[go: up one dir, main page]

WO2012119649A1 - Système et procédé de radiothérapie guidée par imagerie - Google Patents

Système et procédé de radiothérapie guidée par imagerie Download PDF

Info

Publication number
WO2012119649A1
WO2012119649A1 PCT/EP2011/053529 EP2011053529W WO2012119649A1 WO 2012119649 A1 WO2012119649 A1 WO 2012119649A1 EP 2011053529 W EP2011053529 W EP 2011053529W WO 2012119649 A1 WO2012119649 A1 WO 2012119649A1
Authority
WO
WIPO (PCT)
Prior art keywords
patient
therapeutic apparatus
position data
relative
image recording
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/EP2011/053529
Other languages
English (en)
Inventor
Peter Fröberg
Rui Chen
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 PCT/EP2011/053529 priority Critical patent/WO2012119649A1/fr
Publication of WO2012119649A1 publication Critical patent/WO2012119649A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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
    • A61N5/1048—Monitoring, verifying, controlling systems and methods
    • A61N5/1049—Monitoring, verifying, controlling systems and methods for verifying the position of the patient with respect to the radiation beam
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B2090/364—Correlation of different images or relation of image positions in respect to the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/50—Supports for surgical instruments, e.g. articulated arms
    • A61B2090/502—Headgear, e.g. helmet, spectacles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • 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
    • A61N5/1048—Monitoring, verifying, controlling systems and methods
    • A61N5/1049—Monitoring, verifying, controlling systems and methods for verifying the position of the patient with respect to the radiation beam
    • A61N2005/1059—Monitoring, verifying, controlling systems and methods for verifying the position of the patient with respect to the radiation beam using cameras imaging the patient

Definitions

  • the present invention relates to the field of radiation therapy.
  • the invention relates to systems and methods for image guided therapy, such as radiotherapy.
  • Stereotactic radiation surgery is such a minimally invasive treatment modality that allows delivery of a large single dose of radiation to a specific intracranial target while sparing surrounding tissue. Unlike conventional fractionated radiation therapy, stereotactic radiation surgery does not rely on, or exploit, the higher radiation sensitivity of neoplastic lesions relative to normal brain (therapeutic ratio). Its selective destruction depends primarily on sharply focused high-dose radiation and a steep dose gradient away from the defined target. The biological effect is irreparable cellular damage and delayed vascular occlusion within the high-dose target volume. Because a therapeutic ratio is not required, traditionally radiation resistant lesions can be treated. Because destructive doses are used, however, any normal structure included in the target volume is subject to damage.
  • LINAC Linear Accelerator
  • a collimated x-ray beam of a very high energy level is focused on a stereotactically identified intracranial target.
  • electrons are accelerated to near light speed and are collided with a heavy metal, e.g. tungsten.
  • the collision mainly produces heat but a small percentage of the energy is converted into highly energetic photons, which, because they are electrically produced, are called "x-rays".
  • the gantry of the LINAC rotates around the patient, producing an arc of radiation focused on the target.
  • the couch in which the patient rests is then rotated in the horizontal plane, and another arc is performed.
  • multiple non- coplanar arcs of radiation intersect at the target volume and produce a high target dose, resulting in a minimal radiation affecting the surrounding brain.
  • Another system for non-invasive surgery is sold under the name of Leksell Gamma Knife ® , which provides such surgery by means of gamma radiation.
  • the radiation is emitted from a large number of fixed radioactive sources and is focused by means of collimators, i.e. passages or channels for obtaining a beam of limited cross section, towards a defined target or treatment volume.
  • collimators i.e. passages or channels for obtaining a beam of limited cross section
  • Each of the sources provides a dose of gamma radiation which is insufficient to damage intervening tissue.
  • tissue destruction occurs where the radiation beams from all radiation sources intersect or converge, causing the radiation to reach tissue-destructive levels.
  • the point of convergence is hereinafter referred to as the "focus point".
  • Such a gamma radiation device is, for example, referred to and described in US 4,780,898.
  • the head of a patient conventionally is immobilized in a stereotactic instrument which defines the location of the treatment volume in the head. Further, the patient is secured in a patient positioning unit which moves the entire patient so as to position the treatment volume in coincidence with the focus point of the radiation unit of the radiation therapy system.
  • the positioning unit which moves the patient so as to position the treatment volume in coincidence with the focus point of the radiation unit of the system is accurate and reliable. That is, the positioning unit must be capable of position the treatment volume in coincidence with the focus point at a very high precision. This high precision must also be maintained over time.
  • medical therapy systems such as a LINAC system or a Leksell Gamma Knife ® system
  • the positioning unit must be capable of position the treatment volume in coincidence with the focus point at a very high precision. This high precision must also be maintained over time.
  • a routine course of radiation therapy may span from 2 fractions up to a large number of fractions, for example, 50 - 100 fractions over a period from 2 days to several weeks. The number of treatments depends on the specifics of the particular disease. For each fraction the patient must be repositioned at the radiation therapy unit and aligned relative to the radiation beam or beams at a highly precise degree of accuracy.
  • the radiation reaches and hits the target, i.e. the treatment volume, with a high precision and thereby spares the healthy tissue being adjacent to and/or surrounding the treatment volume.
  • the patient is according to conventional technology immobilized during each therapy session and, moreover, the position of the head of the patient must be exactly the same in each therapy session as in the reference position, i.e. the position during the session when the images to create the therapy plan were captured by means of, for example,
  • CT-imaging Computerized Tomography Imaging
  • One prior art method for enabling measurements of the head of a patient and for immobilizing or fixating the head of the patient during neurological diagnosis, therapy or surgery, in particular during radiation therapy relatively an interface unit includes using a stereotactic frame provided with pin support members in form of posts having fixation pins for invasive fixation to the skull of a patient. This kind of frame is not suitable for fractionated therapy.
  • a prior art method more suitable for positioning a patient relative a therapeutic apparatus in connection with fractionated therapy involves mouth pieces or bite-block shaped after upper palate of the patient and is thus adapted to be received in the mouth of the patient, i.e. containing an impression of the teeth of the patient, and support structure and the stereotactic frame for connecting the mouth-piece or bite block with the therapy unit.
  • the patient When positioning the patient, the patient is placed on the treatment couch or bed and is positioned such that the patient can receive the bite-block in the mouth and thereafter the patient is positioned in the treatment position.
  • Another prior art method used for positioning a patient relative a therapeutic apparatus in connection with fractionated therapy uses a mask shaped after the head or face of the patient.
  • the mask is connected to a support structure and the stereotactic frame for connecting the mask with the therapy unit.
  • the principle of this method is the same as the method using a bite-block.
  • the patient is placed on the treatment couch or bed and is positioned such that the mask thereafter can be fitted on the head or face of the patient and the patient is assumed to be positioned in the treatment position.
  • Further prior art method include positioning the patient on the treatment couch or treatment bed in the treatment position, or the supposed treatment position, and thereafter bracing the patient against the treatment couch or bed to keep the patient in the treatment position.
  • the prior art methods may not provide the high degree of reproducibility required in many therapeutic applications, such as e.g.
  • An object of the present invention is to provide improved methods and systems that provide positional reproducibility with a high degree of accuracy in treatments of patients, such as e.g. radiotherapy.
  • Another object of the present invention is to provide improved methods and systems for providing assistance to a surgeon when positioning a patient in connection with fractionated therapy, such as fractionated radiotherapy.
  • a further object of the present invention is to provide image-guidance methods and systems for positioning a patient in connection with fractionated treatment of patients, for example, fractionated radiotherapy.
  • Yet another object of the present invention is to provide image- guidance methods and systems for positioning a patient in connection with fractionated treatment of patients, such as e.g. fractionated radiotherapy, based on augmented reality.
  • the objects of the present invention are to provide an image- guidance method and system based on augmented reality for a therapeutic apparatus, such as an irradiation unit, suitable for non-invasive irradiation treatment of conditions such as cancerous lesions in the brain, eye, head and neck regions.
  • a therapeutic apparatus such as an irradiation unit
  • the image-guidance for locational accuracy provided by the present invention can be used as a complement or alternative to a mask or bite-block or other tools for providing positioning accuracy.
  • the incorporation of an image-guidance system and method into an irradiation routine would therefore allow inter alia for more accurate localization of the target (within the patient) throughout the treatment process.
  • the present invention may be used in a Leksell Gamma Knife ® system and other radiation therapy systems such as the LINAC system where fractionated therapy is common as well as in systems for MEG
  • the present invention may be used in other medical procedures or medical therapies outside
  • radiotherapy where a need for repeat and accurate positioning of a patient or a portion of a patient exists such as where a first medical procedure is performed requiring a precise location of the patient or portions of the patient and, at some later point in time, a second medical procedure is performed on the patient where a precise location of the patient or portions of the patient is required. It might be possible to repeat laborious and time-consuming localizations steps for the second medical procedure at the expense of increased medical costs and complexity.
  • the term "medical procedure” is a procedure for diagnostic and/or remedial purposes.
  • a system for projecting a three-dimensional image of a patient anatomy relative a therapeutic apparatus using augmented reality comprises a tracking and monitoring device configured to: monitor the therapeutic apparatus and provide therapeutic apparatus position data, the therapeutic apparatus position data describing a position of the therapeutic apparatus in six dimensions relative the tracking and monitoring device; and to track an image recording device and providing image recording device position data, the image recording device position data describing a position of the image recording device in six dimension relative the tracking and monitoring device.
  • An image recording device is configured to record images of the therapeutic apparatus or a part of the therapeutic apparatus, the images including at least the portion of the patient including the part being a subject for therapy.
  • a processing unit is configured to:
  • position data of the anatomy of the patient from the therapeutic apparatus, the position data defining a predetermined treatment position of the patient on a treatment surface for a therapy session relative the
  • a display device is configured to display the synchronized images, wherein a user can be provided with guidance when positioning a patient relative the therapeutic apparatus for treatment session.
  • the processing unit comprises a patient position data extraction module
  • the processing unit further comprises a reference image creating module configured to create a three-dimensional reference image of the patient using the extracted patient position data and an image super-position module configured to super-position the three-dimensional reference image of the patient on the treatment surface, the three- dimensional reference image being positioned in the predetermined treatment position relative the therapeutic apparatus.
  • the processing unit includes an image synchronizing module configured to synchronize the super- positioned three-dimensional reference image and the recorded images using relative position data defining a relative position of the therapeutic apparatus to the image recording device.
  • a method for projecting a three-dimensional image of a patient anatomy relative a therapeutic apparatus using augmented reality comprises creating the projection of the patient anatomy based on patient position data defining a predetermined treatment position relative the therapeutic apparatus, wherein the three-dimensional projection is used as a reference position of the patient, obtaining a video-feed including at least a part of the therapeutic apparatus and the patient and superimposing the projection on the video-feed to display the projection and the patient.
  • the method comprises monitoring the therapeutic apparatus or a part of the therapeutic apparatus delivering therapy such as a radiation dose delivery unit or another part having a known position relative the radiation dose delivery unit using a tracking and monitoring device and providing therapeutic apparatus position data, the therapeutic apparatus position data describing a position of the therapeutic apparatus in six dimensions relative the tracking and monitoring device and tracking an image recording device using the tracking and monitoring device and providing image recording device position data, the image recording device position data describing a position of the image recording device in six dimension relative the tracking and monitoring device. Further, relative position data is determined for the therapeutic apparatus relative the image recording device. Patient position data of the anatomy of the patient is extracted defining a predetermined treatment position of the patient on a treatment surface for a therapy session relative the therapeutic apparatus and a three-dimensional reference image of the patient using the extracted patient position data is created.
  • therapy such as a radiation dose delivery unit or another part having a known position relative the radiation dose delivery unit using a tracking and monitoring device and providing therapeutic apparatus position data
  • the therapeutic apparatus position data describing a position of the therapeutic apparatus in six dimensions relative
  • images of the therapeutic apparatus is recorded using the image recording device, the images including at least the portion of the patient including the part being a subject for therapy and the three- dimensional reference image of the patient is super-positioned on the treatment surface, the three-dimensional reference image being positioned in the predetermined treatment position relative the treatment apparatus.
  • the super-positioned three-dimensional reference image and the recorded images are synchronized using the relative position data and the synchronized images are displayed, wherein a user is provided with guidance when positioning a patient relative the therapeutic apparatus for treatment session.
  • the present invention is based on the idea of using augmented reality to project a 3D image of the patient anatomy in the desired treatment position, which projection can be used as a reference by a surgeon to position the patient for a therapy session.
  • the physician or surgeon is thus guided when positioning the patient by a displayed reference image of the part of the patient to be treated, e.g. the head, super-positioned over a video feed of the patient.
  • a description of the patient anatomy, i.e. skull shape, defined from MR or CT images in a treatment planning system in relation to a given dose distribution is extracted and used as basis for creating the 3D super-positioned reference image.
  • the correct position of the patient anatomy i.e.
  • the position of the patient when the target within the patient to be irradiated is positioned in the correct position relative the therapeutic apparatus is super-positioned on the treatment surface using augmented reality allowing the surgeon to see the correct patient position on a display.
  • the target is defined relative the patient anatomy and information about the position of the patient geometry relative the radiation dose is defined in six dimensions.
  • the dose delivery system e.g. a radiation unit in the Perfexion system
  • the dose delivery system and the patient geometry both have known positions relative the planned target.
  • the geometry of the patient when perfectly positioned can be calculated relative the dose delivery system. This will be a position in the centre of the dose delivery system (i.e. inside the radiation unit).
  • the position of the patient positioning system when the dose delivery is initiated is known as well as the position of the patient positioning system when the patient is
  • the inverse of the difference between these two positions can be added to the position of the patient geometry in the treatment position, which translates it out from the dose delivery system to where the patient is located.
  • a tracking and monitoring device e.g. video camera or IR camera including a IR light emitter
  • a marker is preferably arranged to be mounted on the therapeutic apparatus or in the vicinity and the marker arranged to define its position in 6D.
  • the tracking and monitoring device may be an ultra-sound tracking and monitoring device, an electromagnetic tracking and monitoring device or an optical tracking and monitoring device. Examples of optical tracking and monitoring devices include tracking based on computer vision or infra-red (IR) tracking.
  • a system based on computer vision only one marker and one video-camera are required.
  • the same video-camera can be used to capture live feed of the patient as for monitoring the therapeutic apparatus.
  • This system requires a clear sight line between the video-camera and the patient as well the video-camera and the therapeutic apparatus.
  • An alternative embodiment is IR based tracking and monitoring in which case both the therapeutic apparatus and the video-camera have to be provided with markers, for example, reflecting units capable of reflecting IR light. In this case, no clear line of sight is required between the marker on the patient and the video-camera. However, a clear line of sight is required between the markers and the IR tracking and monitoring device (e.g. at least one IR camera).
  • the IR based system includes markers (at least three), a video-camera and at least one IR camera (it is however conceivable to use a video-camera also capable of recording IR light given that at least one IR emitted also is included into the system). At least three markers are needed for the video-camera as well for the therapeutic apparatus or a part of the therapeutic apparatus delivering therapy such as a radiation dose delivery unit or another part having a known position relative the radiation dose delivery unit must be monitored in order to super-position the 3D
  • steps of the methods according to the present invention are suitable to realize as computer program or as a computer readable medium.
  • Fig. 1 is a perspective view of a therapeutic apparatus in which the present invention can be used to position a patient in connection with a therapy session.
  • Fig. 2 is a schematic view of an embodiment of a system in
  • Fig. 3 is a schematic view of an embodiment of a system in
  • Fig. 4 is a flow chart describing the overall steps of the method according to the present invention.
  • Fig. 5 is a flow chart describing steps of an embodiment of a method according to the present invention. Detailed description of the drawings
  • a patient positioning guidance system based on augmented reality can be integrated with, or used in co-operation with, a therapeutic apparatus such as an irradiation unit or a MEG (magnetoencephalography) apparatus for providing aid or guidance to and assisting medical personnel in positioning a patient in connection with fractionated treatment sessions.
  • a therapeutic apparatus such as an irradiation unit or a MEG (magnetoencephalography) apparatus for providing aid or guidance to and assisting medical personnel in positioning a patient in connection with fractionated treatment sessions.
  • an exemplary radiation therapy device e.g. a Leksell Gamma Knife ® system, in which the patient positioning guidance system according to the present invention can be used in
  • the present invention may also be used in other radiation therapy systems such as the LINAC system where fractionated therapy is common.
  • the present invention may be used in other medical procedures or medical therapies outside radiotherapy where a need for repeat and accurate positioning of a patient or a portion of a patient exists such as where a first medical procedure is performed requiring a precise location of the patient or portions of the patient and, at some later point in time, a second medical procedure is performed on the patient where a precise location of the patient or portions of the patient is required. It might be possible to repeat laborious and time-consuming localizations steps for the second medical procedure at the expense of increased medical costs and complexity.
  • the term "medical procedure” is a procedure for diagnostic and/or remedial purposes.
  • the radiation therapy system comprises a radiation therapy unit or therapeutic apparatus 10 and a patient positioning unit 20 will be described.
  • the patient positioning unit 20 uses the patient positioning unit 20, the patient can be positioned relative the radiation unit.
  • the patient positioning guidance system 50 (see Fig. 2 and 3) according to the present invention is used for providing guidance or aid to the medical personnel when positioning the patient.
  • the therapeutic apparatus 10 there are provided radioactive sources, radioactive source holders, a collinnator body, and external shielding elements.
  • the collimator body comprises a large number of collimator channels directed towards a common focus point, in a manner as is commonly known in the art.
  • the collimator body also acts as a radiation shield preventing radiation from reaching the patient other than through the collimator channels.
  • collimator arrangements in radiation therapy systems can be found in US Patent No. 6,931 ,096 , which is hereby incorporated herein by reference in its entirety.
  • the present invention is also applicable to radiation therapy systems using other arrangements for collimating radiation into a fixed focus point, such as is disclosed in US Patent No. 4,780,898.
  • the patient positioning guidance system according to the present invention is also applicable to LINAC radiosurgical systems, in which a collimated x-ray beam is focused on a stereotactically identified intracranial target and the gantry of the LINAC rotates around the patient, producing an arc of radiation focused on the target.
  • the patient positioning unit 20 comprises a rigid framework 22, a slidable or movable carriage 24, and motors (not shown) for moving the carriage 24 in relation to the framework 22.
  • the carriage 24 is further provided with a patient bed 26 for carrying and moving the entire patient.
  • the patient head is fixed relative the therapy system via a fixation unit and a stereotactic head frame, which comprises engagement points adapted for engagement with the engagement points 30, 32 of the radiation therapy system.
  • a bite-block shaped after upper palate of the patient, i.e. containing an impression of the teeth of the patient, and thus adapted to be received in the mouth of the patient is connected to the support structure or the stereotactic frame.
  • the patient bites the bite-block and the bite- block is fixated to the upper palate of the patient by means of a low pressure or vacuum pump device connected to the mouth-piece via tubings.
  • the mouth-piece or bite-block is adapted to be fixated relatively the support structure and stereotactic frame and, thus, relatively the therapy unit.
  • the entire patient is moved along the axes.
  • the present invention is instead based on the idea of using augmented reality to project a 3D image of the patient anatomy in the desired position for guiding and providing guidance to the medical personnel, e.g. the surgeon, when positioning the patient for treatment, for example, in combination with a bite-block or as an alternative to a bite-block.
  • a patient positioning guidance system 50 according to embodiments of the present invention will be discussed.
  • Communication within the system 50 for example, between different units, devices and modules is indicated with arrows in Fig. 2, which communication e.g. may be wireless or via wires.
  • a tracking and monitoring device 52 is configured to monitor the therapeutic apparatus 10 and to provide therapeutic apparatus position data, DatajApos., defining a position of the therapeutic apparatus 10 in six
  • dimensions are translations in the three directions x, y, and z, respectively, and rotation around the x-axis, y-axis, and z-axis, respectively.
  • the tracking and monitoring device 52 is configured to track an image recording device 54 and provide image recording device position data, Datai RDP0S ., defining a position of the image recording device 54 in six dimensions relative the tracking and monitoring device 52.
  • an infra-red (IR) tracking and monitoring device 52 including at least one IR light source 51 configured to emit IR light and a IR detector 53 configured to receive reflected IR light and to provide output signals corresponding to the received IR light.
  • a first reflector unit or marker unit 55 is provided on the therapeutic apparatus 10 to reflect the emitted IR light from the tracking and monitoring device 52.
  • at least three IR reflectors are included in the reflector unit which reflectors are not arranged according to straight line.
  • a second reflector unit or marker unit 57 is provided on the image recording unit 54.
  • the IR tracking and monitoring device 52 is configured to receive and capture the reflected IR light from the reflectors 55 and 57 at the IR detector 53 of the IR tracking and monitoring device 52 and to determine the six dimensional position data for the therapeutic apparatus 10 and image recording device 54, respectively, relative the tracking and monitoring device 52 based on the captured IR light.
  • the determination of the six dimensional position data for the therapeutic apparatus 10 and image recording device 54, respectively, relative the tracking and monitoring device 52 may be performed using technique known within the art.
  • the infra-red tracking and monitoring device comprises both an infra-red tracking and monitoring device and an image recording device.
  • an infra-red tracking and monitoring device for example, it is possible to use a video- camera capable of recording IR Iight.
  • Another optical system may be based on computer vision.
  • the image capturing device also functions as tracking and monitoring device tracking at least one visual marker.
  • ultrasound tracking or electromagnetic tracking and monitoring devices may be used.
  • An image recording device is configured to record images of the therapeutic apparatus 10.
  • a digital video camera is used to repeatedly record images of the therapeutic apparatus.
  • the frame rate of the video camera is preferably capable of feeding real time images to the tracking and monitoring device 52 or to a processing unit 56 (e.g. a personal computer).
  • the video camera 54 is positioned such that a recorded scene includes at least the portion of the patient including the part being a subject for therapy when the patient is positioned in the therapeutic apparatus 10 for a therapy session.
  • the processing unit 56 is configured to communicate with the tracking and monitoring device 52 and to the therapeutic apparatus 10 and the image recording device 54.
  • the modules of the processing unit 56 described below may, for example, be implemented as hardware modules (including
  • processing unit can additionally be considered to be embodied entirely within any form of computer-readable storage medium having stored therein an appropriate set of instructions for use by or in connection with an instruction- execution system, apparatus or device, such as a computer-based system, processors containing system or other system that can fetch instructions from a medium and execute the instructions.
  • a "computer- readable” can be any means that contain, store, communicate, propagate, or transport the program for use by or in connection with the instruction- execution system, apparatus or device.
  • the computer-readable medium can be, for example, but not limited to, an electronic, magnetic, electromagnetic, infrared, or semiconductor system, apparatus, device or propagation medium.
  • the computer-readable medium include an electrical connection having one or more wires, a portable computer diskette, a random access memory (RAM), a read only memory (ROM), an erasable programmable read only memory (EPROM or flash memory), an optical fibre, and a portable compact disc read only memory (CD-ROM).
  • RAM random access memory
  • ROM read only memory
  • EPROM or flash memory erasable programmable read only memory
  • CD-ROM compact disc read only memory
  • the processing unit 56 comprises a patient position data extraction module 58 configured to extract patient position data of the anatomy of the patient from the therapeutic apparatus 10.
  • the position data defines a predetermined treatment position of the patient on the patient bed 26 for a therapy session relative the therapeutic apparatus 10.
  • This predetermined treatment position is thus the position of the patient during the treatment session and the user of the system, e.g. a physician, accordingly strives to position as close as possible to this predetermined treatment position.
  • the processing unit 56 further comprises a relative position data calculation module 59 configured to calculate relative position data, Data(TA rei. icDjpos., defining the position of the therapeutic apparatus 10 relative the image recording device 54 in the six dimensions based on the therapeutic apparatus position data, DataiApos . , and the image recording device position data, DataiRDpos.-
  • the processing unit 56 comprises a reference image creating module 60 configured to create a three-dimensional reference image of the patient using the extracted patient position data.
  • An image super-position module 62 of the processing unit 56 is configured to super-position the three- dimensional reference image of the patient on the patient bed 26, which three-dimensional reference image is positioned in the predetermined treatment position relative the therapeutic apparatus 10.
  • the processing unit 56 includes an image synchronizing module 64 configured to synchronize the super-positioned three-dimensional reference image and the recorded images using the relative position data, Data(TA rei. ICD) P
  • a display device 66 is configured to display the synchronized images, for example, a display device of a personal computer to thereby present the images for a user 70, for example, a physician performing the therapy.
  • the user 70 is hence guided by the displayed reference image of the patient anatomy when positioning the patient since the patient ' s current position also is displayed.
  • the surgeon is provided with feed-back in real-time of a current patient position relative the reference image during the patient positioning procedure.
  • the display device 82 is arranged in a pair of eye glasses 80 having a head mounted display or a heads-up display; see Fig. 3, which the user (user not shown in Fig. 3) may wear during a procedure for positioning the patient.
  • the display device 82 may be complemented by the display device 66 arranged, for example, in a personal computer.
  • the pair of eye glasses 80 may further include a video camera 84 for recording images of the therapeutic apparatus 10 and a communication module 86 for communicating with the processing unit 56 wirelessly, e.g. a Bluetooth module.
  • at least one marker 88 is arranged on the eye glasses 80.
  • three IR reflectors 88 for enabling tracking of the user and the video camera 84 by the IR tracking and monitoring device 52 are arranged on the eye glasses 80.
  • augmented reality is used to project a 3D image of the patient anatomy in the desired treatment position, which projection can be used as a reference by a physician or surgeon to position the patient for a therapy session.
  • the physician or surgeon is thus guided when positioning the patient by a displayed reference image of the part of the patient to be treated, e.g. the head, super-positioned over a video feed of the patient.
  • a projection of the patient anatomy is created based on patient position data defining a predetermined treatment position relative the therapeutic apparatus, wherein the three-dimensional projection is used as a reference position of the patient.
  • a video-feed including at least a part of the therapeutic apparatus and the patient is obtained.
  • step S94 the projection is superimposed on the video- feed to display the projection and the patient.
  • the physician or surgeon is thereby capable of positioning the patient in the treatment position using the super-positioned three-dimensional reference image as a guide.
  • the patient is located in the correct treatment position.
  • the method described below is, for example, executed in connection with positioning a patient in preparation for therapy, for example, a
  • a three-dimensional image of the patient anatomy in the correct treatment position is projected on a display using augmented reality and superimposed a video-feed of the therapeutic apparatus and the patient, which can guide the physician or surgeon when positioning the patient for the treatment.
  • the therapeutic apparatus 10 is monitored using the tracking and monitoring device 52 and therapeutic apparatus position data is provided.
  • the therapeutic apparatus position data DataiApos., defines a position of the therapeutic apparatus 10 in six dimensions relative the tracking and monitoring device 52.
  • the six dimensions are translation in the three directions x, y, and z, respectively, and rotation around the x-axis, y-axis, and z-axis, respectively.
  • the image recording device 54, 84 is tracked by the tracking and monitoring device 52 and image recording device position data is provided.
  • the image recording device position data DataiRD P0S ., defines a position of the image recording device 54 in six dimension relative the tracking and monitoring device 52.
  • step S100 and S1 10 can be executed in reversed order or simultaneously.
  • the therapeutic apparatus position data and image recording device position data is synchronized in time, for example, by simultaneous tracking or by processing the data to obtain the synchronizing.
  • step S120 relative position data, Data(TA rei. ICD) P defining the position of the therapeutic apparatus 10 relative the image recording device 54 in the six dimensions, is determined or calculated based on the therapeutic apparatus position data, DataiApos., and the image recording device position data, DataiRD P0S .-
  • step S130 patient position data of the anatomy of the patient is extracted, for example, from the therapeutic apparatus 10, which patient position data defines a predetermined treatment position of the patient on a treatment surface, e.g. the patient 26, for a therapy session relative the therapeutic apparatus 10.
  • This predetermined treatment position is thus the position of the patient during the treatment session and the user of the system, e.g. a physician, accordingly strives to position as close as possible to this predetermined treatment position.
  • step S130 can be executed, for example, before steps S100 - S120, or after step S100 and S1 10 but before step S120.
  • images of therapeutic apparatus 10 is recorded by the image recording device 54,84, which images include at least the portion of the patient including the part being a subject for therapy.
  • step S150 a three-dimensional reference image of the patient is created using the extracted patient position data. It should be noted that this step (i.e. step S150) instead could be performed after step S130 and thus before the step of recording images of the therapeutic apparatus 10.
  • step S160 the three-dimensional reference image of the patient is super-positioned on the treatment surface, the three- dimensional reference image being positioned in the predetermined treatment position relative the therapeutic apparatus.
  • the super-positioned three-dimensional reference image and the recorded images are synchronized using the relative position data.
  • the synchronized images are displayed, for example, on the display device 66, or on the display device 82 arranged in the pair of eye glasses 80.
  • the physician or surgeon is thereby capable of positioning the patient in the treatment position using the super-positioned three-dimensional reference image as a guide. When the patient is aligned with the three-dimensional reference image, the patient is located in the correct treatment position.

Landscapes

  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Pathology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Radiation-Therapy Devices (AREA)

Abstract

La présente invention appartient au domaine de la thérapie par rayonnements. En particulier, l'invention concerne des systèmes et des procédés de thérapie guidée par imagerie, notamment de radiothérapie. Selon l'invention, l'appareil thérapeutique et le dispositif d'enregistrement d'images sont suivis et des données de position relative de l'appareil thérapeutique par rapport au dispositif d'enregistrement d'images sont déterminées. Les données de position du patient relatives à l'anatomie dudit patient sont extraites et une image tridimensionnelle de référence du patient est créée. En outre, des images dudit appareil thérapeutique sont enregistrées en continu à l'aide d'un dispositif d'enregistrement d'images. L'image tridimensionnelle de référence est superposée aux images enregistrées et celles-ci sont affichées, une assistance étant apportée à un utilisateur lors du positionnement d'un patient par rapport audit appareil thérapeutique pour la session de traitement.
PCT/EP2011/053529 2011-03-09 2011-03-09 Système et procédé de radiothérapie guidée par imagerie Ceased WO2012119649A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/EP2011/053529 WO2012119649A1 (fr) 2011-03-09 2011-03-09 Système et procédé de radiothérapie guidée par imagerie

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/EP2011/053529 WO2012119649A1 (fr) 2011-03-09 2011-03-09 Système et procédé de radiothérapie guidée par imagerie

Publications (1)

Publication Number Publication Date
WO2012119649A1 true WO2012119649A1 (fr) 2012-09-13

Family

ID=44625368

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2011/053529 Ceased WO2012119649A1 (fr) 2011-03-09 2011-03-09 Système et procédé de radiothérapie guidée par imagerie

Country Status (1)

Country Link
WO (1) WO2012119649A1 (fr)

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2506903A (en) * 2012-10-12 2014-04-16 Vision Rt Ltd Positioning patient for radio-therapy using 3D models and reflective markers
WO2014166415A1 (fr) * 2013-04-12 2014-10-16 重庆伟渡医疗设备股份有限公司 Procédé de guidage par image utilisant l'imagerie bidimensionnelle
CN104771839A (zh) * 2015-04-30 2015-07-15 上海联影医疗科技有限公司 放射治疗仪
GB2537686A (en) * 2015-04-24 2016-10-26 Vision Rt Ltd Patient positioning training apparatus
CN108806766A (zh) * 2013-03-15 2018-11-13 Empi有限公司 针对基于能量的治疗设备的基于个人化图像的指导
US11207137B2 (en) 2017-12-07 2021-12-28 Brainlab Ag Patient positioning using a skeleton model

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4780898A (en) 1986-04-30 1988-10-25 Elekta Instrument Arrangement in a gamma unit
WO2005018734A2 (fr) * 2003-08-12 2005-03-03 Loma Linda University Medical Center Systeme de positionnement de patient pour systeme de radiotherapie
US6931096B2 (en) 2002-07-05 2005-08-16 Elekta Ab Radiation therapy device
US20090003528A1 (en) * 2007-06-19 2009-01-01 Sankaralingam Ramraj Target location by tracking of imaging device
US20100208274A1 (en) * 2008-06-04 2010-08-19 Lap Gmbh Laser Applikationen Apparatus and method for the representation of an area on the surface of a patient's body

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4780898A (en) 1986-04-30 1988-10-25 Elekta Instrument Arrangement in a gamma unit
US6931096B2 (en) 2002-07-05 2005-08-16 Elekta Ab Radiation therapy device
WO2005018734A2 (fr) * 2003-08-12 2005-03-03 Loma Linda University Medical Center Systeme de positionnement de patient pour systeme de radiotherapie
US20090003528A1 (en) * 2007-06-19 2009-01-01 Sankaralingam Ramraj Target location by tracking of imaging device
US20100208274A1 (en) * 2008-06-04 2010-08-19 Lap Gmbh Laser Applikationen Apparatus and method for the representation of an area on the surface of a patient's body

Cited By (17)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10183177B2 (en) 2012-10-12 2019-01-22 Vision Rt Limited Patient monitor
WO2014057280A1 (fr) * 2012-10-12 2014-04-17 Vision Rt Limited Moniteur pour patient
US12121751B2 (en) 2012-10-12 2024-10-22 Vision Rt Limited Patient monitor
US11628313B2 (en) 2012-10-12 2023-04-18 Vision Rt Limited Patient monitor
GB2506903A (en) * 2012-10-12 2014-04-16 Vision Rt Ltd Positioning patient for radio-therapy using 3D models and reflective markers
CN104755136B (zh) * 2012-10-12 2017-08-08 维申Rt有限公司 患者监测仪
US10926109B2 (en) 2012-10-12 2021-02-23 Vision Rt Limited Patient monitor
CN108806766B (zh) * 2013-03-15 2022-05-17 Empi有限公司 针对基于能量的治疗设备的基于个人化图像的指导
CN108806766A (zh) * 2013-03-15 2018-11-13 Empi有限公司 针对基于能量的治疗设备的基于个人化图像的指导
US11289186B2 (en) 2013-03-15 2022-03-29 Djo, Llc Personalized image-based guidance for energy-based therapeutic devices
US12040077B2 (en) 2013-03-15 2024-07-16 Djo, Llc Personalized image-based guidance for energy-based therapeutic devices
WO2014166415A1 (fr) * 2013-04-12 2014-10-16 重庆伟渡医疗设备股份有限公司 Procédé de guidage par image utilisant l'imagerie bidimensionnelle
GB2537686A (en) * 2015-04-24 2016-10-26 Vision Rt Ltd Patient positioning training apparatus
CN104771839B (zh) * 2015-04-30 2017-12-22 上海联影医疗科技有限公司 放射治疗仪
CN104771839A (zh) * 2015-04-30 2015-07-15 上海联影医疗科技有限公司 放射治疗仪
US11207137B2 (en) 2017-12-07 2021-12-28 Brainlab Ag Patient positioning using a skeleton model
US11628012B2 (en) 2017-12-07 2023-04-18 Brainlab Ag Patient positioning using a skeleton model

Similar Documents

Publication Publication Date Title
CN1672651B (zh) 在有呼吸运动的情况下用于放射治疗的患者定位系统和方法
US9968801B2 (en) Radiation treatment planning and delivery for moving targets in the heart
Gevaert et al. Setup accuracy of the Novalis ExacTrac 6DOF system for frameless radiosurgery
US8831706B2 (en) Fiducial-less tracking of a volume of interest
US7953204B2 (en) Radiation treatment planning and delivery for moving targets in the heart
CN106714905B (zh) 一种放射治疗设备以及射束成像方法
EP2968974B1 (fr) Système de gestion des mouvements intra-fraction
US7656998B2 (en) Unified quality assurance for a radiation treatment delivery system
US20070038058A1 (en) Patient tracking using a virtual image
WO2012119649A1 (fr) Système et procédé de radiothérapie guidée par imagerie
Paoletti et al. Special stereotactic radiotherapy techniques: Procedures and equipment for treatment simulation and dose delivery
US20140213904A1 (en) Intra-fraction motion management system
US20140275707A1 (en) Intra-fraction motion management system and method
US20240017094A1 (en) Radiation treatment planning and delivery for moving targets in the heart
Ryken et al. Ultrasonographic guidance for spinal extracranial radiosurgery: technique and application for metastatic spinal lesions
Lee et al. From frame to frameless: brain radiosurgery
Saw et al. Implementation of fiducial-based image registration in the Cyberknife robotic system
MOGIRE EVALUATION OF THE ACCURACY AND REPRODUCIBILITY OF THE PLANNING ISOCENTRE USING AUTOMATIC AND MANUAL COUCH MOVEMENTS
Shirato et al. Stereotactic Radiotherapy and Gated Therapy
Lee et al. From frame to frameless: brain radiosurgery
Alexander Stereotactic Radiosurgery and Radiotherapy in Panama
García Vázquez Advances in navigation and intraoperative imaging for intraoperative electron radiotherapy
DUCHATEAU et al. SETUP ACCURACY OF THE NOVALIS EXACTRAC 6DOF SYSTEM FOR FRAMELESS RADIOSURGERY THIERRY GEVAERT, MSc., DIRK VERELLEN, PH. D., KOEN TOURNEL, MS, NADINE LINTHOUT, PH. D., SAMUEL BRAL, MD, BENEDIKT ENGELS, MD, CHRISTINE COLLEN, MD, TOM DEPUYDT, IR

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 11708024

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 11708024

Country of ref document: EP

Kind code of ref document: A1