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WO2004024235A1 - Irm dans un appareil de radiotherapie guidee avec compensateurs d'heterogeneite de faisceau - Google Patents

Irm dans un appareil de radiotherapie guidee avec compensateurs d'heterogeneite de faisceau Download PDF

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Publication number
WO2004024235A1
WO2004024235A1 PCT/IB2003/004472 IB0304472W WO2004024235A1 WO 2004024235 A1 WO2004024235 A1 WO 2004024235A1 IB 0304472 W IB0304472 W IB 0304472W WO 2004024235 A1 WO2004024235 A1 WO 2004024235A1
Authority
WO
WIPO (PCT)
Prior art keywords
radiation therapy
therapy apparatus
mri
linear accelerator
imaging device
Prior art date
Legal status (The legal status 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 status listed.)
Ceased
Application number
PCT/IB2003/004472
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English (en)
Inventor
Jan Jacob Wouter Lagendijk
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Elekta AB
Original Assignee
Elekta AB
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 Elekta AB filed Critical Elekta AB
Priority to AU2003274393A priority Critical patent/AU2003274393A1/en
Publication of WO2004024235A1 publication Critical patent/WO2004024235A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • GPHYSICS
    • G01MEASURING; TESTING
    • G01RMEASURING ELECTRIC VARIABLES; MEASURING MAGNETIC VARIABLES
    • G01R33/00Arrangements or instruments for measuring magnetic variables
    • G01R33/20Arrangements or instruments for measuring magnetic variables involving magnetic resonance
    • G01R33/44Arrangements or instruments for measuring magnetic variables involving magnetic resonance using nuclear magnetic resonance [NMR]
    • G01R33/48NMR imaging systems
    • G01R33/4808Multimodal MR, e.g. MR combined with positron emission tomography [PET], MR combined with ultrasound or MR combined with computed tomography [CT]
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00Radiation therapy
    • A61N5/10X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/1048Monitoring, verifying, controlling systems and methods
    • A61N5/1049Monitoring, verifying, controlling systems and methods for verifying the position of the patient with respect to the radiation beam
    • GPHYSICS
    • G01MEASURING; TESTING
    • G01RMEASURING ELECTRIC VARIABLES; MEASURING MAGNETIC VARIABLES
    • G01R33/00Arrangements or instruments for measuring magnetic variables
    • G01R33/20Arrangements or instruments for measuring magnetic variables involving magnetic resonance
    • G01R33/28Details of apparatus provided for in groups G01R33/44 - G01R33/64
    • G01R33/38Systems for generation, homogenisation or stabilisation of the main or gradient magnetic field
    • G01R33/381Systems for generation, homogenisation or stabilisation of the main or gradient magnetic field using electromagnets
    • HELECTRICITY
    • H05ELECTRIC TECHNIQUES NOT OTHERWISE PROVIDED FOR
    • H05HPLASMA TECHNIQUE; PRODUCTION OF ACCELERATED ELECTRICALLY-CHARGED PARTICLES OR OF NEUTRONS; PRODUCTION OR ACCELERATION OF NEUTRAL MOLECULAR OR ATOMIC BEAMS
    • H05H7/00Details of devices of the types covered by groups H05H9/00, H05H11/00, H05H13/00
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00Radiation therapy
    • A61N5/10X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/1048Monitoring, verifying, controlling systems and methods
    • A61N5/1049Monitoring, verifying, controlling systems and methods for verifying the position of the patient with respect to the radiation beam
    • A61N2005/1055Monitoring, verifying, controlling systems and methods for verifying the position of the patient with respect to the radiation beam using magnetic resonance imaging [MRI]

Definitions

  • This invention relates to improvements in radiotherapy techniques and position verification in radiotherapy.
  • the invention relates to the use of Magnetic Resonance Imaging (MRI) in radiotherapy and position verification.
  • MRI Magnetic Resonance Imaging
  • Existing radiotherapy treatments are commonly carried out by means of a linear accelerator which bombards cancerous tissues with high energy X-rays or electron beams to inhibit growth and spreading of the malignant tissues.
  • An essential parameter monitored in existing radiotherapy treatments is the exact daily position and extension of the target volume of tissue, including variations in position and size both during the treatment session and throughout the whole treatment course. Tumour control probability analyses indicate that dose escalation, which can be performed in case of an exactly known tumour position, may greatly enhance tumour control.
  • the positioning problems can be solved with invasive radio opaque markers inside the tumour, which are visible on amorphous silicon flat panel megavoltage imaging.
  • invasive radio opaque markers inside the tumour, which are visible on amorphous silicon flat panel megavoltage imaging.
  • markers gold seeds of 1.0 mm diameter and 5 mm length used for prostate position verification as reported by Nederveen et al in Phys. Med. Biol. 46(4), 2001, 1219-30.
  • CT computed to position verification
  • Major disadvantages of the use of integrated CT for daily radiotherapy position verification are the inherent slow data acquisition (gantry rotation), the inferior soft-tissue visibility and the 2D, transversal slide, imaging.
  • MRI is commonly used in the 3 dimensional imaging of soft tissues such as the brain and spinal cord to detect abnormalities without the need to expose the subject to harmful radiation such as X-rays.
  • Co-pending International Patent Application PCT/GB2002/03339 discloses a radiotherapy apparatus comprising a magnetic resonance imaging device integrated with a linear accelerator.
  • This invention aims to improve upon the concept described in PCT/GB2002/03339 and to provide an apparatus having improved properties over that disclosed therein.
  • the invention provides a radiotherapy apparatus comprising a magnetic resonance imaging device integrated with a linear accelerator wherein a B-field compensator means is associated with the magnetic resonance imaging device which, in use, adapts the B-field produced by the magnetic resonance imaging device in the vicinity of the linear accelerator thereby to minimise the influence of the B-field on the particles emitted by the accelerator.
  • a magnetic resonance imaging device typically comprises a large ring shaped magnet, typically comprised of electromagnetic coils wound on a core of magnetisable material. Where the coils are arranged closer to the inner surface of the ring, than the outer surface, the B-field (Bp (n ) at the centre of the magnet is substantially greater than that (Bp ou ) at the outer surface of the ring and directed in an opposing direction.
  • the B field of the unadapted magnet (Bp) can be compensated by the introduction of additional coils of opposing polarity. For example, these additional coils may be placed in alignment with one or more existing coils of the MRI at a position closer to the outer surface of the ring.
  • the result of these added coils is to create a compensation field (Be) at the outer and inner surfaces of the ring consisting of an outer field Bc o u t and an inner field Bc in .
  • the compensated field (BO) resulting from the adapted MRI is consequently composed of an outer field equal to Bp out - Bc out and an inner field equal to Bp in - Bc ln .
  • the compensated field BO can be controlled.
  • the coils are selected and positioned so as to produce an area of zero (or minimal) Tesla in the region about the MRI where the particle source of the linear accelerator is to be located.
  • the compensator means is selected and positioned such that the compensation field Bc out at the outer surface of the magnetic ring of the MRI is approximately equal, but oppositely directed to the field Bp out of the uncompensated magnetic ring providing an area of substantially zero Tesla in or near to which the particle source of a linear particle accelerator can be positioned.
  • the invention provides a radiotherapy apparatus comprising a magnetic resonance imaging device integrated with a linear accelerator wherein the particle source of the linear accelerator is positioned a fixed radial distance from the subject to be targeted and has associated therewith a compensation filter for compensating heterogeneity of the beam induced by the magnetic resonance imaging device, thereby to provide a substantially homogenous beam at the target to be treated.
  • This second aspect may be used in conjunction with the first aspect to provide an improved system, or it may be used independently thereof.
  • the inventors have recognised that the physical construction of an MRI can affect the beam quality of a linear accelerator.
  • the inventors have found that deterioration of beam quality can be corrected by suitable positioning of the accelerator and the introduction of a compensation filter.
  • a preferred arrangement has been found to comprise positioning the accelerator at a fixed radial position outside of the solenoid drum of an MRI and positioning a compensation filter in radial alignment with the accelerator, on an inner surface of the solenoid drum, that is adjacent the centre space reserved for receiving the target.
  • the characteristics of the compensation filter are defined by first measuring the heterogeneity induced in the accelerator beam by the structure of the MRI.
  • the filter is designed to introduce heterogeneity which, when added to the heterogeneity introduced by the active MRI, results in a substantially uniform radiation field.
  • the compensation filter may, optionally, be used in conjunction with intensity modulation techniques to further reduce the incidence of radiation scatter in the beam.
  • the gradient coils of the drum of the MRI may be split to provide a gap through which the beam emitted by the linear accelerator may pass.
  • This adaptation to a standard drum arrangement has been found to significantly reduce attenuation of the beam and result in a lower incidence of beam scattering. Furthermore it reduces the copper content of the gradient coils (for example by replacement of 3cm copper with 6cm epoxy, the latter of which provides a more homogeneous transmission of the linear accelerator beam) thus reducing the number of items to be compensated for by the compensation filter rendering the compensation task more simple.
  • This splitting of the gradient coils has been found to have no significant debilitatory affect on the performance of the MRI.
  • the rotatable gantry on which the accelerator is mounted is desirably configured to have a plurality of fixed locating positions for the accelerator all having a fixed radial distance from the target. Spaces in the gradient coils and compensation filters can then be positioned in the non-moving MRI to align with each of the fixed locating positions of the accelerator.
  • an odd number of fixed locating positions for the accelerator Preferably these positions are equally spaced apart about the circumference of the MRI. Preferred numbers of fixed locating positions are 7, 9 or 11. In a preferred embodiment, the number of fixed locations is 11 each spaced at an angle of about 33 degrees from the two adjacent positions.
  • the support structure of the MRI may optionally have material removed adjacent the fixed locating positions of the accelerator. This further simplifies the task for the compensation filter. It has been found that the size (including the radius of the gantry which carries the linear accelerator) and weight of the integrated system can be further reduced by removing material from the cryostat (for example from 4cm Aluminium to 2cm Aluminium).
  • Figure 1 illustrates schematically an open ring type embodiment of the invention
  • Figure 2 illustrates schematically a closed drum type embodiment of the invention
  • Figure 3 illustrates in further detail an embodiment of the type shown in Figure 2;
  • Figure 4 illustrates the B fields of a) a standard MRI as known from the prior art; b) a compensation field produced by compensations means in accordance with the second aspect of the invention; and c) the resultant field of an MRI compensated by compensation means in accordance with the invention;
  • Figure 5 illustrates an embodiment of the invention incorporating compensation means in the form of additional electromagnetic coils
  • Figure 6 illustrates the embodiment of Figure 5 further incorporating a compensation filter
  • Figure 7 illustrates the embodiment of Figure 5 further incorporating a split gradient coil
  • Figure 8 illustrates the embodiment of Figure 7 further incorporating gaps in the support structure.
  • an open ring arrangement comprises 3 rings 1, 2 and 3 arranged linearly along a common centre and slightly spaced apart.
  • a table 4 is arranged slightly below the centre line of the rings and in parallel therewith.
  • a subject 5 lies on the table 4, encircled by the rings 1,2 and 3 for treatment.
  • Rings 1 and 3 represent the MRI, whilst ring 2 incorporates the linear accelerator.
  • the table 4 is moveable linearly through the rings 1, 2 and 3 so that the subject tissue may be located, imaged (using the MRI) and treated (using the linear accelerator.
  • the MRI rings 1 and 3 create an imaging volume which encompasses the accelerator isocentre of ring 2.
  • FIG. 2 illustrates a closed drum arrangement of the invention.
  • the drum comprises two main portions, an outer portion 22 which incorporates the gantry on which the linear accelerator is mounted and an inner portion 21 incorporating the MRI.
  • a common bore 20 extends concentrically through the centre of the two cylindrical portions 23, 21.
  • a table 24 is positioned within the bore, slightly below the centre, and is slideable into and out of the bore 20.
  • Figure 3 shows a more detailed outline sketch of an embodiment of the form shown in Figure 2.
  • the arrangement comprises outer portion 32 which incorporates a linear accelerator having a head including an X-ray gun 39, tube 38 magnet 36 and focus 37.
  • the inner portion 31 of the drum consists of the MRI and surrounds a central bore 30, common to both the MRI and accelerator which share a common isocentre 41.
  • the line 40 indicates the typical floor level relative to the apparatus.
  • Figure 4a shows a primary field configuration for a drum 1 of a conventional drum type MRI.
  • the drum has a plurality of coils 2a, 2b, 2c, 2d encircling its isocentre and positioned towards the inner surface of the magnetic drum of the MRI.
  • the field has a component in an area surrounding the outer surface of the ring Bp out and a component passing through the centre of the drum Bpm.
  • the first component Bp out is relatively less strong than and in a direction opposing that of the second component Bp in .
  • Figure 4b shows the field produced by a drum of similar configuration to that of 4a) but equipped only with a pair of coils 2'e and 2'f positioned toward opposing faces of the drum and near the outer surface thereof.
  • the field has components Bc out which is of similar strength but in an opposing direction to Bp ou and Bc ln which is of significantly lower strength than Bp in and oppositely directed thereto.
  • Figure 4c illustrates the field pattern resulting when the fields of Figures 4a) and 4b) are combined in an MRI compensated in accordance with the first aspect of the invention.
  • the opposing, but substantially equal strength field components Bp out and Bc out cancel each other creating an area of substantially zero Tesla towards the central region of the outer surface of the ring.
  • FIG. 5 shows an embodiment of the invention in further detail.
  • the components of the MRI are further illustrated.
  • the MRI comprises a cryostat containing a support structure 3 onto which are mounted both the primary coils 2a, ...2d and the compensation coils 2'e to 2'f.
  • Positioned around the inner circumference of the drum 1 are gradient coils 6 and RF coils 5.
  • Positioned in the zero Tesla area (as shown in Figure 4c)) is a rotatable gantry 4 on which is mounted a linear accelerator 7.
  • the accelerator emits particles (for example X-rays or electrons) in a beam B to be targeted at a subject introduced into the central bore at the common isocentre of the gantry 4 and drum 1.
  • Figure 6 shows an embodiment broadly similar to that of Figure 5 but incorporating a compensation filter F in alignment with the linear accelerator 7 and the beam B. Whilst only a single filter is shown in the Figure it is to be understood that in practice, the system would be provided with a plurality of such filters positioned at fixed locations about the inner circumference of the drum so as to provide compensation at a plurality of fixed locations for the linear accelerator when the gantry is rotated about the isocentre of the system
  • Figure 7 shows an embodiment broadly similar to that of Figure 6 but incorporating split gradient coils.
  • the gradient coil is split into two substantially even sized portions with a gap between them.
  • the gap aligns with the linear accelerator 7 and the beam B such that the beam B can pass through the gap.
  • the filter F is located in the gap, behind the RF coil.
  • Figure 8 shows a further embodiment of the invention. This embodiment is broadly similar to that of Figure 7 but incorporates a split or perforated support structure 3. As can be seen, a gap or hole is provided in the support structure in radial alignment with the gap in the gradient coil, the compensation filter F and the linear accelerator 7 such that the beam B can pass therethrough.

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  • Physics & Mathematics (AREA)
  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Condensed Matter Physics & Semiconductors (AREA)
  • General Physics & Mathematics (AREA)
  • General Health & Medical Sciences (AREA)
  • Biomedical Technology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Plasma & Fusion (AREA)
  • Pathology (AREA)
  • Electromagnetism (AREA)
  • Animal Behavior & Ethology (AREA)
  • Spectroscopy & Molecular Physics (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Pulmonology (AREA)
  • Theoretical Computer Science (AREA)
  • High Energy & Nuclear Physics (AREA)
  • Radiation-Therapy Devices (AREA)
  • Magnetic Resonance Imaging Apparatus (AREA)

Abstract

L'invention concerne un appareil de thérapie par rayonnement comprenant un dispositif d'imagerie par résonance magnétique intégré avec un accélérateur linéaire dans lequel des moyens de compensation de champ B sont associés au dispositif d'imagerie par résonance magnétique qui, à l'utilisation, adapte le champ B, produit par le dispositif d'imagerie par résonance magnétique, au voisinage de l'accélérateur ce qui permet de minimiser l'influence du champ B sur les particules émises par l'accélérateur.
PCT/IB2003/004472 2002-09-13 2003-09-02 Irm dans un appareil de radiotherapie guidee avec compensateurs d'heterogeneite de faisceau Ceased WO2004024235A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU2003274393A AU2003274393A1 (en) 2002-09-13 2003-09-02 Mri in guided radiotherapy apparatus with beam heterogeneity compensators

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB0221174.6 2002-09-13
GB0221174A GB2393373A (en) 2002-09-13 2002-09-13 MRI in guided radiotherapy and position verification

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WO2004024235A1 true WO2004024235A1 (fr) 2004-03-25

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Cited By (76)

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US11497937B2 (en) 2004-02-20 2022-11-15 University Of Florida Research Foundation, Inc. System for delivering conformal radiation therapy while simultaneously imaging soft tissue
US8190233B2 (en) 2004-02-20 2012-05-29 University Of Florida Research Foundation, Inc. System for delivering conformal radiation therapy while simultaneously imaging soft tissue
US10688319B2 (en) 2004-02-20 2020-06-23 University Of Florida Research Foundation, Inc. System for delivering conformal radiation therapy while simultaneously imaging soft tissue
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