CN101455877A - Design method of pipe holder capable of bearing micro radioactive particles - Google Patents
Design method of pipe holder capable of bearing micro radioactive particles Download PDFInfo
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- CN101455877A CN101455877A CNA2007101721002A CN200710172100A CN101455877A CN 101455877 A CN101455877 A CN 101455877A CN A2007101721002 A CNA2007101721002 A CN A2007101721002A CN 200710172100 A CN200710172100 A CN 200710172100A CN 101455877 A CN101455877 A CN 101455877A
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Abstract
The invention relates to the technical field of medical apparatuses, in particular to a method for designing a pipe support capable of bearing miniature radioactive particle sources, wherein the pipe support is mainly used for internal radiation treatment of intermediate and late pancreatic cancer and malignant bile duct stenosis. The method can optimally design a concrete structure of the pipe support capable of bearing the miniature radioactive particle sources by utilizing natural cavities (including a common bile duct, a main pancreatic duct, an accessory pancreatic duct and so on) on the circumference of the pancreatic head of a human body. The method comprises: S1, designing the outside diameter of the support, the inside diameter of drainage cavities, the length of the support and so on; S2, selecting different support materials according to a clinic radiation planning, and selecting whether to apply materials with different shielding materials to seal a radiation window; and S3, designing the inside diameter of a particle channel, the dimension of the radiation window and interval arrangement. The method realizes the aims of precise positioning, precise planning and precise treatment, and achieves optimum internal radiation treatment effect.
Description
Technical field
The present invention relates to technical field of medical instruments, but be the method for designing of the support of pipelines in a kind of bearing micro radioactive particle source, be mainly used in the internal-radiation therapy of advanced pancreatic cancer and bile duct malignant stricture.
Background technology
Prognosis is dangerous, cure rate is low, the malignant tumor of digestive tract of prognosis extreme difference to cause the malignant disease (cancer of biliary duct, carcinoma of ampulla and vater's papilla cancer etc.) of stenosis of bile duct and cancer of pancreas to be one group, has belonged to middle and advanced stage during most the discovery, often can't excision.Tumor usually can be oppressed ductus pancreaticus, bile duct, causes stenosis or occlusion.For the pipeline stenosis or occlusion, at present mainly adopt under the scope endoscopic retrograde cholangiopancreatography (ERCP) technology (ERCP) to insert the support of pipelines that possesses the drain function to alleviate clinical symptoms, mainly be divided into metal rack and plastic stent two major types.
For the radiotherapy of cancer of pancreas and bile duct malignant stricture, mainly contain outer radiotherapy and interior radiotherapy dual mode at present clinically.Radiotherapy and tissue space implantation radiotherapy in behaveing affectedly after the latter is divided into again.After behave affectedly in radiotherapy mainly by after-loading therapy equipment, mini-radioactive resource is inserted the artificial nest that is positioned in ductus pancreaticus or the bile duct, focus is carried out local irradiation.In this therapeutic process, need resident conduit to communicate with external, complicated operation, and treatment time is shorter, needs interval procedure, influences radiotherapeutic effect.Tissue space implantation radiotherapy mainly by entry needle with miniature radiation particle source implant intralesional or near carry out local radiotherapy.The medical miniature radioactive particle is that radionuclide is encapsulated in the rod-short solid source of making in the titanium alloy casing.Particle at present commonly used have iodine (
125I) and palladium (
103Pd) particle etc., clinical regular size is about long 4.5mm, diameter 0.8mm, surface activity commonly used is 0.3mCi-1.0mCi.Has treatment target spot local dose height, characteristics such as the normal surrounding tissue amount of being subjected to is low and safe, reliable, easy protection.
But patent document 1 has been described the support of pipelines in a kind of bearing micro radioactive particle source, insert affected part in ductus pancreaticus or the bile duct by duodenoscope, easy to operate when not only inserting, wound is minimum, and both had a drainage, can carry out the localized sustained irradiation to tumor on every side again, also can take out as required or regularly replace.
[patent document 1] Chinese utility model patent ZL 2,006 2 0046115.5.
As mentioned above, because above-mentioned patent document 1 described support of pipelines can be positioned over common bile duct, main pancreatic duct or accessory pancreatic duct alone or in combination according to the treatment needs.In conjunction with clinical practice requirement at present, lack the effective support Design scheme of a cover, in order to the concrete structure of one or more support of pipelines of optimal design, and the mini-radioactive resource of carrying corresponding dosage, to reach clinical best irradiation treatment effect.
Summary of the invention
But the invention provides the method for designing of the support of pipelines in a kind of bearing micro radioactive particle source, utilize the natural tract (comprising common bile duct, main pancreatic duct, accessory pancreatic duct, duodenum enteric cavity etc.) in pancreatic head zone in the human body, but place the support of pipelines in bearing micro radioactive particle source, according to the locus of support and the position and the size of tumor, the concrete structure of optimal design support comprises support external diameter, drainage lumens internal diameter, stent length, particle duct specification etc.; According to the internal radiation plan, select the support material, the material of selecting whether to use different screening abilities seals irradiation window.According to edge, the tumor target area dosage of setting, to calculate specification, surface activity and the spacing of rack bearing mini-radioactive resource and arrange, design particle duct internal diameter, irradiation window size and spacing are arranged.
For making great efforts to solve foregoing problems and achieve the above object, method for designing according to a first aspect of the invention may further comprise the steps:
Tumor locus to the patient carries out one or more image scanner scanning, as CT or MRI scanning, obtains the image sequence of respective type.Resulting image sequence is transferred to the tumour radiotherapy planning system, through image fusing method, image sequence is carried out 3D image reconstruction, can accurately determine the tumor target area, the natural tract (comprising common bile duct, main pancreatic duct, accessory pancreatic duct, duodenum enteric cavity etc.) in pancreatic head zone in the clear and definite human body, tumor target area and the relation of the relative tertiary location between the vitals on every side.
Can determine length, external diameter and the drainage lumens internal diameter of support of pipelines according to natural tract diameter, length and the tumor target region shape of above-mentioned three-dimensional reconstruction, determine support two ends fixed part length and shape.According to the spatial relationship of natural tract and adjacent tumor target area situation, determine particle duct number, particle orifice throat length in the support of pipelines.
Further, but before determining the support of pipelines specification in bearing micro radioactive particle source, can be according to patient's situation, selectivity implant the ductus pancreaticus support in advance or/and the accessory pancreatic duct support or/and biliary tract prosthesis.With reference to the ordinary stent specification, determine length, external diameter and the drainage lumens internal diameter of novel pipeline support.Show according to radiography in the art, measure tube chamber and be subjected to the narrow section length that oncothlipsis causes, determine particle duct number, particle orifice throat length in the support of pipelines.
Further, describedly implant support of pipelines in advance, comprise the common plastics support and carry the support of pipelines of miniature radiation particle source prosthese by the ERCP choice of technology;
Further, described image scan mode is CT image, nuclear magnetic resonance image, functional image.
According to a second aspect of the invention, according to clinical irradiation treatment plan and range of exposures requirement, select corresponding timbering material.For the situation of needs limitation range of exposures, should select lonizing radiation are had the material of higher screening ability as far as possible, illumination scheme should be adjusted by set up modes such as irradiation window, expansion window size on the particle duct.Comparatively widely during range of exposures, should select lonizing radiation are had the material of low barrier ability for needs as far as possible.
Further, come off for preventing mini-radioactive resource, can be according to the treatment requirement, the material of selecting to have different screening abilities seals irradiation window.
Further, in placing the miniature radiation source procedure, for preventing the mini-radioactive resource displacement, can be according to the treatment requirement, material that select to use different screening abilities is particle duct closed at both ends, or the material of using different screening abilities seals the particle duct between two adjacent particles.
According to a third aspect of the invention we,, further determine the number in particle duct according to the relative tertiary location relation and adjacent edge, the tumor target area dosage of natural tract, and the spatial arrangements of particle duct in the support tube wall.Determine the type and the specification of rack bearing mini-radioactive resource, design particle duct internal diameter.Calculate by injectivity optimizing, calculate the cloth source rule of the mini-radioactive resource of carrying, comprise quantity, surface activity and spacing arrangement, definite thus irradiation window size and spacing are arranged, and further determine the particle orifice throat length.
Further, in the tumour radiotherapy planning system, position and size and treatment plan requirement according to the tumor target area, according to certain selected cloth source rule, the promptly first fixedly number and the arrangement pitches of mini-radioactive resource are according to the dosage requirement of specified point in the target area, carrying out injectivity optimizing calculates, forward calculates the surface activity of relevant position mini-radioactive resource, and can further adjust the radioactive source spacing, makes to meet internal radiation intended dose distribution requirement.According to result of calculation, determine particle duct number, internal diameter, irradiation window size and spacing arrangement, and further determine the particle orifice throat length.
Further, in the tumour radiotherapy planning system, position and size and treatment plan requirement according to the tumor target area, the artificial dosage requirement of setting specified point in the target area, carrying out reverse injectivity optimizing calculates, automatically calculate at diverse location and place the mini-radioactive resource that activity equates or do not wait, make to meet internal radiation intended dose distribution requirement.Can determine particle duct number, internal diameter, irradiation window size and spacing arrangement, and further determine the particle orifice throat length.
Further, in the tumour radiotherapy planning system, except that the three-dimensional reconstruction technology that can utilize image sequence, also can use radioactive source location technologies commonly used such as quadrature technique, three-dimensional translation, three-dimensional angle, the position of each miniature radiation particle source of simulation pipeline rack bearing further customizes the support of pipelines that meets this requirement on the basis that injectivity optimizing calculates.
The present invention has following advantage: according to patient tumors position and size, utilize the natural tract of human body head of pancreas peripheral region, but the concrete structure of the support of pipelines in optimal design bearing micro radioactive particle source, and design particle duct internal diameter, irradiation window size and spacing are arranged; Can select the different support material according to clinical irradiation plan.Reach the purpose of accurate location, accurate plan, accurate treatment, reach best internal-radiation therapy effect.
Description of drawings
With reference to the accompanying drawings, will be described below and implement a kind of pipe holder capable of bearing micro radioactive particles of the present invention The optimal mode of method for designing. It should be noted that the present invention is not limited to so-called optimal mode.
Step S1 in Fig. 1 processes the image sequence of patient's tumor locus, determines support and tumour The target area relative tertiary location concerns, determines length, external diameter and the drainage lumens internal diameter of support of pipelines, determines in the support of pipelines Particle duct number, particle orifice throat length. Fig. 2 has described the preliminary treatment of tumour radiotherapy planning system digital picture Flow chart. During pre-processing, carry out digital picture importing (step S21), carried out tumour target area, weight Want organ and natural cavity to delineate (step S22), carry out 3D image reconstruction (S23), and carried out different images Sequence image fusion (S24).
At step S2, according to clinical irradiation treatment plan and range of exposures requirement, select corresponding timbering material and The material of suitable sealing irradiation window. Fig. 3 has described selection respective holder material and corresponding sealing irradiation window Flow chart. During selecting timbering material, carried out the three-dimensional structure mould of the support of pipelines that will design among the step S1 Type overlaps (S31) with three-dimensional tube chamber image among the step S1, has carried out and has selected concrete timbering material (S32), holds Gone importing support specifications parameter (pipe thickness, drainage lumens internal diameter etc.) (S33), carried out timbering material shielding meter Calculate (S34), carried out irradiation window cladding material SHIELDING CALCULATION (S35).
At step S3, according to relative tertiary location relation and adjacent edge, the tumour target area dosage of natural cavity, really Decide particle duct internal diameter, number, length and the particle duct space arrangement in the support tube wall. Determine irradiation window Size and arranged with interval. Fig. 4 has described the tumour radiotherapy planning system to work out the flow chart for the treatment of plan. In system During making a plan, carry out type and the specification (S41) of definite rack bearing mini-radioactive resource, carried out miniature radiation The source in the target area or near the target area along the particle duct simulation distribution (S42) in natural cavity, carried out injectivity optimizing Calculate (S43), carried out material SHIELDING CALCULATION (S44), determine to calculate the cloth source rule of the mini-radioactive resource that carries, Comprise quantity, surface activity and arrangement pitches (S45). Fig. 5 has described forward treatment plan flow process in the S43 step Figure. During the forward treatment plan, carried out artificial (also can automatically) and designed target spot number (S51), carried out the people Worker's (also can automatically) design target position (S52) has been carried out fast dose calculating (S53), carried out calculate miniature Radioactive source surface activity (S54) has been carried out isodose curve and has been superimposed upon edge, target area (S55). As meet the internal radiation meter Draw dosage distribution requirement, then finish to work out treatment plan. As do not meet internal radiation intended dose distribution requirement, then return Step S51 meets the irradiation requirement until dosage distributes. Fig. 6 has described reverse treatment plan flow process in the S43 step Figure. During reverse treatment plan, carried out the therapeutic dose (S61) that fixed point in the target area manually is set, carried out fast Speed in reversed direction Rapid Dose Calculation (S62) has been carried out automatic calculating target spot number (S63), has carried out automatic calculating target spot target spot Automatic calculating mini-radioactive resource surface activity (S65) has been carried out in position (S64), has carried out isodose curve and has been superimposed upon Edge, target area (S66).
The present invention is further described below in conjunction with drawings and Examples. For convenience of description, following embodiment is all for phase With an example.
The specific embodiment
Embodiment 1:
Embodiment 1:CT rebuilds the design support
1. digitized video scanning and processing
A. to Pancreas cancer patients row abdominal part Enhanced CT (show tumor target area better) and nuclear magnetic resonance, NMR pancreatic duct water imaging (MRCP) scanning (demonstration ductus pancreaticus, bile duct better), CT and MRCP image sequence are directed into planning system.
B. delineate tumor target area in the CT image sequence, vitals, main pancreatic duct, accessory pancreatic duct and common bile duct on every side, carry out 3D image reconstruction.
C. because CT scan and MRCP scanning have a coordinate system respectively, the position during the reflection patient scan.Adjust position and the relative angle of MRCP scan coordinate system, thereby change the coincidence degree of the three-dimensional reconstruction image of the two with respect to the initial point of CT scan coordinate system; Judge from anatomical structure knowledge, overlap requirement if the common bile duct of common bile duct that CT scan is rebuild and main pancreatic duct and MRCP scan rebuilding and main pancreatic duct meet, then can determine the spatial relation of main pancreatic duct, accessory pancreatic duct and three main ducts of common bile duct and tumor target area.
D. determine that the nearly pancreatic head of main pancreatic duct zone is narrow, length is about 20.0mm, and the narrow section diameter is about 1.5mm; The expansion of pancreas body main pancreatic duct, diameter is about 3mm-5mm.MRCP shows that accessory pancreatic duct length is about 30mm, diameter 2mm.The epimere choledochectasia of pancreatic head zone, the about 10.0mm of diameter, hypomere are subjected to tumor invading narrow section length to be about 40.0mm, the about 3mm of diameter.
E. the length of determining common bile duct interior conduit support is 80.0mm, and external diameter is 3.4mm, and the drainage lumens diameter is 2.2mm.Be provided with 1 particle duct in the tube wall, particle duct internal diameter is 0.8mm, and the particle orifice throat length is 45.0mm.Two agnail length are 7mm, and its root is apart from each 5mm of drainage tube two ends.
F. the length of determining main pancreatic duct interior conduit support is 60.0mm, and external diameter is 2.8mm, and the drainage lumens diameter is 1.8mm.Be provided with 1 particle duct in the tube wall, particle duct internal diameter is 0.8mm, and the particle orifice throat length is 30mm.Two agnail length are 5mm, and its root is apart from each 3mm of drainage tube two ends.
G. the length of determining accessory pancreatic duct interior conduit support is 25mm, and external diameter is 2.0mm, and the drainage lumens diameter is 0.8mm.Be provided with 1 particle duct in the tube wall, particle duct internal diameter is 0.8mm, and the particle orifice throat length is 15mm.1 ductus pancreaticus far-end agnail length is about 3mm, and its root is apart from drainage tube far-end 2mm.
2. shielding material is selected and is calculated
A. with the 3 d structure model of the support of pipelines of above-mentioned specification, overlap with three-dimensional tube chamber image among the step S1.
B. according to the circumfusion area requirement, biliary tract prosthesis is selected polyurethane+barium sulfate (high shielding) material, and main pancreatic duct and accessory pancreatic duct support are selected polyurethane (low shielding) material.
C. parameters such as support tube wall thickness and drainage lumens internal diameter are imported the planned treatment system.
D. carry out the timbering material SHIELDING CALCULATION
E. for preventing that the radioactive particle source from coming off and consider range of exposures, can select polyethylene (low shielding material) sealing irradiation window.
3. formulation treatment plan
A. selective emission
125Clinical treatment dosage 60Gy is determined as miniature radiation particle source in I seed source.Clinical commonly used
125I seed source length is about 4.5mm, and diameter is about 0.85mm.
B. in biliary tract prosthesis, set adjacent
125I seed source spacing 10.0mm is closing on the equidistantly sub-seed of arrangement 5 granules source, position, tumor target area.In the main pancreatic duct support, set adjacent
125I seed source spacing 5.0mm is closing on the equidistantly sub-seed of arrangement 6 granules source, position, tumor target area.In the accessory pancreatic duct support, set adjacent
125I seed source spacing 5.0mm is closing on the equidistantly sub-seed of arrangement 3 granules source, position, tumor target area.
C. carry out fast dose and calculate, calculating the interior seed source of biliary tract prosthesis surface activity is 0.4mCi, and seed source surface activity is 0.5mCi in main pancreatic duct and the accessory pancreatic duct support.
D. input rack material shielding numerical value and surface coating material shield numerical value.
E. isodose curve reference area and tumor target area superpose, and can't effectively cover.
F. adjust the 2nd, 3 seed source radiation activities of main pancreatic duct head side repeatedly in dosage zone on the low side to 0.6mCi, adjust corresponding isodose curve reference area.
G. adjusted isodose curve reference area can cover the tumor target area preferably, and the DVH prompting meets the internal-radiation therapy requirement.
H. the lateral wall in particle duct is provided with 5 irradiation windows in biliary tract prosthesis, and the length and width high score is 4.4 * 0.7 * 0.2 (mm), adjacent irradiation window Center Gap 10.0mm.The head end irradiation window is 5.0mm apart from drainage tube initiating terminal distance, the tail end irradiation window apart from the drainage tube end-to-end distance from being 30.0mm.The single particle surface activity is 0.4mCi.Place
125Behind the I seed source, the using polythene material seals irradiation window.
The lateral wall in particle duct is provided with 6 irradiation windows in the main pancreatic duct support, and the length and width high score is 4.4 * 0.7 * 0.2 (mm), adjacent irradiation window Center Gap 5.0mm.The head end irradiation window is 5.0mm apart from drainage tube initiating terminal distance, the tail end irradiation window apart from the drainage tube end-to-end distance from being 25.0mm.Apart from the 2nd, 3 particle surface activity of support head end is 0.6mCi, and all the other particle activity are 0.5mCi.Place
125Behind the I seed source, the using polythene material seals irradiation window.
The lateral wall in particle duct is provided with 3 irradiation windows in the accessory pancreatic duct support, and the length and width high score is 4.4 * 0.7 * 0.2 (mm), adjacent irradiation window Center Gap 5.0mm.The head end irradiation window is 5.0mm apart from drainage tube initiating terminal distance, the tail end irradiation window apart from the drainage tube end-to-end distance from being 5.0mm.The single particle surface activity is 0.5mCi.Place
125Behind the I seed source, the using polythene material seals irradiation window.
Embodiment 2: place ordinary stent design support of pipelines in advance
1. go the ERCP pre-operation
A. capable ERCP main pancreatic duct intubate, by injection of contrast medium, it is narrow to measure the nearly pancreatic head of main pancreatic duct zone, and length is about 20.0mm, and the narrow section diameter is about 1.5mm; The expansion of pancreas body main pancreatic duct, diameter is about 3mm-5mm.The accessory pancreatic duct radiography shows that accessory pancreatic duct length is about 30mm, diameter 2mm.Choledochography shows the epimere choledochectasia of pancreatic head zone, and the about 10.0mm of diameter, hypomere are subjected to tumor invading narrow section length to be about 40.0mm, the about 3mm of diameter.
B. determine to be provided with 1 particle duct in the common bile duct interior conduit support tube wall, particle duct internal diameter is 0.8mm, and the particle orifice throat length is 45.0mm.Determine to be provided with 1 particle duct in the main pancreatic duct interior conduit support tube wall, particle duct internal diameter is 0.8mm, and the particle orifice throat length is 30mm.Determine to be provided with 1 particle duct in the accessory pancreatic duct interior conduit support tube wall, particle duct internal diameter is 0.8mm, and the particle orifice throat length is 15mm.
2. place the common plastics support
A. place the common plastics support in common bile duct, the length of support is 80.0mm, and external diameter is 3.4mm, and the drainage lumens diameter is 3.0mm.Two agnail length are 7mm, and its root is apart from each 5mm of drainage tube two ends.
The length of b. placing the ductus pancreaticus plastic stent in main pancreatic duct is 60.0mm, and external diameter is 2.8mm, and the drainage lumens diameter is 2.4mm.Two agnail length are 5mm, and its root is apart from each 3mm of drainage tube two ends.
C. determine that accessory pancreatic duct length is 25mm, external diameter is 2.0mm, and the drainage lumens diameter is 1.4mm.1 ductus pancreaticus far-end agnail length is about 3mm, and its root is apart from drainage tube far-end 2mm.
3. digitized video scanning and processing
A. to patient's row abdominal part Enhanced CT, the CT image sequence is directed into planning system.
B. delineate tumor target area in the CT image sequence, vitals, main pancreatic duct support, accessory pancreatic duct support and common bile duct support on every side, carry out 3D image reconstruction.
C. determine the spatial relation of main pancreatic duct support, accessory pancreatic duct support and three plastic stents of common bile duct support and tumor target area.
4. with embodiment 1 step 2.
5. with embodiment 1 step 3.
Embodiment 3: place prosthese support Design support of pipelines in advance
1. go the ERCP pre-operation
A. capable ERCP main pancreatic duct intubate, by injection of contrast medium, it is narrow to measure the nearly pancreatic head of main pancreatic duct zone, and length is about 20.0mm, and the narrow section diameter is about 1.5mm; The expansion of pancreas body main pancreatic duct, diameter is about 3mm-5mm.The accessory pancreatic duct radiography shows that accessory pancreatic duct length is about 30mm, diameter 2mm.Choledochography shows the epimere choledochectasia of pancreatic head zone, and the about 10.0mm of diameter, hypomere are subjected to tumor invading narrow section length to be about 40.0mm, the about 3mm of diameter.
B. determine to be provided with 1 particle duct in the common bile duct interior conduit support tube wall, particle duct internal diameter is 0.8mm, and the particle orifice throat length is 45.0mm.Determine to be provided with 1 particle duct in the main pancreatic duct interior conduit support tube wall, particle duct internal diameter is 0.8mm, and the particle orifice throat length is 30mm.Determine to be provided with 1 particle duct in the accessory pancreatic duct interior conduit support tube wall, particle duct internal diameter is 0.8mm, and the particle orifice throat length is 15mm.
2. place the prosthese support
A. the length of determining common bile duct interior conduit support is 80.0mm, and external diameter is 3.4mm, and the drainage lumens diameter is 2.2mm.Be provided with 1 particle duct in the tube wall, particle duct internal diameter is 0.8mm, and the particle orifice throat length is 45.0mm.Two agnail length are 7mm, and its root is apart from each 5mm of drainage tube two ends.In biliary tract prosthesis, set adjacent
125I seed source spacing 10.0mm is closing on equidistantly 5 prosthese particle seed sources of arrangement, position, tumor target area.
B. the length of determining main pancreatic duct interior conduit support is 60.0mm, and external diameter is 2.8mm, and the drainage lumens diameter is 1.8mm.Be provided with 1 particle duct in the tube wall, particle duct internal diameter is 0.8mm, and the particle orifice throat length is 30mm.Two agnail length are 5mm, and its root is apart from each 3mm of drainage tube two ends.In the main pancreatic duct support, set adjacent
125I seed source spacing 5.0mm is closing on equidistantly 6 prosthese particle seed sources of arrangement, position, tumor target area.
C. the length of determining accessory pancreatic duct interior conduit support is 25mm, and external diameter is 2.0mm, and the drainage lumens diameter is 0.8mm.Be provided with 1 particle duct in the tube wall, particle duct internal diameter is 0.8mm, and the particle orifice throat length is 15mm.1 ductus pancreaticus far-end agnail length is about 3mm, and its root is apart from drainage tube far-end 2mm.In the accessory pancreatic duct support, set adjacent
125I seed source spacing 5.0mm is closing on equidistantly 3 prosthese particle seed sources of arrangement, position, tumor target area.
3. digitized video scanning and processing
A. to patient's row abdominal part Enhanced CT, the CT image sequence is directed into planning system.
B. delineate tumor target area in the CT image sequence, vitals, main pancreatic duct prosthese support, accessory pancreatic duct prosthese support and common bile duct prosthese support on every side, carry out 3D image reconstruction.
C. determine the spatial relation of main pancreatic duct prosthese support, accessory pancreatic duct prosthese support and three plastic stents of common bile duct prosthese support and tumor target area.
D. determine the spatial relation of particle prosthese and tumor target area.
4. with embodiment 1 step 2.
5. formulation treatment plan
A. selective emission
125Clinical treatment dosage 60Gy is determined as miniature radiation particle source in I seed source.Clinical commonly used
125I seed source length is about 4.5mm, and diameter is about 0.85mm.
B. according to particle prosthese position, carry out fast dose and calculate, calculating the interior seed source of biliary tract prosthesis surface activity is 0.4mCi, and seed source surface activity is 0.5mCi in main pancreatic duct and the accessory pancreatic duct support.
C. input rack material shielding numerical value and surface coating material shield numerical value.
D. isodose curve reference area and tumor target area superpose, and can't effectively cover.
E. adjust the 2nd, 3 seed source radiation activities of main pancreatic duct head side repeatedly in dosage zone on the low side to 0.6mCi, adjust corresponding isodose curve reference area.
F. adjusted isodose curve reference area can cover the tumor target area preferably, and the DVH prompting meets the internal-radiation therapy requirement.
G. the lateral wall in particle duct is provided with 5 irradiation windows in biliary tract prosthesis, and the length and width high score is 4.4 * 0.7 * 0.2 (mm), adjacent irradiation window Center Gap 10.0mm.The head end irradiation window is 5.0mm apart from drainage tube initiating terminal distance, the tail end irradiation window apart from the drainage tube end-to-end distance from being 30.0mm.The single particle surface activity is 0.4mCi.Place
125Behind the I seed source, the using polythene material seals irradiation window.
H. the lateral wall in particle duct is provided with 6 irradiation windows in the main pancreatic duct support, and the length and width high score is 4.4 * 0.7 * 0.2 (mm), adjacent irradiation window Center Gap 5.0mm.The head end irradiation window is 5.0mm apart from drainage tube initiating terminal distance, the tail end irradiation window apart from the drainage tube end-to-end distance from being 25.0mm.Apart from the 2nd, 3 particle surface activity of support head end is 0.6mCi, and all the other particle activity are 0.5mCi.Place
125Behind the I seed source, the using polythene material seals irradiation window.
I. the lateral wall in particle duct is provided with 3 irradiation windows in the accessory pancreatic duct support, and the length and width high score is 4.4 * 0.7 * 0.2 (mm), adjacent irradiation window Center Gap 5.0mm.The head end irradiation window is 5.0mm apart from drainage tube initiating terminal distance, the tail end irradiation window apart from the drainage tube end-to-end distance from being 5.0mm.The single particle surface activity is 0.5mCi.After placing 125I seed source, the using polythene material seals irradiation window.
Claims (10)
1. the method for a pipe holder capable of bearing micro radioactive particles comprises:
Step 1, according to the image sequence that obtains after the patient tumors position scanning, resulting image sequence is transferred to the tumour radiotherapy planning system,, image sequence is carried out 3D image reconstruction through image fusing method, determine the tumor target area, natural tract relative tertiary location relation;
Step 2, according to natural tract diameter, length and the tumor target region shape of step 1 3D image reconstruction, determine length, external diameter and the drainage lumens internal diameter of support of pipelines, determine support two ends fixed part length and shape; According to the spatial relationship of natural tract and adjacent tumor target area situation, determine particle duct number, particle orifice throat length in the support of pipelines, determine the type and the specification of rack bearing mini-radioactive resource, design particle duct internal diameter;
Step 3 according to the range of exposures requirement, is selected corresponding timbering material.
2. method according to claim 1 is characterized in that, described image be CT image, nuclear magnetic resonance image, functional image any one or multiple.
3. method according to claim 1, it is characterized in that, can be in the step 2 according to the pre-support of pipelines of implanting of patient, determine length, external diameter and the drainage lumens internal diameter of pipe holder capable of bearing micro radioactive particles, according to the ductography result, determine particle duct number, particle orifice throat length in the support of pipelines.
4. method according to claim 3, it is characterized in that, ordinary stent is common plastics or the support of pipelines that carries miniature radiation particle source prosthetic material, this support of pipelines be the ductus pancreaticus support or/and the accessory pancreatic duct support or/and any one of biliary tract prosthesis or multiple.
5. method according to claim 1, it is characterized in that, the corresponding timbering material of described selection, situation when needs limitation range of exposures, selection has the material of high screening ability to lonizing radiation, by on the particle duct, setting up irradiation window, enlarge mode such as window size and adjust,, select the material that lonizing radiation are had low barrier ability when needs comparatively widely during range of exposures.
6. method according to claim 5 is characterized in that, comes off for preventing mini-radioactive resource, and the material of selecting to have different screening abilities seals irradiation window; For preventing mini-radioactive resource displacement, the material of selecting different screening abilities is particle duct closed at both ends, or the material of using different screening abilities seals the particle duct between two adjacent particles.
7. method according to claim 1 also comprises:
Step 4, calculate according to the relative tertiary location relation of natural tract and adjacent edge, tumor target area injectivity optimizing, further determine type, quantity, surface activity and the spacing arrangement of the mini-radioactive resource of carrying, further determine particle duct internal diameter, the number in particle duct, particle orifice throat length and the particle duct spatial arrangements in the support tube wall thus.
8. method according to claim 5 also comprises:
Step 4 is calculated according to the relative tertiary location relation of natural tract and adjacent edge, tumor target area injectivity optimizing, further determines the arrangement of irradiation window size and spacing.
9. method according to claim 6 also comprises:
Step 4 is calculated according to the relative tertiary location relation of natural tract and adjacent edge, tumor target area injectivity optimizing, further determines the arrangement of irradiation window size and spacing.
10. according to the described method of claim 1～9, it is characterized in that, in the mode of the alternative 3D image reconstruction of radioactive source location technologies commonly used such as quadrature technique, three-dimensional translation, three-dimensional angle, the position of each miniature radiation particle source of simulation pipeline rack bearing.
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN102125717A (en) * | 2011-04-07 | 2011-07-20 | 大连大学 | Biliary tract internal drainage tube carrying radioactive particles |
| CN104353189A (en) * | 2014-11-07 | 2015-02-18 | 滕皋军 | Three-dimensional precise intraluminal radiation therapy method and system for cancer treatment |
| CN106228016A (en) * | 2016-07-29 | 2016-12-14 | 上海市质子重离子医院有限公司 | A kind of flow process using high energy particle beam treatment system diagnosis and treatment and method |
| CN110974419A (en) * | 2019-12-24 | 2020-04-10 | 武汉大学 | Guidewire navigation method and system for endoscopic bile duct stent placement for hilar stenosis |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN102125717A (en) * | 2011-04-07 | 2011-07-20 | 大连大学 | Biliary tract internal drainage tube carrying radioactive particles |
| CN104353189A (en) * | 2014-11-07 | 2015-02-18 | 滕皋军 | Three-dimensional precise intraluminal radiation therapy method and system for cancer treatment |
| WO2016070721A1 (en) * | 2014-11-07 | 2016-05-12 | 滕皋军 | Three-dimensional precise intracavitary radiotherapy method and system for treating tumours |
| CN104353189B (en) * | 2014-11-07 | 2018-02-23 | 滕皋军 | The accurate intracavitary radiotherapy method of 3 D stereo and its system for treating tumour |
| US10646725B2 (en) | 2014-11-07 | 2020-05-12 | Nanjing Rongsheng Medical Technology Co., Ltd. | Three-dimensional precise intracavitary radiotherapy method and system for treating tumours |
| CN106228016A (en) * | 2016-07-29 | 2016-12-14 | 上海市质子重离子医院有限公司 | A kind of flow process using high energy particle beam treatment system diagnosis and treatment and method |
| CN110974419A (en) * | 2019-12-24 | 2020-04-10 | 武汉大学 | Guidewire navigation method and system for endoscopic bile duct stent placement for hilar stenosis |
| CN110974419B (en) * | 2019-12-24 | 2021-07-06 | 武汉大学 | Guidewire navigation method and system for endoscopic bile duct stent placement for hilar stenosis |
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