The present invention relates to a radiation therapy and imaging hybrid device that can reduce, when performing monitoring for detecting annihilation radiations occurring from an irradiation field due to radiation (also referred to as beam) irradiation in radiation therapy which is conducted by irradiating an affected area with X-rays or a particle beam, the incidence of nuclear fragments occurring from beam irradiation on detectors to enable measurement of annihilation radiations and three-dimensional imaging of the irradiation field immediately after irradiation or even during irradiation.
Positron emission tomography (PET) is attracting attention as an effective test method for earlier diagnosis of cancer. In PET, a compound labeled with a trace amount of positron emitting nuclei is administered and annihilation radiations emitted from inside the body are detected to create an image of metabolic functions such as sugar metabolism and check for a disease and its extent. PET devices for practicing it have been put into actual use.
The principle of PET will be described below. A positron emitted from a positron emitting nuclide due to positron decay is annihilated with an ambient electron to produce a pair of 511-keV annihilation radiations, which are measured by a pair of radiation detectors based on the principle of coincidence counting. The position of the nuclide can thus be located on a single line (line of coincidence) that connects the pair of detectors. An axis from the patient's head to feet will be defined as a body axis. The distribution of nuclei on a plane that perpendicularly crosses the body axis is determined by two-dimensional image reconstruction from data on lines of coincidence on the plane, measured in various directions.
Early PET devices therefore have had a single-ring detector in which detectors are closely arranged in a ring shape on a plane to be the field of view so as to surround the field of view. With the advent of a multi-ring detector which includes a lot of single-ring detectors closely arranged in the direction of the body axis, the two-dimensional field of view has subsequently been extended to three dimensions. Since the 1990s, 3D mode PET devices have been actively developed which perform coincidence measurement even between detector rings with a significant improvement in sensitivity.
For cancer detected by the PET diagnosis or the like, treatments have a critical role. Approaches other than surgical operations and medication include radiation therapy of irradiating the affected area with radiations such as X-rays and gamma rays. In particular, particle radiotherapy of irradiating only a cancerous area with a heavy particle beam or proton beam is attracting much attention as a method both with an excellent treatment effect and a sharply concentrated irradiation characteristic with respect to the affected area. Among the methods of particle beam irradiation is conventional bolus irradiation where the irradiating beam is spread out to the shape of the affected area. In addition, spot scanning irradiation is under study, where the affected area is scanned with a pencil beam according to its shape etc. In any case, the directions and dosages of the irradiation beam are precisely controlled according to a treatment plan that is thoroughly calculated based on X-ray CT images or the like obtained separately.
The patient positioning accuracy is the key to administer treatment exactly according to the treatment plan. The irradiation field is often positioned based on X-ray images. In general, X-ray images fail to provide a sufficient contrast between tumor and normal tissues, and it is difficult to identify a tumor itself for positioning. In addition to such misalignment of the irradiation field at the time of patient setup, other problems have been pointed out such as a change in the size of the tumor from the time of creation of the treatment plan, and respiratory and other variations of the tumor position. Under the present circumstances, it is difficult to accurately identify whether irradiation is performed according to the treatment plan. Even if the actual irradiation field deviates from the treatment plan, it is not easy to detect.
To solve the foregoing problems, attention is being given to a method of imaging the irradiation field in real time using PET techniques. In the method, no PET medicine is administered. Instead, annihilation radiations caused by particle beam irradiation or X-ray irradiation through a projectile fragmentation reaction, target fragmentation reaction, and photonuclear reaction are rendered into an image by using the principle of PET. Therapy monitoring is said to be possible since the positions of occurrence of annihilation radiations has a strong correlation with the dose distribution of the irradiation beam. (W. Enghardt, et al. “Charged hadron tumour therapy monitoring by means of PET,” Nucl. Instrum. Methods A 525, pp. 284-288, 2004. S. Janek, et al. “Development of dose delivery verification by PET imaging of photonuclear reactions following high energy photon therapy,” Phys. Med. Biol., vol. 51 (2006) pp. 5769-5783). In heavy particle radiotherapy, direct irradiation of positron-emitting nuclei such as 11C, instead of ordinary stable nuclei such as 12C, can eliminate a mismatch between the positions of occurrence of annihilation radiations and the dose distribution, as well as improve the S/N ratio of PET images.
Device requirements for PET that images an irradiation field in real time (hereinafter, referred to as beam on-line PET) are summarized into the following four points:
1. The detectors not obstruct the treatment beam.
2. The detectors not drop in performance due to nuclear fragments (charged particles and/or neutrons generated by collision of incident particles and target nuclei).
3. PET measurement can be performed immediately after irradiation or even during irradiation for efficient measurement of short life RIs, in order to enhance the precision of PET images and shorten the patient binding time.
4. The irradiation field can be imaged in a three-dimensional fashion.
Concerning the foregoing requirement 2, the incident of nuclear fragments on detectors can radioactivate the scintillators themselves that constitute the detectors. This may lead to the omission of annihilation radiations to be measured and the production of errors in position information. In heavy particle beam irradiation, both charged particles and neutrons occur as nuclear fragments. In proton beam irradiation, neutrons are considered to be dominant. In either case, nuclear fragments are generated with forward directivity with respect to the treatment beam. It has been reported that the forward directivity is accompanied by a wide angle. (N. Matsufuji, et al., “Spatial fragmentation distribution from a therapeutic pencil-like carbon beam in water,” Physics in Medicine and Biology 50 (2005) 3393-3403, S. Yonai, et al., “Measurement of neutron ambient dose equivalent in passive carbon-ion and proton radiotherapies,” Medical Physics 35 (2008) 4782-4792).
As for the requirement 3, the nuclei generated by the radiation irradiation have an extremely short half-life of several tens of seconds to 20 minutes or so. The nuclei can also move inside the living body due to blood flow and other factors. Immediate PET measurement during irradiation is thus desired.
The GSI Laboratory in Germany and the National Cancer Center Hospital East in Japan are making attempts for beam on-line PET by using an opposed gamma camera type PET device in which two PET detectors of flat type are arranged with the bed of a treatment device therebetween. (P. Crespo, et al., “On the detector arrangement for in-beam PET for hadron therapy monitoring,” Phys. Med. Biol., vol. 51 (2006) pp. 2143-2163, T. Nishio, et al., “Dose-volume delivery guided proton therapy using beam ON-LINE PET system,” Med. Phys., vol. 33 (2006) pp. 4190-4197). The opposed gamma camera type device satisfies the requirements 1, 2, and 3 since the detectors can be arranged away from the beam path. However, lines of coincidence measured are highly uneven in direction, some information necessary for image reconstruction missing. This significantly reduces the resolution in directions perpendicular to the detector plane, failing to meet the requirement 4.
There have also been proposed methods of implementing opposed gamma camera type PET device on a rotating treatment gantry in which the treatment beam irradiation device itself rotates around a patient (Japanese Patent Application Laid-Open No. 2008-22994, Japanese Patent Application Laid-Open No. 2008-173299). The requirement 3 is not satisfied, however, since the opposed gamma camera type PET device can be rotated only after beam irradiation, except in some rare cases where beam irradiation is continuously performed from various directions.
The applicant has proposed an open PET device as a method that provides a gap for allowing the passage of a treatment beam and is capable of three-dimensional imaging without rotation of the PET device. In the open PET device, as shown in
The present invention has been achieved in order to solve the foregoing conventional problems. It is an object of the present invention to reduce the incidence of nuclear fragments accompanying beam irradiation on detectors to enable measurement of annihilation radiations and three-dimensional imaging of the irradiation field immediately after irradiation or even during irradiation.
θc=2 sin−1(Wc/(2R)).
Here, R is the radius of the detector ring 20. While
Then, the present invention is directed to operating a shielding structure against nuclear fragments (referred to as a shield) according to the ON and OFF of beam irradiation so as to reduce the incidence of nuclear fragments on detectors during beam irradiation.
The requirements for the shield are as follows:
1. In order to perform measurement for imaging during irradiation, the coverage of the shield shall be minimized so that at least unshielded detectors can be used for measurement for imaging.
2. The material and thickness of the shield are desirably optimized to suppress the radioactivation of the detectors to or below an allowable value while allowing any transmission of annihilation radiations to be measured.
3. The material and thickness of the shield may be uniform, but are preferably designed so that the shielding effect decreases as the scattering angle increases, considering the forward scattering of nuclear fragments.
4. In order to move the shield at high speed and simplify the mechanism, it is important that the shield have a light weight. The foregoing optimization in the size and material of the shield also allows a weight reduction of the shield.
The present invention has been achieved based on the foregoing findings, and attains the foregoing object by the provision of a radiation therapy and imaging hybrid device including an imaging device that has a detector arranged so as to be able to measure a radiation occurring from an affected area due to radiation irradiation and images an irradiation field after irradiation or during irradiation in synchronization with a radiation with which a field of view of the detector is irradiated, the hybrid device including: a radiation therapy device that irradiates a part of a subject with a radiation, the part lying in a field of view of the imaging device; and shielding means for lessening incidence of nuclear fragments on the detector, the nuclear fragments flying forward in a direction of irradiation from the subject due to the radiation irradiation, the shielding means being arranged in a flying space of the nuclear fragments.
The present invention also attains the foregoing object by the provision of a radiation therapy and imaging hybrid device including a PET device that has a group of detectors arranged around a subject so as to be capable of coincidence measurement of a pair of annihilation radiations occurring from the subject and performs tomographic scanning on the subject after irradiation or during irradiation in synchronization with a radiation with which a field of view of the group of detectors is irradiated, the hybrid device including: a radiation therapy device that irradiates a part of the subject with a radiation, the part lying in a field of view of the PET device; and shielding means for lessening incidence of nuclear fragments on the detectors, the nuclear fragments flying forward in a direction of irradiation from the subject due to the radiation irradiation, the shielding means being arranged in a flying space of the nuclear fragments.
Here, the group of detectors may be arranged in a ring shape around an axis of the subject. The shielding means may include a shield that can be inserted and retracted into/from the flying space and lessens passage of nuclear fragments, and control means for controlling the insertion and retraction of the shield. The shield may be located in the flying space during radiation irradiation to lessen incidence of fragments into the detectors.
The shield may make a rotational movement.
The shield may make a reciprocal movement.
The shield may be immediately retracted after radiation irradiation.
The shield may be rotated depending on a position of an irradiation port.
The shield and a drive unit thereof may be integrated with a bed.
A material or thickness of the shield may be changed according to a scattering angle of the nuclear fragments.
The present invention also provides a control program of a detector rotation type radiation therapy and imaging hybrid device including an imaging device that has a detector arranged so as to be able to measure a radiation occurring from an affected area due to radiation irradiation and images an irradiation field after irradiation or during irradiation in synchronization with a radiation with which a field of view of the detector is irradiated, the control program controlling shielding means so as to lessen incidence of nuclear fragments on the detector, the nuclear fragments flying forward in a direction of irradiation from the subject due to the radiation irradiation, the shielding means being arranged in a flying space of the nuclear fragments.
The present invention also provides a control program of a detector rotation type radiation therapy and imaging hybrid device including a PET device that has a group of detectors arranged around a subject so as to be capable of coincidence measurement of a pair of annihilation radiations occurring from the subject and performs tomographic scanning on the subject after irradiation or during irradiation in synchronization with a radiation with which a field of view of the group of detectors is irradiated, the control program controlling shielding means so as to lessen incidence of nuclear fragments on the detectors, the nuclear fragments flying forward in a direction of irradiation from the subject due to the radiation irradiation, the shielding means being arranged in a flying space of the nuclear fragments.
According to the present invention, when performing monitoring for detecting annihilation radiations occurring from an irradiation field due to radiation irradiation in radiation therapy which is conducted by irradiating an affected area with X-rays or a particle beam, the incidence of nuclear fragments accompanying the beam irradiation on detectors can be reduced to enable measurement of annihilation radiations and three-dimensional imaging of the irradiation field immediately after irradiation or even during irradiation.
Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.
As shown in
Single event data on annihilation radiations detected by detectors such as PET detectors is converted by a coincidence circuit 44 into coincidence data for identifying lines of coincidence. The coincidence data is stored into a data collection system 46 in succession. After accumulation of measurement data for a certain period of time, an image reconstruction system 48 performs an image reconstruction operation, whereby images of the irradiation field are displayed or stored on/in a display and storage system 50. The time width for accumulating measurement data will be referred to as a time frame. The processing systems of the PET measurement data may basically continue processing and collecting measurement data independent of the accelerator control system 52 and the shield control system 60. It is needed, however, to include a shield position signal or the like into the coincidence data so that data selection and sensitivity correction can be properly performed at the time of image reconstruction.
For PET measurement, the collection of coincidence data is continued. Data corresponding to a time frame specified afterward is extracted for image reconstruction. Alternatively, a time frame may be specified in advance, and PET measurement may be performed only for the time frame specified. If an image degradation results from missing lines of coincidence or a decrease in the number of counts of annihilation radiations measured, a longer time frame may be set to improve the S/N ratio of the measurement data. It is known that prompt gamma rays are also emitted from the irradiation field during irradiation aside from annihilation radiations. Prompt gamma rays can increase random coincidence which is a noise component to PET measurement. In view of ON/OFF periodicity of microsecond order even during irradiation, countermeasures have been proposed that use only measurement data in OFF states for image reconstruction, excluding measurement data in ON states. (P. Crespo, et al., “Suppression of random coincidences during in-beam PET measurements at ion beam radiation therapy facilities,” IEEE TRANSACTIONS ON NUCLEAR SCIENCE, VOL. 52, NO. 4, AUGUST 2005). Alternatively, imaging may be performed only immediately after irradiation, not during irradiation.
Among methods of particle beam irradiation is conventional bolus irradiation where the irradiating beam is spread out to the shape of the affected area. Spot scanning irradiation is also under study, where the affected area is scanned with a pencil beam according to its shape etc. The present invention is applicable to both the irradiation methods. A synchrotron basically makes intermittent operations to repeat beam irradiation ON and OFF periodically. The shields may thus be inserted and retracted in synchronization with the irradiation periods. The shields may be retracted after the end of a series of irradiations. The latter case also corresponds to when a beam is continuously produced from a synchrotron, instead of periodical irradiations planned for spot scanning irradiation.
Specifically, a pair of shields are opposed to each other with respect to the Z-axis, the body axis of the patient. There is provided a mechanism for rotating the shields about the Z-axis independent of the irradiation port 30. There are two pairs of shields 40 since there are two detector rings arranged in the Z direction with the open space therebetween. The two pairs of shields 40 rotate in the same rotation period and phase. Assuming that the angle of view of each shield 40 as seen from the Z-axis is θs, the angle of view θd of detectors that are not covered with the shields is expressed by θd=180°−θs.
θd≧2 sin−1(r/R′),
where R′ is the radius of the orbit of the shields, and r is the radius of the PET field of view. The upper limit of θd is:
θd≦ts/T×180°−θc.
Here, θs=180°−θd. Since the shields always cover detectors irrespective of the ON or OFF of irradiation, the shield rotation type can only acquire limited lines of coincidence all the time. Lines of coincidence from various angles are needed for image reconstruction. The minimum value of the time frame capable of imaging is thus an irradiation clock of T sec which is equivalent to a 180° rotation of the shields.
The Heavy Ion Medical Accelerator in Chiba (HIMAC) of the National Institute of Radiological Sciences in Japan controls treatment beams in periods of T=3.3 sec. The present invention will be described here in terms of application to HIMAC. Assuming that the radius of the orbit of the shields R′=50 cm and the radius of the PET field of view r=20 cm, the lower limit of θd is θd≧47.2°. Table 1 shows upper limits of θd for different irradiation durations ti and different widths Wc of the critical region. ts=3.3−ti. No device is feasible if the upper limit falls below the lower limit (in the table, denoted as NA). For enhanced sensitivity of the PET device, it is actually desirable to employ the maximum θd (i.e., the minimum θs).
While the present example has dealt with the case with a single irradiation port, the present invention is also applicable to a case with a plurality of irradiation ports such as vertical and horizontal ones. Typically, a plurality of irradiation ports are not simultaneously used for treatment beam irradiation. The phase of shield rotation or the phase of beam irradiation may therefore be relatively changed depending on the movement of the port for beam irradiation. The same holds for a rotating irradiation gantry.
θs≦2 cos−1(r/R′),
where R′ is the radius of the orbit of the shields, and r is the radius of the PET field of view. The lower limit of θs is:
θs≧ti/T×360°+θc.
θs will also be examined in terms of application to HIMAC. Assuming that the radius of the orbit of the shields R′=50 cm and the radius of the PET field of view r=20 cm, the upper limit of θs is θs≦132.8°. Table 2 shows lower limits of θs for different irradiation durations ti and different widths Wc of the critical region. ts=3.3−ti. No device is feasible if the upper limit falls below the lower limit (in the table, denoted as NA). For enhanced sensitivity of the PET device, it is actually desirable to employ the minimum θs. As compared to the case of Table 1, given the same beam irradiation period T, shorter irradiation durations ti are needed since the shield rotation speed is twice as high.
The present invention (shield retraction type and shield rotation type) may be applied to devices other than open PET devices.
The imaging device need not necessarily be a PFT device, and may be a SPECT device with a gamma camera etc. In such a case, it would be possible to measure prompt gamma rays as a signal aside from annihilation radiations.
Specific examples will be described below.
When performing monitoring for detecting annihilation radiations occurring from an irradiation field due to radiation irradiation in radiation therapy which is conducted by irradiating an affected area with X-rays or a particle beam, the incidence of nuclear fragments accompanying the beam irradiation on detectors can be reduced to enable measurement of annihilation radiations and three-dimensional imaging of the irradiation field immediately after irradiation or even during irradiation.
Filing Document | Filing Date | Country | Kind | 371c Date |
---|---|---|---|---|
PCT/JP2009/055702 | 3/23/2009 | WO | 00 | 2/29/2012 |