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WO1999003537A1 - Dispositif pour l'irradiation des tissus - Google Patents

Dispositif pour l'irradiation des tissus Download PDF

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Publication number
WO1999003537A1
WO1999003537A1 PCT/EP1998/004377 EP9804377W WO9903537A1 WO 1999003537 A1 WO1999003537 A1 WO 1999003537A1 EP 9804377 W EP9804377 W EP 9804377W WO 9903537 A1 WO9903537 A1 WO 9903537A1
Authority
WO
WIPO (PCT)
Prior art keywords
ray
ray light
tissue
light guides
radiation
Prior art date
Application number
PCT/EP1998/004377
Other languages
German (de)
English (en)
Inventor
Norbert Langhoff
Rainer Wedell
Original Assignee
Weimann, Martin
Schulz, Wolfgang
Nagler, Olaf
Richter, Uwe
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Weimann, Martin, Schulz, Wolfgang, Nagler, Olaf, Richter, Uwe filed Critical Weimann, Martin
Priority to AU88616/98A priority Critical patent/AU8861698A/en
Publication of WO1999003537A1 publication Critical patent/WO1999003537A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/1001—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy using radiation sources introduced into or applied onto the body; brachytherapy
    • G—PHYSICS
    • G02—OPTICS
    • G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
    • G02B23/00—Telescopes, e.g. binoculars; Periscopes; Instruments for viewing the inside of hollow bodies; Viewfinders; Optical aiming or sighting devices
    • G02B23/24—Instruments or systems for viewing the inside of hollow bodies, e.g. fibrescopes
    • G—PHYSICS
    • G21—NUCLEAR PHYSICS; NUCLEAR ENGINEERING
    • G21K—TECHNIQUES FOR HANDLING PARTICLES OR IONISING RADIATION NOT OTHERWISE PROVIDED FOR; IRRADIATION DEVICES; GAMMA RAY OR X-RAY MICROSCOPES
    • G21K1/00—Arrangements for handling particles or ionising radiation, e.g. focusing or moderating
    • G21K1/06—Arrangements for handling particles or ionising radiation, e.g. focusing or moderating using diffraction, refraction or reflection, e.g. monochromators
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/1001—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy using radiation sources introduced into or applied onto the body; brachytherapy
    • A61N2005/1019—Sources therefor
    • A61N2005/1022—Generators, e.g. X-ray tubes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N2005/1085—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy characterised by the type of particles applied to the patient
    • A61N2005/1091—Kilovoltage or orthovoltage range photons

Definitions

  • the invention relates to a device for irradiating tissue using X-ray light guides or X-ray capillary optics and can be used for medical purposes, in particular for the treatment of diseased tissue.
  • X-rays have been used for medical therapy and diagnostics with great success for decades.
  • Current international research and technical development is aimed at achieving improved methods, higher resolution, image evaluation, three-dimensional image display and reduction in radiation exposure.
  • the fact that irradiation of malignant tissue causes problems is the fact that healthy tissue is also affected to a considerable extent.
  • the task of radiation therapy is to destroy the tumor tissue as completely as possible with as little damage to the surrounding healthy tissue as possible. This means that the radiation dose required for destruction should be concentrated in the area of the tumor. Since tumors occur both on the body surface and at almost every point inside the body, a variety of radiation types and techniques have been developed, whereby the radiation of deep-lying body regions is generally only possible through the use of correspondingly hard radiation. A radiation exposure of the tissue in between is then inevitable.
  • the choice of radiation type and energy as well as the extension of the radiation field are determined by the location (depth) and the size of the tumor, whereby the penetration depth can be estimated on the basis of the tissue half-depth (GHWT) and the 10c ⁇ n% dose.
  • the afterloading technique represents a special form.
  • the empty source carriers are attached to the patient's body, and the sources are then computer-controlled via special guide tubes. drive. In this way, optimal protection against radiation for the operating personnel as well as for the patient can be guaranteed.
  • the sources can be moved by small distances in the applicator during the irradiation, as a result of which very specific dose rate distributions (isodoses) adapted to the shape of the tumor can be achieved.
  • the introduction of several spherical sources, for example, into a tubular applicator serves the same purpose.
  • the use of x-ray capillary optics in medicine is also already known.
  • the generic DE 44 11 330 AI describes an X-ray source with an optical system for the treatment of tumors.
  • the X-ray source is moved on a spherical surface with a lens or half-lens formed from individual X-ray light guides so that the tumor is always at the focal point of the beam and the healthy cells receive only a minimal dose.
  • DE 44 08 057 AI describes the use of an optical element arranged between the X-ray source and the measurement object, which element consists of a large number of very thin, hollow capillaries made of, for example, glass and / or ceramic and / or metal and / or polymers and / or poly /or Composites with a polymer matrix exist and serve as a constructive unit for irradiating the object to be examined while rotating the radiation source, optical element and receiver, around the object to be examined and shifting the entire constructive unit in the longitudinal axis and thus implementing a tomograph.
  • the invention has for its object to provide a device for irradiating tissue, which makes it possible to bring the radiation directly to the affected tissue safely and with simple means with only minimal invasive interventions or through natural body openings.
  • the particular advantage of the invention consists in using X-ray optical systems in conjunction with endoscopic devices to bring the radiation to effect directly on site by arranging at least one X-ray light guide in the insertion part of an endoscope, which is connected at its input to an X-ray source.
  • glass capillary optics designed as X-ray light guides are used in order to guide the radiation generated by an X-ray source into the target area with relatively low intensity losses without impairing healthy tissue.
  • the applied here The physical principle is the total reflection of X-ray photons on smooth surfaces. Since the success of the therapy depends on the photon energy of the radiation, it is important to coat the surfaces, eg the inner walls of glass capillaries, with heavy metals in order to obtain a larger angle of total reflection.
  • an X-ray light guide can be positioned inside such an endoscope. The actual X-ray source is completely shielded outside the body.
  • a light source with a micro-CCD camera can be used, as is customary in minimally invasive surgery.
  • oxygen is introduced into the cell tissue in a separate way or through the capillaries.
  • An additional targeted thermal heating of the tissue via an infrared conductive fiber optic cable increases the therapeutic effect.
  • a further minimization of the X-ray dose is possible by the measure of incorporating chemical compounds into the tumor cells that increase the therapeutic effect.
  • capillaries By choosing the capillary diameter and the distance from the capillary outlet to the tissue to be irradiated, areas from a fraction of a few mm 3 to several cm can be irradiated. If it is necessary to hit a larger volume, a suitably shaped diffuser can be used at the exit. With regard to the X-ray light guides themselves, monocapillaries with ⁇ 1 mm 0 and straight polycapillaries with 5 10 mm 0 are used. With capillaries
  • Borosilicate are X-rays of energy 5 30 KeV, with those from e.g. Lead glass or with a heavy-atom inner coating can be transferred up to 80 KeV.
  • the length of the X-ray light guide used is approximately 100 to 300 mm
  • X-ray light guides are suitable for short-distance and contact therapy applications, the radiation exposure can primarily be intracavitary or intraoperative, but also percutaneous (for superficial tumors). There is also a relationship to interstitial therapy, since it is also used to treat narrowly defined tumors.
  • Fig.l A schematic diagram of the endoscope coupled to a radiation source
  • Fig. 2 is a schematic cross section of the
  • Introductory part with X-ray light guide and other channels the radiation source 1 is coupled directly to the insertion part 2 of an endoscope.
  • At least one x-ray light guide 3 is arranged in the introductory part 2 and its input is connected to the radiation source 1 such that at least a part of the radiation generated by the radiation source 1 is coupled into the x-ray light guide.
  • the output of the X-ray light guide is at the puncture area of the insertion part 2.
  • the X-ray light guide (s) 3 can consist of monocapillaries or polycapillaries and can be arranged in the instrument channel and / or next to the instrument channel of the introduction part 2.
  • the radiation source 1 is a high-performance X-ray tube in the kW range, preferably with heavy-atom anode material (W, Au).
  • W, Au heavy-atom anode material
  • Spectroscopy tubes with a large focal spot are suitable for wider bundles with straight polycapillaries.
  • single capillaries with an inner diameter of a few 0.1 mm are advisable.
  • the energy dose rate available at the output of the X-ray light guide 3 is of the order of at least 30 ... 60 Gy / h, so that in the case of fractional irradiation, for example daily doses of 2 Gy can be achieved with irradiation times of the order of minutes. Because during endoscopic interventions the patient is usually conscious, a longer immobilization is hardly possible.
  • radiation source 1 and endoscope are rigidly and radiation-tightly connected to one another.
  • the x-ray tube and endoscope unit is held in a manipulator 6, which enables exact positioning, so that the same point is repeatedly hit with fractional radiation, with simultaneous visual control.
  • This optical control can, as can also be seen in FIG. 2, be carried out by further light guides 4 arranged in the introduction part 2 in cooperation with light transmitters and light receivers and / or CCD image recording components.
  • the introduction part 2 has at least one line for supplying oxygen and at least one infrared conductor (5).
  • the line for supplying oxygen can be formed by the cavities in the capillaries of the X-ray light guide 3.
  • the relatively small mass and dimensions of the X-ray device with endoscope make interesting applications during the operation (intraoperative) possible.
  • the entire X-ray device is mobile and the operating radiologist can work in the operating room. Since the radiation exit surface of the X-ray light guide 3, like the objective, comes into contact with body fluid, the endoscope is designed to be flushable (flushing stem, at the same time for aspirating body fluid).
  • the endoscope or trocar with an X-ray light guide can also be sterilized.
  • the X-ray light guide is coupled to a microscope.
  • X-ray energies are irradiated with 20 30 keV superficial tumors ⁇ 1mm thick
  • the daily dose required to destroy the tumor is about 60 ... 68 Gy for a tumor of 10 mm 0 with a fractionation of 2 Gy / day, 5 irradiations / week.
  • the dose rate must be> 1 gy / min, the corresponding isodose curve must include the tumor.
  • X-ray light guides 3 smaller tumors of 5-10 mm 0 in the above-mentioned body regions, which are accessible with a straight, rigid endoscope with axial radiation, can be treated.
  • Another one The starting point is tumors that are normally treated interstitially (with radioactive isotopes), but for which the afterloading technique cannot be used because the guide tubes cannot be fixed.
  • An example of this are carcinomas of the paranasal sinuses after the operation, and radiation in the context of neurosurgery during the procedure.
  • a sharply delimited area of a cell culture or a tissue can be irradiated with a mono- or polycapillary of, for example, 1 mm 0, and the reactions in the irradiated and adjacent area during and after the irradiation can be examined (under the microscope).
  • a mono- or polycapillary of, for example, 1 mm 0
  • the reactions in the irradiated and adjacent area during and after the irradiation can be examined (under the microscope).
  • conical capillaries which produce a concentrated bundle with a diameter in the ⁇ m range
  • components of a cell could be irradiated and the effects examined.
  • the prerequisite here is that the dose required for the biological effects can be achieved.

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  • Physics & Mathematics (AREA)
  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • General Health & Medical Sciences (AREA)
  • Pathology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Radiology & Medical Imaging (AREA)
  • Astronomy & Astrophysics (AREA)
  • General Physics & Mathematics (AREA)
  • Optics & Photonics (AREA)
  • Spectroscopy & Molecular Physics (AREA)
  • General Engineering & Computer Science (AREA)
  • High Energy & Nuclear Physics (AREA)
  • Radiation-Therapy Devices (AREA)

Abstract

L'invention concerne un procédé d'irradiation des tissus utilisant des guides optiques aux rayons X ou des optiques capillaires aux rayons X, utilisable en médecine, en particulier pour le traitement de tissus malades. L'invention est caractérisée en ce que dans la partie d'introduction d'un endoscope est disposé au moins un guide optique aux rayons X, qui est connecté à son entrée à une source de rayonnements. En vue d'accroître la précision de positionnement de la sortie du guide optique aux rayons X par rapport au tissu à irradier, comme cela est courant en chirurgie minimale invasive, on utilise une source lumineuse équipée d'une micro-caméra CCD. De l'oxygène est introduit dans le tissu cellulaire en vue de sensibiliser le tissu tumoral. Un chauffage approprié supplémentaire du tissu via un câble à fibres de verre conducteur infrarouge accroît l'effet du traitement.
PCT/EP1998/004377 1997-07-15 1998-07-15 Dispositif pour l'irradiation des tissus WO1999003537A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU88616/98A AU8861698A (en) 1997-07-15 1998-07-15 Device for irradiating tissue

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE19731307A DE19731307C1 (de) 1997-07-15 1997-07-15 Vorrichtung zur Bestrahlung von Gewebe
DE19731307.8 1997-07-15

Publications (1)

Publication Number Publication Date
WO1999003537A1 true WO1999003537A1 (fr) 1999-01-28

Family

ID=7836425

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP1998/004377 WO1999003537A1 (fr) 1997-07-15 1998-07-15 Dispositif pour l'irradiation des tissus

Country Status (3)

Country Link
AU (1) AU8861698A (fr)
DE (1) DE19731307C1 (fr)
WO (1) WO1999003537A1 (fr)

Families Citing this family (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20030053591A1 (en) * 2001-08-07 2003-03-20 Dunham Bruce M. Direct delivery of radiation for radiation therapy
DE102005056066B3 (de) * 2005-11-24 2007-06-28 Siemens Ag Einrichtung für die Röntgen-Brachytherapie mit einer in das Innere eines Körpers einführbaren Sonde
WO2014155283A1 (fr) * 2013-03-26 2014-10-02 Koninklijke Philips N.V. Dispositif d'application de rayonnement

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1990003827A1 (fr) * 1988-10-07 1990-04-19 Hayman Michael H Appareil de radiotherapie in situ
DE4408057A1 (de) 1994-03-07 1995-09-14 Ifg Inst Fuer Geraetebau Gmbh Verfahren und Vorrichtung zur Röntgenfluoreszenzspektroskopie
DE4411330A1 (de) 1994-03-25 1995-09-28 Muradin Abubekirovic Kumachov Verfahren und Vorrichtung zur Herstellung von polykapillaren und monokapillaren Elementen und Strukturen
US5527349A (en) * 1994-01-25 1996-06-18 The United States Of America As Represented By The Secretary Of The Department Of Health And Human Services Photochemotherapy dosimeter
US5566221A (en) 1994-07-12 1996-10-15 Photoelectron Corporation Apparatus for applying a predetermined x-radiation flux to an interior surface of a body cavity
WO1996034656A1 (fr) * 1995-05-02 1996-11-07 Nomet Management Services B.V. Projecteur de sources a chargement differe pour la curietherapie
WO1997012540A1 (fr) * 1995-10-06 1997-04-10 Photoelectron Corporation Appareil ameliore pour appliquer des rayons x sur une surface interieure d'une cavite d'un corps

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1990003827A1 (fr) * 1988-10-07 1990-04-19 Hayman Michael H Appareil de radiotherapie in situ
US5527349A (en) * 1994-01-25 1996-06-18 The United States Of America As Represented By The Secretary Of The Department Of Health And Human Services Photochemotherapy dosimeter
DE4408057A1 (de) 1994-03-07 1995-09-14 Ifg Inst Fuer Geraetebau Gmbh Verfahren und Vorrichtung zur Röntgenfluoreszenzspektroskopie
DE4411330A1 (de) 1994-03-25 1995-09-28 Muradin Abubekirovic Kumachov Verfahren und Vorrichtung zur Herstellung von polykapillaren und monokapillaren Elementen und Strukturen
US5566221A (en) 1994-07-12 1996-10-15 Photoelectron Corporation Apparatus for applying a predetermined x-radiation flux to an interior surface of a body cavity
WO1996034656A1 (fr) * 1995-05-02 1996-11-07 Nomet Management Services B.V. Projecteur de sources a chargement differe pour la curietherapie
WO1997012540A1 (fr) * 1995-10-06 1997-04-10 Photoelectron Corporation Appareil ameliore pour appliquer des rayons x sur une surface interieure d'une cavite d'un corps

Also Published As

Publication number Publication date
DE19731307C1 (de) 1998-11-12
AU8861698A (en) 1999-02-10

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