JP6380237B2 - Radioscopy equipment - Google Patents

Description

  The present invention acquires an image including a marker placed in the body of a subject or an image including a specific portion of the subject from two different directions, thereby moving along with the body movement of the subject. The present invention relates to a radioscopic apparatus such as an X-ray fluoroscopic apparatus that detects the position of a marker or a specific part.

  A head for irradiating a treatment beam and a gantry for rotating the head about the subject are provided, and radiation treatment is performed by irradiating a treatment beam such as an X-ray or an electron beam to an affected part such as a tumor In a radiotherapy apparatus, it is necessary to accurately irradiate the affected area with radiation. However, not only the subject may move the body, but the affected part itself may move. For example, a tumor near the lung moves greatly based on respiration. For this reason, in Patent Document 1, a radiotherapy apparatus having a configuration in which a gold marker is arranged near a tumor, the position of the marker is detected by an X-ray fluoroscope, and irradiation of therapeutic radiation is controlled is proposed. Has been.

  As such a radiotherapy apparatus, Patent Document 2 discloses an X-ray fluoroscopic apparatus for identifying the position of a marker by fluoroscopically viewing an image including the marker placed in the body of a subject. . The X-ray fluoroscopic apparatus described in Patent Document 2 includes a first X-ray tube that irradiates X-rays from the floor side and a first X-ray detector that detects X-rays passing through the subject from the ceiling side. 1 imaging system and a second X-ray system that includes a second X-ray tube that irradiates X-rays from the floor side and a second X-ray detector that detects X-rays passing through the subject from the ceiling side, A marker embedded in the body is detected by template matching or the like. Then, three-dimensional position information is obtained using the two-dimensional perspective image photographed by the first photographing system and the two-dimensional perspective image photographed by the second photographing system. By continuously executing such an operation and calculating the three-dimensional position information of the marker in real time, the marker of the part accompanying movement is detected with high accuracy. Then, by controlling the irradiation of the therapeutic radiation based on the position information of the marker, it becomes possible to execute the radiation irradiation with high accuracy according to the movement of the tumor.

  At this time, since it is necessary to irradiate the treatment beam from various directions toward the affected area depending on the position of the affected area of the subject, as described above, the head that irradiates the treatment beam is the subject. It can be rotated around the center. For this reason, in the X-ray fluoroscopic apparatus described in Patent Document 2, it is necessary for the first imaging system and the second imaging system to perform fluoroscopy from a position where the X-ray is not blocked by the head. In order to make this possible, in the X-ray fluoroscopic apparatus described in Patent Document 2, the first X-ray tube and the first X-ray detector, and the second X-ray tube and the second X-ray detector can be moved along the rail. With this configuration, it is possible to perform X-ray fluoroscopy from three preset positions.

Japanese Unexamined Patent Publication No. 2000-167072 Japanese Patent Application Laid-Open No. 2014-128412

  Such an X-ray fluoroscopic apparatus employs a configuration in which the movement range of the marker or the specific part is specified by referring to the movement locus of the marker or the specific part accompanying the body movement of the subject. In this case, the movement trajectory of the marker or specific part is read and the stored three-dimensional coordinates are extracted, so that the movement trajectory of the marker or specific part is graphically displayed as a pseudo three-dimensional (3D) image. Configuration is adopted.

  FIG. 6 is a schematic diagram showing a pseudo three-dimensional image showing the movement locus of such a marker.

  This pseudo three-dimensional image is displayed on the display unit 25 in the X-ray fluoroscopic apparatus. In this pseudo three-dimensional image, a trajectory display T including the trajectories T1, T2, and T3 of three markers is displayed together with the X axis, the Y axis, and the Z axis. The black circles on the X axis, Y axis, and Z axis represent distances (intervals). The operator refers to the marker movement trajectory from various viewpoints and angles by rotating, enlarging, reducing, and translating this pseudo three-dimensional image using a mouse attached to the fluoroscope. It becomes possible to do.

  However, when such a pseudo three-dimensional image is rotated and translated, the operator can determine the actual direction of the subject and the X, Y, and Z axes in the pseudo three-dimensional image. The problem arises that it is difficult to easily understand the relationship.

  The present invention has been made in order to solve the above-described problems, and is a radiological fluoroscopy that can easily understand the relationship between the direction of a three-dimensional image showing the movement locus of a marker or a specific part and the direction of a subject. An object is to provide an apparatus.

  According to a first aspect of the present invention, an image including a marker placed in a body of a subject or an image including a specific part of the subject is acquired from two different directions, thereby accompanying the body movement of the subject. A radiological fluoroscopy device that detects the position of the marker or the specific part of the subject to be moved, and a movement trajectory display unit that displays a movement trajectory of the marker or the specific part of the subject on a display device; And a subject image display unit that displays an image representing the direction of the subject on the display device in association with the movement locus and the direction.

  The second invention further includes an image rotation unit that rotates the movement trajectory displayed on the display device and an image representing the direction of the subject while maintaining the association of the directions.

  According to a third aspect of the present invention, the subject image display unit displays a human body model image representing the direction of the subject together with a three-dimensional image of the movement locus on the display device based on a treatment plan acquired from the treatment planning device. To display.

  According to a fourth aspect of the present invention, the subject image display unit displays a three-dimensional CT image of the subject based on the anatomical structure of the subject acquired from a CT imaging device. The image is displayed on the display device together with the image.

  According to the first to fourth inventions, the movement trajectory of the marker or the specific part and the image representing the direction of the subject are displayed at the same time. It becomes possible to easily understand the relationship between the direction of the three-dimensional image showing the movement locus and the direction of the subject.

1 is a schematic diagram of an X-ray fluoroscopy device as a radioscopy device according to the present invention. It is a block diagram which shows the control system of the X-ray fluoroscope which concerns on this invention. It is a schematic diagram which shows the pseudo three-dimensional image which shows the movement locus | trajectory of the marker which concerns on 1st Embodiment. It is a schematic diagram which shows the pseudo three-dimensional image which shows the movement locus | trajectory of the marker which concerns on 1st Embodiment. It is a schematic diagram which shows the pseudo three-dimensional image which shows the movement locus | trajectory of the marker which concerns on 2nd Embodiment. It is a schematic diagram which shows the pseudo | simulated three-dimensional image which shows the movement locus | trajectory of a marker.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings. FIG. 1 is a schematic diagram of an X-ray fluoroscopy device as a radioscopy device according to the present invention. FIG. 2 is a block diagram showing a control system of the X-ray fluoroscopic apparatus according to the present invention.

  This X-ray fluoroscopic apparatus as a radioscopic fluoroscopic apparatus is used together with a radiotherapy apparatus for performing radiotherapy by irradiating the affected part of the subject 10 on the table 19 with radiation such as X-rays or electron beams. Is. During such radiotherapy, it is necessary to accurately irradiate the affected area that moves with the body movement of the subject 10. For this reason, a marker is installed in the vicinity of the affected part of the subject 10. Then, the marker embedded in the body of the subject 10 is continuously seen by X-ray fluoroscopy, and the marker is detected with high accuracy by calculating the three-dimensional position information of the marker. It is the composition which performs. In addition, marker-less tracking that uses an image of a specific part such as a tumor in the subject 10 instead of the marker may be employed instead of placing a marker near the affected part in the subject 10.

  The X-ray fluoroscopic apparatus includes a first X-ray tube 11, a second X-ray tube 12, a third X-ray tube 13, a fourth X-ray tube 14, a first flat panel detector 21, a second flat panel detector 22, and a third flat panel. A detector 23 and a fourth flat panel detector 24 are provided. X-rays as radiation emitted from the first X-ray tube 11 are detected by the first flat panel detector 21 after passing through the subject 10 on the table 19. The first X-ray tube 11 and the first flat panel detector 21 constitute a first imaging system. X-rays irradiated from the second X-ray tube 12 pass through the subject 10 on the table 19 and are then detected by the second flat panel detector 22. The second X-ray tube 12 and the second flat panel detector 22 constitute a second imaging system. X-rays irradiated from the third X-ray tube 13 pass through the subject 10 on the table 19 and are then detected by the third flat panel detector 23. The third X-ray tube 13 and the third flat panel detector 23 constitute a third imaging system. X-rays irradiated from the fourth X-ray tube 14 pass through the subject 10 on the table 19 and are then detected by the fourth flat panel detector 24. The fourth X-ray tube 14 and the fourth flat panel detector 24 constitute a fourth imaging system.

  The X-ray fluoroscopic apparatus includes a first power supply unit 28 and a second power supply unit 29. The first power supply unit 28 and the second power supply unit 29 are also called high-voltage devices. The first power supply unit 28 selectively supplies a tube voltage and a tube current necessary for irradiating X-rays to the first X-ray tube 11 or the second X-ray tube 12. The second power supply unit 29 selectively supplies a tube voltage and a tube current necessary for irradiating X-rays to the third X-ray tube 13 or the fourth X-ray tube 14.

  For this reason, the first X-ray tube 11 and the second X-ray tube 12 cannot simultaneously irradiate X-rays, and the third X-ray tube 13 and the fourth X-ray tube 14 simultaneously irradiate X-rays. It is not possible. Therefore, the first imaging system and the second imaging system described above cannot be used at the same time, and the third imaging system and the fourth imaging system cannot be used at the same time. On the other hand, at the time of tracking the moving object described above, in order to calculate the three-dimensional position information of a marker or a specific part (hereinafter collectively referred to as “marker”), the marker needs to be seen through from two directions. Therefore, in this X-ray fluoroscopic apparatus, X-ray fluoroscopy at the first position using the first imaging system and the third imaging system, and the second position using the first imaging system and the fourth imaging system. X-ray in the third position using the second imaging system and the third imaging system, and X-ray in the fourth position using the second imaging system and the fourth imaging system It is possible to perform X-ray fluoroscopy in four patterns, including fluoroscopy.

  Furthermore, this X-ray fluoroscopic apparatus is equipped with a CPU that executes logical operations, a ROM that stores an operation program necessary for controlling the apparatus, a RAM that temporarily stores data during control, and the like, and controls the entire apparatus. The control unit 30 is provided. The control unit 30 is connected to the first flat panel detector 21, the second flat panel detector 22, the third flat panel detector 23, and the fourth flat panel detector 24 described above. The control unit 30 is connected to the first power supply unit 28 and the second power supply unit 29 described above.

  The control unit 30 includes an image processing unit 31 that executes image processing, and a storage unit 36 that stores a movement path of a marker, which will be described later.

  The image processing unit 31 includes a marker detection unit 32 for detecting a marker using two imaging systems of the first imaging system, the second imaging system, the third imaging system, and the fourth imaging system. For example, the marker detection unit 32 is set in advance with an image including a marker placed in the body of the subject 10 photographed by the first photographing system, the second photographing system, the third photographing system, and the fourth photographing system. The three-dimensional position information of the marker is calculated by template matching for comparing with the template image.

  In addition, as will be described later, the image processing unit 31 displays a movement locus display unit 33 that displays the movement locus of the marker as a three-dimensional image, and displays an image representing the direction of the subject 10 together with the three-dimensional image of the movement locus. A subject image display unit that performs the rotation, and an image rotation unit that rotates the three-dimensional image of the movement trajectory and the image representing the direction of the subject to be synchronized with each other.

  The control unit 30 includes a display unit 25 including a liquid crystal display panel for displaying an X-ray fluoroscopic image, an image such as a marker movement locus, and the like, and a keyboard and a mouse, and an operation unit 26 for executing various inputs. And connected to. The control unit 30 also creates a CT imaging device 37 for CT imaging of the subject 10 and a treatment plan for the subject 10 via the in-hospital network 100 which is in-hospital communication of the in-hospital patient management system. And a patient data storage unit 39 for storing various data about the subject 10. Here, based on the CT image of the subject 10 imaged by the CT imaging device 37, the treatment planning device 38 determines how much energy from which direction and how many times the tumor is irradiated with radiation. A treatment plan for the subject 10 is created by scheduling.

  When the moving body tracking for detecting the position of the marker by X-ray fluoroscopy is executed by this X-ray fluoroscopy device, X-ray fluoroscopy is selected from the first imaging system, the second imaging system, the third imaging system, and the fourth imaging system. Two imaging systems to be used are selected, and moving body tracking by X-ray fluoroscopy is performed using these imaging systems. At this time, the marker is detected by the marker detection unit 32 in the image processing unit 31. The movement trajectory of the marker obtained in this way is stored in the storage unit 36 in the control unit 30.

  FIG. 3 is a schematic diagram showing a pseudo three-dimensional image showing the movement trajectory of the marker according to the first embodiment.

  The marker movement locus detected by the marker detection unit 32 in the image processing unit 31 and stored in the storage unit 36 is displayed on the display unit 25 by the action of the movement locus display unit 33 in the image processing unit 31. In FIG. 3, a trajectory display T composed of trajectories T1, T2, and T3 of three markers is displayed as a pseudo three-dimensional image together with the X axis, the Y axis, and the Z axis. The black circles on the X axis, Y axis, and Z axis represent distances (intervals).

  Further, at this time, the action of the subject image display unit 34 in the image processing unit 31 causes the human body model image M representing the direction of the subject 10 to be moved together with the three-dimensional image of the movement locus and the three-dimensional image of the movement locus. Display in association with each other so that their directions match. At this time, the subject image display unit 34 obtains the treatment plan created by the treatment plan device 38 via the in-hospital network 100. Then, the subject image display unit 34 obtains information on the body axis direction of the subject 10 based on the treatment plan, and based on this information, the human body model image M and the body axis of the subject 10 are obtained. Display in the direction that matches. This human body model image M makes it possible to easily understand the relationship between the direction of the trajectory display T composed of the trajectories T1, T2, and T3 of the three markers and the direction of the subject 10.

  In order to confirm the marker locus in more detail, the operator uses the mouse in the operation unit 26 to rotate, enlarge, reduce, or translate the pseudo three-dimensional image. This makes it possible to refer to the marker movement trajectory from various viewpoints and angles. At this time, the image rotation unit 35 in the image processing unit 31 synchronizes the three-dimensional image of the trajectory display T including the trajectories T1, T2, and T3 of the three markers with the human body model image M representing the direction of the subject 10. (That is, in a state in which the association between the direction of the human body model image M and the three-dimensional image of the movement trajectory is maintained).

  FIG. 4 is a schematic diagram showing a pseudo three-dimensional image showing the movement locus of the marker in such a state.

  For example, when an operator drags a part of the image displayed on the display unit 25 using the mouse in the operation unit 26, the three-dimensional trajectory display T including the trajectories T1, T2, and T3 of the three markers. When the image is rotated, the human body model image M indicating the direction of the subject 10 is also rotated by the action of the image rotation unit 35 in the image processing unit 31. Therefore, even when the three-dimensional image of the trajectory display T composed of the three marker trajectories T1, T2, and T3 is rotated, the direction of the trajectory display T composed of the three marker trajectories T1, T2, and T3 The relationship with the direction of the subject 10 can be easily understood.

  FIG. 5 is a schematic diagram showing a pseudo three-dimensional image showing the movement trajectory of the marker according to the second embodiment.

  In the embodiment shown in FIGS. 3 and 4, the human body model image M is used as the image showing the direction of the subject 10, whereas in the embodiment shown in FIG. 5, the subject 10 A three-dimensional CT image B of the subject 10 is used as an image representing the direction of the subject.

  As the three-dimensional CT image B of the subject 10, the CT image of the subject 10 captured by the CT imaging device 37 when the treatment plan is created is used. Then, based on the anatomical structure of the subject 10 based on the CT image acquired from the CT imaging device 37 via the in-hospital network 100, the three-dimensional CT image B of the subject 10 has three marker trajectories. It is displayed on the display unit 25 together with the three-dimensional image of the trajectory display T composed of T1, T2, and T3.

  Also in this embodiment, the operator can drag the image displayed on the display unit 25 using the mouse in the operation unit 26 to display the trajectory display T including the trajectories T1, T2, and T3 of the three markers. When the three-dimensional image is rotated, the three-dimensional CT image B representing the direction of the subject 10 is also rotated accordingly. Therefore, even when the three-dimensional image of the trajectory display T composed of the three marker trajectories T1, T2, and T3 is rotated, the direction of the trajectory display T composed of the three marker trajectories T1, T2, and T3 The relationship with the direction of the subject 10 can be easily understood.

  In the above-described embodiment, the human body model image M representing the subject 10 or the three-dimensional CT image B of the subject 10 is used as the image representing the direction of the subject 10. An image other than these may be used as the image representing the direction of the person 10. For example, an arrow representing the body axis direction of the subject 10 and the direction of the head may be used as an image representing the direction of the subject 10.

  In the above-described embodiment, the three-dimensional image of the trajectory display T including the trajectories T1, T2, and T3 of the three markers is displayed on the display unit 25. However, the number of marker trajectories is limited to this. It is not something. Alternatively, a single marker trajectory may be displayed on the display unit 25.

  At this time, instead of placing a marker in the vicinity of the affected part in the subject 10, when markerless tracking is used in which an image of a specific part such as a tumor in the subject 10 is used instead of the marker, Instead of the locus, the locus of a single or a plurality of specific parts is displayed on the display unit 25.

  In the above-described embodiment, the first imaging system including the first X-ray tube 11 and the first flat panel detector 21, the second imaging system including the second X-ray tube 12 and the second flat panel detector 22, and the third X-ray. There are four imaging systems, a third imaging system comprising a tube 13 and a third flat panel detector 23 and a fourth imaging system comprising a fourth X-ray tube 14 and a fourth flat panel detector 24. There should be at least three systems. That is, a configuration in which three or more imaging systems having an X-ray tube and a flat panel detector are provided and two imaging systems used for X-ray fluoroscopy can be selected from these three or more imaging systems. If it is.

  Further, in the above-described embodiment, a flat panel detector is used as the X-ray detector functioning as the radiation detector according to the present invention, but X-ray detection such as an image intensifier (II) is used. Or other radiation detectors may be used.

DESCRIPTION OF SYMBOLS 10 Subject 11 1st X-ray tube 12 2nd X-ray tube 13 3rd X-ray tube 14 4th X-ray tube 19 Table 21 1st flat panel detector 22 2nd flat panel detector 23 3rd flat panel detector 24 4th flat panel detector 25 Display Unit 26 Operation Unit 28 First Power Supply Unit 29 Second Power Supply Unit 30 Control Unit 31 Marker Detection Unit 32 Image Processing Unit 33 Movement Trajectory Display Unit 34 Subject Image Display Unit 35 Image Rotation Unit 37 CT Imaging Device 38 Treatment planning device 39 Patient data storage unit B 3D CT image M Human model image T Trajectory display T1 Trajectory T2 Trajectory T3 Trajectory

Claims (4)

The marker that moves with the body movement of the subject by acquiring an image including a marker placed in the body of the subject or an image including a specific part of the subject from two different directions, or A radioscopy apparatus that detects a position of a specific part of the subject,
A movement trajectory display unit for displaying a movement trajectory of the specific part of the marker or the subject on a display device;
A subject image display unit that displays an image representing the direction of the subject on the display device in association with the movement locus and the direction;
A radioscopic apparatus comprising: The radiographic apparatus according to claim 1,
A radiological fluoroscopy device further comprising an image rotation unit that rotates the movement locus displayed on the display device and an image representing the direction of the subject while maintaining the association of directions. The radioscopy apparatus according to claim 1 or 2,
The subject image display unit displays a human body model image representing the direction of the subject on the display device together with a three-dimensional image of the movement locus on the display device based on the treatment plan acquired from the treatment plan device. . The radioscopy apparatus according to claim 1 or 2,
The subject image display unit displays a three-dimensional CT image of the subject on the display device together with a three-dimensional image of the movement locus based on the anatomical structure of the subject acquired from a CT imaging device. Radioscopy device to be displayed.

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