JPH09313629A - Radiotherapy equipment - Google Patents

Abstract

PROBLEM TO BE SOLVED: To enable precise therapy with high position accuracy through an X-ray irradiating device while confirming the diseased part in an ultrasonic image provided by an ultrasonic diagnostic system by combining the X-ray irradiating device, which executes therapy by directly irradiating the diseased part inside an examinee with X-rays, with the ultrasonic diagnostic system. SOLUTION: An electron beam source 1 of an X-ray irradiating device 10 for performing therapy irradiating the diseased part 7 inside an examinee 8 with X-rays radiated from an X-ray generating part provided at the top end part inside a fine tube 3 is fitted to a probe 12 of an ultrasonic diagnostic system 11, with which the ultrasonic image of the diseased part 7 inside the examinee 8 is constitutively displayed by processing reflected echo signals collected by this probe 12, in the state of holding that fine tube 3 so as to insert it into the examinee 8 and while confirming the diseased part 7 in the ultrasonic image provided by this ultrasonic diagnostic system 11, this X-ray irradiating device 10 irradiates the diseased part 7 with X-rays. Thus, precise therapy with high position accuracy can be performed through the X-ray irradiating device 10 while confirming the diseased part 7 in the ultrasonic image provided by the ultrasonic diagnostic system 11.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to X-ray irradiator
A radiation therapy apparatus for inserting a radiation generating unit into the vicinity of a lesion in a subject and irradiating the lesion with X-rays for treatment.
In particular, radiation capable of combining the X-ray irradiation device and the ultrasonic diagnostic device and performing precise treatment with high positional accuracy using the X-ray irradiation device while confirming the lesion area on the ultrasonic image obtained by the ultrasonic diagnostic device. Treatment device

[0002]

2. Description of the Related Art A conventional radiotherapy apparatus of this type is described in Japanese Patent Publication No. 6-500661 and is shown in FIG. A source 1 and an electron beam 2 having an outer diameter of several mm which extends from one end of the electron beam source 1 in the axial direction thereof and is inserted into the subject and which guides the electron beam 2 emitted from the electron beam source 1 into the subject. Electric power is supplied to the thin tube 3, an X-ray generator 5 provided at the tip of the thin tube 3 for colliding the electron beam 2 emitted from the electron beam source 1 to generate an X-ray 4, and the electron beam source 1. And an electron beam source controller 6 for controlling the generation of the electron beam 2 and supplying X-rays 4 emitted from the X-ray generator 5 at the tip of the thin tube 3 to a lesion 7 in the subject. X to irradiate and treat
It consisted of a beam irradiation device. Then, the thin tube 3 was inserted into the subject, and the tip portion of the thin tube 3 was brought into close contact with the lesion 7 to emit X-rays 4. Thus, in the case where the thin tube 3 is percutaneously inserted into the subject to directly treat the lesion 7, the distal end of the thin tube 3 is accurately placed at the position of the lesion 7. This is very important.

[0003]

However, in such a conventional radiotherapy apparatus, in order to position the tip of the thin tube 3 at the position of the lesion 7 in the subject, stereotactic brain surgery in the head is used. Similarly, a tomographic image of the diagnosis site is collected in advance by a medical image diagnostic apparatus such as an X-ray CT apparatus or an ultrasonic diagnostic apparatus to measure the position of the lesion site 7, and then the mechanical accuracy of the radiotherapy apparatus is used. The thin tube 3 was percutaneously inserted into the subject to reach the position of the lesion 7. In this case, it was not known whether the tip of the thin tube 3 was really positioned at the lesion 7.
In other words, the lesion 7 may be displaced between the time of imaging with the medical image diagnostic apparatus and the time of actual treatment, so that the positional accuracy cannot be ensured and the distal end of the thin tube 3 may not be correctly positioned.

Further, in the same manner as the endoscopic surgery in the thoracoabdominal region, the thin tube 3 is percutaneously inserted and positioned while observing the lesion 7 directly with an endoscope, and X-rays are emitted. However, since only the surface layer of the lesion 7 can be seen in this case, the lesion in the parenchymal organ cannot be precisely treated according to the depth of the lesion.

Further, in a method called remote afterloading, a dummy radiation source is placed in the lesion area under fluoroscopy in advance, and then the remote radiation source is replaced with the dummy radiation source to perform radiotherapy. Was going on. Again, the position accuracy of the solid source is governed by the mechanical accuracy of the treatment tool,
The position accuracy could not be secured and the solid line source could not be positioned correctly.

Therefore, the present invention addresses such problems and combines an X-ray irradiator and an ultrasonic diagnostic apparatus to confirm X-rays while confirming a lesion portion with an ultrasonic image obtained by the ultrasonic diagnostic apparatus. It is an object of the present invention to provide a radiotherapy device capable of performing precise treatment with high precision by an irradiation device.

[0007]

In order to achieve the above object, the radiotherapy apparatus according to the present invention generates and accelerates an electron beam by an electron beam source whose inside is sealed in a vacuum, and the electron beam source is accelerated. An electron beam emitted from the electron beam source is introduced into the subject by a thin tube extending from one end of the subject in the axial direction and inserted into the subject, and an X-ray generation unit provided at the tip of the thin tube. The electron beam emitted from the electron beam source collides with
An electron beam is generated, and the electron beam source control unit supplies power to the electron beam source and controls the generation of the electron beam, and irradiates the lesion in the subject with X-rays emitted from the X-ray generation unit. The X-ray irradiator that performs treatment by using the probe and the probe that has an ultrasonic transducer inside transmit and receive ultrasonic waves in the subject, and the image processing and display device processes the reflected echo signals collected by the probe. And an ultrasonic diagnostic apparatus for constructing and displaying an ultrasonic image of a lesion in the subject, the electron beam source of the X-ray irradiation apparatus being used as a thin tube for the probe of the ultrasonic diagnostic apparatus. Is attached so that it can be inserted into the subject, and the X-ray irradiation device irradiates the lesion with X-rays while confirming the lesion in the subject by the ultrasonic image obtained by the ultrasonic diagnostic apparatus. It is something that is done.

In the electron beam source of the X-ray irradiator, the thin tube is slidable in the insertion direction with respect to the probe of the ultrasonic diagnostic apparatus, and the insertion angle is variable, and an arbitrary angle is set. The insertion depth and the insertion angle can be detected by the position detection means attached to the probe, and the insertion guideline and the insertion depth of the thin tube are attached. The insertion angle and the insertion angle may be displayed in the display image of the ultrasonic diagnostic apparatus.

Further, the thin tubes of the X-ray irradiating apparatus are capable of exchanging a plurality of types having different X-ray irradiation fields, and by discriminating the type of the thin tubes, the insertion guideline, the insertion depth, and the insertion angle of the thin tube are determined. The X-ray irradiation range may be displayed in the display image of the ultrasonic diagnostic apparatus.

Furthermore, the probe is fixed to a fixing means for the subject, and the thin tube of the X-ray irradiating device is driven by a thin tube driving means attached to the mounting means so that the insertion depth and the insertion angle can be adjusted. In addition, the position may be controllable by a capillary position control device attached to the image processing display device of the ultrasonic diagnostic apparatus.

[0011]

Embodiments of the present invention will be described below in detail with reference to the accompanying drawings. FIG. 1 is an explanatory diagram showing an embodiment of a radiation treatment apparatus according to the present invention. This radiotherapy device is one in which the X-ray generator of the X-ray irradiation device is inserted in the vicinity of the lesion in the subject and the X-ray is irradiated to the lesion to perform the treatment. As shown in FIG. , X-ray irradiation device 1
0 and an ultrasonic diagnostic apparatus 11 are provided, and both are combined.

The X-ray irradiating device 10 irradiates a lesion in a subject with radiated X-rays for treatment, and the inside is sealed in a vacuum to generate an electron beam and accelerate the electron beam. The source 1 and the electron beam 2 (see FIG. 8) emitted from the electron beam source 1 while being inserted into the subject 8 while extending from one end of the electron beam source 1 in the axial direction thereof are fed into the subject 8. X-rays 4 which collide with a thin tube 3 having an outer diameter of a few millimeters and an electron beam 2 emitted from the electron source 1 provided at the tip of the thin tube 3.
The X-ray generator 5 (see FIG. 8) for generating the electron beam and the electron beam source controller 6 for controlling the generation of the electron beam 2 while supplying the electric power to the electron beam source 1 are provided. X-rays 4 emitted from the X-ray generator 5 of
It is designed to irradiate the skin and treat it.

The ultrasonic diagnostic apparatus 11 is for transmitting and receiving ultrasonic waves to and from the subject 8 to obtain and display an ultrasonic image such as a tomographic image of a diagnostic region, and has an ultrasonic transducer inside. A probe 12 that transmits and receives ultrasonic waves to and from the subject 8, and a reflected echo signal collected by the probe 12 is processed to form and display an ultrasound image of the lesion 7 in the subject 8. The image processing and display device 13 is included.

Here, in the present invention, the X-ray irradiating device 10 is provided to the probe 12 of the ultrasonic diagnostic device 11.
The electron beam source 1 is attached with the thin tube 3 held so that it can be inserted into the subject 8, while confirming the lesion 7 in the subject 8 by the ultrasonic image obtained by the ultrasonic diagnostic apparatus 11. The X-ray irradiation device 10 is configured to irradiate the lesion 7 with X-rays. That is, the attachment means 15 is fixed by the attachment metal fitting 14 which is stopped by winding the body portion of the probe 12, and the thin tube 3 is sandwiched and held by the attachment means 15 so that the electron beam source 1 is It is installed.

Further, the electron beam source 1 of the X-ray irradiator 10 is attached to the probe 12 by the mounting means 15 as follows.
The thin tube 3 is slidable in the insertion direction, the insertion angle is variable, and the thin tube 3 is attached so that it can be fixed at an arbitrary position and angle. Further, a thin tube position detecting means (see FIG. 5) including, for example, a rack, a pinion, and a potentiometer is attached inside the mounting means 15, and the thin tube position detecting means detects the insertion depth and the insertion angle of the thin tube 3. It is possible. The position information of the thin tube 3 detected by this thin tube position detecting means is sent to the image processing display device 13 via the probe 12 and its connecting cable 16.

As a result, as shown in FIG. 2, the tomographic image 17 is displayed on the screen of the image processing and displaying device 13 of the ultrasonic diagnostic apparatus 11.
At the same time, the guideline 18 for inserting the thin tube 3 toward the lesion 7, the insertion depth, and the insertion angle are displayed. As a result, while confirming the lesion 7 on the tomographic image 17 obtained by the ultrasonic diagnostic apparatus 11, the thin tube 3 of the X-ray irradiation apparatus 10 is inserted along the insertion guideline 18 to perform a precise treatment and precise treatment. It can be carried out.

FIG. 3 is an explanatory view showing a second embodiment of the present invention. In this embodiment, the thin tube 3 of the X-ray irradiating device 10 has a plurality of types having different X-ray irradiation fields (for example, 3a, 3).
b) is replaceable, and the type of thin tubes 3a, 3b is discriminated, and the insertion guideline 18, insertion depth, insertion angle, and X-ray irradiation range of the thin tube 3 are used for the ultrasonic diagnostic apparatus 1.
1 is displayed in the display image 1. That is, the first thin tube 3a is the X provided inside the thin tube.
X generated when the line generator 5 is attached at the most tip position
The radiation field is wide and the second thin tube 3b is
The X-ray irradiation field generated when the X-ray generation unit 5 is attached at a position inside the tip end by an appropriate distance is the first thin tube 3a.
It is narrower. And each thin tube 3a, 3
In b, the size of the X-ray irradiation field is clearly indicated by marking, engraving, or the like.

Thus, when replacing the thin tubes 3a, 3b, the type of the thin tubes 3a, 3b is discriminated by the markings, markings, etc., and the operator can operate the thin tubes 3a, 3b as shown in FIG. Insertion guideline 18, insertion depth,
The insertion angle and the X-ray irradiation fields 19a and 19b are displayed in the display image of the ultrasonic diagnostic apparatus 11. FIG. 4 (a)
FIG. 4 shows a wide irradiation field 19a in the case of the first thin tube 3a.
(B) shows a narrow irradiation field 19b in the case of the second thin tube 3b.

The detachable member 20 for the thin tubes 3a and 3b is also provided.
A thin tube type indicating means such as a bar code is attached to the inner surface of the tube, and a thin tube type discriminating means 21 such as a bar code reader is attached to the tip of the electron beam source 1 to attach the thin tubes 3a and 3b. When attached to or detached from the electron beam source 1, the type of the thin tubes 3a and 3b is automatically discriminated by the thin tube type discriminating means 21, and as shown in FIG. 4, the insertion guideline 18 and the insertion depth of the thin tubes 3a and 3b. , The X-ray irradiation fields 19a and 19b may be displayed in the display image of the ultrasonic diagnostic apparatus 11. At this time, the electron beam source controller 6 and the image processing display device 13 of the ultrasonic diagnostic apparatus 11 are
It is connected by a cable 22 so that a discrimination signal of the types of the thin tubes 3a and 3b is automatically sent to the image processing display device 13. Further, in FIG. 3, the treatment plan data for the subject 8 is stored in the radiation treatment control unit 23 connected to the electron beam source control unit 6, and the treatment plan data and the thin tubes 3a, 3b actually attached are stored. It may be possible to prevent the mistaken attachment of the thin tubes 3a and 3b by collating with.

FIG. 5 is an explanatory view showing a third embodiment of the present invention. In this embodiment, the probe 12 of the ultrasonic diagnostic apparatus 11 is fixed to the fixing means 24 for the subject 8, and the thin tube 3 of the X-ray irradiation apparatus 10 is its attaching means 15.
The ultrasonic driving device 25 is attached to the ultrasonic diagnostic apparatus 1 so that the insertion depth and the insertion angle can be adjusted.
The position can be controlled by the thin tube position control device 27 attached to the image processing and displaying device 13. That is, the fixing means 24 comprises a stand formed in an arc shape or a spherical shape having an appropriate size.
It is adapted to be fixed to, for example, the head by fixing tools 28 such as screws provided at the three corners or the four corners of No. 4. Then, the probe 12 is movably mounted on the fixing means 24, and the electron beam source 1 is attached to the probe 12.
The thin tube 3 is attached, and the thin tube driving means 25 drives the thin tube 3 so that the insertion depth and the insertion angle of the thin tube 3 can be adjusted. At this time, positions such as the insertion depth and the insertion angle of the thin tube 3 are detected by the thin tube position detecting means 26 and controlled by the thin tube position control device 27 via the image processing display device 13 and the probe 12. The X-ray is irradiated from the thin tube 3 to the lesion 7 while receiving this position control.

FIG. 6 is an explanatory view showing the fourth embodiment of the present invention. In this embodiment, the radiation treatment control unit 23 is connected to the electron beam source controller 6 and the capillary position control device 27 in the embodiment of FIG. 5, and the radiation treatment control unit 23 is read from an external treatment planning device 29. The treatment plan data 30 is stored. Thereby, while controlling the position of the thin tube 3 according to the stored treatment plan data 30, the thin tube 3 can automatically irradiate the lesion 7 with X-rays. Also,
By confirming the organ on the tomographic image displayed on the image processing display device 13, the X-ray dose can be controlled according to the size of the lesion 7.

The overall operation at this time will be described below. First, the treatment planning apparatus 29 determines the dose to be applied to the lesion 7 in the subject 8 in advance, and writes the irradiation dose as a part of the treatment plan data. Then, the treatment plan data 30 is read out from the treatment planning device 29 and input to the radiation treatment control unit 23. Next, the fixing means 24 is fixed on the entrance line of the lesion 7 in the subject 8 by using the fixing tool 28, and the probe 12 and the electron beam source 1 are attached to the fixing means 24 and appropriately moved. And fix it to the subject 8. After that, the thin tube 3 is guided to the lesion part 7 by the thin tube driving means 25 of the attaching means 15, and the lesion part 7 is operated by the operation of the electron beam source control unit 6 and the electron beam source 1.
Then, X-ray irradiation is started. At the same time, the probe 1
The ultrasonic wave is transmitted / received from / into the subject 8 from 2, and the lesion part 7 is extracted by the image analysis unit in the image processing / display device 13 from the ultrasonic image obtained thereby. In this state,
The radiotherapy control unit 23 inputs signals from the electron beam source control unit 6 and the image processing display device 13 to determine the positional relationship between the distal end of the thin tube 3 and the lesion site 7, and the dose to be administered to the lesion site 7. Based on the above, the dose rate of X-ray or irradiation time is determined. In this way, the operation of radiation treatment is controlled.

FIG. 7 is an enlarged sectional view showing a modification of the structure of the tip portion of the thin tube 3 of the X-ray irradiation device 10. This variant is
In order to fix the tip of the thin tube 3 inserted into the subject 8 to the lesion 7, a clamp 31 that can be opened and closed is provided at the tip of the thin tube 3. In this case, a sheath 32 having an inner diameter larger than the outer diameter of the thin tube 3 is fitted on the outer peripheral side of the thin tube 3, the distal end portion of the sheath 32 is connected to the vicinity of the hinge portion of the clamp 31, and the sheath 32 is arrowed. The clamp 31 is opened and closed by moving back and forth like A and B. That is, as shown in FIG. 7 (a), the sheath 31 is retracted as shown by arrow A, whereby the clamp 31 is opened as shown by arrows C and D, and as shown in FIG. 7 (b), the sheath 32 is opened by arrow. When the clamp 31 is moved forward as indicated by B, the clamp 31 is closed as indicated by arrows E and F. The lesion 7 can be grasped by the closed clamp 31. As a result, the distal end of the thin tube 3 can be fixed to the lesion 7, and the lesion 7 can be reliably irradiated with X-rays for treatment.

[0024]

Since the present invention is constructed as described above,
An X provided at the tip of the thin tube for the probe of the ultrasonic diagnostic apparatus that processes the reflected echo signals collected by the probe to form and display an ultrasonic image of the lesion in the subject
The electron beam source of the X-ray irradiation device that irradiates the lesion in the subject with X-rays emitted from the radiation generating unit for treatment is attached in a state in which the thin tube is held so that it can be inserted into the subject, and Ultrasonic waves obtained by the ultrasonic diagnostic apparatus by irradiating X-rays to the lesion area with the X-ray irradiation apparatus while confirming the lesion area in the subject by the ultrasonic image obtained by the ultrasonic diagnostic apparatus. It is possible to perform precise treatment with high positional accuracy using the X-ray irradiation device while confirming the lesion area on the image. That is, since the position and state of the lesion can be observed during the actual treatment, the positional accuracy can be ensured, and the tip of the thin tube can be correctly positioned in the lesion. Also,
Since the depth direction of the lesion can also be observed by the ultrasonic image, it is possible to perform a precise treatment on the lesion within the parenchymal organ according to the depth of the lesion.

[Brief description of drawings]

FIG. 1 is an explanatory diagram showing an embodiment of a radiation treatment apparatus according to the present invention.

FIG. 2 is an explanatory diagram showing an image displayed on the screen of the ultrasonic diagnostic apparatus by the operation of the radiotherapy apparatus.

FIG. 3 is an explanatory diagram showing a second embodiment of the present invention.

FIG. 4 is an explanatory diagram showing an image displayed on the screen of the ultrasonic diagnostic apparatus by the operation of the apparatus according to the second embodiment.

FIG. 5 is an explanatory diagram showing a third embodiment of the present invention.

FIG. 6 is an explanatory diagram showing a fourth embodiment of the present invention.

FIG. 7 is an enlarged cross-sectional view showing a modified example of the tip structure of the thin tube of the X-ray irradiation device.

FIG. 8 is an explanatory diagram showing a conventional radiotherapy apparatus.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Electron beam source 2 ... Electron beam 3 ... Capillary tube 4 ... X-ray 5 ... X-ray generation part 6 ... Electron beam source control part 7 ... Lesion site 8 ... Subject 10 ... X-ray irradiation device 11 ... Ultrasonic diagnostic device 12 ... probe 13 ... image processing display device 15 ... attachment means 17 ... tomographic image 18 ... insertion guideline 19a, 19b ... irradiation field 24 ... fixing means 25 ... capillary tube driving means 26 ... capillary tube position detecting means 27 ... capillary tube position control device 31 … Clamp 32… Sheath

Claims (4)

[Claims] 1. A thin tube which is capable of generating and accelerating an electron beam from an electron beam source whose interior is sealed in a vacuum, and extending in the axial direction from one end of the electron beam source to be inserted into a subject. The electron beam emitted from the electron beam source is guided into the subject, and the electron beam emitted from the electron beam source collides with the X-ray generation section provided at the tip of the thin tube to generate X-rays. The electron beam source control unit supplies electric power to the electron beam source and controls the generation of an electron beam, and irradiates a lesion in the subject with X-rays emitted from the X-ray generation unit to perform treatment. The X-ray irradiator and a probe having an ultrasonic transducer inside transmit and receive ultrasonic waves to and from the inside of the subject, and the image processing and display device processes the reflection echo signals collected by the probe to process the inside of the subject. And an ultrasonic diagnostic apparatus for constructing and displaying an ultrasonic image of a lesion area of The electron beam source of the X-ray irradiating device is attached to the probe in a state in which the thin tube is held so that it can be inserted into the subject, and the inside of the subject is detected by the ultrasonic image obtained by the ultrasonic diagnostic device. The X-ray irradiating device irradiates the lesion with X-rays while checking the lesion. 2. An electron beam source of the X-ray irradiating device, wherein a thin tube is slidable in an inserting direction with respect to a probe of the ultrasonic diagnosing device, an inserting angle is variable, and an arbitrary angle is set. The insertion depth and the insertion angle can be detected by the position detection means attached to the probe, and the insertion guideline and the insertion depth of the thin tube are attached. The radiation treatment apparatus according to claim 1, wherein the insertion angle and the insertion angle are displayed in a display image of the ultrasonic diagnostic apparatus. 3. The thin tube of the X-ray irradiating device is capable of exchanging a plurality of types having different X-ray irradiation fields, and the type of the thin tube is discriminated to determine an insertion guideline, an insertion depth and an insertion angle of the thin tube. The radiation treatment apparatus according to claim 2, wherein the X-ray irradiation range is displayed in a display image of the ultrasonic diagnostic apparatus. 4. The probe is fixed to a fixing means for a subject, and the thin tube of the X-ray irradiation device is driven by a thin tube driving means attached to the mounting means so that the insertion depth and the insertion angle can be adjusted. The radiotherapy apparatus according to claim 2 or 3, wherein the position is controllable by a capillary position control device attached to the image processing display device of the ultrasonic diagnostic apparatus.