the lesion and a marker which is harmless heavy metal for human body. The position of the lesion can be specified in connection with the couch by the X-ray treatment apparatus.
In a seventh aspect in accordance with the present invention, an X-ray treatment apparatus includes preferably two low energy X-ray generators and image sensors corresponding to the low energy X-ray generators, both two low energy X-ray generators and image sensors are installed in a gantry.
In an eighth aspect in accordance with the present invention, an X-ray treatment method using the X-ray treatment apparatus includes the steps of detecting a position of a marker by a marker sensor, irradiating high energy X-rays for treatment to a lesion according to a treatment planning, detecting a penetrated high energy X-ray by an X-ray sensor for treatment, modifying the treatment planning according to the result, performing the next radiation with the modified treatment planning. The data of the X-ray sensor is used for the verification after the treatment also.
In a ninth aspect in accordance with the present invention, an X-ray treatment method using the X-ray treatment apparatus includes preferably the steps of modifying a beam profile, a dosage and an radiation direction of an X-ray for treatment according to the latest data of the image data of the X-ray sensor for treatment or/and the image data of marker sensor. By this, the cyclic treatment is enabled accurately while changing the condition of the radiation, and reduces the patient's mental and physical burdens.
In a tenth aspect in accordance with the present invention, an X-ray treatment apparatus includes preferably an X-ray sensor for treatment detecting the high energy X-ray which is installed in the couch.
The marker is fixed in the vicinity of a tumor in the patient while keeping the predetermined position to the couch. The material of the marker is heavy metal such as Au or Pt which is safe for the human body and absorbs X-rays well.
The marker sensor includes two low energy X-ray generators 3L, 3R which are installed in the couch 2 and are turned to the tumor to detect the position of a marker, and two image sensors 4L, 4R corresponding to each low energy X-ray generator. The marker sensor collects the information about the tumor which keeps the predetermined position to the marker and the three-dimensional position of the marker to the couch 2.
The position of couch 2 is changed by the robot 6 which is the couch position attitude control means. The robot 6 supporting the couch 2 can raise or lower to the Z axial direction in
The marker sensor specifies the three-dimensional position of the marker to the couch 2.
The X-ray generator 1 for treatment can control the profile and the intensity of the X-ray for treatment. The detailed configuration of the X-ray generator is described below in the first embodiment and the second embodiment of the X-ray source.
The X-ray sensor 10 for treatment installed in the couch 2 detects the X-ray for treatment which penetrated the tumor, obtains the profile of the X-ray.
The robot 5 supports X-ray generator 1 for treatment with the six or seven axis robot arm, and controls the position and direction of the X-ray generator 1 for treatment to the tumor.
The robot 6 is installed on the floor so that it is possible to adjust the relative position to the robot 5. The robot 6 can raise or lower to the Z axial direction in
The X-rays of the low energy X-ray generators 3L, 3R for detecting marker are detected respectively by the sensors 4L, 4R, the output signals of the sensors 4L, 4R are taken in CPU 8 through the interface 8b, after image processing by the CPU 8, the images are displayed on the monitors 9-4L and 9-4R, and the data of the images are accumulated in the memory 7.
In this embodiment, CPU 8 calculates the suitable intensity, direction and time to treat for the tumor which the position is specified according to the original treatment planning or the modified treatment planning by the data of the marker sensors 4L, 4R. CPU 8 instructs the operation of the robot 5 and instructs the X-ray generator 1 to operate after completing the preparation of the robot 5. The doctor can observe the situation of the treatment with the monitor unit 9.
The moving tumor can be detected by irradiating to the marker which is embedded in the vicinity of the tumor. The X-ray generators 3L, 3R for detecting marker and the marker sensors 4L, 4R are installed in the couch 2. The energy level of the X-ray generators 3L, 3R are set in low level so as not to influence the normal tissues harmfully if more than 100,000 pulses radiations. The X-ray for detecting marker is irradiated with from two perpendicular directions, and penetrates the patient. The image of the embedded marker is captured by the marker sensors 4L, 4R such as flat panels installed in the couch 2. The X-ray sensor 10 for treatment is installed in the couch 2 also, and detects the intensity, radiation position and direction of the X-ray for treatment. The detected data is applied to the adjustment of the next radiation. The detected data is an important data to verify the result after the treatment also. The detected data facilitates the verification after the treatment and reduces the burden of the doctor.
The treatment using the X-ray treatment apparatus in accordance with an embodiment of the present invention is performed based on the original treatment planning which is decided by the doctor synthetically with the data obtained by the sensors of the X-ray treatment apparatus and the data obtained by other inspection apparatus such as a calculated tomography. The original treatment planning includes the direction of the X-ray beam, the profile of the X-ray beam and the intensity of the X-ray beam in a series of radiation. The steps of the treatment are as follows: (1) The X-ray generators for detecting marker 3L, 3R are started, the tumor and the domain including the markers are irradiated with the low energy X-ray, and the position of the marker is detected, and the captured image data of the marker is compared with the data of the original treatment planning; (2) The X-ray generator 1 for treatment is started, and the high energy X-rays which have the profile of the beam and the intensity determined in the treatment planning are irradiated to the tumor; (3) The radiation of the X-ray generator 1 is detected by the X-ray sensor 10 for treatment at the same time; and (4) The conditions such as the intensity and the profile of the X-ray beam for the next radiation are adjusted according to the results of the steps of (1) and (3). In the next radiation the steps of (1)-(3) are repeated. As mentioned above, the method for treatment using the X-ray treatment apparatus in accordance with an embodiment of the present invention can perform the optimal treatment with adjusting in real time the profile and the dosage of the X-ray for treatment according to the image data with the X-ray sensor 10 and the X-ray sensor 4L, 4R or the combinations of these image data.
The X-ray source for treatment used with the X-ray treatment apparatus in accordance with an embodiment of the present invention has been developed to fit a new technique called MMRT by the same inventor as the present invention, and it was already filed on Dec. 10, 2008 as title of the invention “X-ray generator” (U.S. patent application Ser. No. 12/332,100).
This X-ray source is explained in association with the treatment apparatus in accordance with an embodiment of the present invention as follows.
As shown in
FIG. 2D(a) shows a second embodiment of the X-ray source used with X-ray treatment apparatus of the present invention, FIG. 2D(b) is a sectional view of the X-ray target tube array 205 taken along the line A-A of FIG. 2D(a).
The X-ray target tubes 104 (i, j) are arranged in a matrix shape as shown in FIG. 2D(b), even more particularly, the inlet aperture plane is placed radially so that the electrons deflected by the quadrupole magnet are horizontally incident on the inlet aperture for a medical axis of the X-ray target tube 104 (i, j). Thus, the X-ray are irradiated radially from the X-ray target tube array 205, the radiation field is formed as shown
Thus, because the X-ray treatment apparatus using the second embodiment of the X ray source can shorten the treatment time than the X-ray treatment apparatus using the first embodiment of the X ray source without moving the X-ray generator or the couch, the suitable X-ray treatment apparatus for MMRT can be provided.
The moving body pursuit technique which trucks in real time the markers embedded in the body moving due to breathing and others is a well-known technique as shown in U.S. Pat. No. 6,307,914 (hereinafter referred to as Hokkaido University method). In the present invention, the improved Hokkaido University method is utilized for detecting a marker to the couch 2. The Hokkaido University method uses the X-ray tube 31 as shown in
An embodiment of the X-ray treatment apparatus with the present invention can be transformed within the present invention variously. The example of six axis or seven axis robot arm was shown, but the robot of other form can be utilized. The CT of a gantry or the circular rotational structure can be considered to be kind of the robot with wide denotation, the X-ray source operative means should be interpreted more widely. The example which the X-ray target tubes were drawn up in the X-ray generator for treatment was shown, but, for example, the array of other shapes such as the spiral is considered, too. The examples using the heavy metal which is harmless to a human body as a marker and the IC Tag system were shown, but the use of the active signal source of others is considered. The X-ray source was shown as the source for treatment and detecting markers, but other source can be utilized. The X-ray treatment apparatus with the present invention is a medical instrument used for the treatment such as tumors in medical facilities such as hospitals.
Number | Date | Country | Kind |
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2009-075008 | Mar 2009 | JP | national |