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WO2013016759A1 - Ensemble de thérapie par rayonnement guidé par image - Google Patents

Ensemble de thérapie par rayonnement guidé par image Download PDF

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Publication number
WO2013016759A1
WO2013016759A1 PCT/AU2012/000862 AU2012000862W WO2013016759A1 WO 2013016759 A1 WO2013016759 A1 WO 2013016759A1 AU 2012000862 W AU2012000862 W AU 2012000862W WO 2013016759 A1 WO2013016759 A1 WO 2013016759A1
Authority
WO
WIPO (PCT)
Prior art keywords
assembly
axis
base
couch
movement
Prior art date
Application number
PCT/AU2012/000862
Other languages
English (en)
Inventor
Paul Keall
Original Assignee
Paul Keall
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
Priority claimed from AU2011903046A external-priority patent/AU2011903046A0/en
Application filed by Paul Keall filed Critical Paul Keall
Priority to AU2012289817A priority Critical patent/AU2012289817B2/en
Priority to CN201280034629.7A priority patent/CN103764039B/zh
Publication of WO2013016759A1 publication Critical patent/WO2013016759A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/1048—Monitoring, verifying, controlling systems and methods
    • A61N5/1064—Monitoring, verifying, controlling systems and methods for adjusting radiation treatment in response to monitoring
    • A61N5/1065—Beam adjustment
    • A61N5/1067—Beam adjustment in real time, i.e. during treatment
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/04—Positioning of patients; Tiltable beds or the like
    • A61B6/0407—Supports, e.g. tables or beds, for the body or parts of the body
    • A61B6/0421—Supports, e.g. tables or beds, for the body or parts of the body with immobilising means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G7/00—Beds specially adapted for nursing; Devices for lifting patients or disabled persons
    • A61G7/002—Beds specially adapted for nursing; Devices for lifting patients or disabled persons having adjustable mattress frame
    • A61G7/005—Beds specially adapted for nursing; Devices for lifting patients or disabled persons having adjustable mattress frame tiltable around transverse horizontal axis, e.g. for Trendelenburg position
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G7/00—Beds specially adapted for nursing; Devices for lifting patients or disabled persons
    • A61G7/002—Beds specially adapted for nursing; Devices for lifting patients or disabled persons having adjustable mattress frame
    • A61G7/008—Beds specially adapted for nursing; Devices for lifting patients or disabled persons having adjustable mattress frame tiltable around longitudinal axis, e.g. for rolling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G7/00—Beds specially adapted for nursing; Devices for lifting patients or disabled persons
    • A61G7/05—Parts, details or accessories of beds
    • A61G7/0507—Side-rails
    • 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
    • A61N2005/1061—Monitoring, verifying, controlling systems and methods for verifying the position of the patient with respect to the radiation beam using an x-ray imaging system having a separate imaging source
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N2005/1092—Details
    • A61N2005/1097—Means for immobilizing the patient
    • 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
    • A61N5/1042—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy with spatial modulation of the radiation beam within the treatment head
    • A61N5/1045—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy with spatial modulation of the radiation beam within the treatment head using a multi-leaf collimator, e.g. for intensity modulated radiation therapy or IMRT

Definitions

  • the present invention relates to radiation imaging and therapy apparatus and systems.
  • Radiation therapy is indicated for 53% of cancer patients. However, this number is typically lower in rural areas and developing countries, due in part to the significant cost of purchasing and maintaining radiation therapy equipment and the high construction cost of large bunkers need for the current treatment paradigm, in which the treatment unit rotates around the patient.
  • WO2009/076483 are patient support apparatus. These apparatus are designed to perform specific tasks and not adapted for radiation imaging and therapy apparatus.
  • an assembly to subject a patient to a radiation beam including:
  • a base to be supported on a floor surface
  • a radiation source to provide the beam, the source being mounted in the base so as to be fixed thereto and to project the beam along a path;
  • a patient couch assembly mounted on the base for movement relative thereto, the couch providing a longitudinally extending surface upon which the patient is to be supported and providing a longitudinal couch axis said surface being longitudinally elongated, the couch assembly being movable so that said surface intersects said path;
  • a motor and support assembly operatively associated with the couch assembly and base to cause said movement, the movement including movement longitudinally of said axis and angular movement about said axis.
  • said axis has a horizontal major direction of extension.
  • the surface is locatable in a generally horizontal orientation.
  • said angular movement includes 180° in either angular direction about said axis.
  • said angular movement is limited to 180° in either angular direction about said axis.
  • said path is generally vertically oriented.
  • said path is located in a plane within which said axis is located, and said axis is inclined to the vertical by an acute angle.
  • the assembly further includes an x-ray source and a detector, the x-ray source and detector being mounted in the base and on opposite sides of said couch so that a patient can be located between the x-ray source and detector.
  • an assembly to subject a patient to a radiation beam including:
  • a base to be supported on a floor surface
  • a radiation source to provide the beam, the source being mounted in the base so as to be fixed thereto and to project the beam along a path;
  • a patient couch assembly mounted on the base for movement relative thereto, the couch providing a longitudinally extending surface upon which the patient is to be supported and providing a longitudinal couch axis, the couch assembly being movable longitudinally relative to said axis and angularly relative to said axis so that said surface intersects said path; a motor and support assembly operatively associated with the couch assembly and base to cause said movement, the movement including movement longitudinally relative to said axis and angular movement relative to said axis; and wherein
  • the surface is locatable in a generally horizontal orientation, with the angular movement including 180° in either angular direction relative to said axis from said horizontal orientation.
  • said axis has a major direction of extension that is horizontal.
  • said path is generally perpendicular to said axis.
  • said path is inclined to said axis by an acute angle.
  • said radiation source includes a housing, with said housing being fixed to said base so as to be fixed stationary relative to said base.
  • Figure 1 is a schematic isometric view of an image-guided radio therapy assembly
  • Figure 2 is a schematic further isometric view of the assembly of Figure 1 ;
  • Figure 3 is a schematic parts sectioned isometric view of the assembly of Figures 1 and 2;
  • Figure 4 is a schematic isometric view of a modification of a couch assembly employed in the assembly of Figures 1 to 3;
  • Figure 5 is a further schematic isometric view of the couch assembly of Figure 4.
  • Figure 6 is a schematic side elevation of the couch assembly of Figures 4 and 5;
  • Figure 7 is a schematic top plan view of the couch assembly of Figures 4 and 5;
  • Figure 8 is a schematic end elevation of the couch assembly of Figures 4 and 5.
  • the assembly 10 includes a base 11 that includes a pedestal 12 and a tubular portion 13.
  • the tubular portion 13 is fixed to the pedestal 12 so as to be supported thereby in a stable manner.
  • Fixed to and extending upwardly of the tubular portion 13 is a housing 14 within which there is located a radiation source such as a linear accelerator 15.
  • the housing 14 is fixed in a stationary position in relation to the base 1 1.
  • the accelerator 15 provides a beam that extends longitudinally along a predetermined path providing the axis 16.
  • the axis 16 is generally upright, more preferably vertical.
  • the housing 14 may not be positioned so as to be vertically oriented.
  • the linear accelerator 15 may have its axis 16 inclined by an acute angle to the vertical.
  • the axis 16 is located in a plane containing the axis 16.
  • a cobalt source or particle beams such as proton and carbon therapy beams may be employed.
  • a multileaf collimator 17 is mounted within the housing 14 to shape the radiation beam and adapt this as needed to the changing beam-patient treatment angle and account for any detector tumour and/or normal tissue changes and motion by adaptation.
  • Other beam shaping devices may be used.
  • a kVx-ray detector 18 mounted in one longitudinally extending side of the tubular portion 13 is a kVx-ray detector 18, while in the opposite longitudinally extending side portion is a kVx-ray source 19.
  • an electronic portal imaging device 20 Located in a lower part of the tubular portion 13 or the pedestal 12 is an electronic portal imaging device 20. Other devices may be used.
  • the device 20 is located so as to intersect the axis 16 and preferably is generally planar and normal with respect to the axis 16.
  • the couch assembly 21 is adapted to support a patient 22.
  • the couch assembly 22 would include a couch base 25 that is longitudinally elongated and receives a full length vacuum moulded support 23 placed below the patient 22, with the patient 22 in a surpine position.
  • a retaining sheet 24 or possibly a further moulded member is provided and secured to the base 25 to aid in retaining the patient 22 firmly against the support 23.
  • the detector 18 and source 19 are located on opposite sides of the couch assembly 21 so that the patient is also locatable between the detector 18 and source 19.
  • the base 25 provides a longitudinal axis 26 that preferably extends generally centrally longitudinally through the patient 22.
  • the axis 26 has a major direction of extension that is horizontal.
  • the axis 26 is generally horizontal.
  • the couch assembly 21 is supported by the tubular portion 13 to provide for longitudinal movement of the couch base 25 longitudinal of the axis 26, as well as angular movement about the axis 26.
  • the couch base 25 is movable angularly about the axis 26 through 180° in either direction from the position at which the couch base 25 is generally horizontally oriented.
  • the couch base 25 may actually be rotatable through 360°.
  • the axis 26 intersects and is normal to the axis 16, therefore the axis 16 intersects the couch base 25 and the patient 22.
  • the couch assembly 21 and base 11 may be modified to provide for angular movement about a generally horizontal axis normal to the axis 26 and/or a generally vertical axis normal to the axis 26.
  • the linear accelerator 15 as mentioned above is vertically mounted, and is used to create the radiation treatment beam or an image beam.
  • the multileaf collimator 17 is used to shape the treatment beam, so that the beam shaping can occur in real-time to account for anatomic changes of the tumour and normal tissue due to physiological processes and/or couch rotation.
  • the method employed can adapt the treatment beam to optimally account for tumour and normal tissue translation, rotation and deformation.
  • image guidance and real-time monitoring systems are currently available that can be used to detect anatomic (and potentially physiologic) patient changes from day-to-day, during a treatment and during patient rotation.
  • image guidance systems include systems from Calypso, VisionRT, Navotek, MicroPos, RadPos, Accuray, BrainLab as well as those developed by single modality or combinations of kV, MV and optical methods with and without implanted markets.
  • the x-ray imager could include tomosythesis options, by various means as well as full cone beam capabilities. See also International Patent Application PCT/US2010/001944.
  • the electronic portal imaging device 20 is preferably employed to image the treatment beam and patient anatomy including any radio-opaque implanted markers that may be present.
  • the device 20 can be used to verify the spatial and dosimetric characteristics of the treatment delivery to the patient anatomy that may be changing during the treatment.
  • beam-targeting correction systems such as DMLC tracking, robotically mounted linear accelerators, programmable couches and gimballed linear accelerators.
  • the detector 18 and source 19 may be an image-guidance device that is a kilovoltage x-ray source and detectorV They can be used for pre-treatment planar and volumetric imaging as well as intra-treatment monitoring of anatomy, for 3D trajectory on the individual points on or inside the body, to construction of the entire patient anatomy in realtime.
  • the couch assembly 21 includes a support frame 30 that would be mounted internally of the tubular portion 13 so as to be stationary with respect thereto.
  • Mounted on the support frame 30 is a carriage 31.
  • the carriage 31 is supported by rollers or wheels 32 so as to provide for movement of the carriage longitudinally of the axis 26.
  • at least one of the wheels 32 is driven by a belt 33.
  • the belt 33 is in turn driven by an electric motor and gear box assembly 34.
  • the motor 34 is operated so that the carriage 32 can be moved in either direction 35, that is a direction longitudinally of the axis 26.
  • the carriage 31 includes a pair of upwardly extending end frames 36 that rotatably support a pair of shafts 37.
  • the shafts 37 are fixed to a couch base 38 upon which the patient 22 rests.
  • the shafts 37 are at each end of the base 38 to provide for angular movement of the base 38 about the axis 26.
  • Fixed to one of the shafts 37 is a pulley 39 engaged by a belt 40.
  • the belt 40 is in turn driven by an electric motor and gear box assembly 41. By operation of the motor and gear box assembly 41 , the base 38 can be moved angularly about the axis 26 as described above.
  • a plurality of retaining straps (bands) 42 that are movable between a position engaged with the base 38 and holding the patient 22 in position against the base 38, to a position at which they provide space for the patient 22 to be moved from or delivered to the base 38.
  • the above described preferred embodiment provides a number of advantages including reduced spaced as the patient is rotated, with the base 11 and beam source (linear accelerator) are stationary, that is with the beam source not movable or adjustable by movement relative to the base 1 1.
  • a further advantage is that less shielding is required. Only one primary shield is required, rather than the usual shielding needed for a conventional bunker where the beam source is moved angularly. This advantage can be enhanced if the floor is used for a primary shielding.
  • a still further advantage is cost of the assembly 10. Because the beam source is stationary, complex apparatus is not required to move the beam source.
  • a still further advantage is stability. Since the beam source is stationary, stability problems are substantially ameliorated. Again since the beam source is stationary, there are less moving parts thereby reducing maintenance of the assembly and prolonging the life of the assembly. r

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

L'invention porte sur un ensemble d'imagerie (10) comprenant une base (11) à laquelle est fixé un boitier (14) dans lequel est située une source de rayonnement telle qu'un accélérateur linéaire (15). La source de rayonnement produit un faisceau qui s'étend de façon longitudinale le long d'un trajet prédéterminé fourni par un axe (16). Un ensemble coussin (21) est supporté sur la base (11), lequel ensemble est mobile de façon longitudinale ainsi que de façon angulaire autour de l'axe longitudinal (26) de l'ensemble coussin (21).
PCT/AU2012/000862 2011-07-29 2012-07-18 Ensemble de thérapie par rayonnement guidé par image WO2013016759A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
AU2012289817A AU2012289817B2 (en) 2011-07-29 2012-07-18 An image-guided radiation therapy assembly
CN201280034629.7A CN103764039B (zh) 2011-07-29 2012-07-18 图像引导式放射治疗组件

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
AU2011903046 2011-07-29
AU2011903046A AU2011903046A0 (en) 2011-07-29 An image-guided radiation therapy assembly

Publications (1)

Publication Number Publication Date
WO2013016759A1 true WO2013016759A1 (fr) 2013-02-07

Family

ID=47628542

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/AU2012/000862 WO2013016759A1 (fr) 2011-07-29 2012-07-18 Ensemble de thérapie par rayonnement guidé par image

Country Status (3)

Country Link
CN (1) CN103764039B (fr)
AU (1) AU2012289817B2 (fr)
WO (1) WO2013016759A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2017091864A1 (fr) * 2015-12-03 2017-06-08 Nano-X Pty Ltd Visualisation d'images tridimensionnelles d'objets variables
US12194318B2 (en) 2019-12-24 2025-01-14 Neuboron Therapy System Ltd. Radiation irradiation system

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN114376816A (zh) * 2022-02-22 2022-04-22 陈琪 一种婴儿护理床

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3708662A (en) * 1969-09-11 1973-01-02 Toshio Kurokawa X-ray photographing apparatus
US3848132A (en) * 1972-12-20 1974-11-12 Picker Corp Patient rotator and method of conducting x-ray studies
FR2647332A1 (fr) * 1989-05-26 1990-11-30 Beal Joseph Appareil support orientable notamment pour le maintien d'un enfant en regard d'un ensemble de radiologie
US20030202631A1 (en) * 2002-04-30 2003-10-30 Konica Corporation Radiographic image forming apparatus and radiographic image forming method
US20050085710A1 (en) * 2003-10-17 2005-04-21 Eric Earnst Patient positioning assembly for therapeutic radiation system
US20050218341A1 (en) * 2004-04-06 2005-10-06 Michael Saracen Treatment target positioning system
US20050228255A1 (en) * 2004-04-06 2005-10-13 Michael Saracen Patient positioning assembly

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5963615A (en) * 1997-08-08 1999-10-05 Siemens Medical Systems, Inc. Rotational flatness improvement
GB0324676D0 (en) * 2003-10-23 2003-11-26 Elekta Ab Apparatus for treatment by ionising radiation
US9731148B2 (en) * 2005-07-23 2017-08-15 Tomotherapy Incorporated Radiation therapy imaging and delivery utilizing coordinated motion of gantry and couch
CN101991425A (zh) * 2009-08-26 2011-03-30 史继生 乳腺x线机

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3708662A (en) * 1969-09-11 1973-01-02 Toshio Kurokawa X-ray photographing apparatus
US3848132A (en) * 1972-12-20 1974-11-12 Picker Corp Patient rotator and method of conducting x-ray studies
FR2647332A1 (fr) * 1989-05-26 1990-11-30 Beal Joseph Appareil support orientable notamment pour le maintien d'un enfant en regard d'un ensemble de radiologie
US20030202631A1 (en) * 2002-04-30 2003-10-30 Konica Corporation Radiographic image forming apparatus and radiographic image forming method
US20050085710A1 (en) * 2003-10-17 2005-04-21 Eric Earnst Patient positioning assembly for therapeutic radiation system
US20050218341A1 (en) * 2004-04-06 2005-10-06 Michael Saracen Treatment target positioning system
US20050228255A1 (en) * 2004-04-06 2005-10-13 Michael Saracen Patient positioning assembly

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2017091864A1 (fr) * 2015-12-03 2017-06-08 Nano-X Pty Ltd Visualisation d'images tridimensionnelles d'objets variables
US12194318B2 (en) 2019-12-24 2025-01-14 Neuboron Therapy System Ltd. Radiation irradiation system

Also Published As

Publication number Publication date
CN103764039A (zh) 2014-04-30
AU2012289817A1 (en) 2014-01-23
CN103764039B (zh) 2017-08-29
AU2012289817B2 (en) 2016-07-28

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