JP7553321B2 - Setup support device and setup support method - Google Patents

Description

The embodiments disclosed herein relate to a setup support device and a setup support method.

Various cancer treatment methods are known. Among these, radiation therapy is advantageous in that it does not require surgical incisions and is therefore less invasive, and does not necessarily require hospitalization, allowing patients to pursue hobbies, work, etc. at the same time. Generally, radiation therapy is performed on a patient multiple times, rather than just once, so the patient setup performed for each radiation therapy is important.

Special table 2017-536860 publication JP 2011-72457 A JP 2019-162379 A Special Publication No. 2020-505675

One of the problems that the embodiments disclosed in this specification etc. aim to solve is to set up a patient easily and accurately during radiation therapy. However, the problems solved by the embodiments disclosed in this specification etc. are not limited to the above problem. Problems corresponding to the effects of each configuration shown in the embodiments described below can also be considered as other problems solved by the embodiments disclosed in this specification etc.

The information processing method of the embodiment includes an acquisition unit, a calculation unit, and an output unit. The acquisition unit acquires posture information representing the posture of a patient at the time of planning. The calculation unit determines patient setup information that reproduces the patient's posture at the time of planning represented by the posture information at the time of treatment based on a difference between a first positioning member on which the patient is positioned at the time of planning and a second positioning member on which the patient is positioned at the time of treatment. The output unit outputs the setup information.

FIG. 1 is a block diagram showing an example of the configuration of a medical information processing system according to the first embodiment. FIG. 2 is a block diagram showing an example of the configuration of the X-ray CT apparatus according to the first embodiment. FIG. 3 is a schematic diagram showing the radiotherapy apparatus according to the first embodiment. FIG. 4 is a diagram for explaining radiation therapy according to the first embodiment. FIG. 5 is a diagram for explaining radiation therapy according to the first embodiment. FIG. 6 is a flowchart showing a sequence of steps in radiation therapy according to the first embodiment. FIG. 7 is a diagram for explaining plan creation according to the first embodiment. FIG. 8 is a diagram for explaining radiation therapy according to the first embodiment. FIG. 9 is a diagram for explaining a method for reproducing a patient's posture according to the first embodiment. FIG. 10A is a diagram illustrating an example of a fixing device according to the first embodiment. FIG. 10B is a diagram illustrating an example of a fixing device according to the first embodiment. FIG. 11A is a diagram illustrating an example of a fixing device according to the first embodiment. FIG. 11B is a diagram illustrating an example of a fixing device according to the first embodiment. FIG. 12 is a diagram illustrating an example of a fixing device according to the first embodiment. FIG. 13 is a diagram for explaining a method for acquiring posture information according to the first embodiment. FIG. 14 is a diagram for explaining a method for acquiring posture information according to the first embodiment. FIG. 15 is a diagram showing a display example according to the first embodiment. FIG. 16 is a diagram illustrating an example of a setup support method according to the second embodiment.

Below, an embodiment of the setup support device and setup support method will be described in detail with reference to the attached drawings.

First Embodiment
A medical information processing system 1 including a setup support device 10 will be described as an example. For example, as shown in Fig. 1, the medical information processing system 1 includes the setup support device 10, an X-ray CT (Computed Tomography) device 20, a radiotherapy device 30, and an image storage device 40. Fig. 1 is a block diagram showing an example of the configuration of the medical information processing system 1 according to the first embodiment. The setup support device 10, the X-ray CT device 20, the radiotherapy device 30, and the image storage device 40 are connected to each other via a network NW.

As long as the devices included in the medical information processing system 1 can be installed in any location, they can be connected via the network NW. For example, the image storage device 40 may be an image server installed in a facility different from the X-ray CT device 20. In other words, the network NW may be configured as a closed local network within the facility, or may be a network via the Internet.

The setup support device 10 is a device that outputs setup information for setting up patient P in the radiation therapy device 30. The X-ray CT device 20 is a treatment planning X-ray CT device that collects X-ray CT images used to plan radiation therapy prior to radiation therapy of patient P by the radiation therapy device 30. The radiation therapy device 30 is a device that performs radiation therapy on patient P. The image storage device 40 is a device that stores various medical images collected by the X-ray CT device 20, etc. For example, the image storage device 40 is a server of a PACS (Picture Archiving and Communication System).

First, the configuration of the setup support device 10 will be described. As shown in FIG. 1, the setup support device 10 includes a memory 11, a display 12, an input interface 13, and a processing circuit 14. For example, the setup support device 10 is realized as a wearable device that can be worn on the head of a user such as a doctor.

The memory 11 is realized, for example, by a semiconductor memory element such as a random access memory (RAM) or a flash memory. For example, the memory 11 stores a program that enables the circuits included in the setup support device 10 to realize their functions.

The display 12 is a display device that is placed in front of the eyes of a user wearing the setup support device 10. For example, the display 12 is semi-transparent and configured so that an image that can be seen based on light that has passed through the display 12 and a display on the display 12 can be seen simultaneously. As an example, the display 12 is a lens-shaped display device that uses a holographic optical element.

The input interface 13 is a device that accepts input of various information from outside the setup support device 10. For example, the input interface 13 is realized by an optical camera, and acquires images of the inside of the treatment room during the setup of radiation therapy, and stores them in the memory 11. Here, the input interface 13 can also analyze the acquired images and accept input operations from the user. The input interface 13 also controls transmission and reception to and from various devices via the network NW.

The processing circuit 14 controls the operation of the entire setup support device 10 by executing the control function 14a, the acquisition function 14b, the calculation function 14c, and the output function 14d. The acquisition function 14b is an example of an acquisition unit. The calculation function 14c is an example of a calculation unit. The output function 14d is an example of an output unit.

For example, the processing circuit 14 reads out from the memory 11 a program corresponding to the control function 14a and executes it to control various functions such as the acquisition function 14b, the calculation function 14c, and the output function 14d. The acquisition function 14b acquires posture information that represents the posture of the patient P at the time of planning. The calculation function 14c obtains setup information for the patient P that reproduces the posture of the patient P at the time of planning represented by the posture information during treatment. The output function 14d outputs the setup information. Details of the processing by the acquisition function 14b, the calculation function 14c, and the output function 14d will be described later.

In the setup support device 10 shown in FIG. 1, each processing function is stored in the memory 11 in the form of a program executable by a computer. The processing circuit 14 is a processor that realizes the function corresponding to each program by reading the program from the memory 11 and executing it. In other words, when the processing circuit 14 has read a program, it has the function corresponding to the read program.

In FIG. 1, the control function 14a, acquisition function 14b, calculation function 14c, and output function 14d are described as being realized by a single processing circuit 14, but the processing circuit 14 may be configured by combining multiple independent processors, and each processor may execute a program to realize the functions. Furthermore, each processing function of the processing circuit 14 may be realized by being appropriately distributed or integrated into a single or multiple processing circuits.

The processing circuitry 14 may also realize functions by using a processor of an external device connected via the network NW. For example, the processing circuitry 14 reads out and executes a program corresponding to each function from the memory 11, and realizes each function shown in FIG. 1 by using a group of servers (cloud) connected to the setup support device 10 via the network NW as a computing resource.

Next, an example of the configuration of the X-ray CT device 20 will be described with reference to FIG. 2. FIG. 2 is a block diagram showing an example of the configuration of the X-ray CT device 20 according to the first embodiment. As shown in FIG. 2, the X-ray CT device 20 has a gantry device 210, a bed device 230, and a console device 240.

In FIG. 2, the rotation axis of the rotating frame 213 in a non-tilted state or the longitudinal direction of the top plate 233 of the bed device 230 is the Z-axis direction. The axial direction that is perpendicular to the Z-axis direction and horizontal to the floor surface is the X-axis direction. The axial direction that is perpendicular to the Z-axis direction and perpendicular to the floor surface is the Y-axis direction. For the sake of explanation, FIG. 2 shows the gantry device 210 from multiple directions, and shows a case in which the X-ray CT device 20 has one gantry device 210.

The gantry device 210 has an X-ray tube 211, an X-ray detector 212, a rotating frame 213, an X-ray high voltage device 214, a control device 215, a wedge 216, a collimator 217, and a DAS 218.

The X-ray tube 211 is a vacuum tube having a cathode (filament) that generates thermoelectrons and an anode (target) that generates X-rays when the thermoelectrons collide with it. The X-ray tube 211 generates X-rays to be irradiated to the patient P by irradiating thermoelectrons from the cathode to the anode through application of high voltage from the X-ray high voltage device 214.

The X-ray detector 212 detects X-rays emitted from the X-ray tube 211 and passing through the patient P, and outputs a signal corresponding to the detected X-ray amount to the DAS 218. The X-ray detector 212 has, for example, multiple detection element rows in which multiple detection elements are arranged in the channel direction along an arc centered on the focus of the X-ray tube 211. The X-ray detector 212 has a structure in which, for example, multiple detection element rows in which multiple detection elements are arranged in the channel direction are arranged in the row direction (slice direction, row direction).

For example, the X-ray detector 212 is an indirect conversion type detector having a grid, a scintillator array, and an optical sensor array. The scintillator array has multiple scintillators. The scintillator has scintillator crystals that output light with a photon amount corresponding to the amount of incident X-rays. The grid is arranged on the X-ray incident side of the scintillator array and has an X-ray shielding plate that absorbs scattered X-rays. The grid is sometimes called a collimator (one-dimensional collimator or two-dimensional collimator). The optical sensor array has a function of converting the amount of light from the scintillator into an electrical signal corresponding to the amount of light, and has an optical sensor such as a photodiode. The X-ray detector 212 may be a direct conversion type detector having a semiconductor element that converts the incident X-rays into an electrical signal.

The rotating frame 213 is an annular frame that supports the X-ray tube 211 and the X-ray detector 212 facing each other and rotates the X-ray tube 211 and the X-ray detector 212 by the control device 215. For example, the rotating frame 213 is a casting made of aluminum. In addition to the X-ray tube 211 and the X-ray detector 212, the rotating frame 213 can also support the X-ray high voltage device 214, the wedge 216, the collimator 217, the DAS 218, etc. Furthermore, the rotating frame 213 can also support various components not shown in FIG. 2. Hereinafter, the rotating frame 213 and the part of the gantry device 210 that rotates together with the rotating frame 213 are also referred to as the rotating part.

The X-ray high voltage device 214 has electrical circuits such as a transformer and a rectifier, and includes a high voltage generator that generates a high voltage to be applied to the X-ray tube 211, and an X-ray control device that controls the output voltage according to the X-rays generated by the X-ray tube 211. The high voltage generator may be of a transformer type or an inverter type. The X-ray high voltage device 214 may be provided on the rotating frame 213, or on a fixed frame (not shown).

The control device 215 has a processing circuit having a CPU (Central Processing Unit) and the like, and a driving mechanism such as a motor and an actuator. The control device 215 receives an input signal from the input interface 243 and controls the operation of the gantry device 210 and the bed device 230. For example, the control device 215 controls the rotation of the rotating frame 213, the tilt of the gantry device 210, the operation of the bed device 230, and the like. As an example, the control device 215 rotates the rotating frame 213 around an axis parallel to the X-axis direction according to input inclination angle (tilt angle) information as a control for tilting the gantry device 210. The control device 215 may be provided in the gantry device 210 or in the console device 240.

The wedge 216 is an X-ray filter for adjusting the amount of X-rays emitted from the X-ray tube 211. Specifically, the wedge 216 is an X-ray filter that attenuates the X-rays emitted from the X-ray tube 211 so that the X-rays irradiated from the X-ray tube 211 to the patient P have a predetermined distribution. For example, the wedge 216 is a wedge filter or a bow-tie filter, and is made by processing aluminum or the like to have a predetermined target angle and a predetermined thickness.

The collimator 217 is a lead plate or the like for narrowing the irradiation range of the X-rays that have passed through the wedge 216, and a slit is formed by combining multiple lead plates or the like. The collimator 217 is sometimes called an X-ray aperture. Also, while FIG. 2 shows a case in which the wedge 216 is placed between the X-ray tube 211 and the collimator 217, the collimator 217 may also be placed between the X-ray tube 211 and the wedge 216. In this case, the wedge 216 transmits and attenuates the X-rays that are irradiated from the X-ray tube 211 and whose irradiation range is limited by the collimator 217.

DAS218 collects X-ray signals detected by each detection element of X-ray detector 212. For example, DAS218 has an amplifier that amplifies the electrical signal output from each detection element and an A/D converter that converts the electrical signal into a digital signal, and generates detection data. DAS218 is realized, for example, by a processor.

The data generated by the DAS 218 is transmitted by optical communication from a transmitter having a light emitting diode (LED) provided on the rotating frame 213 to a receiver having a photodiode provided on a non-rotating part of the gantry 210 (e.g., a fixed frame, etc. (not shown in FIG. 2)), and then transferred to the console device 240. Here, the non-rotating part is, for example, a fixed frame that rotatably supports the rotating frame 213. Note that the method of transmitting data from the rotating frame 213 to the non-rotating part of the gantry 210 is not limited to optical communication, and any non-contact data transmission method or a contact data transmission method may be adopted.

The bed device 230 is a device for positioning and moving the patient P to be treated, and includes a base 231, a bed driving device 232, a tabletop 233, and a support frame 234. The base 231 is a housing that supports the support frame 234 so that it can move vertically. The bed driving device 232 is a drive mechanism that moves the tabletop 233 on which the patient P is placed in the longitudinal direction of the tabletop 233, and includes a motor, an actuator, and the like. The tabletop 233 provided on the upper surface of the support frame 234 is a plate on which the patient P is placed. The tabletop 233 is an example of a first positioning member on which the patient P is placed during planning. The bed driving device 232 may move the support frame 234 in the longitudinal direction of the tabletop 233 in addition to the tabletop 233.

The console device 240 has a memory 241, a display 242, an input interface 243, and a processing circuit 244. Note that although the console device 240 is described as being separate from the gantry device 210, the gantry device 210 may include the console device 240 or some of the components of the console device 240.

The memory 241 is realized, for example, by a semiconductor memory element such as a RAM or a flash memory, a hard disk, an optical disk, etc. For example, the memory 241 stores projection data collected by scanning the patient P in the X-ray CT device 20, X-ray CT images reconstructed based on the projection data, etc. The memory 241 also stores a program that enables the circuitry included in the X-ray CT device 20 to realize its functions.

The display 242 displays various information. For example, the display 242 displays a GUI (Graphical User Interface) for receiving various instructions and settings from the user via the input interface 243. For example, the display 242 is a liquid crystal display or a CRT (Cathode Ray Tube) display. The display 242 may be a desktop type, or may be configured as a tablet terminal capable of wireless communication with the X-ray CT device 20 main body.

2, the X-ray CT device 20 is described as having a display 242, but the X-ray CT device 20 may have a projector instead of or in addition to the display 242. The projector can project onto a screen, a wall, a floor, the body surface of the patient P, etc. under the control of the processing circuitry 244. As an example, the projector can also project onto any plane, object, space, etc. by projection mapping.

The input interface 243 accepts various input operations from the user, converts the accepted input operations into electrical signals, and outputs them to the processing circuit 244. For example, the input interface 243 is realized by a mouse, keyboard, trackball, switch, button, joystick, a touchpad that performs input operations by touching the operation surface, a touch screen in which a display screen and a touchpad are integrated, a non-contact input circuit using an optical sensor, a voice input circuit, etc. The input interface 243 may be configured as a tablet terminal or the like that can wirelessly communicate with the X-ray CT device 20 main body. The input interface 243 may also be a circuit that accepts input operations from the user by motion capture. For example, the input interface 243 can accept the user's body movements, gaze, etc. as input operations by processing signals acquired via a tracker and images collected about the user. The input interface 243 is not limited to only those that have physical operating parts such as a mouse and a keyboard. For example, an example of the input interface 243 includes an electrical signal processing circuit that receives an electrical signal corresponding to an input operation from an external input device provided separately from the X-ray CT device 20 and outputs this electrical signal to the processing circuit 244.

The processing circuitry 244 executes the control function 244a, the collection function 244b, and the output function 244c to control the operation of the entire X-ray CT device 20. For example, the processing circuitry 244 reads out a program corresponding to the control function 244a from the memory 241 and executes it to control various functions such as the collection function 244b and the output function 244c based on various input operations received from the user via the input interface 243.

The processing circuit 244 also reads out from the memory 241 a program corresponding to the collection function 244b and executes it to perform a CT scan to collect projection data from the patient P. For example, the collection function 244b controls the X-ray high voltage device 214 to supply a high voltage to the X-ray tube 211. As a result, the X-ray tube 211 generates X-rays to be irradiated to the patient P. The collection function 244b also controls the bed drive device 232 to move the patient P into the imaging opening of the gantry device 210. The collection function 244b also controls the position of the wedge 216 and the opening degree and position of the collimator 217 to control the distribution of X-rays irradiated to the patient P. The collection function 244b also rotates the rotating part by controlling the control device 215. Also, while the scan is being performed by the collection function 244b, the DAS 218 collects X-ray signals from each detection element in the X-ray detector 212 and generates detection data. The collection function 244b also performs preprocessing on the detection data output from the DAS 218. For example, the collection function 244b performs preprocessing such as logarithmic conversion processing, offset correction processing, inter-channel sensitivity correction processing, and beam hardening correction on the detection data output from the DAS 218. Note that data after preprocessing is also referred to as raw data. Furthermore, the detection data before preprocessing and the raw data after preprocessing are collectively referred to as projection data.

The acquisition function 244b also performs reconstruction processing on the projection data to generate an X-ray CT image. For example, the acquisition function 244b performs reconstruction processing on the projection data using a filtered backprojection method, an iterative reconstruction method, an iterative reconstruction method, or the like to generate an X-ray CT image (volume data). The acquisition function 244b can also perform reconstruction processing using AI (Artificial Intelligence) to generate an X-ray CT image. For example, the acquisition function 244b generates an X-ray CT image using a DLR (Deep Learning Reconstruction) method.

The processing circuitry 244 also controls the display on the display 242 by reading from the memory 241 and executing a program corresponding to the output function 244c. For example, the output function 244c generates a display image based on an X-ray CT image and displays it on the display 242. The output function 244c also controls the transmission of data via the network NW. For example, the output function 244c transmits an X-ray CT image collected from the patient P to the image storage device 40 via the network NW.

In the X-ray CT device 20 shown in FIG. 2, each processing function is stored in the memory 241 in the form of a program executable by a computer. The processing circuitry 244 is a processor that realizes the function corresponding to each program by reading the program from the memory 241 and executing it. In other words, the processing circuitry 244 in a state in which a program has been read has the function corresponding to the read program.

2, the control function 244a, the collection function 244b, and the output function 244c are realized by a single processing circuit 244. However, the processing circuit 244 may be configured by combining multiple independent processors, and each processor may execute a program to realize the functions. Each processing function of the processing circuit 244 may be appropriately distributed or integrated into a single or multiple processing circuits. The processing circuit 244 may also realize a function by using a processor of an external device connected via a network. For example, the processing circuit 244 realizes each function shown in FIG. 2 by reading and executing a program corresponding to each function from the memory 241, and by using the cloud as a computing resource.

Next, the radiation therapy device 30 will be described with reference to FIG. 3. FIG. 3 is a schematic diagram showing the radiation therapy device 30 according to the first embodiment.

The radiation therapy device 30 includes a radiation generator 322 and a radiation constrictor 323, and performs radiation therapy on the patient P. That is, the radiation generator 322 irradiates therapeutic radiation, and the radiation constrictor 323 irradiates the therapeutic radiation by constricting it to the area to be treated. The tabletop 341 is an example of a second placement member on which the patient P is placed during treatment. The display 351 displays various GUIs, medical images, and the like. The display 351 can be configured, for example, in the same manner as the display 242 described above. Details of radiation therapy will be described later.

The above describes the overall configuration of the medical information processing system 1, which includes the setup support device 10, the X-ray CT device 20, the radiation therapy device 30, and the image storage device 40. We will now explain the radiation therapy performed on patient P using this configuration.

The target site of radiation therapy in patient P is not particularly limited, but examples of target sites include head and neck cancer, laryngeal cancer, lung cancer, prostate cancer, metastatic brain tumors, breast cancer, and uterine/cervical cancer. In addition, although radiation therapy is described below, radiation therapy may be combined with other treatments. For example, multidisciplinary therapy may be performed that combines radiation therapy with surgery, chemotherapy (anticancer drugs), immunotherapy, etc.

Radiation therapy has multiple purposes, such as curative treatment, palliative (palliative) treatment, and preventive treatment, but the embodiments are not limited in this respect. In other words, the following embodiments are applicable regardless of the purpose for which radiation therapy is performed. Curative treatment is treatment that aims to completely cure cancer and achieve long-term survival through radiation therapy. Palliative treatment is treatment that aims to slow the progression of cancer, relieve symptoms such as pain, and extend life. Palliative treatment is often performed for metastatic bone tumors and metastatic brain tumors. Preventive treatment is treatment in which radiation is irradiated in advance to areas where cancer is predicted to metastasize in the future after cancer has been treated with other treatment methods.

In radiation therapy, cancer tissue is killed by irradiating it with a certain lethal dose. However, when cancer tissue is distributed throughout the body of patient P, it is difficult to irradiate only the cancer tissue with radiation, and generally, when radiation is irradiated to the cancer tissue, normal tissue is also irradiated with radiation at the same time. Therefore, it is important to carry out radiation therapy so as not to exceed the dose that normal tissue can tolerate.

In order to preserve normal tissue, radiation therapy is often performed in multiple sessions. This will be described below with reference to FIG. 4. FIG. 4 is a diagram for explaining radiation therapy according to the first embodiment. The horizontal axis of FIG. 4 indicates the number of radiation irradiations, and the vertical axis indicates the cell survival rate. As shown in FIG. 4, a single irradiation with a certain amount of radiation kills both normal tissue and cancer tissue to the same extent. However, normal tissue recovers faster than cancer tissue. By repeating radiation irradiation while waiting for normal tissue to recover, it is possible to selectively kill cancer tissue.

Normal tissue can also be preserved by adjusting the radiation irradiation direction in radiation therapy. This point will be described below with reference to FIG. 5. FIG. 5 is a diagram for explaining radiation therapy according to the first embodiment. That is, when irradiating a target site R where cancer tissue is distributed with radiation, it is possible to irradiate from only one direction, but by irradiating from multiple directions, a dose distribution localized to the target site R can be obtained. When radiation is irradiated in a certain direction, that irradiation direction is also called a "gate."

The single-port irradiation shown in the upper left of Figure 5 is irradiation from only one direction. In single-port irradiation, a high dose is applied to a wide area, and the dose is higher closer to the entrance surface. The opposing two-port irradiation shown in the upper right of Figure 5 is irradiation from 180° opposite directions. In opposing two-port irradiation, a high dose is applied uniformly along the path of the radiation. The four-port irradiation shown in the lower left of Figure 5 is irradiation from four directions with different angles. The four-port irradiation has the advantage that the radiation is dispersed, so there is no extreme exposure in only one direction. The rotating conformation irradiation shown in the lower right of Figure 5 is irradiation while rotating the rotating gantry 331. If an aperture shaped to match the shape of the target area R is made during rotation and rotation irradiation is performed, the dose can be concentrated on the target area R.

As explained in Figs. 4 and 5, radiation therapy can be achieved with reduced burden on patient P by performing irradiation in multiple steps while adjusting the irradiation direction so as to reduce the amount of radiation irradiated to normal tissue. Next, a series of steps from creating a treatment plan to performing the treatment will be explained using Fig. 6. Fig. 6 is a flowchart showing a series of steps in radiation therapy according to the first embodiment.

First, a treatment plan is decided, and explanation and consent are obtained. That is, in addition to radiation therapy, there are other cancer treatment methods such as surgical therapy, chemotherapy, and immunotherapy. Of these, a decision is made as to which treatment is appropriate for Patient P. Furthermore, if radiation therapy is considered as one of the treatment methods, Patient P is examined and given an explanation about radiation therapy by a radiation oncologist. Then, a specific treatment plan is decided, including the irradiation method, the dose per session, the number of fractions, and the treatment schedule. Furthermore, an explanation is given about side effects that may occur during and after treatment and other points to note, and if Patient P consents, preparations for radiation therapy are made.

After the patient P agrees to radiation therapy, a fixation device such as a shell is created. The fixation device is a holding member that maintains the patient P's posture during treatment. That is, as explained in FIG. 4, radiation therapy is generally performed multiple times. Furthermore, in order to accurately irradiate the same location with each radiation therapy, it is necessary to ensure the repeatability of the patient position with the fixation device while suppressing movement during treatment and ensuring accuracy. There are ready-made fixation devices that can be shared by multiple patients, but since the position of the target area R and the physique differ from patient to patient, they may be created for each patient. Specific examples of fixation devices will be described later.

Next, the planned CT image is captured in the X-ray CT device 20. Specifically, the patient P is placed on the top plate 233 of the X-ray CT device 20. At this time, the previously created fixture is also placed on the top plate 233 to maintain the patient P's posture. That is, the posture of the patient P is maintained by the fixture both during imaging with the X-ray CT device 20 and during treatment with the radiation therapy device 30 so that the patient P's posture is the same during planning and treatment. Then, a CT scan is performed on the range including the target site R, and an X-ray CT image is reconstructed based on the collected projection data. The reconstructed X-ray CT image is transmitted from the X-ray CT device 20 to the image storage device 40 and stored therein.

Next, a radiation therapy plan (treatment plan) is created. Here, the plan creation will be explained using FIG. 7. FIG. 7 is a diagram for explaining the plan creation according to the first embodiment. Note that FIG. 7 explains the case of creating a radiation therapy plan for pharyngeal cancer.

The plan is created, for example, in a treatment planning device (not shown). For example, the treatment planning device is connected to the setup support device 10, X-ray CT device 20, radiation therapy device 30, and image storage device 40 in FIG. 1 via a network NW. For example, the treatment planning device acquires the X-ray CT image collected from patient P by the X-ray CT device 20 and stored in the image storage device 40 as a treatment planning CT image shown in FIG. 7.

Next, the treatment planning device sets the tumor area (cancerous tissue) and normal tissue on the treatment planning CT image. That is, the treatment planning device sets the areas to be irradiated with radiation in radiation therapy and the areas not to be irradiated on the treatment planning CT image. The treatment planning device may automatically set the tumor area and normal tissue by image processing the treatment planning CT image, or may set the tumor area and normal tissue based on input operations from the user. Next, the treatment planning device sets various irradiation conditions including the radiation incidence direction, irradiation field shape, administered dose, and other parameters. The treatment planning device may automatically set the irradiation conditions according to the set tumor area and normal tissue, or may set the irradiation conditions based on input operations from the user.

The treatment planning device then calculates the internal dose distribution based on the set irradiation conditions, creates an internal dose distribution map, and provides it to the user. The user then decides whether or not to perform radiation therapy under the set irradiation conditions, taking into consideration various factors such as whether the internal dose distribution is problematic, whether the dose to the tumor is sufficient, and whether the dose to normal tissue is acceptable. If the user determines that the set irradiation conditions are inappropriate (No), he or she can reset or adjust the irradiation conditions. In other words, the treatment planning device can use the treatment planning CT images to simulate the dose distribution inside the body of patient P when therapeutic radiation is irradiated, and create a plan for the actual conditions under which treatment (irradiation) will be performed.

Then, daily treatment is carried out based on the created plan. Daily treatment will now be described with reference to FIG. 8. FIG. 8 is a diagram for explaining radiation therapy according to the first embodiment.

First, as described above, diagnostic and treatment planning CT images are collected and a treatment plan is created. Then, radiation therapy is performed according to the created treatment plan. That is, the radiation therapy device 30 irradiates the patient P with therapeutic radiation according to the treatment plan. Here, while the collection of treatment planning CT images and the creation of the treatment plan are usually performed once, radiation therapy is performed multiple times (e.g., N times).

In each radiation therapy session, the set-up and radiation irradiation are performed as a set. In the set-up, it is important to reproduce the posture of patient P at the time of treatment planning. That is, since the treatment plan is created based on the treatment planning CT images, in order to perform efficient radiation therapy in accordance with the treatment plan, it is preferable to perform radiation therapy in the same posture as when the treatment planning CT images were collected.

As a method for reproducing the planned posture during treatment, for example, as shown in FIG. 9, a method of marking the body surface of the patient P is known. Specifically, when the patient P is placed on the tabletop 233 to collect treatment planning CT images, the position of the marking on the body surface of the patient P is recorded. Thereafter, when the patient P is placed on the tabletop 341 for radiation therapy, visible light is laser-irradiated to the recorded position of the marking. Then, by adjusting the posture of the patient P so that the marking on the body surface of the patient P coincides with the visible light projected onto the body surface of the patient P, it becomes possible to reproduce the planned posture during treatment. Note that FIG. 9 is a diagram for explaining the method of reproducing the posture of the patient P according to the first embodiment.

The coordinate system in the X-ray CT device 20 and the coordinate system in the radiation therapy device 30 can be associated with each other, for example, based on the center of rotation of the X-ray tube 211 that rotates together with the rotating frame 213 in the X-ray CT device 20 and the center of rotation (isocenter) of the radiation generator 322 that rotates together with the rotating gantry 331 in the radiation therapy device 30. This makes it possible to irradiate visible light with a laser at the position of the marking recorded in the coordinate system of the X-ray CT device 20 in the coordinate system of the radiation therapy device 30. Hereinafter, the coordinate system in the X-ray CT device 20 will also be referred to as the first coordinate system, and the coordinate system in the radiation therapy device 30 will also be referred to as the second coordinate system.

In addition, various types of fixation devices are used to reproduce the posture at the time of planning during treatment. That is, the posture of patient P is maintained by the fixation devices both during imaging with the X-ray CT device 20 and during treatment with the radiation therapy device 30 so that the posture of patient P is the same during planning and treatment.

Examples of the fixing device include fixing device F11 in Fig. 10A and Fig. 10B, and fixing device F12 in Fig. 10B. Fixing device F11 is used to maintain the posture of the upper body of patient P when the target area for radiation therapy is the breast. Fixing device F12 is used to maintain the posture of the lower body of patient P. Note that Fig. 10B shows a case where fixing device F11 and fixing device F12 are used together, but fixing device F11 and fixing device F12 can also be used individually. Figs. 10A and 10B are diagrams showing an example of a fixing device according to the first embodiment.

Other examples of the fixing device include fixing device F21 in FIG. 11A and fixing device F22 in FIG. 11B. Fixing device F21 and fixing device F22 are head and neck shells used to maintain the position of the head of patient P. FIGS. 11A and 11B are diagrams showing an example of a fixing device according to the first embodiment.

Another example of a fixing device is fixing device F3 in FIG. 12. Fixing device F3 is a prostate shell fixing device used to maintain the posture around the waist of patient P. FIG. 12 is a diagram showing an example of a fixing device according to the first embodiment. A wide variety of other fixing devices are also known. For example, a suction-type fixing bag that forms a recess that conforms to the body of patient P may be used as a fixing device.

As described above, the setup for each treatment is done by marking the surface of the patient P's body and using fixation devices to reproduce the patient P's posture at the time of planning. As shown in Figure 8, after completing N radiation treatments, the patient moves to follow-up observation.

The task of reproducing a previous posture is difficult, and the setup on the day of treatment described above often takes time. In order to improve the accuracy of radiation therapy, it is preferable to reproduce the posture of the entire body, not just the area near the target site of radiation therapy. For example, even if the target site is the abdomen, it is preferable to reproduce not only the position of the abdomen, but also the angles of the arms and knees, the position of the face, etc.

Another factor that requires time for setup is that planning and treatment are performed on different devices. For example, if a fixture is placed on the top plate 233 of the X-ray CT scanner 20 during planning, it may be difficult to determine where the fixture should be placed on the top plate 341 of the radiation therapy device 30 during treatment. Also, the top plate 233 of the X-ray CT scanner 20 is often an R-shaped plate with a recess in the center, while the top plate 341 of the radiation therapy device 30 is often flat. In this way, when the shape of the top plate differs between planning and treatment, it is particularly difficult to reproduce the patient's posture. Furthermore, some patients do not like to have markings on their body surface, making setup even more difficult.

The setup support device 10 therefore provides the user with setup information to support the setup for each radiation therapy. Specifically, first, the acquisition function 14b acquires posture information that represents the posture of the patient P at the time of planning. That is, the acquisition function 14b acquires posture information that represents the posture of the patient P placed on the tabletop 233 in order to collect the treatment planning CT images.

As an example, the posture information is a three-dimensional image of patient P at the time of planning, captured using the 3D camera 51 in FIG. 13. Specifically, the user positions patient P on the tabletop 233, and then captures the patient P using the 3D camera 51. The acquisition function 14b can acquire the three-dimensional image of patient P from the 3D camera 51, for example, via the network NW. Note that FIG. 13 is a diagram for explaining a method of acquiring posture information according to the first embodiment.

As another example, the posture information is a three-dimensional image of the patient P at the time of planning, captured using the laser scanner 52 in FIG. 14. Specifically, after the patient P is placed on the tabletop 233, the laser scanner 52 captures the patient P. For example, the laser scanner 52 is installed on a wall or ceiling of an examination room in which the X-ray CT device 20 is installed. For example, the laser scanner 52 automatically captures the patient P when triggered by the start of an operation to insert the tabletop 233 and the patient P into the opening of the gantry device 210. In addition, the acquisition function 14b can acquire a three-dimensional image of the patient P from the laser scanner 52, for example, via the network NW. Note that FIG. 14 is a diagram for explaining a method of acquiring posture information according to the first embodiment.

The three-dimensional image captured by the 3D camera 51 or the laser scanner 52 may show color and shape, or may show only shape. For example, the three-dimensional image may be shape data showing the shape of the body surface of the patient P in a state in which the posture is maintained by the fixing device, and the shape of the fixing device.

Next, the calculation function 14c determines the placement positions of the fixing devices on the tabletop 341 so that the posture of the patient P at the time of planning is reproduced during treatment. For example, the calculation function 14c first analyzes three-dimensional images taken by the 3D camera 51 or the laser scanner 52, and calculates the positions and angles of each fixing device in a first coordinate system in which the center of rotation of the X-ray tube 211 is set as the reference position.

As an example, the 3D camera 51 is equipped with a sensor capable of detecting the position and angle of the 3D camera 51 in the first coordinate system. The calculation function 14c uses this sensor to associate the position and angle of the 3D camera 51 at the time of shooting with the first coordinate system, and by associating the three-dimensional image with the first coordinate system, it is possible to calculate the position and angle in the first coordinate system of each fixture that appears in the three-dimensional image.

As another example, the laser scanner 52 is fixed at a predetermined position in the examination room in which the X-ray CT device 20 is installed. That is, the position and angle of the laser scanner 52 in the first coordinate system are fixed. In this case, since the correspondence between the three-dimensional image captured by the laser scanner 52 and the first coordinate system is known, the calculation function 14c can calculate the position and angle of each fixture appearing in the three-dimensional image in the first coordinate system.

Next, the calculation function 14c associates the position and angle of each fixing tool determined in the first coordinate system with the second coordinate system in the radiation therapy device 30. For example, the calculation function 14c associates the first coordinate system with the second coordinate system based on the center of rotation of the X-ray tube 211 in the X-ray CT device 20 and the isocenter in the radiation therapy device 30. This allows the calculation function 14c to determine the position and angle of the fixing tool in the second coordinate system. In other words, the calculation function 14c can determine the distance and height from the isocenter as the placement position of the fixing tool during treatment.

If there is a difference in shape between the top plate 233 and the top plate 341, the calculation function 14c may determine the placement position of the fixing device by taking this difference into account. For example, if the top plate 233 is R-shaped and the top plate 341 is flat, the deviation in the height direction due to a depression in the top plate 233 may be reflected in the placement position of the fixing device.

Next, the output function 14d outputs setup information for setting up the patient P on the tabletop 341 based on the placement positions of the fixtures calculated by the calculation function 14c. That is, the output function 14d outputs setup information for supporting the setup during treatment based on the placement positions of the fixtures.

For example, the output function 14d causes the display 12 to display, as setup information, an image showing the patient's posture at the time of planning. For example, as shown in FIG. 15, the output function 14d causes the display 12 to display the patient's posture at the time of planning as an AR (Augmented Reality) image based on a three-dimensional image captured by a 3D camera 51 or a laser scanner 52. Note that FIG. 15 is a diagram showing a display example according to the first embodiment.

Specifically, during setup on the day of treatment, the setup support device 10 is attached to the user's head as shown in FIG. 15. Here, the display 12 is placed in front of the user's eyes, for example like the lenses of goggles. The display 12 is semi-transparent, and the user can view the inside of the treatment room in which the radiation therapy device 30 is installed based on the light transmitted through the display 12. In other words, even when the user is wearing the setup support device 10 on their head, they can view real images in the same way as with the naked eye.

Furthermore, the output function 14d causes the display 12 to display the setup information. Specifically, the output function 14d causes the display 12 to display a three-dimensional image of the patient P captured by the 3D camera 51 or the laser scanner 52. Such a three-dimensional image is displayed so as to be superimposed on the real image visually recognized by the user through the display 12.

Here, the output function 14d controls the AR display based on the placement position of the fixture obtained by the calculation function 14c. For example, the output function 14d obtains the position and angle of the setup support device 10 in real time using a sensor. For example, the output function 14d obtains the position and angle of the setup support device 10 in real time in a second coordinate system based on the isocenter of the radiation therapy device 30. The output function 14d also scans the user's eyes to identify the position of the viewpoint (standing point). This allows the output function 14d to calculate which position in the second coordinate system corresponds to the real image viewed by the user through the display 12. That is, the output function 14d obtains a position corresponding to the placement position of the fixture obtained by the calculation function 14c in the real image viewed by the user through the display 12, and can perform AR display of a three-dimensional image based on this position.

When a display such as that shown in FIG. 15 is performed during setup, the user can visually check the actual patient P during setup, while also visually checking the posture of the patient P at the time of planning and the fixtures that were holding the patient P at the time of planning. If there is a discrepancy in posture between the actual patient P and the patient P displayed in AR, the user can instruct the patient P to correct the discrepancy. Also, if there is a discrepancy in position between the actual fixture and the fixture displayed in AR, the position of the fixture can be corrected. In this way, the setup support device 10 makes it possible to easily and accurately set up the patient P during radiation therapy.

In addition, if there is a mismatch between the fixture displayed in AR and the fixture that actually holds the posture of patient P, the user can immediately notice it. In other words, the display shown in FIG. 15 makes it possible to prevent forgetting or making mistakes with the fixture, and to set up the patient more accurately during radiation therapy.

If there is a mismatch in the fixtures, the output function 14d may notify the user of this. Specifically, the output function 14d uses an optical camera to capture video of the patient P during setup in real time. Such an optical camera may be provided in the setup support device 10, or may be provided separately from the setup support device 10, for example, on a wall or ceiling in a treatment room. Next, the output function 14d determines whether there is a mismatch between the fixture holding the patient P during setup and the fixture being displayed in AR.

Specifically, if there is a fixture included in the AR display that is not holding patient P during setup, output function 14d can determine that there is a forgotten fixture. In other words, if there is a fixture that held patient P's position during planning but does not hold patient P's position during treatment, output function 14d determines that there is a forgotten fixture. In this way, the forgotten fixture is also referred to as the first member.

In addition, if there is a fixture that is holding patient P during setup but is not included in the AR display, the output function 14d can determine that there is an incorrect fixture. In other words, if there is a fixture that did not hold patient P's position during planning but holds patient P's position during treatment, the output function 14d determines that there is an incorrect fixture. In this way, the incorrect fixture is also referred to as the second member.

If there is a mismatch in the fixing tools, the output function 14d notifies the user of the presence of the first member or the second member. For example, the output function 14d may display the presence of the first member or the second member on the display 12, or may notify the user by voice or the like. This allows the output function 14d to more reliably prevent forgetting or making mistakes with the fixing tools, and allows for more accurate setup of the patient during radiation therapy.

When determining whether a fixing device has been forgotten or incorrectly used, the setup support device 10 may manage each fixing device by a number and link it to the patient P who uses that fixing device. This allows the calculation function 14c to identify each fixing device as data and more reliably determine whether any fixing devices have been forgotten or incorrectly used.

So far, a case has been described in which a 3D image of patient P taken at the time of planning is displayed as an AR image. Here, the output function 14d may display a processed image based on the 3D image of patient P as an AR image. For example, the output function 14d may display an image in which processing has been performed to emphasize characteristic parts in the 3D image of patient P as an AR image. As one example, the output function 14d emphasizes the target area for radiation therapy, the nipples, navel, etc. of patient P in the 3D image. This increases the number of markers when setting up patient P to align his/her posture with the 3D image displayed in AR, making the setup easier.

The output function 14d may further output a parameter indicating the difference between the posture of the patient P at the time of planning and the posture of the patient P at the time of treatment. For example, the calculation function 14c analyzes the image collected in real time from the patient P during setup, and calculates a parameter indicating the difference from the three-dimensional image displayed in AR. As an example, the calculation function 14c calculates the position coordinates of each position on the current body surface of the patient P in the second coordinate system based on the image collected in real time. Also, the calculation function 14c calculates the position coordinates of each position on the body surface of the patient P at the time of planning in the second coordinate system based on the three-dimensional image displayed in AR. Also, the calculation function 14c calculates the similarity between the position coordinates of each position on the current body surface of the patient P and the position coordinates of each position on the body surface of the patient P at the time of planning as a parameter indicating the difference between the posture of the patient P at the time of planning and the posture of the patient P at the time of treatment. An example of such similarity is, for example, KL divergence. Then, the output function 14d outputs the parameters calculated by the calculation function 14c.

The output function 14d may display the calculated parameters on the display 12, or may notify the user by voice or the like. The output function 14d may also output the parameters as numerical values, or as ranks such as "high, medium, low," or in the form of colors, figures, or the like. The user can then refer to the increase or decrease in the parameters to perform setup more efficiently, so as to reduce the difference between the posture of patient P at the time of planning and the posture of patient P at the time of treatment.

When calculating the parameter indicating the difference between the posture of patient P at the time of planning and the posture of patient P at the time of treatment, weighting may be applied to each part. For example, the calculation function 14c calculates the above parameter by weighting the vicinity of the target part of radiation therapy. This allows the vicinity of the target part to be preferentially aligned, making it possible to perform radiation therapy more accurately. In other words, the setup support device 10 can perform setup so that important parts match the time of planning, even if the entire patient P does not match.

Up to this point, we have described a case where AR display is performed based on the position of the fixing tool. However, in radiation therapy, in addition to the fixing tool for maintaining the patient P's posture, various accessories may be attached to the patient P. For example, when the target area for radiation therapy is the chest, an electrocardiograph may be attached to the patient P in order to irradiate radiation in synchronization with the electrocardiogram. Such an electrocardiograph is an example of an auxiliary member. In this case, the calculation function 14c determines the position of the auxiliary member during treatment in addition to the position of the fixing tool. Furthermore, the output function 14d outputs setup information based on the positions of the fixing tool and auxiliary members.

For example, during planning, a 3D camera 51 and a laser scanner 52 capture a 3D image of the patient P with fixtures and other accessories attached. During treatment, the output function 14d displays the captured 3D image in AR on the display 12. This prevents forgetting or making mistakes about not only fixtures but also various accessories, and allows for more accurate setup of the patient during radiation therapy. If there is a mismatch between accessories during planning and treatment, the output function 14d may notify the user of this fact.

Also, up to this point, AR display has been described as an example of a process for outputting setup information. However, the embodiment is not limited to this. For example, the output function 14d may provide the setup information to the user by projecting it. In this case, the setup support device 10 includes a projector (not shown). The projector may be provided integrally with the setup support device 10, or may be provided separately from the setup support device 10, for example, on a wall or ceiling in a treatment room. Then, the output function 14d projects the setup information from the projector onto the patient P or the tabletop 341 during treatment. For example, the output function 14d projects a three-dimensional image of the patient P taken at the time of planning onto the body surface of the patient P or the tabletop 341 by projection mapping.

The setup support device 10 not only supports the task of reproducing the planned posture of the patient P during treatment, but can also provide various other types of support. For example, before reproducing the planned posture on the tabletop 341, there are various operation procedures, such as lowering the position of the tabletop 341 so that the patient P can easily stand on it, having the patient P stand on the tabletop 341, and raising the position of the tabletop 341 with the patient P on it. In addition, interference between devices may occur in the radiation therapy device 30, and an operation procedure may be required, such as retracting the rotating gantry 331 before moving the tabletop 341. The setup support device 10 can also store such operation procedures and provide them to the user.

For example, the memory 11 stores the operation procedures of the movable parts of the radiation therapy device 30 and the patient P during the past treatment until the patient P is placed on the tabletop 341. The movable parts are parts of the radiation therapy device 30 that can move and rotate. For example, the movable parts include the rotating gantry 331. If the display 351 is configured to be movable, the movable parts also include the display 351. The operation procedures stored in the memory 11 may be the operation procedures during the first radiation therapy for the patient P, or the operation procedures during the second or subsequent radiation therapy. The operation procedures stored in the memory 11 may be automatically acquired from the control information in the radiation therapy device 30, or may be manually registered by the user.

For example, the memory 11 stores operation procedures such as "evacuate the gantry," "lower the tabletop," "position the fixtures," "position the patient," "raise the tabletop," and "return the gantry to its original position" in association with the patient ID of patient P. Then, when the setup for radiation therapy for patient P begins, the output function 14d sequentially notifies the user of the next operation of the moving part or patient P based on the operation procedures read from the memory 11. The output function 14d may display the next operation on the display 12, or may notify the user by voice or the like.

The setup support device 10 may also notify the user of the entire sequence of operation procedures, or may provide notifications as necessary. For example, if it takes a long time to attach accessories to patient P, the output function 14d determines that the user is having difficulty accessing patient P. In this case, the output function 14d notifies the user that "moving (rotating) the gantry will make it easier to access the patient." Also, for example, if the gantry arm position is not appropriate, the output function 14d obtains an appropriate gantry arm position from the treatment plan data and instructs the user. That is, the output function 14d coaches the user. Such notifications and coaching may be provided by displaying on the display 12, or by voice, etc.

In addition, the output function 14d may provide the above-mentioned notification or coaching to the patient P, rather than to a user such as a doctor. For example, the output function 14d may provide voice instructions to the patient P, such as "Turn to the side" or "Raise your hand."

Second Embodiment
In the above-mentioned first embodiment, a case where setup information is output in order to perform setup during radiation therapy simply and accurately is described. In contrast, in the second embodiment, a case where setup can be performed simply and accurately by determining the order in which multiple patients are treated is described. A medical information processing system 1 according to the second embodiment has a configuration similar to that of the medical information processing system 1 shown in FIG. 1. Hereinafter, the points described in the first embodiment are denoted by the same reference numerals as those in FIG. 1 to FIG. 3, and description thereof will be omitted.

For example, the memory 11 stores correspondence information that associates the fixation devices used during radiation therapy for each of a plurality of patients with each other. As an example, the correspondence information is information in which "fixation device F4, fixation device F5, and fixation device F6" are associated with the first patient, "fixation device F4 and fixation device F6" are associated with the second patient, "fixation device F4" is associated with the third patient, "fixation device F7" is associated with the fourth patient, "fixation device F6 and fixation device F7" is associated with the fifth patient, and "none" is associated with the sixth patient. Such correspondence information may be automatically generated based on treatment plan data, etc., or may be manually created by the user.

Alternatively, the correspondence information may be generated based on an image of the patient taken at the time of planning or treatment. For example, when performing the AR display shown in FIG. 15, the setup support device 10 stores in the memory 11 a three-dimensional image of the patient P taken at the time of planning. The setup support device 10 can identify the fixture associated with the patient P based on this three-dimensional image and register it in the correspondence information.

Next, the calculation function 14c determines the order in which to treat multiple patients based on the correspondence information. For example, the calculation function 14c retrieves correspondence information about multiple patients scheduled to be treated on that day from the memory 11, and determines the order of treatment so that patients with common fixation devices are treated consecutively.

For example, if the first patient, second patient, and third patient are treated in that order, the tasks of "preparing fixture F4," "preparing fixture F5," and "preparing fixture F6" occur before the first patient's treatment. In addition, the task of "cleaning up fixture F5" occurs before the second patient's treatment. In addition, the task of "cleaning up fixture F6" occurs before the third patient's treatment.

On the other hand, if the first patient, the third patient, and the second patient are treated in that order, the tasks of "preparing fixture F4," "preparing fixture F5," and "preparing fixture F6" occur before the first patient's treatment. Furthermore, the tasks of "cleaning up fixture F5" and "cleaning up fixture F6" occur before the third patient's treatment. Furthermore, the task of "preparing fixture F6" occurs before the second patient's treatment.

In this way, compared to treating the first patient, the second patient, and the third patient in this order, the amount of work required for setup increases when treating the first patient, the third patient, and the second patient in this order. In response to this, the calculation function 14c determines the order of treatment so that patients who share a common fixation tool are treated consecutively. For example, the calculation function 14c determines the order of treatment for six patients as shown in FIG. 16. This allows the calculation function 14c to create the most efficient treatment plan (treatment order) for that day, minimizing the amount of work required for setup. Note that FIG. 16 is a diagram showing an example of a setup support method according to the second embodiment.

By performing treatment in the order determined by the calculation function 14c, the user's workload is reduced and patient setup during radiation therapy can be simplified. In addition, by reducing the number of times that fixation tools need to be prepared and put away, the risk of forgetting or using the wrong fixation tool is reduced, allowing for more accurate setup.

In FIG. 16, the order is calculated so that patients who share a common fixation device are treated consecutively, but the order may be calculated taking into account various accessories in addition to the fixation device. In other words, the calculation function 14c calculates the treatment order for that day so that patients who share a common fixation device, electrocardiograph, or other accessory are treated consecutively.

The term "processor" used in the above description refers to circuits such as a CPU, a GPU (Graphics Processing Unit), an Application Specific Integrated Circuit (ASIC), a programmable logic device (e.g., a Simple Programmable Logic Device (SPLD), a Complex Programmable Logic Device (CPLD), and a Field Programmable Gate Array (FPGA)). When the processor is, for example, a CPU, the processor realizes functions by reading and executing a program stored in a memory circuit. On the other hand, if the processor is, for example, an ASIC, instead of storing the program in a memory circuit, the function is directly built into the circuit of the processor as a logic circuit. Note that each processor in the embodiments is not limited to being configured as a single circuit for each processor, and may be configured as a single processor by combining multiple independent circuits to realize the function. Furthermore, multiple components in each figure may be integrated into a single processor to realize the function.

1, a single memory 11 is described as storing a program corresponding to each processing function of the processing circuit 14. Also, in FIG. 2, a single memory 241 is described as storing a program corresponding to each processing function of the processing circuit 244. However, the embodiment is not limited to this. For example, a configuration may be adopted in which a plurality of memories 11 are distributed and the processing circuit 14 reads out the corresponding program from each memory 11. Similarly, a configuration may be adopted in which a plurality of memories 241 are distributed and the processing circuit 244 reads out the corresponding program from each memory 241. Also, instead of storing the program in the memory 11 or memory 241, the program may be directly incorporated into the circuit of the processor. In this case, the processor realizes the function by reading and executing the program incorporated in the circuit.

The components of each device according to the above-described embodiments are conceptual and functional, and do not necessarily need to be physically configured as shown in the figures. In other words, the specific form of distribution and integration of each device is not limited to that shown in the figures, and all or part of the devices can be functionally or physically distributed and integrated in any unit depending on various loads and usage conditions. Furthermore, all or any part of the processing functions performed by each device can be realized by a CPU and a program analyzed and executed by the CPU, or can be realized as hardware using wired logic.

The setup support method described in the above embodiment can be realized by executing a prepared program on a computer such as a personal computer or a workstation. This program can be distributed via a network such as the Internet. This program can also be recorded on a non-transitory recording medium that can be read by a computer, such as a hard disk, flexible disk (FD), CD-ROM, MO, or DVD, and executed by being read from the recording medium by a computer.

According to at least one of the embodiments described above, patient setup during radiation therapy can be performed easily and accurately.

Although several embodiments have been described, these embodiments are presented as examples and are not intended to limit the scope of the invention. These embodiments can be implemented in various other forms, and various omissions, substitutions, modifications, and combinations of embodiments can be made without departing from the spirit of the invention. These embodiments and their modifications are within the scope of the invention and its equivalents as set forth in the claims, as well as the scope and spirit of the invention.

REFERENCE SIGNS LIST 1 medical information processing system 10 setup support device 11 memory 12 display 13 input interface 14 processing circuit 14a control function 14b acquisition function 14c calculation function 14d output function 20 X-ray CT device 233 tabletop 241 memory 242 display 243 input interface 244 processing circuit 244a control function 244b collection function 244c output function 30 radiation therapy device 322 radiation generator 323 radiation aperture 331 rotating stand 341 tabletop 351 display 40 image storage device

Claims (15)

An acquisition unit that acquires posture information representing a posture of a patient at the time of planning;
a calculation unit that calculates patient setup information for reproducing the patient's posture at the time of planning represented by the posture information at the time of treatment based on a difference between a first positioning member on which the patient is placed at the time of planning and a second positioning member on which the patient is placed at the time of treatment;
an output unit that outputs the setup information ,
the calculation unit determines a placement position of a holding member that holds the patient's posture during treatment so that the patient's posture at the time of planning is reproduced during treatment, such that a deviation in a height direction caused by a difference in shape between the first placement member and the second placement member is reflected in the placement position;
The output unit outputs the setup information for setting up the patient on the second placement member based on the determined placement position . the calculation unit calculates a first arrangement position which is an arrangement position of a holding member which holds the posture of the patient during treatment, and a second arrangement position which is an arrangement position of an auxiliary member which is attached to the patient during treatment;
The setup support device according to claim 1 , wherein the output unit outputs the setup information based on the first arrangement position and the second arrangement position. the first arrangement member is a top plate in a treatment planning X-ray CT apparatus,
The setup support device according to claim 1 , wherein the second placement member is a top plate of a radiotherapy apparatus. A wearable device that can be worn on a user's head,
Further comprising a display unit disposed in front of a user's eye,
The setup support device according to claim 1 , wherein the output unit causes the display unit to display the setup information. The setup support device according to claim 4 , wherein the output unit causes the display unit to display the setup information in association with an image that is transmitted through the display unit and visually recognized by the user. Further comprising a projector capable of projecting visible light,
4. The setup support device according to claim 1 , wherein the output unit projects the setup information from the projector onto the patient or the second placement member during treatment. The setup support device according to any one of claims 1 to 6, wherein the output unit further notifies a user of the presence of a first member that maintained the patient's posture at the time of planning but does not maintain the patient's posture at the time of treatment, or a second member that did not maintain the patient's posture at the time of planning but maintains the patient's posture at the time of treatment . Further comprising a memory for storing a moving procedure of a movable part of a radiation therapy device used for treating the patient and the patient during a past treatment until the patient is placed on the second placement member;
The setup support device according to any one of claims 1 to 7, wherein the output unit further notifies a user of a next operation of the movable unit or the patient to be performed to position the patient on the second positioning member during a new treatment based on the operation procedure. The calculation unit further calculates a parameter indicating a difference between a posture of the patient at the time of planning and a posture of the patient at the time of treatment,
The setup support device according to claim 1 , wherein the output unit further outputs the parameters. The setup support device according to claim 9 , wherein the calculation unit calculates the parameters by weighting each part of the patient. The setup support device according to claim 1 , wherein the output unit outputs, as the setup information, a three-dimensional image showing a posture of the patient at the time of planning. The setup support device according to claim 11 , wherein the three-dimensional image is a three-dimensional image of the patient at the time of planning, the image having a characteristic portion emphasized. Further comprising a memory for storing correspondence information that corresponds, for each of a plurality of patients, a support member used to support the posture of each patient during treatment;
The setup support device according to claim 1 , wherein the calculation unit is further configured to determine an order in which to treat the plurality of patients based on the correspondence information. The setup support device according to claim 13 , wherein the calculation unit determines the order based on the correspondence information such that patients having a common holding member are treated consecutively. Obtaining posture information representing the patient's posture at the time of planning;
determining a position of a support member for supporting the patient's posture during treatment based on a difference between a first support member on which the patient is placed during planning and a second support member on which the patient is placed during treatment, so that the patient's posture during planning is reproduced during treatment;
outputting setup information for setting up the patient on the second placement member based on the determined placement position,
determining a position of a holding member for holding the patient's posture during treatment so that the patient's posture at the time of planning is reproduced during treatment, such that a deviation in the height direction caused by a difference in shape between the first placement member and the second placement member is reflected in the position;
and outputting the setup information for setting up the patient on the second placement member based on the determined placement position .

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