CN111068186B - CT imaging and image-guided radiotherapy device - Google Patents
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Abstract
A CT imaging and image guided radiation therapy apparatus comprising: at least one high-energy radiation source for generating high-energy radiation to perform radiotherapy on the object; a first PET detector and a second PET detector oppositely arranged; at least one kilovolt KV ray source for medical diagnosis is placed on the first PET detector, the inner side of the first PET detector or the outer side of the first PET detector and used for generating KV rays; the second PET detector receives KV rays and carries out CT imaging; the first PET detector and the second PET detector receive gamma photons emitted by the object and perform PET imaging. The invention realizes the function of the common detector of the two PET detectors through the KV ray source, and assists and/or guides radiotherapy according to KVCT imaging and/or PET imaging, thereby achieving the purpose of realizing the common scanning plane of radiotherapy, KVCT imaging and PET imaging in the image-guided radiotherapy device.
Description
Technical Field
The invention relates to the field of medical imaging and radiotherapy guiding, in particular to a Computed Tomography (CT) and image-guided radiotherapy device.
Background
Radiation Therapy (Radiation Therapy) is one of the major current modalities for treating malignant tumors. In radiotherapy, Image Guidance (Image Guidance) is one of the key means to ensure high precision treatment. The radiotherapy guiding is that before or during the treatment of the patient, the accurate body position information of the patient is acquired by using a medical image means, so that the treatment errors caused by the movement of organs such as the body placement, the heartbeat, the respiration and the like of the patient are reduced, and the precision of radiotherapy is improved or ensured. Currently, the most common radiotherapy treatment is the use of Megavolt (MV) grade high energy X-rays, and the most common radiotherapy treatment guidance is Kilovolt (KV) X-ray based Computed Tomography (CT). In recent years, radiotherapy based on Magnetic Resonance Imaging (MRI) guidance has also been developed successfully and applied clinically. At the same time, scientists and engineers are also actively developing new radiotherapy modalities based on Positron Emission Tomography (PET) guidance.
PET is a functional imaging that can obtain biological information from the human body. In PET imaging, gamma photons generated by positron annihilation have the potential to directly reflect the real-time location information of a tumor in a patient. The real-time tumor position information has great significance for high-precision tumor treatment. Movement of organs during treatment of patients has been a major challenge in radiation therapy. Therefore, the radiotherapy apparatus guided by PET has a strong clinical application potential, and is one of the hot spots and difficulties in research in academia and industry at present. In PET-guided radiotherapy apparatus, PET alone cannot give accurate body contour information of a patient lying on a treatment couch, due to the physical mechanism of PET imaging. Meanwhile, PET generally requires attenuation correction or the like using CT images. Thus, similar to PET/CT in medical diagnostics, in PET-guided radiotherapy devices, a CT is often required to "assist" the PET imaging.
In summary, CT imaging plays a significant role in radiotherapy systems. Currently, there are two main modes of CT subsystems: kilovolt CT (kvct) and megavolt CT. Among them, megavoltage CT is usually a medical linear accelerator, which is a high-energy X-ray (megavoltage) source used directly in treatment. The scan plane of megavolt CT is naturally in the same plane as the treatment, which brings great convenience to image registration and facilitates optimization of the treatment protocol. However, megavolt CT imaging is not of high quality: the reconstructed image has low contrast and the patient receives a large radiation dose. Unlike megavoltage CT, kilovoltage CT typically employs a separate, medical diagnostic (kilovoltage) X-ray source. Kilovolt CT can be subdivided into two broad categories, cone-beam CT based on flat panel detectors and diagnostic-grade CT based on multi-row spiral CT detectors. The kilovolt CT has the advantages of small radiation dose, high contrast and the like.
In the current existing PET guided radiation therapy system design, because PET imaging and treatment must be on the same plane, limited by spatial location, a set of independent kilovoltage CT subsystems cannot share a common scanning plane with treatment and PET imaging. This imposes limitations on radiation treatment and guidance. The main body is as follows: when a patient and a treatment bed are switched between CT imaging and PET imaging or treatment, the position of a human organ is easy to change due to the back-and-forth movement; the inability to image simultaneously or in real time during treatment limits the flow and implementation of the treatment.
With the development of radiation therapy to a helical mode based on a rotating gantry, and the urgent need for "adaptive" treatment protocols, image guidance and treatment co-planarity will certainly be a large trend for future radiation therapy, and also an inevitable consequence of precision radiation therapy.
In PET guided radiation therapy systems, one obvious compromise to achieve CT and PET imaging (radiotherapy) in the same plane is megavolt CT using a linear accelerator directly as the source of radiation, i.e., a "co-radiation source". However, as mentioned above, the megavolt CT radiation dose is large, the contrast is low, and the practicability is not good.
Disclosure of Invention
Technical problem to be solved
It is an object of the present invention to provide a CT imaging and image guided radiation therapy apparatus that solves at least one of the above mentioned problems.
(II) technical scheme
In a first aspect of embodiments of the present invention, there is provided a CT imaging and image guided radiation therapy apparatus, comprising:
at least one high energy radiation source;
a first PET detector and a second PET detector oppositely arranged;
at least one kilovolt KV ray source for medical diagnosis is placed on the first PET detector, the inner side of the first PET detector or the outer side of the first PET detector and used for generating KV rays;
the second PET detector receives the KV ray and carries out KVCT imaging;
the first PET detector and the second PET detector receive gamma photons emitted by an object and perform PET imaging;
the high-energy ray source generates high-energy rays for carrying out radiotherapy on an object;
the KVCT imaging and/or PET imaging is used for assisting and/or guiding the radiotherapy of the object.
In some embodiments of the present invention, the KV radiation source is disposed outside the first PET detector, and the first PET detector is provided with an opening for transmitting the KV radiation.
In some embodiments of the present invention, the apparatus further comprises at least one high-energy detector, disposed opposite to the high-energy radiation source, for receiving high-energy radiation;
the high-energy detector, the high-energy ray source, the first PET detector, the second PET detector and the KV ray source are positioned on the same plane;
the first PET detector and the second PET detector are respectively positioned on two sides of the high-energy ray source and the high-energy detector.
In some embodiments of the present invention, during KVCT imaging, the KV radiation source and the PET detector rotate relatively around the object to obtain CT data at different rotation angles, and then a CT image is obtained through computer operation.
In some embodiments of the invention, the CT data and/or CT images are used to perform a combination of one or more of the following:
assisted PET imaging and/or assisted PET guided radiation therapy, PET attenuation correction, and PET motion artifact correction.
In some embodiments of the present invention, the KV radiation source comprises one of an X-ray tube, a carbon nanotube, and an isotope source.
In some embodiments of the invention, the high energy radiation source comprises an accelerator or an isotope source for radiotherapy, the high energy radiation comprises one of a megavolt MV photon radiation and a MV particle radiation, the MV photon radiation comprises one of a megavolt X-ray and a gamma ray; the MV particle rays include one of protons, neutrons, and carbon ions.
In some embodiments of the invention, the first PET detector and/or the second PET detector are set to an integration mode, KV-ray beaming, enabling independent cone-beam, fan-beam or helical CT scanning, before and/or after treatment; and/or
Before and/or after treatment, the first PET detector and/or the second PET detector are set to be in a counting mode, KV rays are output, and independent cone beam, fan beam or spiral CT scanning is realized; and/or
Before and/or after treatment, the first PET detector and/or the second PET detector are set to be in a counting mode, KV rays are emitted, KV ray photons and gamma photons generated by positron annihilation are distinguished through an energy threshold value of the light counting detector, and PET and CT simultaneous scanning is achieved.
In some embodiments of the invention, in the treatment, the KV radiation source pulses to output beams by using the time gap of the pulse treatment, so as to realize the synchronous proceeding of the CT imaging and the treatment; and/or
During treatment, the first PET detector and/or the second PET detector are set to be in a counting mode, the KV ray source outputs beams in a pulse mode by utilizing a time gap of pulse treatment, KV ray photons and gamma photons generated by positron annihilation are distinguished through an energy threshold value of the optical counting detector, and CT imaging, PET imaging and treatment are carried out synchronously.
In some embodiments of the invention, the first PET detector and/or the second PET detector is comprised of a plurality of PET detection modules and/or detection units, with a uniform gap between each PET detection module and/or detection unit.
(III) advantageous effects
Compared with the prior art, the CT imaging and image guiding radiotherapy device at least has the following advantages:
1. the KV ray source coplanar with the first PET detector, the second PET detector, the high-energy detector and the high-energy ray source is added, the function of a common detector of the first PET detector or the second PET detector can be realized, and the purpose of scanning a plane in common by KVCT imaging, PET imaging and radiotherapy is achieved.
2. The position and the type of the KV ray source are variable, the KV ray source can be adjusted according to the requirements of users, and the universality is high.
3. The CT imaging and image guiding radiotherapy device has multiple imaging and/or radiotherapy guiding modes, can be adjusted according to the actual requirements of users, and is suitable for multiple conditions.
Drawings
FIG. 1 is a schematic structural diagram of a CT imaging and image guided radiation therapy device in accordance with a first embodiment of the present invention;
FIG. 2A is a top view of FIG. 1;
FIG. 2B is a side view of FIG. 1;
FIG. 3A is a schematic structural diagram of a CT imaging and image guided radiation therapy device in accordance with a second embodiment of the present invention;
FIG. 3B is a schematic structural diagram of a CT imaging and image guided radiation therapy device in accordance with a third embodiment of the present invention;
fig. 3C is a schematic structural diagram of a CT imaging and image guided radiation therapy apparatus according to a fourth embodiment of the present invention.
Detailed Description
In the prior art, when the image-guided radiotherapy device realizes PET (positron emission tomography) imaging and KVCT (KVCT) imaging functions, the first PET detector, the second PET detector, the high-energy ray source and the KV ray source are difficult to be placed in the same plane at the same time. In view of this, the present invention provides a CT (computed tomography) imaging and image-guided radiotherapy apparatus, which adds a KV radiation source coplanar with a first PET detector, a second PET detector, a high-energy detector and a high-energy radiation source, and can implement a co-detector function of the first PET detector or the second PET detector, thereby achieving the purpose of a common scan plane for KVCT imaging, PET imaging and radiotherapy.
In order to make the objects, technical solutions and advantages of the present invention more apparent, the present invention is described in further detail below with reference to specific embodiments and the accompanying drawings.
A first embodiment of the present invention provides a CT imaging and image guided radiation therapy apparatus, as shown in fig. 1, including: at least one high energy radiation source for radiotherapy, which may be an accelerator or an isotope source (or other device) for radiotherapy, for generating one of megavoltage MV photon rays or MV particle rays, the megavoltage photon rays comprising one of megavoltage X-photons and gamma rays; the megavoltage particle ray comprises one of a proton, a neutron and a carbon ion; a first PET detector and a second PET detector oppositely arranged; at least one kilovolt KV radiation source for medical diagnosis is arranged on the first PET detector, the inner side of the first PET detector or the outer side of the first PET detector and is used for generating KV radiation (mainly referring to X-ray, but also GAMMA GAMMA radiation with energy in the medical diagnosis range generated by isotope); the second PET detector receives the KV ray and carries out KVCT imaging; the first PET detector and the second PET detector receive gamma photons emitted by an object and perform PET imaging; the high-energy ray source generates high-energy rays for carrying out radiotherapy on an object; the KVCT imaging and/or PET imaging is used for assisting and/or guiding the radiotherapy of the object. Therefore, the CT imaging and image guiding radiotherapy device has the advantages of small radiation dose, high contrast and the like.
Wherein the first and second PET detectors may be in an opposite arc configuration (see FIG. 1), and in other embodiments, the first and second PET detectors may be in an opposite flat panel configuration or a straight configuration.
It should be noted that the first PET detector and/or the second PET detector generally include a plurality of small PET detection modules and/or detection units, and there may be a gap, preferably a uniform gap, between the PET modules and/or detection units, that is, there may be no gap or a non-uniform gap between the PET modules and/or detection units, which is not limited by the present invention.
In fig. 1, the CT imaging and image guided radiation therapy apparatus generally employs a helical scanning (therapy) mode based on a rotating gantry, and is highly versatile because the spatial resolution/density resolution of the apparatus for kv CT imaging and the like is not too high (compared to medical diagnostic CT).
In the first embodiment, the KV radiation source is disposed outside the first PET detector (on the side away from the object), so that the KV radiation can reach the second PET detector, a certain gap, i.e. an opening, needs to be disposed on the first PET detector, so that the KV radiation can irradiate the second PET detector through the opening.
In this embodiment, conventional methods for reducing the CT dose are directly available for the KV radiation source, such as bowtie (bowtie) filtering, pre-collimation, etc. The KV radiation source may be a conventional radiation source such as an X-ray tube, a novel radiation source such as a carbon nanotube, or an isotope source, etc., which are not limited in the present invention.
Because this first PET detector and/or second PET detector can also receive 511 KeV's gamma photon that the object (including the tracker) launched, consequently can carry out PET formation of image, combine CT formation of image simultaneously, can realize the detector function altogether, can possess the contrast height and characteristics that the practicality is strong under the little condition of radiation dose.
Similar to prior art radiotherapy devices, the radiotherapy device referred to in the present invention typically further comprises at least one high-energy detector. Referring to fig. 1, the high-energy detector is located at a position between the first PET detector and the second PET detector, and is disposed opposite to the position of the high-energy source for receiving high-energy rays.
Referring to fig. 2A and fig. 2B, it can be seen that according to the present disclosure, the first PET detector, the second PET detector, the KV radiation source, the high-energy detector, and the high-energy radiation source are located on the same plane, and the first PET detector and the second PET detector are respectively located at two sides of the high-energy radiation source and the high-energy detector, which brings great convenience to image registration and is beneficial to optimizing a treatment scheme.
It should also be noted that the CT imaging and image guided radiation therapy device of the present invention can be used for pre-treatment or post-treatment imaging, and that the imaging can be performed in a variety of modes:
before and/or after treatment, the first PET detector and/or the second PET detector are set to be in an integral mode, KV rays are output, and independent cone beam, fan beam or spiral CT scanning is realized; and/or
Before and/or after treatment, the first PET detector and/or the second PET detector are set to be in a counting mode, KV rays are output, and independent cone beam, fan beam or spiral CT scanning is realized; and/or
Before and/or after treatment, the first PET detector and/or the second PET detector are set to be in a counting mode, KV rays are emitted, KV ray photons and gamma photons generated by positron annihilation are distinguished through an energy threshold value of the light counting detector, and PET and CT simultaneous scanning is achieved.
During CT scanning, the KV ray source and the PET detector perform relative rotation motion around an object, so that CT data under different rotation angles are acquired.
The CT imaging and image guided radiotherapy device of the present invention can have the following two modes in the treatment:
the KV radiation source outputs beams in a pulse mode by utilizing the time gap of pulse type treatment, and CT imaging and treatment are synchronously carried out; and/or
The first PET detector and/or the second PET detector are set to be in a counting mode, the KV ray source outputs beams in a pulse mode by utilizing the time gap of pulse type treatment, KV ray photons and gamma photons generated by positron annihilation are distinguished through the energy threshold value of the light counting detector, and CT imaging, PET imaging and treatment are carried out synchronously.
It should be noted that the three modes before and/or after treatment and the two modes in treatment can be combined arbitrarily.
The imaging mode in the treatment can be combined with any one of the imaging modes before and after the treatment, and the CT imaging and image-guided radiotherapy device can realize multiple imaging functions.
And (3) obtaining the CT image by analyzing the CT data obtained by scanning through an image reconstruction algorithm or an iterative image reconstruction algorithm and utilizing computer operation. The obtained CT data or CT images can be used for realizing auxiliary PET imaging and/or auxiliary PET guide radiotherapy, attenuation correction during PET image reconstruction, motion artifact correction and the like; can also be directly used for guiding the radiation therapy.
In other embodiments, the KV radiation source of the CT imaging and image-guided radiation therapy device can be a plurality of radiation sources, and the KV radiation source can also be arranged on the first PET detector or on the inner side (the side facing the object) of the first PET detector, and both cases do not need to provide an opening on the first PET detector.
As shown in fig. 3A to 3C, in sequence, one KV ray source of the second embodiment is disposed inside the first PET detector, a plurality of KV ray sources of the third embodiment are disposed on the first PET detector, and a plurality of KV ray sources of the fourth embodiment are disposed inside the first PET detector.
In conclusion, the CT imaging and image-guided radiotherapy device provided by the invention is additionally provided with the KV ray source which is coplanar with the first PET detector, the second PET detector, the high-energy detector and the high-energy ray source, so that the co-detector function of the first PET detector or the second PET detector is realized, and the CT data and/or the CT image and/or the PET data and/or the PET image can be used for assisting and/or guiding radiotherapy, the radiotherapy performance is improved, and the purpose of co-scanning planes of radiotherapy, KVCT imaging and PET imaging can be realized.
Unless otherwise indicated, the numerical parameters set forth in the specification and attached claims are approximations that can vary depending upon the desired properties sought to be obtained by the present invention. In particular, all numbers expressing quantities of ingredients, reaction conditions, and so forth used in the specification and claims are to be understood as being modified in all instances by the term "about". Generally, the expression is meant to encompass variations of ± 10% in some embodiments, 5% in some embodiments, 1% in some embodiments, 0.5% in some embodiments by the specified amount.
Furthermore, "comprising" does not exclude the presence of elements or steps not listed in a claim. The word "a" or "an" preceding an element does not exclude the presence of a plurality of such elements.
The use of ordinal numbers such as "first," "second," "third," etc., in the specification and claims to modify a corresponding element does not by itself connote any ordinal number of the element or any ordering of one element from another or the order of manufacture, and the use of the ordinal numbers is only used to distinguish one element having a certain name from another element having a same name.
The above-mentioned embodiments are intended to illustrate the objects, technical solutions and advantages of the present invention in further detail, and it should be understood that the above-mentioned embodiments are only exemplary embodiments of the present invention, and are not intended to limit the present invention, and any modifications, equivalents, improvements and the like made within the spirit and principle of the present invention should be included in the protection scope of the present invention.
Claims (10)
1. A CT imaging and image guided radiation therapy apparatus comprising:
at least one high energy radiation source that generates high energy radiation for radiation treatment of an object;
a first PET detector and a second PET detector oppositely arranged;
the kilovolt KV radiation source is arranged on the side of the first PET detector, is positioned on the first PET detector, and is used for generating KV radiation, and the side of the first PET detector, which is close to the object, or the side of the first PET detector, which is far away from the object;
the second PET detector receives the KV ray and carries out KVCT imaging;
the first PET detector and the second PET detector receive gamma photons emitted by an object and perform PET imaging;
the KVCT imaging and/or PET imaging is used for assisting and/or guiding the radiotherapy of the object.
2. The CT imaging and image guided radiation therapy apparatus of claim 1, wherein said KV radiation source is disposed on a side of the first PET detector remote from said object, the first PET detector having an opening disposed therein, said opening being configured to transmit said KV radiation.
3. The CT imaging and image guided radiation therapy apparatus of claim 1 further comprising at least one high energy detector positioned opposite the location of said high energy source for receiving high energy radiation;
the high-energy detector, the high-energy ray source, the first PET detector, the second PET detector and the KV ray source are positioned on the same plane;
the first PET detector and the second PET detector are respectively positioned on two sides of the high-energy ray source and the high-energy detector.
4. The CT imaging and image guided radiation therapy apparatus according to claim 1, wherein during the KVCT imaging, the KV radiation source and the PET detector are relatively rotated around the object to obtain CT data at different rotation angles, and then the CT image is obtained through computer operation.
5. The CT imaging and image guided radiation therapy device of claim 4, wherein the CT data and/or CT image is used to perform a combination of one or more of the following:
assisted PET imaging and/or assisted PET guided radiation therapy, PET attenuation correction, and PET motion artifact correction.
6. The CT imaging and image guided radiation therapy apparatus of claim 1, wherein the KV radiation source comprises one of an X-ray tube, a carbon nanotube, and an isotope source.
7. The CT imaging and image guided radiation therapy apparatus of claim 1, wherein the high energy radiation source comprises an accelerator or an isotope source for radiation therapy, the high energy radiation comprises one of megavolt MV photon radiation and MV particle radiation, the MV photon radiation comprises one of megavolt X-ray and gamma radiation; the MV particle rays include one of protons, neutrons, and carbon ions.
8. CT imaging and image guided radiotherapy apparatus according to claim 1, wherein the first PET detector and/or the second PET detector are set to an integration mode, KV beaming, enabling independent cone-beam, fan-beam or helical CT scanning before and/or after treatment; and/or
Before and/or after treatment, the first PET detector and/or the second PET detector are set to be in a counting mode, KV rays are output, and independent cone beam, fan beam or spiral CT scanning is realized; and/or
Before and/or after treatment, the first PET detector and/or the second PET detector are set to be in a counting mode, KV rays are emitted, KV ray photons and gamma photons generated by positron annihilation are distinguished through an energy threshold value of the light counting detector, and PET and CT simultaneous scanning is achieved.
9. The CT imaging and image guided radiation therapy apparatus of claim 1, wherein, during therapy, with the time gap of the pulse therapy, the KV radiation source pulses out, and the CT imaging and therapy are performed synchronously; and/or
During treatment, the first PET detector and/or the second PET detector are set to be in a counting mode, the KV ray source outputs beams in a pulse mode by utilizing a time gap of pulse treatment, KV ray photons and gamma photons generated by positron annihilation are distinguished through an energy threshold value of the optical counting detector, and CT imaging, PET imaging and treatment are carried out synchronously.
10. The CT imaging and image guided radiation therapy apparatus of claim 1 wherein the first PET detector and/or the second PET detector is comprised of a plurality of PET detection modules and/or detection units with uniform gaps between the PET detection modules and/or detection units.
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