Aspects of the current invention relate to gamma ray sensors. Particularly, aspects of the current invention relate to a method and apparatus for detecting tumors tagged with radiopharmaceuticals, for example PET radiopharmaceuticals emitting radiation at 511 keV, for gamma ray and/or proton therapy radioisotope using cadmium zinc telluride (CZT) solid state detectors.
Diagnostic techniques in nuclear medicine typically use radioactive tracers that emit gamma rays from within the body of a patient. These tracers are generally short-lived isotopes linked to chemical compounds that permit specific physiological processes to be studied, and can be given to the patient via injection, via inhalation or orally. In one type of diagnostic technique, for example single photons are detected by a gamma ray sensitive camera, which can view organs from many different angles. The camera builds up an image from the points from which radiation is emitted, and the image is enhanced by a computer and viewed by a physician on a monitor for indications of abnormal conditions.
A more recent development is Positron Emission Tomography (PET), which is a more precise technique using isotopes produced in a cyclotron, in which protons are introduced into the nucleus of the isotope, which results in a deficiency of neutrons (i.e., the isotope becomes proton rich). Positron emission tomography (PET) is a nuclear medicine imaging technique that produces a three-dimensional image or picture of functional processes within the body of the patient. The system detects pairs of gamma rays emitted indirectly by a positron-emitting radionuclide (tracer), which is introduced into the body on a biologically active molecule. Three-dimensional images of tracer concentration within the body are then constructed by computer analysis. In modern scanners, three dimensional imaging is often accomplished with the aid of a computed tomography (CT) X-ray scan performed on the patient during the same session. As can be seen in
For use in such imaging devices, the nucleus of a radioisotope usually becomes stable by emitting an alpha and/or beta particle (or a positron), which may be accompanied by the emission of energy in the form of electromagnetic radiation known as gamma rays. This process is known as radioactive decay.
A positron-emitting radionuclide is introduced in the body of a patient, usually via injection, and accumulates in the target tissue of the body of the patient. As the radionuclide decays, the radionuclide emits a positron, which promptly combines with a nearby electron in the target tissue of the body of the patient, resulting in the simultaneous emission of two identifiable gamma rays in opposite directions, each having an energy of 511 keV. These are conventionally detected by a PET camera and give very precise indication of their origin. PET's most important clinical role is in oncology, with Fluorine-18 (F-18) as the tracer, since it has proven to be the most accurate non-invasive method of detecting and evaluating most cancers. Fluorine-18 is one of several cyclotron producible positron emitters, along with Carbon-11, Nitrogen-13, and Oxygen-15, that are used in PET for studying brain physiology and pathology, in particular for localizing epileptic focus, and in dementia, psychiatry and neuropharmacology studies. These positron emitters also have a significant role in cardiology.
When the biologically active molecule chosen for PET is FDG (fluorodeoxyglucose), an analogue of glucose, the concentrations of tracer images generally give a spatially observable indication of tissue metabolic activity in the form of regional glucose uptake. Tumors may have higher metabolic activity than normal surrounding tissue, and therefore exhibit greater uptake of FDG than they would with normal glucose. With respect to cancer detection and therapy, F-18 in FDG has become very important in detection of cancers having elevated glucose metabolisms and the monitoring of progress in their treatment, using PET. A radioactive product such as F-18 in FDG is known as a radiopharmaceutical. Other types of cancer may show an elevated metabolism of different molecules, which therefore may be synthesized with an appropriate radionuclide.
F-18 has a half-life of approximately 110 minutes, which is beneficial in that it does not pose a long-term environmental and health hazard. For example, after 24 hours, the radioactivity level is approximately 0.01% of the product when freshly produced in a cyclotron. Consequently, there is typically no significant long-term hazard either to the patient or the environment, because the decay rate is rapid and short-term.
Whereas PET cameras are effective in imaging uptake of F-18 in FDG, they are typically too large and ineffective for in situ surgical or radiation treatment settings. There is a need in the art, therefore, for a method and apparatus to timely detect tumor location for accurate treatment without having to resort to reliance on imaging data that is only approximately accurate given the time interruption between imaging and treatment. It may further be beneficial to provide a sensing apparatus for tumor detection and imaging that may be used in the same theater as a treatment apparatus. It may also be beneficial if the sensing apparatus can be used to monitor tumor activity during the treatment process.
in light of the above described problems and unmet needs, aspects of methods and systems for detecting radioisotope concentration, activity and sample volume, are provided.
According to various aspects of the current invention, a gamma ray detector may include a gamma ray detecting rod elongated in one direction to a specified length, and a gamma ray shield encapsulating the rod, the shield having an opening opposite an end of the elongated rod to admit gamma rays substantially parallel to the longitudinal axis of the elongated rod, wherein the longitudinal axis of the rod and the opening are directable toward a volume of gamma ray emitting material observable by the detector on the basis of the length of the elongated rod and the opening in the gamma ray shield.
According to other aspects of the current invention, an apparatus for detecting gamma ray emissions from a tumor may include one or more sensors to image the tumor for guiding a radiation treatment device to selectively deliver a measured dose to the tumor on the basis of the image provided by the sensor.
To the accomplishment of the foregoing and related ends, one or more aspects of the current invention include the features hereinafter fully described and particularly pointed out in the claims. The following description and the annexed drawings set forth in detail certain example features of the one or more aspects. These examples provide, however, but a few of the various ways in which the principles of various aspects may be employed and the described aspects are intended to include all such aspects and their equivalents.
Additional advantages and novel features of these aspects of the invention will be set forth in part in the description that follows, and in part will become more apparent to those skilled in the art upon examination of the following or upon learning by practice of aspects of the invention.
These and other sample aspects of the invention will be described in the detailed description that follow, and in the accompanying drawings, wherein:
In accordance with common practice, some of the drawings may be simplified for clarity. Thus, the drawings may not depict all of the components of a given apparatus (e.g., device) or method. Like reference numerals may be used to denote like features throughout the specification and figures.
Various aspects of methods and apparatuses are described more fully hereinafter with reference to the accompanying drawings. These methods and apparatus may, however, be incorporated in many different forms and should not be construed as limited to any specific structure or function presented throughout this disclosure. Rather, these aspects are provided so that this disclosure will be thorough and complete, and will fully convey the scope of these methods and apparatuses to those skilled In the art. Based on the description herein, one skilled in the art will appreciate that that the scope of the disclosure is intended to cover any aspect of the methods and apparatuses disclosed herein, whether implemented independently of or combined with any other aspect(s) of the disclosure. For example, an apparatus may be implemented or a method may be practiced using any number of the aspects set forth herein. In addition, the scope of the disclosure is intended to cover such an apparatus or method which is practiced using other structure, functionality, or structure and functionality in addition to or other than the various aspects of the disclosure set forth herein. It should be understood that any aspect of the disclosure herein may be incorporated within one or more elements of a claim.
In the PET device shown, the radioactive isotope F-18, which is contained in FDG, emits a positron that reacts with an electron in the tissue of the patient to produce two gamma rays in approximately opposite directions, each having an energy of 511 keV. The apparatus according to various aspects of the current invention, may be used to locate and determine the extent and size of body portions, such as tumors, using one or more gamma ray detectors in a configuration that is less intrusive than a full PET system of the related art, and may therefore also be used contemporaneously, for example, with a therapeutic radiation beam treatment system to guide the beam more accurately than in conventional systems. This greater accuracy may result, for example, from the detection/location/imaging using one or more gamma ray detectors contemporaneously with treatment.
According to various aspects, the detector 100 can function accurately as a spectroscopic gamma energy sensor, particularly when the element 110 is CZT. However, geometric aspects may be considered. In related art use of CZT as a gamma ray detector, the CZT element 110 may be a thin platelet, sometimes arranged in multiples to form arrays for imaging, facing the source of gamma ray emission. Therefore, gamma rays of differing energies may traverse a detector element of substantially the same thickness. While absorption of the gamma ray may generally be less than 100% efficient, higher energy gamma rays will liberate more electron-hole pairs than lower energy gamma rays, producing a pulse of greater height. The spectrum and intensity of gamma ray energies may thus be spectroscopically determined by counting the number of pulses generated corresponding to different pulse heights.
According to various aspects, because higher energy photons may travel greater distance in the CZT rod 110 before complete absorption, it is advantageous for the CZT rod 110 to be greater in length in a direction (i.e., the longitudinal axis direction 121), in order to intersect a volume of a tumor containing the radiopharmaceutical being detected. Gamma rays incident on the CZT rod off axis or transverse to the longitudinal axis direction 121 may not be fully absorbed, and may not be as sensitive at detection as a result. Thus, elongating the CZT rod 110 in the one longitudinal axial direction 121 introduces a degree of collimation and directional sensitivity along the axis direction 121.
The absorption coefficient for 511 keV gamma ray absorption in CZT is μ=0.0153 cm2/gm. The absorption probability as a function of μ, density ρ (=6.34 gm/cm3) and penetration distance h is
P(μ, h)=1−e−μρh.
Therefore, the ratio of absorption in a 10 mm length of CZT to a 1 mm length is
That is, the directional sensitivity for gamma ray detection of CZT at 511 keV along the 10 mm length of the longitudinal axis direction 121 of the detector is nearly 10 times greater than in the 1 mm thick transverse direction. According to various aspects, the ratio of the length of the CZT detector 110 to the diameter of the CZT detector 110 may be anywhere between ⅕ and 1/200 with increments corresponding to the diameter of the CZT detector 110, i.e., ⅕, ⅙, 1/7 . . . 1/200.
Referring to
According to various aspects, in charged particle beam radiation systems, such as proton beam system, a beam 411 may be delivered through a series of focusing and beam bending magnets. A last portion of the beam system may be typically included in a gantry system surrounding the patient 420, in which the beam 411 may be delivered over a semicircle, or even a full circle about the axis 421, where the angular positioning of the gantry, and therefore the direction of projection of the proton beam into the patient 420, may be varied, while always passing substantially through the common coordinate 401, with an additional capability of steering magnets to scan a region around the coordinate 401.
According to various aspects, the array 405 may be similarly mounted on the gantry and aimed so the one or more detectors 100 converge at the same common coordinate 401. The array 405 may be configured about a vertical reference axis that is perpendicular to the horizontal axis 421, and the array 405 may be in a fixed relationship with respect to the portion of the radiation delivery therapy system 410 within the gantry and beam 411. Therefore, both the radiation delivery therapy system 410 and the array 405 may rotate together by the same angle θ about the axis 421 at the common coordinate 401 (e.g., under the control of computer system 450, operating similarly to as described above with regard to rotation of the array 405). Therefore, during contemporaneous operation, both the beam 411 and the collimated apertures of the detectors 100 may have an approximately common intersection point at the tumor.
According to various aspects, the array 405 may further include pairs of detectors 100 (the pairs not being shown in
According to various aspects, the detectors may be arranged with a known relationship to a radiation beam source, with the patient located relatively statically on the imaging/treatment table. A tumor or other body part, for example, may be imaged by first injecting the patient with an appropriate radiopharmaceutical, such as F-18 FDG. An array of detectors 100, as shown in
In an aspect of the disclosure, the array of detectors 100 may have a fixed relationship with respect to the radiation beam delivery system, so that the treatment radiation beam intersects approximately or substantially the same intersection point of the collimated acceptance apertures of the detectors. Thus, in one example implementation, the treatment radiation beam 411 may be made operable only when the array of detectors 100 provide signals to the processor that satisfy criteria for tumor identification and location.
According to various aspects, the computing system 450 may be operatively coupled to the therapeutic radiation beam delivery system 410 (e.g., similarly to as discussed above with regard to array rotation). Thus, the therapeutic beam 411, whether gamma rays, proton beam, carbon beam, or any other suitable form of radiation contemplated for tumor treatment, may be directed to a radiation source (such as a body portion that includes a tumor) on the basis of the real-time imaging data acquired by the detectors 100. Furthermore, since the radiation beam delivery system may be rotated while maintaining the same approximate point of intersection at the tumor location, the beam approach direction may be varied to both minimize the damage to normal tissue surrounding the tumor, while passing through and depositing radiation at the body portion location or along a path passing through that location, depending on the form of radiation used.
According to various aspects, depending on a prescription selected for scanning (e.g., software determined program of operation), a determination may be made at 540 whether scanning and data acquisition is complete. If the scanning is not complete (a NO decision), then the gantry containing the array may be rotated at 550, so that radioactivity level data may be taken again from a different viewing direction. If the scanning process is complete (a YES decision), the computing system may proceed with constructing an image of the body portion in the common coordinate space of the radiation beam delivery system and array at 560. It may be appreciated that the order of determining whether the scanning is complete, and operation of the rotation of the gantry, may be reversed, i.e., steps 540 and 550 may be interchanged in order.
As a result of the above example process, a three dimensional map of a tumor present in the body of a patient may be constructed to guide delivery of therapeutic radiation to the tumor by combination of controlled positioning of the scanning table and positioning of the radiation delivery therapy system by controlled rotation of the gantry and control of the beam energy and intensity.
According to various aspects, the use of the CZT detector 100 for surgical procedures may involve the following: a radioactive tracer agent emitting a high energy gamma photon administered to a patient prior to surgery. The agent may include but not be limited to F-18 FDG, F-18 FLT, F-18 MISO, F-18 Choline, and C-11 Acetate. The agent may be allowed to localize in a body portion, such as the diseased area (e.g., tumor at location 430 in
In another aspect of the disclosure, one or more detectors may be mounted relative to the patient in a movable fixture permitting the one or more detectors to be both translated in one or more orthogonal axes, and to swivel angularly on controlled gimbals. Thus, a single detector, or a plurality of detectors, may be employed with mobility and with less obtrusive invasion of the operating theater to aid a surgeon in accurately locating the tumor for surgical excision of a cancerous node or tissue.
According to various aspects, in a surgical theater, for example, separate from the PET/CT facility, there may arise some error for accurate body portion location resulting from the patient being shifted from one facility to another. Where the patient 420 on an operating table 702 has been infused with a radiopharmaceutical, such as F-18 FDG, a detector 100, which may be hand held r mounted in proximity to the patient, may be directed at the patient to directionally detect the tumor 430, which may be a source of radioactive emission. The detector may be coupled to a processing system 750, which may include an indicator, either visual or audible, of the level of radiation measured by the detector 100 to confirm that diseased tissue is being excised from the patient. For example, an audible cue proportional to the detected radiation intensity may be a frequency or an amplitude signal. The cue may be used to guide the surgical procedure to more precisely locate the body portion of the patient (e.g., a tumor). Additionally, the detector 100 may be equipped with a light beam, such as a collimated laser pointer (not shown), to indicate a point on the patient 420 where the detecting “beam” aperture intersects the patient's skin or tissue. The excision instrument and the detector 100 may be integrated into a single hand-held sensing/excision instrument to provide detection feedback to the surgeon as the patient is being operated on.
In another aspect of the disclosure, the detector 100 and scalpel (or other excision instrument) may be manipulated robotically via the processing system 750, similarly to as described above with regard to array rotation. Robotic surgery has advanced to a state of the art where surgical trauma may be minimized and accuracy for more precise tumor removal and preservation of healthy tissue is improved.
Computer programs (also referred to as computer control logic) are stored in main memory 908 and/or secondary memory 910. Computer programs may also be received via communications interface 924. Such computer programs, when executed, enable the computer system 900 to perform various features in accordance with aspects of the present invention, as discussed herein. In particular, the computer programs, when executed, enable the processor 910 to perform such features. Accordingly, such computer programs represent controllers of the computer system 900.
In aspects of the invention implemented using software, the software may be stored in a computer program product and loaded into computer system 900 using removable storage drive 914, hard drive 912, or communications interface 920. The control logic (software), when executed by the processor 904, causes the processor 904 to perform various functions in accordance with aspects of the invention as described herein. In another variation, aspects of the invention may be implemented primarily in hardware using, for example, hardware components, such as application specific integrated circuits (ASICs). Implementation of the hardware state machine so as to perform the functions described herein will be apparent to persons skilled in the relevant art(s).
In yet another variation, aspects of the invention may be implemented using a combination of both hardware and software.
The above description is provided to enable any person skilled in the art to fully understand the full scope of the disclosure. Modifications to the various configurations disclosed herein will be readily apparent to those skilled in the art. Thus, the claims are not intended to be limited to the various aspects of the disclosure described herein, but is to be accorded the full scope consistent with the language of the claims, wherein reference to an element in the singular is not intended to mean “one and only one” unless specifically so stated, but rather “one or more.” Unless specifically stated otherwise, the term “some” refers to one or more. A claim that recites at least one of a combination of elements (e.g., “at least one of A, B, or C”) refers to one or more of the recited elements (e.g., A, or B, or C, or any combination thereof). All structural and functional equivalents to the elements of the various aspects described throughout this disclosure that are known or later come to be known to those of ordinary skill in the art are expressly incorporated herein by reference and are intended to be encompassed by the claims. Moreover, nothing disclosed herein is intended to be dedicated to the public regardless of whether such disclosure is explicitly recited in the claims. No claim element is to be construed under the provisions of 35 U.S.C. §112, sixth paragraph, unless the element is expressly recited using the phrase “means for” or, in the case of a method claim, the element is recited using the phrase “step for.”
This application claims priority from U.S. Patent Application No. 61/531,805, titled “CZT Sensor for Tumor Detection and Treatment,” filed on Sep. 7, 2011, and which is incorporated herein by reference in its entirety.
Number | Date | Country | |
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61531805 | Sep 2011 | US |